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26 papers 0 to 25 followers Collection by paramedic student Mohammed Alhalabi #FOAMED #FOAMEMS @alhalabi1986 @fanshawemedics
By Mo Al
Behrad Golshani, Paul Dong, Scott Evans
Myocardial rupture is a rare imaging diagnosis given its clinical severity and high mortality. Early findings should be promptly communicated to the trauma service to ensure immediate intervention. We present a rare case of blowout perforation of the right ventricle which was prospectively diagnosed on computed tomography (CT) leading to emergent operative repair. The patient subsequently survived and was discharged after a lengthy hospital course.
2016: Case Reports in Radiology
K V Pshenisnov, Yu S Aleksandrovich, P I Mironov, Yu V Suhanov, O V Kuzmin, S A Blinov, A N Kondin
BACKGROUND: Fluid and transfusion therapy is proved to be a required component of treating children with severe major trauma significantly influencing the case outcome. OBJECTIVE: To analyze efficiency of fluid and transfusion therapy in children with severe major trauma and assess its correspondence with current recommendations. MATERIALS AND METHODS: 150 children aged from 0 to 18 years getting treatment in intensive care units of children's city hospitals of Saint Petersburg, Archangelsk, Ufa, Samara, and Leningrad region were included in the research...
January 2016: Anesteziologiia i Reanimatologiia
Mitchell Jay Cohen, S Ariane Christie
Coagulopathy following injury is common and it predicts poor outcomes and increased mortality. For many decades, coagulopathy in trauma was considered as an iatrogenic phenomenon, and clinical practice focused on a resuscitation strategy using large volume crystalloid and packed red blood cells. The discovery of Acute Traumatic Coagulopathy as a distinct pathophysiologic state coupled with a transition towards balanced product resuscitation has fundamentally changed the paradigm of trauma care and represents one of the most active areas of current research in the field of trauma...
September 2016: International Journal of Surgery
Daniel Leisman, Benjamin Wie, Martin Doerfler, Andrea Bianculli, Mary Frances Ward, Meredith Akerman, John K D'Angelo, Jason A Zemmel D'Amore
STUDY OBJECTIVE: We evaluate the association of intravenous fluid resuscitation initiation within 30 minutes of severe sepsis or septic shock identification in the emergency department (ED) with inhospital mortality and hospital length of stay. We also compare intravenous fluid resuscitation initiated at various times from severe sepsis or septic shock identification's association with the same outcomes. METHODS: This was a review of a prospective, observational cohort of all ED severe sepsis or septic shock patients during 13 months, captured in a performance improvement database at a single, urban, tertiary care facility (90,000 ED visits/year)...
September 2016: Annals of Emergency Medicine
Arne Driessen, Matthias Fröhlich, Nadine Schäfer, Manuel Mutschler, Jerome M Defosse, Thomas Brockamp, Bertil Bouillon, Ewa K Stürmer, Rolf Lefering, Marc Maegele
BACKGROUND: Various studies have shown the deleterious effect of high volume resuscitation following severe trauma promoting coagulopathy by haemodilution, acidosis and hypothermia. As the optimal resuscitation strategy during prehospital trauma care is still discussed, we raised the question if the amount and kind of fluids administered changed over the recent years. Further, if less volume was administered, fewer patients should have arrived in coagulopathic depletion in the Emergency Department resulting in less blood product transfusions...
April 6, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
A Kehoe, J E Smith, O Bouamra, A Edwards, D Yates, F Lecky
INTRODUCTION: Recent evidence suggests that presenting GCS may be higher in older rather than younger patients for an equivalent anatomical severity of traumatic brain injury (TBI). The aim of this study was to confirm these observations using a national trauma database and to test explanatory hypotheses. METHODS: The Trauma Audit Research Network database was interrogated to identify all adult cases of severe isolated TBI from 1988 to 2013. Cases were categorised by age into those under 65 years and those 65 years and older...
June 2016: Emergency Medicine Journal: EMJ
Billy Sin, Mabel Wai, Tamara Tatunchak, Sergey M Motov
OBJECTIVES: Acetaminophen (APAP) is a mainstay for pain management worldwide. The intravenous (IV) formulation has been widely used in Europe for more than 20 years in adults and children. In the United States, IV APAP obtained full approval from the Food and Drug Administration in 2010. There is emerging literature to suggest the use of IV APAP for pain reduction in the emergency department (ED). This evidence-based review examines the evidence pertaining to the use of IV APAP for acute pain control in the ED...
May 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Matthew Neame, Octavio Aragon, Ricardo M Fernandes, Ian Sinha
Acute, severe exacerbations of asthma present a challenge due to the significant morbidity associated with this presentation. For exacerbations that are refractory to initial treatments with inhaled and oral therapies, there is still doubt about which intravenous therapies are most likely to be helpful. β-2 agonists and aminophylline have differing mechanisms of action that also affect their adverse effects profiles and these are considered. A review of the available randomised control trials suggests that a bolus of intravenous salbutamol may reduce symptoms and hasten recovery...
August 2015: Archives of Disease in Childhood. Education and Practice Edition
Jack Jaffe
No abstract text is available yet for this article.
January 21, 2016: New England Journal of Medicine
Monica K Borucki, Victoria Lao, Mona Hwang, Shea Gardner, Danielle Adney, Vincent Munster, Richard Bowen, Jonathan E Allen
Middle East respiratory syndrome coronavirus (MERS-CoV) is an emerging human pathogen related to SARS virus. In vitro studies indicate this virus may have a broad host range suggesting an increased pandemic potential. Genetic and epidemiological evidence indicate camels serve as a reservoir for MERS virus but the mechanism of cross species transmission is unclear and many questions remain regarding the susceptibility of humans to infection. Deep sequencing data was obtained from the nasal samples of three camels that had been experimentally infected with a human MERS-CoV isolate...
2016: PloS One
Patrick M Honore, Rita Jacobs, Inne Hendrickx, Sean M Bagshaw, Olivier Joannes-Boyau, Willem Boer, Elisabeth De Waele, Viola Van Gorp, Herbert D Spapen
Sepsis-induced acute kidney injury (SAKI) remains an important challenge in critical care medicine. We reviewed current available evidence on prevention and treatment of SAKI with focus on some recent advances and developments. Prevention of SAKI starts with early and ample fluid resuscitation preferentially with crystalloid solutions. Balanced crystalloids have no proven superior benefit. Renal function can be evaluated by measuring lactate clearance rate, renal Doppler, or central venous oxygenation monitoring...
December 2015: Annals of Intensive Care
L A Murtha, D D McLeod, S K McCann, D Pepperall, S Chung, C R Levi, M B Calford, N J Spratt
BACKGROUND: Intracranial pressure elevation, peaking three to seven post-stroke is well recognized following large strokes. Data following small-moderate stroke are limited. Therapeutic hypothermia improves outcome after cardiac arrest, is strongly neuroprotective in experimental stroke, and is under clinical trial in stroke. Hypothermia lowers elevated intracranial pressure; however, rebound intracranial pressure elevation and neurological deterioration may occur during rewarming. HYPOTHESES: (1) Intracranial pressure increases 24 h after moderate and small strokes...
July 2014: International Journal of Stroke: Official Journal of the International Stroke Society
Anna Lembke
Prescription opioid abuse is an epidemic in the United States. In 2010, there were reportedly as many as 2.4 million opioid abusers in this country, and the number of new abusers had increased by 225% between 1992 and 2000. Sixty percent of the opioids that are abused are obtained directly or..
October 25, 2012: New England Journal of Medicine
Noemí Sansó, Laura Galiana, Amparo Oliver, Antonio Pascual, Shane Sinclair, Enric Benito
CONTEXT: Professionals working in the landscape of death and dying frequently are exposed to existential issues, psychological challenges, and emotional distress associated with care at the end of life. Identifying factors that help professionals cope with frequent exposure to issues related to mortality could enhance palliative care providers' and patients' quality of life. OBJECTIVES: To improve our understanding of the factors associated with professionals' inner life, through the assessment of an adapted version of Kearney and Kearney's awareness model of self-care...
August 2015: Journal of Pain and Symptom Management
David Sweet, Julian Marsden, Kendall Ho, Christina Krause, James A Russell
Many emergency departments have implemented sepsis protocols since the 2001 publication of results from the early goal-directed therapy trial, which showed early targeted resuscitation lowers mortality. As part of an attempt to improve clinical and operational outcomes for emergency departments across British Columbia, we reviewed sepsis management literature and considered sepsis protocol implementation in the province’s emergency departments. During the literature review we found that many observational studies confirmed an association between implementation of emergency sepsis protocols and decreased mortality...
May 2012: BC medical journal: BCMJ
Narinder Kapur, Anam Parand, Tayana Soukup, Tom Reader, Nick Sevdalis
Safety in aviation has often been compared with safety in healthcare. Following a recent article in this journal, the UK government set up an Independent Patient Safety Investigation Service, to emulate a similar well-established body in aviation. On the basis of a detailed review of relevant publications that examine patient safety in the context of aviation practice, we have drawn up a table of comparative features and a conceptual framework for patient safety. Convergence and divergence of safety-related behaviours across aviation and healthcare were derived and documented...
January 2016: JRSM Open
Joseph M Buckley, Andy D Irving, Steve Goodacre
BACKGROUND: There is little in-depth research into how patients feel about emergency medical trials, and what influences these feelings. OBJECTIVES: To investigate patients' feelings on taking part in emergency medical research, particularly trials conducted without prospective consent. METHODS: Seventeen inpatients, all recently admitted with a medical emergency, were interviewed. Questions focused on feelings on taking part in hypothetical trials, particularly trials conducted with deferred consent...
June 2016: Emergency Medicine Journal: EMJ
Clifford John Mann
No abstract text is available yet for this article.
March 2016: Emergency Medicine Journal: EMJ
Steven Karceski
No abstract text is available yet for this article.
November 24, 2015: Neurology
L Lee Hamm, Nazih Nakhoul, Kathleen S Hering-Smith
Acid-base homeostasis and pH regulation are critical for both normal physiology and cell metabolism and function. The importance of this regulation is evidenced by a variety of physiologic derangements that occur when plasma pH is either high or low. The kidneys have the predominant role in regulating the systemic bicarbonate concentration and hence, the metabolic component of acid-base balance. This function of the kidneys has two components: reabsorption of virtually all of the filtered HCO3(-) and production of new bicarbonate to replace that consumed by normal or pathologic acids...
December 7, 2015: Clinical Journal of the American Society of Nephrology: CJASN
2016-01-19 16:10:51
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