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73 papers 25 to 100 followers
P E Marik
No abstract text is available yet for this article.
September 2015: British Journal of Anaesthesia
M J Edwards, R T Fothergill, J Williams, P Gompertz
Accurate identification of stroke patients is essential to ensure appropriate and timely treatment. Stroke mimics-patients initially suspected to have suffered a stroke who are subsequently diagnosed with a condition other than stroke-are estimated to account for 5-33% of suspected stroke patients conveyed by paramedics to a hospital stroke unit. The prevalence of stroke mimics in London has not been investigated although pan-London hospital data suggests that one quarter of all patients admitted to hyper-acute stroke units (HASUs) are stroke mimics...
May 2015: Emergency Medicine Journal: EMJ
Dean J Kereiakes, Robert W Yeh, Joseph M Massaro, Priscilla Driscoll-Shempp, Donald E Cutlip, P Gabriel Steg, Anthony H Gershlick, Harald Darius, Ian T Meredith, John Ormiston, Jean Francois Tanguay, Stephan Windecker, Kirk N Garratt, David E Kandzari, David P Lee, Daniel I Simon, Adrian Corneliu Iancu, Jaroslaw Trebacz, Laura Mauri
IMPORTANCE: Despite antirestenotic efficacy of coronary drug-eluting stents (DES) compared with bare metal stents (BMS), the relative risk of stent thrombosis and adverse cardiovascular events is unclear. Although dual antiplatelet therapy (DAPT) beyond 1 year provides ischemic event protection after DES, ischemic event risk is perceived to be less after BMS, and the appropriate duration of DAPT after BMS is unknown. OBJECTIVE: To compare (1) rates of stent thrombosis and major adverse cardiac and cerebrovascular events (MACCE; composite of death, myocardial infarction, or stroke) after 30 vs 12 months of thienopyridine in patients treated with BMS taking aspirin and (2) treatment duration effect within the combined cohorts of randomized patients treated with DES or BMS as prespecified secondary analyses...
March 17, 2015: JAMA: the Journal of the American Medical Association
Sally A Santen, William J Peterson, Sorabh Khandelwal, Joseph B House, David E Manthey, Cemal B Sozener
OBJECTIVES: Medical education is a continuum from medical school through residency to unsupervised clinical practice. There has been a movement toward competency-based medical education prompted by the Accreditation Council for Graduate Medical Education (ACGME) using milestones to assess competence. While implementation of milestones for residents sets specific standards for transition to internship, there exists a need for the development of competency-based instruments to assess medical students as they progress toward internship...
August 2014: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Michael M Liao, Dennis Lezotte, Steven R Lowenstein, Kevin Howard, Zachary Finley, Zipei Feng, Richard L Byyny, Jeffrey D Sankoff, Ivor S Douglas, Jason S Haukoos
BACKGROUND: Little is known about the diagnostic accuracy of systemic inflammatory response syndrome (SIRS) criteria for critical illness among emergency department (ED) patients with and without infection. Our objective was to assess the diagnostic accuracy of SIRS criteria for critical illness in ED patients. METHODS: This was a retrospective cohort study of ED patients at an urban academic hospital. Standardized chart abstraction was performed on a random sample of all adult ED medical patients admitted to the hospital during a 1-year period, excluding repeat visits, transfers, ED deaths, and primary surgical or psychiatric admissions...
November 2014: American Journal of Emergency Medicine
Mitchell M Levy, Andrew Rhodes, Gary S Phillips, Sean R Townsend, Christa A Schorr, Richard Beale, Tiffany Osborn, Stanley Lemeshow, Jean-Daniel Chiche, Antonio Artigas, R Phillip Dellinger
PURPOSE: To determine the association between compliance with the Surviving Sepsis Campaign (SSC) performance bundles and mortality. DESIGN: Compliance with the SSC performance bundles, which are based on the 2004 SSC guidelines, was measured in 29,470 subjects entered into the SSC database from January 1, 2005, through June 30, 2012. Compliance was defined as evidence that all bundle elements were achieved. SETTING: Two hundred eighteen community, academic, and tertiary care hospitals in the United States, South America, and Europe...
January 2015: Critical Care Medicine
J A Myburgh
The administration of intravenous fluids for resuscitation is the most common intervention in acute medicine. There is increasing evidence that the type of fluid may directly affect patient-centred outcomes. There is a lack of evidence that colloids confer clinical benefit over crystalloids and they may be associated with harm. Hydroxyethyl starch preparations are associated with increased mortality and use of renal replacement therapy in critically ill patients, particularly those with sepsis; albumin is associated with increased mortality in patients with severe traumatic brain injury...
January 2015: Journal of Internal Medicine
Prachi Sanghavi, Anupam B Jena, Joseph P Newhouse, Alan M Zaslavsky
IMPORTANCE: Most out-of-hospital cardiac arrests receiving emergency medical services in the United States are treated by ambulance service providers trained in advanced life support (ALS), but supporting evidence for the use of ALS over basic life support (BLS) is limited. OBJECTIVE: To compare the effects of BLS and ALS on outcomes after out-of-hospital cardiac arrest. DESIGN, SETTING, AND PARTICIPANTS: Observational cohort study of a nationally representative sample of traditional Medicare beneficiaries from nonrural counties who experienced out-of-hospital cardiac arrest between January 1, 2009, and October 2, 2011, and for whom ALS or BLS ambulance services were billed to Medicare (31,292 ALS cases and 1643 BLS cases)...
February 2015: JAMA Internal Medicine
A Patel, S A R Nouraei
Emergency and difficult tracheal intubations are hazardous undertakings where successive laryngoscopy-hypoxaemia-re-oxygenation cycles can escalate to airway loss and the 'can't intubate, can't ventilate' scenario. Between 2013 and 2014, we extended the apnoea times of 25 patients with difficult airways who were undergoing general anaesthesia for hypopharyngeal or laryngotracheal surgery. This was achieved through continuous delivery of transnasal high-flow humidified oxygen, initially to provide pre-oxygenation, and continuing as post-oxygenation during intravenous induction of anaesthesia and neuromuscular blockade until a definitive airway was secured...
March 2015: Anaesthesia
Jeffrey A Kraut, Nicolaos E Madias
New England Journal of Medicine, Volume 371, Issue 24, Page 2309-2319, December 2014.
December 11, 2014: New England Journal of Medicine
Anne-Maree Kelly
Blood gas analysis is an integral part of the assessment of emergency department (ED) patients with acute respiratory or metabolic disease. Traditionally ABG analyses have been used, but increasingly, emergency clinicians are using venous blood gas (VBG) analyses. This has been challenged, especially by respiratory physicians, as being too inaccurate. This clinical review, using case examples, summarises the evidence supporting use of VBG to guide management decisions. Arteriovenous agreement for pH is such that values are clinically interchangeable and agreement for bicarbonate is also close...
February 2016: Emergency Medicine Journal: EMJ
Richard H Sterns
New England Journal of Medicine, Volume 372, Issue 1, Page 55-65, January 2015.
January 1, 2015: New England Journal of Medicine
John B Holcomb, Barbara C Tilley, Sarah Baraniuk, Erin E Fox, Charles E Wade, Jeanette M Podbielski, Deborah J del Junco, Karen J Brasel, Eileen M Bulger, Rachael A Callcut, Mitchell Jay Cohen, Bryan A Cotton, Timothy C Fabian, Kenji Inaba, Jeffrey D Kerby, Peter Muskat, Terence O'Keeffe, Sandro Rizoli, Bryce R H Robinson, Thomas M Scalea, Martin A Schreiber, Deborah M Stein, Jordan A Weinberg, Jeannie L Callum, John R Hess, Nena Matijevic, Christopher N Miller, Jean-Francois Pittet, David B Hoyt, Gail D Pearson, Brian Leroux, Gerald van Belle
IMPORTANCE: Severely injured patients experiencing hemorrhagic shock often require massive transfusion. Earlier transfusion with higher blood product ratios (plasma, platelets, and red blood cells), defined as damage control resuscitation, has been associated with improved outcomes; however, there have been no large multicenter clinical trials. OBJECTIVE: To determine the effectiveness and safety of transfusing patients with severe trauma and major bleeding using plasma, platelets, and red blood cells in a 1:1:1 ratio compared with a 1:1:2 ratio...
February 3, 2015: JAMA: the Journal of the American Medical Association
Mark Woods, David Hodgson
A shortcut review was carried out to establish whether a normal partial pressure of carbon dioxide (pCO2) on a venous blood sample could be used to rule out hypercarbia. Eleven studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line is that a normal venous pCO2 effectively rules out arterial hypercarbia.
March 2015: Emergency Medicine Journal: EMJ
Clare L Atzema, Tyler W Barrett
No abstract text is available yet for this article.
May 2015: Annals of Emergency Medicine
Elena Spinelli, Robert H Bartlett
OBJECTIVE: The objective of this report is to review the physiology and management of anemia in critical care. Selected publications on physiology and transfusion related to anemia and critical care, including the modern randomized trials of conservative versus liberal transfusion policy, were used. Anemia is compensated and tolerated in most critically ill patients as long as oxygen delivery is at least twice oxygen consumption. There are risks to blood transfusion which can be minimized by blood banking practice...
June 2016: Journal of Intensive Care Medicine
Paul R Mouncey, Tiffany M Osborn, G Sarah Power, David A Harrison, M Zia Sadique, Richard D Grieve, Rahi Jahan, Sheila E Harvey, Derek Bell, Julian F Bion, Timothy J Coats, Mervyn Singer, J Duncan Young, Kathryn M Rowan
BACKGROUND: Early, goal-directed therapy (EGDT) is recommended in international guidelines for the resuscitation of patients presenting with early septic shock. However, adoption has been limited, and uncertainty about its effectiveness remains. METHODS: We conducted a pragmatic randomized trial with an integrated cost-effectiveness analysis in 56 hospitals in England. Patients were randomly assigned to receive either EGDT (a 6-hour resuscitation protocol) or usual care...
April 2, 2015: New England Journal of Medicine
Ulrike Holzinger, Richard Brunner, Heidrun Losert, Valentin Fuhrmann, Harald Herkner, Christian Madl, Fritz Sterz, Bruno Schneeweiß
INTRODUCTION: Targeted temperature management improves outcome after cardiopulmonary resuscitation. Reduction of resting energy expenditure might be one mode of action. The aim of this study was to correlate resting energy expenditure and substrate oxidation rates with targeted temperature management at 33°C and outcome in patients after cardiac arrest. METHODS: This prospective, observational cohort study was performed at the department of emergency medicine and a medical intensive care unit of a university hospital...
March 29, 2015: Critical Care: the Official Journal of the Critical Care Forum
Yuzhou Liu, Jie Lao, Kaiming Gao, Yudong Gu, Xin Zhao
BACKGROUND: Nerve transfer is a valuable surgical technique in peripheral nerve reconstruction, especially in brachial plexus injuries. Phrenic nerve transfer for elbow flexion was proved to be one of the optimal procedures in the treatment of brachial plexus injuries in the study of Gu et al. OBJECTIVE: The aim of this study was to compare phrenic nerve transfers with and without nerve graft for elbow flexion after brachial plexus injury. METHODS: A retrospective review of 33 patients treated with phrenic nerve transfer for elbow flexion in posttraumatic global root avulsion brachial plexus injury was carried out...
January 2014: Injury
Bernardo Hontanilla, Diego Marre, Alvaro Cabello
BACKGROUND: Longstanding unilateral facial paralysis is best addressed with microneurovascular muscle transplantation. Neurotization can be obtained from the cross-facial or the masseter nerve. The authors present a quantitative comparison of both procedures using the FACIAL CLIMA system. METHODS: Forty-seven patients with complete unilateral facial paralysis underwent reanimation with a free gracilis transplant neurotized to either a cross-facial nerve graft (group I, n=20) or to the ipsilateral masseteric nerve (group II, n=27)...
June 2013: Plastic and Reconstructive Surgery
2015-04-24 20:13:49
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