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Critical care & Emergency med

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By Howie Real Advanced Practice Nurse
https://www.readbyqxmd.com/read/29704160/there-is-more-to-septic-shock-than-arterial-hypotension-and-elevated-lactate-levels-another-appeal-to-rethink-current-resuscitation-strategies
#1
REVIEW
Martin W Dünser, Arnaldo Dubin
No abstract text is available yet for this article.
April 27, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29691755/my-patient-has-received-fluid-how-to-assess-its-efficacy-and-side-effects
#2
REVIEW
Xavier Monnet, Jean-Louis Teboul
Many efforts have been made to predict, before giving fluid, whether it will increase cardiac output. Nevertheless, after fluid administration, it is also essential to assess the therapeutic efficacy and to look for possible adverse effects. Like for any drug, this step should not be missed. Basically, volume expansion is aimed at improving tissue oxygenation and organ function. To assess this final result, clinical signs are often unhelpful. The increase in urine output in case of acute kidney injury is a poor marker of the kidney perfusion improvement...
April 24, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/23690514/race-and-acute-abdominal-pain-in-a-pediatric-emergency-department
#3
Kerry Caperell, Raymond Pitetti, Keith P Cross
OBJECTIVE: To investigate the demographic and clinical factors of children who present to the pediatric emergency department (ED) with abdominal pain and their outcomes. METHODS: A review of the electronic medical record of patients 1 to 18 years old, who presented to the Children's Hospital of Pittsburgh ED with a complaint of abdominal pain over the course of 2 years, was conducted. Demographic and clinical characteristics, as well as visit outcomes, were reviewed...
June 2013: Pediatrics
https://www.readbyqxmd.com/read/23915604/pediatric-ent-emergencies
#4
REVIEW
Michael J Stoner, Marlie Dulaurier
Otolaryngology (ear, nose, and throat) emergencies are a common complaint in the emergency department. These can present as a result of infection, trauma, foreign bodies, or postprocedure complications. The emergency department physician is called on to offer initial if not definitive management of these patients. This article discusses common ear, nose, and throat emergencies presenting to the emergency department.
August 2013: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/25998446/use-of-mobile-apps-a-patient-centered-approach
#5
Lauren A Houdek VonHoltz, Kendra A Hypolite, Brendan G Carr, Frances S Shofer, Flaura K Winston, C William Hanson, Raina M Merchant
OBJECTIVES: This study explored what smartphone health applications (apps) are used by patients, how they learn about health apps, and how information about health apps is shared. METHODS: Patients seeking care in an academic ED were surveyed about the following regarding their health apps: use, knowledge, sharing, and desired app features. Demographics and health information were characterized by summary statistics. RESULTS: Of 300 participants, 212 (71%) owned smartphones, 201 (95%) had apps, and 94 (44%) had health apps...
June 2015: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29534630/antibiotic-use-in-the-intensive-care-unit-optimization-and-de-escalation
#6
Maureen Campion, Gail Scully
Appropriate antimicrobial therapy is essential to ensuring positive patient outcomes. Inappropriate or suboptimal utilization of antibiotics can lead to increased length of stay, multidrug-resistant infections, and mortality. Critically ill intensive care patients, particularly those with severe sepsis and septic shock, are at risk of antibiotic failure and secondary infections associated with incorrect antibiotic use. Through the initiation of active empiric antibiotic therapy based upon local susceptibilities, daily evaluation of signs and symptoms of infection and narrowing of antibiotic therapy when feasible, providers can streamline the treatment of common intensive care unit (ICU) infections...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/26033108/hiring-appropriate-providers-for-different-populations-acute-care-nurse-practitioners
#7
REVIEW
Cathy Haut, Maureen Madden
Acute care nurse practitioners, prepared as providers for a variety of populations of patients, continue to make substantial contributions to health care. Evidence indicates shorter stays, higher satisfaction among patients, increased work efficiency, and higher quality outcomes when acute care nurse practitioners are part of unit- or service-based provider teams. The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification, and Education outlines detailed guidelines for matching nurse practitioners' education with certification and practice by using a population-focused algorithm...
June 2015: Critical Care Nurse
https://www.readbyqxmd.com/read/29478864/management-of-acute-kidney-injury-core-curriculum-2018
#8
Peter K Moore, Raymond K Hsu, Kathleen D Liu
Acute kidney injury (AKI) is a heterogeneous disorder that is common in hospitalized patients and associated with short- and long-term morbidity and mortality. When AKI is present, prompt workup of the underlying cause should be pursued, with specific attention to reversible causes. Measures to prevent AKI include optimization of volume status and avoidance of nephrotoxic medications. Crystalloids are preferred over colloids for most patients, and hydroxyethyl starches should be avoided. Volume overload in the setting of AKI is associated with adverse outcomes, so attention should be paid to overall fluid balance...
February 22, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/19318384/intensive-versus-conventional-glucose-control-in-critically-ill-patients
#9
RANDOMIZED CONTROLLED TRIAL
Simon Finfer, Dean R Chittock, Steve Yu-Shuo Su, Deborah Blair, Denise Foster, Vinay Dhingra, Rinaldo Bellomo, Deborah Cook, Peter Dodek, William R Henderson, Paul C Hébert, Stephane Heritier, Daren K Heyland, Colin McArthur, Ellen McDonald, Imogen Mitchell, John A Myburgh, Robyn Norton, Julie Potter, Bruce G Robinson, Juan J Ronco
BACKGROUND: The optimal target range for blood glucose in critically ill patients remains unclear. METHODS: Within 24 hours after admission to an intensive care unit (ICU), adults who were expected to require treatment in the ICU on 3 or more consecutive days were randomly assigned to undergo either intensive glucose control, with a target blood glucose range of 81 to 108 mg per deciliter (4.5 to 6.0 mmol per liter), or conventional glucose control, with a target of 180 mg or less per deciliter (10...
March 26, 2009: New England Journal of Medicine
https://www.readbyqxmd.com/read/29351759/tracheal-intubation-in-critically-ill-patients-a-comprehensive-systematic-review-of-randomized-trials
#10
Luca Cabrini, Giovanni Landoni, Martina Baiardo Radaelli, Omar Saleh, Carmine D Votta, Evgeny Fominskiy, Alessandro Putzu, Cézar Daniel Snak de Souza, Massimo Antonelli, Rinaldo Bellomo, Paolo Pelosi, Alberto Zangrillo
BACKGROUND: We performed a systematic review of randomized controlled studies evaluating any drug, technique or device aimed at improving the success rate or safety of tracheal intubation in the critically ill. METHODS: We searched PubMed, BioMed Central, Embase and the Cochrane Central Register of Clinical Trials and references of retrieved articles. Finally, pertinent reviews were also scanned to detect further studies until May 2017. The following inclusion criteria were considered: tracheal intubation in adult critically ill patients; randomized controlled trial; study performed in Intensive Care Unit, Emergency Department or ordinary ward; and work published in the last 20 years...
January 20, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29295971/special-k-with-no-license-to-kill-accidental-ketamine-overdose-on-induction-of-general-anesthesia
#11
Lindsay L Warner, Nathan Smischney
BACKGROUND Ketamine is used as an induction and sedation agent in emergency departments and operating rooms throughout the country. Despite its widespread clinical use, there are few cases of significant morbidity and mortality attributed to ketamine overdose in the clinical setting. CASE REPORT The anesthesia provider in the room was an oral maxillofacial surgeon who inadvertently took out a more highly concentrated bottle of ketamine that is typically used for pediatric patients. The patient received 950 mg (100 mg/ml concentration) of intravenous ketamine instead of the intended 95 mg (10 mg/ml concentration)...
January 3, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29297793/colonic-diverticulosis-and-diverticular-hemorrhage-in-a-geriatric-female-orangutan-pongo-abelii
#12
Simone Vitali, Paul Eden, Karen Payne, Geoffrey Forbes
A 57-yr-old female Sumatran orangutan ( Pongo abelii) presented with signs of intermittent lethargy and inappetence, then subsequently developed profuse hemorrhagic diarrhea. Colonoscopy under anesthesia revealed diverticulosis of the descending colon, with multiple large diverticula containing fecoliths. There was no evidence of diverticulitis, but a regenerative anemia had developed following an acute diverticular bleed. The orangutan recovered with conservative therapy. Colonic diverticulosis has been reported in nonhuman primates and appears to have a similar clinical presentation to the condition as it occurs in humans...
December 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/29230392/non-invasive-monitoring-of-cardiac-output-in-critical-care-medicine
#13
REVIEW
Lee S Nguyen, Pierre Squara
Critically ill patients require close hemodynamic monitoring to titrate treatment on a regular basis. It allows administering fluid with parsimony and adjusting inotropes and vasoactive drugs when necessary. Although invasive monitoring is considered as the reference method, non-invasive monitoring presents the obvious advantage of being associated with fewer complications, at the expanse of accuracy, precision, and step-response change. A great many methods and devices are now used over the world, and this article focuses on several of them, providing with a brief review of related underlying physical principles and validation articles analysis...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/12427661/medication-errors-in-acute-cardiac-care-an-american-heart-association-scientific-statement-from-the-council-on-clinical-cardiology-subcommittee-on-acute-cardiac-care-council-on-cardiopulmonary-and-critical-care-council-on-cardiovascular-nursing-and-council
#14
REVIEW
Jane E Freedman, Richard C Becker, Jesse E Adams, Steven Borzak, Robert L Jesse, L Kristin Newby, Patrick O'Gara, John C Pezzullo, Richard Kerber, Bernice Coleman, Joseph Broderick, Sally Yasuda, Christopher Cannon
No abstract text is available yet for this article.
November 12, 2002: Circulation
https://www.readbyqxmd.com/read/22721978/first-do-no-harm-less-training-%C3%A2-quality-care
#15
EDITORIAL
Michael H Baumann, Steven Q Simpson, Mary Stahl, Suhail Raoof, Darcy D Marciniuk, David D Gutterman
In an attempt to transform the health care system in the United States to improve upon the inadequacies and deficiencies of our current model, the Robert Wood Johnson Foundation and the Institute of Medicine created a collaborative partnership to spell out what aspects of our health care system need to be remodeled. They envisioned that "interprofessional collaboration and coordination would be the 'norm,'"(1) because no discipline functions in isolation of others, certainly not in our intensive care units...
July 2012: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/25978438/an-official-ats-aacn-accp-esicm-sccm-policy-statement-responding-to-requests-for-potentially-inappropriate-treatments-in-intensive-care-units
#16
Gabriel T Bosslet, Thaddeus M Pope, Gordon D Rubenfeld, Bernard Lo, Robert D Truog, Cynda H Rushton, J Randall Curtis, Dee W Ford, Molly Osborne, Cheryl Misak, David H Au, Elie Azoulay, Baruch Brody, Brenda G Fahy, Jesse B Hall, Jozef Kesecioglu, Alexander A Kon, Kathleen O Lindell, Douglas B White
BACKGROUND: There is controversy about how to manage requests by patients or surrogates for treatments that clinicians believe should not be administered. PURPOSE: This multisociety statement provides recommendations to prevent and manage intractable disagreements about the use of such treatments in intensive care units. METHODS: The recommendations were developed using an iterative consensus process, including expert committee development and peer review by designated committees of each of the participating professional societies (American Thoracic Society, American Association for Critical Care Nurses, American College of Chest Physicians, European Society for Intensive Care Medicine, and Society of Critical Care)...
June 1, 2015: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/17541752/evidence-based-guidelines-for-the-prevention-of-ventilator-associated-pneumonia-results-of-a-knowledge-test-among-intensive-care-nurses
#17
Stijn I Blot, Sonia Labeau, Dominique Vandijck, Paul Van Aken, Brigitte Claes
OBJECTIVE: To determine intensive care nurses' knowledge of evidence-based guidelines for the prevention of ventilator-associated pneumonia (VAP). DESIGN: A survey using a validated multiple-choice questionnaire, developed to evaluate nurses' knowledge of VAP prevention. The questionnaire was distributed and collected during the annual congress of the Flemish Society for Critical Care Nurses (Ghent, November 2005). Demographic data included were gender, years of intensive care experience, number of critical beds, and whether respondents hold a special degree in emergency and intensive care...
August 2007: Intensive Care Medicine
https://www.readbyqxmd.com/read/22981532/barriers-to-feeding-critically-ill-patients-a-multicenter-survey-of-critical-care-nurses
#18
MULTICENTER STUDY
Naomi E Cahill, Lauren Murch, Deborah Cook, Daren K Heyland
PURPOSE: The aims of this study were to describe the barriers to enterally feeding critically ill patients from a nursing perspective and to examine whether these barriers differ across centers. MATERIALS AND METHODS: A cross-sectional survey was conducted in 5 hospitals in North America. A 45-item questionnaire was administered to critical care nurses to evaluate the barriers to enterally feeding patients. RESULTS: A total of 138 of 340 critical care nurses completed the questionnaire (response rate of 41%)...
December 2012: Journal of Critical Care
https://www.readbyqxmd.com/read/18158392/critical-care-nurses-knowledge-of-evidence-based-guidelines-for-preventing-infections-associated-with-central-venous-catheters-an-evaluation-questionnaire
#19
S Labeau, A Vereecke, D M Vandijck, B Claes, S I Blot
BACKGROUND: Lack of adherence to recommended evidence-based guidelines for preventing infections associated with use of central venous catheters may be due to nurses' lack of knowledge of the guidelines. OBJECTIVE: To develop a reliable and valid questionnaire for evaluating critical care nurses' knowledge of evidence-based guidelines for preventing infections associated with central venous catheters. METHODS: A total of 10 nursing-related strategies were identified from current evidence-based guidelines for preventing infections associated with use of central venous catheters...
January 2008: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/25271745/an-official-american-thoracic-society-american-association-of-critical-care-nurses-american-college-of-chest-physicians-society-of-critical-care-medicine-policy-statement-the-choosing-wisely%C3%A2-top-5-list-in-critical-care-medicine
#20
Scott D Halpern, Deborah Becker, J Randall Curtis, Robert Fowler, Robert Hyzy, Lewis J Kaplan, Nishi Rawat, Curtis N Sessler, Hannah Wunsch, Jeremy M Kahn
RATIONALE: The high costs of health care in the United States and other developed nations are attributable, in part, to overuse of tests, treatments, and procedures that provide little to no benefit for patients. To improve the quality of care while also combating this problem of cost, the American Board of Internal Medicine Foundation developed the Choosing Wisely Campaign, tasking professional societies to develop lists of the top five medical services that patients and physicians should question...
October 1, 2014: American Journal of Respiratory and Critical Care Medicine
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