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Emergency Care Practitioner—SA

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315 papers 100 to 500 followers
By Struan Reid Emergency Care Practitioner in South Africa with a passion for advanced airway management.
https://www.readbyqxmd.com/read/28904070/antiarrhythmic-drugs-for-non-shockable-turned-shockable-out-of-hospital-cardiac-arrest-the-amiodarone-lidocaine-or-placebo-study-alps
#1
Peter J Kudenchuk, Brian G Leroux, Mohamud Daya, Thomas Rea, Christian Vaillancourt, Laurie J Morrison, Clifton W Callaway, James Christenson, Joseph P Ornato, James V Dunford, Lynn Wittwer, Myron L Weisfeldt, Tom P Aufderheide, Gary M Vilke, Ahamed H Idris, Ian G Stiell, M Riccardo Colella, Tami Kayea, Debra A Egan, Patrice Desvigne-Nickens, Pamela Gray, Randal Gray, Ron Straight, Paul Dorian
Background -Out-of-hospital cardiac arrest (OHCA) commonly presents with non-shockable rhythms (asystole and pulseless electrical activity (PEA)). Whether antiarrhythmic drugs are safe and effective when these evolve to shockable rhythms (ventricular fibrillation/pulseless ventricular tachycardia (VF/VT)) during resuscitation is not known. Methods -Adults with non-traumatic OHCA, vascular access and VF/VT anytime after ≥1 shock(s) were prospectively randomized, double-blind, to receive amiodarone, lidocaine or placebo by paramedics...
September 13, 2017: Circulation
https://www.readbyqxmd.com/read/28701178/the-future-of-mechanical-ventilation-lessons-from-the-present-and-the-past
#2
REVIEW
Luciano Gattinoni, John J Marini, Francesca Collino, Giorgia Maiolo, Francesca Rapetti, Tommaso Tonetti, Francesco Vasques, Michael Quintel
The adverse effects of mechanical ventilation in acute respiratory distress syndrome (ARDS) arise from two main causes: unphysiological increases of transpulmonary pressure and unphysiological increases/decreases of pleural pressure during positive or negative pressure ventilation. The transpulmonary pressure-related side effects primarily account for ventilator-induced lung injury (VILI) while the pleural pressure-related side effects primarily account for hemodynamic alterations. The changes of transpulmonary pressure and pleural pressure resulting from a given applied driving pressure depend on the relative elastances of the lung and chest wall...
July 12, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28860875/extraglottic-airway-devices-technology-update
#3
REVIEW
Bimla Sharma, Chand Sahai, Jayashree Sood
Extraglottic airway devices (EADs) have revolutionized the field of airway management. The invention of the laryngeal mask airway was a game changer, and since then, there have been several innovations to improve the EADs in design, functionality, safety and construction material. These have ranged from changes in the shape of the mask, number of cuffs and material used, like rubber, polyvinylchloride and latex. Phthalates, which were added to the construction material in order to increase device flexibility, were later omitted when this chemical was found to have serious adverse reproductive outcomes...
2017: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/24089000/freeze-dried-plasma-at-the-point-of-injury-from-concept-to-doctrine
#4
REVIEW
Elon Glassberg, Roy Nadler, Sami Gendler, Amir Abramovich, Philip C Spinella, Robert T Gerhardt, John B Holcomb, Yitshak Kreiss
While early plasma transfusion for the treatment of patients with ongoing major hemorrhage is widely accepted as part of the standard of care in the hospital setting, logistic constraints have limited its use in the out-of-hospital setting. Freeze-dried plasma (FDP), which can be stored at ambient temperatures, enables early treatment in the out-of-hospital setting. Point-of-injury plasma transfusion entails several significant advantages over currently used resuscitation fluids, including the avoidance of dilutional coagulopathy, by minimizing the need for crystalloid infusion, beneficial effects on endothelial function, physiological pH level, and better maintenance of intravascular volume compared with crystalloid-based solutions...
December 2013: Shock
https://www.readbyqxmd.com/read/28887934/transport-while-on-extracorporeal-membrane-oxygenation-support
#5
REVIEW
Kyle C Niziolek, Thomas J Preston, Erik C Osborn
Extracorporeal membrane oxygenation (ECMO) support for severe acute respiratory failure has been increasing. Evidence suggests that higher volume centers have better outcomes, leading to a need for specialized ECMO transport teams. The inherent nature of the prehospital environment adds an additional layer of complexity; however, the experience of multiple centers has demonstrated that cannulating and transporting a patient on ECMO can be performed safely. The purpose of this review article is to discuss the state of knowledge with respect to ECMO transport with special emphasis given to how to actually undertake such complex transports...
October 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28814478/effect-of-patient-weight-on-first-pass-success-and-neuromuscular-blocking-agent-dosing-for-rapid-sequence-intubation-in-the-emergency-department
#6
Asad E Patanwala, John C Sakles
OBJECTIVES: The primary objective of this study was to determine the association between patient weight and first pass success (FPS) during rapid sequence intubation (RSI) in the ED. The secondary objective was to evaluate the association between patient weight and neuromuscular blocking agent (NMBA) dosing. METHODS: This was a retrospective cohort study conducted in a tertiary care academic ED. Consecutive adult patients who underwent RSI in the ED between January 2014 and June 2016 were included...
August 16, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28627014/review-article-paediatric-status-epilepticus-in-the-pre-hospital-setting-an-update
#7
REVIEW
Jeremy Furyk, Kerriane Watt, Theophilus I Emeto, Stuart Dalziel, Daniel Bodnar, Kate Riney, Franz E Babl
Paediatric status epilepticus (SE) is a medical emergency and a common critical condition confronting pre-hospital providers. Management in the pre-hospital environment is challenging but considered extremely important as a potentially modifiable factor on outcome. Recent data from multicentre clinical trials, quality observational studies and consensus documents have influenced management in this area, and is important to both pre-hospital providers and emergency physicians. The objective of this review was to: (i) present an overview of the available evidence relevant to pre-hospital care of paediatric SE; and (ii) assess the current pre-hospital practice guidelines in Australia and New Zealand...
June 18, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28784609/understanding-cardiac-troponin-part-1-avoiding-troponinitis
#8
REVIEW
Richard Body, Edward Carlton
Cardiac troponin (cTn) is a highly specific biomarker of myocardial injury and is central to the diagnosis of acute myocardial infarction (AMI). By itself, however, cTn cannot identify the cause of myocardial injury. 'Troponinitis' is the condition that leads clinicians to falsely assign a diagnosis of AMI based only on the fact that a patient has an elevated cTn concentration. There are many causes of myocardial injury other than AMI. Clinicians are required to differentiate myocardial injury caused by AMI from other causes...
August 7, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28707967/mechanical-ventilation
#9
(no author information available yet)
No abstract text is available yet for this article.
July 15, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27566791/systematic-review-of-the-anaesthetic-management-of-non-iatrogenic-acute-adult-airway-trauma
#10
S J Mercer, C P Jones, M Bridge, E Clitheroe, B Morton, P Groom
INTRODUCTION: Non-iatrogenic trauma to the airway is rare and presents a significant challenge to the anaesthetist. Although guidelines for the management of the unanticipated difficult airway have been published, these do not make provision for the 'anticipated' difficult airway. This systematic review aims to inform best practice and suggest management options for different injury patterns. METHODS: A literature search was conducted using Embase, Medline, and Google Scholar for papers after the year 2000 reporting on the acute airway management of adult patients who suffered airway trauma...
September 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27563928/adult-status-epilepticus-a-review-of-the-prehospital-and-emergency-department-management
#11
REVIEW
Michael Billington, Osama R Kandalaft, Imoigele P Aisiku
Seizures are a common presentation in the prehospital and emergency department setting and status epilepticus represents an emergency neurologic condition. The classification and various types of seizures are numerous. The objectives of this narrative literature review focuses on adult patients with a presentation of status epilepticus in the prehospital and emergency department setting. In summary, benzodiazepines remain the primary first line therapeutic agent in the management of status epilepticus, however, there are new agents that may be appropriate for the management of status epilepticus as second- and third-line pharmacological agents...
August 23, 2016: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/27448995/mechanical-ventilation-strategies-for-intensive-care-unit-patients-without-acute-lung-injury-or-acute-respiratory-distress-syndrome-a-systematic-review-and-network-meta-analysis
#12
Lei Guo, Weiwei Wang, Nana Zhao, Libo Guo, Chunjie Chi, Wei Hou, Anqi Wu, Hongshuang Tong, Yue Wang, Changsong Wang, Enyou Li
BACKGROUND: It has been shown that the application of a lung-protective mechanical ventilation strategy can improve the prognosis of patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). However, the optimal mechanical ventilation strategy for intensive care unit (ICU) patients without ALI or ARDS is uncertain. Therefore, we performed a network meta-analysis to identify the optimal mechanical ventilation strategy for these patients. METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, EMBASE, MEDLINE, CINAHL, and Web of Science for studies published up to July 2015 in which pulmonary compliance or the partial pressure of arterial oxygen/fraction of inspired oxygen (PaO2/FIO2) ratio was assessed in ICU patients without ALI or ARDS, who received mechanical ventilation via different strategies...
July 22, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27417010/management-of-patients-with-nste-acs-a-comparison-of-the-recent-aha-acc-and-esc-guidelines
#13
REVIEW
Fatima Rodriguez, Kenneth W Mahaffey
Non-ST-segment elevation acute coronary syndromes (NSTE-ACS) are the leading cause of morbidity and mortality from cardiovascular disease worldwide. The American Heart Association/American College of Cardiology and the European Society of Cardiology periodically release practice guidelines to guide clinicians in the management of NSTE-ACS, most recently in in 2014 and 2015, respectively. The present review compares and contrasts the 2 guidelines, with a focus on the strength of recommendation and level of evidence in the approach to initial presentation and diagnosis of NSTE-ACS, risk assessment, treatments, and systems of care...
July 19, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27411704/the-neurological-and-cognitive-consequences-of-hyperthermia
#14
REVIEW
Edward James Walter, Mike Carraretto
An elevated temperature has many aetiologies, both infective and non-infective, and while the fever of sepsis probably confers benefit, there is increasing evidence that the central nervous system is particularly vulnerable to damage from hyperthermia. A single episode of hyperthermia may cause short-term neurological and cognitive dysfunction, which may be prolonged or become permanent. The cerebellum is particularly intolerant to the effects of heat. Hyperthermia in the presence of acute brain injury worsens outcome...
July 14, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27371641/management-of-critical-illness-with-non-invasive-ventilation-by-an-australian-hems
#15
Andrew R Coggins, Erin N Cummins, Brian Burns
BACKGROUND: Non-invasive ventilation (NIV) therapy is widely used for the management of acute respiratory failure. The objective of this study was to investigate the current use of NIV during interhospital retrievals in an Australian physician-led aeromedical service. METHODS: We reviewed patients receiving NIV during interhospital retrieval at the Greater Sydney Area Helicopter Medical Services (GSA-HEMS) over a 14-month period. The main objectives were to describe the number of retrievals using NIV, the need for intubation in NIV patients and the effect of the therapy on mission duration...
November 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/26409258/2015-acc-aha-hrs-guideline-for-the-management-of-adult-patients-with-supraventricular-tachycardia-executive-summary-a-report-of-the-american-college-of-cardiology-american-heart-association-task-force-on-clinical-practice-guidelines-and-the-heart-rhythm-society
#16
Richard L Page, José A Joglar, Mary A Caldwell, Hugh Calkins, Jamie B Conti, Barbara J Deal, N A Mark Estes, Michael E Field, Zachary D Goldberger, Stephen C Hammill, Julia H Indik, Bruce D Lindsay, Brian Olshansky, Andrea M Russo, Win-Kuang Shen, Cynthia M Tracy, Sana M Al-Khatib
No abstract text is available yet for this article.
April 5, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27374939/fluid-bolus-therapy-in-emergency-department-patients-indications-and-physiological-changes
#17
Shailesh Bihari, David J Teubner, Shivesh Prakash, Thomas Beatty, Mark Morphett, Rinaldo Bellomo, Andrew Bersten
OBJECTIVE: The aim of the present paper is to study the indications for fluid bolus therapy (FBT) and its associated physiological changes in ED patients. METHODS: Prospective observational study of FBT in a tertiary ED, we recorded indications, number, types and volumes, resuscitation goals and perceived success rates of FBT. Moreover, we studied key physiological variables before, 10 min, 1 h and 2 h after FBT. RESULTS: We studied 500 FBT episodes (750 [500-1250] mL)...
October 2016: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/27377669/resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-in-the-pre-hospital-setting-an-additional-resuscitation-option-for-uncontrolled-catastrophic-haemorrhage
#18
Samy Sadek, David J Lockey, Robbie A Lendrum, Zane Perkins, Jonathan Price, Gareth Edward Davies
This report describes the first use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in the pre-hospital setting to control catastrophic haemorrhage. The patient, who had fallen 15 meters, suffered catastrophic internal haemorrhage associated with a pelvic fracture. He was treated by London's Air Ambulance's Physician-Paramedic team. This included insertion of a REBOA balloon catheter at the scene to control likely fatal exsanguination. The patient survived transfer to hospital, emergency angio-embolization and subsequent surgery...
October 2016: Resuscitation
https://www.readbyqxmd.com/read/27342820/understanding-preoxygenation-and-apneic-oxygenation-during-intubation-in-the-critically-ill
#19
Jarrod M Mosier, Cameron D Hypes, John C Sakles
No abstract text is available yet for this article.
February 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/27339225/the-utility-of-noninvasive-nasal-positive-pressure-ventilators-for-optimizing-oxygenation-during-rapid-sequence-intubation
#20
Tae Hoon Kim, Sung Oh Hwang, Yong Sung Cha, Oh Hyun Kim, Kang Hyun Lee, Hyun Kim, Kyoung-Chul Cha
OBJECTIVES: The objective of the study is to investigate the feasibility of noninvasive nasal positive pressure ventilation (NINPPV) for optimizing oxygenation during the rapid sequence intubation in critically ill patients. METHODS: A prospective, observational study was performed in an emergency department. Noninvasive nasal positive pressure ventilation was applied in the preoxygenation step and maintained until successful intubation. A pulse oximetry (Spo2) was continuously monitored throughout the procedure and recorded 5 times...
August 2016: American Journal of Emergency Medicine
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