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Emergengy

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171 papers 100 to 500 followers
https://www.readbyqxmd.com/read/28870355/mechanical-ventilation-state-of-the-art
#1
REVIEW
Tài Pham, Laurent J Brochard, Arthur S Slutsky
Mechanical ventilation is the most used short-term life support technique worldwide and is applied daily for a diverse spectrum of indications, from scheduled surgical procedures to acute organ failure. This state-of-the-art review provides an update on the basic physiology of respiratory mechanics, the working principles, and the main ventilatory settings, as well as the potential complications of mechanical ventilation. Specific ventilatory approaches in particular situations such as acute respiratory distress syndrome and chronic obstructive pulmonary disease are detailed along with protective ventilation in patients with normal lungs...
September 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29114010/2017-international-consensus-on-cardiopulmonary-resuscitation-and-emergency-cardiovascular-care-science-with-treatment-recommendations-summary
#2
REVIEW
Theresa M Olasveengen, Allan R de Caen, Mary E Mancini, Ian K Maconochie, Richard Aickin, Dianne L Atkins, Robert A Berg, Robert M Bingham, Steven C Brooks, Maaret Castrén, Sung Phil Chung, Julie Considine, Thomaz Bittencourt Couto, Raffo Escalante, Raúl J Gazmuri, Anne-Marie Guerguerian, Tetsuo Hatanaka, Rudolph W Koster, Peter J Kudenchuk, Eddy Lang, Swee Han Lim, Bo Løfgren, Peter A Meaney, William H Montgomery, Peter T Morley, Laurie J Morrison, Kevin J Nation, Kee-Chong Ng, Vinay M Nadkarni, Chika Nishiyama, Gabrielle Nuthall, Gene Yong-Kwang Ong, Gavin D Perkins, Amelia G Reis, Giuseppe Ristagno, Tetsuyo Sakamoto, Michael R Sayre, Stephen M Schexnayder, Alfredo F Sierra, Eunice M Singletary, Naoki Shimizu, Michael A Smyth, David Stanton, Janice A Tijssen, Andrew Travers, Christian Vaillancourt, Patrick Van de Voorde, Mary Fran Hazinski, Jerry P Nolan
The International Liaison Committee on Resuscitation has initiated a near-continuous review of cardiopulmonary resuscitation science that replaces the previous 5-year cyclic batch-and-queue approach process. This is the first of an annual series of International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations summary articles that will include the cardiopulmonary resuscitation science reviewed by the International Liaison Committee on Resuscitation in the previous year...
November 6, 2017: Circulation
https://www.readbyqxmd.com/read/28243766/every-second-counts-signs-of-a-failing-heart-on-thoracic-ct-in-the-ed
#3
REVIEW
David J Maldow, Abhishek Chaturvedi, Katherine Kaproth-Joslin
Impending cardiac failure is often difficult to recognize and requires a multidisciplinary approach. Upon arrival in the emergency department, patients are promptly screened for potentially life-threatening conditions through a history and physical examination. In many cases, the diagnosis is not clear until confirmatory laboratory or imaging tests are performed. Unfortunately, patients can rapidly decompensate as this diagnostic information is being obtained. Emergent CT plays a key role in identifying conditions that may result in cardiovascular collapse, including severe congestive heart failure, myocardial infarction, cardiac tamponade, and impending cardiac failure...
June 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28923988/contemporary-management-of-cardiogenic-shock-a-scientific-statement-from-the-american-heart-association
#4
REVIEW
Sean van Diepen, Jason N Katz, Nancy M Albert, Timothy D Henry, Alice K Jacobs, Navin K Kapur, Ahmet Kilic, Venu Menon, E Magnus Ohman, Nancy K Sweitzer, Holger Thiele, Jeffrey B Washam, Mauricio G Cohen
Cardiogenic shock is a high-acuity, potentially complex, and hemodynamically diverse state of end-organ hypoperfusion that is frequently associated with multisystem organ failure. Despite improving survival in recent years, patient morbidity and mortality remain high, and there are few evidence-based therapeutic interventions known to clearly improve patient outcomes. This scientific statement on cardiogenic shock summarizes the epidemiology, pathophysiology, causes, and outcomes of cardiogenic shock; reviews contemporary best medical, surgical, mechanical circulatory support, and palliative care practices; advocates for the development of regionalized systems of care; and outlines future research priorities...
October 17, 2017: Circulation
https://www.readbyqxmd.com/read/28682895/acute-decompensated-heart-failure-in-the-emergency-department-identification-of-early-predictors-of-outcome
#5
Luigi Mario Castello, Luca Molinari, Alessandra Renghi, Elena Peruzzi, Andrea Capponi, Gian Carlo Avanzi, Mario Pirisi
Identification of clinical factors that can predict mortality and hospital early readmission in acute decompensated heart failure (ADHF) patients can help emergency department (ED) physician optimize the care-path and resource utilization.We conducted a retrospective observational study of 530 ADHF patients evaluated in the ED of an Italian academic hospital in 2013.Median age was 82 years, females were 55%; 31.1% of patients were discharged directly from the ED (12.5% after short staying in the observation unit), while 68...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28745846/acute-decompensated-heart-failure-new-strategies-for-improving-outcomes-digest
#6
Emily Singer Fisher, Boyd Burns, Jeremy Kim
Acute decompensated heart failure is a common emergency department presentation with significant associated morbidity and mortality. Heart failure accounts for more than 1 million hospitalizations annually, with a steadily increasing incidence as our population ages. This issue reviews recent literature regarding appropriate management of emergency department presentations of acute decompensated heart failure, with special attention to newer medication options. Emergency department management and appropriate interventions are discussed, along with critical decision-making points in resuscitation for both hypertensive and hypotensive patients...
May 22, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28772049/the-role-of-procalcitonin-in-acute-heart-failure-patients
#7
REVIEW
Martin Möckel, Julia Searle, Alan Maisel
Acute dyspnoea is a common chief complaint in the emergency department and is mainly caused by cardiac and pulmonary underlying diagnoses. In patients with acute heart failure (AHF), an early initiation of adequate therapy is important to improve patient outcome. Clinical differentiation of pulmonary and cardiac underlying causes and of concomitant pathologies determines which therapeutic strategy is chosen. Procalcitonin is a marker of bacterial infection, which is markedly increased in AHF patients with concomitant bacterial infection and thus has the potential to guide the early initiation of adequate antibiotic therapy...
August 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28776539/characteristics-management-and-outcomes-of-acute-heart-failure-in-the-emergency-department-a-multicenter-registry-study-with-1-year-follow-up-in-a-chinese-cohort-in-beijing
#8
Guo-Gan Wang, Si-Jia Wang, Jian Qin, Chun-Sheng Li, Xue-Zhong Yu, Hong Shen, Li-Pei Yang, Yan Fu, Ya-An Zheng, Bin Zhao, Dong-Min Yu, Fu-Jun Qin, De-Gui Zhou, Ying Li, Fu-Jun Liu, Wei Li, Wei Zhao, Xin Gao, Zheng Wang, Ming Jin, Hong Zeng, Yi Li, Guo-Xing Wang, Hong Zhou, Xiao-Lu Sun, Peng-Bo Wang, Kam-Sang Woo
BACKGROUND: The emergency department (ED) has a pivotal influence on the management of acute heart failure (AHF), but data concerning current ED management are scarce. This Beijing AHF Registry Study investigated the characteristics, ED management, and short- and long-term clinical outcomes of AHF. METHODS: This prospective, multicenter, observational study consecutively enrolled 3335 AHF patients who visited 14 EDs in Beijing from January 1, 2011, to September 23, 2012...
August 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28826899/impact-of-frailty-and-disability-on-30-day-mortality-in-older-patients-with-acute-heart-failure
#9
Francisco Javier Martín-Sánchez, Esther Rodríguez-Adrada, Maria Teresa Vidan, Guillermo Llopis García, Juan González Del Castillo, Miguel Alberto Rizzi, Aitor Alquezar, Pascual Piñera, Paula Lázaro Aragues, Pere Llorens, Pablo Herrero, Javier Jacob, Víctor Gil, Cristina Fernández, Héctor Bueno, Òscar Miró
The objectives were to determine the impact of frailty and disability on 30-day mortality and whether the addition of these variables to HFRSS EFFECT risk score (FBI-EFFECT model) improves the short-term mortality predictive capacity of both HFRSS EFFECT and BI-EFFECT models in older patients with acute decompensated heart failure (ADHF) atended in the emergency department. We performed a retrospective analysis of OAK Registry including all consecutive patients ≥65 years old with ADHF attended in 3 Spanish emergency departments over 4 months...
October 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28830266/using-biomarkers-to-guide-heart-failure-management
#10
Kay-Won Chang, Sutton Fox, Sean Mojaver, Alan S Maisel
Biomarkers have revolutionized the diagnosis of heart failure (HF), but it remains unclear how to use biomarkers to guide management of HF. Areas covered: An exhaustive literature search on using biomarkers to guide HF management was performed. HF guidelines were carefully scrutinized for references pertaining to this topic, and Medline was employed to identify further references. This review focused on natriuretic peptides, troponin, and ST2 as biomarkers used to guide HF management. Most trials have examined secondary prevention of chronic HF patients, and data on primary prevention of HF and therapy of acute HF are emerging...
October 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28865801/approach-to-acute-heart-failure-in-the-emergency-department
#11
REVIEW
Benton R Hunter, Jennifer Martindale, Osama Abdel-Hafez, Peter S Pang
Acute heart failure (AHF) patients rarely present complaining of 'acute heart failure.' Rather, they initially present to the emergency department (ED) with a myriad of chief complaints, symptoms, and physical exam findings. Such heterogeneity prompts an initially broad differential diagnosis; securing the correct diagnosis can be challenging. Although AHF may be the ultimate diagnosis, the precipitant of decompensation must also be sought and addressed. For those AHF patients who present in respiratory or circulatory failure requiring immediate stabilization, treatment begins even while the diagnosis is uncertain...
September 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28952056/pathophysiology-of-acute-heart-failure-syndrome-a-knowledge-gap
#12
REVIEW
Hani N Sabbah
Although much remains unknown regarding the pathophysiology of acute heart failure (AHF), precipitating events are thought to involve a complex set of interactions between the heart, kidneys, and peripheral vasculature. In addition to these interactions, which are considered the primary abnormalities in patients with AHF, several other organ systems may also be affected and contribute to disease progression. Currently available scientific literature suggests that the natural history and pathophysiology of AHF consists of two phases: (1) an "initiation phase" involving a series of triggering events, and (2) an "amplification phase," in which multiple mechanisms contribute to worsening HF and exacerbate end-organ damage...
November 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28446982/management-of-chest-trauma
#13
REVIEW
Corinna Ludwig, Aris Koryllos
Trauma is the leading cause of death worldwide. Approximately 2/3 of the patients have a chest trauma with varying severity from a simple rib fracture to penetrating injury of the heart or tracheobronchial disruption. Blunt chest trauma is most common with 90% incidence, of which less than 10% require surgical intervention of any kind. Mortality is second highest after head injury, which underlines the importance of initial management. Many of these deaths can be prevented by prompt diagnosis and treatment...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28139311/fluid-resuscitation-of-trauma-patients-how-much-fluid-is-enough-to-determine-the-patient-s-response
#14
Yasuaki Mizushima, Shota Nakao, Koji Idoguchi, Tetsuya Matsuoka
No abstract text is available yet for this article.
June 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27286136/clinical-and-research-considerations-for-patients-with-hypertensive-acute-heart-failure-a-consensus-statement-from-the-society-for-academic-emergency-medicine-and-the-heart-failure-society-of-america-acute-heart-failure-working-group
#15
Sean P Collins, Phillip D Levy, Jennifer L Martindale, Mark E Dunlap, Alan B Storrow, Peter S Pang, Nancy M Albert, G Michael Felker, Gregory J Fermann, Gregg C Fonarow, Michael M Givertz, Judd E Hollander, David E Lanfear, Daniel J Lenihan, JoAnn M Lindenfeld, W Frank Peacock, Douglas B Sawyer, John R Teerlink, Javed Butler
Management approaches for patients in the emergency department (ED) who present with acute heart failure (AHF) have largely focused on intravenous diuretics. Yet, the primary pathophysiologic derangement underlying AHF in many patients is not solely volume overload. Patients with hypertensive AHF (H-AHF) represent a clinical phenotype with distinct pathophysiologic mechanisms that result in elevated ventricular filling pressures. To optimize treatment response and minimize adverse events in this subgroup, we propose that clinical management be tailored to a conceptual model of disease that is based on these mechanisms...
August 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27027730/reliability-of-clinical-assessments-in-older-adults-with-syncope-or-near-syncope
#16
MULTICENTER STUDY
Daniel K Nishijima, Amber L Laurie, Robert E Weiss, Annick N Yagapen, Susan E Malveau, David H Adler, Aveh Bastani, Christopher W Baugh, Jeffrey M Caterino, Carol L Clark, Deborah B Diercks, Judd E Hollander, Bret A Nicks, Manish N Shah, Kirk A Stiffler, Alan B Storrow, Scott T Wilber, Benjamin C Sun
OBJECTIVES: Clinical prediction models for risk stratification of older adults with syncope or near syncope may improve resource utilization and management. Predictors considered for inclusion into such models must be reliable. Our primary objective was to evaluate the inter-rater agreement of historical, physical examination, and electrocardiogram (ECG) findings in older adults undergoing emergency department (ED) evaluation for syncope or near syncope. Our secondary objective was to assess the level of agreement between clinicians on the patient's overall risk for death or serious cardiac outcomes...
September 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27306497/spontaneous-subarachnoid-hemorrhage-a-systematic-review-and-meta-analysis-describing-the-diagnostic-accuracy-of-history-physical-examination-imaging-and-lumbar-puncture-with-an-exploration-of-test-thresholds
#17
REVIEW
Christopher R Carpenter, Adnan M Hussain, Michael J Ward, Gregory J Zipfel, Susan Fowler, Jesse M Pines, Marco L A Sivilotti
BACKGROUND: Spontaneous subarachnoid hemorrhage (SAH) is a rare, but serious etiology of headache. The diagnosis of SAH is especially challenging in alert, neurologically intact patients, as missed or delayed diagnosis can be catastrophic. OBJECTIVES: The objective was to perform a diagnostic accuracy systematic review and meta-analysis of history, physical examination, cerebrospinal fluid (CSF) tests, computed tomography (CT), and clinical decision rules for spontaneous SAH...
September 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27611638/emergency-department-management-of-patients-with-febrile-neutropenia-guideline-concordant-or-overly-aggressive
#18
Christopher W Baugh, Thomas J Wang, Jeffrey M Caterino, Olesya N Baker, Gabriel A Brooks, Audrey C Reust, Daniel J Pallin
OBJECTIVES: The Infectious Diseases Society of America and the American Society of Clinical Oncology recommend risk stratification of patients with febrile neutropenia (FN) and discharge with oral antibiotics for low-risk patients. We studied guideline concordance and clinical outcomes of FN management in our emergency department (ED). METHODS: Our urban, tertiary care teaching hospital provides all emergency and inpatient services to a large comprehensive cancer center...
January 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/27743490/an-observational-study-of-dyspnea-in-emergency-departments-the-asia-australia-and-new-zealand-dyspnea-in-emergency-departments-study-aanzdem
#19
MULTICENTER STUDY
Anne Maree Kelly, Gerben Keijzers, Sharon Klim, Colin A Graham, Simon Craig, Win Sen Kuan, Peter Jones, Anna Holdgate, Charles Lawoko, Said Laribi
OBJECTIVES: The objective was to describe the epidemiology of dyspnea presenting to emergency departments (EDs) in the Asia-Pacific region, to understand how it is investigated and treated and its outcome. METHODS: Prospective interrupted time series cohort study conducted at three time points in EDs in Australia, New Zealand, Singapore, Hong Kong, and Malaysia of adult patients presenting to the ED with dyspnea as a main symptom. Data were collected over three 72-hour periods and included demographics, comorbidities, mode of arrival, usual medications, prehospital treatment, initial assessment, ED investigations, treatment in the ED, ED diagnosis, disposition from ED, in-hospital outcome, and final hospital diagnosis...
March 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/25144398/predictive-accuracy-and-feasibility-of-risk-stratification-scores-for-28-day-mortality-of-patients-with-sepsis-in-an-emergency-department
#20
Michelle J M Hilderink, Asselina A Roest, Maud Hermans, Yolande C Keulemans, Coen D A Stehouwer, Patricia M Stassen
OBJECTIVES: Sepsis is associated with high mortality. Because early therapy has proven to decrease mortality, a risk stratification tool that quickly and easily quantifies mortality risk of patients will be helpful to guide appropriate treatment. We investigated five scores in terms of (a) predicting 28-day mortality and (b) their feasibility for use in the emergency department (ED). MATERIALS AND METHODS: We carried out a historical cohort study in the ED of Maastricht University Medical Centre (MUMC)...
October 2015: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
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