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https://read.qxmd.com/read/30769350/-focused-transthoracic-echocardiography-in-the-perioperative-setting
#1
Benjamin Vojnar, Martin Zoremba
With focused transthoracic echocardiography (TTE) we rapidly and non-invasively receive up-to-date information on a patient's hemodynamic status. These can subsequently influence our therapy and thus our risk management. Postoperatively, TTE has proved its worth as an examination method in the recovery room and in the intensive care unit to promptly diagnose life-threatening causes of circulatory depression. Acute pathology such as a pericardial tamponade or fulminant pulmonary artery embolism can be detected quickly and thus possibly time-consuming transport to a CT can be avoided...
February 2019: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://read.qxmd.com/read/30760326/achieving-ethnic-equality-in-the-israel-trauma-healthcare-system-the-case-of-the-elderly-population
#2
Nura Abdel-Rahman, Nechemia Yoffe, Maya Siman-Tov, Irina Radomislensky, Kobi Peleg
OBJECTIVE: To determine if ethnic disparities exist with regard to the risk of injury and injury outcomes among elderly hospitalized casualties in Israel. METHODS: A retrospective study based on data from the Israeli National Trauma Registry between 2008 and 2017. Data included demographic, injury and hospitalization characteristics. Descriptive statistics and adjusted logistic regression were used to examine the differences between Jewish and Arab casualties, aged 65 and older...
February 13, 2019: Israel Journal of Health Policy Research
https://read.qxmd.com/read/30711087/uncuffed-endotracheal-tubes-not-appropriate-for-pediatric-critical-care-transport
#3
Thomas E Pearson, Meg A Frizzola, Henry H Khine
OBJECTIVE: The effect of using uncuffed endotracheal tubes in children during interfacility critical care transport has not yet been assessed. We hypothesized that many children with uncuffed endotracheal tubes experience complications leading to replacement with a cuffed tube after arrival at a tertiary pediatric care facility. METHODS: We conducted a retrospective case review of all intubated patients transported by our dedicated pediatric critical care transport team to our pediatric intensive care unit over a 3-year period...
January 2019: Air Medical Journal
https://read.qxmd.com/read/30681711/injuries-associated-with-standing-electric-scooter-use
#4
Tarak K Trivedi, Charles Liu, Anna Liza M Antonio, Natasha Wheaton, Vanessa Kreger, Anna Yap, David Schriger, Joann G Elmore
Importance: Since September 2017, standing electric scooters have proliferated rapidly as an inexpensive, easy mode of transportation. Although there are regulations for safe riding established by both electric scooter companies and local governments, public common use practices and the incidence and types of injuries associated with these standing electric scooters are unknown. Objective: To characterize injuries associated with standing electric scooter use, the clinical outcomes of injured patients, and common use practices in the first US metropolitan area to experience adoption of this technology...
January 4, 2019: JAMA network open
https://read.qxmd.com/read/30674422/improving-quality-and-safety-during-intrahospital-transport-of-critically-ill-patients-a-critical-incident-study
#5
Lina Bergman, Monica Pettersson, Wendy Chaboyer, Eric Carlström, Mona Ringdal
BACKGROUND: Intrahospital transport is a high-risk procedure for critically ill patients, yet there is little known about how the transport team manages critical incidents that occur. OBJECTIVES: The aim of this study was to explore critical care nurses' and physicians' experiences and practices associated with critical incidents during the transfer process in critically ill patients. METHODS: As a part of an ethnographic study, semistructured interviews were performed using the critical incident technique...
January 21, 2019: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://read.qxmd.com/read/30654012/the-acute-respiratory-distress-syndrome-after-out-of-hospital-cardiac-arrest-incidence-risk-factors-and-outcomes
#6
Nicholas J Johnson, Ellen Caldwell, David J Carlbom, David F Gaieski, Matthew E Prekker, Thomas D Rea, Michael Sayre, Catherine L Hough
OBJECTIVE: To define the incidence of the acute respiratory distress syndrome (ARDS) following out-of-hospital cardiac arrest (OHCA) and characterize its impact on outcome. METHODS: This was a retrospective cohort study conducted at two urban, tertiary, academic hospitals from 2007 to 2014. We included adults with non-traumatic OHCA and survived for ≥48 h. Patients who received mechanical ventilation for ≥24 h, had 2 consecutive arterial blood gases with a ratio of the partial pressure of oxygen to the fraction of inspired oxygen ≤300, and bilateral radiographic opacities within 48 h of hospital admission were defined as having ARDS...
January 14, 2019: Resuscitation
https://read.qxmd.com/read/30585862/superior-performance-of-national-early-warning-score-compared-with-quick-sepsis-related-organ-failure-assessment-score-in-predicting-adverse-outcomes-a-retrospective-observational-study-of-patients-in-the-prehospital-setting
#7
Daniel J Silcock, Alasdair R Corfield, Kevin D Rooney, Harry Staines
BACKGROUND: Early intervention and response to deranged physiological parameters in the critically ill patient improve outcomes. A National Early Warning Score (NEWS) based on physiological observations has been developed for use throughout the National Health Service in the UK. The quick Sepsis-related Organ Failure Assessment Score (qSOFA) was developed as a simple bedside criterion to identify adult patients outwith the ICU with suspected infection who are likely to have a prolonged ICU stay or die in hospital...
December 24, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://read.qxmd.com/read/30580487/adverse-events-in-radiation-oncology-a-case-series-from-wake-up-safe-the-pediatric-anesthesia-quality-improvement-initiative
#8
Robert E Christensen, Rebecca C Nause-Osthoff, Jeffrey C Waldman, Daniel E Spratt, Jason W D Hearn
BACKGROUND: Radiation therapy in pediatric patients often requires anesthesia and poses environmental challenges. Monitoring must be done remotely to limit radiation exposure to the provider. Airway access can be limited by masks or frames. Care is often delivered in relatively inaccessible locations in the hospital. While individual institutions have reported their outcomes, this case series aims to review a multicenter registry of significant adverse events (SAE) and make recommendations for improved care...
December 23, 2018: Paediatric Anaesthesia
https://read.qxmd.com/read/30579349/a-comparison-of-postoperative-outcomes-with-pda-ligation-in-the-or-versus-the-nicu-a-retrospective-cohort-study-on-the-risks-of-transport
#9
Lisa K Lee, Michelle Y Woodfin, Marissa G Vadi, Tristan R Grogan, Phillip J Ross, Richard L Applegate, Marc Iravani
BACKGROUND: Although patent ductus arteriosus (PDA) ligations in the Neonatal Intensive Care Unit (NICU) have been an accepted practice, many are still performed in the Operating Room (OR). Whether avoiding transport leads to improved perioperative outcomes is unclear. Here we aimed to determine whether PDA ligations in the NICU corresponded to higher risk of surgical site infection or mortality and if transport was associated with worsened perioperative outcomes. METHODS: We performed a retrospective cohort study of NICU patients, ≤37 weeks post-menstrual age, undergoing surgical PDA ligation in the NICU or OR...
December 22, 2018: BMC Anesthesiology
https://read.qxmd.com/read/30551233/impact-of-time-to-neonatal-transport-on-outcomes-of-transient-tachypnea-of-the-newborn
#10
Katsuya Hirata, Masatoshi Nozaki, Narutaka Mochizuki, Shinya Hirano, Kazuko Wada
OBJECTIVE:  To assess effects of neonatal transport on transient tachypnea of the newborn (TTN) in outborn term neonates. STUDY DESIGN:  This retrospective cohort study included 66 term neonates diagnosed with TTN and transported to the Osaka Women's and Children's Hospital neonatal intensive care unit between January 2003 and March 2018. A multivariate logistic regression analysis identified perinatal and neonatal transport factors associated with adverse short-term outcomes defined as mechanical ventilation >48 hours, continuous positive airway pressure >72 hours, pulmonary hemorrhage, and requirement for inhaled nitric oxide, thoracentesis, or surfactant replacement therapy...
December 14, 2018: American Journal of Perinatology
https://read.qxmd.com/read/30535190/cerebrospinal-fluid-pharmacokinetics-of-ceftaroline-in-neurosurgical-patients-with-an-external-ventricular-drain
#11
Alexia Chauzy, Abdelouaid Nadji, Jean-Christophe Combes, Nadine Defrance, Belaid Bouhemad, William Couet, Pascal Chavanet
Background: Owing to its antibacterial properties, ceftaroline could be attractive for prevention or treatment of bacterial post-neurosurgical meningitis/ventriculitis. However, few data are available concerning its meningeal concentrations. Objectives: To investigate ceftaroline CSF pharmacokinetics in ICU patients with an external ventricular drain (EVD). Methods: Patients received a single 600 mg dose of ceftaroline as a 1 h intravenous infusion...
December 6, 2018: Journal of Antimicrobial Chemotherapy
https://read.qxmd.com/read/30527483/can-planned-traffic-patterns-improve-survival-among-the-injured-during-mass-casualty-motorcycle-rallies
#12
Cecily DuPree, Aaron Pinnola, Stefanie Gibson, Keely Muertos, John M Davis, Jason D Sciarretta
BACKGROUND: Mass casualty events are infrequent and create an abrupt surge of patients requiring emergency medical services within a brief period. We hypothesize that implementation of a controlled "traffic loop" pattern during a planned high-volume motorcycle rally could improve overall mortality and impact patient outcomes. MATERIALS AND METHODS: We performed a retrospective analysis of all motorcycle-related injuries during the city's annual motorcycle rally over a 4-y period...
February 2019: Journal of Surgical Research
https://read.qxmd.com/read/30517197/the-aquaporin-5-1364a-c-promoter-polymorphism-impacts-on-resolution-of-acute-kidney-injury-in-pneumonia-evoked-ards
#13
Tim Rahmel, Hartmuth Nowak, Katharina Rump, Winfried Siffert, Jürgen Peters, Michael Adamzik
BACKGROUND: Aquaporin 5 (AQP5) expression impacts on cellular water transport, renal function but also on key mechanisms of inflammation and immune cell migration that prevail in sepsis and ARDS. Thus, the functionally relevant AQP5 -1364A/C promoter single nucleotide polymorphism could impact on the development and resolution of acute kidney injury (AKI). Accordingly, we tested the hypothesis that the AQP5 promoter -1364A/C polymorphism is associated with AKI in patients suffering from pneumonia evoked ARDS...
2018: PloS One
https://read.qxmd.com/read/30513050/homeward-bound-a-case-series-of-cross-cultural-care-at-end-of-life-enhanced-by-pediatric-palliative-transport
#14
Megan J Thorvilson, Aubrey J Manahan, Brenda M Schiltz, Christopher A Collura
For most families, the preferred location of death for their child is home, yet most children still die in the hospital. Many children with life-threatening and life-limiting illness are medically dependent on technology, and palliative transport can serve as a bridge from the intensive care unit to the family's home to achieve family-centered goals of care. Palliative transport may also present an opportunity to prioritize cultural care and rituals at end of life which cannot be provided in the hospital. We describe a case series of pediatric patients from communities espousing markedly diverse cross-cultural values and limited financial resources...
December 4, 2018: Journal of Palliative Medicine
https://read.qxmd.com/read/30508979/effectiveness-of-intrahospital-transportation-of-mechanically-ventilated-patients-in-medical-intensive-care-unit-by-the-rapid-response-team-a-cohort-study
#15
Won Gun Kwack, Miae Yun, Dong Seon Lee, Hyunju Min, Yun Young Choi, Sung Yoon Lim, Youlim Kim, Sang Hoon Lee, Yeon Joo Lee, Jong Sun Park, Young-Jae Cho
Critically ill patients could experience various risks including life-threatening events during intrahospital transportation (IHT), with a global incidence of 20% to 79.8%. Evidence on the clinical benefits of the presence of specialized intensive care members such as the rapid response team (RRT) during their transportation is limited. We aimed to elucidate the RRT's effectiveness in promoting patient's safety outcomes during transportation by comparing with those transport by general members.A single-center retrospective cohort study was conducted from January 2016 to February 2017, including critically ill patients admitted to the medical intensive care unit (ICU) due to respiratory failure under mechanical ventilation...
November 2018: Medicine (Baltimore)
https://read.qxmd.com/read/30477034/association-between-the-degree-of-twin-birthweight-discordance-and-perinatal-outcomes
#16
Lena H Kim, Aaron B Caughey, Lynn M Yee, Yvonne W Cheng
BACKGROUND:  Twin birthweight discordance is associated with adverse outcomes. OBJECTIVE:  To determine what degree of twin birthweight discordance is associated with adverse outcomes. STUDY DESIGN:  This is a retrospective cohort study of twins with vertex twin A delivered vaginally at 36 to 40 weeks (U.S. Vital Statistics Natality birth certificate registry data 2012-2014). The primary outcome was a composite of neonatal morbidity: 5-minute Apgar < 7, neonatal intensive care unit admission, neonatal mechanical ventilation > 6 hours, neonatal seizure, and/or neonatal transport to a higher level of care...
November 26, 2018: American Journal of Perinatology
https://read.qxmd.com/read/30473224/differences-in-hospital-outcomes-following-traumatic-injury-for-patients-experiencing-immediate-transfer-to-a-level-i-trauma-facility-versus-resuscitation-at-a-critical-access-hospital-cah
#17
Jered Windorski, Jared Reyes, Stephen D Helmer, Jeanette G Ward, James M Haan
BACKGROUND: Critical access hospitals (CAH) serve a key role in providing medical care to rural patients. The purpose of this study was to assess effectiveness of CAHs in initial care of trauma patients. METHODS: A 5-year retrospective review was conducted of all adult trauma patients who were transported directly to a level I trauma facility or were transported to a CAH then transferred to a level I trauma facility after initial resuscitation. RESULTS: Of 1478 patients studied, 1084 were transferred from a CAH with 394 transported directly to the level I facility...
November 14, 2018: American Journal of Surgery
https://read.qxmd.com/read/30472669/management-of-severe-bronchiolitis-impact-of-nice-guidelines
#18
Benedict Griffiths, Shelley Riphagen, Jon Lillie
OBJECTIVE: To understand the impact of the National Institute for Health and Care Excellence (NICE) bronchiolitis guidelines on the management of children referred to paediatric intensive care unit (PICU) with bronchiolitis. DESIGN AND SETTING: Data were collected on all children referred to a regional PICU transport service with the clinical diagnosis of bronchiolitis during the winter prior to the NICE consultation period (2011-2012) and during the winter after publication (2015-2016)...
November 24, 2018: Archives of Disease in Childhood
https://read.qxmd.com/read/30460180/from-the-street-to-the-icu-a-review-of-pediatric-emergency-medical-services-and-critical-care-transport
#19
REVIEW
Sang Hoon Lee, Hamilton P Schwartz, Michael T Bigham
Emergency medical services and critical care transport teams are relatively new parts of the American healthcare delivery system. Although most healthcare providers regularly interact with these groups and rely upon their almost ubiquitous availability, few know how these services developed or what sort of infrastructure currently exists to maintain them. This article provides a focused overview of the history and present practices of both emergency medical services and critical care transport teams, with a concentrated look at the implementation of these services in the pediatric population...
October 2018: Translational Pediatrics
https://read.qxmd.com/read/30454985/sepsis-alerts-in-ems-and-the-results-of-pre-hospital-etco2
#20
Steven J Weiss, Angel Guerrero, Christian Root-Bowman, Amy Ernst, Kurt Krumperman, Jon Femling, Phil Froman
BACKGROUND: Field sepsis alerts have the ability to expedite initial ED sepsis treatment. Our hypothesis is that in patients that meet EMS sepsis alert criteria there is a strong relationship between prehospital end-tidal carbon dioxide (ETCO2) readings and the outcome of diagnosed infection. METHODS: In 2014, our EMS service initiated a protocol requiring hospitals to receive notification of a "sepsis alert" on all suspected sepsis patients. The EMS service transports 70,000 patients/year to a number of urban centers...
November 8, 2018: American Journal of Emergency Medicine
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