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By Jesse Guscott McMaster Family Practice Anesthesia program director. Medical educator, ER, Anesthesia Twitter:@GuscottJesse
Audrey De Jong, Amélie Rolle, Nicolas Molinari, Catherine Paugam-Burtz, Jean-Michel Constantin, Jean-Yves Lefrant, Karim Asehnoune, Boris Jung, Emmanuel Futier, Gérald Chanques, Elie Azoulay, Samir Jaber
OBJECTIVES: To determine the prevalence of and risk factors for cardiac arrest during intubation in ICU, as well as the association of ICU intubation-related cardiac arrest with 28-day mortality. DESIGN: Retrospective analysis of prospectively collected data. SETTING: Sixty-four French ICUs. PATIENTS: Critically ill patients requiring intubation in the ICU. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: During the 1,847 intubation procedures included, 49 cardiac arrests (2...
April 2018: Critical Care Medicine
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
Christian Braun, Ulrich Kisser, Astrid Huber, Klaus Stelter
INTRODUCTION: In various motion pictures, medical TV shows and internet chatrooms, non-medical devices were presented as tools for life-saving cricothyroidotomies. However, there is uncertainty about whether it is possible for a bystander to perform a cricothyroidotomy and maintain gas exchange using improvised household items. This study examines the ability of bystanders to carry out an emergency cricothyroidotomy in fresh human cadavers using only a pocket knife and a ballpoint pen...
January 2017: Resuscitation
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
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
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
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
Laurie J Morrison, Allan de Caen, Farhan Bhanji, Blair L Bigham, Ian E Blanchard, Steven C Brooks, Anne-Marie Guerguerian, Jan L Jensen, Andrew H Travers, Christian Vaillancourt, Michelle Welsford, Karen Woolfrey
No abstract text is available yet for this article.
May 2016: CJEM
John C Sakles, Jarrod M Mosier, Asad E Patanwala, Brittany Arcaris, John M Dicken
OBJECTIVES: The objective was to determine the effect of apneic oxygenation (AP OX) on first pass success without hypoxemia (FPS-H) in adult patients undergoing rapid sequence intubation (RSI) in the emergency department (ED). METHODS: Continuous quality improvement data were prospectively collected on all patients intubated in an academic ED from July 1, 2013, to June 30, 2015. During this period the use of AP OX was introduced and encouraged for all patients undergoing RSI in the ED...
June 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Won Young Kim, Myoung Kwan Kwak, Byuk Sung Ko, Jae Chol Yoon, Chang Hwan Sohn, Kyoung Soo Lim, Lars W Andersen, Michael W Donnino
OBJECTIVES: Emergency tracheal intubation has achieved high success and low complication rates in the emergency department (ED). The objective of this study was to evaluate the incidence of post-intubation CA and determine the clinical factors associated with this complication. METHODS: A matched case-control study with a case to control ratio of 1:3 was conducted at an urban tertiary care center between January 2007 and December 2011. Critically ill adult patients requiring emergency airway management in the ED were included...
2014: PloS One
Nathan J Smischney, Onur Demirci, Daniel A Diedrich, David W Barbara, Benjamin J Sandefur, Sangita Trivedi, Sean McGarry, Rahul Kashyap
BACKGROUND: We aim to report the incidence of post-intubation hypotension in the critically ill, to report in-hospital mortality and length of stay in those who developed post-intubation hypotension, and to explore possible risk factors associated with post-intubation hypotension. MATERIAL/METHODS: Adult (≥18 years) ICU patients who received emergent endotracheal intubation were included. We excluded patients if they were hemodynamically unstable 60 minutes pre-intubation...
February 2, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Sophie T Williams, Mark C Sykes, Phang Boon Lim, Justin D Salciccioli
The International Liaison Committee on Resuscitation recently released updated 2015 recommendations for resuscitation. The guidelines form the basis for all levels of resuscitation training, now from first aid to advanced life support (ALS), and for trainees of varying medical skills, from schoolchildren to medical students and consultants. We highlight major updates relating to intra-arrest and postarrest care, and the evidence for their recommendation. We also summarise areas of uncertainty in the evidence for ALS, and highlight current discussions that will likely inform the next round of recommendations...
May 2016: Emergency Medicine Journal: EMJ
Cheng-Yu Chien, Yi-Chia Su, Chi-Chun Lin, Chan-Wei Kuo, Shen-Che Lin, Yi-Ming Weng
BACKGROUND: Previous guidelines suggest up to 15 minutes of cardiopulmonary resuscitation (CPR) accompanied by other resuscitative interventions before terminating resuscitation of a traumatic cardiac arrest. The current study evaluated the duration of CPR according to outcome using the model of a county-based emergency medical services (EMS) system in Taiwan. METHODS: This study was performed as a prospectively defined retrospective review from EMS records and cardiac arrest registration between June 2011 and November 2012 in Taoyuan, Taiwan...
March 2016: American Journal of Emergency Medicine
Shannon M Fernando, Sheldon Cheskes, Daniel Howes
BACKGROUND: Reducing pauses during cardiopulmonary resuscitation (CPR) compressions result in better outcomes in cardiac arrest. Artefact filtering technology (AFT) gives rescuers the opportunity to visualize the underlying electrocardiogram (ECG) rhythm during chest compressions, and reduces the pauses that occur before and after delivering a shock. We conducted a simulation study to measure the reduction of peri-shock pause and impact on chest compression fraction (CCF) through AFT...
July 2016: CJEM
Paul E Marik
No abstract text is available yet for this article.
October 2016: Critical Care Medicine
Kathleen S Romanowski, Tina L Palmieri, Soman Sen, David G Greenhalgh
Advanced Burn Life Support emphasizes endotracheal intubation for patients with facial burns before transfer to a burn center to prevent airway obstruction. Many patients are intubated before transport and are often extubated shortly after burn center arrival. We hypothesize that many intubations performed before burn center transport are unnecessary. We conducted a retrospective review of all adults who were intubated before burn transfer and survived to discharge from August 2003 to June 2013. Intubations that had 2 or fewer ventilator days (i...
September 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
Milena Talikowska, Hideo Tohira, Judith Finn
AIM: To conduct a systematic review and meta-analysis to determine whether cardiopulmonary resuscitation (CPR) quality, as indicated by parameters such as chest compression depth, compression rate and compression fraction, is associated with patient survival from cardiac arrest. METHODS: Five databases were searched (MEDLINE, Embase, CINAHL, Scopus and Cochrane) as well as the grey literature (MedNar). To satisfy inclusion criteria, studies had to document human cases of in- or out-of hospital cardiac arrest where CPR quality had been recorded using an automated device and linked to patient survival...
November 2015: Resuscitation
Jon C Rittenberger, Ankur A Doshi, Joshua C Reynolds
Cardiac arrest afflicts more than 300,000 persons annually in North America alone. Advances in systematic, regimented postresuscitation care have lowered mortality and improved neurologic outcomes in select cohorts of patients over the last decade. Postcardiac arrest care now comprises its own link in the chain of survival. For most patients, high-quality postcardiac arrest care begins in the Emergency Department. This article reviews the evidence and offers treatment strategies for the key components of postcardiac arrest care...
August 2015: Emergency Medicine Clinics of North America
Keith Couper, Peter K Kimani, Benjamin S Abella, Mehboob Chilwan, Matthew W Cooke, Robin P Davies, Richard A Field, Fang Gao, Sarah Quinton, Nigel Stallard, Sarah Woolley, Gavin D Perkins
OBJECTIVE: To evaluate the effect of implementing real-time audiovisual feedback with and without postevent debriefing on survival and quality of cardiopulmonary resuscitation quality at in-hospital cardiac arrest. DESIGN: A two-phase, multicentre prospective cohort study. SETTING: Three UK hospitals, all part of one National Health Service Acute Trust. PATIENTS: One thousand three hundred and ninety-five adult patients who sustained an in-hospital cardiac arrest at the study hospitals and were treated by hospital emergency teams between November 2009 and May 2013...
November 2015: Critical Care Medicine
Joyce H Y Yeung, G J Ong, Robin P Davies, Fang Gao, Gavin D Perkins
OBJECTIVE: This study aims to explore the relationship between team-leadership skills and quality of cardiopulmonary resuscitation in an adult cardiac-arrest simulation. Factors affecting team-leadership skills were also assessed. DESIGN: Forty advanced life-support providers leading a cardiac arrest team in a standardized cardiac-arrest simulation were videotaped. Background data were collected, including age (in yrs), sex, whether they had received any leadership training in the past, whether they were part of a professional group, the most recent advanced life-support course (in months) they had undergone, advanced life-support instructor/provider status, and whether they had led in any cardiac arrest situation in the preceding 6 months...
September 2012: Critical Care Medicine
2016-01-12 23:02:17
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