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jrgEmergency medicine

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76 papers 25 to 100 followers
By Jesse Guscott McMaster Family Practice Anesthesia program director. Medical educator, ER, Anesthesia Twitter:@GuscottJesse
https://www.readbyqxmd.com/read/28754357/what-is-the-utility-of-end-tidal-capnography-for-procedural-sedation-and-analgesia-in-the-emergency-department
#1
EDITORIAL
Michael Gottlieb, Melissa Rice
No abstract text is available yet for this article.
July 26, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28538645/increased-mortality-in-trauma-patients-who-develop-post-intubation-hypotension
#2
Robert S Green, Michael B Butler, Mete Erdogan
BACKGROUND: Post-intubation hypotension (PIH) is common and associated with poor outcomes in critically ill patient populations requiring emergency endotracheal intubation (ETI). The importance of PIH in the trauma population remains unclear. The objective of this study was to determine the prevalence of PIH in trauma patients and assess the association of PIH with patient outcomes. METHODS: Retrospective case series of adult (≥16 years) patients who were intubated on arrival at a tertiary trauma center in Halifax, Nova Scotia, Canada between 2000 and 2015...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28505486/respiratory-support-techniques-to-avoid-desaturation-in-critically-ill-patients-requiring-endotracheal-intubation-a-systematic-review-and-meta-analysis
#3
REVIEW
Vincenzo Russotto, Andrea Cortegiani, Santi Maurizio Raineri, Cesare Gregoretti, Antonino Giarratano
PURPOSE: To evaluate which respiratory support method for critically ill patients undergoing endotracheal intubation (ETI) is associated with less desaturation. METHODS: We searched PubMed, Cochrane Library, Scopus and CINAHL databases. We included randomized (RCT) and non-randomized (non-RCT) studies investigating any method of respiratory support before/during ETI compared to a reference control. RESULTS: Apneic oxygenation (ApOx) was the most commonly investigated respiratory support technique for critically ill patients undergoing intubation (4 RCTs, 358 patients)...
May 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28109012/the-impact-of-a-soiled-airway-on-intubation-success-in-the-emergency-department-when-using-the-glidescope-or-the-direct-laryngoscope
#4
John C Sakles, G Judson Corn, Patrick Hollinger, Brittany Arcaris, Asad E Patanwala, Jarrod M Mosier
BACKGROUND: The objective was to determine the impact of a soiled airway on firstpass success when using the GlideScope video laryngoscope or the direct laryngoscope for intubation in the emergency department (ED). METHODS: Data were prospectively collected on all patients intubated in an academic ED from July 1, 2007, to June 30, 2016. Patients ≥ 18 years of age, who underwent rapid sequence intubation by an emergency medicine resident with the GlideScope or the direct laryngoscope, were included in the analysis...
May 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28487139/a-multicenter-randomized-trial-of-ramped%C3%A2-position-vs%C3%A2-sniffing-position-during%C3%A2-endotracheal-intubation-of-critically%C3%A2-ill-adults
#5
Matthew W Semler, David R Janz, Derek W Russell, Jonathan D Casey, Robert J Lentz, Aline N Zouk, Bennett P deBoisblanc, Jairo I Santanilla, Yasin A Khan, Aaron M Joffe, William S Stigler, Todd W Rice
BACKGROUND: Hypoxemia is the most common complication during endotracheal intubation of critically ill adults. Intubation in the ramped position has been hypothesized to prevent hypoxemia by increasing functional residual capacity and decreasing the duration of intubation, but has never been studied outside of the operating room. METHODS: Multicenter, randomized trial comparing the ramped position (head of the bed elevated to 25°) with the sniffing position (torso supine, neck flexed, and head extended) among 260 adults undergoing endotracheal intubation by pulmonary and critical care medicine fellows in four ICUs between July 22, 2015, and July 19, 2016...
May 6, 2017: Chest
https://www.readbyqxmd.com/read/28420641/should-we-intubate-patients-during-cardiopulmonary-resuscitation
#6
EDITORIAL
Carl L Gwinnutt
No abstract text is available yet for this article.
April 18, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28186265/pulmonary-aspiration-during-procedural-sedation-a-comprehensive-systematic-review
#7
S M Green, K P Mason, B S Krauss
Background: Although pulmonary aspiration complicating operative general anaesthesia has been extensively studied, little is known regarding aspiration during procedural sedation. Methods: We performed a comprehensive, systematic review to identify and catalogue published instances of aspiration involving procedural sedation in patients of all ages. We sought to report descriptively the circumstances, nature, and outcomes of these events. Results: Of 1249 records identified by our search, we found 35 articles describing one or more occurrences of pulmonary aspiration during procedural sedation...
March 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/22962052/a-re-conceptualisation-of-acute-spinal-care
#8
Mark Hauswald
The emergency care of patients who may have spinal injuries has become highly ritualised. There is little scientific support for many of the recommended interventions and there is evidence that at least some methods now used in the field and emergency department are harmful. Since prospective clinical trials are not likely to resolve these issues I propose a reconceptualisation of spinal trauma to allow a more rational approach to treatment. To do this I analyse the basic physics, biomechanics and physiology involved...
September 2013: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27460905/propofol-or-ketofol-for-procedural-sedation-and-analgesia-in-emergency-medicine-the-poker-study-a-randomized-double-blind-clinical-trial
#9
RANDOMIZED CONTROLLED TRIAL
Ian Ferguson, Anthony Bell, Greg Treston, Lisa New, Mingshuang Ding, Anna Holdgate
STUDY OBJECTIVE: We determine whether emergency physician-provided deep sedation with 1:1 ketofol versus propofol results in fewer adverse respiratory events requiring physician intervention when used for procedural sedation and analgesia. METHODS: Consenting patients requiring deep sedation were randomized to receive either ketofol or propofol in a double-blind fashion according to a weight-based dosing schedule. The primary outcome was the occurrence of a respiratory adverse event (desaturation, apnea, or hypoventilation) requiring an intervention by the sedating physician...
November 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/25362671/family-presence-during-resuscitation-and-invasive-procedures-in-pediatric-critical-care-a-systematic-review
#10
REVIEW
Sarah Smith McAlvin, Aimee Carew-Lyons
BACKGROUND: In pediatric critical care, family-centered care is a central theme that ensures holistic care of the patient and the patient's family. Parents expect and are encouraged to be involved in the care of their child throughout all phases of the child's illness. Family presence is generally accepted when the child's condition is stable; however, there is less consensus about family presence when the child becomes critically ill and requires resuscitation and/or invasive procedures...
November 2014: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/27815588/the-new-sepsis-consensus-definitions-the-good-the-bad-and-the-ugly
#11
EDITORIAL
Charles L Sprung, Roland M H Schein, Robert A Balk
No abstract text is available yet for this article.
December 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/28050802/the-effectiveness-of-apneic-oxygenation-during-tracheal-intubation-in-various-clinical-settings-a-narrative-review
#12
REVIEW
David T Wong, Amanda J Yee, Siaw May Leong, Frances Chung
PURPOSE: During the process of tracheal intubation, patients are apneic or hypoventilating and are at risk of becoming hypoxemic. This risk is especially high in patients with acute or chronic respiratory failure and accompanying compromised respiratory reserve. To address this concern, apneic oxygenation can be administered during tracheal intubation to aid in maintaining arterial oxygen saturation. The objective of this narrative review is to examine the utilization of apneic oxygenation within the operating room, intensive care unit (ICU), emergency department, and pre-hospital settings and to determine its efficacy compared with controls...
April 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27993308/comparison-of-etomidate-and-ketamine-for-induction-during-rapid-sequence-intubation-of%C3%A2-adult-trauma-patients
#13
COMPARATIVE STUDY
Cameron P Upchurch, Carlos G Grijalva, Stephan Russ, Sean P Collins, Matthew W Semler, Todd W Rice, Dandan Liu, Jesse M Ehrenfeld, Kevin High, Tyler W Barrett, Candace D McNaughton, Wesley H Self
STUDY OBJECTIVE: Induction doses of etomidate during rapid sequence intubation cause transient adrenal dysfunction, but its clinical significance on trauma patients is uncertain. Ketamine has emerged as an alternative for rapid sequence intubation induction. Among adult trauma patients intubated in the emergency department, we compare clinical outcomes among those induced with etomidate and ketamine. METHODS: The study entailed a retrospective evaluation of a 4-year (January 2011 to December 2014) period spanning an institutional protocol switch from etomidate to ketamine as the standard induction agent for adult trauma patients undergoing rapid sequence intubation in the emergency department of an academic Level I trauma center...
January 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27791428/cpr-induced-consciousness-during-out-of-hospital-cardiac-arrest-a-case-report-on-an-emerging-phenomenon
#14
Joshua Pound, P Richard Verbeek, Sheldon Cheskes
BACKGROUND: High quality cardiopulmonary resuscitation (CPR) has produced a relatively new phenomenon of consciousness in patients with vital signs absent. Further research is necessary to produce a viable treatment strategy during and post resuscitation. OBJECTIVE: To provide a case study done by paramedics in the field illustrating the need for sedation in a patient whose presentation was consistent with CPR induced consciousness. Resuscitative challenges are provided as well as potential future treatment options to minimize harm to both patients and prehospital providers...
March 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27694410/corticosteroids-for-community-acquired-pneumonia-a-critical-view-of-the-evidence
#15
EDITORIAL
James D Chalmers
No abstract text is available yet for this article.
October 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/27640182/the-critical-care-management-of-spontaneous-intracranial-hemorrhage-a-contemporary-review
#16
REVIEW
Airton Leonardo de Oliveira Manoel, Alberto Goffi, Fernando Godinho Zampieri, David Turkel-Parrella, Abhijit Duggal, Thomas R Marotta, R Loch Macdonald, Simon Abrahamson
Spontaneous intracerebral hemorrhage (ICH), defined as nontraumatic bleeding into the brain parenchyma, is the second most common subtype of stroke, with 5.3 million cases and over 3 million deaths reported worldwide in 2010. Case fatality is extremely high (reaching approximately 60 % at 1 year post event). Only 20 % of patients who survive are independent within 6 months. Factors such as chronic hypertension, cerebral amyloid angiopathy, and anticoagulation are commonly associated with ICH. Chronic arterial hypertension represents the major risk factor for bleeding...
September 18, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/25423534/tranexamic-acid-administration-to-pediatric-trauma-patients-in-a-combat-setting-the-pediatric-trauma-and-tranexamic-acid-study-ped-trax
#17
Matthew J Eckert, Thomas M Wertin, Stuart D Tyner, Daniel W Nelson, Seth Izenberg, Matthew J Martin
BACKGROUND: Early administration of tranexamic acid (TXA) has been associated with a reduction in mortality and blood product requirements in severely injured adults. It has also shown significantly reduced blood loss and transfusion requirements in major elective pediatric surgery, but no published data have examined the use of TXA in pediatric trauma. METHODS: This is a retrospective review of all pediatric trauma admissions to the North Atlantic Treaty Organization Role 3 hospital, Camp Bastion, Afghanistan, from 2008 to 2012...
December 2014: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/20889085/massive-transfusion-and-blood-product-use-in-the-pediatric-trauma-patient
#18
REVIEW
Jeffrey J Dehmer, William T Adamson
Hemorrhagic shock in the pediatric trauma patient is an uncommon but fundamental problem for the treating clinician. Current management of hemorrhagic shock involves initial resuscitation with crystalloid fluids followed by infusion of blood components as necessary. In management of the adult trauma patient, many institutions have implemented massive transfusion protocols to guide transfusion in situations requiring or anticipating the use of greater than 10 U of packed red blood cells. In the pediatric population, guidelines for massive transfusion are vague or nonexistent...
November 2010: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/22128884/implementation-of-a-pediatric-trauma-massive-transfusion-protocol-one-institution-s-experience
#19
Jeanne E Hendrickson, Beth H Shaz, Greg Pereira, Paul M Parker, Paula Jessup, Falisha Atwell, Beth Polstra, Elizabeth Atkins, Karen K Johnson, Gaobin Bao, Kirk A Easley, Cassandra D Josephson
BACKGROUND: Massive transfusion protocols (MTPs) with fixed ratios of blood products may improve outcomes in coagulopathic adult trauma patients. However, there is a paucity of data on transfusion support protocols for pediatric trauma patients, whose mechanisms of injury may differ from those seen in adults. We hypothesized that an MTP would improve outcomes in children, through a balanced blood product resuscitation. STUDY DESIGN AND METHODS: A pediatric trauma MTP, with a fixed ratio of red blood cells (RBCs):fresh-frozen plasma (FFP):platelets:cryoprecipitate in quantities based on the patient's weight, was initiated at a pediatric hospital...
June 2012: Transfusion
https://www.readbyqxmd.com/read/25043066/tranexamic-acid-in-pediatric-trauma-why-not
#20
REVIEW
Suzanne Beno, Alun D Ackery, Jeannie Callum, Sandro Rizoli
Trauma is a leading cause of death in pediatrics. Currently, no medical treatment exists to reduce mortality in the setting of pediatric trauma; however, this evidence does exist in adults. Bleeding and coagulopathy after trauma increases mortality in both adults and children. Clinical research has demonstrated a reduction in mortality with early use of tranexamic acid in adult trauma patients in both civilian and military settings. Tranexamic acid used in the perioperative setting safely reduces transfusion requirements in children...
July 2, 2014: Critical Care: the Official Journal of the Critical Care Forum
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