1225 Records downloaded - Wed Jan 24 17:30:41 UTC 2018
RECORD 1
TITLE
Spatial methods for evaluating critical care and trauma transport: A scoping
review
AUTHOR NAMES
Vasilyeva K.
Widener M.J.
Galvagno S.M.
Ginsberg Z.
AUTHOR ADDRESSES
(Vasilyeva K.; Widener M.J., michael.widener@utoronto.ca) Department of
Geography and Planning, University of Toronto St. George, 100 St. George St,
Toronto, Canada.
(Galvagno S.M.) Department of Anesthesiology and the Program in Trauma, R
Adams Cowley Shock Trauma Center University of Maryland School of Medicine,
655 W Baltimore S, Baltimore, United States.
(Ginsberg Z.) Kettering Medical Center, Departments of Emergency Medicine &
Critical Care, 3535 Southern Blvd, Kettering, United States.
CORRESPONDENCE ADDRESS
M.J. Widener, Department of Geography and Planning, University of Toronto
St. George, 100 St. George St, Toronto, Canada. Email:
michael.widener@utoronto.ca
SOURCE
Journal of Critical Care (2018) 43 (265-270). Date of Publication: 1 Feb
2018
ISSN
1557-8615 (electronic)
0883-9441
BOOK PUBLISHER
W.B. Saunders
ABSTRACT
Purpose The objective of this scoping review is to inform future
applications of spatial research regarding transportation of critically ill
patients. We hypothesized that this review would reveal gaps and limitations
in the current research regarding use of spatial methods for critical care
and trauma transport research. Materials and methods Four online databases,
Ovid Medline, PubMed, Embase and Scopus, were searched. Studies were
selected if they used geospatial methods to analyze a patient transports
dataset. 12 studies were included in this review. Results Majority of the
studies employed spatial methods only to calculate travel time or distance
even though methods and tools for more complex spatial analyses are widely
available. Half of the studies were found to focus on hospital bypass, 2
studies focused on transportation (air or ground) mode selection, 2 studies
compared predicted versus actual travel times, and 2 studies used spatial
modeling to understand spatial variation in travel times. Conclusions There
is a gap between the availability of spatial tools and their usage for
analyzing and improving medical transportation. The adoption of geospatially
guided transport decisions can meaningfully impact healthcare expenditures,
especially in healthcare systems looking to strategically control
expenditures with minimum impact on patient outcomes.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
medical geography
patient transport
spatial analysis
EMTREE MEDICAL INDEX TERMS
air medical transport
emergency health service
geographic information system
human
review
statistical model
systematic review
traffic and transport
travel
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170872890
PUI
L619600261
DOI
10.1016/j.jcrc.2017.08.039
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jcrc.2017.08.039
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 2
TITLE
Skin-to-skin hospital transfers are physiologically sound and empower
parents
AUTHOR NAMES
Kjellberg M.
AUTHOR ADDRESSES
(Kjellberg M., mattias.kjellberg@akademiska.se) Neonatal Transport Service,
Department of Neonatal Intensive Care, Uppsala University Childrens
Hospital, Uppsala, Sweden.
CORRESPONDENCE ADDRESS
M. Kjellberg, Neonatal Transport Service, Department of Neonatal Intensive
Care, Uppsala University Childrens Hospital, Uppsala, Sweden. Email:
mattias.kjellberg@akademiska.se
SOURCE
Acta Paediatrica, International Journal of Paediatrics (2018) 107:1 (165).
Date of Publication: 1 Jan 2018
ISSN
1651-2227 (electronic)
0803-5253
BOOK PUBLISHER
Blackwell Publishing Ltd, customerservices@oxonblackwellpublishing.com
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
newborn intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
human
medical staff
neonatal intensive care unit
note
parent
patient safety
priority journal
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20170875243
PUI
L619712125
DOI
10.1111/apa.14129
FULL TEXT LINK
http://dx.doi.org/10.1111/apa.14129
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 3
TITLE
Highlights in this issue
AUTHOR NAMES
Käll A.
Lagercrantz H.
AUTHOR ADDRESSES
(Käll A.; Lagercrantz H., hugo.lagercrantz@actapaediatrica.se) Acta
Paediatrica, Stockholm, Sweden.
SOURCE
Acta Paediatrica, International Journal of Paediatrics (2018) 107:1 (6-7).
Date of Publication: 1 Jan 2018
ISSN
1651-2227 (electronic)
0803-5253
BOOK PUBLISHER
Blackwell Publishing Ltd, customerservices@oxonblackwellpublishing.com
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
oxygen
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cost control
delivery room
dyslexia
health personnel attitude
neonatal intensive care unit
patient transport
practice guideline
prematurity
professional-patient relationship
EMTREE MEDICAL INDEX TERMS
clinical outcome
editorial
health practitioner
human
medical staff
parent
priority journal
resuscitation
CAS REGISTRY NUMBERS
oxygen (7782-44-7)
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Neurology and Neurosurgery (8)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20170875244
PUI
L619712127
DOI
10.1111/apa.14146
FULL TEXT LINK
http://dx.doi.org/10.1111/apa.14146
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 4
TITLE
The really organized and detailed transporting of inpatients: The road trip
study
AUTHOR NAMES
Kapileshwarkar Y.
Cashen K.
Shah J.
Tilford B.
AUTHOR ADDRESSES
(Kapileshwarkar Y.; Cashen K.; Shah J.; Tilford B.) Children's Hospital of
Michigan, Detroit, United States.
CORRESPONDENCE ADDRESS
Y. Kapileshwarkar, Children's Hospital of Michigan, Detroit, United States.
SOURCE
Critical Care Medicine (2018) 46 Supplement 1 (625). Date of Publication: 1
Jan 2018
CONFERENCE NAME
47th Society of Critical Care Medicine Critical Care Congress, SCCM 2018
CONFERENCE LOCATION
San Antonio, TX, United States
CONFERENCE DATE
2018-02-25 to 2018-02-28
ISSN
1530-0293
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Learning Objectives: Inter and intra-facility transport has focused on
adverse events (AEs) because the transport of critically ill patients puts
them at risk for morbidity and mortality. Few studies have identified a tool
for transporting patients to a new PICU. We developed a novel QI tool for
transporting patients to a new PICU in a large tertiary care facility. The
objective of this study was to evaluate the efficiency of a standardized
tool, identify missing equipment and describe the frequency and severity of
AEs. Methods: A transport safety tool was developed with multidisciplinary
input. The tool addressed patient features, equipment, medications and
availability of resources for transport. The tool was used in a simulated
move and modified for consistency then utilized during the actual move. The
tool was reviewed to identify failures and adverse events. Minor failures
included missed assessment, equipment or chart. Major failures included
missing respiratory equipment, circulatory equipment/monitoring, or critical
medications. Minor AEs were defined as any event where the patient remained
stable. Major AEs included an event requiring intervention to improve
cardiorespiratory status. Data are reported as frequency (n) with proportion
(%) or median with IQR. Univariate analyses were performed using the
Wilcoxon rank sum or Fisher's exact tests. Statistical analysis was
performed using SPSS version 21. Results: Included were 27 transports. The
median age was 24 months IQR (6, 108). Median weight was 18 kg IQR (6.8,
28). In this cohort, 63% of patients had a diagnosis of congenital heart
disease, 15% had chronic respiratory failure, 11% had a primary neurologic
diagnosis, 11% had a primary oncologic diagnosis. 19 episodes of minor
failures and 17 major failures were identified. The median preparation time
was 15 minutes IQR (9.7, 28.6). The median travel time was 7 minutes IQR (4,
7). 12 (44%) patients suffered an AE during transport. Major AEs requiring
intervention occurred in 18.5% of transports and minor AEs occurred in 26%.
Patients receiving mechanical ventilation (MV) were more likely to suffer
major AEs compared to patients without MV (80% vs. 5%, p = 0.001). AEs were
not associated with the need for inotropic support (p = 0.15). No patient
had a severe life-threatening event during transport. Conclusions: Using a
novel standardized tool to transport PICU patients to a new unit was
feasible, efficient and useful in identifying missing patient assessments,
equipment, and medications.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital patient
EMTREE MEDICAL INDEX TERMS
adverse event
artificial ventilation
child
chronic respiratory failure
clinical article
cohort analysis
congenital heart disease
controlled study
data analysis software
diagnosis
female
human
inotropism
male
monitoring
nervous system
patient assessment
preschool child
respiratory equipment
simulation
tertiary care center
travel
univariate analysis
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L620080662
DOI
10.1097/01.ccm.0000529287.19017.65
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000529287.19017.65
COPYRIGHT
Copyright 2018 Elsevier B.V., All rights reserved.
RECORD 5
TITLE
Elective transfers of preterm neonates to regional centres on non-invasive
respiratory support is cost effective and increases tertiary care bed
capacity
AUTHOR NAMES
Zein H.
Yusuf K.
Paul R.
Kowal D.
Thomas S.
AUTHOR ADDRESSES
(Zein H., hussein.zein@ucalgary.ca; Yusuf K.; Thomas S.) Section of
Neonatology, Department of Paediatrics, Cumming School of Medicine,
University of Calgary, Calgary, Canada.
(Paul R.; Kowal D.) Foothills Medical Centre, Calgary, Canada.
CORRESPONDENCE ADDRESS
H. Zein, Section of Neonatology, Department of Paediatrics, Cumming School
of Medicine, University of Calgary, Calgary, Canada. Email:
hussein.zein@ucalgary.ca
SOURCE
Acta Paediatrica, International Journal of Paediatrics (2018) 107:1 (52-56).
Date of Publication: 1 Jan 2018
ISSN
1651-2227 (electronic)
0803-5253
BOOK PUBLISHER
Blackwell Publishing Ltd, customerservices@oxonblackwellpublishing.com
ABSTRACT
Aim: Managing capacity at regional facilities caring for sick neonates is
increasingly challenging. This study estimated the clinical and economic
impact of the elective transfer of stable infants requiring nasal continuous
positive airway pressure (NCPAP) from level three to level two neonatal
intensive care units (NICUs) within an established clinical network of five
NICUs. Methods: We retrospectively analysed the records of 99 stable infants
transferred on NCPAP between two level three NICUs and three level two NICUs
in Calgary, Canada, between June 2014 and May 2016. Results: The median
gestational age and weight at birth were 28 weeks and 955 g, and the median
corrected gestational age and weight at transfer were 33 weeks and 1597 g,
respectively. This resulted in cost savings of $2.65 million Canadian
dollars during the two-year study period, and 848 level three NICU days were
freed up for potentially sick neonates. There were no adverse events
associated with the transfers. Conclusion: The elective transfer of stable
neonates on NCPAP from level three to level two NICUs within an established
clinical network led to substantial cost savings, was safe and increased the
bed capacity at the two level three NICUs.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital bed capacity
neonatal intensive care unit
noninvasive ventilation
patient transport
positive end expiratory pressure
prematurity (disease management)
tertiary health care
EMTREE MEDICAL INDEX TERMS
article
birth weight
Canada
cost control
cost effectiveness analysis
female
gestational age
human
infant
major clinical study
male
priority journal
retrospective study
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170703954
PUI
L618655371
DOI
10.1111/apa.14059
FULL TEXT LINK
http://dx.doi.org/10.1111/apa.14059
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 6
TITLE
Near-infrared spectroscopy use in critical care transport in a patient with
multifactorial shock
AUTHOR NAMES
Walenta T.
Parker J.
Turner-Nelson K.
Maurer J.
AUTHOR ADDRESSES
(Walenta T.; Parker J.; Turner-Nelson K.; Maurer J.) Children's Hospital of
Wisconsin, Wauwatosa, United States.
CORRESPONDENCE ADDRESS
T. Walenta, Children's Hospital of Wisconsin, Wauwatosa, United States.
SOURCE
Critical Care Medicine (2018) 46 Supplement 1 (147). Date of Publication: 1
Jan 2018
CONFERENCE NAME
47th Society of Critical Care Medicine Critical Care Congress, SCCM 2018
CONFERENCE LOCATION
San Antonio, TX, United States
CONFERENCE DATE
2018-02-25 to 2018-02-28
ISSN
1530-0293
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Learning Objectives: A 14 year old patient with a history of truncus
arteriosus, status post repair, presented to an outside hospital ER in
respiratory distress. The information relayed to our transport referral
center included vital signs reported as Temp 36.6 °C, RR 26, HR 144, BP
113/52 with sPO2 95% on 4L via oxymask. Additional information included
severe RV to PA conduit stenosis seen on echo with poor visualization of
function, no urine output over 2 days and cool, mottled extremities. He
received a 500 ml normal saline bolus and antibiotics were initiated.
Methods: Our transport team was dispatched via helicopter. Upon arrival,
initial vital signs obtained by our transport team were: Temp 36.5° C, HR
153, RR 48, BP 81/52 MAP 62, SpO2 96% on 8L oxymask with an initial
assessment indicating that the patient was alert and oriented x3, tachypneic
with bilateral wheezes and mild retractions. Patient was tachycardic with a
right bundle branch block, mottled, dusky, cyanotic, with a capillary refill
time of greater than 7 seconds. Within 10 minutes the patients BP was
unobtainable, HR 150, RR 51, SpO2 100% and upon placement of near-infrared
spectroscopy (NIRs), the cerebral (cNIRs) was 71 and renal (rNIRs) was 39.
An epinephrine drip was initiated for poor perfusion and low renal (rNIRs)
signifying late stages of shock. Within 5 minutes of initiation, the patient
developed unobtainable renal NIRs despite having an improved BP of 83/46 and
therefore the epinephrine drip was titrated up until improvement in rNIRs.
Subsequent vital signs were a BP 90/42, HR 146, RR 66, sPO2 100%, cNIRs 64,
rNIRs 45 a norepinephrine drip was also initiated. Vital signs after
initiation of norepinephrine were HR 142, BP 91/51, RR 56, sPO2 99%, cNIRs
75 and rNIRs 53. Upon return to the receiving hospital the patient required
initiation of mechanical circulatory support Results: In this patient
scenario, NIRs monitoring helped us escalate inotropic support rapidly in a
pre-cardiac arrest state. NIRs assisted in decision making when we were
unable to rely on vitals or exam findings to demonstrate a change in
perfusion.
EMTREE DRUG INDEX TERMS
antibiotic agent
epinephrine
noradrenalin
sodium chloride
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
near infrared spectroscopy
EMTREE MEDICAL INDEX TERMS
adolescent
arterial trunk
assisted circulation
brain
clinical article
decision making
diuresis
heart arrest
heart right bundle branch block
helicopter
human
inotropism
learning
limb
male
monitoring
patient referral
perfusion
respiratory distress
stenosis
tachycardia
vital sign
wheezing
CAS REGISTRY NUMBERS
epinephrine (51-43-4, 55-31-2, 6912-68-1)
noradrenalin (1407-84-7, 51-41-2)
sodium chloride (7647-14-5)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L620081791
DOI
10.1097/01.ccm.0000528349.63041.87
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000528349.63041.87
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 7
TITLE
Using polyethylene plastic bag to prevent moderate hypothermia during
transport in very low birth weight infants: a randomized trial
AUTHOR NAMES
Hu X.-J.
Wang L.
Zheng R.-Y.
Lv T.-C.
Zhang Y.-X.
Cao Y.
Huang G.-Y.
AUTHOR ADDRESSES
(Hu X.-J.; Wang L.; Zheng R.-Y.; Lv T.-C.; Zhang Y.-X.; Cao Y.; Huang G.-Y.,
gyhuang@shmu.edu.cn) Neonatal Intensive Care Unit, Children’s Hospital of
Fudan University, Shanghai, China.
(Huang G.-Y., gyhuang@shmu.edu.cn) Shanghai Key Laboratory of Birth Defects,
Shanghai, China.
CORRESPONDENCE ADDRESS
G.-Y. Huang, Neonatal Intensive Care Unit, Children’s Hospital of Fudan
University, Shanghai, China. Email: gyhuang@shmu.edu.cn
SOURCE
Journal of Perinatology (2017) (1-5). Date of Publication: 27 Dec 2017
ISSN
1476-5543 (electronic)
0743-8346
BOOK PUBLISHER
Nature Publishing Group, Houndmills, Basingstoke, Hampshire, United Kingdom.
ABSTRACT
Objective: Hypothermia remains a significant problem among very low birth
weight (VLBW) infants. The use of occlusive polyethylene plastic bags
immediately after birth has been proven to be effective for preterm infants
to reduce hypothermia. This study aims to determine whether placing VLBW
infants in plastic bags during transport reduces hypothermia. Study design:
Study infants were randomly assigned to a standard thermoregulation protocol
or to a standard thermoregulation protocol with placement of the torso and
lower extremities inside a polyethylene plastic bag during transport. The
primary outcome measures were axillary temperature before and after
transport and the occurrence of moderate hypothermia upon neonatal intensive
care unit admission. Result: The 108 VLBW infants recruited into the study
were randomized to the plastic bag (n = 54) group or to standard group (n =
54) and had similar baseline characteristics. VLBW infants in the plastic
bag group had a lower rate of moderate hypothermia (3.7 vs 27.8%; risk ratio
0.10; confidence interval 0.02–0.46; P < 0.001) and higher axillary
temperatures (36.4 ± 0.4 °C vs 35.9 ± 0.9 °C; P = 0.001) upon NICU admission
compared to infants receiving standard care. Conclusion: Placing VLBW
infants in polyethylene plastic bags during transport reduces the occurrence
of hypothermia, especially moderate hypothermia.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
polyethylene
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hypothermia
very low birth weight
EMTREE MEDICAL INDEX TERMS
axilla temperature
drug therapy
female
human
infant
lower limb
major clinical study
male
neonatal intensive care unit
outcome assessment
prevention
randomized controlled trial
study design
thermoregulation
trunk
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170907679
PUI
L619981034
DOI
10.1038/s41372-017-0028-0
FULL TEXT LINK
http://dx.doi.org/10.1038/s41372-017-0028-0
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 8
TITLE
Feasibility and Safety of Controlled Active Hypothermia Treatment during
Transport in Neonates with Hypoxic-Ischemic Encephalopathy
AUTHOR NAMES
Szakmar E.
Kovacs K.
Meder U.
Nagy A.
Szell A.
Bundzsity B.
Somogyvari Z.
Szabo A.J.
Szabo M.
Jermendy A.
AUTHOR ADDRESSES
(Szakmar E.; Kovacs K.; Meder U.; Szabo A.J.; Szabo M.; Jermendy A.,
jermendy.agnes@med.semmelweis-univ.hu) 1st Department of Paediatrics,
Semmelweis University, 53 Bokay ut, Budapest, Hungary.
(Nagy A.; Szell A.; Bundzsity B.; Somogyvari Z.) Neonatal Emergency and
Transport Services of Peter Cerny Foundation, Budapest, Hungary.
(Szabo A.J.) MTA-SE Pediatric and Nephrology Research Group, Budapest,
Hungary.
CORRESPONDENCE ADDRESS
A. Jermendy, 1st Department of Paediatrics, Semmelweis University, 53 Bokay
ut, Budapest, Hungary. Email: jermendy.agnes@med.semmelweis-univ.hu
SOURCE
Pediatric Critical Care Medicine (2017) 18:12 (1159-1165). Date of
Publication: 1 Dec 2017
ISSN
1947-3893 (electronic)
1529-7535
BOOK PUBLISHER
Lippincott Williams and Wilkins, kathiest.clai@apta.org
ABSTRACT
Objectives: To evaluate the feasibility and safety of controlled active
hypothermia versus standard intensive care during neonatal transport in
patients with hypoxic-ischemic encephalopathy. Design: Cohort study with a
historic control group. Setting: All infants were transported by Neonatal
Emergency & Transport Services to a Level-III neonatal ICU. Patients: Two
hundred fourteen term newborns with moderate-to-severe hypoxic-ischemic
encephalopathy. An actively cooled group of 136 newborns were compared with
a control group of 78 newborns. Interventions: Controlled active hypothermia
during neonatal transport. Measurements and Main Results: Key measured
variables were timing of hypothermia initiation, temperature profiles, and
vital signs during neonatal transport. Hypothermia was initiated a median
2.58 hours earlier in the actively cooled group compared with the control
group (median 1.42 [interquartile range, 0.83-2.07] vs 4.0 [interquartile
range, 2.08-5.79] hours after birth, respectively; p < 0.0001), and target
temperature was also achieved a median 1.83 hours earlier (median 2.42
[1.58-3.63] vs 4.25 [2.42-6.08] hours after birth, respectively; p <
0.0001). Blood gas values and vital signs were comparable between the two
groups with the exception of heart rate, which was significantly lower in
the actively cooled group. The number of infants in the target temperature
range (33-34°C) on arrival was 79/136 (58.1%) and the rate of overcooling
was 16/136 (11.8%) in the actively cooled group. In the overcooled infants,
Apgar scores, pH, base deficit, and eventual death rate (7/16; 43.8%)
indicated more severe asphyxia suggesting poor temperature control in this
subgroup of patients. Adverse events leading to pulmonary or circulatory
failure were not observed in either groups during the transport period.
Conclusions: Therapeutic hypothermia during transport is feasible and safe,
allowing for significantly earlier initiation and achievement of target
temperature, possibly providing further benefit for neonates with
hypoxic-ischemic encephalopathy.
EMTREE DRUG INDEX TERMS
base
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
controlled active hypothermia
hypoxic ischemic encephalopathy (therapy)
induced hypothermia
patient transport
EMTREE MEDICAL INDEX TERMS
Apgar score
article
asphyxia
blood gas
cohort analysis
controlled study
disease severity
human
intensive care
ischemia
lung insufficiency
major clinical study
mortality rate
neonatal intensive care unit
newborn
pH
priority journal
retrospective study
temperature
vital sign
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Pediatrics and Pediatric Surgery (7)
Neurology and Neurosurgery (8)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170864097
PUI
L619574067
DOI
10.1097/PCC.0000000000001339
FULL TEXT LINK
http://dx.doi.org/10.1097/PCC.0000000000001339
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 9
TITLE
The influence of insurance type on interfacility pediatric emergency
department transfers
AUTHOR NAMES
Rees C.A.
Pryor S.
Choi B.
Senthil M.V.
Tsarouhas N.
Myers S.R.
Monuteaux M.C.
Bachur R.G.
Li J.
AUTHOR ADDRESSES
(Rees C.A., chrisrees2@gmail.com; Monuteaux M.C.,
Michael.Monuteaux@childrens.harvard.edu; Bachur R.G.,
Richard.Bachur@childrens.harvard.edu; Li J., Joyce.Li@childrens.harvard.edu)
Division of Emergency Medicine, Boston Children's Hospital, Harvard Medical
School, 300 Longwood Avenue, BCH 3066, Boston, United States.
(Pryor S., stephanie.pryor@seattlechildrens.org) Department of Pediatrics,
Seattle Children's Hospital, University of Washington School of Medicine,
4800 Sand Point Way NE, Seattle, United States.
(Choi B., bc134109@bcm.edu) Department of Pediatrics, Texas Children's
Hospital, Baylor College of Medicine, 6621 Fannin Street, Suite A2210,
Houston, United States.
(Senthil M.V., VenepallyM@email.chop.edu; Tsarouhas N.,
TSAROUHAS@email.chop.edu; Myers S.R., MYERSS@email.chop.edu) Department of
Pediatrics, The Children's Hospital of Philadelphia, University of
Pennsylvania, 3400 Civic Center Blvd, Philadelphia, United States.
CORRESPONDENCE ADDRESS
C.A. Rees, Boston Children's Hospital, Division of Emergency Medicine, 300
Longwood Avenue, BCH 3066, Boston, United States. Email:
chrisrees2@gmail.com
SOURCE
American Journal of Emergency Medicine (2017) 35:12 (1907-1909). Date of
Publication: 1 Dec 2017
ISSN
1532-8171 (electronic)
0735-6757
BOOK PUBLISHER
W.B. Saunders
ABSTRACT
Background Disparities exist in the care children receive in the emergency
department (ED) based on their insurance type. It is unknown if these
differences exist among children transferred from outside EDs to pediatric
tertiary care EDs. Objective To compare reasons for transfer and services
received at pediatric tertiary care EDs between children with private and
public insurance. Methods We performed a secondary analysis of a multicenter
survey of ED providers transferring patients to pediatric tertiary care EDs
in three major U.S. cities. Risk differences (RD) and 95% confidence
intervals (CI) were calculated to compare reasons for transfer and care
received at pediatric tertiary care EDs based on insurance type. Results
There were 561 surveys completed by transferring providers describing
reasons for transfer to pediatric tertiary care EDs with 52.2% of patients
with private insurance and 47.8% with public insurance. We found no
significant differences between privately and publicly insured children in
reason for transfer for subspecialty consultation or need for admission. We
found no significant differences in frequency of admission, radiologic
studies, or ED procedures at the receiving facilities. However, a greater
proportion of privately insured children had a subspecialty consultation at
receiving facilities compared to publicly insured children (RD 9.7, 95% CI
2.0 to 17.4). Conclusions Transferred pediatric patients with private
insurance were more likely to have subspecialty consultations than children
with public insurance. Further studies are needed to better characterize the
interplay between patients’ insurance type and both the request for, and the
provision of, ED subspecialty consultations.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency ward
health insurance
patient transport
pediatric emergency medicine
EMTREE MEDICAL INDEX TERMS
article
attributable risk
child
comparative study
consultation
funding
health survey
hospital admission
human
medical record review
medically uninsured
pediatric intensive care unit
priority journal
secondary analysis
tertiary health care
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170526979
MEDLINE PMID
28743480 (http://www.ncbi.nlm.nih.gov/pubmed/28743480)
PUI
L617459968
DOI
10.1016/j.ajem.2017.07.048
FULL TEXT LINK
http://dx.doi.org/10.1016/j.ajem.2017.07.048
COPYRIGHT
Copyright 2018 Elsevier B.V., All rights reserved.
RECORD 10
TITLE
Optimizing Outcomes in Regionalized Perinatal Care: Integrating Maternal and
Neonatal Emergency Referral, Triage, and Transport
AUTHOR NAMES
Stewart M.J.
Smith J.
Boland R.A.
AUTHOR ADDRESSES
(Stewart M.J., michael.stewart@rch.org.au; Smith J.; Boland R.A.) Paediatric
Infant Perinatal Emergency Retrieval, Royal Children’s Hospital, Level 2,
East Building, 50 Flemington Road, Parkville, Australia.
(Stewart M.J., michael.stewart@rch.org.au; Boland R.A.) Clinical Sciences,
Murdoch Children’s Research Institute, 50 Flemington Road, Parkville,
Australia.
(Stewart M.J., michael.stewart@rch.org.au) Department of Paediatrics,
University of Melbourne, Royal Children’s Hospital, 50 Flemington Road,
Parkville, Australia.
(Boland R.A.) Department of Obstetrics and Gynecology, University of
Melbourne, 7th Floor, Royal Women’s Hospital, 20 Flemington Road, Parkville,
Australia.
CORRESPONDENCE ADDRESS
M.J. Stewart, Paediatric Infant Perinatal Emergency Retrieval, Royal
Children’s Hospital, Level 2, East Building, 50 Flemington Road, Parkville,
Australia. Email: michael.stewart@rch.org.au
SOURCE
Current Treatment Options in Pediatrics (2017) 3:4 (313-326). Date of
Publication: 1 Dec 2017
ISSN
2198-6088 (electronic)
BOOK PUBLISHER
Springer International Publishing
ABSTRACT
The purpose of integrating emergency maternal referral and triage capability
into a neonatal retrieval service is to improve the effectiveness of
regionalized perinatal care and to ensure opportunities for in utero
transfer are maximized. Evidence for the effectiveness of regionalized
perinatal care is presented, emphasizing the striking difference in survival
of outborn extremely preterm (EPT) infants compared with inborn EPT infants.
Barriers to achieving high rates of in utero transfer are identified and
strategies to address preventable factors discussed. There is evidence of
variation in rates of outborn extremely preterm births. As birth in transit
is a rare event, this variation suggests there are opportunities for
significant improvement in areas with high rates of outborn extremely
preterm births. Variation in the level of risk aversion by triaging
obstetricians and transport platform providers may be a significant
preventable factor in deciding if a particular high-risk pregnant woman is
deemed safe to transfer. Collaboration between obstetricians triaging these
referrals and their neonatal retrieval colleagues within an integrated
service is proposed as a model to address such issues. The integrated
perinatal emergency referral and retrieval service is a key component of a
system structured to support regionalized care. We propose this service
should sit below the regional entity responsible for clinical governance
that provides an imprimatur to ensure timely and equitable access to
perinatal services for high-risk women and their newborn infants.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
maternal care
newborn care
patient referral
perinatal care
EMTREE MEDICAL INDEX TERMS
antepartum hemorrhage
health care quality
human
leukomalacia
mortality rate
neonatal intensive care unit
obstetrician
premature labor
prevalence
priority journal
regionalization
resuscitation
review
EMBASE CLASSIFICATIONS
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170753253
PUI
L618962268
DOI
10.1007/s40746-017-0103-y
FULL TEXT LINK
http://dx.doi.org/10.1007/s40746-017-0103-y
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 11
TITLE
Effect of Transition From a Unit-Based Team to External Transport Team for a
Pediatric Critical Care Unit
AUTHOR NAMES
Cummings B.M.
Kaliannan K.
Yager P.H.
Noviski N.
AUTHOR ADDRESSES
(Cummings B.M., bmcummings@partners.org; Kaliannan K.; Yager P.H.; Noviski
N.) Department of Pediatrics, Pediatric Critical Care Medicine,
Massachusetts General Hospital, Boston, United States.
CORRESPONDENCE ADDRESS
B.M. Cummings, Department of Pediatrics, Pediatric Critical Care Medicine,
Massachusetts General Hospital, 175 Cambridge St (520), Boston, United
States. Email: bmcummings@partners.org
SOURCE
Journal of Intensive Care Medicine (2017) 32:10 (597-602). Date of
Publication: 1 Dec 2017
ISSN
1525-1489 (electronic)
0885-0666
BOOK PUBLISHER
SAGE Publications Inc., claims@sagepub.com
ABSTRACT
Objective: Pediatric hospitals must consider staff, training, and direct
costs required to maintain a pediatric specialized transport team, balanced
with indirect potential benefits of marketing and referral volume. The
effect of transitioning a unit-based transport team to an external service
on the pediatric intensive care unit (PICU) is unknown, but information is
needed as hospital systems focus on population management. We examined the
impact on PICU transports after transition to an external transport vendor.
Methods: Single-center retrospective review performed of PICU admissions,
referrals, and transfers during baseline, post-, and maintenance period with
a total of 9-year follow-up. Transfer volume was analyzed during pre-,
post-, and maintenance phase with descriptive statistics and statistical
process control charts from 1999 to 2012. Results: Total PICU admissions
increased with an annual growth rate of 3.7%, with mean annual 626
admissions prior to implementation to the mean of 890 admissions at the end
of period, P <.001. The proportion of transport to total admissions
decreased from 27% to 21%, but mean annual transports were unchanged, 175 to
183, P =.6, and mean referrals were similar, 186 to 203, P =.8. Seasonal
changes in transport volume remained as a predominant source of variability.
Annual transport refusals increased initially in the postimplementation
phase, mean 11 versus 33, P <.03, but similar to baseline in the maintenance
phase, mean 20/year, P =.07. Patient refusals were due to bed and staffing
constraints, with 7% due to the lack of transport vendor availability.
Conclusion: In a transition to a regional transport service, PICU transport
volume was maintained in the long-term follow-up and total PICU admissions
increased. Further research on the direct and indirect impact of transport
regionalization is needed to determine the optimal cost–benefit and quality
of care as health-care systems focus on population management.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient care
pediatric intensive care unit
population dynamics
teamwork
transitional care
EMTREE MEDICAL INDEX TERMS
article
feedback system
follow up
funding
growth rate
health care quality
health care system
hospital admission
hospital planning
patient referral
patient transport
priority journal
process control
retrospective study
seasonal variation
EMBASE CLASSIFICATIONS
Health Policy, Economics and Management (36)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170795959
PUI
L619208604
DOI
10.1177/0885066616662815
FULL TEXT LINK
http://dx.doi.org/10.1177/0885066616662815
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 12
TITLE
Penumbral freeze: Travel distance and delays provide an opportunity to study
prerecanalization therapy neuroprotection
AUTHOR NAMES
Blacker D.J.
AUTHOR ADDRESSES
(Blacker D.J., davidblackermd@hotmail.com) Department of Neurology, Charles
Gairdner Hospital, Perron Institute for Neurological and Translational
Science, Nedlands, Australia.
CORRESPONDENCE ADDRESS
D.J. Blacker, Department of Neurology, Charles Gairdner Hospital, Perron
Institute for Neurological and Translational Science, Nedlands, Australia.
Email: davidblackermd@hotmail.com
SOURCE
Future Neurology (2017) 12:4 (185-188). Date of Publication: 1 Dec 2017
ISSN
1748-6971 (electronic)
1479-6708
BOOK PUBLISHER
Future Medicine Ltd., info@futuremedicine.com
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
brain ischemia
neuroprotection
patient transport
penumbral freeze
prerecanalization therapy
recanalization
surgical technique
time to treatment
EMTREE MEDICAL INDEX TERMS
blood clot lysis
brain tissue
clinical decision making
health care access
health care facility
human
mechanical thrombectomy
neuroimaging
priority journal
review
stroke unit
telehealth
therapy delay
EMBASE CLASSIFICATIONS
Radiology (14)
Public Health, Social Medicine and Epidemiology (17)
Neurology and Neurosurgery (8)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20170805516
PUI
L619268307
DOI
10.2217/fnl-2017-0025
FULL TEXT LINK
http://dx.doi.org/10.2217/fnl-2017-0025
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 13
TITLE
Multiple intra-hospital transports during relocation to a new critical care
unit
AUTHOR NAMES
O’Leary R.-A.
Conrick-Martin I.
O’Loughlin C.
Curran M.-R.
Marsh B.
AUTHOR ADDRESSES
(O’Leary R.-A., ruthaoibheann@yahoo.co.uk; Conrick-Martin I.; O’Loughlin C.;
Curran M.-R.; Marsh B.) Department of Critical Care Medicine, Mater
Misericordiae University Hospital, Dublin 7, Ireland.
CORRESPONDENCE ADDRESS
R.-A. O’Leary, Department of Critical Care Medicine, Mater Misericordiae
University Hospital, Dublin 7, Ireland. Email: ruthaoibheann@yahoo.co.uk
SOURCE
Irish Journal of Medical Science (2017) 186:4 (815-820). Date of
Publication: 1 Nov 2017
ISSN
1863-4362 (electronic)
0021-1265
BOOK PUBLISHER
Springer London
ABSTRACT
Objective: Intra-hospital transport (IHT) of critically ill patients is
associated with morbidity and mortality. Mass transfer of patients, as
happens with unit relocation, is poorly described. We outline the process
and adverse events associated with the relocation of a critical care unit.
Design: Extensive planning of the relocation targeted patient and equipment
transfer, reduction in clinical pressure prior to the event and patient care
during the relocation phase. Setting: The setting was a 30-bed, tertiary
referral, combined medical and surgical critical care unit, located in a
570-bed hospital that serves as the national referral centre for
cardiothoracic surgery and spinal injuries. Participants: All stakeholders
relevant to the critical care unit relocation were involved, including
nursing and medical staff, porters, information technology services,
laboratory staff, project development managers, pharmacy staff and building
contractors. Main outcome measures: Mortality at discharge from critical
care unit and discharge from hospital were the main outcome measures. A wide
range of adverse events were prospectively recorded, as were transfer times.
Results: Twenty-one patients underwent IHT, with a median transfer time of
10 min. Two transfers were complicated by equipment failure and three
patients experienced an episode of hypotension requiring intervention. There
were no cases of central venous or arterial catheter or endotracheal tube
dislodgement, and hospital mortality at 30 days was 14%. Conclusion:
Although IHT is associated with morbidity and mortality, careful logistical
planning allows for efficient transfer with low complication rates.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
intra hospital transport
traffic and transport
EMTREE MEDICAL INDEX TERMS
artery catheter
article
clinical article
device failure
heart transplantation
hospital bed
hospital discharge
hospital mortality
human
hypotension
information service
information technology
laboratory personnel
lung transplantation
manager
medical staff
nursing
outcome assessment
patient care
personal experience
pharmacist
prospective study
spine injury
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160820570
PUI
L613201966
DOI
10.1007/s11845-016-1528-1
FULL TEXT LINK
http://dx.doi.org/10.1007/s11845-016-1528-1
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 14
TITLE
Risk factors for unplanned transfer to the intensive care unit after
emergency department admission: Methodological issues
AUTHOR NAMES
Safiri S.
Ayubi E.
AUTHOR ADDRESSES
(Safiri S.) Managerial Epidemiology Research Center, Department of Public
Health, School of Nursing and Midwifery, Maragheh University of Medical
Sciences, Maragheh, Iran.
(Ayubi E., aubi65@gmail.com) Department of Epidemiology, School of Public
Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
(Ayubi E., aubi65@gmail.com) Department of Epidemiology & Biostatistics,
School of Public Health, Tehran University of Medical Sciences, Tehran,
Iran.
CORRESPONDENCE ADDRESS
E. Ayubi, Department of Epidemiology, School of Public Health, Shahid
Beheshti University of Medical Sciences, Tehran, Iran. Email:
aubi65@gmail.com
SOURCE
American Journal of Emergency Medicine (2017) 35:10 (1573). Date of
Publication: 1 Oct 2017
ISSN
1532-8171 (electronic)
0735-6757
BOOK PUBLISHER
W.B. Saunders
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hypercapnia
intensive care unit
patient transport
risk factor
EMTREE MEDICAL INDEX TERMS
cross-sectional study
disease association
emergency ward
epidemiological data
general condition deterioration
hospital admission
human
letter
longitudinal study
outcome assessment
patient risk
priority journal
risk assessment
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Public Health, Social Medicine and Epidemiology (17)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20170365187
PUI
L616339775
DOI
10.1016/j.ajem.2017.04.031
FULL TEXT LINK
http://dx.doi.org/10.1016/j.ajem.2017.04.031
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 15
TITLE
Safety hazards during intrahospital transport: A prospective observational
study
AUTHOR NAMES
Bergman L.M.
Pettersson M.E.
Chaboyer W.P.
Carlström E.D.
Ringdal M.L.
AUTHOR ADDRESSES
(Bergman L.M., lina.bergman@gu.se; Pettersson M.E.; Chaboyer W.P.; Carlström
E.D.; Ringdal M.L.) Institute of Health and Care Sciences, Sahlgrenska
Academy, University of Gothenburg, Gothenburg, Sweden.
(Pettersson M.E.) Vascular Department, Sahlgrenska University
Hospital/Sahlgrenska, Gothenburg, Sweden.
(Chaboyer W.P.) Menzies Health Institute Queensland, Griffith University,
Southport, Australia.
(Carlström E.D.) University College of Southeast Norway, Notodden, Norway.
(Ringdal M.L.) Department of Anesthesiology and Intensive Care, Kungälvs
Hospital, Kungälv, Sweden.
CORRESPONDENCE ADDRESS
L.M. Bergman, Institute of Health and Care Sciences, Sahlgrenska Academy,
University of Gothenburg, Gothenburg, Sweden. Email: lina.bergman@gu.se
SOURCE
Critical Care Medicine (2017) 45:10 (e1043-e1049). Date of Publication: 1
Oct 2017
ISSN
1530-0293 (electronic)
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins, kathiest.clai@apta.org
ABSTRACT
Objective: To identify, classify, and describe safety hazards during the
process of intrahospital transport of critically ill patients. Design: A
prospective observational study. Data from participant observations of the
intrahospital transport process were collected over a period of 3 months.
Setting: The study was undertaken at two ICUs in one university hospital.
Patients: Critically ill patients transported within the hospital by
critical care nurses, unlicensed nurses, and physicians. Interventions:
None. Measurements and Main Results: Content analysis was performed using
deductive and inductive approaches. We detected a total of 365 safety
hazards (median, 7; interquartile range, 4-10) during 51 intrahospital
transports of critically ill patients, 80% of whom were mechanically
ventilated. The majority of detected safety hazards were assessed as
increasing the risk of harm, compromising patient safety (n = 204). Using
the System Engineering Initiative for Patient Safety, we identified safety
hazards related to the work system, as follows: team (n = 61), tasks (n =
83), tools and technologies (n = 124), environment (n = 48), and
organization (n = 49). Inductive analysis provided an in-depth description
of those safety hazards, contributing factors, and process-related outcomes.
Conclusions: Findings suggest that intrahospital transport is a hazardous
process for critically ill patients. We have identified several factors that
may contribute to transport-related adverse events, which will provide the
opportunity for the redesign of systems to enhance patient safety.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health hazard
patient safety
patient transport
EMTREE MEDICAL INDEX TERMS
article
clinical handover
content analysis
critically ill patient
equipment design
human
intensive care
intensive care unit
interhospital cooperation
interpersonal communication
nurse
observational study
participant observation
physician
priority journal
prospective study
risk factor
university hospital
workload
workplace
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170754515
MEDLINE PMID
28787292 (http://www.ncbi.nlm.nih.gov/pubmed/28787292)
PUI
L618978848
DOI
10.1097/CCM.0000000000002653
FULL TEXT LINK
http://dx.doi.org/10.1097/CCM.0000000000002653
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 16
TITLE
Long distance heart transplantation: a tale of two cities
AUTHOR NAMES
Jain P.
Prichard R.A.
Connellan M.B.
Dhital K.K.
Macdonald P.S.
AUTHOR ADDRESSES
(Jain P., pankaj185@gmail.com; Prichard R.A.; Connellan M.B.; Dhital K.K.;
Macdonald P.S.) Heart Transplant Unit, St Vincent's Hospital, Sydney,
Australia.
(Prichard R.A.) University of Technology, Sydney, Australia.
(Connellan M.B.; Dhital K.K.; Macdonald P.S.) Department of Medicine,
University of New South Wales, Sydney, Australia.
(Dhital K.K.; Macdonald P.S.) Victor Chang Cardiac Research Institute,
Sydney, Australia.
CORRESPONDENCE ADDRESS
P. Jain, Heart Transplant Unit, St Vincent's Hospital, Sydney, Australia.
Email: pankaj185@gmail.com
SOURCE
Internal Medicine Journal (2017) 47:10 (1202-1205). Date of Publication: 1
Oct 2017
ISSN
1445-5994 (electronic)
1444-0903
BOOK PUBLISHER
Blackwell Publishing, info@asia.blackpublishing.com.au
ABSTRACT
In this ‘paired’ case report, we describe two heart transplants performed 3
days apart at our centre. Both cases involved very prolonged transportation
time of the donor heart. In one case, the donor heart was transported in an
ice chest, while in the other case the organ was transported using a
normothermic ex vivo perfusion (NEVP) system. The additional retrieval costs
incurred by the use NEVP were more than offset by the reduction in
subsequent inpatient costs.
EMTREE DRUG INDEX TERMS
glyceryl trinitrate
hypertensive agent
inotropic agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
heart transplantation
patient transport
EMTREE MEDICAL INDEX TERMS
aortic clamping
article
brain death
brain hemorrhage
cardiac index
cardiac resynchronization therapy
cardiopulmonary bypass
complete heart block
congestive cardiomyopathy
extracorporeal oxygenation
extubation
heart catheterization
heart failure
heart left ventricle ejection fraction
heart muscle biopsy
heart output
heart size
human
hypertrophic cardiomyopathy
intensive care unit
lung edema
normothermic ex vivo perfusion
perfusion
postoperative period
priority journal
recurrent disease
reperfusion
tertiary care center
transesophageal echocardiography
transthoracic echocardiography
venoarterial extracorporeal membrane oxygenation
CAS REGISTRY NUMBERS
glyceryl trinitrate (55-63-0, 80738-44-9)
EMBASE CLASSIFICATIONS
Radiology (14)
Public Health, Social Medicine and Epidemiology (17)
Cardiovascular Diseases and Cardiovascular Surgery (18)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170709272
PUI
L618682031
DOI
10.1111/imj.13568
FULL TEXT LINK
http://dx.doi.org/10.1111/imj.13568
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 17
TITLE
Early complications in patients who undergo surgery for complex pediatric
spinal deformity and are transferred to the pediatric intensive care unit.
Retrospective cohort study
AUTHOR NAMES
Martínez Gonzélez C.
Egea Gémez R.M.
Certucha Barragén J.
Gonzélez Diaz R.
AUTHOR ADDRESSES
(Martínez Gonzélez C.; Certucha Barragén J.; Gonzélez Diaz R.) Hospital
Infantil Niño Jesús, Madrid, Spain.
(Egea Gémez R.M.) Hospital Universitario De Móstoles, Madrid, Spain.
CORRESPONDENCE ADDRESS
C. Martínez Gonzélez, Hospital Infantil Niño Jesús, Madrid, Spain.
SOURCE
European Spine Journal (2017) 26:10 (2688-2691). Date of Publication: 1 Oct
2017
CONFERENCE NAME
31. Congreso Nacional de la Sociedad Espanola de Columna Vertebral, GEER
2017
CONFERENCE LOCATION
San Sebastian, Spain
CONFERENCE DATE
2017-06-02 to 2017-06-03
ISSN
1432-0932
BOOK PUBLISHER
Springer Verlag
ABSTRACT
Introduction: In deformity surgery, assessing surgical complications, as
well as the outcome of the procedure, is a very common practice; however,
immediate medical complications are frequently omitted in our research
studies. In the present study, we aim to analyze the most frequent
postoperative medical complications in corrective complex pediatric
deformity surgeries. Materials and methods: Retrospective cohort study of
patients who underwent surgery due to scoliosis and were transferred to the
pediatric intensive care unit (PICU) between 2014 and 2016; 81 patients (43
idiopathic scoliosis, 24 neurological, 7 neuromuscular, 4 congenital, and 3
syndromic) were included in the study. Mean age was 15 years (2-19 years).
We analyzed the various complications, their cause, and the
treatment/treatment length to overcome the complications. Furthermore, we
studied the management of postoperative pain and the differences between the
various diagnostic groups. Results: The mean stay in the PICU was 3.71 days
(3% of total hospital stay). The most frequent complications were
hemodynamic alterations, seen in 26/81 study participants who required
inotropic agents: dopamine in eight cases and dopamine + adrenaline in one
case. Twenty-two (22) from the 81 study patients experienced some kind of
renal disturbance (metabolic or lactic acidosis and SIADH), from which 14
required bicarbonate. Six cases of sepsis were identified (1 central line
catheter), 3 surgical site infections, and 12 pneumonias. In 60 cases,
morphine-derivatives were used for pain control, whilst for the remaining
patients lower ladder analgesics-as per the WHO-were administered.
Conclusions: The most frequent complications were hemodynamic alterations,
followed by renal and infectious difficulties. The complications occurred
more often in neuromuscular patients. Being aware on the potential adverse
outcomes after scoliosis surgery, allows improving the management of our
patients, as well as prevent their inadequate control. Achieving a
stabilization over the first 24 h and an effective control of pain
facilitates patient progression.
EMTREE DRUG INDEX TERMS
analgesic agent
bicarbonate
dopamine
inotropic agent
morphine derivative
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cohort analysis
pediatric intensive care unit
retrospective study
spine malformation
EMTREE MEDICAL INDEX TERMS
adolescent
adverse outcome
central venous catheter
child
complication
controlled study
diagnosis related group
drug therapy
female
hemodynamics
hospitalization
human
idiopathic scoliosis
inappropriate vasopressin secretion
lactic acidosis
major clinical study
male
metabolic acidosis
peroperative complication
pneumonia
postoperative pain
sepsis
surgery
surgical infection
CAS REGISTRY NUMBERS
bicarbonate (144-55-8, 71-52-3)
dopamine (51-61-6, 62-31-7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L619082716
DOI
10.1007/s00586-017-5270-9
FULL TEXT LINK
http://dx.doi.org/10.1007/s00586-017-5270-9
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 18
TITLE
Transfer of Neonates with Critical Congenital Heart Disease Within a
Regionalized Network
AUTHOR NAMES
Swartz M.F.
Cholette J.M.
Orie J.M.
Jacobs M.L.
Jacobs J.P.
Alfieris G.M.
AUTHOR ADDRESSES
(Swartz M.F., Michael_swartz@urmc.rochester.edu; Cholette J.M.; Alfieris
G.M.) Pediatric Cardiac Consortium of Upstate New York, New York, United
States.
(Swartz M.F., Michael_swartz@urmc.rochester.edu; Cholette J.M.; Orie J.M.;
Alfieris G.M.) University of Rochester Medical Center, Rochester, United
States.
(Jacobs M.L.) Division of Cardiac Surgery, Johns Hopkins University,
Baltimore, United States.
(Jacobs J.P.) Division of Cardiac Surgery, Johns Hopkins All Children’s
Heart Institute, St. Petersburg, United States.
(Swartz M.F., Michael_swartz@urmc.rochester.edu) Strong Memorial Hospital,
601 Elmwood Ave, Box Surg/Cardiac, Rochester, United States.
CORRESPONDENCE ADDRESS
M.F. Swartz, Strong Memorial Hospital, 601 Elmwood Ave, Box Surg/Cardiac,
Rochester, United States. Email: Michael_swartz@urmc.rochester.edu
SOURCE
Pediatric Cardiology (2017) 38:7 (1350-1358). Date of Publication: 1 Oct
2017
ISSN
1432-1971 (electronic)
0172-0643
BOOK PUBLISHER
Springer New York LLC, barbara.b.bertram@gsk.com
ABSTRACT
Regionalization of pediatric cardiac surgical care varies between and within
states. In most geographic regions, at least some neonates with critical
heart disease are transferred from their birth hospital to a different
hospital for surgery. The impact of neonatal transfer for surgery,
particularly over a considerable distance (>10 miles), has been largely
unexplored. We sought to examine the impact of transferring neonates for
cardiac surgery. We queried the New York State Cardiac Surgery database
(2005–2014) from a single institution to identify neonates born within the
cardiac surgery center and those transferred for surgery. Outcomes were
compared between groups, with subgroup analysis of neonates with single
ventricle anatomy. 113 surgical neonates were born at the cardiac surgery
center, and 268 were transferred to the cardiac surgery center. Median
transfer distance was 91 (IQR 73, 94) miles. Age at operation and the need
for preoperative ventilation were significantly lower in neonates born at
the cardiac surgery center. In addition, single ventricle anatomy was more
prevalent among those born at the cardiac surgery center (48.7 vs. 31.3%;
p = 0.001). However, postoperative outcomes were the same—30-day survival
was similar across groups (birth: 89% vs. transfer: 90%; p = 0.7), and for
those with single ventricle palliation (birth: 81% vs. transfer: 81%;
p = 0.9). Within our regionalized network, we found no difference in 30-day
survival between neonates either born or transferred to a cardiac surgery
center, which supports the use of a regionalized network of hospitals to the
care of children with congenital heart disease.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
congenital heart disease (surgery)
critical illness (surgery)
patient transport
regionalization
EMTREE MEDICAL INDEX TERMS
age
article
artificial ventilation
controlled study
female
heart single ventricle
heart surgery
human
length of stay
major clinical study
male
neonatal intensive care unit
newborn
newborn death
palliative therapy
prenatal diagnosis
preoperative care
survival
treatment outcome
EMBASE CLASSIFICATIONS
Cardiovascular Diseases and Cardiovascular Surgery (18)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170509860
PUI
L617341321
DOI
10.1007/s00246-017-1668-8
FULL TEXT LINK
http://dx.doi.org/10.1007/s00246-017-1668-8
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 19
TITLE
Critical Care Air Transport Team severe traumatic brain injury short-term
outcomes during flight for Operation Iraqi Freedom/Operation Enduring
Freedom
AUTHOR NAMES
Boyd L.R.
Borawski J.
Lairet J.
Limkakeng A.T.
AUTHOR ADDRESSES
(Boyd L.R.; Borawski J.; Limkakeng A.T.) Emergency Medicine, Duke University
Medical Center, Durham, North Carolina, USA
(Lairet J.) Emergency Medicine, Emory University School of Medicine,
Atlanta, Georgia, USA
SOURCE
Journal of the Royal Army Medical Corps (2017) 163:5 (342-346). Date of
Publication: 1 Oct 2017
ISSN
0035-8665
ABSTRACT
INTRODUCTION: Our understanding of the expertise and equipment required to
air transport injured soldiers with severe traumatic brain injuries (TBIs)
continue to evolve.METHODS: We conducted a retrospective chart review of
characteristics, interventions required and short-term outcomes of patients
with severe TBI managed by the US Air Force Critical Care Air Transport
Teams (CCATTs) deployed in support of Operation Iraqi Freedom and Operation
Enduring Freedom between 1 June 2007 and 31 August 2010. Patients were cared
for based on guidelines given by the Brain Trauma Foundation and the Joint
Theater Trauma System by non-neurosurgeon physicians with dedicated
neurocritical care training. We report basic characteristics, injuries,
interventions required and complications during transport.RESULTS:
Intracranial haemorrhage was the most common diagnosis in this cohort. Most
injuries were weapon related. During this study, there were no reported
in-flight deaths. The majority of patients were mechanically ventilated.
There were 45 patients who required at least one vasopressor to maintain
adequate tissue perfusion, including four patients who required three or
more. Some patients required intracranial pressure (ICP) management,
treatment of diabetes insipidus and/or seizure prophylaxis
medications.CONCLUSIONS: Air transport personnel must be prepared to provide
standard critical care but also care specific to TBIs, including ICP control
and management of diabetes insipidus. Although these patients and their
potential complications are traditionally managed by neurosurgeons, those
providers without neurosurgical backgrounds can be provided this training to
help fill a wartime need. This study provides data for the future
development of air transport guidelines for validating and clearing flight
surgeons.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
statistics and numerical data
traumatic brain injury (epidemiology, therapy)
EMTREE MEDICAL INDEX TERMS
air medical transport
female
human
intensive care
male
military medicine
patient transport
retrospective study
treatment outcome
war
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
28385926 (http://www.ncbi.nlm.nih.gov/pubmed/28385926)
PUI
L619834696
DOI
10.1136/jramc-2016-000743
FULL TEXT LINK
http://dx.doi.org/10.1136/jramc-2016-000743
COPYRIGHT
Copyright 2017 Medline is the source for the citation and abstract of this
record.
RECORD 20
TITLE
The impact of neonatal transfer on follow up screening for retinopathy of
prematurity - Data from a Tertiary Care Children's Hospital in NSW Australia
AUTHOR NAMES
Burbidge A.
Bhate M.
AUTHOR ADDRESSES
(Burbidge A., andyburbidge88@gmail.com) Hunter New England Area Health
Service, Newcastle, Australia.
(Burbidge A., andyburbidge88@gmail.com) University of Newcastle, Newcastle,
Australia.
(Burbidge A., andyburbidge88@gmail.com) Hunter Medical Research Institute,
Newcastle, Australia.
(Bhate M.) Department of Ophthalmology, Hunter New England Area Health
Service, Newcastle, Australia.
CORRESPONDENCE ADDRESS
A. Burbidge, Hunter New England Area Health Service, Newcastle, Australia.
Email: andyburbidge88@gmail.com
SOURCE
Clinical and Experimental Ophthalmology (2017) 45 Supplement 1 (126). Date
of Publication: 1 Oct 2017
CONFERENCE NAME
49th Annual Scientific Congress of the Royal Australian and New Zealand
College of Ophthalmologists
CONFERENCE LOCATION
Perth, WA, Australia
CONFERENCE DATE
2017-10-28 to 2017-11-01
ISSN
1442-9071
BOOK PUBLISHER
Blackwell Publishing
ABSTRACT
Purpose: The aim of this study was to investigate the impact of neonatal
transfer within a geographically large regional health care model on
follow-up retinal screening for neonates investigated for ROP. Methods: A
retrospective review was conducted on two-hundred-ninety-one neonates born
less than 32 weeks gestation age; or, weighing <1251grams, who consecutively
underwent ROP screening during their admissions between 1stSeptember 2014
and 30th June 2016, at the John Hunter Children's Hospital Neonatal
Intensive Care Unit (NICU); a large regional tertiary referral center.
Variables assessed included: screening outcomes, transfer and follow-up
trends. Data was extracted and analyzed with SPSS statistical software via
Wilcoxon rank sum test and relative risk ratios. Results: A total of 291
neonates were screened for ROP. 94.2% (n=274) infants survived until
discharge. Of surviving infants 64.96% (n= 178) had no ROP identified. A
total of 17.15% (n= 47) were diagnosed with ROP. A further 17.88% (n= 49)
were transferred prior to screening. The relative risk for infants failing
to meet scheduled follow-up ophthalmic care, as a result of the transfer
process was 0.8750, [95% confidence interval CI (0.3802- 2.0140)] when
compared to the non-transferred cohort. Mean distance of transfer was
145.55kms (Range 7- 561km's) occurring at 37.5 weeks gestational age (SD =
3.2 weeks). Conclusion: Our study demonstrates that neonatal transfer
contributes significant complexity to timely ROP screening service delivery.
Large geographical distances and transfers, present additional barriers,
which may be detrimental to follow-up eye care. Our findings emphasize the
importance of a centralized, scheduled ROP screening examination post NICU
discharge.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Australia
follow up
retrolental fibroplasia
tertiary care center
EMTREE MEDICAL INDEX TERMS
child
clinical assessment
controlled study
data analysis software
diagnosis
eye care
female
gestational age
human
infant
major clinical study
male
neonatal intensive care unit
newborn
rank sum test
retina
retrospective study
risk factor
treatment failure
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L619285008
DOI
10.1111/ceo.13054/full
FULL TEXT LINK
http://dx.doi.org/10.1111/ceo.13054/full
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 21
TITLE
The impact of Italian regionalisation on transporting neonatal patients back
from the neonatal intensive care unit to the referring level two unit
AUTHOR NAMES
Bellini C.
Risso F.M.
Ramenghi L.A.
AUTHOR ADDRESSES
(Bellini C., carlobellini@ospedale-gaslini.ge.it; Risso F.M.; Ramenghi L.A.)
Neonatal Intensive Care Unit, Neonatal Emergency Transport Service, IRCCS
Istituto Giannina Gaslini, Genoa, Italy.
CORRESPONDENCE ADDRESS
C. Bellini, Neonatal Intensive Care Unit, Neonatal Emergency Transport
Service, IRCCS Istituto Giannina Gaslini, Genoa, Italy. Email:
carlobellini@ospedale-gaslini.ge.it
SOURCE
Acta Paediatrica, International Journal of Paediatrics (2017) 106:8 (1358).
Date of Publication: 1 Aug 2017
ISSN
1651-2227 (electronic)
0803-5253
BOOK PUBLISHER
Blackwell Publishing Ltd, customerservices@oxonblackwellpublishing.com
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
neonatal intensive care unit
newborn care
patient transport
regionalization
EMTREE MEDICAL INDEX TERMS
article
feces culture
human
medical literature
newborn
practice guideline
prematurity
priority journal
shared decision making
very low birth weight
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20170290892
PUI
L615604229
DOI
10.1111/apa.13821
FULL TEXT LINK
http://dx.doi.org/10.1111/apa.13821
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 22
TITLE
Introducing high-flow nasal cannula to the neonatal transport environment
AUTHOR NAMES
Boyle M.A.
Dhar A.
Broster S.
AUTHOR ADDRESSES
(Boyle M.A., mijkboyle@yahoo.com; Dhar A.; Broster S.) Acute Neonatal
Transfer Service, Cambridge University Hospitals NHS Foundation Trust,
Cambridge, United Kingdom.
CORRESPONDENCE ADDRESS
M.A. Boyle, Acute Neonatal Transfer Service, Cambridge University Hospitals
NHS Foundation Trust, Cambridge, United Kingdom. Email: mijkboyle@yahoo.com
SOURCE
Acta Paediatrica, International Journal of Paediatrics (2017) 106:8 (1363).
Date of Publication: 1 Aug 2017
ISSN
1651-2227 (electronic)
0803-5253
BOOK PUBLISHER
Blackwell Publishing Ltd, customerservices@oxonblackwellpublishing.com
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
assisted ventilation
nasal cannula
newborn care
patient transport
EMTREE MEDICAL INDEX TERMS
human
neonatal intensive care unit
note
patient risk
priority journal
standard
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20170425253
PUI
L616781160
DOI
10.1111/apa.13910
FULL TEXT LINK
http://dx.doi.org/10.1111/apa.13910
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 23
TITLE
Prehospital notification for major trauma patients requiring emergency
hospital transport: A systematic review
AUTHOR NAMES
Synnot A.
Karlsson A.
Brichko L.
Chee M.
Fitzgerald M.
Misra M.C.
Howard T.
Mathew J.
Rotter T.
Fiander M.
Gruen R.L.
Gupta A.
Dharap S.
Fahey M.
Stephenson M.
O'Reilly G.
Cameron P.
Mitra B.
AUTHOR ADDRESSES
(Synnot A.; Stephenson M.) Australian and New Zealand Intensive Care
Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine,
Monash University, Melbourne, Australia.
(Synnot A.) Cochrane Consumers and Communication, Centre for Health
Communication and Participation, School of Psychology and Public Health, La
Trobe University, Melbourne, Australia.
(Synnot A.; Chee M.; Fitzgerald M.; Howard T.; Mathew J.; Fahey M.; O'Reilly
G.; Cameron P.; Mitra B., biswadev.mitra@monash.edu) National Trauma
Research Institute, Melbourne, Australia.
(Synnot A.) Central Clinical School, Monash University, Melbourne,
Australia.
(Karlsson A.) Lund University, Lund, Sweden.
(Brichko L.; Fitzgerald M.; Mathew J.; Gupta A.; O'Reilly G.; Cameron P.;
Mitra B., biswadev.mitra@monash.edu) The Alfred Hospital, Melbourne,
Australia.
(Misra M.C.; Gupta A.) JPN Apex Trauma Centre, All India Institute of
Medical Sciences, New Delhi, India.
(Rotter T.) College of Pharmacy and Nutrition, University of Saskatchewan,
Saskatoon, Canada.
(Fiander M.) Information Specialist (consultant), Canada.
(Gruen R.L.) Lee Kong Chian School of Medicine, Nanyang Technological
University, Singapore.
(Dharap S.) Lokmanya Tilak Municipal General Hospital, Mumbai, India.
(Stephenson M.) Ambulance Victoria, Melbourne, Australia.
(O'Reilly G.; Cameron P.; Mitra B., biswadev.mitra@monash.edu) School of
Public Health and Preventive Medicine, Monash University, Melbourne,
Australia.
()
CORRESPONDENCE ADDRESS
B. Mitra, National Trauma Research Institute, Melbourne, Australia. Email:
biswadev.mitra@monash.edu
SOURCE
Journal of Evidence-Based Medicine (2017) 10:3 (212-221). Date of
Publication: 1 Aug 2017
ISSN
1756-5391 (electronic)
1756-5383
BOOK PUBLISHER
Blackwell Publishing, info@asia.blackpublishing.com.au
ABSTRACT
Objective: This systematic review aimed to determine the effect of
prehospital notification systems for major trauma patients on overall (<30
days) and early (<24 hours) mortality, hospital reception, and trauma team
presence (or equivalent) on arrival, time to critical interventions,
and length of hospital stay. Methods: Experimental and observational studies
of prehospital notification compared with no notification or another type of
notification in major trauma patients requiring emergency transport were
included. Risk of bias was assessed using the Cochrane ACROBAT-NRSI tool. A
narrative synthesis was conducted and evidence quality rated using the GRADE
criteria. Results: Three observational studies of 72,423 major trauma
patients were included. All were conducted in high-income countries in
hospitals with established trauma services, with two studies undertaking
retrospective analysis of registry data. Two studies reported overall
mortality, one demonstrating a reduction in mortality; (adjusted odds ratio
(OR) 0.61, 95% confidence interval (CI) 0.39 to 0.94, 72,073 participants);
and the other demonstrating a nonsignificant change (OR 0.61, 95% CI 0.23 to
1.64, 81 participants). The quality of this evidence was rated as very low.
Conclusion: Limited research on the topic constrains conclusive evidence on
the effect of prehospital notification on patient-centered outcomes after
severe trauma. Composite interventions that combine prehospital notification
with effective actions on arrival to hospital such as trauma bay
availability, trauma team presence, and early access to definitive
management may provide more robust evidence towards benefits of early
interventions during trauma reception and resuscitation.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
blunt trauma
emergency care
medical information
patient transport
penetrating trauma
prehospital notification
EMTREE MEDICAL INDEX TERMS
article
disease severity
health care availability
health care cost
high income country
human
intensive care unit
length of stay
low income country
middle income country
mortality rate
priority journal
resuscitation
systematic review
thorax radiography
time to treatment
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170617388
PUI
L618087576
DOI
10.1111/jebm.12256
FULL TEXT LINK
http://dx.doi.org/10.1111/jebm.12256
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 24
TITLE
Assessing guidelines for burn referrals in a resource-constrained setting:
Demographic and clinical factors associated with inter-facility transfer
AUTHOR NAMES
Klingberg A.
Wallis L.
Rode H.
Stenberg T.
Laflamme L.
Hasselberg M.
AUTHOR ADDRESSES
(Klingberg A., anders.klingberg@ki.se; Stenberg T.; Laflamme L.; Hasselberg
M.) Department of Public Health Sciences, Karolinska Institutet,
Widerströmska Huset, Tomtebodavägen 18 A, Stockholm, Sweden.
(Wallis L.) Division of Emergency Medicine, Faculty of Medicine and Health
Sciences, Stellenbosch University, Private Bag X24, Bellville, South Africa.
(Rode H.) Department of Paediatric Surgery, Red Cross War Memorial
Children's Hospital and Faculty of Health Sciences, University of Cape Town,
South Africa.
(Laflamme L.) University of South Africa, Preller Street, Pretoria, South
Africa.
CORRESPONDENCE ADDRESS
A. Klingberg, Department of Public Health Sciences, Karolinska Institutet,
Widerströmska Huset, Tomtebodavägen 18 A, Stockholm, Sweden. Email:
anders.klingberg@ki.se
SOURCE
Burns (2017) 43:5 (1070-1077). Date of Publication: 1 Aug 2017
ISSN
1879-1409 (electronic)
0305-4179
BOOK PUBLISHER
Elsevier Ltd
ABSTRACT
Aim The aim was to assess demographic and clinical factors associated with
inter-facility referrals for patients with burns in a resource-constrained
setting. Methods This was a cross-sectional case review of patients
presenting with a burn at the trauma unit at the Red Cross War Memorial
Children's Hospital (RXH) in Cape Town, South Africa. Results Six hundred
and eleven—(71%) children were referred to the burns or the intensive care
unit and 253 children were treated and discharged from the trauma unit. Of
those admitted as inpatients 94% fulfilled at least one of the criteria for
referral and 80% of those treated and discharged fulfilled the criteria for
referral. Conclusions Almost three out of four children evaluated at the
trauma unit were referred to the burns unit for further management. However,
a large number of patients were treated and discharged from the trauma unit
despite being eligible for referral.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
burn
patient referral
EMTREE MEDICAL INDEX TERMS
article
chemical burn
child
clinical feature
cross-sectional study
demography
electric burn
female
hospital admission
human
infant
intensive care unit
major clinical study
male
preschool child
scald
school child
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Surgery (9)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170276959
PUI
L615407154
DOI
10.1016/j.burns.2017.01.035
FULL TEXT LINK
http://dx.doi.org/10.1016/j.burns.2017.01.035
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 25
TITLE
The T3 Trial: Triage, Treatment and Transfer of patients with stroke in
emergency departments
AUTHOR NAMES
Middleton S.
Levi C.
Dale S.
Wah Cheung N.
McInnes E.
Considine J.
D'Este C.
Cadilhac D.
Grimshaw J.
Gerraty R.
Craig L.
Schadewaldt V.
McElduff P.
Fitzgerald M.
Quinn C.
Cadigan G.
Denisenko S.
Longworth M.
Ward J.
AUTHOR ADDRESSES
(Middleton S.; Dale S.; McInnes E.; Craig L.; Schadewaldt V.) St Vincent's
Health Australia Sydney, Australian Catholic University, Darlinghurst,
Australia.
(Levi C.) Centre for Translational Neuroscience and Mental Health,
Newcastle, Australia.
(Wah Cheung N.) Centre for Diabetes and Endocrinology Research, Westmead
Hospital, University of Sydney, Westmead, Australia.
(Considine J.) Deakin University, Nursing and Midwifery Research Centre,
School of Nursing and Midwifery, Burwood, Australia.
(D'Este C.) National Centre for Epidemiology and Population Health (NCEPH),
Australian National University, Canberra, Australia.
(Cadilhac D.) School of Clinical Sciences, Monash Health, Monash Clayton,
Australia.
(Grimshaw J.) Ottawa Health Research Institute, University of Ottawa,
Ottawa, Canada.
(Gerraty R.) Department of Medicine, Epworth Hospital, Richmond, Australia.
(McElduff P.) School of Medicine and Public Health, University of Newcastle,
Newcastle, Australia.
(Fitzgerald M.) Monash University, Swinburne University of Technology,
Melbourne, Australia.
(Quinn C.) Prince of Wales Hospital of Wales, Sydney, Australia.
(Cadigan G.) Statewide Stroke Clinical Network, Brisbane, Australia.
(Denisenko S.) Victorian Stroke Clinical Network, Melbourne, Australia.
(Longworth M.) Stroke Services NSW, Sydney, Australia.
(Ward J.) University of Ottawa, Ottawa, Canada.
(Ward J.) University of Notre Dame Australia, Broome, Australia.
CORRESPONDENCE ADDRESS
S. Middleton, St Vincent's Health Australia Sydney, Australian Catholic
University, Darlinghurst, Australia.
SOURCE
International Journal of Stroke (2017) 12:2 Supplement 1 (15). Date of
Publication: 1 Aug 2017
CONFERENCE NAME
2017 SMART STROKES Conference
CONFERENCE LOCATION
Gold Coast, QLD, Australia
CONFERENCE DATE
2017-08-10 to 2017-08-11
ISSN
1747-4949
BOOK PUBLISHER
SAGE Publications Inc.
ABSTRACT
Background & Aims: The T3 cluster randomised trial aimed to improve Triage,
Treatment and Transfer (T3) of patients with acute stroke in emergency
departments (EDs). Methods: Our prospective, multicentre, parallel group,
cluster randomised trial with blinded outcome assessment, randomised EDs 1:1
to receive either the T3 intervention or no support (control EDs). Our
evidence-based intervention targeted: (1) Triage: patients with suspected
stroke assigned to Australian Triage Scale category 1 or 2 (seen within 10
minutes); (2) Treatment: screening for tPA eligibility and administration of
tPA where applicable; protocols for management of fever, hyperglycaemia and
swallowing; and (3) rapid Transfer from ED to the stroke unit, implemented
using (i) workshops to determine barriers and solutions; (ii) education;
(iii) use of clinical opinion leaders; (iv) email, telephone and site visit
reminders. Primary outcome: 90-days post-admission death or dependency
(mRS>2). Secondary outcomes: 90-day: health status (SF-36), functional
dependency (Barthel Index), quality of life (EQ-5D); and in-hospital
quality-of-care outcomes: triage practices; monitoring and management for
thrombolysis, fever, hyperglycaemia, swallowing; and transfer practices.
Results: Of the 26 eligible sites from three states and one territory in
Australia, all (100%) agreed to participate with 2253 patients consenting
(pre-implementation n=645; post-implementation n=1608). Of these, 1879 will
be analysed (pre-implementation n=574; post-implementation n=1305). In the
post-implementation cohort, 751 patients were randomised to the intervention
group and 554 to the control group. Data currently are being analysed.
Conclusion: This large trial will provide rigorous evidence for assisted
implementation of nurse-initiated ED stroke protocols aiming to improve
outcomes for patients with stroke.
EMTREE DRUG INDEX TERMS
endogenous compound
tissue plasminogen activator
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
emergency ward
female
male
stroke unit
EMTREE MEDICAL INDEX TERMS
Australia
Barthel index
blood clot lysis
control group
controlled clinical trial
controlled study
death
e-mail
education
evidence based nursing
evidence based practice center
fever
health status
human
hyperglycemia
leadership
major clinical study
monitoring
nurse
parallel design
randomized controlled trial
Rankin scale
screening
Short Form 36
swallowing
telephone
treatment outcome
CAS REGISTRY NUMBERS
tissue plasminogen activator (105913-11-9)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L617955282
DOI
10.1177/1747493017714154
FULL TEXT LINK
http://dx.doi.org/10.1177/1747493017714154
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 26
TITLE
Comments
AUTHOR NAMES
Konakondla S.
Schirmer C.M.
AUTHOR ADDRESSES
(Konakondla S.) Danville, United States.
(Schirmer C.M.) Wilkes Barre, United States.
SOURCE
Neurosurgery (2017) 81:2 (249-250). Date of Publication: 1 Aug 2017
ISSN
1524-4040 (electronic)
0148-396X
BOOK PUBLISHER
Lippincott Williams and Wilkins, kathiest.clai@apta.org
EMTREE DRUG INDEX TERMS
clopidogrel
warfarin
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
neurosurgery
patient transport
EMTREE MEDICAL INDEX TERMS
anticoagulation
brain hemorrhage
deterioration
disease severity
Glasgow coma scale
health care delivery
human
hydrocephalus
major clinical study
mortality
neurological intensive care unit
neurosurgeon
note
priority journal
risk factor
treatment outcome
CAS REGISTRY NUMBERS
clopidogrel (113665-84-2, 120202-66-6, 90055-48-4, 94188-84-8)
warfarin (129-06-6, 2610-86-8, 3324-63-8, 5543-58-8, 81-81-2)
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Health Policy, Economics and Management (36)
Drug Literature Index (37)
Neurology and Neurosurgery (8)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20170569470
PUI
L617701491
DOI
10.1093/neuros/nyx012
FULL TEXT LINK
http://dx.doi.org/10.1093/neuros/nyx012
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 27
TITLE
Interfacility Transport Shock Index Is Associated With Decreased Survival in
Children
AUTHOR NAMES
Jennings R.M.
Kuch B.A.
Felmet K.A.
Orr R.A.
Carcillo J.A.
Fink E.L.
AUTHOR ADDRESSES
(Jennings R.M.) From the *University of Pittsburgh School of Medicine and
†Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA; and ‡Oregon
Health and Science University, Portland, OR.
(Kuch B.A.; Felmet K.A.; Orr R.A.; Carcillo J.A.; Fink E.L.)
CORRESPONDENCE ADDRESS
R.M. Jennings, From the *University of Pittsburgh School of Medicine and
†Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA; and ‡Oregon
Health and Science University, Portland, OR.
SOURCE
Pediatric Emergency Care (2017). Date of Publication: 11 Jul 2017
ISSN
1535-1815 (electronic)
0749-5161
BOOK PUBLISHER
Lippincott Williams and Wilkins, kathiest.clai@apta.org
ABSTRACT
BACKGROUND: Shock index, the ratio of heart rate to systolic blood pressure
that changes with age, is associated with mortality in adults after trauma
and in children with sepsis. We assessed the utility of shock index to
predict sepsis diagnosis and survival in children requiring interfacility
transport to a tertiary care center. METHODS: We studied children aged 1
month to 21 years who had at least 2 sets of vital signs recorded during
interfacility transport to the Children’s Hospital of Pittsburgh by our
critical care transport team. Subjects were divided into 4 age groups: group
1 (<1 year), group 2 (1–3 years), group 3 (4–11 years), and group 4 (≥12
years). Children were also grouped into sepsis or nonsepsis group based on
the International Classification of Diseases, Ninth Revision categories.
Primary outcome was survival to hospital discharge. RESULTS: Of 3519
children studied, 493 (14%) had sepsis. Initial shock index decreased with
increasing age: group 1, 1.45 ± 0.42 (mean ± SD); group 2, 1.35 ± 0.32;
group 3, 1.20 ± 0.34; and group 4, 1.00 ± 0.32 (P < 0.001). Initial shock
index was increased in children with sepsis versus those with no sepsis
overall and in all age groups (all P < 0.05). Initial shock index showed a
trend for association with survival in univariate analysis (P = 0.05) but
was not associated with survival in a multivariable logistic regression.
Highest quartile of shock index was associated with need for intensive care
unit admission posttransport. CONCLUSIONS: Increased shock index in children
requiring intrafacility transport was associated with hospital discharge
diagnosis of sepsis but not hospital survival.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
female
male
shock
EMTREE MEDICAL INDEX TERMS
adult
child
controlled study
diagnosis
hospital discharge
human
infant
intensive care unit
International Classification of Diseases
logistic regression analysis
major clinical study
sepsis
tertiary care center
univariate analysis
vital sign
young adult
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170502370
PUI
L617304034
DOI
10.1097/PEC.0000000000001205
FULL TEXT LINK
http://dx.doi.org/10.1097/PEC.0000000000001205
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 28
TITLE
The need for setting standards in critical care transfers
AUTHOR NAMES
Venter M.
Stanton D.
Conradie N.
Jordaan L.
Venter C.
Stassen W.
AUTHOR ADDRESSES
(Venter M., monique.venter@netcare.co.za; Stanton D.) Netcare (Pty) Ltd.,
Netcare 911, Midrand, South Africa.
(Conradie N.) Critical Care Transport Unit, Department of Health, Gauteng
Provincial Government, South Africa.
(Conradie N.; Stassen W.) Department of Emergency Medical Care, Faculty of
Health Sciences, University of Johannesburg, South Africa.
(Jordaan L.) Department of Emergency Medical Care, Faculty of Health
Sciences, Cape Peninsula University of Technology, Cape Town, South Africa.
(Venter M., monique.venter@netcare.co.za; Venter C.; Stassen W.) Critical
Care Retrieval Services, ER24, Johannesburg, South Africa.
CORRESPONDENCE ADDRESS
M. Venter, Critical Care Retrieval Services, ER24, Johannesburg, South
Africa. Email: monique.venter@netcare.co.za
SOURCE
Southern African Journal of Critical Care (2017) 33:1 (32). Date of
Publication: 1 Jul 2017
ISSN
2078-676X (electronic)
1562-8264
BOOK PUBLISHER
South African Medical Association, Lansdale Building, Gardener Way,
Pinelands, Cape Town, South Africa. publishing@samedical.org
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
EMTREE MEDICAL INDEX TERMS
critically ill patient
emergency care
human
letter
postgraduate education
scope of practice
treatment outcome
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20170510466
PUI
L617342990
DOI
10.7196/SAJCC.2017.v33i1.319
FULL TEXT LINK
http://dx.doi.org/10.7196/SAJCC.2017.v33i1.319
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 29
TITLE
Outcome of paediatric patients with congenital heart disease transferred
from their regional cardiac intensive care unit to a unit with transplant
and mechanical support capability
AUTHOR NAMES
Cardoso B.
Simpson E.
Ferguson L.
Llevadias J.
Chilà T.
Guillèn M.
Thiru Y.
De Rita F.
Hasan A.
Crossland D.S.
AUTHOR ADDRESSES
(Cardoso B.; Simpson E.; Ferguson L.; Llevadias J.; Guillèn M.; Thiru Y.)
Freeman Hospital, Department of Paediatric Intensive Care, Newcastle Upon
Tyne, United Kingdom.
(De Rita F.; Hasan A.) Freeman Hospital, Department of Cardiothoracic
Surgery, Newcastle Upon Tyne, United Kingdom.
(Crossland D.S.) Freeman Hospital, Epartment of Paediatric Cardiology,
Newcastle Upon Tyne, United Kingdom.
(Chilà T.)
CORRESPONDENCE ADDRESS
B. Cardoso, Freeman Hospital, Department of Paediatric Intensive Care,
Newcastle Upon Tyne, United Kingdom.
SOURCE
Cardiology in the Young (2017) 27:4 (S77-S78). Date of Publication: 1 Jul
2017
CONFERENCE NAME
7th World Congress of Pediatric Cardiology and Cardiac Surgery
CONFERENCE LOCATION
Barcelona, Spain
CONFERENCE DATE
2017-07-16 to 2017-07-21
ISSN
1467-1107
BOOK PUBLISHER
Cambridge University Press
ABSTRACT
Background: Children with congenital heart disease (CHD) admitted to a
Paediatric Cardiac Intensive Care Unit (PCICU) who exhaust conventional
therapy or surgical options may be transferred to a PCICU with transplant
and mechanical support capability for further management. We aimed to
describe the management and outcome of this group- not all of whom are
referred 'for transplant'. Materials and Methods: Retrospective analysis of
the records of patients with CHD and circulatory failure transferred from
their regional PCICU between January 2011 and January 2016. Patients with
cardiomyopathy were excluded. Results: Twenty-seven patients were
transferred and overall survival was 78% at 1 month and 61% at 1 year. 59.3%
were male, median age 9.8 months IQR 4.4-44.6 months and 11 (41%) had
univentricular physiology. Eight (29.6%) were transferred on ECMO. Seventeen
patients were listed for cardiac transplant: 12 transplanted, 5 deaths on
waiting list, 2 post-transplant deaths (day 102 and 109). Six VADs were
undertaken as bridge to transplant (3 transplanted, 3 deaths onlist). Six
patients were managed conventionally (4 further surgery, 2 medical/ ECMO
only), all survived. Four patients were considered unsuitable for any
further intervention including transplant. There was no difference in
mortality between univentricular and biventricular circulations (p = 0.346)
or those transferred on ECMO vs non-ECMO (p =0.476). Survival was lower at
<1 year of age compared to >1 year (survival at 30 days 64% v. 92%; one year
44% v. 77%, p= 0.051). Conclusions: Although transplant is effective for CHD
patients transferred acutely to a quaternary PCICU, mortality on the waiting
list is a serious issue, partially due to limited mechanical support options
for these patients. A carefully selected sub-group can be managed
successfully with medical therapy and conventional surgery and this should
be an integral part of the management offered by such PCICUs.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
congenital heart disease
coronary care unit
EMTREE MEDICAL INDEX TERMS
cardiomyopathy
child
clinical article
death
female
heart graft
hospital admission
human
infant
information processing
male
mortality
overall survival
physiology
retrospective study
shock
surgery
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L620076943
DOI
10.1017/S104795111700110X
FULL TEXT LINK
http://dx.doi.org/10.1017/S104795111700110X
COPYRIGHT
Copyright 2018 Elsevier B.V., All rights reserved.
RECORD 30
TITLE
Use of point of care laboratory testing during critical care interfacility
transport
AUTHOR NAMES
Collopy K.
Langston B.
Powers W.F.
AUTHOR ADDRESSES
(Collopy K.; Langston B.; Powers W.F.) AirLink/VitaLink Critical Care
Transport, New Hanover Regional Medical Center, Wilmington, United States.
CORRESPONDENCE ADDRESS
K. Collopy, AirLink/VitaLink Critical Care Transport, New Hanover Regional
Medical Center, Wilmington, United States.
SOURCE
Air Medical Journal (2017) 36:4 (209-211). Date of Publication: 1 Jul 2017
CONFERENCE NAME
2017 Critical Care Transport Medicine Conference
CONFERENCE LOCATION
San Antonio, TX, United States
CONFERENCE DATE
2017-04-10 to 2017-04-12
ISSN
1067-991X
BOOK PUBLISHER
Mosby Inc.
ABSTRACT
Introduction: Laboratory data is used to drive more than 70% of medical care
decisions.1 Point of Care laboratory Testing (POCT) is one of the fastest
growing areas of laboratory testing, as it has shown to reduce both time
from first contact to intervention as well as length of stay within
emergency departments.2,3 To date there is limited literature describing the
use of POCT in critical care transport4 though its reliability and
cost-effectiveness have been previously studied.5 This study aims to
describe the use of POCT in critical care transport using the EPOC® blood
analyzer (Alere, Inc), a CLIA-moderate complexity testing system.
AirLink/VitaLink Critical Care Transport is (Figure Presented) accredited by
the College of American Pathology to perform moderate complexity POCT as an
independent laboratory. Methods: This is an IRB approved retrospective
review of all patients transported by our adult Critical Care Team between 1
Oct 2013 and 31 Sept 2015. Patients transported by neonatal ICU and basic
life support teams were excluded. Transports were screened for attempted
POCT testing via the EPOC® blood analyzer where blood analysis occurs with a
single test cartridge (Figure 1). Patients who received waived-POCT testing
only (e.g. via glucometer) were not included in the final analysis. Patient
Care Records were screened to determine patient age, sex, complaint,
diagnosis, POCT success, and reason for inability to complete testing (if
applicable). During the study period, patient care protocols did not mandate
POCT. Teams were permitted to perform lab testing based on anticipated
potential benefit given the patient's condition, as noted in patient care
protocol including POCT (Figure 2). Results: Critical care transport teams
treated 11,454 patients during the study period. POCT labs were attempted on
659 transports (5.75%) with a 95.78% success rate (n=632). Patients had a
mean age of 58 years and 56.3% were males. POCT was most frequently
performed when patients had a chief complaint of: respiratory distress,
altered mental state, abdominal pain, or weakness/dizziness (Figure 3). POCT
most frequently resulted in patient care changes when patients complained
of: respiratory failure, unresponsiveness, fever, respiratory distress, and
altered mental state (>10 patients) (Figure 4). Conclusions: Point of Care
Lab Testing using the EPOC® blood analyzer was successfully performed during
95.78% of attempts and most frequently altered patient care for patients
with chief complaint of respiratory failure, unresponsiveness, fevers,
respiratory distress, and altered mental state. This information may be
helpful in standardizing the use of POCT during critical care transport
medicine, foster protocol development and facilitate patient care.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
neonatal intensive care unit
EMTREE MEDICAL INDEX TERMS
abdominal pain
adult
analyzer
blood analysis
clinical trial
college
cost effectiveness analysis
diagnosis
dizziness
emergency ward
female
fever
human
information processing
length of stay
major clinical study
male
medical care
medicine
mental health
middle aged
newborn
pathology
patient care
reliability
respiratory distress
respiratory failure
retrospective study
weakness
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L617549258
DOI
10.1016/j.amj.2017.04.011
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2017.04.011
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 31
TITLE
2017 Critical Care Transport Medicine Conference
AUTHOR ADDRESSES
SOURCE
Air Medical Journal (2017) 36:4. Date of Publication: 1 Jul 2017
CONFERENCE NAME
2017 Critical Care Transport Medicine Conference
CONFERENCE LOCATION
San Antonio, TX, United States
CONFERENCE DATE
2017-04-10 to 2017-04-12
ISSN
1067-991X
BOOK PUBLISHER
Mosby Inc.
ABSTRACT
The proceedings contain 11 papers. The topics discussed include:
mobilization time among neonatal/pediatric transport teams: the ground and
air medical quality in transport (GAMUT) collaborative; use of point of care
laboratory testing during critical care interfacility transport; assessing
lift-off times for a hospital-based helicopter transport program; asthma
scores may be a reliable tool to determine the need for advanced asthma
management in the pediatric patient; does the use of video laryngoscopy
improve first time success rates overall success rates in HEMS?;
identification of a pre-arrest systolic blood pressure inflection point for
air medical cardiopulmonary arrest victims; and tranexamic acid: promise or
panacea - the impact of air medical administration of tranexamic acid on
morbidity, mortality and length of stay.
EMTREE DRUG INDEX TERMS
tranexamic acid
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
medicine
EMTREE MEDICAL INDEX TERMS
asthma
cardiopulmonary arrest
child
doctor patient relation
drug therapy
helicopter
human
instrument validation
laryngoscopy
length of stay
morbidity
mortality
newborn
systolic blood pressure
victim
videorecording
CAS REGISTRY NUMBERS
tranexamic acid (1197-18-8, 701-54-2)
LANGUAGE OF ARTICLE
English
PUI
L617549278
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 32
TITLE
Transfer of KPC-2 carbapenemase from Klebsiella pneumoniae to Enterobacter
cloacae in a patient receiving meropenem therapy
AUTHOR NAMES
Martins E.R.
Estofolete C.F.
Zequini A.B.
Cerdeira L.
de Oliveira Garcia D.
Bueno M.F.C.
Francisco G.R.
de Andrade L.N.
da Costa Darini A.L.
Tolentino F.M.
Casella T.
Lincopan N.
Nogueira M.C.L.
AUTHOR ADDRESSES
(Martins E.R., evelin.rod.martins@gmail.com; Estofolete C.F.,
cassiafestofolete@gmail.com; Casella T., tiago_casella@yahoo.com.br;
Nogueira M.C.L., ml.nogueira@famerp.br) Faculdade de Medicina de São José do
Rio Preto, São José do Rio Preto, Brazil.
(Estofolete C.F., cassiafestofolete@gmail.com; Zequini A.B.,
andressa.zequini@yahoo.com.br; Nogueira M.C.L., ml.nogueira@famerp.br)
Hospital de Base de São José do Rio Preto, São José do Rio Preto, Brazil.
(Cerdeira L., lcerdeira@gmail.com; Lincopan N., lincopan@usp.br)
Departamento de Análises Clínicas, Faculdade de Ciências Farmacêuticas,
Universidade de São Paulo, São Paulo, Brazil.
(de Oliveira Garcia D., dogarcia@yahoo.com; Bueno M.F.C.,
mf.campagnari@gmail.com; Francisco G.R., gabis.francisco@gmail.com)
Instituto Adolfo Lutz, São Paulo, Brazil.
(de Andrade L.N., leoandrade02es@gmail.com; da Costa Darini A.L.,
aldarini@fcfrp.usp.br) Faculdade de Ciências Farmacêuticas, Universidade de
São Paulo, Ribeirão Preto, Brazil.
(Tolentino F.M., fernandaTollentino@hotmail.com; Casella T.,
tiago_casella@yahoo.com.br) Universidade Estadual Paulista “Júlio de
Mesquita Filho”, São José do Rio Preto, Brazil.
(Tolentino F.M., fernandaTollentino@hotmail.com) Instituto Adolfo Lutz, São
José do Rio Preto, Brazil.
(Lincopan N., lincopan@usp.br) Departamento de Microbiologia, Instituto de
Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil.
CORRESPONDENCE ADDRESS
M.C.L. Nogueira, Faculdade de Medicina de São José do Rio Preto, São José do
Rio Preto, Brazil. Email: ml.nogueira@famerp.br
SOURCE
Diagnostic Microbiology and Infectious Disease (2017) 88:3 (287-289). Date
of Publication: 1 Jul 2017
ISSN
1879-0070 (electronic)
0732-8893
BOOK PUBLISHER
Elsevier Inc., usjcs@elsevier.com
ABSTRACT
The horizontal transfer of a plasmid bearing the bla(KPC-2) gene from K.
pneumoniae to E. cloacae infecting the respiratory tract of a patient during
meropenem therapy was elucidated. This finding is particularly worrisome,
since these drugs are of last resort for multidrug-resistant Gram-negative
pathogens.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
amikacin
ciprofloxacin
colistimethate
meropenem
EMTREE DRUG INDEX TERMS
piperacillin plus tazobactam
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
bacterial gene
blaKPC2 gene
Enterobacter cloacae
Klebsiella pneumoniae
EMTREE MEDICAL INDEX TERMS
antibiotic resistance
antibiotic sensitivity
aortic aneurysm
article
artificial ventilation
bacterial strain
bacterium isolate
brain ischemia
Brazil
cause of death
cold sweat
computer assisted tomography
congestive heart failure
consciousness disorder
coronary care unit
deterioration
diabetes mellitus
dyspnea
emergency ward
endoprosthesis
epigastric pain
gene sequence
hospital admission
hospital discharge
human
hypertension
intubation
mental disease
nonhuman
pallor
plasmid
pleura effusion
pneumonia
polymerase chain reaction
priority journal
septic shock
tachypnea
tracheal aspiration procedure
trypanosomiasis
CAS REGISTRY NUMBERS
amikacin (37517-28-5, 39831-55-5)
ciprofloxacin (85721-33-1)
colistimethate (12705-41-8, 8068-28-8)
meropenem (96036-03-2)
EMBASE CLASSIFICATIONS
Drug Literature Index (37)
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170296128
PUI
L615634678
DOI
10.1016/j.diagmicrobio.2017.04.004
FULL TEXT LINK
http://dx.doi.org/10.1016/j.diagmicrobio.2017.04.004
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 33
TITLE
A Workflow-Driven Formal Methods Approach to the Generation of Structured
Checklists for Intrahospital Patient Transfers
AUTHOR NAMES
Manataki A.
Fleuriot J.
Papapanagiotou P.
AUTHOR ADDRESSES
(Manataki A., A.Manataki@ed.ac.uk; Fleuriot J., jdf@inf.ed.ac.uk;
Papapanagiotou P., pe.p@ed.ac.uk) School of Informatics, University of
Edinburgh, Edinburgh, United Kingdom.
SOURCE
IEEE Journal of Biomedical and Health Informatics (2017) 21:4 (1156-1162)
Article Number: 7489005. Date of Publication: 1 Jul 2017
ISSN
2168-2194
BOOK PUBLISHER
Institute of Electrical and Electronics Engineers Inc.
ABSTRACT
Intrahospital transfers are a common but hazardous aspect of hospital care,
with a large number of incidents posing a threat to patient safety. A
growing body of work advocates the use of checklists for minimizing
intrahospital transfer risk, but the majority of existing checklists are not
guaranteed to be error-free and are difficult to adapt to different clinical
settings or changing hospital policies. This paper details an approach that
addresses these challenges through the employment of workflow technologies
and formal methods for generating structured checklists. A three-phased
methodology is proposed, where intrahospital transfer processes are first
conceptualized, then rigorously composed into workflows that are
mechanically verified, and finally, translated into a set of checklists that
support hospital staff while maintaining the dependencies between different
transfer tasks. A case study is presented, highlighting the feasibility of
this approach, and the correctness and maintainability benefits brought by
the logical underpinning of this methodology. A checklist evaluation is
discussed, with promising results regarding their usefulness.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
checklist
patient transport
process model
workflow
EMTREE MEDICAL INDEX TERMS
employment
feasibility study
hospital personnel
human
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170507109
MEDLINE PMID
27305690 (http://www.ncbi.nlm.nih.gov/pubmed/27305690)
PUI
L617287447
DOI
10.1109/JBHI.2016.2579881
FULL TEXT LINK
http://dx.doi.org/10.1109/JBHI.2016.2579881
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 34
TITLE
A Case of Succinyl-CoA:3-Oxoacid CoA Transferase Deficiency Presenting with
Severe Acidosis in a 14-Month-Old Female: Evidence for Pathogenicity of a
Point Mutation in the OXCT1 Gene
AUTHOR NAMES
Zheng D.J.
Hooper M.
Spencer-Manzon M.
Pierce R.W.
AUTHOR ADDRESSES
(Zheng D.J.; Hooper M.; Spencer-Manzon M.; Pierce R.W.,
Richard.pierce@yale.edu) Department of Pediatrics, Yale School of Medicine,
New Haven, Connecticut, United States
(Spencer-Manzon M.) Department of Genetics, Yale School of Medicine, New
Haven, Connecticut, United States
CORRESPONDENCE ADDRESS
R.W. Pierce, Department of Pediatrics, Yale School of Medicine, 333 Cedar
Street, P.O. Box 208064, New Haven, CT 06520-8064, United States Email:
Richard.pierce@yale.edu
SOURCE
Journal of Pediatric Intensive Care (2017). Date of Publication: 12 Jun 2017
ISSN
2146-4626 (electronic)
2146-4618
BOOK PUBLISHER
Georg Thieme Verlag, kunden.service@thieme.de
ABSTRACT
We describe a case of succinyl-CoA:3-oxoacid CoA transferase (SCOT)
deficiency in an otherwise healthy 14 month-old female. She presented with
lethargy, tachypnea, and hyperpnea with hypoglycemia and a severe anion gap
metabolic acidosis. Early management included correction of the acidosis and
metabolic support with dextrose and insulin. Inborn errors of metabolism are
rare outside the neonatal period. However, SCOT deficiency may present at
older ages. Maintaining a high index of suspicion, immediate transfer to a
pediatric intensive care unit, and prompt metabolic support are key to
achieving a favorable outcome.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
3 oxoacid coenzyme A transferase
EMTREE DRUG INDEX TERMS
endogenous compound
glucose
insulin
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
ketoacidosis
pathogenicity
point mutation
EMTREE MEDICAL INDEX TERMS
case report
child
female
human
hyperpnea
hypoglycemia
inborn error of metabolism
infant
lethargy
metabolic acidosis
newborn
newborn period
pediatric intensive care unit
population based case control study
tachypnea
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170531424
PUI
L617480564
DOI
10.1055/s-0037-1604270
FULL TEXT LINK
http://dx.doi.org/10.1055/s-0037-1604270
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 35
TITLE
Helicopter Transport From the Scene of Injury: Are There Improved Outcomes
for Pediatric Trauma Patients?
AUTHOR NAMES
Farach S.M.
Walford N.E.
Bendure L.
Amankwah E.K.
Danielson P.D.
Chandler N.M.
AUTHOR ADDRESSES
(Farach S.M.) From the *Division of Pediatric Surgery, †Clinical and
Translational Research Organization, All Childrenʼs Hospital Johns Hopkins
Medicine, St Petersburg, FL.
(Walford N.E.; Bendure L.; Amankwah E.K.; Danielson P.D.; Chandler N.M.)
CORRESPONDENCE ADDRESS
S.M. Farach, From the *Division of Pediatric Surgery, †Clinical and
Translational Research Organization, All Childrenʼs Hospital Johns Hopkins
Medicine, St Petersburg, FL.
SOURCE
Pediatric Emergency Care (2017). Date of Publication: 6 Jun 2017
ISSN
1535-1815 (electronic)
0749-5161
BOOK PUBLISHER
Lippincott Williams and Wilkins, kathiest.clai@apta.org
ABSTRACT
BACKGROUND: There is conflicting data to support the routine use of
helicopter transport (HT) for the transfer of trauma patients. The purpose
of this study was to evaluate outcomes for trauma patients transported via
helicopter from the scene of injury to a regional pediatric trauma center.
METHODS: The institutional trauma registry was queried for trauma patients
presenting from January 2000 through March 2012. Of 9119 patients, 1709
patients who presented from the scene were selected for further evaluation.
This cohort was stratified into HT and ground transport (GT) for analysis.
Associations between mode of transport and outcomes were estimated using
odds ratios and 95% confidence intervals from multivariable logistic
regression models. RESULTS: Seven hundred twenty-five patients (42.4%)
presented via HT, whereas 984 (57.6%) presented via GT. Patients arriving by
HT had a higher Injury Severity Score, lower Glasgow Coma Scale, were less
likely to undergo surgery within 3 hours, more likely to present after
motorized trauma, and had longer intensive care unit (ICU) and hospital
length of stay (LOS). Multivariate analysis controlling for Injury Severity
Score, Glasgow Coma Scale, mechanism of injury, scene distance, and time to
arrive to the hospital revealed that patients arriving by HT were more
likely to have longer hospital LOS compared with those arriving by GT (odds
ratios = 2.3, 95% confidence interval = 1.00–5.28, P = 0.049). However, no
statistically significant association was observed for prehospital
intubation, surgery within 3 hours, ICU admissions, or ICU LOS. CONCLUSIONS:
Although patients arriving by helicopter are more severely injured and
arrive from greater distances, when controlling for injuries, scene
distance, and time to hospital arrival, only hospital LOS was significantly
affected by HT.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
childhood injury
female
helicopter
male
EMTREE MEDICAL INDEX TERMS
confidence interval
emergency health service
Glasgow coma scale
human
intensive care unit
intubation
length of stay
logistic regression analysis
major clinical study
model
multivariate analysis
odds ratio
register
surgery
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170413030
PUI
L616682156
DOI
10.1097/PEC.0000000000001190
FULL TEXT LINK
http://dx.doi.org/10.1097/PEC.0000000000001190
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 36
TITLE
GES-14-producing acinetobacter baumannii isolates in a neonatal intensive
care unit in Tunisia are associated with a typical middle east clone and a
transferable plasmid
AUTHOR NAMES
Mabrouk A.
Grosso F.
Botelho J.
Achour W.
Hassen A.B.
Peixe L.
AUTHOR ADDRESSES
(Mabrouk A.) Faculté des Sciences de Bizerte, Université de Carthage, Tunis,
Tunisia.
(Mabrouk A.; Achour W.; Hassen A.B.) Service des Laboratoires, Centre
National de Greffe de Moelle Osseuse, Tunis, Tunisia.
(Grosso F.; Botelho J.; Peixe L., lpeixe@ff.up.pt) Laboratório de
Microbiologia, Faculdade de Farmácia, Universidade do Porto,
UCIBIO-REQUIMTE, Porto, Portugal.
(Achour W.; Hassen A.B.) Faculté de Médecine de Tunis, Université de Tunis
El Manar, Tunis, Tunisia.
CORRESPONDENCE ADDRESS
L. Peixe, Laboratório de Microbiologia, Faculdade de Farmácia, Universidade
do Porto, UCIBIO-REQUIMTE, Porto, Portugal. Email: lpeixe@ff.up.pt
SOURCE
Antimicrobial Agents and Chemotherapy (2017) 61:6 Article Number: e00142-17.
Date of Publication: 1 Jun 2017
ISSN
1098-6596 (electronic)
0066-4804
BOOK PUBLISHER
American Society for Microbiology, Journals@asmusa.org
EMTREE DRUG INDEX TERMS
amikacin
aminoglycoside derivative
gentamicin
imipenem
kanamycin
meropenem
piperacillin plus tazobactam
plasmid DNA
quinolone derivative
rifampicin
spectinomycin
streptomycin
tobramycin
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Acinetobacter baumannii
EMTREE MEDICAL INDEX TERMS
bacterium isolate
DNA replication origin
homologous recombination
human
infrared spectroscopy
letter
Middle East
neonatal intensive care unit
nonhuman
open reading frame
plasmid
priority journal
respiratory tract infection
Tunisia
CAS REGISTRY NUMBERS
amikacin (37517-28-5, 39831-55-5)
gentamicin (1392-48-9, 1403-66-3, 1405-41-0)
imipenem (64221-86-9)
kanamycin (11025-66-4, 61230-38-4, 8063-07-8)
meropenem (96036-03-2)
rifampicin (13292-46-1)
spectinomycin (1695-77-8, 21736-83-4, 23312-56-3)
streptomycin (57-92-1)
tobramycin (32986-56-4)
EMBASE CLASSIFICATIONS
Drug Literature Index (37)
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20170383467
PUI
L616382708
DOI
10.1128/AAC.00142-17
FULL TEXT LINK
http://dx.doi.org/10.1128/AAC.00142-17
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 37
TITLE
Network analysis: A novel method for mapping neonatal acute transport
patterns in California
AUTHOR NAMES
Kunz S.N.
Zupancic J.A.F.
Rigdon J.
Phibbs C.S.
Lee H.C.
Gould J.B.
Leskovec J.
Profit J.
AUTHOR ADDRESSES
(Kunz S.N., skunz@bidmc.harvard.edu; Zupancic J.A.F.) Division of Newborn
Medicine, Harvard Medical School, Boston, United States.
(Kunz S.N., skunz@bidmc.harvard.edu; Zupancic J.A.F.) Department of
Neonatology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue,
Rose 3, Boston, United States.
(Rigdon J.) Quantitative Sciences Unit, Stanford University School of
Medicine, Stanford, United States.
(Phibbs C.S.; Lee H.C.; Gould J.B.; Profit J.) Department of
Pediatrics-Neonatal and Developmental Medicine, Stanford University School
of Medicine, Stanford, United States.
(Phibbs C.S.) Health Economics Resource Center, Veterans Affairs Palo Alto
Healthcare System, Menlo Park, United States.
(Lee H.C.; Gould J.B.; Profit J.) California Perinatal Quality Care
Collaborative, Stanford, United States.
(Leskovec J.) Department of Computer Science, Stanford University, Stanford,
United States.
CORRESPONDENCE ADDRESS
S.N. Kunz, Department of Neonatology, Beth Israel Deaconess Medical Center,
330 Brookline Avenue, Rose 3, Boston, United States. Email:
skunz@bidmc.harvard.edu
SOURCE
Journal of Perinatology (2017) 37:6 (702-708). Date of Publication: 1 Jun
2017
ISSN
1476-5543 (electronic)
0743-8346
BOOK PUBLISHER
Nature Publishing Group, Houndmills, Basingstoke, Hampshire, United Kingdom.
ABSTRACT
Objective:The objectives of this study are to use network analysis to
describe the pattern of neonatal transfers in California, to compare
empirical sub-networks with established referral regions and to determine
factors associated with transport outside the originating sub-network.Study
design:This cross-sectional database study included 6546 infants <28 days
old transported within California in 2012. After generating a graph
representing acute transfers between hospitals (n=6696), we used community
detection techniques to identify more tightly connected sub-networks. These
empirically derived sub-networks were compared with state-defined regional
referral networks. Reasons for transfer between empirical sub-networks were
assessed using logistic regression.Results:Empirical sub-networks showed
significant overlap with regulatory regions (P<0.001). Transfer outside the
empirical sub-network was associated with major congenital anomalies
(P<0.001), need for surgery (P=0.01) and insurance as the reason for
transfer (P<0.001).Conclusion:Network analysis accurately reflected
empirical neonatal transfer patterns, potentially facilitating quantitative,
rather than qualitative, analysis of regionalized health care delivery
systems.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
analytic method
network analysis
patient transport
EMTREE MEDICAL INDEX TERMS
article
California
congenital malformation (congenital disorder, surgery)
construct validity
controlled study
cross-sectional study
female
health care delivery
health insurance
human
infant
major clinical study
male
measurement accuracy
neonatal intensive care unit
population research
regionalization
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
Health Policy, Economics and Management (36)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170219408
PUI
L614979254
DOI
10.1038/jp.2017.20
FULL TEXT LINK
http://dx.doi.org/10.1038/jp.2017.20
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 38
TITLE
Proton Pump Inhibitor Administration Triggers Encephalopathy in Cirrhotic
Patients by Modulating Blood–Brain Barrier Drug Transport
AUTHOR NAMES
Assaraf J.
Weiss N.
Thabut D.
AUTHOR ADDRESSES
(Assaraf J.) Unité de Soins Intensifs d'Hépato-gastroentérologie, Groupement
Hospitalier Pitié-Salpêtrière-Charles Foix, Paris, France.
(Weiss N.) Brain Liver Pitié-Salpêtrière Study Group and Unité de
Réanimation Neurologique, Fédération de Neurologie, Pôle des Maladies du
Système Nerveux, Groupement Hospitalier Pitié-Salpêtrière-Charles Foix,
Paris, France.
(Thabut D.) Unité de Soins Intensifs d'Hépato-gastroentérologie and Brain
Liver Pitié-Salpêtrière Study Group, Groupement Hospitalier
Pitié-Salpêtrière-Charles Foix, Paris, France.
SOURCE
Gastroenterology (2017) 152:8 (2077). Date of Publication: 1 Jun 2017
ISSN
1528-0012 (electronic)
0016-5085
BOOK PUBLISHER
W.B. Saunders
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
proton pump inhibitor (adverse drug reaction)
EMTREE DRUG INDEX TERMS
ABC transporter (endogenous compound)
ABC transporter subfamily B (endogenous compound)
ammonia (endogenous compound)
antibiotic agent
endotoxin (endogenous compound)
fluconazole
multidrug resistance protein 1 (endogenous compound)
quinolone derivative
toxin
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
blood brain barrier
drug transport
hepatic encephalopathy (side effect, side effect)
liver cirrhosis
EMTREE MEDICAL INDEX TERMS
ammonia blood level
concentration response
disease association
drug brain level
drug use
dysbiosis
gastrointestinal hemorrhage
hospital admission
human
hyperammonemia
intensive care unit
intestine flora
letter
medical history
Model For End Stage Liver Disease Score
patient risk
priority journal
prospective study
risk assessment
risk factor
self medication
CAS REGISTRY NUMBERS
ammonia (14798-03-9, 51847-23-5, 7664-41-7)
fluconazole (86386-73-4)
multidrug resistance protein (149200-37-3, 208997-77-7)
EMBASE CLASSIFICATIONS
Drug Literature Index (37)
Adverse Reactions Titles (38)
Gastroenterology (48)
Neurology and Neurosurgery (8)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20170398114
PUI
L616583411
DOI
10.1053/j.gastro.2016.10.049
FULL TEXT LINK
http://dx.doi.org/10.1053/j.gastro.2016.10.049
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 39
TITLE
What do patients who are not transported by the Smur understand about the
information provided by the physician?
ORIGINAL (NON-ENGLISH) TITLE
Que comprennent les patients laissés sur place par le Smur quant aux
informations communiquées par le médecin ?
AUTHOR NAMES
Sanchez A.
Bejinariu L.
Schaeffer M.
Pelaccia T.
AUTHOR ADDRESSES
(Sanchez A.) Service d’accueil des urgences du centre hospitalier de
Haguenau, 64, avenue du Professeur Leriche, Haguenau, France.
(Bejinariu L.) Service d’accueil des urgences du centre hospitalier de
Sélestat, 23, avenue Louis Pasteur, Sélestat, France.
(Schaeffer M.) Service de biostatistiques, hôpitaux universitaires de
Strasbourg, 1, place de l’Hôpital, Strasbourg, France.
(Pelaccia T., pelaccia@unistra.fr) Service d’aide médicale urgente du
Bas-Rhin, hôpitaux universitaires de Strasbourg, 70, rue de l’Engelbreit,
Strasbourg, France.
(Pelaccia T., pelaccia@unistra.fr) Centre de formation et de recherche en
pédagogie des sciences de la santé (CFRPS), faculté de médecine, université
de Strasbourg, 4, rue Kirschleger, Strasbourg, France.
CORRESPONDENCE ADDRESS
T. Pelaccia, Service d’accueil des urgences du centre hospitalier de
Haguenau, 64, avenue du Professeur Leriche, Haguenau, France. Email:
pelaccia@unistra.fr
SOURCE
Annales Francaises de Medecine d'Urgence (2017) 7:3 (159-165). Date of
Publication: 1 Jun 2017
ISSN
2108-6591 (electronic)
2108-6524
BOOK PUBLISHER
Springer-Verlag France, 22, Rue de Palestro, Paris, France.
york@springer-paris.fr
ABSTRACT
Objectives: The quality of communication between a physician and a patient
is the main determinant of the patient’s compliance. Poor communication
generates misunderstandings that increase the risk of morbidity and
mortality, and engages the physician’s legal responsibility. Previous
research has shown that physicians communicate badly with their patients,
including in emergency departments. In this study, we assessed the level of
understanding of patients who have not been transported by the mobile
emergency and intensive care unit (Smur) with respect to the diagnosis,
treatment, recommended follow-up and reasons for calling back the emergency
medical assistance service. Methods: We conducted a monocentric prospective
observational study. The aim was to compare the untransported patient’s
level of understanding after their management by the Smur and the
information provided to the patient by the physician. Phone interviews were
held with the patients. Physicians completed a self-administered
questionnaire. Results: 81% of the patients who had not been transported by
the Smur did not understand information transmitted by the physician in at
least one of the four areas studied. Both patients and physicians were
unaware of this lack of understanding. Conclusion: A vast majority of
untransported patients who have been managed by the Smur insufficiently
understand the instructions given by the physician. These results should
draw our attention to the need to implement remedial and risk management
measures, in particular, as regards the training of emergency physicians.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
doctor patient relation
emergency medicine
emergency physician
female
male
EMTREE MEDICAL INDEX TERMS
clinical study
controlled study
diagnosis
follow up
human
intensive care unit
interview
observational study
questionnaire
risk management
LANGUAGE OF ARTICLE
French
LANGUAGE OF SUMMARY
English, French
EMBASE ACCESSION NUMBER
20170470404
PUI
L617005003
DOI
10.1007/s13341-017-0744-2
FULL TEXT LINK
http://dx.doi.org/10.1007/s13341-017-0744-2
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 40
TITLE
Pre-analytic of ammonia: Stability, transport and temperature of
centrifugation
AUTHOR NAMES
Favresse J.
Despas N.
AUTHOR ADDRESSES
(Favresse J., julien.favresse@uclouvain.be) Cliniques Universitaires Saint
Luc, Belgium.
(Despas N.) Cliniques Universitaires Saint-Luc, Belgium.
CORRESPONDENCE ADDRESS
J. Favresse, Cliniques Universitaires Saint Luc, Belgium. Email:
julien.favresse@uclouvain.be
SOURCE
Clinical Chemistry and Laboratory Medicine (2017) 55 Supplement 1 (S1067).
Date of Publication: 1 Jun 2017
CONFERENCE NAME
22nd IFCC-EFLM European Congress of Clinical Chemistry and Laboratory
Medicine, 25th Meeting of the Balkan Clinical Laboratory Federation, 15th
National Congress of GSCC-CB
CONFERENCE LOCATION
Athens, Greece
CONFERENCE DATE
2017-06-11 to 2017-06-15
ISSN
1437-4331
BOOK PUBLISHER
Walter de Gruyter GmbH
ABSTRACT
Background: Ammonia is particularly sensitive to pre-analytical requirements
with errors from contamination, collection or sampling handling.
Pre-analytical errors could account for ammonia values 2-3 times upper
normal range and may be confusing for the clinician. We designed a study
protocol to assess multiple factors affecting the pre-analytic of ammonia.
Methods: In the first protocol, we evaluated the post-decantation stability
of ammonia in 20 volunteers and 11 intensive care unit (ICU) patients
according to the temperature (T°C) of centrifugation (4°C vs room T°C). In
the second protocol, four blood samples were drawn from 21 healthy
volunteers and 20 ICU patients. The first sample was conserved at room T°C
and spun at room T°C (3.500 rpm, 10 min), the second conserved at room T°C
and spun at 4°C, the third conserved in icy water and spun at room T°C and
the last conserved in icy water and spun at 4°C. All these samples were
stored for 30 min before centrifugation. Finally, blood from 20 volunteers
and two ICU patients was used to test the performance of Crioplast®
containers in comparison to icy water. Samples were left for 30 and 60 min
in icy water and then spun at 4°C before measurement. Results: The stability
study showed non-statistical difference between samples spun at 4°C and at
room T°C for healthy and ICU patients (P > 0.05). The period of stability in
healthy subjects achieved 1h30 and at least 4h30 in ICU patients. In healthy
volunteers, ammonia values for samples left in icy water and spun at 4°C
were statistically lower compared to all other combined conditions,
especially in comparison to samples left and spun at room T°C (absolute
difference of 28.7%, P = 0.0001). However, no statistical difference was
observed in ICU patients (P > 0.05). The lower red blood cell count of ICU
patients may explain this difference (3.3 x 10∧6; normal range 4-6 x 10∧6).
The Crioplast® device brought results in agreement with samples conserved in
icy water for 30 and 60 min (P > 0.05). Conclusions: All routine samples
must be kept in icy water or in Crioplast® containers and be spun at 4°C.
The major reason is to avoid false elevated ammonia values leading to
unnecessary additional blood sampling and laboratory testing. Discussion
between physicians and biologists is primordial to reach such pre-analytical
requirements.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
ammonia
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
centrifugation
EMTREE MEDICAL INDEX TERMS
blood sampling
clinical article
container
doctor patient relation
drug combination
erythrocyte count
female
human
intensive care unit
male
volunteer
CAS REGISTRY NUMBERS
ammonia (14798-03-9, 51847-23-5, 7664-41-7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L616773029
DOI
10.1515/cclm-2017-5031
FULL TEXT LINK
http://dx.doi.org/10.1515/cclm-2017-5031
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 41
TITLE
Impact of relocation and environmental cleaning on reducing the incidence of
healthcare-associated infection in NICU
AUTHOR NAMES
Li Q.-F.
Xu H.
Ni X.-P.
Lin R.
Jin H.
Wei L.-Y.
Liu D.
Shen L.-H.
Zha J.
Xu X.-F.
Wu B.
AUTHOR ADDRESSES
(Li Q.-F.; Liu D.) Department of NICU, Women’s Hospital, Zhejiang University
School of Medicine, Hangzhou, China.
(Lin R.; Xu X.-F.; Wu B., fbygk@zju.edu.cn) Department of Infection Control,
Women’s Hospital, Zhejiang University School of Medicine, Hangzhou, China.
(Xu H.; Ni X.-P.; Jin H.; Wei L.-Y.; Shen L.-H.; Zha J.) Department of
Disinfection Surveillance and Vector Control, Hangzhou Center for Disease
Control and Prevention, Hangzhou, China.
CORRESPONDENCE ADDRESS
B. Wu, Department of Infection Control, Women's Hospital, Zhejiang
University School of Medicine, Xueshi Road, Hangzhou, China. Email:
fbygk@zju.edu.cn
SOURCE
World Journal of Pediatrics (2017) 13:3 (217-221). Date of Publication: 1
Jun 2017
ISSN
1867-0687 (electronic)
1708-8569
BOOK PUBLISHER
Institute of Pediatrics of Zhejiang University, wjpch@zju.edu.cn
ABSTRACT
Background: Hospital environment remains a risk for healthcare-associated
infections (HAIs). This was a prospective study to evaluate the
comprehensive impact of relocating a neonatal intensive care unit (NICU) to
a new facility and improved environmental cleaning practice on the presence
of methicillin-resistant Staphylococcus aureus (MRSA) on inanimate surfaces
and the incident rate of HAIs. Methods: New environmental cleaning measures
were adopted after the NICU was moved to a new and better-designed location.
The effect of moving and the new environmental cleaning practice was
investigated by comparing the positive number of MRSA on ward surfaces and
the incidence density of HAIs between the baseline and intervention periods.
Results: Only 2.5% of environmental surfaces were positive for MRSA in the
intervention period compared to 44.0% in the baseline period (P<0.001).
Likewise, the total incident rate of HAIs declined from 16.8 per 1000
cot-days to 10.0 per 1000 cot-days (P<0.001). Conclusion: The comprehensive
measures of relocating the NICU to a new facility design with improved
environmental cleaning practice are effective and significantly reduce the
incidence of HAIs.
EMTREE DRUG INDEX TERMS
disinfectant agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cleaning
healthcare associated infection (prevention)
hospital infection (prevention)
infection control
neonatal intensive care unit
EMTREE MEDICAL INDEX TERMS
article
catheter infection
controlled study
disinfection
human
incubator
infection rate
length of stay
major clinical study
methicillin resistant Staphylococcus aureus
monitor
newborn
prospective study
syringe
ventilator associated pneumonia
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170058982
PUI
L614134296
DOI
10.1007/s12519-017-0001-1
FULL TEXT LINK
http://dx.doi.org/10.1007/s12519-017-0001-1
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 42
TITLE
Impact of post-graduate year training level on unplanned floor to intensive
care unit transfers within 24 hours from the emergency department
AUTHOR NAMES
Solano J.
Ilg A.
Bilello L.
Chiu D.T.
AUTHOR ADDRESSES
(Solano J.; Ilg A.; Bilello L.; Chiu D.T.) Beth Israel Deaconess Medical
Center, Harvard Medical School, United States.
CORRESPONDENCE ADDRESS
J. Solano, Beth Israel Deaconess Medical Center, Harvard Medical School,
United States.
SOURCE
Academic Emergency Medicine (2017) 24 Supplement 1 (S66-S67). Date of
Publication: 1 May 2017
CONFERENCE NAME
2017 Annual Meeting of the Society for Academic Emergency Medicine, SAEM
2017
CONFERENCE LOCATION
Orlando, FL, United States
CONFERENCE DATE
2017-05-16 to 2017-05-19
ISSN
1553-2712
BOOK PUBLISHER
Blackwell Publishing Inc.
ABSTRACT
Background: Emergency medicine (EM) residents are supervised by attending
physicians and, therefore, the residents' post-graduate year (PGY) should
not have a negative impact on patient care. Unexpected floor to intensive
care unit (ICU) transfers may be an indication of an adverse event or error
(AEE) as these transfers have been shown to have higher mortality rates than
patients admitted directly to the ICU. It is unclear if the level of EM
resident training correlates with AEE in this patient population. Methods:
We performed a retrospective study at an academic tertiary care center with
an affiliated three year EM residency. A member of the ED quality assurance
(QA) committee reviewed all patient cases presenting to the ED between
12/01/2010 to 05/31/2016 who had a floor to ICU transfer within the first 24
hours of admission. The primary outcome measure is an AEE, as adjudicated
and defined by the QA committee. Adverse events are circumstances that cause
patient harm, while errors represent violations of the standard of care. The
variable of primary interest is EM PGY level. The expected number of AEEs
per EM class was calculated by taking the total number of AEEs and dividing
by 3. Chi squared test was performed to test the null hypothesis that there
is no difference between EM PGY level and AEE rates. Results: A total of 921
floor to ICU transfers were reviewed and 29 involved an AEE attributable to
an EM resident. This represents an AEE rate of 3.1%. Eight AEEs were
attributed to a PGY1, 19 attributed to a PGY2 and 2 attributed to a PGY3.
Chi squared test yielded a p < 0.001, rejecting the null hypothesis.
Conclusion: There is an association between PGY level and AEEs for floor to
ICU transfers. This may be due to the increased acuity and complexity of
patients seen by the PGY2 residents. However, it may be due to decreased
supervision of PGY2 residents with comparison to the PGY1 residents and may
present an opportunity for quality improvement.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency ward
intensive care unit
postgraduate student
EMTREE MEDICAL INDEX TERMS
controlled study
emergency medicine
error
female
health care quality
human
human experiment
male
null hypothesis
patient harm
resident
retrospective study
tertiary care center
total quality management
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L616280004
DOI
10.1111/acem.13203
FULL TEXT LINK
http://dx.doi.org/10.1111/acem.13203
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 43
TITLE
Assessment of post-graduate year training and unplanned floor to intensive
care unit transfer within 24 hours from the emergency department
AUTHOR NAMES
Bilello L.
Ilg A.
Solano J.
Chiu D.T.
AUTHOR ADDRESSES
(Bilello L.; Ilg A.; Solano J.; Chiu D.T.) Beth Israel Deaconess Medical
Center, Harvard Medical School, United States.
CORRESPONDENCE ADDRESS
L. Bilello, Beth Israel Deaconess Medical Center, Harvard Medical School,
United States.
SOURCE
Academic Emergency Medicine (2017) 24 Supplement 1 (S67). Date of
Publication: 1 May 2017
CONFERENCE NAME
2017 Annual Meeting of the Society for Academic Emergency Medicine, SAEM
2017
CONFERENCE LOCATION
Orlando, FL, United States
CONFERENCE DATE
2017-05-16 to 2017-05-19
ISSN
1553-2712
BOOK PUBLISHER
Blackwell Publishing Inc.
ABSTRACT
Background: Academic emergency departments (ED) utilize residents of
different post-graduate year (PGY) training levels to provide clinical care
for patients under the supervision of attending physicians. Admitted
patients that have an unplanned transfer from the floor to the intensive
care unit (ICU) within 24 hours have been shown to have higher mortality and
are a potential focus for quality improvement. It is unclear if the level of
training of the EM resident correlates with unplanned transfers. Methods: We
performed a retrospective chart review with a primary outcome measure of
unplanned floor to ICU transfers within 24 hours after ED admission. The
variable of primary interest is PGY level. The study was done at an urban,
academic tertiary care referral center with an affiliated 3 year EM
residency. All patients presenting to the ED between 07/01/2012 to
06/30/2015 were eligible. Logistic regression was used to test for
significance and to control for confounders such as emergency severity index
(ESI), age, gender, unstable vital signs at triage, changes from ED
observation to full hospital admission, ED length of stay (LOS), and time to
doctor. Odds ratios (OR) with 95% confidence interval (CI) were used as the
primary effect estimate. Results: We reviewed the records of 60,609 admitted
patients and found 1,769 (2.9%) were unplanned transfers from floor to ICU
within 24 hours. The odds ratio for each resident PGY level and attending
physicians are as follows: PGY1 0.47 (CI 0.39-0.49), PGY2 0.43 (CI
0.38-0.48), PGY3 0.42 (CI 0.37-0.47) and attendings 0.21 (CI 0.20-0.22).
There is an inverse relationship between the ORs of unplanned floor to ICU
transfers and EM PGY level. This is not statistically significant as all
p-values are greater than 0.05. Unstable vital signs at triage, age, ESI, ED
LOS, ED observation status that required admission, time of arrival to time
seen by physician, and gender were significant predictors of unplanned floor
to ICU in 24 hours with a p-value of < 0.05. Conclusions: This data shows
that there was no significant difference between the PGY training level of
the EM resident and unplanned floor to ICU transfer within the first 24
hours. Identification of variables significantly related with unplanned
floor to ICU transfer within 24 hours may be valuable to prevent this
adverse event.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency ward
intensive care unit
postgraduate student
EMTREE MEDICAL INDEX TERMS
adverse drug reaction
confidence interval
emergency health service
female
gender
hospital admission
human
length of stay
logistic regression analysis
major clinical study
male
medical record review
odds ratio
patient referral
prevention
resident
side effect
statistical significance
tertiary health care
vital sign
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L616280018
DOI
10.1111/acem.13203
FULL TEXT LINK
http://dx.doi.org/10.1111/acem.13203
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 44
TITLE
Anticipation and management of the difficult paediatric airway in the
emergency department: A series of cases encountered by a regional critical
care transport service
AUTHOR NAMES
Parkins K.
Kanaris C.
Bordoni J.
Emsden S.
Phatak R.
Pritchard L.
AUTHOR ADDRESSES
(Parkins K.; Kanaris C.; Bordoni J.) Paediatric Intensive Care Unit, Alder
Hey Children's Hospital, Liverpool, United Kingdom.
(Parkins K.; Kanaris C.; Bordoni J.; Emsden S.; Phatak R.; Pritchard L.)
North West and North Wales Transport Service, Warrington, United Kingdom.
(Phatak R.) Paediatric Intensive Care Unit, Royal Manchester Children's
Hospital, Manchester, United Kingdom.
CORRESPONDENCE ADDRESS
K. Parkins, Paediatric Intensive Care Unit, Alder Hey Children's Hospital,
Liverpool, United Kingdom.
SOURCE
Archives of Disease in Childhood (2017) 102 Supplement 1 (A179-A180). Date
of Publication: 1 May 2017
CONFERENCE NAME
Annual Conference of the Royal College of Paediatrics and Child Health,
RCPCH 2017
CONFERENCE LOCATION
Birmingham, United Kingdom
CONFERENCE DATE
2017-05-24 to 2017-05-26
ISSN
1468-2052
BOOK PUBLISHER
BMJ Publishing Group
ABSTRACT
Centralisation of children's services in the UK has decreased exposure of
district general hospital (DGH) emergency department staff to paediatric
airway management, especially in critically ill children. Regional Retrieval
Teams such as the North West and North Wales Paediatric Transport Service
(NWTS) provide advice and support but cannot be considered as the primary
difficult airway management team leading to challenging scenarios,
particularly for DGH teams managing patients with predicted or known
difficult airways. Early recognition of the difficult airway is vital in
decreasing morbidity and mortality, and anxiety for those involved. Prompt
assembling of a competent multidisciplinary team in the emergency
department, with appropriate equipment, drugs, monitoring as well as
planning for failure or deterioration represents a major challenge. The
difficult airway is the clinical situation in which a conventionally trained
anaesthetist experiences difficulties with facemask ventilation, tracheal
intubation, or both. Difficult intubation occurs approximately 0.42% in all
elective paediatric tertiary intubations. Of these 0.08% occur in healthy
children, increasing to 0.24% in the under ones. Difficult mask ventilation
occurs in approximately 0.02%. Can't intubate can't ventilate situations
occurs1 in 10-50,000 in adults. Paucity of published data on incidence of
difficult airway during emergency intubation for respiratory failure is
unknown, but likely to be significantly higher. NWTS data revealed 11.2%
incidence of grade 2 or above laryngoscopy (357 intubations of critically
sick 1-5 year olds); and in under 2 year olds 21% complication risk such as
hypotension or hypoxia. We describe 8 cases referred to North West and North
Wales Paediatric Transport Service (NWTS) from different emergency
departments across the North West of the UK, that highlight importance of
anticipating problems managing paediatric airways, and the proposed regional
difficult airway and intubation guideline. The guideline highlights the
importance of alternative plans required to ensure a successful outcome.
Equipment and monitoring ideally should be standardised across all hospital
departments where a critically sick child/neonate may present. Education and
regular training in airway management reduces the risk of paediatric airway
difficulties. Regional paediatric intensive care transport teams can
facilitate access to specialist equipment and transfer to tertiary
specialised units when required.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
case study
emergency ward
respiration control
EMTREE MEDICAL INDEX TERMS
anesthesist
anxiety
child
complication
critically ill patient
deterioration
education
endotracheal intubation
exposure
female
general hospital
hospital department
human
hypotension
hypoxia
information retrieval
laryngoscopy
major clinical study
male
monitoring
morbidity
mortality
newborn
practice guideline
respiratory failure
Wales
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L616987348
DOI
10.1136/archdischild-2017-313087.449
FULL TEXT LINK
http://dx.doi.org/10.1136/archdischild-2017-313087.449
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 45
TITLE
Weaning from prolonged veno-venous extracorporeal membrane oxygenation
(ECMO) after transfer to a specialized ECMO center-a retrospective study
AUTHOR NAMES
Seiler F.
Trudzinski F.C.
Hörsch S.
Kamp A.
Metz C.
Alqudrah M.
Wehrfritz H.
Muellenbach R.M.
Haake H.
Bals R.
Lepper P.M.
AUTHOR ADDRESSES
(Seiler F.; Trudzinski F.C.; Kamp A.; Metz C.; Alqudrah M.; Wehrfritz H.;
Bals R.; Lepper P.M.) Department of Internal Medicine V-Pneumology,
Allergology, and Critical Care Medicine, Germany.
(Seiler F.; Trudzinski F.C.; Hörsch S.; Kamp A.; Metz C.; Alqudrah M.;
Wehrfritz H.; Bals R.; Lepper P.M.) ECLS Centre Saar, Germany.
(Hörsch S.) Department of Anesthesiology, Intensive Care Medicine, and Pain
Medicine, University Hospital of Saarland, Homburg/Saar, Germany.
(Muellenbach R.M.) Department of Anesthesiology, Intensive Care Medicine,
and Pain Therapy, Klinikum Kassel, Campus Kassel of the University of
Southampton, Kassel, Germany.
(Haake H.) Department of Cardiology, Electrophysiology and Intensive Care
Medicine, Kliniken Maria Hilf, Mönchengladbach, Germany.
CORRESPONDENCE ADDRESS
F. Seiler, Department of Internal Medicine V-Pneumology, Allergology, and
Critical Care Medicine, Germany.
SOURCE
European Journal of Heart Failure (2017) 19 Supplement 2 (48). Date of
Publication: 1 May 2017
CONFERENCE NAME
6th Euro-ELSO Annual Congress
CONFERENCE LOCATION
Maastricht, Netherlands
CONFERENCE DATE
2017-05-04 to 2017-05-07
ISSN
1878-1314
BOOK PUBLISHER
John Wiley and Sons Ltd
ABSTRACT
Introduction/Aim: Veno-venous extracorporeal membrane oxygenation (vV-ECMO)
is increasingly used as a rescue therapy in severe respiratory failure. In
patients with pre-existent lung diseases or persistent lung injury weaning
from vV-ECMO can be challenging. This study sought to investigate outcomes
of patients transferred to a specialized ECMO centre after prolonged ECMO
therapy. Methods: Retrospective analysis of all patients treated at our
medical intensive care unit (ICU) between 01/2013 and 07/2016 who were
transferred from an external ICU after>8 days on vV-ECMO. Results: We
identified 10 patients on ECMO for>8 days. Prior to transfer, patients
underwent ECMO therapy for 18 (9-34)±9.5 days. Total time on ECMO was 46
(16-135)±33 days. 9/10 patients were weaned from ECMO in the first 28 days
after transfer, 7 after at least partial lung recovery, 2 after salvage lung
transplant (10±8.3 ECMO-free days at day 28). No patient died or needed
re-initiation of ECMO therapy at day 28. Conclusion: Weaning from vV-ECMO
was feasible even after prolonged ECMO courses and salvage lung transplant
could be avoided in most cases. Patients may benefit from transfer to a
specialized ECMO centre.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
extracorporeal oxygenation
retrospective study
vein
weaning
EMTREE MEDICAL INDEX TERMS
clinical article
female
human
lung
male
medical intensive care unit
remission
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L616170764
DOI
10.1002/ejhf.869
FULL TEXT LINK
http://dx.doi.org/10.1002/ejhf.869
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 46
TITLE
A protocol designed to reduce inhospital delays in treatment with
intravenous thrombolysis also allows to reduce time to groin puncture for
endovascular treatment
AUTHOR NAMES
Iglesias Mohedano A.M.
García Pastor A.
Díaz Otero F.
Vázquez Alen P.
Fernández Bullido Y.
Del Valle Diéguez M.
Saura Lorente J.
Castro Reyes E.
Villoria Medina F.
Fortea Gil F.
Gil Núnez A.
AUTHOR ADDRESSES
(Iglesias Mohedano A.M.; García Pastor A.; Díaz Otero F.; Vázquez Alen P.;
Fernández Bullido Y.; Gil Núnez A.) Hospital General Universitario Gregorio
Maranõ N, Neurology Department-Vascular Neurology Section, Madrid, Spain.
(Del Valle Diéguez M.; Saura Lorente J.; Castro Reyes E.; Villoria Medina
F.; Fortea Gil F.) Hospital General Universitario Gregorio Maranõ N,
Radiology Department-Neuroradiology Section, Madrid, Spain.
CORRESPONDENCE ADDRESS
A.M. Iglesias Mohedano, Hospital General Universitario Gregorio Maranõ N,
Neurology Department-Vascular Neurology Section, Madrid, Spain.
SOURCE
European Stroke Journal (2017) 2:1 Supplement 1 (244). Date of Publication:
1 May 2017
CONFERENCE NAME
3rd European Stroke Organisation Conference, ESOC 2017
CONFERENCE LOCATION
Prague, Czech Republic
CONFERENCE DATE
2017-05-16 to 2017-05-18
ISSN
2396-9881
BOOK PUBLISHER
SAGE Publications Ltd
ABSTRACT
Background and Aims: To determine if a protocol originally designed to
reduce in-hospital time to intravenous thrombolysis (IVT) in acute ischemic
stroke is also effective reducing time to endovascular treatment. Method: A
series of interventions aimed to reduce IVT treatment delays were
implemented in a tertiary care hospital in February 2014. Consecutive
ischemic stroke patients treated with endovascular treatment were
prospectively registered. In-hospital delays of endovascular treatment were
analyzed before (pre-intervention period: January 2011-January 2014) and
after the new protocol (post-intervention period: February 2014-December
2016). Endovascular treatment is only available in our institution during
office hours. Intra-hospital strokes and patients transferred from other
hospitals with part of their work-up complete were excluded. Results: 50
patients. Mean age (SD) 64.8 (13.9). 46% were males. 16 patients were
included before and 34 after the new protocol. Among these patients, 32%
were treated previously with IVT. Median time in minutes before/after the
new interventions were respectively: Door-toimaging 20/15 (p=0.06);
Door-to-IVT 48/32 (p=0.02); imaging-to-groin puncture 106/54 (p=0.002);
door-to-groin puncture 122/76 (p=0.001); door-to-reperfusion 162/154
(p=0.71); endovascular procedure time 73/90 (p=0.51). Time from
imaging-to-groin puncture in patients with/ without IVT performed was 116/54
minutes respectively (p<0.001). When IVT was initiated on CT table this
interval was reduced to 51 minutes. Conclusion: Interventions aimed to
reduce in-hospital delays to IVT appear to be also effective reducing time
to groin puncture. IVT was identified as delaying factor for endovascular
treatment when not started on CT table. Other more specific measures should
be implemented in order to reduce endovascular procedure time and
conclusively time to reperfusion.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
blood clot lysis
inguinal region
puncture
EMTREE MEDICAL INDEX TERMS
brain ischemia
clinical article
endovascular surgery
female
human
human tissue
imaging
male
reperfusion
stroke patient
tertiary care center
therapy delay
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L616966596
DOI
10.1177/2396987317705242
FULL TEXT LINK
http://dx.doi.org/10.1177/2396987317705242
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 47
TITLE
The t3 trial: Triage, treatment and transfer of patients with stroke in
emergency departments
AUTHOR NAMES
Middleton S.
Levi C.
Dale S.
Cheung N.W.
McInnes E.
Considine J.
D'Este C.
Cadilhac D.
Grimshaw J.
Gerraty R.
Craig L.
Schadewaldt V.
McElduff P.
Fitzgerald M.
Quinn C.
Cadigan G.
Denisenko S.
Longworth M.
Ward J.
AUTHOR ADDRESSES
(Middleton S.; Dale S.; McInnes E.; Craig L.; Schadewaldt V.) St Vincent's
Health Australia Sydney SVHAS and Australian Catholic University ACU,
Nursing Research Institute, Sydney, Australia.
(Levi C.) University of Newcastle, Centre for Translational Neuroscience and
Mental Health, Newcastle, Australia.
(Cheung N.W.) University of Sydney and Westmead Hospital, Centre for
Diabetes and Endocrinology Research, Sydney, Australia.
(Considine J.) Deakin University, Nursing and Midwifery Research Centre
School of Nursing and Midwifery, Burwood, Australia.
(D'Este C.) Australian National University, National Centre for Epidemiology
and Population Health NCEPH, Canberra, Australia.
(Cadilhac D.) Monash University, Stroke and Ageing Research-School of
Clinical Sciences, Clayton, Australia.
(Cadilhac D.) University of Melbourne, Florey Institute of Neuroscience and
Mental Health, Melbourne, Australia.
(Grimshaw J.) University of Ottawa, Department of Medicine, Canada.
(Grimshaw J.) Ottawa Health Research Institute, Clinical Epidemiology
Program, Canada.
(Gerraty R.) Monash University, Department of Medicine, Clayton, Australia.
(Gerraty R.) Epworth Hospital, Neurosciences Clinical Institute, Richmond,
Australia.
(McElduff P.) University of Newcastle, School of Medicine and Public Health,
Newcastle, Australia.
(Fitzgerald M.) Monash University, Central Clinical School, Clayton,
Australia.
(Fitzgerald M.) Swinburne University of Technology, Faculty of
Science-Engineering and Technology, Hawthorn, Australia.
(Quinn C.) Prince of Wales Hospital, Speech Pathology, Sydney, Australia.
(Cadigan G.) Royal Brisbane and Women's Hospital, Statewide Stroke Clinical
Network, Hertson, Australia.
(Denisenko S.) Department of Health Victoria, Victorian Stroke Clinical
Network, Melbourne, Australia.
(Longworth M.) Agency for Clinical Innovation, Stroke Services NSW, Sydney,
Australia.
(Ward J.) University of Ottawa, School of Epidemiology-Public Health and
Preventive Medicine, Canada.
(Ward J.) University of Notre Dame Australia, Nulungu Research Institute,
Broome, Australia.
CORRESPONDENCE ADDRESS
S. Middleton, St Vincent's Health Australia Sydney SVHAS and Australian
Catholic University ACU, Nursing Research Institute, Sydney, Australia.
SOURCE
European Stroke Journal (2017) 2:1 Supplement 1 (490-491). Date of
Publication: 1 May 2017
CONFERENCE NAME
3rd European Stroke Organisation Conference, ESOC 2017
CONFERENCE LOCATION
Prague, Czech Republic
CONFERENCE DATE
2017-05-16 to 2017-05-18
ISSN
2396-9881
BOOK PUBLISHER
SAGE Publications Ltd
ABSTRACT
Background and Aims: Placeholder abstract number: AS01-007]. The T3 cluster
randomised trial aimed to improve Triage, Treatment and Transfer (T3) of
patients with acute stroke in emergency departments (EDs) Method: Our
prospective, multicentre, parallel group, cluster randomised trial with
blinded outcome assessment, randomised EDs 1:1 to receive either the T3
intervention or no support (control EDs). Our evidence-based intervention
targeted: (1) Triage: patients with suspected stroke assigned to Australian
Triage Scale category 1 or 2 (seen within 10 minutes); (2) Treatment:
screening for tPA eligibility and administration of tPA where applicable;
protocols for management of fever, hyperglycaemia and swallowing; and (3)
rapid Transfer from ED to the stroke unit, implemented using (i) workshops
to determine barriers and solutions; (ii) education; (iii) use of clinical
opinion leaders; (iv) email, telephone and site visit reminders. Primary
outcome: 90-days post-admission death or dependency (mRS>2). Secondary
outcomes: 90-day: health status (SF-36), functional dependency (Barthel
Index), quality of life (EQ-5D); and inhospital quality-of-care outcomes:
triage practices; monitoring and management for thrombolysis, fever,
hyperglycaemia, swallowing; and transfer practices. Results: Of the 26
eligible sites from three states and one territory in Australia, all (100%)
agreed to participate with 2253 patients consenting (pre-implementation
n=645; post-implementation n=1608). Of these, 1875 will be analysed
(pre-implementation n=574; post-implementation n=1301). In the
post-implementation cohort, 749 patients were randomised to the intervention
group and 552 to the control group. Data currently are being analysed.
Conclusion: This large trial will provide rigorous evidence for assisted
implementation of nurse-initiated ED stroke protocols aiming to improve
outcomes for patients with stroke.
EMTREE DRUG INDEX TERMS
endogenous compound
tissue plasminogen activator
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
emergency ward
female
male
stroke unit
EMTREE MEDICAL INDEX TERMS
Australia
Barthel index
blood clot lysis
clinical trial
control group
controlled clinical trial
controlled study
death
e-mail
education
evidence based nursing
evidence based practice center
fever
health status
human
hyperglycemia
leadership
major clinical study
monitoring
nurse
parallel design
randomized controlled trial
Rankin scale
screening
Short Form 36
swallowing
telephone
treatment outcome
CAS REGISTRY NUMBERS
tissue plasminogen activator (105913-11-9)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L616967245
DOI
10.1177/2396987317706897
FULL TEXT LINK
http://dx.doi.org/10.1177/2396987317706897
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 48
TITLE
Newly-developed in-house ELISA methods: For measuring serum ferritin,
soluble transferrin receptor, C-reactive protein and alpha-1-acid
glycoprotein
AUTHOR NAMES
Esmaeili R.
Zhang M.
Mapango C.
Pfeiffer C.M.
AUTHOR ADDRESSES
(Esmaeili R.; Zhang M.; Mapango C.; Pfeiffer C.M.) Centers for Disease
Control and Prevention, Chamblee, United States.
CORRESPONDENCE ADDRESS
R. Esmaeili, Centers for Disease Control and Prevention, Chamblee, United
States.
SOURCE
FASEB Journal (2017) 31:1 Supplement 1. Date of Publication: 1 Apr 2017
CONFERENCE NAME
Experimental Biology 2017, EB
CONFERENCE LOCATION
Chicago, IL, United States
CONFERENCE DATE
2017-04-22 to 2017-04-26
ISSN
1530-6860
BOOK PUBLISHER
FASEB
ABSTRACT
Assessment of population iron status has been an importantelement in
nutrition surveys to identify the population groups at risk for iron
deficiency and to monitor the impact of iron intervention. The commercially
available kit assays performed on clinical analyzers to measure biomarkers
of iron and inflammation status require specimen volumes and resources that
are usually not available in nutrition surveys conducted in low resource
settings. The goal of this project was to develop in-house ELISA assays for
testing serum ferrit in (FER), soluble transferrin receptor (sTfR),
C-reactive protein (CRP), and alpha-1-acidglycoprotein (AGP) that require
small specimen volume and are inexpensive and simple to perform;
furthermore, to evaluate the potential application of these methods in
nutrition surveys. We developed four sandwich ELISA assays by screening and
pairing commercially available capture and detection(conjugated with horse
radish peroxidase) antibodies for FER, sTfR, CRP, and AGP. We optimized the
assay conditions for each analyte with regards to plate coating procedure,
antibody concentration, sample dilution, incubation time, washing procedure,
and timing for color development for detection. Each ELISA plate contained a
6-point (FER) or 8-point calibration curve (sTfR, CRP and AGP), 2 levels of
quality control samples, 1 adjuster sample, 1 blank sample and 32 unknown
samples (duplicate measurement each). Twenty-five μL of serum was sufficient
to test all four biomarkers. The reportable ranges were 8-360 ng/mL for FER,
0.1-15μg/mL for sTfR, 0.3-38 μg/mL for CRP, and 0.064-8.2 mg/mL for AGP. The
intra- and interassay variability was acceptable:7% (n=6) and 7% (n=25) for
FER, 11% (n=6) and 8% (n=25) for sTfR, 5% (n=6) and 13%(n=40) for CRP, and
6% (n=6) and 12% (n=12) for AGP, respectively. We observed complete dilution
linearity recovery (2-fold dilution below or above routine dilution): 101±5%
for FER, 101±14% for sTfR, 103±7% for CRP, and 100±9% for AGP. However, the
sTfR assay exhibited a concentration dependent bias. An initial comparison
between the in-house ELISA assays and the Roche Mod PE clinical analyzer
demonstrated good correlation (Pearson r=0.99 (n=82) for FER, r=0.95
(n=38)for sTfR, and r=0.99 (n=33) for CRP) and an acceptable mean difference
of -6% for FER, -3% for sTfR, and -7% for CRP. For AGP, the comparison
between the in-house ELISA and the Quantikine AGP kit showed a weaker
correlation (Pearson r=0.7 (n=18))and a high mean difference of 75%.
However, our AGP ELISA assay (0.642 mg/mL)produced comparable results to the
international reference material ERM-DA470(0.656 mg/mL). In conclusion, the
performance for these four in-house ELIS Aassays is acceptable with regards
to sensitivity, precision, dilution linearity recovery, and agreement with
commercially available methods or in the case of AGP, with an international
standard. These inhouse ELISA assays require only a small specimen volume
and are designed for use as a routine procedure. They allow the laboratory
control over assay long-term stability. To evaluate their robustness for
nutrition surveys, we plan to conduct more experiments in a routine assay
setting.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
C reactive protein
CD71 antigen
orosomucoid
EMTREE DRUG INDEX TERMS
antibody
endogenous compound
horseradish peroxidase
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
drug solubility
ELISA kit
ferritin blood level
EMTREE MEDICAL INDEX TERMS
analyzer
calibration
dilution
human
human tissue
incubation time
major clinical study
nutrition
quality control
screening
CAS REGISTRY NUMBERS
C reactive protein (9007-41-4)
orosomucoid (79921-18-9)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L616959451
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 49
TITLE
An audit of pregnancis complicated by preeclampsia necessitating in-utero
transfer
AUTHOR NAMES
Reilly S.
Brennecke S.
Smith J.
Boland R.
AUTHOR ADDRESSES
(Reilly S.) University of Melbourne, Australia.
(Brennecke S.) Royal Women's Hospital, Department of Maternal Fetal
Medicine, Melbourne, Australia.
(Smith J.; Boland R.) Paediatric Infant Perinatal Emergency Retrieval, Royal
Children's Hospital, Melbourne, Australia.
CORRESPONDENCE ADDRESS
S. Reilly, University of Melbourne, Australia.
SOURCE
Journal of Paediatrics and Child Health (2017) 53 Supplement 2 (84). Date of
Publication: 1 Apr 2017
CONFERENCE NAME
21st Annual Congress of the Perinatal Society of Australia and New Zealand,
PSANZ
CONFERENCE LOCATION
Canberra, ACT, Australia
CONFERENCE DATE
2017-04-02 to 2017-04-05
ISSN
1440-1754
BOOK PUBLISHER
Blackwell Publishing
ABSTRACT
Background: Pre-eclampsia poses significant risks to mother and fetus. Women
with pre-eclampsia at high risk of adverse outcomes may require transfer to
a higher level of care for optimal management. In Victoria, Australia, a
single centralised service, the Paediatric Infant Perinatal Emergency
Retrieval (PIPER), coordinates in-utero transfers of high-risk pregnancies.
Our aim was to describe clinical features and outcomes of a populationbased
cohort of women with a diagnosis of preeclampsia referred to PIPER and
subsequently transferred in-utero. Methods: We conducted a retrospective
audit of consecutive pregnancies referred to PIPER over a two-year period
(01.01.2013-31.12.2014). Inclusion criteria were a primary diagnosis of
pre-eclampsia,?20 weeks' gestation and transferred in-utero. Perinatal
characteristics, transfer details and outcomes up to 7 days post transfer
were recorded. Results: 199 transfers met inclusion criteria. Of these, 146
(73%) presented with severe pre-eclampsia. A wide range of clinical features
(n = 24) was reported. Overall, 59% of transfers were for maternal
indications, 24% for a combination of maternal and fetal indications, 12%
for fetal indications and 5% were not specified. 156 (78%) women were
transferred to a tertiary centre and 43 (22%) to a Level 5 maternity
service. Within 7 days, 153 (77%) women gave birth to 165 live-born and 3
stillborn infants. Mean gestational age at birth was 30.9 weeks (SD 3.3). 29
women required high dependency/intensive care unit admission. No maternal
deaths were reported. Conclusion: This audit gives insight into the
complexity of clinical presentations and outcomes of women diagnosed with
preeclampsia and transferred in-utero.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
preeclampsia
EMTREE MEDICAL INDEX TERMS
clinical article
clinical feature
diagnosis
emergency
female
fetus
gestational age
human
infant
information retrieval
intensive care unit
male
maternal death
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L617840356
DOI
10.1111/jpc.13494_248
FULL TEXT LINK
http://dx.doi.org/10.1111/jpc.13494_248
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 50
TITLE
Nurse only retrieval:Act neonatal emergency transport team
AUTHOR NAMES
Watson W.
Colwill D.
Carlisle H.
AUTHOR ADDRESSES
(Watson W.; Colwill D.) Department of Neonatology, Centenary Hospital for
Women and Children, Australia.
(Carlisle H.) Department of Neonatology, Canberra Hospital, Canberra,
Australia.
CORRESPONDENCE ADDRESS
W. Watson, Department of Neonatology, Centenary Hospital for Women and
Children, Australia.
SOURCE
Journal of Paediatrics and Child Health (2017) 53 Supplement 2 (111-112).
Date of Publication: 1 Apr 2017
CONFERENCE NAME
21st Annual Congress of the Perinatal Society of Australia and New Zealand,
PSANZ
CONFERENCE LOCATION
Canberra, ACT, Australia
CONFERENCE DATE
2017-04-02 to 2017-04-05
ISSN
1440-1754
BOOK PUBLISHER
Blackwell Publishing
ABSTRACT
Background: In 2008 a partnership between NETS NSW and ACT was formed to
retrieve preterm and sick neonates in the ACT and regional NSW. As part of
the service nurses undertake retrieval of neonates without medical support
(nurse only). The aim of this study was to assess the impact of nurse only
retrieval. Method: A prospective audit is in progress to assess nurse only
and medically led retrievals from Jan 2015-Dec 2016. Data being reviewed
includes: Number, region, staff required, age and time taken. Records were
reviewed to identify reason for transfer and any incidents. Data analysis
was undertaken using excel 2010. Results: Since January 2015 the ACT NETS
team have undertaken 123 retrievals from ACT and NSW regional hospitals 28%
(35) were nurse only. Results to date highlight differences between the
retrieval populations. 34%(12/35) of nurse only retrievals compared to 58%
(51/88) of medical led retrievals occurred within 24 hours of birth. A nurse
only retrieval was more likely from General Practitioner led special care
units (52% vs 31%). There have been no adverse events during retrievals.
Review of the service has highlighted the benefits of nurse initiated
telephone conferencing and monthly multidisciplinary meetings to audit
retrievals. On-going developments include the introduction of Telehealth at
triage and at point of nursing assessment to assist in accurate diagnosis
and safe transfer. Conclusion: Nurse only retrievals were safe with nursing
assessments accurate. Nurse only retrievals are cost effective and
beneficial in meeting the need of transporting stable neonates to a tertiary
hospital.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
information retrieval
nurse
EMTREE MEDICAL INDEX TERMS
data analysis
diagnosis
general practitioner
human
intensive care unit
newborn
nursing assessment
staff
telehealth
telephone
tertiary care center
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L617847939
DOI
10.1111/jpc.13494_349
FULL TEXT LINK
http://dx.doi.org/10.1111/jpc.13494_349
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 51
TITLE
Determination of reference range of gamma glutamyl transferase in the
neonatal intensive care unit
AUTHOR NAMES
Kim D.B.
Lim G.
Oh K.W.
AUTHOR ADDRESSES
(Kim D.B.; Lim G., jinadmb@hanmail.net; Oh K.W.) Department of Pediatrics,
Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan,
South Korea.
CORRESPONDENCE ADDRESS
G. Lim, Department of Pediatrics, Ulsan University Hospital, University of
Ulsan College of Medicine, Ulsan, South Korea. Email: jinadmb@hanmail.net
SOURCE
Journal of Maternal-Fetal and Neonatal Medicine (2017) 30:6 (670-672). Date
of Publication: 19 Mar 2017
ISSN
1476-4954 (electronic)
1476-7058
BOOK PUBLISHER
Taylor and Francis Ltd, healthcare.enquiries@informa.com
ABSTRACT
Objective: We aimed to establish the reference range of gamma glutamyl
transferase (GGT) in the first week of life at each gestational age (GA).
Methods: This retrospective study included infants born and admitted before
7 days of age with no apparent congenital liver disease during four
consecutive years. Early GGT levels measured at 3–7 days of age were
analyzed according to GA. Differences according to sex, mode of delivery,
small for gestational age, and the predictability for cholestasis were
analyzed. Results: We analyzed early GGT values in 2091 neonates. The
average reference value in neonates (156.7 ± 98.2 IU/L) was much higher than
that in adults. The GGT values were significantly higher in preterm than in
term infants and in male infants than in female infants. Mode of delivery
and small for gestational age were not significantly related to GGT level.
Early GGT had no predictive value for cholestasis occurrence. Conclusions:
Early GGT levels were much higher in neonates, especially preterm infants
with GA of 31–35 weeks.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
gamma glutamyltransferase (endogenous compound)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
neonatal intensive care unit
EMTREE MEDICAL INDEX TERMS
article
cholestasis
female
gestational age
hospital admission
human
infant
major clinical study
male
newborn
obstetric delivery
priority journal
retrospective study
sex
small for date infant
CAS REGISTRY NUMBERS
gamma glutamyltransferase (85876-02-4)
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Clinical and Experimental Biochemistry (29)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160387840
MEDLINE PMID
27124251 (http://www.ncbi.nlm.nih.gov/pubmed/27124251)
PUI
L610463359
DOI
10.1080/14767058.2016.1182974
FULL TEXT LINK
http://dx.doi.org/10.1080/14767058.2016.1182974
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 52
TITLE
Transferring patients home to die: what is the potential population in UK
critical care units?
AUTHOR NAMES
Coombs M.A.
Darlington A.-S.E.
Long-Sutehall T.
Pattison N.
Richardson A.
AUTHOR ADDRESSES
(Coombs M.A.) Graduate School of Nursing, Midwifery and Health, Victoria
University of Wellington, Wellington, New Zealand
(Darlington A.-S.E.) Faculty of Health Sciences, University of Southampton,
Southampton, UK
(Long-Sutehall T.) Faculty of Health Sciences, University of Southampton,
Southampton, UK
(Pattison N.) Royal Marsden NHS Foundation Trust, London, UK
(Richardson A.) Faculty of Health Sciences, University of Southampton,
Southampton, UK
SOURCE
BMJ supportive & palliative care (2017) 7:1 (98-101). Date of Publication: 1
Mar 2017
ISSN
2045-4368 (electronic)
ABSTRACT
RESULTS: 7844 patients were admitted over a 12-month period. 422 (5.4%)
patients died. Using the criteria developed 100 (23.7%) patients could have
potentially been transferred home to die. Of these 41 (41%) patients were
diagnosed with respiratory disease. 53 (53%) patients were conscious, 47
(47%) patients were self-ventilating breathing room air/oxygen via a mask.
20 (20%) patients were ventilated via an endotracheal tube. 76 (76%)
patients were not requiring inotropes/vasopressors. Mean time between
discussion about treatment withdrawal and time of death was 36.4 h
(SD=46.48). No patients in this cohort were transferred home.CONCLUSIONS: A
little over 20% of patients dying in critical care demonstrate potential to
be transferred home to die. Staff should actively consider the practice of
transferring home as an option for care at end of life for these
patients.OBJECTIVES: Most people when asked, express a preference to die at
home, but little is known about whether this is an option for critically ill
patients. A retrospective cohort study was undertaken to describe the size
and characteristics of the critical care population who could potentially be
transferred home to die if they expressed such a wish.METHODS: Medical notes
of all patients who died in, or within 5 days of discharge from seven
critical care units across two hospital sites over a 12-month period were
reviewed. Inclusion/exclusion criteria were developed and applied to
identify the number of patients who had potential to be transferred home to
die and demographic and clinical data (eg, conscious state, respiratory and
cardiac support therapies) collected.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
statistics and numerical data
EMTREE MEDICAL INDEX TERMS
epidemiology
hospital discharge
human
intensive care
terminal care
treatment withdrawal
United Kingdom
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
26628534 (http://www.ncbi.nlm.nih.gov/pubmed/26628534)
PUI
L614631756
DOI
10.1136/bmjspcare-2014-000834
FULL TEXT LINK
http://dx.doi.org/10.1136/bmjspcare-2014-000834
COPYRIGHT
Copyright 2017 Medline is the source for the citation and abstract of this
record.
RECORD 53
TITLE
A clinical audit of pleural procedures performed at a new general secondary
hospital
AUTHOR NAMES
Ramakrishnan S.
Clarke S.
Manners D.
Jones S.
Piccolo F.
AUTHOR ADDRESSES
(Ramakrishnan S.; Clarke S.) Sir Charles Gairdner Hospital, Nedlands,
Australia.
(Ramakrishnan S.; Clarke S.; Manners D.; Jones S.; Piccolo F.) SJOG Midland
Public and Private Hospital, Midland, Australia.
CORRESPONDENCE ADDRESS
S. Ramakrishnan, Sir Charles Gairdner Hospital, Nedlands, Australia.
SOURCE
Respirology (2017) 22 Supplement 2 (158). Date of Publication: 1 Mar 2017
CONFERENCE NAME
Annual Scientific Meeting of the New Zealand Branch of the Thoracic Society
of Australia and New Zealand, TSANZ and the Australian and New Zealand
Society of Respiratory Science, ANZSRS 2017
CONFERENCE LOCATION
Canberra, ACT, Australia
CONFERENCE DATE
2017-03-24 to 2017-03-28
ISSN
1440-1843
BOOK PUBLISHER
Blackwell Publishing
ABSTRACT
Introduction and Aims: St John of God Midland Public and Private Hospital is
a general secondary hospital that services outer metropolitan Perth. Medical
admissions are managed by general physicians with consulting specialities
including respiratory medicine. We describe the pleural procedures performed
since the hospital opened. Methods: A retrospective audit was performed of
pleural procedures from December 2015 to September 2016. Data was obtained
from an electronic worksheet prospectively collated by the respiratory
service at the hospital. Complications were defined as minor, if they were
unwanted but did not cause any harm, or major, complications if they
necessitated another procedure or caused harm. Complications were further
classified as clinical or operational. Results: Eighty-four pleural
procedures were performed on seventyfive patients. Most were performed (n =
54; 64%), or directly supervised (n = 9; 11%) by respiratory physicians, and
involved the insertion of an intercostal catheter as opposed to
thoracocentesis alone (n = 62; 74% vs n = 21; 25%). Common aetiologies were
malignancy (n = 28; 33%), pleural infection (n = 14; 17%) and parapneumonic
effusion (n = 9; 11%). Seventeen individuals (20%) had intra-pleural
therapies. The total complication rate was 28.5% (n = 24), comprising four
(5%) major clinical complications (presumed iatrogenic pleural infection,
post thoracocentesis pneumothorax requiring drainage, subcutaneous
emphysema, post thrombolysis pleural bleed) and three (4%) major operational
complications (intra-hospital transfer for intercostal catheter insertion,
urgent radiology intervention after equipment failure and repeat procedure
needed after cytology sample not sent). There were seven minor clinical and
ten minor operational complications. Three patients required transfer to a
tertiary hospital. Conclusions: The majority of pleural interventions have
been led by the respiratory medicine service at SJOG Midland with a low rate
of major clinical complications. Links with supportive tertiary care
respiratory and cardiothoracic units are required for more complex cases.
Ongoing audit is crucial to guide resource requirements, system improvements
and education to minimise future complications.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
clinical audit
secondary care center
thoracocentesis
EMTREE MEDICAL INDEX TERMS
blood clot lysis
catheter
cytology
device failure
education
female
human
infection
major clinical study
male
malignant neoplasm
medicine
patient transport
physician
pneumothorax
radiology
repeat procedure
subcutaneous emphysema
tertiary care center
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L617841360
DOI
10.1111/resp.13010
FULL TEXT LINK
http://dx.doi.org/10.1111/resp.13010
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 54
TITLE
Pa o (2)/F io (2) Ratio Derived from the Sp o (2)/F io (2) Ratio to Improve
Mortality Prediction Using the Pediatric Index of Mortality-3 Score in
Transported Intensive Care Admissions∗
AUTHOR NAMES
Ray S.
Rogers L.
Pagel C.
Raman S.
Peters M.J.
Ramnarayan P.
AUTHOR ADDRESSES
(Ray S., Samiran.ray@gosh.nhs.uk; Raman S.; Peters M.J.; Ramnarayan P.)
Respiratory Critical Care and Anaesthesia Unit, UCL Great Ormond Street
Institute of Child Health, London, United Kingdom.
(Ray S., Samiran.ray@gosh.nhs.uk; Pagel C.; Peters M.J.; Ramnarayan P.)
Children's Acute Transport Service, Great Ormond Street Hospital, London,
United Kingdom.
(Rogers L.; Pagel C.) UCL Clinical Operational Research Unit, London, United
Kingdom.
CORRESPONDENCE ADDRESS
S. Ray, Respiratory Critical Care and Anaesthesia Unit, UCL Great Ormond
Street Institute of Child Health, London, United Kingdom. Email:
Samiran.ray@gosh.nhs.uk
SOURCE
Pediatric Critical Care Medicine (2017) 18:3 (e131-e136). Date of
Publication: 1 Mar 2017
ISSN
1947-3893 (electronic)
1529-7535
BOOK PUBLISHER
Lippincott Williams and Wilkins, kathiest.clai@apta.org
ABSTRACT
Objectives: To derive a relationship between the Spo(2)/Fio(2) ratio and
Pao(2)/Fio(2) ratio across the entire range of Spo(2) values (0-100%) and to
evaluate whether mortality prediction using the Pediatric Index of
Mortality-3 can be improved by the use of Pao(2)/Fio(2) values derived from
Spo(2)/Fio(2). Design: Retrospective analysis of prospectively collected
data. Setting: A regional PICU transport service. Patients: Children
transported to a PICU. Interventions: None. Measurements and Main Results:
The relationship between Spo(2)/Fio(2) and Pao(2)/Fio(2) across the entire
range of Spo(2) values was first studied using several mathematical models
in a derivation cohort (n = 1,235) and then validated in a separate cohort
(n = 306). The best Spo(2)/Fio(2)-Pao(2)/Fio(2) relationship was chosen
according to the ability to detect respiratory failure (Pao(2)/Fio(2) ≤
200). The discrimination of the original Pediatric Index of Mortality-3
score and a derived Pediatric Index of Mortality-3 score (where
Spo(2)/Fio(2)-derived Pao(2)/Fio(2) values were used in place of missing
Pao(2)/Fio(2) values) were compared in a different cohort (n = 1,205). The
best Spo(2)/Fio(2)-Pao(2)/Fio(2) relationship in 1,703
Spo(2)/Fio(2)-to-Pao(2)/Fio(2) data pairs was a linear regression equation
of ln[PF] regressed on ln[SF]. This equation identified children with a
Pao(2)/Fio(2) less than or equal to 200 with a specificity of 73% and
sensitivity of 61% in children with Spo(2) less than 97% (92% and 33%,
respectively, when Spo(2) ≥ 97%) in the validation cohort. Pao(2)/Fio(2)
derived from Spo(2)/Fio(2) (derived Pao(2)/Fio(2)) was better at predicting
PICU mortality (area under receiver operating characteristic curve, 0.64;
95% CI, 0.55-0.73) compared with the original Pao(2)/Fio(2) (area under
receiver operating characteristic curve, 0.54; 95% CI, 0.49-0.59; p = 0.02).
However, there was no difference in the original and derived Pediatric Index
of Mortality-3 scores and their discriminatory ability for mortality.
Conclusions: Spo(2)-based metrics perform no worse than arterial blood
gas-based metrics in mortality prediction models. Future Pediatric Index of
Mortality score versions may be improved by the inclusion of risk factors
based on oxygen saturation values, especially in settings where Pao(2)
values are missing in a significant proportion of cases.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
blood oxygen tension
childhood mortality
oxygen saturation
Pediatric Index of Mortality 3 Score
scoring system
EMTREE MEDICAL INDEX TERMS
arterial gas
article
child
cohort analysis
comparative study
discriminant analysis
hospital admission
human
infant
intensive care unit
major clinical study
mathematical model
newborn
observational study
prediction
preschool child
priority journal
prospective study
respiratory failure
retrospective study
sensitivity and specificity
United Kingdom
validation study
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Anesthesiology (24)
Hematology (25)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170081154
MEDLINE PMID
28121834 (http://www.ncbi.nlm.nih.gov/pubmed/28121834)
PUI
L614243853
DOI
10.1097/PCC.0000000000001075
FULL TEXT LINK
http://dx.doi.org/10.1097/PCC.0000000000001075
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 55
TITLE
How Much Does ICU Structure Account for Variation in Mobility Practices
between Acute Respiratory Distress Syndrome Network Hospitals?
AUTHOR NAMES
Taito S.
Sarada K.
Yasuda H.
AUTHOR ADDRESSES
(Taito S.; Sarada K.) Division of Rehabilitation, Department of Clinical
Practice and Support, Hiroshima University Hospital, Minami-ku, Hiroshima,
Japan.
(Yasuda H.) Department of Intensive Care Medicine, Kameda Medical Center,
Kamogawa, Chiba, Japan.
SOURCE
Critical Care Medicine (2017) 45:3 (e329-e330). Date of Publication: 1 Mar
2017
ISSN
1530-0293 (electronic)
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins, kathiest.clai@apta.org
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
adult respiratory distress syndrome
clinical practice
intensive care unit
mobility practice
patient transport
EMTREE MEDICAL INDEX TERMS
body mass
hospital
human
letter
obesity
priority journal
risk
safety
United States
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20170140902
PUI
L614528142
DOI
10.1097/CCM.0000000000002194
FULL TEXT LINK
http://dx.doi.org/10.1097/CCM.0000000000002194
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 56
TITLE
Passive hypothermia (≥35 - <36°C) during transport of newborns with
hypoxicischaemic encephalopathy
AUTHOR NAMES
Sellam A.
Lode N.
Ayachi A.
Jourdain G.
Dauger S.
Jones P.
AUTHOR ADDRESSES
(Sellam A.; Lode N.; Jones P., sejjprj@ucl.ac.uk) SMUR Pédiatrique, AP-HP,
Hôpital Robert Debré, Paris, France.
(Ayachi A.) SMUR Pédiatrique, AP-HP, Hôpital André Gregoire,
Montreuil-sous-Bois, France.
(Jourdain G.) SMUR Pédiatrique, AP-HP, Hôpital Clamart, France.
(Dauger S.; Jones P., sejjprj@ucl.ac.uk) Réanimation Pédiatrique (PICU),
Hôpital Robert Debré, Paris, France.
(Jones P., sejjprj@ucl.ac.uk) Portex Unit, Critical Care Group - Portex
Unit, Institute of Child Health, University College London, London, United
Kingdom.
(Jones P., sejjprj@ucl.ac.uk) London School of Hygiene and Tropical
Medicine, London, United Kingdom.
SOURCE
PLoS ONE (2017) 12:3 Article Number: e0170100. Date of Publication: 1 Mar
2017
ISSN
1932-6203 (electronic)
BOOK PUBLISHER
Public Library of Science, plos@plos.org
ABSTRACT
Background Hypothermia initiated in the first six hours of life in term
infants with hypoxic ischemic encephalopathy reduces the risk of death and
severe neurological sequelae. Our study's principal objective was to
evaluate transport predictors potentially influencing arrival in NICU
(Neonatal Intensive Care Unit) at a temperature ≥35-<36°C.
Methodology/Principal findings A multi-centric, prospective cohort study was
conducted during 18 months by the three Neonatal Transport Teams and 13
NICUs. Newborns were selected for inclusion according to biological and
clinical criteria before transport using passive hypothermia using a target
temperature of ≥35-<36°C. Data on 120 of 126 inclusions were available for
analysis. Thirtythree percent of the children arrived in NICU with the
target temperature of ≥35-<36°C. The mean temperature for the whole group of
infants on arrival in NICU was 35.4°C (34.3-36.5). The median age of all
infants on arrival in NICU was 3h03min [2h25min-3h56min]. Three infants
arrived in NICU with a temperature of <33°C and eleven with a temperature
≥37°C. Adrenaline during resuscitation was associated with a lower mean
temperature on arrival in NICU. Conclusions/Significance Our strategy using
≥35-<36°C passive hypothermia combined with short transport times had little
effect on temperature after the arrival of Neonatal Transport Team although
did reduce numbers of infants arriving in NICU in deep hypothermia. For
those infants where hypothermia was discontinued in NICU our strategy
facilitated re-warming. Re-adjustment to a lower target temperature to
≥34.5-<35.5°C may reduce the proportion of infants with high/normothermic
temperatures.
EMTREE DRUG INDEX TERMS
epinephrine
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hypoxic ischemic encephalopathy (therapy)
induced hypothermia
passive hypothermia
EMTREE MEDICAL INDEX TERMS
adult
article
cohort analysis
controlled study
female
human
infant
major clinical study
male
multicenter study
neonatal intensive care unit
newborn
newborn transport
outcome assessment
patient transport
prediction
prospective study
resuscitation
temperature sensitivity
treatment response
CAS REGISTRY NUMBERS
epinephrine (51-43-4, 55-31-2, 6912-68-1)
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Pediatrics and Pediatric Surgery (7)
Neurology and Neurosurgery (8)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170191480
PUI
L614714207
DOI
10.1371/journal.pone.0170100
FULL TEXT LINK
http://dx.doi.org/10.1371/journal.pone.0170100
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 57
TITLE
Drip 'n Ship Versus Mothership for Endovascular Treatment: Modeling the Best
Transportation Options for Optimal Outcomes
AUTHOR NAMES
Milne M.S.W.
Holodinsky J.K.
Hill M.D.
Nygren A.
Qiu C.
Goyal M.
Kamal N.
AUTHOR ADDRESSES
(Milne M.S.W.; Nygren A.) Department of Biomedical Engineering, Schulich
School of Engineering, Calgary, Canada.
(Hill M.D.; Kamal N., nrkamal@ucalgary.ca) Department of Clinical
Neurosciences, Hotchkiss Brain Institute, University of Calgary, Canada.
(Hill M.D.; Goyal M.) Departments of Medicine, Radiology and Community
Health Sciences, Canada.
(Holodinsky J.K.; Hill M.D.) Departments of Community Health Sciences,
Cumming School of Medicine, University of Calgary, Canada.
(Qiu C.) Department of Mathematics and Statistics, Faculty of Science,
University of Calgary, Canada.
CORRESPONDENCE ADDRESS
N. Kamal, Department of Clinical Neurosciences, Hotchkiss Brain Institute,
University of Calgary, Canada. Email: nrkamal@ucalgary.ca
SOURCE
Stroke (2017) 48:3 (791-794). Date of Publication: 1 Mar 2017
ISSN
1524-4628 (electronic)
0039-2499
BOOK PUBLISHER
Lippincott Williams and Wilkins, kathiest.clai@apta.org
ABSTRACT
Background and Purpose - There is uncertainty regarding the best way for
patients outside of endovascular-capable or Comprehensive Stroke Centers
(CSC) to access endovascular treatment for acute ischemic stroke. The role
of the nonendovascular-capable Primary Stroke Centers (PSC) that can offer
thrombolysis with alteplase but not endovascular treatment is unclear. A key
question is whether average benefit is greater with early thrombolysis at
the closest PSC before transportation to the CSC (Drip 'n Ship) or with PSC
bypass and direct transport to the CSC (Mothership). Ideal transportation
options were mapped based on the location of their endovascular-capable CSCs
and nonendovascular-capable PSCs. Methods - Probability models for
endovascular treatment were developed from the ESCAPE trial's (Endovascular
Treatment for Small Core and Anterior Circulation Proximal Occlusion With
Emphasis on Minimizing CT to Recanalization Times) decay curves and for
alteplase treatment were extracted from the Get With The Guidelines decay
curve. The time on-scene, needle-to-door-out time at the PSC, door-to-needle
time at the CSC, and door-to-reperfusion time were assumed constant at 25,
20, 30, and 115 minutes, respectively. Emergency medical services
transportation times were calculated using Google's Distance Matrix
Application Programming Interface interfaced with MATLAB's Mapping Toolbox
to create map visualizations. Results - Maps were generated for multiple
onset-to-first medical response times and door-to-needle times at the PSCs
of 30, 60, and 90. These figures demonstrate the transportation option that
yields the better modeled outcome in specific regions. The probability of
good outcome is shown. Conclusions - Drip 'n Ship demonstrates that a PSC
that is in close proximity to a CSC remains significant only when the PSC is
able to achieve a door-to-needle time of ≤30 minutes when the CSC is also
efficient.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
alteplase (drug therapy)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
brain ischemia (drug therapy, disease management, drug therapy, surgery)
endovascular surgery
fibrinolytic therapy
patient transport
practice guideline
stroke unit
EMTREE MEDICAL INDEX TERMS
article
brain perfusion
clinical outcome
emergency health service
human
map
mathematical model
priority journal
probability
reperfusion
time to treatment
CAS REGISTRY NUMBERS
alteplase (105857-23-6)
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Drug Literature Index (37)
Neurology and Neurosurgery (8)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170159442
MEDLINE PMID
28100764 (http://www.ncbi.nlm.nih.gov/pubmed/28100764)
PUI
L614623349
DOI
10.1161/STROKEAHA.116.015321
FULL TEXT LINK
http://dx.doi.org/10.1161/STROKEAHA.116.015321
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 58
TITLE
Paediatric retrieval services: is it better to 'stay and play' or 'scoop and
run'?
AUTHOR NAMES
Lodwick G.
Edwards L.
AUTHOR ADDRESSES
(Lodwick G.) Clinical Fellow, Paediatric Intensive Care Department,
Birmingham Children's Hospital, Birmingham B4 6NH
(Edwards L.) Consultant, Paediatric Intensive Care Department, Birmingham
Children's Hospital, Birmingham
SOURCE
British journal of hospital medicine (London, England : 2005) (2017) 78:2
(118). Date of Publication: 2 Feb 2017
ISSN
1750-8460
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
organization and management
patient transport
pediatric intensive care unit
point of care system
EMTREE MEDICAL INDEX TERMS
human
nonbiological model
patient care
United Kingdom
LANGUAGE OF ARTICLE
English
MEDLINE PMID
28165792 (http://www.ncbi.nlm.nih.gov/pubmed/28165792)
PUI
L616925675
DOI
10.12968/hmed.2017.78.2.118
FULL TEXT LINK
http://dx.doi.org/10.12968/hmed.2017.78.2.118
COPYRIGHT
Copyright 2017 Medline is the source for the citation and abstract of this
record.
RECORD 59
TITLE
Complications and benefits of intrahospital transport of adult intensive
care unit patients
AUTHOR NAMES
Harish M.
Janarthanan S.
Siddiqui S.
Chaudhary H.
Prabu N.
Divatia J.
Kulkarni A.
AUTHOR ADDRESSES
(Harish M.; Janarthanan S.; Siddiqui S.; Chaudhary H.; Prabu N.; Kulkarni
A., kaivalyaak@yahoo.co.in) Division of Critical Care Medicine, Department
of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Mumbai,
Maharashtra, India.
(Divatia J.) Department of Anaesthesiology, Critical Care and Pain, Tata
Memorial Hospital, Mumbai, Maharashtra, India.
CORRESPONDENCE ADDRESS
A. Kulkarni, Division of Critical Care Medicine, Department of
Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Mumbai,
Maharashtra, India. Email: kaivalyaak@yahoo.co.in
SOURCE
Indian Journal of Critical Care Medicine (2017) 21:2 (112). Date of
Publication: 1 Feb 2017
ISSN
1998-359X (electronic)
0972-5229
BOOK PUBLISHER
Medknow Publications, B9, Kanara Business Centre, off Link Road, Ghatkopar
(E), Mumbai, India.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
APACHE
artificial ventilation
heart arrest
human
incidence
intensive care
letter
resuscitation
Sequential Organ Failure Assessment Score
ventilated patient
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Cardiovascular Diseases and Cardiovascular Surgery (18)
Anesthesiology (24)
Internal Medicine (6)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20170125473
PUI
L614456268
DOI
10.4103/ijccm.IJCCM_26_17
FULL TEXT LINK
http://dx.doi.org/10.4103/ijccm.IJCCM_26_17
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 60
TITLE
Influence of Immediate Skin-to-Skin Contact During Cesarean Surgery on Rate
of Transfer of Newborns to NICU for Observation
AUTHOR NAMES
Schneider L.W.
Crenshaw J.T.
Gilder R.E.
AUTHOR ADDRESSES
(Schneider L.W.; Crenshaw J.T.; Gilder R.E.)
SOURCE
Nursing for women's health (2017) 21:1 (28-33). Date of Publication: 1 Feb
2017
ISSN
1751-486X (electronic)
ABSTRACT
We conducted an evidence-based practice project to determine if skin-to-skin
contact immediately after cesarean birth influenced the rate of transfer of
newborns to the NICU for observation. We analyzed data for 5 years (2011
through 2015) and compared the rates for the period before implementation of
skin-to-skin contact with rates for the period after. The proportion of
newborns transferred to the NICU for observation was significantly different
and lower after implementing skin-to-skin contact immediately after cesarean
birth (Pearson's χ2 = 32.004, df = 1, p < .001). These results add to the
growing body of literature supporting immediate, uninterrupted skin-to-skin
contact for all mother-newborn pairs, regardless of birth mode.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
mother child relation
organization and management
psychology
touch
EMTREE MEDICAL INDEX TERMS
adult
cesarean section
evidence based nursing
female
human
neonatal intensive care unit
newborn
nursing
pregnancy
procedures
retrospective study
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
28187837 (http://www.ncbi.nlm.nih.gov/pubmed/28187837)
PUI
L617079558
DOI
10.1016/j.nwh.2016.12.008
FULL TEXT LINK
http://dx.doi.org/10.1016/j.nwh.2016.12.008
COPYRIGHT
Copyright 2017 Medline is the source for the citation and abstract of this
record.
RECORD 61
TITLE
Hospital transfer cost savings from triaging selected stroke patients
directly to the comprehensive stroke centers (CSCs) courtesy of the mobile
stroke treatment unit (MSTU)
AUTHOR NAMES
Zafar A.
Udeh B.
Reimer A.
Ramanathan R.S.
Vela-Duarte D.
Taqui A.
Wisco D.
Winners S.
Buletko A.B.
Organek N.
Hustey F.
Hussain S.
Uchino K.
AUTHOR ADDRESSES
(Zafar A.) UNM, Albuquerque, United States.
(Udeh B.; Reimer A.; Ramanathan R.S.; Taqui A.; Wisco D.; Winners S.;
Buletko A.B.; Organek N.; Hustey F.; Hussain S.; Uchino K.) Cleveland
Clinic, Cleveland, United States.
(Vela-Duarte D.) Univ of Colorado, Aurora, United States.
CORRESPONDENCE ADDRESS
A. Zafar, UNM, Albuquerque, United States.
SOURCE
Stroke (2017) 48 Supplement 1. Date of Publication: 1 Feb 2017
CONFERENCE NAME
American Heart Association/American Stroke Association 2017 International
Stroke Conference and State-of-the-Science Stroke Nursing Symposium
CONFERENCE LOCATION
Houston, TX, United States
CONFERENCE DATE
2017-02-22 to 2017-02-24
ISSN
1524-4628
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: The Mobile Stroke Treatment Unit (MSTU) is a novel onsite
pre-hospital treatment team with all basic infra-structure to diagnose,
emergently treat and hence timely triage acute ischemic and hemorrhagic
stroke patients to either the primary stroke center (PSCs) or comprehensive
stroke centers (CSCs). Recent evidence supports outcome benefits in favor of
intra-arterial therapy (IAT) in large vessel strokes and transfers to
neuro-critical care units for managing large strokes. This has resulted in a
surge in transfers to CSCs summing additional transfer costs for patients
not initially presenting to a CSC. This is the first ever study in the
United States that utilizes a basic cost generation model to measure the
economic benefits of MSTU triage directly to the CSCs by-passing PSCs, for
the those patients requiring higher-level care. Method: Mobile Stroke
Treatment Unit database was used to identify patients that stroke
neurologists triaged to CSCs. These included all acute ICH, IAT candidates
and severe strokes with ICU needs. We calculated the average costs of a
typical primary stroke center emergency room visit and the cost of a
critical care transport, generating a cost savings model. Result: Fifty two
patients who were evaluated by stroke neurologists in the mobile stroke unit
from July 2014 to October 2015 were adjudged candidates for comprehensive
stroke centers. Twenty four (46%) of these were intra-cerebral hemorrhage
(ICH) confirmed on portable head CT while the other 28 (54%) presented with
major strokes with possible IA thrombectomy candidacy or anticipated Neuro
ICU needs due to stroke severity. Eleven ICH and 13 ischemic stroke patients
(46%) of the 52 patients by-passed PSC to be taken directly to comprehensive
stroke centers with a potential of saving millions of dollars in costs and
critical time. Conclusion: Even in a city with dense presence of
comprehensive stroke centers, a large cohort of patients by-passed primary
stroke centers with a potential of saving millions of dollars in costs and
critical time. Future goals include evaluating for difference in outcome in
this group of patients that bypassed PSC courtesy MSTU. Additionally, this
needs to be replicated in other counties and cities before policy changes
are proposed.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
brain hemorrhage
cost control
emergency ward
female
male
stroke patient
EMTREE MEDICAL INDEX TERMS
artery
brain ischemia
city
data base
disease model
emergency health service
head
human
major clinical study
neurological intensive care unit
neurologist
stroke unit
thrombectomy
United States
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L617465155
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 62
TITLE
The Patient and Family Perioperative Experience During Transfer of Care: A
Qualitative Inquiry
AUTHOR NAMES
Stutzman S.E.
Olson D.M.
Greilich P.E.
Abdulkadir K.
Rubin M.A.
AUTHOR ADDRESSES
(Stutzman S.E.; Olson D.M.; Greilich P.E.; Abdulkadir K.; Rubin M.A.)
SOURCE
AORN journal (2017) 105:2 (193-202). Date of Publication: 1 Feb 2017
ISSN
1878-0369 (electronic)
ABSTRACT
Patient transfers between the OR and intensive care unit are high-risk
events. Previous studies regarding mechanisms to improve these transfers do
not account for the perspectives of family members or patients. Using
transfer-of-care reports from health care providers, we performed a
qualitative study of patient and family member perspectives by transcribing,
coding, and analyzing seven interviews using hermeneutic cycling, which
revealed three main themes: communication, clinical interaction, and
clinician demeanor. Participants reported that anxiety about the plan of
care and its outcomes eased when they had more frequent communication with
members of the clinical team, observed the team interacting with one
another, and felt the clinicians' demeanors were confident. The results of
this study showed that families perceived that clinicians who communicated
the timing and frequency of protocols and procedures improved patient care.
Clinician training on empathy, professionalism, and accessibility may
increase patient and family satisfaction and decrease negative interactions
between clinicians and patients and their family members.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
family
health personnel attitude
intensive care unit
interpersonal communication
operating room
patient transport
EMTREE MEDICAL INDEX TERMS
anxiety
human
human relation
prevention and control
qualitative research
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
28159078 (http://www.ncbi.nlm.nih.gov/pubmed/28159078)
PUI
L618871046
DOI
10.1016/j.aorn.2016.12.006
FULL TEXT LINK
http://dx.doi.org/10.1016/j.aorn.2016.12.006
COPYRIGHT
Copyright 2017 Medline is the source for the citation and abstract of this
record.
RECORD 63
TITLE
Benefits of and untoward events during intrahospital transport of pediatric
intensive care unit patients
AUTHOR NAMES
Harish M.M.
Siddiqui S.S.
Prabu Natesh R.
Chaudhari H.K.
Divatia J.V.
Kulkarni A.P.
AUTHOR ADDRESSES
(Harish M.M.; Siddiqui S.S.; Prabu Natesh R.; Chaudhari H.K.; Kulkarni A.P.,
kaivalyaak@yahoo.co.in) Department of Anaesthesia Critical Care and Pain,
Division of Critical Care Medicine, Tata Memorial Hospital, Dr. E. Borges
Road, Parel, Mumbai, Maharashtra, India.
(Divatia J.V.) Department of Anaesthesia Critical Care and Pain, Tata
Memorial Hospital, Mumbai, Maharashtra, India.
CORRESPONDENCE ADDRESS
A.P. Kulkarni, Department of Anaesthesia Critical Care and Pain, Division of
Critical Care Medicine, Tata Memorial Hospital, Dr. E. Borges Road, Parel,
Mumbai, Maharashtra, India. Email: kaivalyaak@yahoo.co.in
SOURCE
Indian Journal of Critical Care Medicine (2017) 21:1 (46-48). Date of
Publication: 1 Jan 2017
ISSN
1998-359X (electronic)
0972-5229
BOOK PUBLISHER
Medknow Publications, B9, Kanara Business Centre, off Link Road, Ghatkopar
(E), Mumbai, India.
ABSTRACT
Background and Aims: The transport of critically ill patients for procedures
or imaging outside the Intensive Care Unit (ICU) is potentially hazardous;
hence, the transport process must be organized and efficient. The literature
about benefits of and untoward events (UEs) during intrahospital transport
of pediatric critically ill patient is scarce. We, therefore, audited the
UEs during and benefits of intrahospital transport of critically ill
pediatric patients in our ICU. Subjects and Methods: Eighty critically ill
pediatric (<18 years) cancer patients, transported from the ICU for either
diagnostic or therapeutic procedure over a period of 6 months, were included
in the study. The data collected included the destination (computed
tomography scan, intervention radiology, magnetic resonance imaging scan,
and operation theater), accompanying medical personnel, UEs, and benefits
obtained during transport. Results: Among eighty pediatric patients, the
median age was 8 years (range 2-17 years). During the transport, four (5%)
patients required endotracheal intubation, three (3.75%) patients required
intercostal drain placement, and six (7.5%) patients required
cardiopulmonary resuscitation. Accidental removal of central venous catheter
was reported in three (3.75%) patients, drain came out in four (5%)
patients, and three (3.75%) patients had accidental extubation. Transport
indirectly led to a change in antibiotic therapy in 24 (30%) patients and
directly helped in change of therapy in the form of interventions in 20
(25%) patients. Conclusion: Critically ill children can be transported
safely with adequate pretransport preparations, which may help in avoiding
major UEs and benefit the patient by change in the therapy.
EMTREE DRUG INDEX TERMS
antibiotic agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient transport
pediatric intensive care unit
risk
risk benefit analysis
untoward events
EMTREE MEDICAL INDEX TERMS
adolescent
antibiotic therapy
article
cancer patient
central venous catheter
chest tube
child
clinical audit
critically ill patient
endotracheal intubation
extubation
female
human
major clinical study
male
medical personnel
nuclear magnetic resonance imaging
operating room
patient safety
radiology
resuscitation
x-ray computed tomography
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170067915
PUI
L614185097
DOI
10.4103/0972-5229.198326
FULL TEXT LINK
http://dx.doi.org/10.4103/0972-5229.198326
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 64
TITLE
Pediatric Critical Care Transport as a Conduit to Terminal Extubation at
Home: A Case Series
AUTHOR NAMES
Noje C.
Bernier M.L.
Costabile P.M.
Klein B.L.
Kudchadkar S.R.
AUTHOR ADDRESSES
(Noje C., cnicule1@jhmi.edu; Bernier M.L.; Kudchadkar S.R.) Department of
Anesthesiology and Critical Care Medicine, Johns Hopkins University School
of Medicine, Baltimore, United States.
(Costabile P.M.) Department of Nursing, Johns Hopkins Hospital, Baltimore,
United States.
(Klein B.L.; Kudchadkar S.R.) Department of Pediatrics, Johns Hopkins
University School of Medicine, Baltimore, United States.
SOURCE
Pediatric Critical Care Medicine (2017) 18:1 (e4-e8). Date of Publication: 1
Jan 2017
ISSN
1947-3893 (electronic)
1529-7535
BOOK PUBLISHER
Lippincott Williams and Wilkins, kathiest.clai@apta.org
ABSTRACT
Objectives: To present our single-center's experience with three palliative
critical care transports home from the PICU for terminal extubation. Design:
We performed a retrospective chart review of patients transported between
January 1, 2012, and December 31, 2014. Setting: All cases were identified
from our institutional pediatric transport database. Patients: Patients were
terminally ill children unable to separate from mechanical ventilation in
the PICU, who were transported home for terminal extubation and end-of-life
care according to their families' wishes. Interventions: Patients underwent
palliative care transport home for terminal extubation. Measurements and
Main Results: The rate of palliative care transports home for terminal
extubation during the study period was 2.6 per 100 deaths. The patients were
7 months, 6 years, and 18 years old and had complex chronic conditions. The
transfer process was protocolized. The families were approached by the PICU
staff during multidisciplinary goals-of-care meetings. Parental expectations
were clarified, and home hospice care was arranged pretransfer. All
transports were performed by our pediatric critical care transport team, and
all terminal extubations were performed by physicians. All patients had
unstable medical conditions and urgent needs for transport to comply with
the families' wishes for withdrawal of life support and death at home. As
such, all three cases presented similar logistic challenges, including
establishing do-not-resuscitate status pretransport, having limited time to
organize the transport, and coordinating home palliative care services with
available community resources. Conclusions: Although a relatively infrequent
practice in pediatric critical care, transport home for terminal extubation
represents a feasible alternative for families seeking out-of-hospital
end-of-life care for their critically ill technology-dependent children. Our
single-center experience supports the need for development of formal
programs for end-of-life critical care transports to include patient
screening tools, palliative care home discharge algorithms, transport
protocols, and resource utilization and cost analyses.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
extubation
home care
hospice care
patient transport
pediatric intensive care unit
EMTREE MEDICAL INDEX TERMS
acute lymphoblastic leukemia
acute myeloid leukemia
adult
article
artificial ventilation
bone marrow transplantation
cardiopulmonary arrest
case report
child
chronic respiratory failure
data base
expectation
extracorporeal oxygenation
female
gastrointestinal hemorrhage
hemolytic anemia
human
hydrocephalus
kidney failure
male
medical record review
nasal cannula
palliative therapy
preschool child
priority journal
prostate cancer
pulmonary hypertension
respiratory failure
retrospective study
rhabdomyosarcoma
septic shock
spinal muscular atrophy
terminally ill patient
EMBASE CLASSIFICATIONS
Cancer (16)
Anesthesiology (24)
Hematology (25)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160795369
MEDLINE PMID
27801708 (http://www.ncbi.nlm.nih.gov/pubmed/27801708)
PUI
L613085370
DOI
10.1097/PCC.0000000000000997
FULL TEXT LINK
http://dx.doi.org/10.1097/PCC.0000000000000997
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 65
TITLE
Improving handover between the transport team and neonatal intensive care
unit staff in neonatal transports using the plan-do-study-act tool
AUTHOR NAMES
Kresch M.J.
Christensen S.
Kurtz M.
Lubin J.
AUTHOR ADDRESSES
(Kresch M.J., mkresch@pennstatehealth.psu.edu) Department of Pediatrics,
Division of Newborn Medicine, Penn State Health Children's Hospital,
Hershey, United States.
(Christensen S.; Kurtz M.; Lubin J.) Department of Emergency Medicine,
Division of Prehospital and Transport Medicine, Penn State Health Milton S.
Hershey Medical Center, Hershey, United States.
CORRESPONDENCE ADDRESS
M.J. Kresch, Department of Pediatrics, Division of Newborn Medicine, Penn
State Health Children's Hospital, Hershey, United States. Email:
mkresch@pennstatehealth.psu.edu
SOURCE
Journal of Neonatal-Perinatal Medicine (2017) 10:3 (301-306). Date of
Publication: 2017
ISSN
1878-4429 (electronic)
1934-5798
BOOK PUBLISHER
IOS Press, Nieuwe Hemweg 6B, Amsterdam, Netherlands.
ABSTRACT
OBJECTIVES: The aim was to achieve 100% effective handover from the critical
care transport team to the neonatal intensive care unit (NICU) medical team.
STUDY DESIGN: All patients transferred from referring hospitals by the
critical care transport team to the Level IV NICU were included. Data for
each infant was collected prospectively. The percentage of transported
patients for which medical team and nursing handover occurredwas
recorded.Aquality improvement projectwas launched using the
Plan-Do-Study-Act (PDSA) tool. We implemented several processes including
call from the transport team before arrival and the completion of a transfer
of care form on arrival to the NICU. The process measures and the outcome
measure of completion of handover were monitored. Run charts of process
measures and the outcome measure were analyzed. RESULTS: Completion of
medical handover increased from 95% (baseline) to 100% after 3 PDSA cycles
and this has been maintained for 18 consecutive months. CONCLUSION: Medical
handover from the critical care transport team to the NICU medical staff has
been achieved and sustained for all neonatal transports.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
clinical handover
medical staff
neonatal intensive care unit
patient transport
plan do study act tool
EMTREE MEDICAL INDEX TERMS
article
emergency health service
health care quality
human
infant
intensive care
medical record review
nurse
outcome assessment
priority journal
prospective study
teamwork
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170736829
PUI
L618859673
DOI
10.3233/NPM-16111
FULL TEXT LINK
http://dx.doi.org/10.3233/NPM-16111
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 66
TITLE
Quantitative Analysis of Estimated Burn Size Accuracy for Transfer Patients
AUTHOR NAMES
Armstrong J.R.
Willand L.
Gonzalez B.
Sandhu J.
Mosier M.J.
AUTHOR ADDRESSES
(Armstrong J.R., joe.r.armstrong@gmail.com; Willand L.) Loyola University
Stritch School of Medicine, Maywood, United States.
(Gonzalez B.; Sandhu J.) Clinical Research Office, Health Sciences Division,
Loyola University Chicago, United States.
(Mosier M.J.) Department of Surgery, Loyola University Medical Center,
Maywood, United States.
CORRESPONDENCE ADDRESS
J.R. Armstrong, 2160 S 1st Ave., Maywood, United States. Email:
joe.r.armstrong@gmail.com
SOURCE
Journal of Burn Care and Research (2017) 38:1 (e30-e35). Date of
Publication: 1 Jan 2017
ISSN
1559-0488 (electronic)
1559-047X
BOOK PUBLISHER
Lippincott Williams and Wilkins, kathiest.clai@apta.org
ABSTRACT
The objective of this study was to quantify differences between estimated
TBSA from referring hospitals vs calculated TBSA in the burn unit in regards
to several variables. We conducted a retrospective review of 735 burn
patients admitted over a 17-month period. Three hundred twenty-six patients
fit the criteria of transfers with recorded %TBSA estimations from referring
hospitals. Referring %TBSA was compared with actual %TBSA, and the
difference was expressed as a percentage of actual %TBSA. This was then used
to group referring estimations as underestimated (less than -25%),
satisfactory (-25 to 25%), or overestimated (greater than 25%). A paired
t-test was used to assess the paired differences for significance. Secondary
variables were then assessed between groups. When assessing associations of
these clinical measures, a one-way analysis of variance was used for
continuous variables and Pearson's χ 2 test or Fisher's exact test was used.
Of the 326 patients analyzed, 13 were underestimated, 63 were satisfactory,
and 250 were overestimated. The ratio of overestimation to underestimation
exceeded 19:1 and the ratio of overestimation to satisfactory estimation was
nearly 4:1, with a statistically significant difference in referred %TBSA
and actual %TBSA (P <.0001). Within the over and underestimated groups,
there were significant differences between referred %TBSA and actual %TBSA
(P <.0001). Larger burns were more accurately estimated (P <.0001). There
are significant inaccuracies between referring hospital estimated %TBSA and
actual %TBSA, which consistently and grossly skew toward overestimation.
Inaccuracy in burn size estimation is systemic and can affect patient care
and burn unit efficiency.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
burn patient
quantitative analysis
EMTREE MEDICAL INDEX TERMS
analysis of variance
body surface
burn unit
chi square test
controlled study
human
major clinical study
patient care
quantitative study
retrospective study
Student t test
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170025568
PUI
L614004510
DOI
10.1097/BCR.0000000000000460
FULL TEXT LINK
http://dx.doi.org/10.1097/BCR.0000000000000460
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 67
TITLE
The early natural history of sepsis: Symptoms and visits in the days leading
up to sepsis hospitalization
AUTHOR NAMES
DeMerle K.M.
Prescott H.C.
Liu V.
AUTHOR ADDRESSES
(DeMerle K.M., kmgrady@med.umich.edu; Prescott H.C.) University of Michigan,
Ann Arbor, United States.
(Liu V.) Kaiser Permanente, Oakland, United States.
CORRESPONDENCE ADDRESS
K.M. DeMerle, University of Michigan, Ann Arbor, United States. Email:
kmgrady@med.umich.edu
SOURCE
American Journal of Respiratory and Critical Care Medicine (2017) 195. Date
of Publication: 2017
CONFERENCE NAME
American Thoracic Society International Conference, ATS 2017
CONFERENCE LOCATION
Washington, DC, United States
CONFERENCE DATE
2017-05-19 to 2017-05-24
ISSN
1535-4970
BOOK PUBLISHER
American Thoracic Society
ABSTRACT
Background: Sepsis is a leading cause of hospitalization and death. The CDC
recently reported that 70% of sepsis patients have a healthcare visit in the
month prior to sepsis hospitalization, but this was estimated indirectly
based on patients' burden of comorbid illness. Little is known about the
duration of infectious symptoms prior to sepsis hospitalization. However, it
is likely that patients have prodromal infectious symptoms-and if
identifiable, this might represent an untapped opportunity for prevention
and intervention. Methods: We are reviewing 400 charts, a random sample of
811 community-acquired sepsis hospitalizations at University of Michigan
(U-M) Health System (January 1 to December 31, 2014). Specifically, we are
examining hospitalizations with a principal ICD-9-CM diagnosis of sepsis,
severe sepsis or septic shock, excluding intra-hospital transfers and
patients without evidence (or suspicion) of infection on hospital
presentation. We are completing structured abstractions of ED and admission
documentation and compiling data in REDCaps, a secure online reporting tool
frequently used for clinical trials. We are collecting information on
illness severity at presentation (SOFA score, suspected site of infection),
duration of symptoms prior to presentation, and medical care sought and
received prior to hospital presentation. Results: To date we have reviewed
197 of a planned 400 charts. 26 were excluded (7 with no suggestion of
infection at hospital presentation and 18 intra-hospital transfers), leaving
172 community-acquired sepsis hospitalizations admitted directly to U-M. Of
these 172 patients with community-acquired sepsis, 131 (76.2%) had sepsis
present on admission (infection plus SOFA score (3)2). The most common organ
failures were pulmonary (64.5%) and cardiovascular (60.4%). Suspected sites
of infection at presentation were commonly respiratory (41.9%),
gastrointestinal (28.5%) and urinary (35.5%). 159 (92.5%) patients reported
prodromal symptoms. Fevers (44.8%), dyspnea (25.5%) and confusion (24.4%)
were the most common symptoms immediately prior to hospital presentation. Of
the 159 patients with prodromal symptoms, 77 (44.8%) patients sought
treatment prior to hospitalization. Patients most commonly sought medical
evaluation earlier on the day of admission, generally a telephone call to a
physician (28, 16.3%) or a primary care physician visit (11, 6.4%). Of these
77 patients who sought evaluation prior to hospitalization, 43 (25%)
received a treatment, 24(13.9%) were prescribed antibiotics, 16(9.3%) had
cultures and/or labs drawn, and 51 (29.6%) were referred to the Emergency
Department within 24 hours of physician contact. Conclusions: Over 90% of
community-acquired sepsis hospitalizations have prodromal symptoms and about
half seek medical evaluation prior to hospitalization.
EMTREE DRUG INDEX TERMS
antibiotic agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
history
hospitalization
prodromal symptom
septic shock
EMTREE MEDICAL INDEX TERMS
cardiovascular system
clinical trial
diagnosis
doctor patient relation
documentation
drug therapy
dyspnea
emergency ward
female
fever
gastrointestinal tract
general practitioner
human
ICD-9-CM
major clinical study
male
medical assessment
Michigan
random sample
Sequential Organ Failure Assessment Score
telephone
university
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L617709971
DOI
10.1164/ajrccmconference.2017.C102
FULL TEXT LINK
http://dx.doi.org/10.1164/ajrccmconference.2017.C102
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 68
TITLE
Introduction of the identification, situation, background, assessment,
recommendations tool to improve the quality of information transfer during
medical handover in intensive care
AUTHOR NAMES
Ramasubbu B.
Stewart E.
Spiritoso R.
AUTHOR ADDRESSES
(Ramasubbu B., ramasubb@tcd.ie; Stewart E.; Spiritoso R.) Department of
Cardio-Thoracic Intensive Care Medicine and Surgery, St George’s Hospital,
London, United Kingdom.
CORRESPONDENCE ADDRESS
B. Ramasubbu, Cardio-Thoracic Intensive Care Unit, St George’s Hospital,
Blackshaw Road, London, United Kingdom. Email: ramasubb@tcd.ie
SOURCE
Journal of the Intensive Care Society (2017) 18:1 (17-23). Date of
Publication: 2017
ISSN
1751-1437
BOOK PUBLISHER
SAGE Publications Inc., claims@sagepub.com
ABSTRACT
Objective: To audit the quality and safety of the current doctor-to-doctor
handover of patient information in our Cardiothoracic Intensive Care Unit.
If deficient, to implement a validated handover tool to improve the quality
of the handover process. Methods: In Cycle 1 we observed the verbal handover
and reviewed the written handover information transferred for 50 consecutive
patients in St George’s Hospital Cardiothoracic Intensive Care Unit. For
each patient’s handover, we assessed whether each section of the
Identification, Situation, Background, Assessment, Recommendations tool was
used on a scale of 0–2. Zero if no information in that category was
transferred, one if the information was partially transferred and two if all
relevant information was transferred. Each patient’s handover received a
score from 0 to 10 and thus, each cycle a total score of 0–500. Following
the implementation of the Identification, Situation, Background, Assessment,
Recommendations handover tool in our Intensive Care Unit in Cycle 2, we
re-observed the handover process for another 50 consecutive patients hence,
completing the audit cycle. Results: There was a significant difference
between the total scores from Cycle 1 and 2 (263/500 versus 457/500, p <
0.001). The median handover score for Cycle 1 was 5/10 (interquartile range
4–6). The median handover score for Cycle 2 was 9/10 (interquartile range
9–10). Patient handover scores increased significantly between Cycle 1 and
2, U = 13.5, p < 0.001. Conclusions: The introduction of a standardised
handover template (Identification, Situation, Background, Assessment,
Recommendations tool) has improved the quality and safety of the
doctor-to-doctor handover of patient information in our Intensive Care Unit.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
coronary care unit
patient safety
total quality management
EMTREE MEDICAL INDEX TERMS
clinical article
clinical handover
doctor patient relation
human
patient information
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170098722
PUI
L614327223
DOI
10.1177/1751143716660982
FULL TEXT LINK
http://dx.doi.org/10.1177/1751143716660982
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 69
TITLE
Study of ICU patients transferred to a palliative care unit
AUTHOR NAMES
Conner A.
Conner A.F.
Earle B.
Turrin D.
AUTHOR ADDRESSES
(Conner A., afc5bc@virginia.edu) North Shore University Hospital, Northwell
Health, 300 Community Drive, Manhasset, United States.
(Conner A.F.; Earle B.; Turrin D.)
CORRESPONDENCE ADDRESS
A. Conner, North Shore University Hospital, Northwell Health, 300 Community
Drive, Manhasset, United States. Email: afc5bc@virginia.edu
SOURCE
Journal of Palliative Medicine (2017) 20:4 (A25). Date of Publication: 2017
CONFERENCE NAME
Center to Advance Palliative Care National Seminar Practical Tools for
Making Change, CAPC 2016
CONFERENCE LOCATION
Orlando, FL, United States
CONFERENCE DATE
2016-10-26 to 2016-10-29
ISSN
1557-7740
BOOK PUBLISHER
Mary Ann Liebert Inc.
ABSTRACT
Description: Introduction: North Shore University Hospital (NSUH) has a
10-bed Palliative Care Unit (PCU) that admits over 500 patients annually for
symptom management. 25% of these patients come from an Intensive Care Unit
(ICU). The unit was designed to implement palliative symptom relief and
hospice care for end of life patients including mechanically ventilated
patients. Literature demonstrates the role of palliative care as an
essential component of comprehensive medical care. In order to provide high
quality care to ICU patient transfers, we wanted to better understand the
intricacies of their hospital course. Method: A retrospective review was
conducted for PCU transfers from April 1, 2016 - June 30, 2016 and
specifically ICU transfers. All data was collected from Electronic Medical
Records (EMRs). This data included patient demographics, hospital units,
hospital length of stay (LOS), PCU LOS, admission to PCU consult time, and
PCU consult to PCU admission time. Results: From April 1, 2016 - June 30,
2016, 130 patients were admitted to the PCU. Of these patients, 30 came from
ICUs. For all 130 patients, the average hospital LOS ranged from 11.2- 15.4
days with an average PCU LOS ranging from 3.7-5.2 days. For ICU patients,
hospital LOS range from 12.4-18.0 days while PCU LOS stay was 2.5-5.0 days.
The average admission to PCU consult time for all patients was 4.4 days
while for ICU patients it was 7.8 days. 61.5% of all PCU patients expired in
the unit during this time period, 92.3% of the ICU patients expired.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
female
male
palliative therapy
EMTREE MEDICAL INDEX TERMS
electronic medical record
health care quality
human
intensive care unit
length of stay
major clinical study
patient transport
retrospective study
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L616394740
DOI
10.1089/jpm.2017.0051
FULL TEXT LINK
http://dx.doi.org/10.1089/jpm.2017.0051
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 70
TITLE
Late mobilization: In Hospital physical therapy after intensive care unit
transfer
AUTHOR NAMES
Callahan L.P.
Kelly A.P.
Supinski G.S.
AUTHOR ADDRESSES
(Callahan L.P.; Kelly A.P.; Supinski G.S.) University of Kentucky,
Lexington, United States.
CORRESPONDENCE ADDRESS
L.P. Callahan, University of Kentucky, Lexington, United States.
SOURCE
American Journal of Respiratory and Critical Care Medicine (2017) 195. Date
of Publication: 2017
CONFERENCE NAME
American Thoracic Society International Conference, ATS 2017
CONFERENCE LOCATION
Washington, DC, United States
CONFERENCE DATE
2017-05-19 to 2017-05-24
ISSN
1535-4970
BOOK PUBLISHER
American Thoracic Society
ABSTRACT
Rationale: Early mobilization (EM), a key component of care during critical
illness is provided even in patients who require multiple pressors, high
levels of mechanical ventilation/PEEP and/or dialysis. Recent clinical
practice guidelines suggest EM implementation in order to improve outcomes.
Since many patients who survive an episode of critical illness exhibit
persistent physical disabilities for years, it seems reasonable that EM
would be followed by aggressive physical therapy (PT) throughout
hospitalization and following hospital discharge, with the goal to provide
restoration of physical function and prevention of progressive debilitation.
Objective: The present study examined the continuum of PT rehabilitation in
patients transferred from an intensive care unit (ICU) to a general medicine
(GM) service until hospital discharge. We tested the hypothesis that high
levels of PT delivery for post-ICU patients continue throughout
hospitalization. Methods: Data were extracted from the University of
Kentucky Enterprise Data Warehouse (electronic health record and the
diagnosis coding system). We examined patients who were transferred from an
ICU to the GM service from January-August 2016. We also evaluated the number
of PT sessions post-ICU patients received while on the GM floor service.
Results: As indicated below, 543 (15%) of 3,609 GM hospital discharges from
January-August 2016 were patients transferred to the floor after an ICU
stay. Of these, 128 (23.6%) received PT while in the ICU and while on the
floor. PT assessments averaged 2.8 ± 6.4 SD sessions per patient over an
average of 13 days while on the GM service. Notably, a paucity of patients
(1.5%, n=8) with an ICU stay were discharged from the GM service to a
rehabilitation facility. Conclusions: While there is a strong emphasis on
aggressive EM in the ICU with its obligatory resources and inherent risks,
maintenance of PT in post-ICU patients after transfer to the floor is
deficient, particularly during a time when PT may be much more feasible and
safe. Moreover, many patients who likely suffer from significant post-ICU
weakness and concomitant physical debilitation and frailty are not provided
access to rehabilitation at hospital discharge. Additional investigation is
warranted to delineate the short and long-term consequences of this absence
of late mobilization. We speculate that more objective assessments of
physical function at the time of ICU transfer as well as upon hospital
discharge may provide guidance for targeted, patient-specific interventions
that could improve recovery in this population. (Table Presented).
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
physiotherapy
EMTREE MEDICAL INDEX TERMS
clinical article
data base
diagnosis
electronic health record
female
frailty
general practice
hospital discharge
hospitalization
human
Kentucky
male
mobilization
rehabilitation
remission
university
weakness
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L617713354
DOI
10.1164/ajrccm-conference.2017.A50
FULL TEXT LINK
http://dx.doi.org/10.1164/ajrccm-conference.2017.A50
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 71
TITLE
Horizontal transfer of OXA-23-carbapenemase-producing Acinetobacter species
in intensive care units at an academic complex hospital, Durban,
KwaZulu-Natal, South Africa
AUTHOR NAMES
Swe-Han K.S.
Pillay M.
Schnugh D.
Mlisana K.P.
Baba K.
Pillay M.
AUTHOR ADDRESSES
(Swe-Han K.S., dr.khine85@gmail.com; Pillay M.; Mlisana K.P.) Department of
Medical Microbiology, National Health Laboratory Service, Durban, South
Africa.
(Swe-Han K.S., dr.khine85@gmail.com; Mlisana K.P.; Pillay M.) Medical
Microbiology and Infection Control, School of Laboratory Medicine and
Medical Science, College of Health Sciences, University of KwaZulu-Natal,
Durban, South Africa.
(Schnugh D.) Infection Control Services Laboratory, Department of Clinical
Microbiology and Infectious Diseases, Witwatersrand Medical School,
Johannesburg, South Africa.
(Baba K.) Department of Medical Microbiology, National Health Laboratory
Service, Universitas Academic Laboratory, University of the Free State,
Bloemfontein, South Africa.
CORRESPONDENCE ADDRESS
K.S. Swe-Han, Department of Medical Microbiology, National Health Laboratory
Service, Durban, South Africa. Email: dr.khine85@gmail.com
SOURCE
Southern African Journal of Epidemiology and Infection (2017) 32:4
(119-126). Date of Publication: 2017
ISSN
2220-1084 (electronic)
1015-8782
BOOK PUBLISHER
Medpharm Publications, PO Box 14804, Lyttelton, Gauteng, South Africa.
ABSTRACT
Introduction: Carbapenemase production is an important mechanism of
carbapenem resistance in Acinetobacter species. This study investigated the
presence of the carbapenem-hydrolysing class D β–lactamase- encoding genes,
bla(OXA-23) and bla(OXA-58), and their association with the spread of
multidrug-resistant (MDR) Acinetobacter species in intensive care units at
an academic hospital. Method: Forty-four MDR Acinetobacter species were
confirmed using VITEK(®)2 and Epsilometer tests. The bla(OXA-23) and
bla(OXA-58) genes were detected by polymerase chain reaction (PCR) in
twenty-four selected isolates. The bla(OXA-23) amplicons were sequenced and
compared to the GenBank database. Genotypic relatedness of isolates was
determined by pulsed field gel electrophoresis (PFGE). Clinical and
laboratory data were analysed. Results: Among the twenty-four isolates,
eighteen were carbapenem resistant and six were sensitive. The bla(OXA-23)
gene, but not bla(OXA-58), was detected in the eighteen resistant strains.
The bla(OXA-23) amplicons showed 100% identity with the GenBank database of
bla(OXA-23). The MICs of carbapenems against Acinetobacter species carrying
the bla(OXA-23) gene were 8 to > 16 μg/ml. Genetic relatedness was evident
among isolates of seven pairs from fourteen patients. Of these patients,
twelve were in the same ICUs and two were adjacent to another ICU during the
same hospitalisation period. Conclusion: The selected MDR Acinetobacter
species carried the bla(OXA-23) gene responsible for resistance to
carbapenems, while molecular and clinical data analysis suggested horizontal
transmission in ICUs. In addition, the PFGE typing of a diverse collection
of MDR Acinetobacter species clones showed that isolates were related to no
more than two patients, suggesting that no outbreak had occurred.
EMTREE DRUG INDEX TERMS
carbapenem derivative
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Acinetobacter
intensive care unit
EMTREE MEDICAL INDEX TERMS
amplicon
article
bacterial strain
bacterium isolate
clinical article
controlled study
epsilometer test
gene
hospital
human
minimum inhibitory concentration
polymerase chain reaction
pulsed field gel electrophoresis
South Africa
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170809928
PUI
L619293618
DOI
10.1080/23120053.2017.1335482
FULL TEXT LINK
http://dx.doi.org/10.1080/23120053.2017.1335482
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 72
TITLE
25(th) Critical Care Transport Medicine Conference
AUTHOR NAMES
Newman M.
Petersen P.
Good N.
AUTHOR ADDRESSES
(Newman M.; Petersen P.; Good N.)
SOURCE
Air Medical Journal (2017) 36:1 (24-26). Date of Publication: 1 Jan 2017
ISSN
1532-6497 (electronic)
1067-991X
BOOK PUBLISHER
Mosby Inc., customerservice@mosby.com
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
conference paper
human
medical education
priority journal
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20170048853
PUI
L614093481
DOI
10.1016/j.amj.2016.11.001
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2016.11.001
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 73
TITLE
Retrospective Review of Pediatric Transport: Where Do Our Patients Go After
Transport?
AUTHOR NAMES
Krennerich E.
Sitler C.G.
Shah M.
Lam F.
Graf J.
AUTHOR ADDRESSES
(Krennerich E., emily.krennerich@gmail.com; Sitler C.G.; Lam F.; Graf J.)
Department of Pediatric Critical Care, Texas Children's Hospital, Houston,
TX
(Krennerich E., emily.krennerich@gmail.com; Shah M.; Lam F.; Graf J.) Baylor
College of Medicine, Houston, TX
(Shah M.) Department of Pediatric Emergency Medicine, Texas Children's
Hospital, Houston, TX
CORRESPONDENCE ADDRESS
E. Krennerich, Department of Pediatric Critical Care, Texas Children's
Hospital, Houston, TX Email: emily.krennerich@gmail.com
SOURCE
Air Medical Journal (2017). Date of Publication: 2017
ISSN
1532-6497 (electronic)
1067-991X
BOOK PUBLISHER
Mosby Inc., customerservice@mosby.com
ABSTRACT
Objective: This review describes disposition of transported children and
identifies contributing factors affecting optimal patient placement. The
study describes timing and patient placement indicators in transport
patients to identify areas of improvement, re-education, and training.
Methods: A retrospective chart review for transports via our pediatric
specialty transport team from January 1, 2012, to December 31, 2014, was
performed. Patients were identified by the transport quality assurance
performance improvement database, hospital electronic medical records, and
transport medical records. Results: Three thousand two hundred fifty-six
pediatric patient transports were reviewed. One hundred forty-three records
were excluded. Of the remaining 3,113 patients, admission disposition was:
1,487 (47%) pediatric intensive care unit, 120 (4%) pediatric cardiovascular
intensive care unit, 835 (27%) step-down critical care unit, 438 (14%)
emergency department, 194 (6%) general floor, 29 (1%) neonatal intensive
care unit, and 10 (< 1%) operating room. Of the 22% transported to a
lower-acuity unit, several subsequently required critical care. Children
transported for traumatic injuries had a shorter emergency department length
of stay than medical patients. Conclusion: Our study validates the efficient
use of pediatric specialty transport team resources. Many transported
patients are critically ill, require specialized pediatric services, or
require definitive pediatric emergency department care.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
female
male
retrospective study
EMTREE MEDICAL INDEX TERMS
child
coronary care unit
critically ill patient
electronic medical record
emergency ward
human
injury
length of stay
major clinical study
medical record review
neonatal intensive care unit
newborn
operating room
patient transport
pediatric intensive care unit
quality control
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170609216
PUI
L618025537
DOI
10.1016/j.amj.2017.06.006
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2017.06.006
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 74
TITLE
Drip and ship versus direct to comprehensive stroke center
AUTHOR NAMES
Holodinsky J.K.
Williamson T.S.
Kamal N.
Mayank D.
Hill M.D.
Goyal M.
AUTHOR ADDRESSES
(Holodinsky J.K.; Williamson T.S.; Hill M.D.) Department of Community Health
Sciences, University of Calgary, Calgary, Canada.
(Williamson T.S.) Alberta Children's Hospital Research Institute, O'Brien
Institute for Public Health, University of Calgary, Calgary, Canada.
(Kamal N.; Hill M.D.; Goyal M., mgoyal@ucalgary.ca) Departments of Clinical
Neurosciences, University of Calgary, Calgary, Canada.
(Hill M.D.; Goyal M., mgoyal@ucalgary.ca) Departments of Radiology,
University of Calgary, Calgary, Canada.
(Hill M.D.; Goyal M., mgoyal@ucalgary.ca) Calgary Stroke Program, Hotchkiss
Brain Institute, University of Calgary, Calgary, Canada.
(Mayank D.) Division of Engineering Science, University of Toronto, Ontario,
Canada.
CORRESPONDENCE ADDRESS
M. Goyal, Department of Radiology, Seaman Family MR Research Centre,
Foothills Medical Centre, 1403 29th St NW, Calgary, Canada. Email:
mgoyal@ucalgary.ca
SOURCE
Stroke (2017) 48:1 (233-238). Date of Publication: 1 Jan 2017
ISSN
1524-4628 (electronic)
0039-2499
BOOK PUBLISHER
Lippincott Williams and Wilkins, kathiest.clai@apta.org
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
alteplase (drug therapy)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
brain ischemia (drug therapy, drug therapy)
patient transport
stroke unit
EMTREE MEDICAL INDEX TERMS
endovascular surgery
human
methodology
note
priority journal
probability
randomized controlled trial (topic)
statistical model
CAS REGISTRY NUMBERS
alteplase (105857-23-6)
EMBASE CLASSIFICATIONS
Drug Literature Index (37)
Internal Medicine (6)
Neurology and Neurosurgery (8)
CLINICAL TRIAL NUMBERS
ClinicalTrials.gov (NCT02795962)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20160885250
PUI
L613535400
DOI
10.1161/STROKEAHA.116.014306
FULL TEXT LINK
http://dx.doi.org/10.1161/STROKEAHA.116.014306
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 75
TITLE
Implementation of a standardized handoff protocol for post-operative
admissions to the surgical intensive care unit
AUTHOR NAMES
Mukhopadhyay D.
Wiggins-Dohlvik K.C.
MrDutt M.M.
Hamaker J.S.
Machen G.L.
Davis M.L.
Regner J.L.
Smith R.W.
Ciceri D.P.
Shake J.G.
AUTHOR ADDRESSES
(Mukhopadhyay D., dhriti@utexas.edu; Wiggins-Dohlvik K.C.; MrDutt M.M.;
Hamaker J.S.; Machen G.L.; Davis M.L.; Regner J.L.; Smith R.W.; Ciceri D.P.)
Texas A and M University/Scott and White Hospital, 2401 S. 31st Street,
Temple, TX, 76508, USA
(Shake J.G.) University of Mississippi Medical Center, 2500 N State Street,
Jackson, MS, 39216, USA
CORRESPONDENCE ADDRESS
D. Mukhopadhyay, Texas A and M University/Scott and White Hospital, 2401 S.
31st Street, Temple, TX, 76508, USA Email: dhriti@utexas.edu
SOURCE
American Journal of Surgery (2017). Date of Publication: 2017
ISSN
1879-1883 (electronic)
0002-9610
BOOK PUBLISHER
Elsevier Inc., usjcs@elsevier.com
ABSTRACT
Background: The transfer of critically ill patients from the operating room
(OR) to the surgical intensive care unit (SICU) involves handoffs between
multiple providers. Incomplete handoffs lead to poor communication, a major
contributor to sentinel events. Our aim was to determine whether handoff
standardization led to improvements in caregiver involvement and
communication. Methods: A prospective intervention study was designed to
observe thirty one patient handoffs from OR to SICU for 49 critical
parameters including caregiver presence, peri-operative details, and time
required to complete key steps. Following a six month implementation period,
thirty one handoffs were observed to determine improvement. Results: A
significant improvement in presence of physician providers including
intensivists and surgeons was observed (p = 0.0004 and p < 0.0001,
respectively). Critical details were communicated more consistently,
including procedure performed (p = 0.0048), complications (p < 0.0001),
difficult airways (p < 0.0001), ventilator settings (p < 0.0001) and pressor
requirements (p = 0.0134). Conversely, handoff duration did not increase
significantly (p = 0.22). Conclusions: Implementation of a standardized
protocol for handoffs between OR and SICU significantly improved caregiver
involvement and reduced information omission without affecting provider time
commitment.
EMTREE DRUG INDEX TERMS
hypertensive factor
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
operating room
patient transport
surgical intensive care unit
EMTREE MEDICAL INDEX TERMS
airway
caregiver
clinical article
clinical handover
complication
controlled study
doctor patient relation
female
human
intensivist
intervention study
male
standardization
surgeon
ventilator
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170593017
MEDLINE PMID
28823594 (http://www.ncbi.nlm.nih.gov/pubmed/28823594)
PUI
L617920852
DOI
10.1016/j.amjsurg.2017.08.005
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amjsurg.2017.08.005
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 76
TITLE
Intra hospital transport's complications: Incidence and risk factors
AUTHOR NAMES
Sedghiani I.
Doghri H.
Jendoubi A.
Hamdi D.
Cherif M.A.
El Hechmi Y.Z.
Zouheir J.
AUTHOR ADDRESSES
(Sedghiani I., sedghiani.ines@gmail.com; Jendoubi A.; Hamdi D.) Emergency
and Intensive Care Department, Hôpital Habib Thameur, Tunis, Tunisia.
(Doghri H.; Cherif M.A.; El Hechmi Y.Z.; Zouheir J.) Emergency and Intensive
Care Department, Hopital Habib Thameur, Tunis, Tunisia.
CORRESPONDENCE ADDRESS
I. Sedghiani, Emergency and Intensive Care Department, Hôpital Habib
Thameur, Tunis, Tunisia. Email: sedghiani.ines@gmail.com
SOURCE
Annals of Intensive Care (2017) 7:1 Supplement 1 (26). Date of Publication:
1 Jan 2017
CONFERENCE NAME
French Intensive Care Society, International Congress - Reanimation 2017
CONFERENCE LOCATION
Paris, France
CONFERENCE DATE
2017-01-11 to 2017-01-13
ISSN
2110-5820
BOOK PUBLISHER
Springer Verlag
ABSTRACT
Introduction Caring for patients during intra hospital transport (IHT) is a
high-risk activity. Adverse events during transport are frequent and may
have significant consequences for the patient. The aim of this study was to
assess the incidence of complications occurring during the IHT and to
analyze the causes of such complications. Patients and methods We
prospectively describe IHT from the emergency department, realized from
January 2016 to March 2016. Were included in the study IHT of compromised
patients for whom critical care monitoring was needed and emergency
physician is required. Clinical characteristics of patient's departure and
technical equipments (mechanical ventilation, drugs) were noted.
Complications were defined as follows: patient related problems
(desaturation, haemodynamic instability, arrhythmia, extubation, acute
change in mental status, death) and ventilator related problems (breakdown
or defect of the material). Results During the inclusion period, 102 IHT
were carried out. The IHT were realized for imaging procedure in 41 cases
and for transferring patients to the intensive care unit in 24 cases and to
the other wards in 37 cases. The median IHT duration was 15 min [10-30].
Twenty patients (19%) were mechanically ventilated. The majority of IHT
(60%) were performed by the night shift emergency team. The incidence of
complications was 44% (45 patients). Most events were related to
haemodynamic instability in 25 cases, desaturation in 22 cases, agitation in
14 cases and cardiac arrest in 2 cases and one death. Therapeutic
interventions were volume resuscitation in 13 cases, optimization of
sedation in 12 cases, vasopressor managment in 12 patients and
cardiopulmonary resuscitation in 3 cases. The occurrence of complications
during transport was significantly increased in mechanically ventilated
patients (p = 0.009), especially with inspiratory oxygen fraction >0.5 (p =
0.00), sedation before transport (p = 0.001), vasopressor requirement before
transport (p = 0.03) and with the night shift team (p = 0.007). Sedation and
mechanical ventilation were the independent risk factors of IHT
complications. Conclusion This study confirms that the intrahospital
transport of compromised patients leads to a significant number of
complications. This finding emphasises the need of improving medical skills
during IHT.
EMTREE DRUG INDEX TERMS
hypertensive factor
oxygen
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency ward
risk factor
EMTREE MEDICAL INDEX TERMS
agitation
artificial ventilation
clinical article
complication
death
emergency physician
extubation
heart arrest
heart arrhythmia
hemodynamics
human
imaging
intensive care unit
mental health
monitoring
night
resuscitation
sedation
skill
ventilated patient
CAS REGISTRY NUMBERS
oxygen (7782-44-7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L614626277
DOI
10.1186/s13613-016-0223-8
FULL TEXT LINK
http://dx.doi.org/10.1186/s13613-016-0223-8
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 77
TITLE
Validation of the sepsis in obstetrics score: A model to predict intensive
care unit transfer for sepsis in pregnancy
AUTHOR NAMES
Albright C.M.
Has P.
Rouse D.J.
Hughes B.L.
AUTHOR ADDRESSES
(Albright C.M.) University of Washington, Seattle, United States.
(Has P.; Rouse D.J.; Hughes B.L.) Women and Infants Hospital, Brown
University, Providence, United States.
CORRESPONDENCE ADDRESS
C.M. Albright, University of Washington, Seattle, United States.
SOURCE
American Journal of Obstetrics and Gynecology (2017) 216:1 Supplement 1
(S407-S408). Date of Publication: 1 Jan 2017
CONFERENCE NAME
37th Annual Meeting of the Society for Maternal-Fetal Medicine: The
Pregnancy Meeting
CONFERENCE LOCATION
Las Vegas, NV, United States
CONFERENCE DATE
2017-01-23 to 2017-01-28
ISSN
1097-6868
BOOK PUBLISHER
Mosby Inc.
ABSTRACT
OBJECTIVE: To validate the Sepsis in Obstetrics Score (SOS), a
pregnancy-specific sepsis scoring system. STUDY DESIGN: Women were included
in this prospective validation study of the SOS if they presented to the
emergency department meeting criteria for the systemic inflammatory response
syndrome (SIRS), were suspected to have an infection, and were either
pregnant or up to two weeks postpartum. The primary outcome was admission to
the intensive care unit (ICU) for sepsis. The areas under the receiver
operator characteristic curves for the SOS to predict ICU transfer between
this validation cohort and the derivation cohort were compared to evaluate
for an acceptable difference of 15%. Using the pre-determined cut-point of
an SOS of 6, the test characteristics were evaluated in this cohort.
RESULTS: Between March 2012 and May 2015, 1,250 women who were pregnant or
within two weeks postpartum presented to the emergency department and met
SIRS criteria. Of those, 425 (34%) had a clinical suspicion or diagnosis of
infection: 14 patients (3.3%) were transferred to the ICU, and 45 (10.6%) to
a telemetry unit. The SOS had an area under the receiver operator
characteristic curve of 0.85 (95% CI 0.76-0.95) for prediction of ICU
transfer for sepsis. This is within the 15% acceptable margin of the
derivation cohort (Figure). An SOS cut-off of 6 had a sensitivity of 64%, a
specificity of 88%, a positive predictive value of 15%, and a negative
predictive value of 98.6% for ICU admission. After adjusting for age, BMI,
and race/ethnicity, the OR for ICU transfer was 14.4 (95% CI, 4.0-52.1) and
for ICU or telemetry unit transfer was 10.2 (95% CI, 5.2-20.1). By applying
other validated scoring systems to our cohort of patients, each scoring
system performed similarly well (Table). CONCLUSION: The SOS is the first
scoring system derived and validated in a pregnant population and can
predict ICU transfer for sepsis. Future studies should evaluate its
incorporation into clinical practice in an attempt to more quickly recognize
and treat sepsis in pregnancy. (Figure Presented).
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
model
obstetrics
pregnancy
sepsis
validation process
EMTREE MEDICAL INDEX TERMS
body mass
clinical practice
controlled study
diagnosis
diagnostic test accuracy study
emergency ward
ethnicity
female
human
major clinical study
prediction
predictive value
race
scoring system
telemetry
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L614090794
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 78
TITLE
International aircraft ECMO transportation: First French pediatric
experience
AUTHOR NAMES
Rambaud J.
Léger P.L.
Porlier L.
Larroquet M.
Raffin H.
Pierron C.
Walti H.
Carbajal R.
AUTHOR ADDRESSES
(Rambaud J., jerome.rambaud@aphp.fr; Léger P.L.; Porlier L.; Walti H.)
Pediatric Intensive Care Unit, Armand-Trousseau Hospital, Assistance
Publique-Hôpitaux de Paris, Paris, France.
(Larroquet M.) Pediatric Surgery Department, Armand-Trousseau Hospital,
Assistance Publique-Hôpitaux de Paris, Paris, France.
(Raffin H.) Medic'air International, Bagnolet, France.
(Pierron C.) Pediatric Intensive Care Unit, Kannerklinik, Centre Hospitalier
de Luxembourg, Luxembourg City, Luxembourg.
(Carbajal R.) Pediatric Emergency Department, Armand-Trousseau Hospital,
Assistance Publique-Hôpitaux de Paris, Paris, France.
CORRESPONDENCE ADDRESS
J. Rambaud, Armand-Trousseau Hospital, 26 Avenue du Dr Arnold Netter, Paris,
France. Email: jerome.rambaud@aphp.fr
SOURCE
Perfusion (United Kingdom) (2017) 32:3 (253-255). Date of Publication: 2017
ISSN
1477-111X (electronic)
0267-6591
BOOK PUBLISHER
SAGE Publications Ltd, info@sagepub.co.uk
ABSTRACT
Refractory severe hemodynamic or respiratory failure may require
extracorporeal membrane oxygenation (ECMO). Since some patients are too sick
to be transported safely to a referral ECMO center on conventional
transportation, mobile ECMO transport teams have been developed. The
experiences of some ECMO transport teams have already been reported,
including air and international transport. We report the first French
pediatric international ECMO transport by aircraft. This case shows that a
long distance intervention of the pediatric ECMO transport team is feasible,
even in an international setting. Long distance ECMO transportations are
widely carried out for adults, but remain rare in neonates and children.
EMTREE DRUG INDEX TERMS
dobutamine
epinephrine
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
aircraft
extracorporeal oxygenation
EMTREE MEDICAL INDEX TERMS
adult respiratory distress syndrome
article
artificial ventilation
blood flow
bronchiolitis
case report
electroencephalography
female
heart arrest
hemodynamics
human
Human respiratory syncytial virus
infant
intensive care unit
nuclear magnetic resonance imaging
positive end expiratory pressure
priority journal
resuscitation
CAS REGISTRY NUMBERS
dobutamine (34368-04-2, 52663-81-7, 49745-95-1, 61661-06-1)
epinephrine (51-43-4, 55-31-2, 6912-68-1)
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Drug Literature Index (37)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170307743
MEDLINE PMID
27590633 (http://www.ncbi.nlm.nih.gov/pubmed/27590633)
PUI
L615749876
DOI
10.1177/0267659116667805
FULL TEXT LINK
http://dx.doi.org/10.1177/0267659116667805
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 79
TITLE
Improving Transfer Times for Acute Ischemic Stroke Patients to a
Comprehensive Stroke Center
AUTHOR NAMES
Kodankandath T.V.
Wright P.
Power P.M.
De Geronimo M.
Libman R.B.
Kwiatkowski T.
Katz J.M.
AUTHOR ADDRESSES
(Kodankandath T.V.; Wright P.; Libman R.B.; Katz J.M., jkatz2@northwell.edu)
Department of Neurology, North Shore University Hospital, Hofstra Northwell
School of Medicine, Manhasset, United States.
(Power P.M.) Department of Workforce Safety, Northwell Health, United
States.
(De Geronimo M.) Department of Informatics and Quality, Northwell Health,
United States.
(Kwiatkowski T.) Department of Emergency Medicine, Hofstra Northwell School
of Medicine, United States.
CORRESPONDENCE ADDRESS
J.M. Katz, North Shore University Hospital, Department of Neurology, 300
Community Drive, 9 Tower, Manhasset, United States. Email:
jkatz2@northwell.edu
SOURCE
Journal of Stroke and Cerebrovascular Diseases (2017) 26:1 (192-195). Date
of Publication: 1 Jan 2017
ISSN
1532-8511 (electronic)
1052-3057
BOOK PUBLISHER
W.B. Saunders
ABSTRACT
Background and Objective The transfer of acute ischemic stroke (AIS)
patients to a comprehensive stroke center (CSC) must be rapid. Delays pose
an obstacle to time-sensitive stroke treatments and, therefore, increase the
likelihood of exclusion from endovascular stroke therapy. This study aims to
evaluate the impact of the Stroke Rescue Program, with its goal of
minimizing interfacility transfer delays and increasing the number of
transport times completed within 60 minutes. Methods The Stroke Rescue
Program was initiated to facilitate the rapid transfer of AIS patients from
regional primary stroke centers (PSCs) to the network's CSC. The transfer
process was divided into 3 time elements: transport 1 time (initial phone
call from the PSC until emergency medical service [EMS] arrival at the PSC),
emergency department (ED) time (EMS PSC arrival to PSC departure), and
transport 2 time (PSC departure to CSC arrival). The total transport time
target was set at less than 60 minutes. Protocols and procedures were
implemented with a focus on decreasing the ED time. Results Comparing
baseline (preimplementation) quarter (n = 21) to postproject quarter (1 year
later, n = 31), the percent transported within 60 minutes increased from 62%
to 81%. A statistically significant improvement was seen for both median ED
time (23 minutes versus 14 minutes; U = 171, P < .01) and median total
transport time (56 minutes versus 44 minutes; U = 199, P < .05). Conclusion
Interfacility transfer protocols minimizing the time paramedics spend in a
PSC ED can significantly reduce total transfer time to a comprehensive
stroke center.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
brain ischemia
patient transport
time
EMTREE MEDICAL INDEX TERMS
article
emergency health service
emergency ward
health impact assessment
health program
human
outcome assessment
priority journal
stroke patient
stroke unit
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Neurology and Neurosurgery (8)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160898394
MEDLINE PMID
27743926 (http://www.ncbi.nlm.nih.gov/pubmed/27743926)
PUI
L613586257
DOI
10.1016/j.jstrokecerebrovasdis.2016.09.008
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2016.09.008
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 80
TITLE
Textual analysis of physician progress notes for patients transferred from
the intensive care unit to hospital ward
AUTHOR NAMES
Brown K.
Parsons Leigh J.
Kamran H.
Dodek P.M.
Bagshaw S.M.
Forster A.J.
Turgeon A.F.
Fowler R.A.
Lamontagne F.
Stelfox H.T.
AUTHOR ADDRESSES
(Brown K.; Kamran H.) Calgary, Canada.
(Parsons Leigh J.) University of Calgary and Alberta Health Services,
Calgary, Canada.
(Dodek P.M.) University of British Columbia, Vancouver, Canada.
(Bagshaw S.M.) University of Alberta, Edmonton, Canada.
(Forster A.J.) University of Ottawa, Ottawa, Canada.
(Turgeon A.F.) Université Laval, Québec, Canada.
(Fowler R.A.) University of Toronto, Toronto, Canada.
(Lamontagne F.) Universite de Sherbrooke, Sherbrooke, Canada.
(Stelfox H.T., tstelfox@ucalgary.ca) University of Calgary, Calgary, Canada.
CORRESPONDENCE ADDRESS
H.T. Stelfox, University of Calgary, Calgary, Canada. Email:
tstelfox@ucalgary.ca
SOURCE
American Journal of Respiratory and Critical Care Medicine (2017) 195. Date
of Publication: 2017
CONFERENCE NAME
American Thoracic Society International Conference, ATS 2017
CONFERENCE LOCATION
Washington, DC, United States
CONFERENCE DATE
2017-05-19 to 2017-05-24
ISSN
1535-4970
BOOK PUBLISHER
American Thoracic Society
ABSTRACT
RATIONALE Transfer of patients from the intensive care unit (ICU) to a
hospital ward is a risky period in healthcare delivery that relies on
multiple forms of communication. Information entered into the medical record
by physicians is particularly important because it is a durable source of
information in the context of frequently changing care teams. However,
little is known about the structure and content of physician documentation
in the medical record during transfers of care. We therefore sought to
describe physician progress notes before, during, and after ICU to hospital
ward transfer. METHODS We conducted a prospective multicenter cohort study
of 451 adult patients who were transferred from an ICU to a hospital ward in
10 Canadian hospitals. Anonymized physician progress notes were collected
from each patient's medical record for 10 consecutive calendar days: two
days before ICU transfer, the day of transfer, and seven days' after
transfer to the hospital ward. Quantitative and qualitative (open coding by
two reviewers) analyses were used to identify and compare textual
communication structure and content in ICU and ward physician notes. RESULTS
A total of 447 patient medical records that included 7,201 progress notes
(mean of 16 notes per patient [95% confidence interval 14.0-18.9]) were
collected. Of these notes 96% [91%-100%] were handwritten and 86% of these
[77%-97%] were legible. Of all notes, 93% [88%-98%] included a date, 51%
[42%-61%] included a time, and 55% [42%-68%] included the identification of
the writer. Notes written by ICU physicians were significantly longer than
those written by ward physicians (mean number of lines of text 23.5 vs.
15.3, p<0.001). Qualitative analysis of a purposive sample (n=30) of records
revealed several differences between ICU and ward physicians' notes. ICU
physician notes followed a standardized structure, and focused on multiple
patient issues whereas ward physician notes were mainly focused on issues
that pertained to their specialty. The initial notes written by the
accepting ward physicians followed a structured format similar to that of
the ICU physicians and largely informed the structure and content of
subsequent notes. However, over the course of the patients' ward stay, notes
became progressively shorter and less structured. CONCLUSIONS We identified
differences in the structure and content of ICU and ward physician progress
notes, whereby there are important differences in how information is
recorded. A standardized progress note template may facilitate communication
across care settings and physician specialities.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
doctor patient relation
female
intensive care unit
male
EMTREE MEDICAL INDEX TERMS
clinical trial
cohort analysis
confidence interval
controlled clinical trial
controlled study
human
major clinical study
medical record
multicenter study
purposive sample
qualitative analysis
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L617710326
DOI
10.1164/ajrccmconference.2017.D22
FULL TEXT LINK
http://dx.doi.org/10.1164/ajrccmconference.2017.D22
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 81
TITLE
Ward capacity strain: Defining a new construct based on ed boarding time and
icu transfers
AUTHOR NAMES
Kohn R.
Bayes B.
Ratcliffe S.J.
Halpern S.D.
Kerlin M.P.
AUTHOR ADDRESSES
(Kohn R., rachel.kohn2@uphs.upenn.edu; Bayes B.; Ratcliffe S.J.; Halpern
S.D.; Kerlin M.P.) University of Pennsylvania, Philadelphia, United States.
CORRESPONDENCE ADDRESS
R. Kohn, University of Pennsylvania, Philadelphia, United States. Email:
rachel.kohn2@uphs.upenn.edu
SOURCE
American Journal of Respiratory and Critical Care Medicine (2017) 195. Date
of Publication: 2017
CONFERENCE NAME
American Thoracic Society International Conference, ATS 2017
CONFERENCE LOCATION
Washington, DC, United States
CONFERENCE DATE
2017-05-19 to 2017-05-24
ISSN
1535-4970
BOOK PUBLISHER
American Thoracic Society
ABSTRACT
Rationale: Most ICU survivors are initially discharged to general hospital
wards. Capacity strain on these wards could impact ICU survivors' care and
outcomes in the way that ICU capacity strain impacts ICU patients.
Therefore, we sought to define ward capacity strain and understand its
potential role in ICU patient flow. Methods: This cross-sectional analysis
of three Penn Medicine hospitals included all patients admitted to general
wards 2014-2015. Candidate ward strain variables included daily measurements
of: admissions, discharges, transports, census, severity of illness, total
transfusions, proportion of patients seen by respiratory therapy and on
telemetry monitoring, and mean total, intravenous, oral, and inhaled
medications per patient. We examined two processes of care hypothesized to
be altered by strain: ED boarding time (hours) and patient transfers to the
ICU. All analyses were performed at the level of calendar day. Generalized
estimating equations (GEE) were used for all analyses to account for
clustering by ward. First, we evaluated associations of each candidate
strain variable with each process of care in pairwise combinations, and
retained strain variables with p<0.2 for further evaluation. We next
evaluated correlations between remaining candidate strain variables in
pairwise combinations and retained one per pair with strong correlation
(equivalent of r>0.7). Finally, we built two multivariable GEE models, one
for each process, using the retained candidate strain variables as
independent variables. Results: The final dataset included 730 days with
89,677 patient encounters on 25 wards. Univariate analyses of candidate ward
strain variables with processes of care resulted in retention of admissions,
discharges, transports, census, severity of illness, and mean total and
intravenous medications per patient for further analysis. Census, severity
of illness, and mean total and intravenous medications had strong
correlations in pairwise comparisons, and census was retained. Multivariable
GEE regression of each remaining candidate strain variable with each process
of care demonstrated that increased numbers of ward admissions were
associated with increases in ED boarding time, increased number of ward
discharges were associated with a small decrease in transfers to the ICU,
and increased numbers of transports and higher census were associated with
small increases in ICU transfers (Table). Conclusions: The novel construct
of ward capacity strain is defined by ward admissions, discharges,
transports, and census. Different factors are associated with different
process measures, and differences in ICU transfers are small. Future
directions include assessing ward strain's impact on ICU patient flow and
outcomes among survivors of critical illness (Table presented).
EMTREE MEDICAL INDEX TERMS
critical illness
cross-sectional study
exposure
female
hospital
human
independent variable
intravenous drug administration
major clinical study
male
medicine
monitoring
patient transport
respiratory care
statistical model
survivor
telemetry
univariate analysis
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L617710339
DOI
10.1164/ajrccmconference.2017.D22
FULL TEXT LINK
http://dx.doi.org/10.1164/ajrccmconference.2017.D22
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 82
TITLE
Improving transfers from the intensive care unit to hospital ward: A
multicenter qualitative study of barriers and facilitators to quality
transfers
AUTHOR NAMES
De Grood C.
Parsons Leigh J.
Bagshaw S.M.
Dodek P.M.
Forster A.J.
Fowler R.A.
Boyd J.
Stelfox H.T.
AUTHOR ADDRESSES
(De Grood C.; Boyd J.; Stelfox H.T., tstelfox@ucalgary.ca) University of
Calgary, Calgary, Canada.
(Parsons Leigh J.) University of Calgary and Alberta Health Services,
Calgary, Canada.
(Bagshaw S.M.) University of Alberta, Edmonton, Canada.
(Dodek P.M.) University of British Columbia, Vancouver, Canada.
(Forster A.J.) University of Ottawa, Ottawa, Canada.
(Fowler R.A.) University of Toronto, Toronto, Canada.
CORRESPONDENCE ADDRESS
H.T. Stelfox, University of Calgary, Calgary, Canada. Email:
tstelfox@ucalgary.ca
SOURCE
American Journal of Respiratory and Critical Care Medicine (2017) 195. Date
of Publication: 2017
CONFERENCE NAME
American Thoracic Society International Conference, ATS 2017
CONFERENCE LOCATION
Washington, DC, United States
CONFERENCE DATE
2017-05-19 to 2017-05-24
ISSN
1535-4970
BOOK PUBLISHER
American Thoracic Society
ABSTRACT
RATIONALE The transfer of patients from the intensive care unit (ICU) to a
hospital ward is one of the most challenging, high risk, and inefficient
transitions of care because the patients are sick and complex, the level of
care changes from high-intensity to lower-intensity, and many different
professionals are involved. However, little is known about the perspectives
of providers and patients regarding barriers and facilitators associated
with these transfers. METHODS We conducted a mixed methods prospective
multicenter observational cohort study of 451 patients transferred from an
ICU to a hospital ward in 10 Canadian hospitals. From this study cohort we
purposively recruited one ICU provider, one ward provider, one patient, and
one patient family member from each of the 8 English-speaking study sites
(n=32 participants). Semi-structured telephone interviews were conducted to
capture individual experiences and identify perceived barriers and
facilitators associated with high quality transfers. Two investigators
conducted qualitative content analysis of the transcribed interviews to
identify themes and subthemes, which were iteratively refined with axial
coding. RESULTS ICU and ward providers (physicians, nurses) described three
overarching themes for barriers and facilitators: Capacity
Strain/Availability of Resources, Communication, and Culture. Subthemes from
ICU providers included: Continuity of Communication, ICU Follow-Up, Bed
Availability, and Attending to Attending Communication; subthemes from ward
providers included Timing of Transfer, Collegiality between Providers, Human
Resources, and Patient Information at Transfer. Patients and their family
members described similar barriers and facilitators as providers:
Availability of Resources, Patient-Provider Communication and Provider
Culture. However, subthemes differed from those given by providers: Staff
Availability, Family Engagement, Provider Follow-Up, Ward Orientation, and
Communication Aids. Ten recommendations to improve ICU transfers were
suggested by stakeholders. The top recommendation across all study sites and
stakeholder groups was to implement Standardized Communication Tools that
streamline provider-provider and provider-patient communication during ICU
to ward transfers (e.g., script for verbal handover & template for written
handover). Participants from most study sites recommended development of
Procedures to Manage Delays in Patient Transfer (e.g., scheduled
communication updates). CONCLUSIONS We identified common barriers and
facilitators associated with perceived high quality ICU-to-ward transfers.
Recommendations to improve transfers include implementation of standardized
multi-modal communication tools and procedures to optimize communication
when there are delays in patient transfer. These barriers, facilitators, and
recommendations can inform development of standardized protocols to improve
the transfer of patients from the ICU to the hospital ward.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
controlled study
intensive care unit
qualitative research
EMTREE MEDICAL INDEX TERMS
clinical trial
cohort analysis
communication aid
content analysis
controlled clinical trial
DNA transcription
doctor nurse relation
doctor patient relation
family study
female
follow up
human
instrument validation
major clinical study
male
multicenter study
patient information
patient transport
speech
structured interview
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L617710359
DOI
10.1164/ajrccmconference.2017.D22
FULL TEXT LINK
http://dx.doi.org/10.1164/ajrccmconference.2017.D22
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 83
TITLE
Physician handoffs at ICU-ward transfer: Communication failures and patient
consequences
AUTHOR NAMES
Lyons P.G.
Farnan J.M.
Arora V.
AUTHOR ADDRESSES
(Lyons P.G., plyons@wustl.edu) Washington University in St. Louis School of
Medicine, St. Louis, United States.
(Farnan J.M.; Arora V.) University of Chicago, Chicago, United States.
CORRESPONDENCE ADDRESS
P.G. Lyons, Washington University in St. Louis School of Medicine, St.
Louis, United States. Email: plyons@wustl.edu
SOURCE
American Journal of Respiratory and Critical Care Medicine (2017) 195. Date
of Publication: 2017
CONFERENCE NAME
American Thoracic Society International Conference, ATS 2017
CONFERENCE LOCATION
Washington, DC, United States
CONFERENCE DATE
2017-05-19 to 2017-05-24
ISSN
1535-4970
BOOK PUBLISHER
American Thoracic Society
ABSTRACT
Rationale: Patient transfers from the intensive care unit (ICU) to the wards
may be high-risk due to patient complexity and decreased monitoring
intensity. We recently showed that physician handoff communication failures
- including omitted and incorrect information - were related to adverse
patient events or near-misses around the time of transfer. We aimed to
characterize the information subject to communication failure and evaluate
the burden of handoff failures in terms of patient consequences and
physician workload. Methods: Between August 2015 and April 2016, all PGY-2
and PGY-3 internal medicine residents at the University of Chicago were
recruited to complete a 31-item anonymous, paper-based, self-administered
survey regarding the quality of written handoff notes and resident
perceptions of patient care-related consequences of communication failures
during ICU-ward handoffs. Residents were asked to estimate the frequency of
omitted or incorrect information within transfer notes, with response
options including “never,” “< 5 times per year,” “about 2 times per month,”
“at least once per week,” and “almost every handoff.” Residents were also
asked to recall adverse patient events or near-misses, and to estimate time
spent addressing patient care issues resulting from missing or incorrect
information, and the frequency with which they received handoffs on patients
who were ultimately not transferred to their team. Results: Of 73 residents
approached, 60 (82%) completed the survey. Information most frequently
transmitted incorrectly included oxygen requirements, current antibiotics,
current mental status, and hardware (Figure 1). Additionally, over 60% of
respondents reported that at least twice per month notes omitted active
subspecialty consultants, goals of care, venous thromboembolism prophylaxis,
and information regarding healthcare decision makers. More than 40% of
respondents were aware of missed critical results, medication errors,
discharge delays, and patients lost in the hospital without an assigned care
team resulting from incorrect or missing information. Finally, over 90% of
respondents reported spending 15 minutes or more per patient repeating
already-completed patient care tasks due to errors or omissions in handoffs.
Conclusions: To our knowledge, this is the first survey of resident
perceptions of ICU-ward patient handoffs. Respondents reported frequent
errors of commission and omission of important information in transfer
notes, were aware of numerous adverse patient events or near-misses related
to these communication failures, and spent substantial time working to
recover lost or incorrect information to avoid additional adverse outcomes.
More work is needed to determine whether interventions targeted at more
effective handoff communications can improve patient outcomes. (Figure
presented).
EMTREE DRUG INDEX TERMS
antibiotic agent
oxygen
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
clinical handover
doctor patient relation
female
male
EMTREE MEDICAL INDEX TERMS
adverse outcome
clinical article
clinical trial
computer
consultation
human
Illinois
intensive care unit
internal medicine
medication error
mental health
perception
prophylaxis
recall
resident
treatment failure
university
venous thromboembolism
workload
CAS REGISTRY NUMBERS
oxygen (7782-44-7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L617710372
DOI
10.1164/ajrccmconference.2017.D22
FULL TEXT LINK
http://dx.doi.org/10.1164/ajrccmconference.2017.D22
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 84
TITLE
The challenge of ICU to floor transitions: A standardized transfer note
improves documentation and resident satisfaction
AUTHOR NAMES
Kim B.
Barmaimon G.
Yudelevich E.
Bambrick-Santoyo G.
Basu A.
Shapiro J.
AUTHOR ADDRESSES
(Kim B.; Barmaimon G.; Yudelevich E.; Bambrick-Santoyo G.; Basu A.; Shapiro
J.) Mount Sinai St. Luke's West, New York, United States.
CORRESPONDENCE ADDRESS
B. Kim, Mount Sinai St. Luke's West, New York, United States.
SOURCE
American Journal of Respiratory and Critical Care Medicine (2017) 195. Date
of Publication: 2017
CONFERENCE NAME
American Thoracic Society International Conference, ATS 2017
CONFERENCE LOCATION
Washington, DC, United States
CONFERENCE DATE
2017-05-19 to 2017-05-24
ISSN
1535-4970
BOOK PUBLISHER
American Thoracic Society
ABSTRACT
RATIONALE: Transitions of care require thorough transfer of information
between providers. Resident work hour limitations, misuse of the electronic
medical record (EMR), and the complexity of Intensive Care Unit (ICU)
patients increase the risk of inadequate exchange of critical information,
which can lead to adverse patient outcomes. We created a standardized
transfer note (STN) in the EMR to improve exchange of information during ICU
to medical floor transfers. METHODS: Mount Sinai St. Luke's-West ICUs are
staffed by medical residents (PGY1-3), supervised by a fellow and an
attending. During Phase 1 of our project, a housestaff survey was conducted
to examine the current handoff process. Phase 2 consisted of reviewing 50
pre-intervention medical records to assess the inclusion of essential ICU
information. In Phase 3, we created a STN to include essential domains of
ICU care. Educational training sessions were held and the STN was
implemented. In Phase 4, 57 post-intervention medical records were reviewed
and the housestaff were re-surveyed. Chart review and survey results pre-
and post-intervention were compared. RESULTS: Utilization of the STN was
100% for all transfers. Pre-intervention review revealed widespread deficits
in documentation of essential information. Post-intervention, documentation
improved for the following domains (Figure 1): mechanical ventilation 64%
pre vs 86% post, current method of oxygenation 62% vs 82%, procedures 60% vs
82%, current IV access 50% vs 81%, transfusions 44% vs 79%, home medications
continued 54% vs 82%, home medications held 38% vs 82%, relevant cultures
50% vs 86%, tests pending 64% vs 86%, goals of care 54% vs 74%, emergency
contact information 62% vs 91%. The common practice of copy-paste was
resolved by the design of the STN. Only 35% of the housestaff felt the
pre-intervention transfer note was useful vs 64% post intervention. Overall,
86.7% of the housestaff felt the STN either moderately or significantly
improved the handoff process and 92.7% felt that the STN led to an
improvement in patient care and patient safety. CONCLUSION: Implementation
of a standardized ICU transfer note led to substantial improvement in
documentation of critical information, decreased redundancy and
copy/pasting, and increased resident satisfaction with the handoff process.
We believe that introduction of a STN optimizes documentation, facilitates
more thorough transitions of care and may ultimately lead to improved
patient care and safety. Transitions of care are challenging and require
continued improvement; standardized documentation of critical information is
just the first step. (Figure Presnted).
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
medical record review
resident
satisfaction
EMTREE MEDICAL INDEX TERMS
artificial ventilation
controlled clinical trial
controlled study
emergency
female
human
human experiment
intensive care unit
male
oxygenation
patient care
patient safety
phase 1 clinical trial
phase 2 clinical trial
phase 3 clinical trial
phase 4 clinical trial
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L617704228
DOI
10.1164/ajrccm-conference.2017.A25
FULL TEXT LINK
http://dx.doi.org/10.1164/ajrccm-conference.2017.A25
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 85
TITLE
Intrahospital transport of ICU patients: Clinician perceptions and proposed
solutions
AUTHOR NAMES
Lencioni A.
Timothy K.
Schell-Chaple H.
Gross K.
Shimabukuro D.
Lipshutz A.
Barchas D.
AUTHOR ADDRESSES
(Lencioni A.; Timothy K.; Schell-Chaple H.; Gross K.; Shimabukuro D.;
Lipshutz A.; Barchas D.)
CORRESPONDENCE ADDRESS
A. Lencioni,
SOURCE
Critical Care Medicine (2016) 44:12 Supplement 1 (379). Date of Publication:
1 Dec 2016
CONFERENCE NAME
46th Critical Care Congress of the Society of Critical Care Medicine, SCCM
2016
CONFERENCE LOCATION
Honolulu, HI, United States
CONFERENCE DATE
2017-01-21 to 2017-01-25
ISSN
1530-0293
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Learning Objectives: Intrahospital transport (IHT) of ICU patients occurs
frequently due to need for diagnostic and interventional procedures. Adverse
outcomes (airway, hemodynamic, metabolic, etc.) are associated with IHT of
ICU patients. The aim of this project was to examine ICU clinician
perceptions regarding the safety of IHT and to identify systems improvements
to optimize safety during transport. Methods: We administered a 13-question
survey to registered nurses (RNs) and respiratory therapists (RTs) in a
32-bed medical-surgical ICU at an academic medical center. Clinicians were
surveyed on their perceptions of IHT safety, barriers to IHT safety, and on
select interventions that may improve IHT safety. Results: The survey was
completed by 103 clinicians (93 RNs, 10 RTs). Over three-quarters of RNs
(77%) and half of RTs (50%) perceive overall IHT conditions as safe. Patient
factors (e.g. instability) were reported as the most common safety concern
by both RNs (78%) and RTs (80%). Lack of access to supplies, equipment and
medications was the second most common safety concern among RNs (53%), while
time constraints (50%) and lack of planning (50%) were the second most
common safety concerns among RTs. Both RNs and RTs reported unfamiliarity
with destination areas (54% RNs, 40% RTs) and staffing concerns (58% RNs,
80% RTs) as the most common challenges experienced during IHT. Over half of
RNs (55%) did not feel confident they would receive adequate assistance if
the patient's condition deteriorated. Respondents identified new
interventions to optimize safety during IHT. The development of references
with pertinent information about destination areas and a transport order set
were commonly selected. Conclusions: Clinicians perceive overall IHT
conditions as safe, but identified several factors that impede safety and
emergency response. The design and implementation of standardized practice
guidelines to minimize adverse events during IHT was recommended. Additional
research is needed to further evaluate the safety barriers during IHT and
identify system interventions to prevent harm during IHT of ICU patients.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
perception
EMTREE MEDICAL INDEX TERMS
consensus development
emergency
human
human experiment
intensive care unit
prevention
registered nurse
respiratory therapist
safety
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L613520997
DOI
10.1097/01.ccm.0000509889.18395.64
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000509889.18395.64
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 86
TITLE
Transport teams' documentation of interfacility transferred patients with
aortic dissections
AUTHOR NAMES
Duncan R.
Boualam B.
Newton C.
Rose M.
Borja M.
Bogne N.
Robinson W.
Tran Q.
AUTHOR ADDRESSES
(Duncan R.; Boualam B.; Newton C.; Rose M.; Borja M.; Bogne N.; Robinson W.;
Tran Q.)
CORRESPONDENCE ADDRESS
R. Duncan,
SOURCE
Critical Care Medicine (2016) 44:12 Supplement 1 (167). Date of Publication:
1 Dec 2016
CONFERENCE NAME
46th Critical Care Congress of the Society of Critical Care Medicine, SCCM
2016
CONFERENCE LOCATION
Honolulu, HI, United States
CONFERENCE DATE
2017-01-21 to 2017-01-25
ISSN
1530-0293
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Learning Objectives: Critically ill patients are often transferred between
facilities for higher level of care, and documentations during transport
ensure good patients' hands-off communication and care. The 2010 American
Heart Association guideline for aortic dissection (AoD) recommends fast
reduction of systolic blood pressure, heart rate (HR) and pain levels.
Therefore, close monitoring of these patients during transport is important
to provide appropriate treatment en route and upon arrival at accepting
intensive care units (ICUs). There is no previous study about transportation
teams' documentations (TTD) in this patient population. We hypothesized that
40% of transport team will not have documentation of vital signs or pain
score upon arriving at referring facility (Arriving vital signs), at leaving
(Departure vital signs) and en route (en route vital signs) to accepting
ICUs. Methods: We performed a retrospective study of interfacility
transferred patients for AoD, identified by ICD-9 billing codes of 441. XX,
to a tertiary academic center between 01/01/2011 and 10/31/2013. Patients
were excluded if a) not accompanied with transport teams' documents; b)
intra-facility transfer. Results: Charts from 268 patients with AoD were
reviewed. Eighty (80) intra-facility transferred patients were excluded.
One-hundred-eighty (180) interfacility transferred patients' charts were
analyzed, 100 charts (56%) were not accompanied with TTD. Among the
remaining 80 patients, 55% did not have documentation of SBP, HR, 65%
without pain score at arriving at referring facilities. At departure, 34% of
TTD did not document SBP & HR, while 48% did not document pain score.
Fifteen charts (19%) did not have documentation of re-evaluation during
transportation. Conclusions: Transport teams' documentations are poor.
Absence of documentations suggested no monitoring was provided in this group
of critically ill patients during transport. Transport teams should be more
thorough in documenting vital signs and pain levels of patients with AoD,
not only to avoid medicolegal issues but also to provide high quality
patient care.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
aortic dissection
documentation
EMTREE MEDICAL INDEX TERMS
critically ill patient
heart rate
human
ICD-9
intensive care unit
major clinical study
monitoring
pain
patient care
retrospective study
systolic blood pressure
vital sign
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L613521839
DOI
10.1097/01.ccm.0000509040.64685.b8
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000509040.64685.b8
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 87
TITLE
ICU, ED, OR, MED doctors' perceptions of teamwork and patient transfers:
Evidence from HSOPS
AUTHOR NAMES
Lee S.-H.
Dorman T.
Pronovost P.
Phan P.
AUTHOR ADDRESSES
(Lee S.-H.; Dorman T.; Pronovost P.; Phan P.)
CORRESPONDENCE ADDRESS
S.-H. Lee,
SOURCE
Critical Care Medicine (2016) 44:12 Supplement 1 (347). Date of Publication:
1 Dec 2016
CONFERENCE NAME
46th Critical Care Congress of the Society of Critical Care Medicine, SCCM
2016
CONFERENCE LOCATION
Honolulu, HI, United States
CONFERENCE DATE
2017-01-21 to 2017-01-25
ISSN
1530-0293
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Learning Objectives: ICU doctors transfer patients with ED, OR, and Medicine
units. We sought to understand better the perceived differences between ICU,
ED, Medicine, and OR doctors in communication, learning, and supervisory
support practices may improve interunit patient transfers. Methods: Design
was a cross-sectional study utilizing data from the 2010 AHRQ Hospital
Survey on Patient Safety Culture (HSOPS) for Individuals. Responses from
doctors in ICU (n=333), ED (n=719), Medicine (n=1130), and OR (n=904) at 885
U.S. hospitals were analyzed using t-tests and hierarchical regressions.
Outcome measures included respondents' perceptions of the degree of
interunit teamwork and quality of interunit transfers. Predictor variables
consisted of 5-point Likert scale composites. Results: Compared to ICU, ED,
Medicine and OR doctors have lower perceived teamwork quality (ICU=4.3;
ED=4.02; Med=4.01; OR=3.92; p<.001), communications about error (ICU=3.65;
ED=3.56; Med=3.52; OR=3.47; p<.05), learning (ICU=3.89; ED=3.66; Med=3.73;
OR=3.68; p<.001), and supervisory support practices (ICU=3.9; ED=3.76;
Med=3.74; OR=3.7; p<.05) but higher perceived quality of interunit transfers
(ICU=2.82; ED=3.01; Med=2.99; OR=2.96; p<.05). Regressions show that the
quality of interunit teamwork depends on management support for patient
safety (ICU=.32; ED=.4; Med=.29; OR=.37; p<.01), staffing adequacy (ICU=.17;
ED=.14; Med=.09; OR=.1; p<.01), and intra-unit teamwork quality (ICU=.11;
ED=.12; Med=.13; OR=.17; p<.01). Quality of interunit transfer depends on
interunit teamwork quality (ICU=.54; ED=.54; Med=.56; OR=.7; p<.01), which
explains about 50% of interunit transfer quality (ICU=48%; ED=54%; Med=51%;
OR=58%; p<.01). Conclusions: Interunit transfers can be improved with better
interunit teamwork from support of management, staffing adequacy, and
teamwork culture as well as better understanding and accommodation of the
practices and constraints faced by other units. Interunit differences in
perceived teamwork and transfer quality may limit quality improvement
efforts.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient transport
perception
teamwork
EMTREE MEDICAL INDEX TERMS
clinical trial
controlled clinical trial
controlled study
cross-sectional study
doctor patient relation
human
learning
Likert scale
major clinical study
medicine
multicenter study
patient safety
predictor variable
Student t test
total quality management
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L613522976
DOI
10.1097/01.ccm.0000509761.70669.66
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000509761.70669.66
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 88
TITLE
Seizure treatment in children transported to tertiary care: Recommendation
adherence and outcomes
AUTHOR NAMES
Siefkes H.M.
Holsti M.
Morita D.
Cook L.J.
Bratton S.
AUTHOR ADDRESSES
(Siefkes H.M., hsiefkes@ucdavis.edu; Cook L.J.; Bratton S.) Divisions of
Critical Care Medicine, University of Utah, Salt Lake City, United States.
(Siefkes H.M., hsiefkes@ucdavis.edu) Division of Critical Care Medicine,
Department of Pediatrics, University of California Davis, 2516 Stockton
Blvd., Sacramento, United States.
(Holsti M.) Emergency Medicine, Department of Pediatrics, University of
Utah, Salt Lake City, United States.
(Morita D.) Pediatric Neurology, Granger Medical Clinic, Riverton, United
States.
CORRESPONDENCE ADDRESS
H.M. Siefkes, Division of Critical Care Medicine, Department of Pediatrics,
University of California Davis, 2516 Stockton Blvd., Sacramento, United
States. Email: hsiefkes@ucdavis.edu
SOURCE
Pediatrics (2016) 138:6 Article Number: e20161527. Date of Publication: 1
Dec 2016
ISSN
1098-4275 (electronic)
0031-4005
BOOK PUBLISHER
American Academy of Pediatrics, 141 Northwest Point Blvd, P.O. Box 927, Elk
Grove Village, United States.
ABSTRACT
BACKGROUND AND OBJECTIVES: Convulsive seizures account for 15% of pediatric
air transports. We evaluated seizure treatment received in community
hospital emergency departments among transported patients for adherence to
recommended management. METHODS: This study was a retrospective cohort study
of children transported for an acute seizure to a tertiary pediatric
hospital from 2010 to 2013. Seizure treatment was evaluated for adherence to
recommended management. The primary outcome was intubation. RESULTS: Among
126 events, 61% did not receive recommended acute treatment. The most common
deviation from recommended care was administration of >2 benzodiazepine
doses. Lack of adherence to recommended care was associated with a greater
than twofold increased risk of intubation (relative risk 2.4; 95% confidence
interval, 1.4-4.13) and 1.5-fold increased risk of admission to the ICU
(relative risk 1.65; 95% confidence interval, 1.24-2.16). Duration of
ventilation was commonly <24 hours (87%) for patients who did or did not
receive recommended acute seizure care. Among events treated initially with
a benzodiazepine, only 32% received a recommended weight-based dosage, and
underdosing was most common. CONCLUSIONS: Adherence to evidence-based
recommended acute seizure treatment during initial care of pediatric
patients using medical air transportation was poor. Intubation was more
common when patients did not receive recommended acute seizure care.
Educational efforts with a sustained quality focus should be directed to
increase adherence to appropriate pediatric seizure treatment of children in
community emergency departments.
EMTREE DRUG INDEX TERMS
anticonvulsive agent (drug therapy)
diazepam (drug dose, drug therapy, intravenous drug administration, rectal
drug administration)
fosphenytoin sodium (drug therapy)
levetiracetam (drug therapy)
lorazepam (drug dose, drug therapy, intramuscular drug administration,
intravenous drug administration)
midazolam (drug dose, drug therapy, intramuscular drug administration,
intravenous drug administration)
phenobarbital (drug therapy)
phenytoin (drug therapy)
valproic acid (drug therapy)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient transport
protocol compliance
seizure (drug therapy, drug therapy)
tertiary care center
EMTREE MEDICAL INDEX TERMS
adolescent
adult
article
body weight
child
cohort analysis
emergency care
evidence based medicine
female
health care
hospital admission
human
infant
intensive care unit
intubation
lung ventilation
major clinical study
male
newborn
outcome assessment
pediatric hospital
preschool child
priority journal
recommended drug dose
retrospective study
school child
treatment duration
Utah
CAS REGISTRY NUMBERS
diazepam (439-14-5)
fosphenytoin sodium (92134-98-0)
levetiracetam (102767-28-2)
lorazepam (846-49-1)
midazolam (59467-70-8)
phenobarbital (50-06-6, 57-30-7, 8028-68-0)
phenytoin (57-41-0, 630-93-3)
valproic acid (1069-66-5, 99-66-1)
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Drug Literature Index (37)
Epilepsy Abstracts (50)
Pediatrics and Pediatric Surgery (7)
Neurology and Neurosurgery (8)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170023412
MEDLINE PMID
27940691 (http://www.ncbi.nlm.nih.gov/pubmed/27940691)
PUI
L613996971
DOI
10.1542/peds.2016-1527
FULL TEXT LINK
http://dx.doi.org/10.1542/peds.2016-1527
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 89
TITLE
Hemodynamic management of patients with aortic dissection in emergency
departments prior to transfer
AUTHOR NAMES
Walker A.
Henry A.
Yi J.
Tracy T.
Qureshi M.
Tucker L.
Bonhag C.
Tran Q.
AUTHOR ADDRESSES
(Walker A.; Henry A.; Yi J.; Tracy T.; Qureshi M.; Tucker L.; Bonhag C.;
Tran Q.)
CORRESPONDENCE ADDRESS
A. Walker,
SOURCE
Critical Care Medicine (2016) 44:12 Supplement 1 (153). Date of Publication:
1 Dec 2016
CONFERENCE NAME
46th Critical Care Congress of the Society of Critical Care Medicine, SCCM
2016
CONFERENCE LOCATION
Honolulu, HI, United States
CONFERENCE DATE
2017-01-21 to 2017-01-25
ISSN
1530-0293
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Learning Objectives: Acute Aortic Dissections (AoD) is a hypertensive
emergency and associated with high morbidity and mortality. The 2010
American Heart Association (AHA) guidelines recommend reduction of systolic
blood pressure (SBP) to <120mmHg, heart rate (HR) to <60 beats per minute,
and pain control. Beta-blockers are the first line treatment for SBP and HR.
From a previous study of 62 interfacility transferred patients, we
hypothesized that up to 60% of non-hypotensive, non-bradycardic
interfacility transferred patients will have SBP >121, HR > 61 at time of
transfer. Fifty percent (50%) of the patients will have pain score ≥ 5/10.
Methods: We performed a retrospective study of patients with diagnosis of
aortic dissection, identified by ICD-9 codes of 441. XX, and transferred
from referring EDs to a tertiary academic center between 01/01/2014 and
09/30/2015. Patients were excluded if a) not transferred from an ED; b)
SBP≤89; c) HR≤59, d) no ED records available. Patient's vital signs and pain
scores at time of presenting to EDs and at leaving EDs (Transfer Time) were
compared. Results: Two-hundred-forty-eight (248) patients' charts were
reviewed. One-hundred-forty-one (141) patients met one of the exclusion
criteria and were excluded. One-hundred-seven (107) patients, who were
admitted from 30 different EDs, were included in the analysis. Median
[interquartile] of SBP, HR, pain score at triage were 150 [127-183], 79
[69-93], 7 [4-10] and at time of transfer were 134 [119-162], 79 [66-85], 3
[0-6], respectively. At time of transfer, 65% of patients had SBP≥121, 79%
with HR≥61, 22% had pain score≥5. Fifty-four patients (51%) DID NOT receive
any beta-blocker during their ED stays. Conclusions: Pain among patients
with non-hypotensive, nonbradycardic Aortic Dissections were well controlled
by Emergency Physicians. However, patients' SBP and HR were still not
managed effectively according to AHA guidelines. Intensivists at accepting
Intensive Care Units should be aware and actively involved in patients'
hemodynamic management early and prior to transfer to improve patient care.
EMTREE DRUG INDEX TERMS
beta adrenergic receptor blocking agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
aortic dissection
emergency ward
systolic blood pressure
EMTREE MEDICAL INDEX TERMS
blood pressure monitoring
diagnosis
emergency health service
emergency physician
heart rate
human
ICD-9
information processing
intensive care unit
intensivist
major clinical study
medical society
pain
practice guideline
retrospective study
vital sign
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L613521107
DOI
10.1097/01.ccm.0000508986.30208.73
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000508986.30208.73
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 90
TITLE
Unplanned device dislodgement: A quality metric in critical care transport
AUTHOR NAMES
Bigham M.
Schwartz H.
AUTHOR ADDRESSES
(Bigham M.; Schwartz H.)
CORRESPONDENCE ADDRESS
M. Bigham,
SOURCE
Critical Care Medicine (2016) 44:12 Supplement 1 (371). Date of Publication:
1 Dec 2016
CONFERENCE NAME
46th Critical Care Congress of the Society of Critical Care Medicine, SCCM
2016
CONFERENCE LOCATION
Honolulu, HI, United States
CONFERENCE DATE
2017-01-21 to 2017-01-25
ISSN
1530-0293
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Learning Objectives: Emergency Medical Services for Children emphasizes the
value of “procedures and processes to prepare a child for safe interfacility
transfer (securing airways, critical vascular access, etc.).” However, best
practice measures to prevent unplanned therapeutic device dislodgement
during interfacility transport do not exist. By comparing quality
performance metrics among diverse institutional neonatal/pediatric/adult
transport teams, programs excelling at specific measures will emerge,
together with the detailed practices producing superior performance.
Methods: Data are contained in the Ground and Air Medical qUality Transport
(GAMUT) database. Unplanned device dislodgement (UDD) is defined as follows:
NUMERATOR = The number of documented UDDs (may be more than 1 per transport)
while under the care of the transport team of the following devices (IOs,
IVs, UACs/UVCs, central venous lines, arterial lines, advanced airway, chest
tubes, and tracheostomy tubes). This does not include IVs that infiltrate
without obvious dislodgement. DENOMINATOR = Number of transport patient
contacts during the calendar month. GAMUT data are reported using the REDCap
database and quality metrics data from January 2014 - November 2015 were
analyzed. Analyses included simple statistics and satisfaction of normality
assumptions when determining confidence intervals for high and
low-performing centers. Results: 89 transport programs supplied GAMUT data
for > 6 consecutive months during the study period, and 49 programs
submitted data specific to UDD. 68,322 patient contacts were noted, with
only 19 programs (38.8%) providing a minimum 1,352 patient contacts (to
satisfy normality). There were 250 (0.37%) UDD, with 10 insutitions
performing better (<0.1% UDD) vs. 3 worse performing centers with 0.9% UDD.
Conclusions: GAMUT QIC allows identification of better performing centers
with lower UDD, using a large international database. Best practices from
the high-performers can be learned and replicated to improve quality in CCT.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
EMTREE MEDICAL INDEX TERMS
airway
arterial line
central venous catheter
chest tube
confidence interval
data base
human
major clinical study
satisfaction
statistics
tracheostomy tube
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L613522015
DOI
10.1097/01.ccm.0000509855.77817.a8
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000509855.77817.a8
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 91
TITLE
Characteristics of neonatal transports in California
AUTHOR NAMES
Akula V.P.
Gould J.B.
Kan P.
Bollman L.
Profit J.
Lee H.C.
AUTHOR ADDRESSES
(Akula V.P., akulavishnupriya@gmail.com; Gould J.B.; Profit J.; Lee H.C.)
Division of Neonatal and Developmental Medicine, Department of Pediatrics,
Stanford University School of Medicine and Lucile Salter Packard Childreńs
Hospital, 750 Welch Road, Suite 315, Palo Alto, United States.
(Gould J.B.; Bollman L.) California Perinatal Transport System, Palo Alto,
United States.
(Gould J.B.; Kan P.; Bollman L.; Profit J.; Lee H.C.) California Perinatal
Quality Care Collaborative, Palo Alto, United States.
CORRESPONDENCE ADDRESS
V.P. Akula, Division of Neonatal and Developmental Medicine, Department of
Pediatrics, Stanford University School of Medicine and Lucile Salter Packard
Childreńs Hospital, 750 Welch Road, Suite 315, Palo Alto, United States.
Email: akulavishnupriya@gmail.com
SOURCE
Journal of Perinatology (2016) 36:12 (1122-1127). Date of Publication: 1 Dec
2016
ISSN
1476-5543 (electronic)
0743-8346
BOOK PUBLISHER
Nature Publishing Group, Houndmills, Basingstoke, Hampshire, United Kingdom.
ABSTRACT
Objective:To describe the current scope of neonatal inter-facility
transports.Study design:California databases were used to characterize
infants transported in the first week after birth from 2009 to
2012.Results:Transport of the 22 550 neonates was classified as emergent
9383 (41.6%), urgent 8844 (39.2%), scheduled 2082 (9.2%) and other 85
(0.4%). In addition, 2152 (9.5%) were initiated for delivery attendance.
Most transports originated from hospitals without a neonatal intensive care
unit (68%), with the majority transferred to regional centers (66%).
Compared with those born and cared for at the birth hospital, the odds of
being transported were higher if the patient's mother was Hispanic, <20
years old, or had a previous C-section. An Apgar score <3 at 10 min of age,
cardiac compressions in the delivery room, or major birth defect were also
risk factors for neonatal transport.Conclusion:As many neonates receive
transport within the first week after birth, there may be opportunities for
quality improvement activities in this area.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
neonatal transport
patient transport
EMTREE MEDICAL INDEX TERMS
Apgar score
article
California
congenital malformation (congenital disorder)
delivery room
female
Hispanic
hospital
human
male
neonatal intensive care unit
newborn
prenatal care
risk factor
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160706526
MEDLINE PMID
27684413 (http://www.ncbi.nlm.nih.gov/pubmed/27684413)
PUI
L612477304
DOI
10.1038/jp.2016.102
FULL TEXT LINK
http://dx.doi.org/10.1038/jp.2016.102
COPYRIGHT
Copyright 2018 Elsevier B.V., All rights reserved.
RECORD 92
TITLE
Improving inpatient NICU staff utilization with an integrated consortium
transport system
AUTHOR NAMES
Frakes M.
Roumiantsev S.
Farkas A.
Gorman T.
Prendergast M.
Cohen J.
AUTHOR ADDRESSES
(Frakes M.; Roumiantsev S.; Farkas A.; Gorman T.; Prendergast M.; Cohen J.)
CORRESPONDENCE ADDRESS
M. Frakes,
SOURCE
Critical Care Medicine (2016) 44:12 Supplement 1 (106). Date of Publication:
1 Dec 2016
CONFERENCE NAME
46th Critical Care Congress of the Society of Critical Care Medicine, SCCM
2016
CONFERENCE LOCATION
Honolulu, HI, United States
CONFERENCE DATE
2017-01-21 to 2017-01-25
ISSN
1530-0293
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Learning Objectives: Multiple national and international organizations have
advanced recommendations for safe and efficient interfacility transport of
neonatal patients. Three tertiary care newborn intensive care units serving
different populations and partner facilities developed a partnership with an
existing fully integrated, multi-modal critical care transport team within
the bounds of these recommendations. Each center previously had separate
out-of-hospital transport models, using a mix of their own NICU staff and
various emergency medical services providers. We hypothesized utilization of
existing transport resources would allow NICU staff to re-allocate nursing
staff time to inpatient care. Methods: The three facilities were already
served by an internationally-accredited, fullyintegrated, multi-modal
nurse/paramedic critical care transport team with neonatal transport
experience. Stakeholder meetings identified basic needs and key performance
indicators for all parties, and multi-party analyses identified gaps and
opportunities for improvement. The parties established logistical,
educational, clinical, operational, and performance improvement structures
to enable that team to become the primary provider for the participating
tertiary NICUs. Records from the transport team communication center were
queried for volume, completion, and time data. Results: In the first year,
the team completed 85% of outbound transports from the three facilities that
previously would have been completed using inpatient staff. The average time
dedicated to the outbound transport (arrival-at-sending facility to
arrival-at-receiving facility) was 82 minutes. The transport team does not
return to the sending facility; we are satisfied that the measured
first-half time is a reasonable estimate for the time spent on the return
leg. With that, we identify 298 hours per institution that inpatient nurses
were able to re-allocate from retro transports over the course of the year.
Conclusions: Creation and utilization of a distinct transport system
provides time benefit to inpatient staff resources.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital patient
nursing staff
EMTREE MEDICAL INDEX TERMS
basic needs
case report
human
information processing
intensive care
leg
newborn
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L613522448
DOI
10.1097/01.ccm.0000508797.42158.c0
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000508797.42158.c0
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 93
TITLE
Effect of early ICU transfer in pediatric oncology patients with hypotension
AUTHOR NAMES
Wenger J.
Villavicencio E.
Watson R.
Geyer R.
Zimmerman J.
Kroon L.
Roberts J.
AUTHOR ADDRESSES
(Wenger J.; Villavicencio E.; Watson R.; Geyer R.; Zimmerman J.; Kroon L.;
Roberts J.)
CORRESPONDENCE ADDRESS
J. Wenger,
SOURCE
Critical Care Medicine (2016) 44:12 Supplement 1 (152). Date of Publication:
1 Dec 2016
CONFERENCE NAME
46th Critical Care Congress of the Society of Critical Care Medicine, SCCM
2016
CONFERENCE LOCATION
Honolulu, HI, United States
CONFERENCE DATE
2017-01-21 to 2017-01-25
ISSN
1530-0293
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Learning Objectives: Pediatric oncology patients frequently require fluid
resuscitation for hypotension, which can be a sign of impending clinical
deterioration. Our institution implemented a policy change to optimize
outcomes for oncology patients by transferring these patients to the PICU
earlier in the course of hemodynamic instability. After the policy change,
all oncology patients with persistent signs of hemodynamic instability after
40 ml/kg of fluid required a rapid response team (RRT) activation. We
hypothesized that RRT activation and early ICU transfer (EIT) would result
in a decrease in time to normotension and/or amount of fluid resuscitation
required. Methods: We compared oncology patients transferred to the PICU for
hemodynamic instability before and after implementation of a policy change.
Patients admitted to the bone marrow transplant service were excluded. The
control (pre-EIT) population included oncology patients transferred to the
PICU between March 2012-June 2014 (n=18). The EIT population included
oncology patients transferred to the PICU after implementation of the
policy, from July 2014-July 2015 (n=26). Time to normotension was defined as
the time from mean arterial blood pressure (MAP) less than the 5th
percentile for age to attainment of two consecutive blood pressures 15
minutes apart above the 5th percentile for age. Amount of fluid
resuscitation was defined as the amount of fluid boluses from 24 hours prior
to RRT activation until normotension was achieved. Results: There was a
significantly decreased time to normotension after the policy change
(pre-EIT=6.3 ± 4.5 hours, post- EIT=3.0 ± 2.2 hours; Wilcoxon Rank Sum Test
p=0.006). There was no difference in the amount of fluid resuscitation
needed to achieve normotension after the policy change (pre-EIT=59.3 ± 21.2
ml/kg, post-EIT=56.9 ± 24.9ml/kg; student T-test p=0.43). Conclusions: After
implementation of a policy to more quickly identify oncology patients with
persistent hemodynamic instability, there was a significantly decreased time
to normotension, without a change in amount of fluid resuscitation.
EMTREE DRUG INDEX TERMS
endogenous compound
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
childhood cancer
hypotension
EMTREE MEDICAL INDEX TERMS
bone marrow transplantation
cancer epidemiology
clinical article
controlled study
fluid resuscitation
human
mean arterial pressure
mental capacity
rank sum test
rapid response team
Student t test
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L613520798
DOI
10.1097/01.ccm.0000508982.43669.e9
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000508982.43669.e9
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 94
TITLE
Tracheal intubation in critical care transport: Global consensus quality
metric performance
AUTHOR NAMES
Bigham M.
Schwartz H.
Gothard M.
Gothard M.
Parrish P.
AUTHOR ADDRESSES
(Bigham M.; Schwartz H.; Gothard M.; Gothard M.; Parrish P.)
CORRESPONDENCE ADDRESS
M. Bigham,
SOURCE
Critical Care Medicine (2016) 44:12 Supplement 1 (310). Date of Publication:
1 Dec 2016
CONFERENCE NAME
46th Critical Care Congress of the Society of Critical Care Medicine, SCCM
2016
CONFERENCE LOCATION
Honolulu, HI, United States
CONFERENCE DATE
2017-01-21 to 2017-01-25
ISSN
1530-0293
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Learning Objectives: Tracheal intubation (TI) is a life-saving critical care
skill and failed TI attempts can harm patients. Critical care transport
(CCT) teams function as the 1st point of critical care contact for patients
being transported to tertiary medical centers for specialized surgical,
medical or trauma care. The Ground and Air Medical qUality in Transport
(GAMUT) Quality Improvement Collaborative uses a quality metric database to
track CCT quality metric performance, including TI. We sought to describe TI
amongst GAMUT participants. Methods: GAMUT database is a global, voluntary
database for tracking consensus quality metric performance amongst CCT
programs performing neonatal(neo), pediatric(ped), and adult(adlt)
transports. The TI-specific quality metrics are 1st attempt TI success and
definitive airway sans hypoxia/hypotension on 1st attempt (DASH1A). The 2015
GAMUT database was queried and analysis included patient age, program type,
and intubation success. Analysis included simple statistics and Pearson
chi-square with Bonferroni adjusted post-hoc z tests (significance=p<0.05).
Results: 85,704 patient contacts were included [neo n(%)=12,664(14.8%), ped
n(%)=28,992(33.8%), adlt n(%)=44,048(51.4%)] with 4,036(4.7%) TI attempts.
1st attempt TI success was lowest in neos [59.3%, 617 attempts], better in
peds [81.7%, 519 attempts], and best in adlts [87%, 2900 attempts], p<0.001.
Adult-focused CCT teams had higher overall 1st attempt TI success vs.
non-adult teams (86.9% vs 63.5%, p<0.001) and higher ped 1st attempt TI
success (86.5% vs. 75.3%, p<0.001). DASH1A rates were lower across all
patient types [neo rate in %=51.9%, ped=74.3%, adlt=79.8%]. Stratification
of performers (z±1.645) identified a single high-performing and 2
lowperforming CCT teams using weighted average for expected TI success vs.
observed TI success based on patient population. Conclusions: TI is common
in CCT, with higher rates of TI and DASH1A success in adult patients and
adult-focused CCT teams. Identifying factors influencing TI success amongst
high performers should influence best practice strategies for CCT TI.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
consensus
endotracheal intubation
intensive care
EMTREE MEDICAL INDEX TERMS
adult
airway
child
controlled study
data base
human
hypotension
hypoxia
major clinical study
newborn
statistics
stratification
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L613522603
DOI
10.1097/01.ccm.0000509611.83430.d5
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000509611.83430.d5
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 95
TITLE
The effectiveness of a pediatric expedited transfer team for critically ill
children
AUTHOR NAMES
Bernier M.
Vanderwagen S.
Laura A.
Foronda C.
Jeffers J.
AUTHOR ADDRESSES
(Bernier M.; Vanderwagen S.; Laura A.; Foronda C.; Jeffers J.)
CORRESPONDENCE ADDRESS
M. Bernier,
SOURCE
Critical Care Medicine (2016) 44:12 Supplement 1 (344). Date of Publication:
1 Dec 2016
CONFERENCE NAME
46th Critical Care Congress of the Society of Critical Care Medicine, SCCM
2016
CONFERENCE LOCATION
Honolulu, HI, United States
CONFERENCE DATE
2017-01-21 to 2017-01-25
ISSN
1530-0293
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Learning Objectives: Handover of critically ill children is high-risk for
harm with delayed hand off impacting time to definitive treatment. Our aim
was to examine if a quality improvement initiative, the Pediatric Expedited
Transfer (PET) team, decreased Pediatric Emergency Department (PED) length
of stay (LOS) and time to Pediatric Intensive Care Unit (PICU) admission.
Methods: We identified seven criteria activating the PET team:
out-of-hospital arrest with return of spontaneous circulation, status
epilepticus, complex cardiac history with unstable vital signs, intubation
or new assisted ventilation, new Glasgow Coma Scale of <10, shock physiology
requiring vasopressors, and high risk for acute decompensation per attending
physician. PET team activation lead to a standardized tool driven bedside
hand off within 10 minutes (min) between PED and PICU nurses and physicians.
We implemented the PET team in 9/2015 and performed a retrospective pre/post
intervention analysis on the first 6 months of pilot patients to determine
if PED LOS and time to PICU admission were decreased. PET patients were
matched to pre-intervention patients from 9/2014-2/2015 by admitting
diagnosis, age, sex, and season. Results: Of 370 PED to PICU admissions
during the pilot period, 45 activated the PET team. Compared with 90 matched
pre intervention patients, PET patients had decreased PED LOS (257.9 min vs.
147.4 min, p<0.001) and decreased time to PICU arrival (99.7 min vs. 66.9
min, p=0.006). PET patients required more PICU respiratory and
cardiovascular interventions (51.1% and 33.3%, respectively, and 17.8% of
patients required both) in the first 24 hours compared with matched pre
patients (41.1% respiratory, 26.7% cardiac, 12.2% both). Mortality was
similar in both groups (3.4% pre and 4.4% post) as was PICU LOS (4.4 days
pre and 5.9 post, p=0.21). Conclusions: Implementation of the PET team,
including use of established patient criteria, an interdisciplinary
standardized tool, and bedside handover, decreased PED LOS and accelerated
PICU admission, suggesting earlier receipt of definitive care for critically
ill children.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
EMTREE MEDICAL INDEX TERMS
assisted ventilation
child
controlled study
diagnosis
doctor nurse relation
emergency ward
epileptic state
Glasgow coma scale
heart
human
instrument validation
intubation
length of stay
major clinical study
mortality
pediatric intensive care unit
physiology
return of spontaneous circulation
season
total quality management
vital sign
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L613522165
DOI
10.1097/01.ccm.0000509749.30766.78
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000509749.30766.78
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 96
TITLE
Prehospital Transport for Pediatric Trauma: A Comparison of Private
Transport and Emergency Medical Services
AUTHOR NAMES
Lin Y.-C.
Lee Y.T.
Feng J.X.Y.
Chiang L.W.
Nah S.A.
AUTHOR ADDRESSES
(Lin Y.-C.) From the Department of Paediatric Surgery, KK Womenʼs and
Childrenʼs Hospital, Singapore.
(Lee Y.T.; Feng J.X.Y.; Chiang L.W.; Nah S.A.)
CORRESPONDENCE ADDRESS
Y.-C. Lin, From the Department of Paediatric Surgery, KK Womenʼs and
Childrenʼs Hospital, Singapore.
SOURCE
Pediatric Emergency Care (2016). Date of Publication: 29 Nov 2016
ISSN
1535-1815 (electronic)
0749-5161
BOOK PUBLISHER
Lippincott Williams and Wilkins, kathiest.clai@apta.org
ABSTRACT
OBJECTIVES: We describe the demographics of pediatric patients with trauma
transferred using private transport (PT) versus emergency medical services
(EMS) and evaluate the potential impact on their treatment and outcome.
METHODS: We accessed data from our national trauma registry, a prospectively
collected database. Data were extracted on all patients with trauma admitted
to our institution between January 2011 and June 2013, with injury severity
score (ISS) higher than 8. We categorized unstable injuries as head
injuries, spinal injuries, or proximal long bone fractures. Major trauma was
defined as the presence of any of the following: ISS of 16 or higher,
intensive care unit (ICU) admission or death. RESULTS: Ninety children were
studied, including 27 major trauma and 66 unstable injuries; 69 patients
(77%) used PT. Most patients with major trauma (17/27, 63%) and unstable
injuries (50/66, 76%) used PT. Compared with EMS patients, PT patients were
younger, smaller, took longer for emergency department physician review and
stayed longer in the emergency department. Rates of ICU admission were
similar in both groups, but length of stay in ICU and total hospital stay
were shorter in the PT group despite similar proportions of major trauma and
unstable injuries as well as median ISS. Each group had 1 mortality.
CONCLUSIONS: Most children with major trauma and unstable injuries were
brought by PT, risking deterioration en route. Nevertheless, this does not
seem to translate to worse outcomes overall.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
childhood injury
emergency health service
EMTREE MEDICAL INDEX TERMS
child
controlled study
data base
death
deterioration
emergency ward
fracture
head injury
hospitalization
human
injury scale
intensive care unit
length of stay
long bone
major clinical study
mortality
physician
register
spine injury
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160884931
PUI
L613534560
DOI
10.1097/PEC.0000000000000979
FULL TEXT LINK
http://dx.doi.org/10.1097/PEC.0000000000000979
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 97
TITLE
Benchmarking Pain Assessment Rate in Critical Care Transport
AUTHOR NAMES
Reichert R.J.
Gothard M.D.
Schwartz H.P.
Bigham M.T.
AUTHOR ADDRESSES
(Reichert R.J.) Pediatric Resident, Akron Children's Hospital, Akron, United
States.
(Gothard M.D.) Statitician, BIOSTATS, Inc, East Canton, United States.
(Schwartz H.P.) Department of Pediatrics, Cincinnati Children's Hospital
Medical Center, Cincinnati, United States.
(Bigham M.T., mbigham@chmca.org) Akron Children's Hospital, Akron, United
States.
CORRESPONDENCE ADDRESS
M.T. Bigham, Akron Children's Hospital, Akron, United States. Email:
mbigham@chmca.org
SOURCE
Air Medical Journal (2016) 35:6 (344-347). Date of Publication: 1 Nov 2016
ISSN
1532-6497 (electronic)
1067-991X
BOOK PUBLISHER
Mosby Inc., customerservice@mosby.com
ABSTRACT
The purpose of this study is to determine the rate of pain assessment in
pediatric neonatal critical care transport (PNCCT). The GAMUT database was
interrogated for an 18-month period and excluded programs with less than 10%
pediatric or neonatal patient contacts and less than 3 months of any metric
data reporting during the study period. We hypothesized pain assessment
during PNCCT is superior to prehospital pain assessment rates, although
inferior to in-hospital rates. Sixty-two programs representing 104,445
patient contacts were analyzed. A total of 21,693 (20.8%) patients were
reported to have a documented pain assessment. Subanalysis identified 17 of
the 62 programs consistently reporting pain assessments. This group
accounted for 24,599 patients and included 7,273 (29.6%) neonatal, 12,655
(51.5%) pediatric, and 4,664 (19.0%) adult patients. Among these programs,
the benchmark rate of pain assessment was 90.0%. Our analysis shows a rate
below emergency medical services and consistent with published hospital
rates of pain assessment. Poor rates of tracking of this metric among
participating programs was noted, suggesting an opportunity to investigate
the barriers to documentation and reporting of pain assessments in PNCCT and
a potential quality improvement initiative.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
benchmarking
intensive care
pain assessment
patient transport
EMTREE MEDICAL INDEX TERMS
article
controlled study
data base
emergency health service
hospital
human
major clinical study
priority journal
total quality management
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Neurology and Neurosurgery (8)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160872896
MEDLINE PMID
27894556 (http://www.ncbi.nlm.nih.gov/pubmed/27894556)
PUI
L613466625
DOI
10.1016/j.amj.2016.07.001
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2016.07.001
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 98
TITLE
The relocation and road transfer of intensive care patients to a new
hospital in Bristol: Our experiences
AUTHOR NAMES
Gough C.
Grier S.
AUTHOR ADDRESSES
(Gough C.; Grier S.) Southmead Hospital, United Kingdom.
CORRESPONDENCE ADDRESS
C. Gough, Southmead Hospital, United Kingdom.
SOURCE
Journal of the Intensive Care Society (2016) 17:4 Supplement 1 (147). Date
of Publication: 1 Nov 2016
CONFERENCE NAME
Intensive Care Society State-of-the-Art Meeting, ICSSOA 2016
CONFERENCE LOCATION
London, United Kingdom
CONFERENCE DATE
2016-12-05 to 2016-12-07
ISSN
1751-1437
BOOK PUBLISHER
SAGE Publications Inc.
ABSTRACT
In May 2014, North Bristol NHS Trust merged its two existing hospitals -
Southmead and Frenchay - into a new, purpose-built building. The project
involved the movement of 540 patients, many over a distance of several
miles. It was one of the largest single patient transfer operations ever
conducted in the United Kingdom. We describe the planning processes and
transfer of 24 level two and three patients from two intensive care units
into the new hospital. These transfers were performed successfully, without
significant incident and under intense scrutiny from the Trust, patients and
the media. In this, we also reflect upon our experiences of this process,
which may be of benefit to those encountering a similar move in the future.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
female
intensive care unit
male
EMTREE MEDICAL INDEX TERMS
doctor patient relation
human
major clinical study
trust
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L617401221
DOI
10.1177/1751143717708966
FULL TEXT LINK
http://dx.doi.org/10.1177/1751143717708966
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 99
TITLE
Characteristics and outcomes of critically ill children following emergency
transport by a specialist paediatric transport team
AUTHOR NAMES
Hamrin T.H.
Berner J.
Eksborg S.
Radell P.J.
Fläring U.
AUTHOR ADDRESSES
(Hamrin T.H., tova.hannegard-hamrin@karolinska.se; Berner J.; Radell P.J.;
Fläring U.) Section of Anesthesiology and Intensive Care, Department of
Physiology and Pharmacology, Karolinska Institutet, Astrid Lindgren
Children's Hospital, Karolinska University Hospital Solna, Stockholm,
Sweden.
(Eksborg S.) Childhood Cancer Research Unit Q6:05, Department of Women's and
Children's Health, Karolinska Institutet, Astrid Lindgren Children's
Hospital, Karolinska University Hospital Solna, Stockholm, Sweden.
CORRESPONDENCE ADDRESS
T.H. Hamrin, Section of Anesthesiology and Intensive Care, Department of
Physiology and Pharmacology, Karolinska Institutet, Astrid Lindgren
Children's Hospital, Karolinska University Hospital Solna, Stockholm,
Sweden. Email: tova.hannegard-hamrin@karolinska.se
SOURCE
Acta Paediatrica, International Journal of Paediatrics (2016) 105:11
(1329-1334). Date of Publication: 1 Nov 2016
ISSN
1651-2227 (electronic)
0803-5253
BOOK PUBLISHER
Blackwell Publishing Ltd, customerservices@oxonblackwellpublishing.com
ABSTRACT
Aim: We compared acute patients admitted to a single paediatric intensive
care unit (PICU) following an emergency transfer by a specialist paediatric
transport team and by other routes. Methods: This was a retrospective
descriptive register-based study of consecutive admissions to a tertiary
PICU in Sweden from 1 January 2008 to 31 December 2013. We compared the
general characteristics of the cohorts, together with predicted death rates
(PDR), PICU mortality, 30-day mortality, PICU length of stay (PICU LOS) and
resource use. Results: Of the 3665 nonelective admissions, 221 patients
received emergency transport from referring hospitals to the PICU by the
specialist paediatric transport team. Their median age was lower (146 versus
482 days), PDR was higher (5.58% versus 1.39%), PICU LOS was longer (4.24
days versus 1.06 days), and they received more PICU-specific therapies. The
standardised mortality ratio did not differ between the cohorts, and the
PICU mortality was lower than predicted in both groups. The transport
distance and mode of transport did not influence survival. Conclusion:
Children admitted to the PICU following emergency transfers by the
specialist paediatric transport team were younger, sicker, received more
PICU-specific therapies and had longer PICU LOS than other acutely admitted
critically ill patients. This indicates that these transfers were
appropriate.
EMTREE DRUG INDEX TERMS
nitric oxide
vasoactive agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
clinical outcome
critically ill patient
emergency health service
emergency transport
patient transport
EMTREE MEDICAL INDEX TERMS
article
artificial ventilation
child
extracorporeal oxygenation
female
hospital admission
human
infant
length of stay
major clinical study
male
medical specialist
mortality rate
pediatric intensive care unit
priority journal
renal replacement therapy
retrospective study
survival
Sweden
tertiary care center
CAS REGISTRY NUMBERS
nitric oxide (10102-43-9)
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160778445
MEDLINE PMID
27241071 (http://www.ncbi.nlm.nih.gov/pubmed/27241071)
PUI
L612950202
DOI
10.1111/apa.13492
FULL TEXT LINK
http://dx.doi.org/10.1111/apa.13492
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 100
TITLE
Association between intensive care unit transfer delay and hospital
mortality: A multicenter investigation
AUTHOR NAMES
Churpek M.M.
Wendlandt B.
Zadravecz F.J.
Adhikari R.
Winslow C.
Edelson D.P.
AUTHOR ADDRESSES
(Churpek M.M., matthew.churpek@uchospitals.edu; Wendlandt B.; Zadravecz
F.J.; Adhikari R.; Edelson D.P.) Department of Medicine, University of
Chicago, Chicago, United States.
(Winslow C.) Department of Medicine, NorthShore University HealthSystem,
Evanston, United States.
CORRESPONDENCE ADDRESS
M.M. Churpek, Department of Medicine, University of Chicago, Chicago, United
States. Email: matthew.churpek@uchospitals.edu
SOURCE
Journal of Hospital Medicine (2016) 11:11 (757-762). Date of Publication: 1
Nov 2016
ISSN
1553-5606 (electronic)
1553-5592
BOOK PUBLISHER
John Wiley and Sons Inc., jhospitalmedicine@jjeditorial.com
ABSTRACT
BACKGROUND: Previous research investigating the impact of delayed intensive
care unit (ICU) transfer on outcomes has utilized subjective criteria for
defining critical illness. OBJECTIVE: To investigate the impact of delayed
ICU transfer using the electronic Cardiac Arrest Risk Triage (eCART) score,
a previously published early warning score, as an objective marker of
critical illness. DESIGN: Observational cohort study. SETTING:
Medical-surgical wards at 5 hospitals between November 2008 and January
2013. PATIENTS: Ward patients. INTERVENTION: None. MEASUREMENTS: eCART
scores were calculated for all patients. The threshold with a specificity of
95% for ICU transfer (eCART ≥ 60) denoted critical illness. A logistic
regression model adjusting for age, sex, and surgical status was used to
calculate the association between time to ICU transfer from first critical
eCART value and in-hospital mortality. RESULTS: A total of 3789 patients met
the critical eCART threshold before ICU transfer, and the median time to ICU
transfer was 5.4 hours. Delayed transfer (>6 hours) occurred in 46% of
patients (n = 1734) and was associated with increased mortality compared to
patients transferred early (33.2% vs 24.5%, P < 0.001). Each 1-hour increase
in delay was associated with an adjusted 3% increase in odds of mortality (P
< 0.001). In patients who survived to discharge, delayed transfer was
associated with longer hospital length of stay (median 13 vs 11 days, P <
0.001). CONCLUSIONS: Delayed ICU transfer is associated with increased
hospital length of stay and mortality. Use of an evidence-based early
warning score, such as eCART, could lead to timely ICU transfer and reduced
preventable death. Journal of Hospital Medicine 2016;11:757–762. © 2016
Society of Hospital Medicine.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
article
cohort analysis
controlled study
critical illness
critically ill patient
disease severity
heart arrest
human
length of stay
mortality
multicenter study
observational study
priority journal
scoring system
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160529852
MEDLINE PMID
27352032 (http://www.ncbi.nlm.nih.gov/pubmed/27352032)
PUI
L611267723
DOI
10.1002/jhm.2630
FULL TEXT LINK
http://dx.doi.org/10.1002/jhm.2630
COPYRIGHT
Copyright 2018 Elsevier B.V., All rights reserved.
RECORD 101
TITLE
The relocation and road transfer of intensive care patients to a new
hospital in Bristol: Our experiences
AUTHOR NAMES
Grier S.
Gough C.J.R.
Wrathall G.J.
AUTHOR ADDRESSES
(Grier S.; Gough C.J.R.; Wrathall G.J., Gareth.Wrathall@nbt.nhs.uk) North
Bristol NHS Trust, Intensive Care Unit, Southmead Hospital, Bristol, United
Kingdom.
CORRESPONDENCE ADDRESS
G.J. Wrathall, North Bristol NHS Trust, Intensive Care Unit, Southmead
Hospital, Brunel Building, Southmead Road, Bristol, United Kingdom. Email:
Gareth.Wrathall@nbt.nhs.uk
SOURCE
Journal of the Intensive Care Society (2016) 17:4 (326-331). Date of
Publication: 1 Nov 2016
ISSN
1751-1437
BOOK PUBLISHER
SAGE Publications Inc., claims@sagepub.com
ABSTRACT
In May 2014, North Bristol NHS Trust merged its two existing hospitals –
Southmead and Frenchay – into a new, purpose-built building. The project
involved the movement of 540 patients, many over a distance of several
miles. We describe the planning process and transfer of 24 level two and
three patients from two intensive care units into the new hospital. These
transfers were performed successfully, without significant incident and
under intense scrutiny from the Trust, the patients and the media. In this
paper, we reflect upon our experiences of this process, which may be of
benefit to those encountering a similar move in the future.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
patient safety
patient transport
EMTREE MEDICAL INDEX TERMS
doctor patient relation
human
major clinical study
trust
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160781036
PUI
L612957219
DOI
10.1177/1751143716644460
FULL TEXT LINK
http://dx.doi.org/10.1177/1751143716644460
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 102
TITLE
A consensus to determine the ideal critical care transfer bag
AUTHOR NAMES
Van Zwanenberg G.
Dransfield M.
Juneja R.
AUTHOR ADDRESSES
(Van Zwanenberg G., gezz.zwanenberg@nhs.net) North West London Critical Care
Network, London, United Kingdom.
(Dransfield M.) Imperial College NHS Healthcare Trust, London, United
Kingdom.
(Juneja R.) The Royal Marsden NHS Foundation Trust, London, United Kingdom.
()
CORRESPONDENCE ADDRESS
G. Van Zwanenberg, North West London Critical Care Network, London, United
Kingdom. Email: gezz.zwanenberg@nhs.net
SOURCE
Journal of the Intensive Care Society (2016) 17:4 (332-340). Date of
Publication: 1 Nov 2016
ISSN
1751-1437
BOOK PUBLISHER
SAGE Publications Inc., claims@sagepub.com
ABSTRACT
Background: Familiarity with environment, processes and equipment reduces
the risk inherently associated with critical care transfers. Therefore, the
North West London Critical Care Network decided to create a standardised
ideal transfer bag and contents to improve patient safety. Methods: A
four-round modified Delphi survey developed a condensed and clinically
tested content list. An expert panel then designed an ideal transfer bag
based on agreed important principles. Results: Participants completed two
rounds of an electronic survey. Round 3 comprised an expert clinical panel
review, while round 4 tested the contents over 50 clinical transfers. The
prototype bag’s design was adjusted after clinical use and feedback.
Discussion: This project has introduced a standardised critical care
transfer bag across our network. A similar technique could be used for other
healthcare regions. Alternatively, the above critical care transfer bag
could be adopted or adapted for regional use by clinicians.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
consensus
Delphi study
intensive care
patient safety
patient transport
EMTREE MEDICAL INDEX TERMS
human
human experiment
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160781047
PUI
L612957487
DOI
10.1177/1751143716658912
FULL TEXT LINK
http://dx.doi.org/10.1177/1751143716658912
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 103
TITLE
The development of an acute multidisciplinary team to enhance intensive care
without borders
AUTHOR NAMES
Hunt R.
AUTHOR ADDRESSES
(Hunt R.) Derriford Hospital, United Kingdom.
CORRESPONDENCE ADDRESS
R. Hunt, Derriford Hospital, United Kingdom.
SOURCE
Journal of the Intensive Care Society (2016) 17:4 Supplement 1 (107-108).
Date of Publication: 1 Nov 2016
CONFERENCE NAME
Intensive Care Society State-of-the-Art Meeting, ICSSOA 2016
CONFERENCE LOCATION
London, United Kingdom
CONFERENCE DATE
2016-12-05 to 2016-12-07
ISSN
1751-1437
BOOK PUBLISHER
SAGE Publications Inc.
ABSTRACT
The acute care team (ACT) is a multidisciplinary team working in a busy
teaching hospital with a wealth of clinical skills and experience. The team
was developed in 2011 through the combination of the acute and chronic pain
teams, the vascular access team, the outreach team and the emergency
resuscitation teams. Since 2014, the team have become responsible for the
follow-up of patients on the trauma pathway and they assist with
intrahospital transfers when needed. The team is available 24 h a day, 365
days a year, and is very active, averaging over 1000 patient interactions a
month. They are invaluable in providing timely, safe, quality care to
patients in the hospital. Testament to this is that the Care Quality
Commission singled out the team in their most recent report, describing the
ACT as outstanding. Emergency care of the unwell, deteriorating patient has
become a particular feature of the team's workload since 2012. As seen in
Table 1, the number of medical emergency calls has more than doubled,
whereas the number of in hospital cardiac arrests has decreased
significantly. The outcomes for patients having an in hospital cardiac
arrest have also improved significantly. Survival over the last year has
increased to 34% and we are now one of the leading hospitals in the country
for survival after in hospital cardiac arrest. This aetiology of this
improvement is multifactorial, though; during the same period the number of
patients having a do not attempt resuscitation order in place decreased. The
ACT is under appreciated, yet offers huge benefit to patients and provides
invaluable assistance to the busy and very appreciative junior doctor
workforce. The development of the doctor's assistant (DA) role has expanded
the team over the last two years and there are now 19 DA's within the ACT.
This expansion will mean we can provide the services of this outstanding
team more effectively and so improve the quality of patient care within our
hospital. (Table Presented).
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
resuscitation
EMTREE MEDICAL INDEX TERMS
averaging
chronic pain
emergency care
female
follow up
heart arrest
human
injury
jurisprudence
major clinical study
male
patient transport
skill
teaching hospital
vascular access
workload
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L617404325
DOI
10.1177/1751143717708966
FULL TEXT LINK
http://dx.doi.org/10.1177/1751143717708966
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 104
TITLE
Erratum to: Intrahospital transport of critically ill patients (Méd.
Intensive Réa, 10.1007/s13546-016-1219-y)
AUTHOR NAMES
Brouard F.
Muller G.
Michel P.
Ehrmann S.
da Silva D.
Kimmoun A.
Hamzaoui O.
Lacherade J.C.
Audoin C.
Boissier F.
Hraiech S.
Grimaldi D.
Aissaoui N.
AUTHOR ADDRESSES
(Brouard F.) CH de Périgueux, service de réanimation polyvalente, 80 avenue
Georges Pompidou, Périgueux cedex, France.
(Muller G.) Service réanimation polyvalente, CHR d’Orléans, hôpital de la
Source, Orléans, France.
(Michel P.) Service de réanimation médicochirurgicale, CH René Dubos,
Pontoise, France.
(Ehrmann S.) Service de réanimation médicale polyvalente, CHRU de Tours,
Tours, France.
(da Silva D.) Service de réanimation médicale polyvalente, CH de
Saint-Denis, hôpital Delafontaine, Saint-Denis, France.
(Kimmoun A.) Service de réanimation médicale, CHU Nancy, hôpital Brabois
adultes, Nancy, France.
(Hamzaoui O.) Service de réanimation polyvalente, CHU Antoine Béclère,
Clamart, France.
(Lacherade J.C.) Service de réanimation polyvalente, CHD Les Oudairies, La
Roche-sur-Yon, France.
(Audoin C.) Service de réanimation polyvalente, clinique des Cèdres,
Cornebarrieu, France.
(Boissier F.) Service de réanimation médicale, CHU de Poitiers, Poitiers,
France.
(Hraiech S.) Service de réanimation médicale, CHU de Marseille-Hôpital Nord,
Marseille, France.
(Grimaldi D.) Services des soins intensifs, cliniques universitaires de
Bruxelles, hôpital Érasme, Bruxelles, Belgium.
(Aissaoui N., cerc@cerc.a6tole.fr) Service de réanimation médicale,
CHU-hôpital européen Georges Pompidou, Paris, France.
()
CORRESPONDENCE ADDRESS
N. Aissaoui, Service de réanimation médicale, CHU-hôpital européen Georges
Pompidou, Paris, France. Email: cerc@cerc.a6tole.fr
SOURCE
Reanimation (2016) 25:6 (655). Date of Publication: 1 Nov 2016
ISSN
1951-6959 (electronic)
1624-0693
BOOK PUBLISHER
Springer-Verlag France, 22, Rue de Palestro, Paris, France.
york@springer-paris.fr
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
error
EMTREE MEDICAL INDEX TERMS
erratum
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
French
LANGUAGE OF SUMMARY
French
EMBASE ACCESSION NUMBER
20160835217
PUI
L613201241
DOI
10.1007/s13546-016-1235-y
FULL TEXT LINK
http://dx.doi.org/10.1007/s13546-016-1235-y
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 105
TITLE
Transfer of allogeneic stem cell transplant recipients to the intensive care
unit: Guidelines from the Francophone society of marrow transplantation and
cellular therapy (SFGM-TC)
ORIGINAL (NON-ENGLISH) TITLE
Transfert des patients allogreffés de cellules-souches hématopoïétiques en
réanimation : recommandations de la Société francophone de greffe de moelle
et de thérapie cellulaire (SFGM-TC)
AUTHOR NAMES
Moreau A.-S.
Bourhis J.-H.
Contentin N.
Couturier M.-A.
Delage J.
Dumesnil C.
Gandemer V.
Hichri Y.
Jost E.
Platon L.
Jourdain M.
Pène F.
Yakoub-Agha I.
AUTHOR ADDRESSES
(Moreau A.-S.; Jourdain M.) CHU, centre de réanimation, université de Lille
2, Inserm UII90, Lille, France.
(Bourhis J.-H.) Institut Gustave-Roussy, service d'hématologie, 114, rue
Édouard-Vaillant, Villejuif, France.
(Contentin N.) Centre Henri-Becquerel, service d'hématologie, rue d'Amiens,
Rouen, France.
(Couturier M.-A.) CHU de Brest, hôpital Morvan, service d'hématologie
stérile, 2, avenue Foch, Brest, France.
(Delage J.) Département d'hématologie et de thérapie cellulaire, CHRU
Montpellier-site Saint-Eloi, 80, avenue Augustin-Fliche, Montpellier,
France.
(Dumesnil C.) CHU de Rouen, service d'hémato-oncologie pédiatrique, 1, rue
Germont, Rouen, France.
(Gandemer V.) CHU Hôpital Sud, université Rennes 1, 2, rue
Henri-le-Guilloux, Rennes, France.
(Hichri Y.) CHU Montpellier, département d'hématologie clinique,
Montpellier, France.
(Jost E.) Hématologie/oncologie, Uniklinik RWTH Aachen, Aachen, Germany.
(Platon L.) Réanimation médicale, CHU Lapeyronie, 345, rue du Muscadet,
Montpellier, France.
(Pène F.) Service de réanimation médicale, hôpital Cochin, AP–HP, université
Paris Descartes, Paris, France.
(Yakoub-Agha I., sfgm-tc-iya@live.fr) CHU de Lille, LIRIC Inserm U995,
université Lille 2, Lille, France.
CORRESPONDENCE ADDRESS
I. Yakoub-Agha, CHU de Lille, LIRIC Inserm U995, université Lille 2, Lille,
France. Email: sfgm-tc-iya@live.fr
SOURCE
Bulletin du Cancer (2016) 103:11 Supplement (S220-S228). Date of
Publication: 1 Nov 2016
ISSN
1769-6917 (electronic)
0007-4551
BOOK PUBLISHER
John Libbey Eurotext, 127, avenue de la Republique, Montrouge, France.
ABSTRACT
Transferring a patient undergoing an allogeneic stem cell transplantation to
the intensive care unit (ICU) is always a challenging situation on a medical
and psychological point of view for the patient and his relatives as well as
for the medical staff. Despite the progress in hematology and intensive care
during the last decade, the prognosis of these patients admitted to the ICU
remains poor and mortality is around 50 %. The harmonization working party
of the SFGM-TC assembled hematologists and intensive care specialist in
order to improve conditions and modalities of the transfer of a patient
after allogeneic stem cell transplantation to the ICU. We propose a
structured medical form comprising all essential information necessary for
optimal medical care on ICU.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
allogeneic stem cell transplantation
bone marrow
graft recipient
intensive care unit
practice guideline
transplantation
EMTREE MEDICAL INDEX TERMS
hematologist
hematology
human
human experiment
human tissue
intensivist
male
medical care
medical staff
mortality
prognosis
relative
LANGUAGE OF ARTICLE
English, French
LANGUAGE OF SUMMARY
English, French
EMBASE ACCESSION NUMBER
20160879865
MEDLINE PMID
27816169 (http://www.ncbi.nlm.nih.gov/pubmed/27816169)
PUI
L613501840
DOI
10.1016/j.bulcan.2016.09.008
FULL TEXT LINK
http://dx.doi.org/10.1016/j.bulcan.2016.09.008
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 106
TITLE
The capabilities and scope-of-practice requirements of advanced life support
practitioners undertaking critical care transfers: A Delphi study
AUTHOR NAMES
Venter M.
Stassen W.
AUTHOR ADDRESSES
(Venter M.; Stassen W., stassen88@gmail.com) Department of Emergency Medical
Care, Faculty of Health Sciences, University of Johannesburg, South Africa.
CORRESPONDENCE ADDRESS
W. Stassen, Department of Emergency Medical Care, Faculty of Health
Sciences, University of Johannesburg, South Africa. Email:
stassen88@gmail.com
SOURCE
Southern African Journal of Critical Care (2016) 32:2 (58-61). Date of
Publication: 1 Nov 2016
ISSN
1562-8264
BOOK PUBLISHER
South African Medical Association, publishing@samedical.org
ABSTRACT
Background. Critical care transfers (CCT) refer to the high level of care
given during transport (via ambulance, helicopter or fixed-wing aircraft) of
patients who are of high acuity. In South Africa (SA), advanced life support
(ALS) paramedics undertake CCTs. The scope of ALS in SA has no extended
protocol regarding procedures or medications in terms of dealing with these
CCTs. Aim. The aim of this study was to obtain the opinions of several
experts in fields pertaining to critical care and transport and to gain
consensus on the skills and scope-of-practice requirements of paramedics
undertaking CCTs in the SA setting. Methods. A modified Delphi study
consisting of three rounds was undertaken using an online survey platform. A
heterogeneous sample (n=7), consisting of specialists in the fields of
anaesthesiology, emergency medicine, internal medicine, critical care,
critical care transport and paediatrics, was asked to indicate whether, in
their opinion, selected procedures and medications were needed within the
scope of practice of paramedics undertaking CCTs. Results. After three
rounds, consensus was obtained in 70% (57/81) of procedures and medications.
Many of these items are not currently within the scope of paramedics'
training. The panel felt that paramedics undertaking these transfers should
have additional postgraduate training that is specific to critical care.
Conclusion. Major discrepancies exist between the current scope of paramedic
practice and the suggested required scope of practice for CCTs. An extended
scope of practice and additional training should be considered for these
practitioners.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Delphi study
intensive care
physician
scope of practice
EMTREE MEDICAL INDEX TERMS
anesthesiology
clinical article
consensus
emergency medicine
human
internal medicine
postgraduate education
skill
South Africa
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160867611
PUI
L613439789
DOI
10.7196/SAJCC.2016.v32i2.275
FULL TEXT LINK
http://dx.doi.org/10.7196/SAJCC.2016.v32i2.275
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 107
TITLE
Fly away with me
AUTHOR NAMES
McSharry B.
AUTHOR ADDRESSES
(McSharry B., BrentM@adhb.govt.nz) Starship Children's Health – Paediatric
Intensive Care, Auckland, New Zealand.
CORRESPONDENCE ADDRESS
B. McSharry, Starship Children's Health – Paediatric Intensive Care,
Auckland, New Zealand. Email: BrentM@adhb.govt.nz
SOURCE
Acta Paediatrica, International Journal of Paediatrics (2016) 105:11 (1336).
Date of Publication: 1 Nov 2016
ISSN
1651-2227 (electronic)
0803-5253
BOOK PUBLISHER
Blackwell Publishing Ltd, customerservices@oxonblackwellpublishing.com
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient transport
pediatric intensive care unit
EMTREE MEDICAL INDEX TERMS
childhood disease
critical illness
extubation
human
length of stay
mortality
note
priority journal
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20160778451
PUI
L612950517
DOI
10.1111/apa.13530
FULL TEXT LINK
http://dx.doi.org/10.1111/apa.13530
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 108
TITLE
More than a bus ride: quality and outcomes of paediatric specialty transport
AUTHOR NAMES
Bigham M.T.
AUTHOR ADDRESSES
(Bigham M.T., mbigham@chmca.org) Division of Critical Care Medicine,
Department of Pediatrics, Akron Children's Hospital, Akron, United States.
CORRESPONDENCE ADDRESS
M.T. Bigham, Division of Critical Care Medicine, Department of Pediatrics,
Akron Children's Hospital, Akron, United States. Email: mbigham@chmca.org
SOURCE
Acta Paediatrica, International Journal of Paediatrics (2016) 105:11 (1335).
Date of Publication: 1 Nov 2016
ISSN
1651-2227 (electronic)
0803-5253
BOOK PUBLISHER
Blackwell Publishing Ltd, customerservices@oxonblackwellpublishing.com
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health care quality
patient transport
pediatrics
traffic and transport
EMTREE MEDICAL INDEX TERMS
Antiquity
critically ill patient
disease severity
health care delivery
hospital admission
human
length of stay
mortality rate
note
outcome assessment
pediatric intensive care unit
priority journal
respiratory failure
standardized mortality ratio
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20160778452
MEDLINE PMID
27444883 (http://www.ncbi.nlm.nih.gov/pubmed/27444883)
PUI
L612950522
DOI
10.1111/apa.13534
FULL TEXT LINK
http://dx.doi.org/10.1111/apa.13534
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 109
TITLE
Complications and benefits of intrahospital transport of adult Intensive
Care Unit patients
AUTHOR NAMES
Sai Saran P.V.
Azim A.
AUTHOR ADDRESSES
(Sai Saran P.V.; Azim A., draazim2002@gmail.com) Department of Critical Care
Medicine, SGPGIMS, Lucknow, India.
CORRESPONDENCE ADDRESS
A. Azim, Department of Critical Care Medicine, SGPGIMS, Lucknow, India.
Email: draazim2002@gmail.com
SOURCE
Indian Journal of Critical Care Medicine (2016) 20:10 (628-629). Date of
Publication: 1 Oct 2016
ISSN
1998-359X (electronic)
0972-5229
BOOK PUBLISHER
Medknow Publications, B9, Kanara Business Centre, off Link Road, Ghatkopar
(E), Mumbai, India.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
clinical evaluation
human
hyperventilation
intensive care
letter
patient
pneumothorax
safety
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Anesthesiology (24)
Internal Medicine (6)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20160799030
PUI
L613097010
DOI
10.4103/0972-5229.192069
FULL TEXT LINK
http://dx.doi.org/10.4103/0972-5229.192069
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 110
TITLE
Frequency, Composition, and Predictors of In-Transit Critical Events during
Pediatric Critical Care Transport∗
AUTHOR NAMES
Singh J.M.
Gunz A.C.
Dhanani S.
Aghari M.
Macdonald R.D.
AUTHOR ADDRESSES
(Singh J.M.) Division of Critical Care Medicine, Department of Medicine,
University Health Network, Toronto, Canada.
(Singh J.M.) Interdepartmental Division of Critical Care Medicine,
Department of Medicine, University of Toronto, Toronto, Canada.
(Gunz A.C.) Department of Pediatrics, Schulich School of Medicine and
Dentistry, Western University, London, Canada.
(Dhanani S.) Division of Pediatric Critical Care, Department of Pediatrics,
Children's Hospital of Eastern Ontario, Ottawa, Canada.
(Dhanani S.) Department of Pediatrics, Faculty of Medicine, University of
Ottawa, Ottawa, Canada.
(Aghari M.; Macdonald R.D.) Ornge Transport Medicine, Mississauga, Canada.
(Macdonald R.D.) Division of Emergency Medicine, Department of Medicine,
University of Toronto, Toronto, Canada.
SOURCE
Pediatric Critical Care Medicine (2016) 17:10 (984-991). Date of
Publication: 1 Oct 2016
ISSN
1947-3893 (electronic)
1529-7535
BOOK PUBLISHER
Lippincott Williams and Wilkins, kathiest.clai@apta.org
ABSTRACT
Objectives: Transport of pediatric patients is common due to healthcare
regionalization. We set out to determine the frequency of in-transit
critical events during pediatric critical care transport and identify
factors associated with these events. Design: Retrospective cohort study
using administrative and clinical data. Setting: Single pediatric critical
care transport provider in Ontario, Canada. Patients: All pediatric care
transports between January 1, 2005, and December 31, 2010. Measurements and
Main Results: The primary outcome was in-transit critical events, defined by
an adaptation of a recent consensus definition. In-transit critical events
occurred in 1,094 (12.3%) of 8,889 transports. Hypotension (3.6%),
tachycardia (3.7%), and bradycardia (3.3%) were the most common critical
events. Crews performed medical interventions in 194 transports (2.2%). The
frequency and makeup of critical events varied across patient age groups.
Age, pretransport mechanical ventilation, pretransport cardiovascular
instability, transport duration, scene calls, and paramedic crew level were
independently associated with increased risk of in-transit critical events
in multivariate analysis. A Transport Pediatric Early Warning Score of 7 or
greater predicted in-transit critical events with high specificity but low
sensitivity (92.0% and 20.0%, respectively), but was not superior of the
combination of pretransport mechanical ventilation and pretransport
cardiovascular instability (sensitivity and specificity of 12.6% and 97.4%,
respectively). Removal of early warning signs from the definition resulted
in critical event rates comparable to those published in adults and improved
predictive performance. Conclusions: Using new consensus definitions of
transport-related critical events, we found critical events occurred in
almost one in eight transports, and were strongly associated with
pretransport cardiovascular instability. Transport Pediatric Early Warning
Score was poorly predictive of in-transit critical events, and was not
superior to the presence of pretransport mechanical ventilation and
cardiovascular instability. Future prospective studies are required to
elucidate the optimal matching of transport resources to patients, in
particular those with both pretransport cardiovascular instability and
mechanical ventilation.
EMTREE DRUG INDEX TERMS
adenosine
atropine
bicarbonate
dopamine
glucagon
glucose
hypertensive factor
lidocaine
naloxone
noradrenalin
phenylephrine
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
intensive care
patient transport
pediatrics
EMTREE MEDICAL INDEX TERMS
adolescent
adult
adverse outcome
article
artificial ventilation
assisted ventilation
bradycardia
cardiovascular disease
child
cohort analysis
endotracheal intubation
female
human
hypotension
infant
major clinical study
male
manual emergency ventilator
nasotracheal intubation
newborn
Ontario
outcome assessment
paramedical personnel
patient safety
preschool child
priority journal
retrospective study
sensitivity and specificity
sentinel event
tachycardia
thoracostomy
tracheotomy
CAS REGISTRY NUMBERS
adenosine (58-61-7)
atropine (51-55-8, 55-48-1)
bicarbonate (144-55-8, 71-52-3)
dopamine (51-61-6, 62-31-7)
glucagon (11140-85-5, 62340-29-8, 9007-92-5)
glucose (50-99-7, 84778-64-3)
lidocaine (137-58-6, 24847-67-4, 56934-02-2, 73-78-9)
naloxone (357-08-4, 465-65-6)
noradrenalin (1407-84-7, 51-41-2)
phenylephrine (532-38-7, 59-42-7, 61-76-7)
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Cardiovascular Diseases and Cardiovascular Surgery (18)
Drug Literature Index (37)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160593799
MEDLINE PMID
27505717 (http://www.ncbi.nlm.nih.gov/pubmed/27505717)
PUI
L611645723
DOI
10.1097/PCC.0000000000000919
FULL TEXT LINK
http://dx.doi.org/10.1097/PCC.0000000000000919
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 111
TITLE
Critical Care Transport: How Perilous the Trip∗
AUTHOR NAMES
Bigham M.T.
Brilli R.J.
AUTHOR ADDRESSES
(Bigham M.T.) Department of Pediatrics, Akron Children's Hospital, Akron,
United States.
(Bigham M.T.) Department of Pediatrics, Northeast Ohio Medical University,
Rootstown, United States.
(Brilli R.J.) Department of Pediatrics Nationwide, Children's Hospital,
Columbus, United States.
(Brilli R.J.) Department of Pediatrics, Ohio State University, College of
Medicine, Columbus, United States.
SOURCE
Pediatric Critical Care Medicine (2016) 17:10 (1008-1009). Date of
Publication: 1 Oct 2016
ISSN
1947-3893 (electronic)
1529-7535
BOOK PUBLISHER
Lippincott Williams and Wilkins, kathiest.clai@apta.org
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
abnormal laboratory result
artificial ventilation
childhood mortality
critically ill patient
disease severity
editorial
general condition deterioration
hospital admission
human
laboratory test
priority journal
resuscitation
risk assessment
sentinel event
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20160717102
PUI
L612540803
DOI
10.1097/PCC.0000000000000927
FULL TEXT LINK
http://dx.doi.org/10.1097/PCC.0000000000000927
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 112
TITLE
Simulation-based training for pulmonary and critical care fellows in urgent
endotracheal intubation: Does skill transfer to the clinical arena?
AUTHOR NAMES
Shah R.
Makaryus M.
Feldman M.
Mayo-Malasky P.
Narasimhan M.
Mayo P.
Singas E.
AUTHOR ADDRESSES
(Shah R.; Makaryus M.; Feldman M.; Mayo-Malasky P.; Narasimhan M.; Mayo P.;
Singas E.) Northwell/North Shore and LIJ, New York, United States.
CORRESPONDENCE ADDRESS
R. Shah, Northwell/North Shore and LIJ, New York, United States.
SOURCE
Chest (2016) 150:4 Supplement 1 (636A). Date of Publication: 1 Oct 2016
CONFERENCE NAME
CHEST 2016
CONFERENCE LOCATION
Los Angeles, CA, United States
CONFERENCE DATE
2016-10-22 to 2016-10-26
ISSN
1931-3543
BOOK PUBLISHER
Elsevier B.V.
ABSTRACT
PURPOSE: Simulation-based training (SBT) for high-risk, low-frequency
clinical events such as urgent endotracheal intubation (UEI) is a widely
used training tool. Training effect is generally demonstrated by testing the
learner on the simulator. We studied whether SBT for UEI performed by
pulmonary/critical care medicine (PCCM) fellows transferred to real-life
UEI. METHODS: In July of 2015, four first-year PCCM fellows attended 15
mandatory training sessions to develop skill at UEI. Each session included a
short didactic discussion followed by SBT using a computerized patient
simulator (CPS). Sessions emphasized task training, crew resource management
(CRM) communication, mastery of a Do/Confirm 46-point checklist, standard
crew assignments, and combined team tactics. The fellows executed multiple
scenarios of increasing complexity and stress with one fellow assigned to be
team leader while the others assumed the roles of crew members on a rotating
basis. Each scenario was followed by a formal debriefing session. At the end
of the entire training period, each fellow was tested on the CPS while
wearing a body mounted video camera. The same video assessment was done on
the fellow's first real patient UEI to evaluate if SBT translated to
real-life patient encounter. Video recordings were scored by two independent
investigators using a standardized score sheet. Forty of the 46 items on the
checklist could be scored from the video recordings. RESULTS: Results of
testing on the CPS for execution of the checklist ranged from 36/40 (90%) to
40/40 (100%). Results of testing on real-life patient UEI for execution of
the checklist ranged from 37/40 (92.5%) to 39/40 (97.5%). Use of task
training, CRM, and combined team tactics was excellent with the CPS and
real-life UEI with all fellows. There was minimal inter-observer variability
in scoring. CONCLUSIONS: SBT is an effective approach to train PCCM fellows
in UEI. Video recording is a useful method to objectively assess the
training effect of SBT for real-life patient UEI.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
endotracheal intubation
intensive care
lung
skill
EMTREE MEDICAL INDEX TERMS
checklist
crew member
human
human experiment
leadership
medicine
resource management
simulator
stress
videorecording
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L613468004
DOI
10.1016/j.chest.2016.08.728
FULL TEXT LINK
http://dx.doi.org/10.1016/j.chest.2016.08.728
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 113
TITLE
Pneumothorax during transportation of patient on Ayres T-piece: A rare but
lethal experience!
AUTHOR NAMES
Nikhar S.
Gupta K.
AUTHOR ADDRESSES
(Nikhar S.) Department of Anaesthesia and Intensive Care, Nizam Institute of
Medical Sciences, Hyderabad, India.
(Gupta K., doc_krishan31@yahoo.co.in) Department of Anaesthesia and
Intensive Care, GGS Medical College and Hospital, Medical Campus, Faridkot,
India.
CORRESPONDENCE ADDRESS
K. Gupta, Department of Anaesthesia and Intensive Care, GGS Medical College
and Hospital, Medical Campus, Faridkot, India. Email:
doc_krishan31@yahoo.co.in
SOURCE
Saudi Journal of Anaesthesia (2016) 10:4 (490-491). Date of Publication: 1
Oct 2016
ISSN
0975-3125 (electronic)
1658-354X
BOOK PUBLISHER
Medknow Publications, B9, Kanara Business Centre, off Link Road, Ghatkopar
(E), Mumbai, India.
EMTREE DRUG INDEX TERMS
atropine (drug therapy)
oxygen
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient transport
patient transport device
T piece
tension pneumothorax (complication, diagnosis, therapy)
EMTREE MEDICAL INDEX TERMS
bradycardia (drug therapy)
case report
chest tube
child
endotracheal tube
extubation
general anesthesia
human
intensive care unit
intermittent positive pressure ventilation
intestine obstruction
letter
male
manual ventilation
needle
oxygen saturation
priority journal
respiratory distress
school child
CAS REGISTRY NUMBERS
atropine (51-55-8, 55-48-1)
oxygen (7782-44-7)
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Anesthesiology (24)
Biophysics, Bioengineering and Medical Instrumentation (27)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20160693952
PUI
L612358178
DOI
10.4103/1658-354X.179124
FULL TEXT LINK
http://dx.doi.org/10.4103/1658-354X.179124
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 114
TITLE
Unfavorable Results After Free Tissue Transfer to Head and Neck: Lessons
Learned at the University of Washington
AUTHOR NAMES
Houlton J.J.
Bevans S.E.
Futran N.D.
AUTHOR ADDRESSES
(Houlton J.J., jhoulton@uw.edu; Bevans S.E.; Futran N.D.) Department of
Otolaryngology, University of Washington, 1959 Northeast Pacific Street,
Box 356515, Seattle, United States.
CORRESPONDENCE ADDRESS
J.J. Houlton, Department of Otolaryngology, University of Washington, 1959
Northeast Pacific Street, Box 356515, Seattle, United States. Email:
jhoulton@uw.edu
SOURCE
Clinics in Plastic Surgery (2016) 43:4 (683-693). Date of Publication: 1 Oct
2016
ISSN
1558-0504 (electronic)
0094-1298
BOOK PUBLISHER
W.B. Saunders
ABSTRACT
This article discusses the lessons learned from nearly 2700 free tissue
transfer procedures to reconstruct defects of the head and neck at the
University of Washington. It discusses the authors’ perioperative management
practices regarding perioperative tracheotomy tube placement, their method
of postoperative flap monitoring, and their current protocol for use of
postoperative antibiotics. It reports on the reconstructive preferences for
2 difficult defects that frequently result in unfavorable outcomes: the
total glossectomy defect and the pharyngolaryngectomy defect. Key points for
harvesting and insetting flaps, to maximize reconstructive outcomes, are
provided.
EMTREE DRUG INDEX TERMS
antibiotic agent
clindamycin
levofloxacin
sultamicillin
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
free tissue graft
head and neck surgery
tissue flap
treatment outcome
EMTREE MEDICAL INDEX TERMS
anterolateral thigh flap
atrophy
clinical practice
Doppler flowmeter
drug use
esophagus resection
fascia
glossectomy
hospitalization
human
intensive care unit
intubation
length of stay
medical procedures
morbidity
needle stick technique
patient monitoring
percutaneous endoscopic gastrostomy
perioperative period
peripherally inserted central venous catheter
postoperative care
review
surface area
swallowing
tracheotomy
United States
voice change
CAS REGISTRY NUMBERS
clindamycin (18323-44-9)
levofloxacin (100986-85-4, 138199-71-0)
sultamicillin (58694-35-2, 76497-13-7)
EMBASE CLASSIFICATIONS
Biophysics, Bioengineering and Medical Instrumentation (27)
Drug Literature Index (37)
Surgery (9)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160845067
MEDLINE PMID
27601392 (http://www.ncbi.nlm.nih.gov/pubmed/27601392)
PUI
L613297618
DOI
10.1016/j.cps.2016.05.006
FULL TEXT LINK
http://dx.doi.org/10.1016/j.cps.2016.05.006
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 115
TITLE
Identification and Cost of Potentially Avoidable Transfers to a Tertiary
Care Neurosurgery Service: A Pilot Study
AUTHOR NAMES
Kuhn E.N.
Warmus B.A.
Davis M.C.
Oster R.A.
Guthrie B.L.
AUTHOR ADDRESSES
(Kuhn E.N., ekuhn@uabmc.edu; Warmus B.A.; Davis M.C.; Guthrie B.L.)
Department of Neurological Surgery, Division of Preventive Medicine,
University of Alabama at Birmingham, 1720 Second Ave S, Birmingham, United
States.
(Warmus B.A.) Medical Scientist Training Program, Division of Preventive
Medicine, University of Alabama at Birmingham, Birmingham, United States.
(Oster R.A.) Department of Medicine, Division of Preventive Medicine,
University of Alabama at Birmingham, Birmingham, United States.
CORRESPONDENCE ADDRESS
E.N. Kuhn, Department of Neurological Surgery, Division of Preventive
Medicine, University of Alabama at Birmingham, 1720 Second Ave S,
Birmingham, United States. Email: ekuhn@uabmc.edu
SOURCE
Neurosurgery (2016) 79:4 (541-548). Date of Publication: 1 Oct 2016
ISSN
1524-4040 (electronic)
0148-396X
BOOK PUBLISHER
Lippincott Williams and Wilkins, kathiest.clai@apta.org
ABSTRACT
BACKGROUND: Thousands of neurosurgical emergencies are transferred yearly to
tertiary care facilities to assume a higher level of care. Several studies
have examined how neurosurgical transfers influence patient outcomes, but
characteristics of potentially avoidable transfers have yet to be
investigated. OBJECTIVE: To identify whether potentially avoidable transfers
represent a significant portion of transfers to a tertiary neurosurgical
facility. METHODS: In this cohort study, we evaluated 916 neurosurgical
patients transferred to a tertiary care facility over a 2-year period.
Transfers were classified as potentially avoidable when no neurosurgical
diagnostic test, intervention, or intensive monitoring was deemed necessary
(n 180). The remaining transfers were classified as justifiable (n 736). The
main outcomes and measures were age, sex, diagnosis, insurance status,
intervention, distance of transfer, length of hospital and intensive care
unit stay, mortality, discharge disposition, and cost. RESULTS: Nearly 20%
of transfers were identified as being potentially avoidable. Although some
of these patients had suffered devastating, irrecoverable neurological
insults, many had innocuous conditions that did not require transfer to a
higher level of care. Justifiable transfers tend to involve patients with
nontraumatic intracranial hemorrhage and cranial neoplasm. Both groups were
admitted to the intensive care unit at the same rate (approximately 70% of
patients). Finally, the direct transportation cost of potentially avoidable
transfers was $1.46 million over 2 years. CONCLUSION: This study identified
the frequency and expense of potentially avoidable transfers. There is a
need for closer examination of the clinical and financial implications of
potentially avoidable transfers.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health care cost
health care facility
health service
neurosurgery
potentially avoidable transfer
tertiary health care
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
article
brain hemorrhage
child
cohort analysis
diagnostic test
female
health insurance
hospital cost
hospital discharge
hospitalization
human
intensive care unit
intervention study
length of stay
major clinical study
male
outcome assessment
pilot study
priority journal
tertiary care center
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Health Policy, Economics and Management (36)
Neurology and Neurosurgery (8)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160577300
MEDLINE PMID
27489167 (http://www.ncbi.nlm.nih.gov/pubmed/27489167)
PUI
L611548023
DOI
10.1227/NEU.0000000000001378
FULL TEXT LINK
http://dx.doi.org/10.1227/NEU.0000000000001378
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 116
TITLE
Preventing critical care transfers for antibiotic desensitization to improve
patient and staff satisfaction
AUTHOR NAMES
Wesson S.J.
Smith E.
Egener N.
AUTHOR ADDRESSES
(Wesson S.J.; Smith E.; Egener N.) National Jewish Health, Saint Joseph
Hospital, Denver, United States.
CORRESPONDENCE ADDRESS
S.J. Wesson, National Jewish Health, Saint Joseph Hospital, Denver, United
States.
SOURCE
Pediatric Pulmonology (2016) 51 Supplement 45 (412). Date of Publication: 1
Oct 2016
CONFERENCE NAME
30th Annual North American Cystic Fibrosis Conference
CONFERENCE LOCATION
Orlando, FL, United States
CONFERENCE DATE
2016-10-27 to 2016-10-29
ISSN
1099-0496
BOOK PUBLISHER
John Wiley and Sons Inc.
ABSTRACT
Background: Patients with cystic fibrosis (CF) receive many antibiotics
throughout their lifetime to treat pulmonary infections. Over time, they can
develop allergies to antibiotics that may be considered optimal for
effective treatment. Patients with history of type-I hypersensitivity
reaction to an antibiotic can be desensitized to that drug if clinically
necessary. Desensitization induces a temporary immune-tolerant state,
allowing for safe administration of the allergenic medication until
scheduled doses are stopped. It is accomplished by administering increasing
doses until the therapeutic dose is reached and tolerated. Due to risk for
allergic reaction during this process, 1:1 nursing care is necessary.
However, severe reactions are rare (Legere H, et al. J Cyst Fibros.
2009;8(6),418-24). CF patients are traditionally transferred to the
intensive care unit (ICU) for this procedure and once completed, move back
to the pulmonary unit (PU). This process was noted to cause delays in
patient care, decreased patient and staff satisfaction, increased risk for
handoff errors, and misuse of ICU resources. Purpose: The purpose of this
project is to allow CF patients to remain on the PU for desensitization when
clinically appropriate. With this process change, we aim to expand nursing
skills, improve patient and staff satisfaction, maintain patient safety, and
retain successful outcomes. Methods: In collaboration with PU hospitalists,
a non-ICU protocol for antibiotic desensitization was developed. It includes
an order to call rapid response for a severe reaction. Patients must have
had a prior successful desensitization to the drug to desensitize on the PU.
Staff nurses are trained by shadowing a desensitization in ICU and
completing a skill check off with a competent nurse. A post-implementation
survey of was utilized to evaluate the effects of this change on staff and
patient satisfaction. Results from a staff satisfaction survey issued prior
to the process change were utilized for comparison. Participating patients
were interviewed. Outcomes of ICU vs PU desensitizations were reviewed for
potential outcome differences. Outcomes: The process change took effect in
March 2016. By the end of April 2016, four patients had been desensitized on
the PU. One patient was desensitized in ICU per developed criteria. All five
were successful with no moderate or severe reactions. All four patients
desensitized on the PU had been desensitized in ICU on prior admissions. All
participating patients had a positive response when asked their opinion
about the process change. Seven PU nurses completed training. They report
feeling nursing skills have been elevated. The staff felt this was a
positive change in process for desensitizing. Nurse satisfaction survey
response to the question “my job makes good use of my skills and abilities”
went from 83% favorable to 100% favorable post-implementation. Conclusions:
This project resolved many delay issues due to beds/ staff limitations,
patient care transfers, and handoffs. Overall, the change has been a success
demonstrated by consistent patient outcomes, positive patient response, and
increased staff satisfaction.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
antibiotic agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
desensitization
intensive care unit
medical staff
patient satisfaction
EMTREE MEDICAL INDEX TERMS
allergic reaction
case report
cyst
cystic fibrosis
drug resistance
drug therapy
error
human
lung infection
nursing care
nursing competence
patient care
patient safety
prevention
staff nurse
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L612359225
DOI
10.1002/ppul.23576
FULL TEXT LINK
http://dx.doi.org/10.1002/ppul.23576
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 117
TITLE
Profile of Interfacility Emergency Department Transfers: Transferring
Medical Providers and Reasons for Transfer
AUTHOR NAMES
Li J.
Pryor S.
Choi B.
Rees C.A.
Senthil M.V.
Tsarouhas N.
Myers S.R.
Monuteaux M.C.
Bachur R.G.
AUTHOR ADDRESSES
(Li J.) From the *Boston Childrenʼs Hospital, Harvard Medical School, Boston
MA; †Seattle Childrenʼs Hospital, University of Washington School of
Medicine, Seattle, WA; ‡Texas Childrenʼs Hospital, Baylor College of
Medicine, Houston TX; and §The Childrenʼs Hospital of Philadelphia, Perelman
School of Medicine, University of Pennsylvania, Philadelphia, PA.
(Pryor S.; Choi B.; Rees C.A.; Senthil M.V.; Tsarouhas N.; Myers S.R.;
Monuteaux M.C.; Bachur R.G.)
CORRESPONDENCE ADDRESS
J. Li, From the *Boston Childrenʼs Hospital, Harvard Medical School, Boston
MA; †Seattle Childrenʼs Hospital, University of Washington School of
Medicine, Seattle, WA; ‡Texas Childrenʼs Hospital, Baylor College of
Medicine, Houston TX; and §The Childrenʼs Hospital of Philadelphia, Perelman
School of Medicine, University of Pennsylvania, Philadelphia, PA.
SOURCE
Pediatric Emergency Care (2016). Date of Publication: 23 Sep 2016
ISSN
1535-1815 (electronic)
0749-5161
BOOK PUBLISHER
Lippincott Williams and Wilkins, kathiest.clai@apta.org
ABSTRACT
OBJECTIVES: The aim of this study was to determine the reasons for pediatric
emergency department (ED) transfers and the professional characteristics of
transferring providers. METHODS: We performed a multicenter, cross-sectional
survey of ED medical providers transferring patients younger than 18 years
to 1 of 4 tertiary care childrenʼs hospitals. Referring providers completed
surveys detailing the primary reasons for transfer and their medical
training. RESULTS: The survey data were collected for 25 months, during
which 641 medical providers completed 890 surveys, with an overall response
rate of 25%. Most pediatric patients were seen by physicians (89.4%) with
predominantly general emergency medicine training (64.2%). The median age of
patients seen was 5.6 years. The 3 most common diagnoses were closed
extremity fracture (12.2%), appendicitis (11.6%), and pneumonia (3.7%). The
3 most common reasons for transfer were need for medical/surgical
subspecialist consultation (62.6%), admission to the inpatient unit (17.1%),
and admission to the intensive care unit (6.5%). When asked about the need
for supportive pediatric services, referring providers ranked pediatric
subspecialty and pediatric inpatient unit availability as the highest.
CONCLUSIONS: Most pediatric interfacility ED transfers are referred by
general emergency medicine physicians who often transfer for inpatient
admission or subspecialty consultation. Understanding the needs of the
community-based ED providers is an important step to forming more
collaborative efforts for regionalized pediatric emergency care.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency ward
EMTREE MEDICAL INDEX TERMS
appendicitis
child
clinical trial
consultation
controlled clinical trial
controlled study
diagnosis
doctor patient relation
emergency care
emergency medicine
human
intensive care unit
limb fracture
major clinical study
medical education
multicenter study
pediatrics
pneumonia
preschool child
surgery
tertiary health care
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160694824
PUI
L612362886
DOI
10.1097/PEC.0000000000000848
FULL TEXT LINK
http://dx.doi.org/10.1097/PEC.0000000000000848
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 118
TITLE
Transfer delay from intensive care unit: Retrospective analytical study in
an Indian tertiary care hospital
AUTHOR NAMES
Pattnaik S.K.
Ray B.
AUTHOR ADDRESSES
(Pattnaik S.K.) Apollo Hospitals, Critical Care Unit, Bhubaneswar, India.
(Ray B.) Apollo Hospitals, Bhubaneswar, India.
CORRESPONDENCE ADDRESS
S.K. Pattnaik, Apollo Hospitals, Critical Care Unit, Bhubaneswar, India.
SOURCE
Intensive Care Medicine Experimental (2016) 4 Supplement 1. Date of
Publication: 1 Sep 2016
CONFERENCE NAME
29th Annual Congress of the European Society of Intensive Care Medicine,
ESICM 2016
CONFERENCE LOCATION
Milan, Italy
CONFERENCE DATE
2016-10-01 to 2016-10-05
ISSN
2197-425X
BOOK PUBLISHER
SpringerOpen
ABSTRACT
Introduction: There lies scarcity of Intensive Care Unit (ICU) beds in every
tertiary care hospitals, and on top of it delayed transfer of patients from
ICU to wards is further increasing the burdensome. Numerous factors affect
in making delayed transfer, which in itself is a risk factor for patient
related morbidity and mortality, especially the after hour transfers.
Objectives: The aim of the study was to analyze the hours of transfer delay
and their effect on readmission rates in the ICU. Methods: We conducted a
retrospective study of patients transfer from our ICU to the wards over last
one year (Jan-Dec'2015). Data collected from the ICU database by the
secretarial staff during the study period and divided into following
categories of transfer delays: 1) Less than 4 hrs 2) 4-8 hrs 3) 8-24 hrs 4)
More than 24 hrs 5) After hour transfers (from 8 PM-8 AM) Results: There
were 3362 patients admitted to our ICU during the study period of which 2475
patients were shifted to the wards. The average delay in shifting was around
6.5 hours (2-10.5 hrs). Delayed transfer of more than 8 hrs was found in 64
% patients and the percentage of after-hours transfer was 43 % of the total
transfers. There were 16 readmissions into the ICU within 48 hrs of shift
out among patients transferred in after hours as against 3 in patients
transferred during routine hours. Conclusions: Prevalence of delayed
discharge from ICU was significant, especially the after hour discharges,
which has got an impact on readmission rate as well. Discharge delay should
be considered as an important quality indicator for critically ill patients
to decrease the morbidity and mortality in ICU patients. Further studies are
warranted to identify factors associated with delayed discharge.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
tertiary care center
EMTREE MEDICAL INDEX TERMS
critically ill patient
data base
female
hospital readmission
human
major clinical study
male
morbidity
mortality
prevalence
retrospective study
staff
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L617992032
DOI
10.1186/s40635-016-0100-7
FULL TEXT LINK
http://dx.doi.org/10.1186/s40635-016-0100-7
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 119
TITLE
Consecutive lactate measurement in high risk oncohaematological patients as
a tool for transfer to intensive care unit
AUTHOR NAMES
Judickas S.
Serpytis M.
Kezyte G.
Urbanaviciute I.
Gaizauskas E.
AUTHOR ADDRESSES
(Judickas S.; Serpytis M.; Gaizauskas E.) Clinics of Anaesthesiology and
Intensive Care, Vilnius, Lithuania.
(Kezyte G.; Urbanaviciute I.) Vilnius University, Vilnius, Lithuania.
CORRESPONDENCE ADDRESS
S. Judickas, Clinics of Anaesthesiology and Intensive Care, Vilnius,
Lithuania.
SOURCE
Anesthesia and Analgesia (2016) 123:3 Supplement 2 (147). Date of
Publication: 1 Sep 2016
CONFERENCE NAME
16th World Congress of Anaesthesiologists, WCA 2016
CONFERENCE LOCATION
Hong Kong, Hong Kong
CONFERENCE DATE
2016-08-28 to 2016-09-02
ISSN
1526-7598
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Background & Objectives: Lactate elevation is strongly associated with
morbidity and mortality in critically ill medical and surgical patients.
Patients with oncohaematological (OH) malignancies are at a very high risk
of developing severe infectious complications that need immediate
recognition and prompt treatment. It is difficult to apply classical SIRS
criteria for OH patients due to preexisting malignancy, chemotherapy and
insufficiency of immune response [1]. Our aim was to evaluate the prognostic
value of consecutive lactate measurements as an additive indicator of
transfer of high risk OH patients to Intensive Care Unit (ICU). Materials &
Methods: A retrospective study was conducted in Vilnius University Hospital
Santariskiu Clinics during 1-year period from September 1, 2014 until August
31, 2015. During this period 88 patients were transferred from General
Haematology Unit and Bone Marrow Transplantation Unit to ICU. A control
group were patients treated during the same period of time in the same units
but who did not require transfer to ICU. Data of lactate measurements on the
day of transfer and up to 7 previous days were obtained with vital signs
(heart beat, respiration rate, temperature, white blood cell count) from
medical records. Study group was divided into survivors and non-survivors.
Statistical Package for the Social Sciences (SPSS) was used for statistical
analysis, using percentages to describe qualitative variables and means or
medians to describe quantitative variables. Results: Overall analysis
included 80 patients in study group and 190 patients in control group. ICU
mortality in study group was 46,25% (43 patients survived). Transferred
patients had significantly higher lactate level on transfer day compared to
control group (2,13 (0,62- 17,78) vs. 1,57 (0,54-13,26), p=0,001). A day
prior transfer lactate was measured in survivors group for 41,9% patients
and in non-survivors for 43,2% of patients. Lactate level obtained in ICU
after transfer was significantly higher in non-survivors group (2,5
(0,4-14,6) vs. 1,4 (0,4- 7,6), p=0,014). Non survivors group had
significantly higher heart rate (116±26 vs. 105±22, p=0,04) and respiratory
rate (25 (14-44) vs. 30 (20-43), p=0,013). Conclusion: A simple and
inexpensive consecutive lactate level measurements can have additive value
to vital signs monitoring identifying early deterioration of OH patients.
Careful and frequent evaluation of OH patients and their dynamics is
essential to identify those who will need more intensive treatment.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
lactic acid
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
EMTREE MEDICAL INDEX TERMS
bone marrow transplantation
breathing rate
control group
controlled study
deterioration
heart beat
heart rate
hematology
human
leukocyte count
major clinical study
medical record
monitoring
mortality
normal human
retrospective study
sociology
statistical analysis
survivor
university hospital
vital sign
CAS REGISTRY NUMBERS
lactic acid (113-21-3, 50-21-5)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L612648553
DOI
10.1213/01.ane.0000492513.66329.01
FULL TEXT LINK
http://dx.doi.org/10.1213/01.ane.0000492513.66329.01
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 120
TITLE
3D mapping of oxygen and CO(2) transport rates in the lung: a new imaging
tool for use in lung surgery, intensive care and basic research
AUTHOR NAMES
Johansen T.
Venegas J.G.
AUTHOR ADDRESSES
(Johansen T.) Department of Respiratory Diseases, Aarhus University
Hospital, Aarhus, Denmark.
(Venegas J.G., jvenegas@vqpet.mgh.harvard.edu) Department of Anesthesia,
Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard
Medical School, Boston, United States.
CORRESPONDENCE ADDRESS
J.G. Venegas, Department of Anesthesia, Critical Care and Pain Medicine,
Massachusetts General Hospital and Harvard Medical School, Boston, United
States. Email: jvenegas@vqpet.mgh.harvard.edu
SOURCE
Expert Review of Respiratory Medicine (2016) 10:9 (935-937). Date of
Publication: 1 Sep 2016
ISSN
1747-6356 (electronic)
1747-6348
BOOK PUBLISHER
Taylor and Francis Ltd, info@expert-reviews.com
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
carbon dioxide transport
lung gas exchange
oxygen transport
three dimensional imaging
EMTREE MEDICAL INDEX TERMS
arterial gas
arterial pH
basic research
blood gas tension
capillary wall
computer assisted tomography
editorial
forced expiratory volume
human
image segmentation
lung diffusion capacity
lung lobectomy
oxygen consumption
oxygen saturation
EMBASE CLASSIFICATIONS
Radiology (14)
Physiology (2)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20160521328
PUI
L611216000
DOI
10.1080/17476348.2016.1206818
FULL TEXT LINK
http://dx.doi.org/10.1080/17476348.2016.1206818
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 121
TITLE
Neonatal transport characteristics
ORIGINAL (NON-ENGLISH) TITLE
La spécificité du transport néonatal
AUTHOR NAMES
Baleine J.F.
Fournier-Favre P.
Fabre A.
AUTHOR ADDRESSES
(Baleine J.F., jf-baleine@chu-montpellier.fr; Fournier-Favre P.; Fabre A.)
Smur néonatal, CHU Montpellier, 371 avenue du Doyen Gaston Giraud, 34295
Montpellier, France
SOURCE
Soins. Pediatrie, puericulture (2016) 37:292 (25-29). Date of Publication: 1
Sep 2016
ISSN
1259-4792
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
organization and management
EMTREE MEDICAL INDEX TERMS
emergency health service
France
human
intensive care
neonatal intensive care unit
newborn
patient transport
LANGUAGE OF ARTICLE
French
LANGUAGE OF SUMMARY
English
MEDLINE PMID
27664306 (http://www.ncbi.nlm.nih.gov/pubmed/27664306)
PUI
L616563530
DOI
10.1016/j.spp.2016.07.005
FULL TEXT LINK
http://dx.doi.org/10.1016/j.spp.2016.07.005
COPYRIGHT
Copyright 2017 Medline is the source for the citation and abstract of this
record.
RECORD 122
TITLE
Perinatal outcomes after fresh versus frozen embryo transfers
AUTHOR NAMES
Chan S.
Greenstein Y.
Dasig D.
Farah-Eways L.
AUTHOR ADDRESSES
(Chan S.) Obstetrics and Gynecology, Kaiser Permanente Medical Center, Santa
Clara, United States.
(Greenstein Y.) Obstetrics and Gynecology, Kaiser Permanente, Modesto,
United States.
(Dasig D.; Farah-Eways L.) Reproductive Endocrinology and Infertility,
Kaiser Permanente Center for Reproductive Health, Fremont, United States.
CORRESPONDENCE ADDRESS
S. Chan, Obstetrics and Gynecology, Kaiser Permanente Medical Center, Santa
Clara, United States.
SOURCE
Fertility and Sterility (2016) 106 Supplement 3 (e324-e325). Date of
Publication: 1 Sep 2016
CONFERENCE NAME
ASRM Scientific Congress and Expo Scaling New Heights in Reproductive
Medicine, ASRM 2016
CONFERENCE LOCATION
Salt Lake City, UT, United States
CONFERENCE DATE
2016-10-15 to 2016-10-19
ISSN
1556-5653
BOOK PUBLISHER
Elsevier Inc.
ABSTRACT
OBJECTIVE: To determine whether there is a difference in perinatal outcome
when in vitro fertilization (IVF) with a fresh embryo transfer is compared
to IVF using cryopreserved embryos. DESIGN: Retrospective cohort. MATERIALS
AND METHODS: All fresh and frozen IVF cycles performed at an IVF center
between Feb. 2006 and Aug. 2011 that resulted in a live birth were included
in the study. Outcomes of interest included rates of gestational
hypertension (GHTN), preeclampsia, small for gestational age (SGA), preterm
delivery, gestational diabetes (GDM), and neonatal intensive care unit
(NICU) admission. IVF data was obtained from the IVF program's SART database
and outcome data was abstracted using ICD-9 codes from patient medical
records. For patients with more than one birth during the study period, only
the first delivery was included in the analysis. Chisquared analysis was
used to analyze the differences in rates of the outcomes of interest between
groups. RESULTS: A total of 669 live births following fresh transfer and 197
births following frozen transfer were analyzed. The groups were similar in
terms of age, nulliparity, and rates of chronic hypertension. Multiple
gestations were more common in pregnancies following fresh transfer than
after frozen transfer (36.4% vs. 24.9%, p= 0.0025). Ethnic distribution of
patients also varied between the groups (p = 0.0405). When including all
gestations, there was a significantly higher rate of GHTN following frozen
transfers when compared to fresh transfers (25.3% vs. 13.5%, p <0.0001).
Among only singleton gestations, the rate of GHTN was still significantly
higher following frozen transfer (27.0% vs 10.8%, p < 0.0001). The
difference in the rate of preeclampsia was not as pronounced after frozen
transfers vs fresh transfers (10.8% vs 6.1%, p = 0.0592). Rates of GDM, SGA,
preterm delivery or NICU admission were similar for all gestations and
singletons, and there were no significant differences in outcomes among only
multiple gestations. CONCLUSIONS: Our data suggest that frozen embryo
transfers were associated with a significantly higher rate of GHTN compared
to fresh transfers. Patients should be counseled that pregnancies following
frozen transfers may be at higher risk for developing hypertensive disorders
of pregnancy. Additional risk factors should be identified to further
stratify patients at greatest risk.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
embryo transfer
EMTREE MEDICAL INDEX TERMS
clinical article
data base
embryo
ethnic difference
female
human
ICD-9
live birth
maternal hypertension
medical record
neonatal intensive care unit
newborn
nullipara
preeclampsia
pregnancy diabetes mellitus
prematurity
risk factor
small for date infant
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L612867505
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 123
TITLE
Cross-sectional Survey of Canadian Pediatric Critical Care Transport
AUTHOR NAMES
Kawaguchi A.
Gunz A.
de Caen A.
AUTHOR ADDRESSES
(Kawaguchi A.) From the *Department of Pediatrics, Pediatric Critical Care
Medicine, and †School of Public Health, University of Alberta, Edmonton,
Alberta; and ‡Department of Pediatrics, Schulich School of Medicine &
Dentistry, Western University, London, Ontario, Canada.
(Gunz A.; de Caen A.)
CORRESPONDENCE ADDRESS
A. Kawaguchi, From the *Department of Pediatrics, Pediatric Critical Care
Medicine, and †School of Public Health, University of Alberta, Edmonton,
Alberta; and ‡Department of Pediatrics, Schulich School of Medicine &
Dentistry, Western University, London, Ontario, Canada.
SOURCE
Pediatric Emergency Care (2016). Date of Publication: 20 Aug 2016
ISSN
1535-1815 (electronic)
0749-5161
BOOK PUBLISHER
Lippincott Williams and Wilkins, kathiest.clai@apta.org
ABSTRACT
OBJECTIVES: This study aimed to better understand the unique aspects of
pediatric critical care transport programs across Canada by characterizing
the current workforce of each transport program. METHODS: A cross-sectional
questionnaire was sent to the 13 medical directors of Canadaʼs pediatric
critical care transport teams, and to 2 nonhospital-affiliated transport
services. If a childrenʼs hospital did not have a dedicated team for
pediatric transport, the regional transport team providing this service was
identified. RESULTS: Eight of the 13 pediatric intensive care units surveyed
have unit-based pediatric transport teams. The median annual transport
volume for the 8 hospital-based teams was 371 (range, 45–2300) with a total
of 5686 patients being transported annually. Among patients transported by
the 8 teams, 45% (2579 patients) were pediatric patients (older than 28 days
and younger than 18 years) and 40% (1022 patients) of the pediatric patients
were admitted to the pediatric intensive care units. Eighty-eight percent of
the responding teams also transported neonates (older than 28 days), and 38%
transported premature infants.A team composition of registered
nurse–respiratory therapist–physician was used by 6/13 teams (75%); however,
it accounted for only a small proportion of the transports for most of the
teams (median, 2%; range, 2%–100%).The average transport time from dispatch
(from team home site) to arrival at receiving facility was reported by 6
teams, and has a median of 195 minutes (range, 90–360 minutes). The median
distance from home site to the farthest referral site in the catchment area
was 700 km (range, 15–2500 km). CONCLUSIONS: This is the first Canadian
nationwide study of pediatric critical care transport programs. It revealed
a complexity and variability in transport team demographics, transport
volume, team composition, and decision-making process.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
EMTREE MEDICAL INDEX TERMS
administrative personnel
Canada
catchment
child
consensus development
decision making
human
infant
major clinical study
newborn
patient referral
prematurity
questionnaire
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160624309
PUI
L611873485
DOI
10.1097/PEC.0000000000000853
FULL TEXT LINK
http://dx.doi.org/10.1097/PEC.0000000000000853
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 124
TITLE
Improvement in patient transfer process from the operating room to the PICU
using a lean and six sigma-based quality improvement project
AUTHOR NAMES
Gleich S.J.
Nemergut M.E.
Stans A.A.
Haile D.T.
Feigal S.A.
Heinrich A.L.
Bosley C.L.
Tripathi S.
AUTHOR ADDRESSES
(Gleich S.J., gleich.stephen@mayo.edu; Nemergut M.E.) Department of
Pediatrics, Mayo Clinic, 200 1st St SW, Rochester, United States.
(Gleich S.J., gleich.stephen@mayo.edu; Nemergut M.E.; Haile D.T.; Bosley
C.L.) Department of Anesthesiology, Mayo Clinic, Rochester, United States.
(Stans A.A.) Department of Orthopedics, Mayo Clinic, Rochester, United
States.
(Feigal S.A.; Heinrich A.L.) Department of Nursing, Mayo Clinic, Rochester,
United States.
(Tripathi S.) Department of Clinical Pediatrics, University of Illinois,
College of Medicine, Peoria, United States.
CORRESPONDENCE ADDRESS
S.J. Gleich, Department of Pediatrics, Mayo Clinic, 200 1st St SW,
Rochester, United States. Email: gleich.stephen@mayo.edu
SOURCE
Hospital Pediatrics (2016) 6:8 (483-489). Date of Publication: 1 Aug 2016
ISSN
2154-1671 (electronic)
2154-1663
BOOK PUBLISHER
American Academy of Pediatrics, 141 Northwest Point Blvd, P.O. Box 927, Elk
Grove Village, United States.
ABSTRACT
BACKGROUND AND OBJECTIVES: Ineffective and inefficient patient transfer
processes can increase the chance of medical errors. Improvements in such
processes are high-priority local institutional and national patient safety
goals. At our institution, nonintubated postoperative pediatric patients are
first admitted to the postanesthesia care unit before transfer to the PICU.
This quality improvement project was designed to improve the patient
transfer process from the operating room (OR) to the PICU. METHODS: After
direct observation of the baseline process, we introduced a structured,
direct OR-PICU transfer process for orthopedic spinal fusion patients. We
performed value stream mapping of the process to determine error-prone and
inefficient areas. We evaluated primary outcome measures of handoff error
reduction and the overall efficiency of patient transfer process time. Staff
satisfaction was evaluated as a counterbalance measure. RESULTS: With the
introduction of the new direct OR-PICU patient transfer process, the handoff
communication error rate improved from 1.9 to 0.3 errors per patient handoff
(P = .002). Inefficiency (patient wait time and non-value-creating activity)
was reduced from 90 to 32 minutes. Handoff content was improved with fewer
information omissions (P < .001). Staff satisfaction significantly improved
among nearly all PICU providers. CONCLUSIONS: By using quality improvement
methodology to design and implement a new direct OR-PICU transfer process
with a structured multidisciplinary verbal handoff, we achieved sustained
improvements in patient safety and efficiency. Handoff communication was
enhanced, with fewer errors and content omissions. The new process improved
efficiency, with high staff satisfaction.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
operating room
patient transport
EMTREE MEDICAL INDEX TERMS
article
clinical handover
human
interpersonal communication
patient safety
patient satisfaction
spine fusion
total quality management
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160578288
MEDLINE PMID
27471214 (http://www.ncbi.nlm.nih.gov/pubmed/27471214)
PUI
L611554753
DOI
10.1542/hpeds.2015-0232
FULL TEXT LINK
http://dx.doi.org/10.1542/hpeds.2015-0232
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 125
TITLE
Multi-task transfer learning for in-hospital-death prediction of ICU
patients
AUTHOR NAMES
Karmakar C.
Saha B.
Palaniswami M.
Venkatesh S.
AUTHOR ADDRESSES
(Karmakar C.; Saha B.; Palaniswami M.; Venkatesh S.)
SOURCE
Conference proceedings : ... Annual International Conference of the IEEE
Engineering in Medicine and Biology Society. IEEE Engineering in Medicine
and Biology Society. Annual Conference (2016) 2016 (3321-3324). Date of
Publication: 1 Aug 2016
ISSN
1557-170X
ABSTRACT
Multi-Task Transfer Learning (MTTL) is an efficient approach for learning
from inter-related tasks with small sample size and imbalanced class
distribution. Since the intensive care unit (ICU) data set (publicly
available in Physionet) has subjects from four different ICU types, we
hypothesize that there is an underlying relatedness amongst various ICU
types. Therefore, this study aims to explore MTTL model for in-hospital
mortality prediction of ICU patients. We used single-task learning (STL)
approach on the augmented data as well as individual ICU data and compared
the performance with the proposed MTTL model. As a performance measurement
metrics, we used sensitivity (Sens), positive predictivity (+Pred), and
Score. MTTL with class balancing showed the best performance with score of
0.78, 0.73, o.52 and 0.63 for ICU type 1 (Coronary care unit), 2 (Cardiac
surgery unit), 3 (Medical ICU) and 4 (Surgical ICU) respectively. In
contrast the maximum score obtained using STL approach was 0.40 for ICU type
1 & 2. These results indicates that the performance of in-hospital mortality
can be improved using ICU type information and by balancing the
`non-survivor' class. The findings of the study may be useful for
quantifying the quality of ICU care, managing ICU resources and selecting
appropriate interventions.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital mortality
intensive care unit
theoretical model
EMTREE MEDICAL INDEX TERMS
decision support system
factual database
human
intensive care
length of stay
procedures
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
28324982 (http://www.ncbi.nlm.nih.gov/pubmed/28324982)
PUI
L618064346
DOI
10.1109/EMBC.2016.7591438
FULL TEXT LINK
http://dx.doi.org/10.1109/EMBC.2016.7591438
COPYRIGHT
Copyright 2017 Medline is the source for the citation and abstract of this
record.
RECORD 126
TITLE
The association between prehospital transportation and clinical outcomes in
patients with non–STEMI
AUTHOR NAMES
Kobayashi A.
Misumida N.
Kanei Y.
AUTHOR ADDRESSES
(Kobayashi A., akobayashi@chpnet.org; Misumida N.) Department of Internal
Medicine, Mount Sinai Beth Israel, New York, United States.
(Kanei Y.) Department of Cardiology, Mount Sinai Beth Israel, New York,
United States.
CORRESPONDENCE ADDRESS
A. Kobayashi, Mount Sinai Beth Israel, Department of Internal Medicine, 1st
Ave at 16th St, New York, United States. Email: akobayashi@chpnet.org
SOURCE
American Journal of Emergency Medicine (2016) 34:8 (1676-1677). Date of
Publication: 1 Aug 2016
ISSN
1532-8171 (electronic)
0735-6757
BOOK PUBLISHER
W.B. Saunders
EMTREE DRUG INDEX TERMS
troponin (endogenous compound)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
clinical outcome
non ST segment elevation myocardial infarction
patient transport
EMTREE MEDICAL INDEX TERMS
electrocardiogram
emergency health service
heart catheterization
heart infarction
hospital admission
hospital mortality
human
intensive care unit
International Classification of Diseases
letter
priority journal
retrospective study
sepsis
thorax pain
EMBASE CLASSIFICATIONS
Cardiovascular Diseases and Cardiovascular Surgery (18)
Internal Medicine (6)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20160387013
MEDLINE PMID
27220865 (http://www.ncbi.nlm.nih.gov/pubmed/27220865)
PUI
L610457698
DOI
10.1016/j.ajem.2016.04.050
FULL TEXT LINK
http://dx.doi.org/10.1016/j.ajem.2016.04.050
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 127
TITLE
Safe transport combined with prospective nursing intervention in
intra-hospital transport of emergency critically ill patients
AUTHOR NAMES
Jiang X.-X.
Wang J.
Zhang W.
Wang X.-J.
Meng X.-H.
AUTHOR ADDRESSES
(Jiang X.-X.; Wang X.-J.) Department of Emergency, Liaocheng People’s
Hospital, Liaocheng, China.
(Wang J., wangjingwj1123@163.com; Meng X.-H.) Department of Neurology,
Liaocheng People’s Hospital, Liaocheng, China.
(Zhang W.) Department of Imaging, Liaocheng People’s Hospital, Liaocheng,
China.
CORRESPONDENCE ADDRESS
J. Wang, Department of Neurology, Liaocheng People’s Hospital, Huashan Road,
No. 45, Liaocheng, China. Email: wangjingwj1123@163.com
SOURCE
International Journal of Clinical and Experimental Medicine (2016) 9:7
(13166-13171). Date of Publication: 30 Jul 2016
ISSN
1940-5901 (electronic)
BOOK PUBLISHER
E-Century Publishing Corporation, 40 White Oaks Lane, Madison, United
States.
ABSTRACT
Objective: We aimed to investigate the application values of safe transport
combined with prospective nursing intervention in intra-hospital transport
(IHT) of emergency critically ill patients. Methods: A sum of 546 critically
ill patients receiving and curing in our hospital was randomly enrolled in
our study, and divided into convention group and intervention group
according to table of random number. Conventional nursing plan and safe
transport combined with prospective nursing intervention were applied for
comparing waiting time, transport time, nursing care, patient satisfaction,
and monitoring items after transport between two groups. Results: Waiting
time, transport time and accident rate in convention group were higher than
that in intervention group, while, nursing score and patient satisfaction
were found higher in intervention group. Higher scores were found in
comparison of vital signs, stable condition after transport, nursing score,
and management of respiratory tract and digestive tract in intervention
group compared with those in convention group. Higher probabilities of
unexpected events were observed in convention group comparing with
intervention group. Besides, lower degree of satisfaction of receiving
department, successful rescue and degree of satisfaction of patients were
observed in convention group comparing with intervention group. Conclusion:
Our study found that safe transport combined with prospective nursing
intervention in intra-hospital transport of emergency critically ill
patients presented very good application values in ensuring patients’
safety, reasonable arrangement of rescue time, avoiding unnecessary waste of
time, improving patients’ satisfaction and ensuring the efficiency of the
emergency treatment of patients.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
emergency treatment
nursing care
nursing intervention
EMTREE MEDICAL INDEX TERMS
accident
controlled study
digestive system
human
major clinical study
monitoring
patient satisfaction
probability
respiratory system
safety
vital sign
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160581389
PUI
L611502201
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 128
TITLE
Transition From Hospital to Home in Preterm Infants and Their Families
AUTHOR NAMES
Boykova M.
AUTHOR ADDRESSES
(Boykova M.) The Council of International Neonatal Nurses (COINN), Yardley,
Pennsylvania
SOURCE
The Journal of perinatal & neonatal nursing (2016) 30:3 (270-272). Date of
Publication: 1 Jul 2016
ISSN
1550-5073 (electronic)
ABSTRACT
When the day of discharge from a neonatal intensive care unit (NICU) comes
for the parents of newborn infants, they are filled with long-awaited joy
and happiness. They go home feeling as parents, away from scheduled routines
of the hospital, monitor alarms, clinical rounds, numerous tests, and so on.
What do we know about what happens after these little patients and their
families leave the NICU? What happens from the point of leaving the hospital
until when things get settled and life becomes perceived as normal? This
article presents a short summary of research conducted with the vulnerable
population of high-risk and preterm infants and their families
postdischarge. Available evidence suggests that transition to home after
hospital discharge, a phenomenon that many families experience, is
challenging and requires attention from clinicians and researchers if we are
to provide effective, efficient, and high-quality care.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
infant care
organization and management
parent
patient transport
standards
EMTREE MEDICAL INDEX TERMS
education
female
hospital discharge
human
male
needs assessment
neonatal intensive care unit
newborn
prematurity
procedures
psychology
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
27465464 (http://www.ncbi.nlm.nih.gov/pubmed/27465464)
PUI
L617394702
DOI
10.1097/JPN.0000000000000198
FULL TEXT LINK
http://dx.doi.org/10.1097/JPN.0000000000000198
COPYRIGHT
Copyright 2017 Medline is the source for the citation and abstract of this
record.
RECORD 129
TITLE
Inter-hospital and intra-hospital patient transfer: Recent concepts
AUTHOR NAMES
Kulshrestha A.
Singh J.
AUTHOR ADDRESSES
(Kulshrestha A., kulshi_20@rediffmail.com) Department of Anaesthesia and
Intensive Care, Vardan Multispecialty Hospital, Garhi Sikrod, NH-58, Meerut
Road, Ghaziabad, India.
(Singh J.) Department of Anaesthesia and Intensive Care, Government Medical
College and Hospital, Chandigarh, India.
CORRESPONDENCE ADDRESS
A. Kulshrestha, Villa No. 83, Villa Anandam, NH-58, Meerut Road, Ghaziabad,
India. Email: kulshi_20@rediffmail.com
SOURCE
Indian Journal of Anaesthesia (2016) 60:7 (451-457). Date of Publication: 1
Jul 2016
ISSN
0019-5049
BOOK PUBLISHER
Indian Society of Anaesthetists, Flat No 12/1A K Point, 68-BAPC Roy Road,
Kolkata, India.
ABSTRACT
The intra- and inter-hospital patient transfer is an important aspect of
patient care which is often undertaken to improve upon the existing
management of the patient. It may involve transfer of patient within the
same facility for any diagnostic procedure or transfer to another facility
with more advanced care. The main aim in all such transfers is maintaining
the continuity of medical care. As the transfer of sick patient may induce
various physiological alterations which may adversely affect the prognosis
of the patient, it should be initiated systematically and according to the
evidence-based guidelines. The key elements of safe transfer involve
decision to transfer and communication, pre-transfer stabilisation and
preparation, choosing the appropriate mode of transfer, i.e., land transport
or air transport, personnel accompanying the patient, equipment and
monitoring required during the transfer, and finally, the documentation and
handover of the patient at the receiving facility. These key elements should
be followed in each transfer to prevent any adverse events which may
severely affect the patient prognosis. The existing international guidelines
are evidence based from various professional bodies in developed countries.
However, in developing countries like India, with limited infrastructure,
these guidelines can be modified accordingly. The most important aspect is
implementation of these guidelines in Indian scenario with periodical
quality assessments to improve the standard of care.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
consensus development
doctor patient relation
patient transport
EMTREE MEDICAL INDEX TERMS
developed country
developing country
diagnosis
documentation
health care quality
human
human experiment
India
monitoring
patient care
prevention
prognosis
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160518624
PUI
L611204602
DOI
10.4103/0019-5049.186012
FULL TEXT LINK
http://dx.doi.org/10.4103/0019-5049.186012
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 130
TITLE
Cord Wraps Facilitate Patient Transfer
AUTHOR NAMES
Lambert D.H.
AUTHOR ADDRESSES
(Lambert D.H.) Department of Anesthesiology, Boston University School of
Medicine, Boston, United States.
CORRESPONDENCE ADDRESS
D.H. Lambert, Department of Anesthesiology, Boston University School of
Medicine, Boston, United States.
SOURCE
Anesthesia and Analgesia (2016) 123:1 (257). Date of Publication: 1 Jul 2016
ISSN
1526-7598 (electronic)
0003-2999
BOOK PUBLISHER
Lippincott Williams and Wilkins, kathiest.clai@apta.org
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cord wrap
devices
patient transport
EMTREE MEDICAL INDEX TERMS
human
infection control
intensive care unit
letter
priority journal
EMBASE CLASSIFICATIONS
Biophysics, Bioengineering and Medical Instrumentation (27)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20160471142
MEDLINE PMID
27314701 (http://www.ncbi.nlm.nih.gov/pubmed/27314701)
PUI
L610934592
DOI
10.1213/ANE.0000000000001376
FULL TEXT LINK
http://dx.doi.org/10.1213/ANE.0000000000001376
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 131
TITLE
Intra-hospital transfer: Human error and safety concerns with improper
setting up of a cylinder-based oxygen delivery system
AUTHOR NAMES
Deepak D.
Kavitha J.
Kiran S.
Vidhu B.
AUTHOR ADDRESSES
(Deepak D., deepakdwivedi739@gmail.com; Kavitha J.; Kiran S.; Vidhu B.)
Department of Anaesthesia and Critical Care, Institute of Naval Medicine,
INHS ASVINI, Colaba, Mumbai, India.
CORRESPONDENCE ADDRESS
D. Deepak, Department of Anaesthesia and Critical Care, Institute of Naval
Medicine, INHS ASVINI, Colaba, Mumbai, India. Email:
deepakdwivedi739@gmail.com
SOURCE
Indian Journal of Anaesthesia (2016) 60:7 (519-520). Date of Publication: 1
Jul 2016
ISSN
0019-5049
BOOK PUBLISHER
Indian Society of Anaesthetists, Flat No 12/1A K Point, 68-BAPC Roy Road,
Kolkata, India.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cylinder based oxygen delivery system
hospital management
intra hospital transfer
oxygen delivery device
EMTREE MEDICAL INDEX TERMS
barotrauma
device failure
human
letter
risk factor
thoracotomy
volutrauma
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Biophysics, Bioengineering and Medical Instrumentation (27)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20160518638
PUI
L611204886
DOI
10.4103/0019-5049.186015
FULL TEXT LINK
http://dx.doi.org/10.4103/0019-5049.186015
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 132
TITLE
Suspected large vessel occlusion: Should emergency medical services
transport to the nearest primary stroke center or bypass to a comprehensive
stroke center with endovascular capabilities?
AUTHOR NAMES
Southerland A.M.
Johnston K.C.
Molina C.A.
Selim M.H.
Kamal N.
Goyal M.
AUTHOR ADDRESSES
(Southerland A.M.; Johnston K.C., kj4v@virginia.edu) Departments of
Neurology, University of Virginia Health System, PO Box 800394,
Charlottesville, United States.
(Southerland A.M.; Johnston K.C., kj4v@virginia.edu) Departments of Public
Health Sciences, University of Virginia Health System, Charlottesville,
United States.
(Molina C.A.) Department of Neurology, Hospital Vall d'Hebron-Barcelona,
Barcelona, Spain.
(Selim M.H.) Department of Neurology, Beth Israel Deaconess Medical Center,
Boston, United States.
(Kamal N.; Goyal M., mgoyal@ucalgary.ca) Departments of Clinical
Neurosciences, University of Calgary, Foothills Medical Centre, Seaman
Family MR Research Center, 1403 29th St NW, Calgary, Canada.
(Goyal M., mgoyal@ucalgary.ca) Departments of Radiology, University of
Calgary, Foothills Medical Centre, Calgary, Canada.
CORRESPONDENCE ADDRESS
M. Goyal, Departments of Clinical Neurosciences, University of Calgary,
Foothills Medical Centre, Seaman Family MR Research Center, 1403 29th St NW,
Calgary, Canada. Email: mgoyal@ucalgary.ca
SOURCE
Stroke (2016) 47:7 (1965-1967). Date of Publication: 1 Jul 2016
ISSN
1524-4628 (electronic)
0039-2499
BOOK PUBLISHER
Lippincott Williams and Wilkins, kathiest.clai@apta.org
EMTREE DRUG INDEX TERMS
tissue plasminogen activator (intravenous drug administration)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cerebrovascular accident
comprehensive stroke center
emergency health service
endovascular surgery
health center
primary stroke center
EMTREE MEDICAL INDEX TERMS
article
brain ischemia
computer assisted tomography
health care quality
human
National Institutes of Health Stroke Scale
neuroimaging
outcome assessment
patient selection
practice guideline
priority journal
randomized controlled trial (topic)
stroke patient
stroke unit
telemedicine
thrombectomy
workflow
CAS REGISTRY NUMBERS
tissue plasminogen activator (105913-11-9)
EMBASE CLASSIFICATIONS
Radiology (14)
Public Health, Social Medicine and Epidemiology (17)
Drug Literature Index (37)
Internal Medicine (6)
Neurology and Neurosurgery (8)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20160165606
PUI
L608644781
DOI
10.1161/STROKEAHA.115.011149
FULL TEXT LINK
http://dx.doi.org/10.1161/STROKEAHA.115.011149
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 133
TITLE
Challenges and Resources for New Critical Care Transport Crewmembers: A
Descriptive Exploratory Study
AUTHOR NAMES
Alfes C.M.
Steiner S.
Rutherford-Hemming T.
AUTHOR ADDRESSES
(Alfes C.M., cms11@case.edu) Learning Resource Skills and Simulation Center,
Frances Payne Bolton School of Nursing, Case Western Reserve University,
Cleveland, United States.
(Steiner S.) Dorothy Ebersbach Academic Center for Flight Nursing, Frances
Payne Bolton School of Nursing, Case Western Reserve University, Cleveland,
United States.
(Rutherford-Hemming T.) Ursuline College and Case Western Reserve University
Schools of Nursing, Cleveland, United States.
CORRESPONDENCE ADDRESS
C.M. Alfes, Learning Resource Skills and Simulation Center, Frances Payne
Bolton School of Nursing, Case Western Reserve University, Cleveland, United
States. Email: cms11@case.edu
SOURCE
Air Medical Journal (2016) 35:4 (212-215). Date of Publication: 1 Jul 2016
ISSN
1532-6497 (electronic)
1067-991X
BOOK PUBLISHER
Mosby Inc., customerservice@mosby.com
ABSTRACT
Objective The purpose of this study was to identify the challenges new
crewmembers experience in the critical care transport (CCT) environment and
to determine the most valuable resources when acclimating to the transport
environment. To date, no study has focused on the unique challenges nor the
resources most effective in CCT training. Methods This descriptive
exploratory study was conducted with a convenience survey sent to the 3
largest professional CCT organizations: the Association of Air Medical
Services, the Air and Surface Transport Nurses Association, and the
Association of Critical Care Transport. Results The study survey responses
revealed that more education and training are needed. Novice crewmembers
identified areas in safety, communication, environment, and crew resource
management as particularly challenging. Responses also validate the need for
more simulation training, especially for CCT of low-volume/high-risk patient
populations. Conclusion Results of this survey provide valuable insight for
improving training effectiveness of health care professionals transitioning
to the CCT environment. More information regarding best practice on the
frequency and timing of CCT simulation training should be collected,
particularly for simulations completed in the transport environment.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
crew member
critical care transport
intensive care
resource management
EMTREE MEDICAL INDEX TERMS
article
exploratory research
health care personnel
high risk patient
human
medical society
nurse
nurse practitioner
physician
priority journal
respiratory therapist
simulation training
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160406112
MEDLINE PMID
27393756 (http://www.ncbi.nlm.nih.gov/pubmed/27393756)
PUI
L610567524
DOI
10.1016/j.amj.2016.04.006
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2016.04.006
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 134
TITLE
Impact of intrahospital transport (known as « Tertiaries ») performed by
Angers’s Smur on the SAMU’s activity
ORIGINAL (NON-ENGLISH) TITLE
Impact sur l’activité du SAMU 49 des transports médicalisés internes (dits «
tertiaires ») réalisés au CHU par le Smur d’Angers
AUTHOR NAMES
Hamdan D.
Schotté T.
Roy P.M.
Soulié C.
Courjault Y.
Carneiro B.
Templier F.
AUTHOR ADDRESSES
(Hamdan D., hamdandavid@yahoo.fr; Courjault Y.; Templier F.) département de
médecine d’urgence, CHU Angers, Samu 49, 4 rue Larrey, Angers cedex 9,
France.
(Schotté T.; Soulié C.; Carneiro B.) département de médecine d’urgence, CHU
Angers, 4 rue Larrey, Angers cedex 9, France.
(Roy P.M.) département de médecine d’urgence, CHU Angers, université
d’Angers, 4 rue Larrey, Angers cedex 9, France.
CORRESPONDENCE ADDRESS
D. Hamdan, département de médecine d’urgence, CHU Angers, Samu 49, 4 rue
Larrey, Angers cedex 9, France. Email: hamdandavid@yahoo.fr
SOURCE
Annales Francaises de Medecine d'Urgence (2016) 6:4 (258-262). Date of
Publication: 1 Jul 2016
ISSN
2108-6591 (electronic)
2108-6524
BOOK PUBLISHER
Springer-Verlag France, 22, Rue de Palestro, Paris, France.
york@springer-paris.fr
ABSTRACT
Aims: At Angers, ward hospital, the organization of an ambulance ride
complicates the intra-hospital transport. If this transport has to be
medicalised it is called “tertiary transport”, and has to be performed by a
Smur team of SAMU 49. This causes adverse organizational events (AOE) and a
diminution of regulation’s reinforcement at the 15 Center. The aim was to
study the consequences of this organization on the frequency of AOE and the
frequency of periods with no regulation’s reinforcement available.
Procedure: A prospective observational study has been conducted during 120
days in which we identified the AOE and the period of time with no
regulation’s reinforcement available. The AOE were: the deficiencies, the
delays and the disengagements of a Smur team. We first compared the
frequency of AOE between periods with and without tertiary transport. We
then compared the frequency of periods with no regulation’s reinforcement
available between periods with and without tertiary transport. Results: We
identified 156 AOE. The difference of AOE’s frequencies were significative
between periods with and without tertiary transport (p<0,05). The difference
of frequencies of periods with no regulation’s reinforcement available were
significative between periods with and without tertiary transport (p<0,05).
Conclusion: The actual planning of tertiary transports by a Smur team has a
negative impact on SAMU 49’s organization. Corrective measures have been
implemented in October 2014 and a new evaluation is essential.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency care
EMTREE MEDICAL INDEX TERMS
human
observational study
reinforcement
LANGUAGE OF ARTICLE
French
LANGUAGE OF SUMMARY
English, French
EMBASE ACCESSION NUMBER
20160626500
PUI
L611827059
DOI
10.1007/s13341-016-0663-7
FULL TEXT LINK
http://dx.doi.org/10.1007/s13341-016-0663-7
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 135
TITLE
Work conditions, mental workload and patient care quality: A multisource
study in the emergency department
AUTHOR NAMES
Weigl M.
Müller A.
Holland S.
Wedel S.
Woloshynowych M.
AUTHOR ADDRESSES
(Weigl M., matthias.weigl@med.lmu.de; Holland S.) Institute and Outpatient
Clinic for Occupational, Social, and Environmental Medicine, Munich
University, Ziemssenstr. 1, Munich, Germany.
(Müller A.) Institute for Occupational and Social Medicine, University of
Düsseldorf, Düsseldorf, Germany.
(Wedel S.) Fürstenfeldbruck Hospital, Fürstenfeldbruck, Germany.
(Woloshynowych M.) Centre for Patient Safety and Service Quality, Department
of Surgery and Cancer, Imperial College London, London, United Kingdom.
CORRESPONDENCE ADDRESS
M. Weigl, Institute and Outpatient Clinic for Occupational, Social, and
Environmental Medicine, Munich University, Ziemssenstr. 1, Munich, Germany.
Email: matthias.weigl@med.lmu.de
SOURCE
BMJ Quality and Safety (2016) 25:7 (499-508). Date of Publication: 1 Jul
2016
ISSN
2044-5415
BOOK PUBLISHER
BMJ Publishing Group, subscriptions@bmjgroup.com
ABSTRACT
Background Workflow interruptions, multitasking and workload demands are
inherent to emergency departments (ED) work systems. Potential effects of ED
providers' work on care quality and patient safety have, however, been
rarely addressed. We aimed to investigate the prevalence and associations of
ED staff's workflow interruptions, multitasking and workload with patient
care quality outcomes. Methods We applied a mixed-methods design in a
two-step procedure. First, we conducted a time-motion study to observe the
rate of interruptions and multitasking activities. Second, during 20-day
shifts we assessed ED staff's reports on workflow interruptions,
multitasking activities and mental workload. Additionally, we assessed two
care quality indicators with standardised questionnaires: first, ED
patients' evaluations of perceived care quality; second, patient
intrahospital transfers evaluated by ward staff. The study was conducted in
a medium-sized community ED (16 600 annual visits). Results ED personnel's
workflow was disrupted on average 5.63 times per hour. 30% of time was spent
on multitasking activities. During 20 observations days, data were gathered
from 76 ED professionals, 239 patients and 205 patient transfers. After
aggregating daywise data and controlling for staffing levels, prospective
associations revealed significant negative associations between ED
personnel's mental workload and patients' perceived quality of care.
Conversely, workflow interruptions were positively associated with
patient-related information on discharge and overall quality of transfer.
Conclusions Our investigation indicated that ED staff's capability to cope
with demanding work conditions was associated with patient care quality. Our
findings contribute to an improved understanding of the complex effects of
interruptions and multitasking in the ED environment for creating safe and
efficient ED work and care systems.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency ward
patient care
workload
EMTREE MEDICAL INDEX TERMS
doctor patient relation
human
major clinical study
motion
patient transport
prevalence
questionnaire
workflow
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160554441
MEDLINE PMID
26350066 (http://www.ncbi.nlm.nih.gov/pubmed/26350066)
PUI
L611385243
DOI
10.1136/bmjqs-2014-003744
FULL TEXT LINK
http://dx.doi.org/10.1136/bmjqs-2014-003744
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 136
TITLE
An evaluation of intra-hospital transport outcomes from tertiary neonatal
intensive care unit
AUTHOR NAMES
Bastug O.
Gunes T.
Korkmaz L.
Elmali F.
Kucuk F.
Ozturk M.A.
Kurtoglu S.
AUTHOR ADDRESSES
(Bastug O., drosman76@hotmail.com; Gunes T.; Korkmaz L.; Ozturk M.A.;
Kurtoglu S.) Department of Pediatrics, Division of Neonatology, Kayseri,
Turkey.
(Elmali F.) Department of Biostatistics and Medical Bioinformatics, Kayseri,
Turkey.
(Kucuk F.) Department of Nursing, Erciyes University Medical Faculty,
Kayseri, Turkey.
CORRESPONDENCE ADDRESS
O. Bastug, Department of Neonatology, Erciyes University, School of
Medicine, Talas C Kayseri, Turkey. Email: drosman76@hotmail.com
SOURCE
Journal of Maternal-Fetal and Neonatal Medicine (2016) 29:12 (1993-1998).
Date of Publication: 17 Jun 2016
ISSN
1476-4954 (electronic)
1476-7058
BOOK PUBLISHER
Taylor and Francis Ltd, healthcare.enquiries@informa.com
ABSTRACT
Introduction: Patient transport has more important side effects in patients
in the newborn age group than in other age groups. This study was performed
to evaluate the intra-hospital transport of infants in the neonatal
intensive care unit(NICU). Methods: A total of 284 babies hospitalized in
the neonatal unit and transported inside the hospital were divided into
three groups based on their weights at the time of transport. Their places
of transport and important changes in the vital functions of the newborn
that might have been caused by transport were recorded with a view to
understand the vital effects of intra-hospital transport on the newborn.
Results: In our unit, the primary reasons for transport were determined to
be echocardiography and radiology (26.4% and 25.7%, respectively). In our
study, hyperglycemia and hypothermia were among the statistically most
significant side effects associated with transport (p < 0.05). It was found
that 19% and 27% of the patients had hyperglycemia and hypothermia,
respectively. There was a significant difference in the blood sugar levels
and the body temperature between pre- and post-transport (p < 0.05). There
were no significant differences in the pH, blood gas CO(2), heart rate and
breath rate values between pre- and post-transport (p > 0.05). As expected,
the complication rate was higher in babies with low weight. Conclusions:
Current weight is useful for assessing the risks of untoward outcomes
associated with intra-hospital transport. Protecting patients from
hypothermia during the time spent outside of the NICU would reduce the risk
of complications.
EMTREE DRUG INDEX TERMS
glucose (endogenous compound)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
intrahospital transport
patient transport
tertiary neonatal intensive care unit
EMTREE MEDICAL INDEX TERMS
article
birth weight
blood carbon dioxide tension
body temperature
breath rate
clinical evaluation
controlled study
disease predisposition
echocardiography
female
glucose blood level
heart rate
human
hyperglycemia (complication)
hypothermia (complication)
male
newborn
pH
priority journal
radiology
respiratory tract parameters
risk assessment
risk reduction
CAS REGISTRY NUMBERS
glucose (50-99-7, 84778-64-3)
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2015348448
MEDLINE PMID
26335382 (http://www.ncbi.nlm.nih.gov/pubmed/26335382)
PUI
L605878296
DOI
10.3109/14767058.2015.1072158
FULL TEXT LINK
http://dx.doi.org/10.3109/14767058.2015.1072158
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 137
TITLE
Universal surveillance versus targeted surveillance in reduction of HA-MRSA
in endemic setting
AUTHOR NAMES
Yuen T.K.
Gillian L.L.X.
Ming T.Y.
Hua S.J.
Amin I.M.
Lin L.M.
AUTHOR ADDRESSES
(Yuen T.K.; Gillian L.L.X.; Ming T.Y.; Hua S.J.; Amin I.M.) Singapore
General Hospital, Singapore.
(Lin L.M.) Department of Infection Control, Singapore General Hospital,
Singapore.
CORRESPONDENCE ADDRESS
T.K. Yuen, Singapore General Hospital, Singapore.
SOURCE
American Journal of Infection Control (2016) 44:6 (S100). Date of
Publication: 2 Jun 2016
CONFERENCE NAME
43rd Annual Conference of the Association for Professionals in Infection
Control and Epidemiology, APIC 2016
CONFERENCE LOCATION
Charlotte, NC, United States
CONFERENCE DATE
2016-06-11 to 2016-06-13
ISSN
1527-3296
BOOK PUBLISHER
Mosby Inc.
ABSTRACT
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is endemic in
Singapore with about 50% of all Staphyloccus aureus isolates reported as
MRSA. This study aims to determine the impact of universal MRSA screening in
reducing healthcare-associated MRSA (HA-MRSA) in an acute tertiary care
hospital. METHODS: From 2007, high risk patient groups were screened for
MRSA on admission (previous history of MRSA, history of hospitalization
(local or overseas) in past 6 months, inter-hospital or intra-hospital
transfers, history of stay at long-term care facilities in past 6 months,
end stage renal failure patient requiring dialysis and length of stay more
than 7 days as an inpatient). This was changed to universal MRSA screening
for all admissions from May 2014. Screening swabs taken from nasal, axillae
and groins were put in enrichment broth before plating onto chromogenic agar
at the Microbiology Laboratory. Nurse-led ordering system was also
implemented to facilitate good compliance to screening. MRSA patients are
identified on clinical management system and an orange sticker is placed at
all documents and bedside to alert all staffs to practise Contact
Precautions as well as cleaning of environment with sodium hypochlorite 1000
ppm. MRSA rates are displayed monthly on the Infection Control dashboard for
all stakeholders to review. RESULTS: HA-MRSA rate is reduced from0.82 per
1000 patient days (June 13-April 14) to 0.68 per 1000 patient days following
universal screening (May 14-August 15) [p: 0.015, paired t-test]. There was
no significant reduction in HA-MRSA bacteraemia following universal
screening [0.99 per 10,000 patient days (June 13-April 14) and 1.05 per
10,000 patient days (May 14 to August 15); p: 0.823, paired t-test].
CONCLUSIONS: Universal screening with combination of infection control
practices significantly reduced HA-MRSA in the endemic setting. Reduction of
HA-MRSA bacteremia may need decolonization measures to be included in the
program.
EMTREE DRUG INDEX TERMS
agar
hypochlorite sodium
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
epidemiology
infection control
methicillin resistant Staphylococcus aureus
EMTREE MEDICAL INDEX TERMS
axilla
dialysis
end stage renal disease
environment
health care
high risk patient
hospital
hospital patient
hospitalization
human
inguinal region
laboratory
length of stay
long term care
methicillin resistant Staphylococcus aureus infection
microbiology
nurse
patient
screening
Singapore
Student t test
tertiary care center
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72334455
DOI
10.1016/j.ajic.2016.04.134
FULL TEXT LINK
http://dx.doi.org/10.1016/j.ajic.2016.04.134
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 138
TITLE
Mass gatherings: Experience and difficulties in elaborating an ebola virus
disease outbreak response plan in a private hospital in Brazil
AUTHOR NAMES
De Miranda B.G.
Cais D.
Nunes J.
Duarte L.
Moura M.L.
Costa A.
AUTHOR ADDRESSES
(De Miranda B.G.) Hospital Samaritano De São Paulo, Brazil.
(Cais D.) Infection Control Team Leader, Hospital Samaritano, Brazil.
(Nunes J.; Duarte L.; Moura M.L.; Costa A.) Infection Control Team, Hospital
Samaritano, Brazil.
CORRESPONDENCE ADDRESS
B.G. De Miranda, Hospital Samaritano De São Paulo, Brazil.
SOURCE
American Journal of Infection Control (2016) 44:6 (S123-S124). Date of
Publication: 2 Jun 2016
CONFERENCE NAME
43rd Annual Conference of the Association for Professionals in Infection
Control and Epidemiology, APIC 2016
CONFERENCE LOCATION
Charlotte, NC, United States
CONFERENCE DATE
2016-06-11 to 2016-06-13
ISSN
1527-3296
BOOK PUBLISHER
Mosby Inc.
ABSTRACT
BACKGROUND: The 2014 Ebola Virus Disease (EVD) outbreak in West Africa
raised high concern around the world due to its high lethality and
contagiousness. Even with low risk of epidemic striking in Brazil, it was
imperative to develop a response plan for management of suspected EVD cases,
intending to minimize the occupational risks. We aimed to describe the main
challenges on implementation of a response plan to EVD outbreak in a 300-bed
private hospital in Brazil. METHODS: In August 2014, Infection Control Team
(ICT) started internal discussions to implement a detailed plan for initial
management of suspect EVD cases, including its correct identification,
adequate use of personal protective equipment (PPE), intrahospital
transport, sanity authorities notification and transport to referring
hospital. Some adaptations from international guidelines recommendations to
Brazilian reality were necessary. RESULTS: The plan implementation faced
several difficulties: first, the guarantee of healthcare worker (HCW)
security during the suspected case transport from reception area to the
designated room, which required a 170-feet displacement without traffic on
that route; second, the divergences between national and international
recommendations about the sequence of putting in and taking off the PPE and
its several steps required the presence of an ICT nurse besides the HCW
during this process; third, training professionals in four shifts required
six days of almost exclusive dedication by the ICT; fourth, there was a
delay on acquisition of adequate PPE due to its high cost and low
availability. CONCLUSIONS: Although there was no suspect EVD case in the
institution, the elaboration of a response plan to the EVD outbreak resulted
in a good experience for the service regarding the preparation for future
mass gatherings. The involvement of the ICT as a supportive area was
essential to improve the confidence of multi professional team on the first
care of emergency epidemiologic situations.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Brazil
Ebolavirus
epidemic
epidemiology
infection control
private hospital
virus infection
EMTREE MEDICAL INDEX TERMS
adaptation
Africa
Brazilian
emergency
health care personnel
hospital
human
lethality
nurse
occupational hazard
protective equipment
receptive field
risk
traffic
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72334472
DOI
10.1016/j.ajic.2016.04.148
FULL TEXT LINK
http://dx.doi.org/10.1016/j.ajic.2016.04.148
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 139
TITLE
The prognostic significance of the birmingham vasculitis activity score
(BVAS) in patients with systemic vasculitis transferred to the intensive
care unit (ICU)
AUTHOR NAMES
Biscetti F.
Carbonella A.
Parisi F.
Cianci F.
Bosello S.L.
Tolusso B.
Gremese E.
Ferraccioli G.
AUTHOR ADDRESSES
(Biscetti F.; Carbonella A.; Parisi F.; Cianci F.; Bosello S.L.; Tolusso B.;
Gremese E.; Ferraccioli G.) Rheumatology, Catholic University, School of
Medicine, Rome, Italy.
CORRESPONDENCE ADDRESS
F. Biscetti, Rheumatology, Catholic University, School of Medicine, Rome,
Italy.
SOURCE
Annals of the Rheumatic Diseases (2016) 75 Supplement 2 (1090). Date of
Publication: 1 Jun 2016
CONFERENCE NAME
Annual European Congress of Rheumatology of the European League Against
Rheumatism, EULAR 2016
CONFERENCE LOCATION
London, United Kingdom
CONFERENCE DATE
2016-06-08 to 2016-06-11
ISSN
1468-2060
BOOK PUBLISHER
BMJ Publishing Group
ABSTRACT
Background: Systemic vasculitides represent a heterogeneous group of
diseases that share clinical features including respiratory distress, renal
dysfunction, and neurologic disorders. These diseases may often cause
life-threatening complications requiring admission to an intensive care unit
(ICU) [1]. Birmingham Vasculitis Activity Score (BVAS) is the most widely
used generic tool to quantify disease activity in systemic vasculitis. Acute
Physiology And Chronic Health Evaluation (APACHE II) is a simple and
accurate assessment scale of the severity of disease in critically ill
patients newly admitted to ICU. Objectives: The aim of this study was to
identify possible prognostic biomarkers for patients with vasculitis
admitted to ICU. Methods: A retrospective study was carried out from 2004 to
2014 in patients with systemic vasculitis admitted to the Rheumatology
division and transferred to ICU due to clinical worsening, with a length of
stay beyond 24 hours. An additional group of patients admitted to ICU, and
without history of systemic vasculitis, were used as a matched-control
group. A total of 25 patients were included in the analysis. Results: ICU
mortality was significantly associated with higher BVAS scores performed in
the ward (p<0.01) and at the admission in ICU (p=0.01), regardless of the
value of APACHE II scores (p=0.50). We used receiver-operator characteristic
(ROC) curve analysis to evaluate the possible cutoff value for the BVAS in
the ward and in ICU and we found that a BVAS >8 in the ward and that a BVAS
>10 in ICU were significantly related to the mortality in ICU (p<0.01).
Conclusions: BVAS appears to be an excellent tool for assessing ICU
mortality risk of patients with systemic vasculitides admitted to specialty
departments. Our experience has shown that performing the assessment at
admission to the ward is more important than determining the evaluation
before the clinical aggravation causing the transfer to ICU.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
systemic vasculitis
EMTREE MEDICAL INDEX TERMS
APACHE
clinical article
control group
controlled study
critically ill patient
human
length of stay
mortality risk
retrospective study
rheumatology
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L612779318
DOI
10.1136/annrheumdis-2016-eular.3502
FULL TEXT LINK
http://dx.doi.org/10.1136/annrheumdis-2016-eular.3502
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 140
TITLE
Presentation and Management of Venomous Snakebites: Should All Patients Be
Transferred to a Tertiary Referral Hospital?
AUTHOR NAMES
Irion V.H.
Barnes J.
Montgomery B.E.
Suva L.J.
Montgomery C.O.
AUTHOR ADDRESSES
(Irion V.H., virion919@yahoo.com) Department of Orthopaedic Surgery,
University of Arkansas for Medical Sciences, Little Rock, Arkansas
(Barnes J.; Montgomery B.E.; Suva L.J.; Montgomery C.O.)
SOURCE
Journal of surgical orthopaedic advances (2016) 25:2 (69-73). Date of
Publication: 1 Jun 2016
ISSN
1548-825X
ABSTRACT
Venomous snakebites may be difficult to manage because of the varied
clinical presentations that may lead to uncertainty regarding the most
appropriate medical and surgical management. Frequently, snakebite victims
are referred from smaller rural hospitals to larger tertiary centers
offering more specialized services and care. A retrospective chart review
was performed using medical records from both adult and pediatric hospitals
in a rural state over a 7-year period (January 2004 to January 2011) to
investigate the utility of intensive care and specialized medical services
offered at tertiary referral centers. The results demonstrated that
presentation of venomous snakebites is the same in adults and children as
well as the management. The results also demonstrated that the use of
supportive care and antivenin alone was successful in the management of the
vast majority of snakebites. Most snakebite victims recovered with
nonsurgical care; thus surgical intervention is rarely warranted. These
findings demonstrate that snakebite victims may not need referral to a
tertiary center, if the primary local hospital has supportive care capacity
and familiarity with antivenin usage.
EMTREE DRUG INDEX TERMS
venom antiserum (drug therapy)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Agkistrodon
patient transport
tertiary care center
EMTREE MEDICAL INDEX TERMS
adult
age distribution
animal
child
cohort analysis
female
hospital
human
intensive care unit
lower limb
male
patient referral
retrospective study
season
sex ratio
snakebite (epidemiology, therapy)
time to treatment
United States
upper limb
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
27518288 (http://www.ncbi.nlm.nih.gov/pubmed/27518288)
PUI
L616046666
COPYRIGHT
Copyright 2017 Medline is the source for the citation and abstract of this
record.
RECORD 141
TITLE
High-frequency percussive ventilation during neonatal transportation: A
pilot study
AUTHOR NAMES
Colomb B.
Kolev-Descamp K.
Marie Petion A.
Queudet L.
Savajols E.
Litzler-Renault S.
Semama D.
AUTHOR ADDRESSES
(Colomb B., benoit.colomb@chu-dijon.fr; Litzler-Renault S.) Réanimation
Pédiatrique Polyvalente, Chu Dijon, Dijon, France.
(Kolev-Descamp K.) Réanimation Pédiatrique, Hôpital Femme Mère Enfant, Bron,
France.
(Marie Petion A.; Queudet L.) Smur Pédiatrique, Chu Dijon, Dijon, France.
(Savajols E.; Semama D.) Pédiatrie 2, Chu Dijon, Dijon, France.
CORRESPONDENCE ADDRESS
B. Colomb, Réanimation Pédiatrique Polyvalente, Chu Dijon, Dijon, France.
Email: benoit.colomb@chu-dijon.fr
SOURCE
Annals of Intensive Care (2016) 6 SUPPL. 1. Date of Publication: June 2016
CONFERENCE NAME
French Intensive Care Society, International Congress - Reanimation 2016
CONFERENCE LOCATION
Paris, France
CONFERENCE DATE
2016-01-13 to 2016-01-15
ISSN
2110-5820
BOOK PUBLISHER
Springer Verlag
ABSTRACT
Introduction Neonatal respiratory distress syndrome (RDS) is a frequent
medical condition encountered in preterm neonates. Outborn neonates with RDS
may require mechanical ventilation (MV) and surfactant therapy before their
transportation to the tertiary neonatal intensive care unit (NICU).
High-frequency percussive ventilation (HFPV) has previously been used for
management of RDS in neonates hospitalized in NICU. The aim of the present
study was to assess the feasibility and safety of HFPV for the management of
neonatal RDS during transportation. Patients and methods We performed a
retrospective observational monocentric study from September 2008 to August
2011. All outborn neonates requiring invasive mechanical ventilation for RDS
before their transportation were included. Neonates with severe
malformations and those transported after 48 h of life were not included.
When required, HFPV was provided by the Sinusoidal Bronchotron™ device
(IMAPe®). For each infant, we recorded the mode of mechanical ventilation
(conventional vs. HFPV), the evolution of SpO(2)/FiO(2) ratio, and maternal
and neonatal characteristics. Our main outcome was SpO(2)/ FiO(2) ratio, 1 h
after initiation of either conventional mechanical ventilation or HFPV
(M60). The comparison was stratified by range of gestational age: <28,
28-31, 32-37, >37 weeks GA. In order to examine SpO(2)/FiO(2) ratio in
relation to mode of ventilation, we defined potential confounding variables:
baseline SpO(2)/FiO(2) ratio observed at the initiation of MV, obstetrical,
maternal and neonatal characteristics. Categorical variables were compared
using Chi square or Fisher's test as needed while continuous variables were
compared using Student's t test. For main outcome, a multivariate analysis
was performed using linear regression. p values <0.05 were considered
statistically significant. Results Out of the 169 neonates included in the
study, 57 received HFPV while 112 were placed on conventional mechanical
ventilation (CMV). Univariate analysis for obstetrical, demographic and
neonatal data showed no statistical difference between HFPV and CMV group
whatever the gestational age, except for Apgar score at 1' and 5' which was
significantly lower in the neonates aged 37 weeks or more and receiving
HFPV. In 28-31 and 32-37 weeks subgroups, baseline SpO(2)/FiO(2) ratio was
found significantly lower in infants receiving HFPV and this ratio remained
lower after 1 h of ventilation. In the more mature infants, HFPV was
associated with a higher increase in SpO(2)/FiO(2) ratio when compared to
CMV, but this difference failed to reach statistical significance. After
multivariate analysis, the main determinant for SpO(2)/FiO(2) ratio at M60
was the baseline value of this ratio. Noteworthy that complications usually
associated with mechanical ventilation were not reported in this study.
Discussion This observational study emphasizes the feasibility and safety of
HFPV in neonatal transportation. The use of both HFPV and CMV resulted in
favorable respiratory outcome. The significant initial lower values of
SpO(2)/FiO(2) ratio in neonates between 28 and 37 weeks requiring HFPV may
be explained by the retrospective design of the study. It is indeed
reasonable to suspect that the more severe forms of RDS were immediately
ventilated with HPFV. Conclusion To our knowledge, this is the first study
to assess the feasibility and safety of HFPV during neonatal transportation.
More studies are necessary to confirm these results and define the
indications for HFPV.
EMTREE DRUG INDEX TERMS
surfactant
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air conditioning
intensive care
pilot study
resuscitation
society
traffic and transport
EMTREE MEDICAL INDEX TERMS
Apgar score
artificial ventilation
confounding variable
congenital malformation
devices
Fisher exact test
gestational age
human
infant
intensive care unit
linear regression analysis
multivariate analysis
neonatal respiratory distress syndrome
newborn
newborn intensive care
observational study
patient
prematurity
respiratory distress syndrome
retrospective study
safety
statistical significance
Student t test
therapy
univariate analysis
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72342803
DOI
10.1186/s13613-016-0114-z
FULL TEXT LINK
http://dx.doi.org/10.1186/s13613-016-0114-z
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 142
TITLE
Transportation of children on extracorporeal membrane oxygenation: 1-year
experience of a tertiary referral center in the Paris region
AUTHOR NAMES
Rambaud J.
Leger P.-L.
Larroquet M.
Amblard A.
Lode N.
Guilbert J.
Jean S.
Guellec I.
Casadevall I.
Kessous K.
Walti H.
Carbajal R.
AUTHOR ADDRESSES
(Rambaud J., jerome.rambaud@aphp.fr; Leger P.-L.; Amblard A.; Guilbert J.;
Jean S.; Guellec I.; Walti H.; Carbajal R.) Réanimation Pédiatrique Et
Néonatale, Hopital Pour Enfants Trousseau, Paris, France.
(Larroquet M.) Chirugie Pédiatrique, Hopital Pour Enfants Trousseau, Paris,
France.
(Lode N.; Casadevall I.; Kessous K.) Smur Pédiatrique, Robert Debré, Paris,
France.
CORRESPONDENCE ADDRESS
J. Rambaud, Réanimation Pédiatrique Et Néonatale, Hopital Pour Enfants
Trousseau, Paris, France. Email: jerome.rambaud@aphp.fr
SOURCE
Annals of Intensive Care (2016) 6 SUPPL. 1. Date of Publication: June 2016
CONFERENCE NAME
French Intensive Care Society, International Congress - Reanimation 2016
CONFERENCE LOCATION
Paris, France
CONFERENCE DATE
2016-01-13 to 2016-01-15
ISSN
2110-5820
BOOK PUBLISHER
Springer Verlag
ABSTRACT
Introduction Extracorporeal membrane oxygenation (ECMO) is used as a rescue
therapy in patients with severe and refractory respiratory and/or
hemodynamic failure. Ideally, neonates or children candidates for ECMO
support should be transferred to a referral ECMO center. However, sometimes
patients are too ill to be safely moved with conventional ventilator
support. In these situations, ECMO cannulation at the referring facility and
transfer by a transport ECMO team is a potentially lifesaving intervention.
With a 25-year experience on neonatal and pediatric ECMO, the pediatric
intensive care unit and the pediatric surgery unit of the Armand-Trousseau
Hospital in Paris developed in November 2014 a transport ECMO team. This
mobile team has been developed in collaboration with the Robert Debré
emergency transport unit and the Civil Security of Paris. We report the
first-year experience of this mobile team. Patients and methods We
retrospectively reviewed all neonatal and pediatric ECMO transports from
November 2014 through September 2015. Reviewed data included referring
facility, mode and duration of transport, type of ECMO, clinical severity
score (PaO(2)/FiO(2), inotrope score) and laboratory tests (lactate, pH)
before and after transport. Results Twenty-two requests for intervention of
the mobile team were received. In 8 cases, the team intervention was not
deemed necessary or exceeded status. In 14 cases, the mobile team travelled
to the referring center. In one case the child was transported on
conventional ventilation, and in 2 patients ECMO cannulation was not
possible because of vascular problems. Eleven patients, including 4 neonates
and 7 children, were transported on ECMO support. One patient was cannulated
in our PICU and then transported to a pulmonary transplantation center. The
median (range) run distance and round-trip duration were 117 km (4-392 km)
and 8 h (2-13 h), respectively. Nine (81 %) transports were on
venous-arterial ECMO and two (19 %) on venous-venous ECMO. Median (range)
pre-ECMO cannulation pH, lactate, PaO(2)/FiO(2) and inotrope score were,
respectively, 7.03 (6.67-7.27), 5.5 mmol/L (0.6-13.8 mmol/L), 36 (24-127)
and 568 (50-890). Corresponding post-ECMO cannulation values were 7.33
(7.17-7.43), 2.8 mmol/L (1-12.6 mmol/L) and 60 (0 à 310). No adverse events
during ECMO transport were noticed. Discussion This first-year experience
suggests that the development of the first neonatal and pediatric mobile
ECMO team in the north of France. This rapidly increased activity meets a
significant need for ECMO support in children too critically ill to be moved
on conventional therapy. The ECMO rapidly improved respiratory and
hemodynamic parameters allowing transportation in good conditions to our
ECMO center. It allows children hospitalized in non-ECMO centers to benefit
from this rescue treatment. It contributes to improve the access to the
continuity of health care in France. Conclusion Implantations and
transportations of children on ECMO supports can be proposed to children
with refractory respiratory or circulatory diseases and now accessible in a
large perimeter around Paris region.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child
extracorporeal oxygenation
France
human
intensive care
resuscitation
society
tertiary care center
traffic and transport
EMTREE MEDICAL INDEX TERMS
air conditioning
cannulation
critically ill patient
diseases
emergency
health care
hemodynamic parameters
hospital
implantation
intensive care unit
laboratory test
lung transplantation
newborn
patient
pediatric surgery
perimeter
pH
therapy
ventilator
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72342810
DOI
10.1186/s13613-016-0114-z
FULL TEXT LINK
http://dx.doi.org/10.1186/s13613-016-0114-z
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 143
TITLE
Impact of Telemedicine on Severity of Illness and Outcomes among Children
Transferred from Referring Emergency Departments to a Children's Hospital
PICU
AUTHOR NAMES
Dayal P.
Hojman N.M.
Kissee J.L.
Evans J.
Natale J.E.
Huang Y.
Litman R.L.
Nesbitt T.S.
Marcin J.P.
AUTHOR ADDRESSES
(Dayal P., pdayal@ucdavis.edu; Hojman N.M.; Kissee J.L.; Evans J.; Natale
J.E.; Huang Y.; Litman R.L.; Nesbitt T.S.; Marcin J.P.) Department of
Pediatrics, University of California, Davis Sacramento, United States.
CORRESPONDENCE ADDRESS
P. Dayal, Department of Pediatrics, University of California, Davis
Sacramento, United States. Email: pdayal@ucdavis.edu
SOURCE
Pediatric Critical Care Medicine (2016) 17:6 (516-521). Date of Publication:
1 Jun 2016
ISSN
1947-3893 (electronic)
1529-7535
BOOK PUBLISHER
Lippincott Williams and Wilkins, kathiest.clai@apta.org
ABSTRACT
Objectives: To compare the severity of illness and outcomes among children
admitted to a children's hospital PICU from referring emergency departments
with and without access to a pediatric critical care telemedicine program.
Design: Retrospective cohort study. Setting: Tertiary academic children's
hospital PICU. Patients: Pediatric patients admitted directly to the PICU
from referring emergency departments between 2010 and 2014. Interventions:
None. Measurements: Demographic factors, severity of illness, and clinical
outcomes among children receiving care in emergency departments with and
without access to pediatric telemedicine, as well as a subcohort of children
admitted from emergency departments before and after the implementation of
telemedicine. Main Results: Five hundred eighty-two patients from 15
emergency departments with telemedicine and 524 patients from 60 emergency
departments without telemedicine were transferred and admitted to the PICU.
Children admitted from emergency departments using telemedicine were younger
(5.6 vs 6.9 yr; p< 0.001) and less sick (Pediatric Risk of Mortality III
score, 3.2 vs 4.0; p < 0.05) at admission to the PICU compared with children
admitted from emergency departments without telemedicine. Among transfers
from emergency departments that established telemedicine programs during the
study period, children arrived significantly less sick (mean Pediatric Risk
of Mortality III scores, 1.2 units lower; p = 0.03) after the implementation
of telemedicine (n = 43) than before the implementation of telemedicine (n =
95). The observed-to-expected mortality ratios of posttelemedicine,
pretelemedicine, and no-telemedicine cohorts were 0.81 (95% CI, 0.53-1.09),
1.07 (95% CI, 0.53-1.60), and 1.02 (95% CI, 0.71-1.33), respectively.
Conclusions: The implementation of a telemedicine program designed to assist
in the care of seriously ill children receiving care in referring emergency
departments was associated with lower illness severity at admission to the
PICU. This study contributes to the body of evidence that pediatric critical
care telemedicine programs assist referring emergency departments in the
care of critically ill children and could result in improved clinical
outcomes.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
disease severity
intensive care unit
telemedicine
EMTREE MEDICAL INDEX TERMS
article
child
emergency ward
human
intensive care
length of stay
major clinical study
mortality
priority journal
retrospective study
EMBASE CLASSIFICATIONS
Health Policy, Economics and Management (36)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160322868
MEDLINE PMID
27099972 (http://www.ncbi.nlm.nih.gov/pubmed/27099972)
PUI
L610067642
DOI
10.1097/PCC.0000000000000761
FULL TEXT LINK
http://dx.doi.org/10.1097/PCC.0000000000000761
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 144
TITLE
BMR-06 - Investigations about 2 cases of oxa-23, per-7 Acinetobacter
baumannii outbreaks occurring in an intensive care unit before and after its
relocation
ORIGINAL (NON-ENGLISH) TITLE
BMR-06 - Investigations autour de 2 épidémies à Acinetobacter baumannii
oxa-23, per-7, survenues dans une unité de soins intensifs avant et après
son déménagement
AUTHOR NAMES
Kadi A.
Seytre D.
Potron A.
Saada N.
Billard-Pomares T.
Jacolot A.
Van Der Meersch G.
Picard B.
Carbonnelle E.
AUTHOR ADDRESSES
(Kadi A.; Seytre D.; Saada N.; Billard-Pomares T.; Jacolot A.; Van Der
Meersch G.; Picard B.; Carbonnelle E.) CHU Avicenne, Bobigny, France.
(Potron A.) CHRU, Besançon, France.
SOURCE
Medecine et Maladies Infectieuses (2016) 46:4 (26). Date of Publication: 1
Jun 2016
ISSN
1769-6690 (electronic)
0399-077X
BOOK PUBLISHER
Elsevier Masson SAS, 62 rue Camille Desmoulins, Issy les Moulineaux Cedex,
France.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Acinetobacter infection (epidemiology)
epidemic
intensive care unit
EMTREE MEDICAL INDEX TERMS
article
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
LANGUAGE OF ARTICLE
English, French
EMBASE ACCESSION NUMBER
20170046754
PUI
L614068924
DOI
10.1016/S0399-077X(16)30315-8
FULL TEXT LINK
http://dx.doi.org/10.1016/S0399-077X(16)30315-8
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 145
TITLE
The critical care air transport experience Topical Collection on Pulmonology
in Combat Medicine
AUTHOR NAMES
Crawley P.G.
AUTHOR ADDRESSES
(Crawley P.G., peter.crawley@us.af.mil) Pulmonary Department, Wilford Hall
Ambulatory Surgical Center, 2200 Bergquist Dr, San Antonio, United States.
CORRESPONDENCE ADDRESS
P.G. Crawley, Pulmonary Department, Wilford Hall Ambulatory Surgical Center,
2200 Bergquist Dr, San Antonio, United States. Email:
peter.crawley@us.af.mil
SOURCE
Current Pulmonology Reports (2016) 5:2 (77-85). Date of Publication: 1 Jun
2016
ISSN
2199-2428 (electronic)
BOOK PUBLISHER
Springer US
ABSTRACT
There have been over 8000 documented patients transported by US Air Force
critical care air transport teams (CCATT) since the beginning of US military
involvement in Iraq and Afghanistan (Ingalls et al. in JAMA 149:807-13,
2014). As part of the joint service, integrated and multi-tiered aeromedical
evacuation system (AES), critically ill or injured service members are
transported by CCATT on tactical (short range, within a theatre of
operations) and strategic (long range, between theatres of operation)
missions. Within the AE system, patients move through five echelons of care,
beginning with care at the point of injury and culminating at major military
medical centers in the United States. Patients with critical injuries
sustained during support of Operation Iraqi Freedom (OIF) or Operation
Enduring Freedom (OEF) are first transported to Landstuhl Regional Medical
Center (LRMC) in Germany where they are further stabilized for transport
back to US facilities. Flight times between evacuation hospitals within the
theatre of operations and LRMC can be as long as nine hours. During
transport, CCATT monitor patients and continue ongoing resuscitation and
treatment plans. Teams are equipped and prepared to intervene should
emergent care be required. Critical patients transported to LRMC will often
undergo further surgery and frequently require ICU level care with CCATT for
transport from LRMC back to the USA. During the peak of conflicts in Iraq
and Afghanistan, aeromedical evacuation of critical patients from the point
of injury back to the US typically took 2-4 days (Dorlac et al. in J Trauma
66:S164-71, 2009). The paradigm of transporting "stabilizing" patients, even
those with severe traumatic injuries over transcontinental distances and
often just hours after initial damage control surgery, is supported by a
0.02 % en route mortality rate and a 98 % survival rate among individuals
wounded in OIF/OEF that are transported back to LRMC (Ingalls et al. in JAMA
149:807-13, 2014). The long-range transport of critical patients in the
austere environment of a military aircraft creates unique challenges for the
transport team and is a vital part of the evolving globally mobile medical
support apparatus. This article describes both the role of Air Force CCATT
within the context of the integrated military AES and the CCATT mission
experience in the deployed environment. The role of specialized transport
teams and the expanding role of CCATT in a variety of noncombat operations
will also be discussed.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
experience
intensive care
EMTREE MEDICAL INDEX TERMS
Afghanistan
altitude
article
emergency health service
flight
human
injury
Iraq
medical education
military medicine
oxygen consumption
patient safety
priority journal
rescue personnel
survival rate
teamwork
United States
EMBASE CLASSIFICATIONS
Occupational Health and Industrial Medicine (35)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170767297
PUI
L619012459
DOI
10.1007/s13665-016-0148-6
FULL TEXT LINK
http://dx.doi.org/10.1007/s13665-016-0148-6
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 146
TITLE
Pediatric transport medicine and the dawn of the pediatric anesthesiology
and critical care medicine subspecialty: An interview with pioneer Dr. Alvin
Hackel
AUTHOR NAMES
Mai C.L.
Ahmed Z.
Maze A.
Noorulla F.
Yaster M.
AUTHOR ADDRESSES
(Mai C.L., cmai1@partners.org) Department of Anesthesia, Critical Care and
Pain Medicine, Massachusetts General Hospital, Harvard Medical School, 55
Fruit Street, Boston, United States.
(Mai C.L., cmai1@partners.org) Department of Anesthesia, Massachusetts Eye
and Ear Infirmary, Boston, United States.
(Ahmed Z.) Anesthesia Asociates of Ann Arbor, Wayne State University,
Detroit, United States.
(Maze A.) Valley Anesthesiology and Pain Consultants, Phoenix, United
States.
(Noorulla F.) Wayne State University School of Medicine, Detroit, United
States.
(Yaster M.) Departments of Anesthesiology, Critical Care Medicine and
Pediatrics, Johns Hopkins University, Baltimore, United States.
CORRESPONDENCE ADDRESS
C.L. Mai, Department of Anesthesia, Critical Care and Pain Medicine,
Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street,
Boston, United States. Email: cmai1@partners.org
SOURCE
Paediatric Anaesthesia (2016) 26:5 (475-480). Date of Publication: 1 May
2016
ISSN
1460-9592 (electronic)
1155-5645
BOOK PUBLISHER
Blackwell Publishing Ltd, customerservices@oxonblackwellpublishing.com
ABSTRACT
Dr. Alvin 'Al' Hackel (1932-) Professor Emeritus of Anesthesiology,
Perioperative and Pain Medicine, and Pediatrics at the Stanford University
School of Medicine, has been an influential pioneer in shaping the scope and
practice of pediatric anesthesia. His leadership helped to formally define
the subspecialty of pediatric anesthesiology ('who is a pediatric
anesthesiologist?') and the importance of specialization and regionalization
of expertise in both patient transport and perioperative care. His enduring
impact on pediatric anesthesia and critical care practice was recognized in
2006 by the American Academy of Pediatrics when it bestowed upon him the
profession's highest lifetime achievement award, the Robert M. Smith Award.
Of his many contributions, Dr. Hackel identifies his early involvement in
the development of pediatric transport medicine as well as the subspecialty
of pediatric anesthesiology as his defining contribution. Based on a series
of interviews held with Dr. Hackel between 2009 and 2014, this article
reviews the early development of transportation medicine and the remarkable
career of a pioneering pediatric anesthesiologist.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
anesthesiology
intensive care
patient transport
pediatric anesthesiology
pediatric transport medicine
pediatrics
EMTREE MEDICAL INDEX TERMS
accreditation
achievement
awards and prizes
history
human
leadership
medical practice
medical society
perioperative period
practice guideline
priority journal
review
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160237088
MEDLINE PMID
26992643 (http://www.ncbi.nlm.nih.gov/pubmed/26992643)
PUI
L609167184
DOI
10.1111/pan.12880
FULL TEXT LINK
http://dx.doi.org/10.1111/pan.12880
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 147
TITLE
The impact of transfer on pediatric trauma outcomes
AUTHOR NAMES
Locke T.
Rekman J.
Brennan M.
Nasr A.
AUTHOR ADDRESSES
(Locke T., tlock016@uottawa.ca; Nasr A., anasr@cheo.on.ca) University of
Ottawa Medical School, 451 Smyth Road, Ottawa, Canada.
(Locke T., tlock016@uottawa.ca; Brennan M.; Nasr A., anasr@cheo.on.ca)
Department of Pediatric Surgery, Children's Hospital of Eastern Ontario, 401
Smyth Road, Ottawa, Canada.
(Rekman J., janellerekman@gmail.com) University of Ottawa, Division of
General Surgery, Ottawa Hospital, General Campus, 501 Smyth Road, Ottawa,
Canada.
(Nasr A., anasr@cheo.on.ca) Division Pediatric General Surgery, Children's
Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Canada.
CORRESPONDENCE ADDRESS
A. Nasr, Division Pediatric General Surgery, Children's Hospital of Eastern
Ontario, 401 Smyth Road, Ottawa, Canada. Email: anasr@cheo.on.ca
SOURCE
Journal of Pediatric Surgery (2016) 51:5 (843-847). Date of Publication: 1
May 2016
ISSN
1531-5037 (electronic)
0022-3468
BOOK PUBLISHER
W.B. Saunders
ABSTRACT
Background Recently, concerns have been raised over delays that result from
transferring patients to designated trauma centers. This study aimed to
assess whether transfer status had an impact on pediatric trauma outcomes.
Methods Using a local 1996-2014 pediatric trauma database containing 1541
patients, the following outcomes were tested: death, major complication,
time to definitive treatment (TDT), hospital length of stay (LOS), and ICU
length of stay (ICU LOS). Logistic, generalized linear, and Poisson
regression models were used. Results Mortality and complication rates did
not differ significantly between direct (mortality = 52/1000, complications
= 54/1000) and transferred (mortality = 59/1000; complications = 67/1000)
patients (mortality aRR: 1.17, 95% CI: 0.76-1.80, p = 0.48; complication
aRR: 1.13, 95% CI: 0.75-1.70, p = 0.57). Transfer status was not a
significant predictor of ICU LOS (p = 0.72). Transfer status was a
significant predictor of time to definitive treatment (transfer x-= 17.4 h
vs. direct x-= 2.6 h, p = 0.0035) and of LOS for severely injured patients
(p = 0.005). The significant predictors of pediatric trauma mortality were:
ISS, transport mode, age, and TDT, and of major complication were ISS and
TDT. Conclusions Although transferred patients had longer time to
specialized care, there were no significant differences in the mortality or
complication rates between transferred and direct patients after adjusting
for injury severity.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
childhood injury
outcome assessment
patient transport
EMTREE MEDICAL INDEX TERMS
adolescent
child
conference paper
death
female
hospitalization
human
infant
intensive care unit
length of stay
male
mortality
predictor variable
preschool child
priority journal
school child
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Pediatrics and Pediatric Surgery (7)
Neurology and Neurosurgery (8)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160169897
MEDLINE PMID
26932250 (http://www.ncbi.nlm.nih.gov/pubmed/26932250)
PUI
L608674272
DOI
10.1016/j.jpedsurg.2016.02.035
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jpedsurg.2016.02.035
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 148
TITLE
Factors associated with early death in burn transfer patients
AUTHOR NAMES
Savetamal A.
Rotta S.A.
AUTHOR ADDRESSES
(Savetamal A.; Rotta S.A.) Bridgeport Hospital, Bridgeport, CT; Bridgeport
Hospital, West Haven, CT
CORRESPONDENCE ADDRESS
A. Savetamal,
SOURCE
Journal of Burn Care and Research (2016) 37 SUPPL. 1 (S177). Date of
Publication: May-June 2016
CONFERENCE NAME
48th Annual Meeting of the American Burn Association
CONFERENCE LOCATION
Las Vegas, NV, United States
CONFERENCE DATE
2016-05-03 to 2016-05-06
ISSN
1559-0488
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: The creation of regional burn centers has streamlined patient
care and dramatically improved morbidity and mortality after burn injury.
However, there are some patients with such devastating injuries that death
occurs within the first 48 hours of transfer. For these patients and their
families, urgent transfer can intensify stress, create prognostic confusion,
and increase the expense of an already unimaginable situation. After
discussion with some of our referring hospitals, we sought to investigate
which, if any, pre-hospital factors were associated with early death after
transfer to our burn unit. Methods: A retrospective analysis of deaths in
burn patients from September 2011 through September 2015 was undertaken.
Patient data including age, TBSA, burn etiology, inhalation injury, CPR
prior to burn unit arrival, patient co-morbidities, and length of stay in
the burn unit prior to death were collected. Results: In total, 36 patient
deaths were observed in the study time period, 16 of which occurred within
48 hours of admission. After applying Fisher's exact test to the early death
and later death groups, significant associations were found between early
death and pre burn unit CPR (p = 0.003) as well as inhalation injury
(p=0.0448). Structure fire as the etiology of the burn was not a significant
factor and patient comorbidities were quite varied and non-predictive. Age
and TBSA, (after analysis with student's T test) were not found to be
significant predictors of death within 48 hours of burn injury (p=0.23 and
p= 0.45). Average age for the early death group was 54.07 years versus 63.18
years in the late death group; mean TBSA for the study population was 28.20%
in the early death patients and 34.18% in the late death group. Conclusions:
Patients transferred to our burn unit that died within 48 hours of admission
were more likely to have received pre-transfer CPR and were more likely to
have suffered an inhalation injury compared to patients that died later in
their hospital course. Applicability of Research to Practice: Identifying
burn patients that have a high likelihood of death within 48 hours of injury
can help transferring and receiving facilities set expectations and convey
prognostic information to family members prior to patient transfer.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
American
death
human
patient
EMTREE MEDICAL INDEX TERMS
burn
burn patient
burn unit
etiology
fire
Fisher exact test
hospital
inhalation
injury
length of stay
morbidity
mortality
patient care
patient coding
patient transport
population
Student t test
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72281637
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 149
TITLE
Are staff identification badges a vector for pathogen transfer
AUTHOR NAMES
Taylor D.E.
Durkee P.
James L.
Madsen H.
Fowler L.
Gottschlich M.M.
Warden G.D.
Warner P.
AUTHOR ADDRESSES
(Taylor D.E.; Durkee P.; James L.; Madsen H.; Fowler L.; Gottschlich M.M.;
Warden G.D.; Warner P.) Shriners Hospitals for Children, Cincinnati, United
States.
CORRESPONDENCE ADDRESS
D.E. Taylor, Shriners Hospitals for Children, Cincinnati, United States.
SOURCE
Journal of Burn Care and Research (2016) 37 SUPPL. 1 (S180). Date of
Publication: May-June 2016
CONFERENCE NAME
48th Annual Meeting of the American Burn Association
CONFERENCE LOCATION
Las Vegas, NV, United States
CONFERENCE DATE
2016-05-03 to 2016-05-06
ISSN
1559-0488
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: Health Care Workers (HCW) are required to display identity
badges. In addition to the identification (ID) badge, other cards are worn
for quick reference and allow access to electronic health records. Badges
are handled frequently, have potential for patient contact and could act as
a vector for transmission of organisms. The purpose of this study was to
determine if ID badges worn by HCW harbor potential bacterial pathogens that
might contribute to pathogens identified in the burn unit. Methods:
Microbiological samples of 100 badge components (ID, badge holder, smart
card and other protocol badge cards) were obtained from a cross-section of
clinical staff (n=31) at a pediatric hospital dedicated to treatment of
burns, plastic and reconstructive conditions from February to September
2015. Components were cultured for bacterial growth using standard lab
procedures, stratifying for nosocomial pathogens. Comparisons of positive
cultures between ICU nurses and other clinical staff were made by χ2 tests
and by Fisher's exact test when sample sizes were low. Results: Ten ICU
nurses, 5 non-ICU nurses, 3 pharmacists, 3 radiology techs, 2 physicians, 2
respiratory therapists and 6 from other disciplines participated in this
study. Fifty-seven (57%) of 100 samples were no growth, thirty-eight (38%)
grew commensal skin flora and 5 (5%) had a potential pathogen identified
(Enterobacter aerogenes, Enterobacter agglomerans, Pantoea agglomerans, and
Staphylococcus aureus). There were no significant differences between ICU
nurses and other patient care staff in the recovery of potential pathogens.
Conclusions: Our study demonstrated a 5% incidence of potentially pathogenic
contamination. This result adds to the growing data suggesting HCW clothing
and equipment as potential vectors, albeit a small risk observed at our
facility. It is not easy to establish the precise role that identity badges
play in the transmission of pathogens to patients. Even when hand hygiene
practices have been followed, badges are constantly touched, which may
re-contaminate hands with pathogens. It is speculated that the practice of
regular decontamination of ID cards may reduce the potential threat of
bacterial transmission and improve patient safety. Applicability of Research
to Practice: HCW need to be aware that identity cards may harbor potentially
pathogenic bacteria, which place patients at risk for harmful infections.
Enhanced awareness may also improve compliance to infection prevention
practices already in place in the health care setting. (Table presented).
EMTREE DRUG INDEX TERMS
plastic
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
American
pathogenesis
EMTREE MEDICAL INDEX TERMS
bacterial growth
bacterial transmission
bacterium
burn unit
clothing
commensal
contamination
electronic medical record
Enterobacter aerogenes
Fisher exact test
hand washing
health care
health care personnel
human
identity
infection
infection prevention
nurse
Pantoea agglomerans
patient
patient care
patient safety
pediatric hospital
pharmacist
physician
procedures
radiology
respiratory therapist
risk
sample size
skin flora
smart card
Staphylococcus aureus
waste management
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72281644
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 150
TITLE
Hyperacute management-excluding clinical trial results: The race-direct
(Rapid arterial occlusion evaluation for direct to endovascular treatment
center transfer): A proposal for prehospital evaluation of acute stroke
AUTHOR NAMES
Rodriguez-Pardo J.
Fuentes B.
Alonso De Leciñana M.
Ximénez-Carrillo A.
Zapata-Wainberg G.
Barriga F.J.
Castillo L.
Carneado J.
Diaz-Guzmán J.
Egido-Herrero J.
De Felipe-Mimbrera A.
Fernández-Ferro J.C.
Garćia-Pastor A.
Gil-Núñez A.
Gómez-Escalonilla C.
Guillan M.
Masjuán-Vallejo J.
Ortega-Casarrubios M.A.
Vivancos-Mora J.
Diez-Tejedor E.
AUTHOR ADDRESSES
(Rodriguez-Pardo J.; Fuentes B.; Alonso De Leciñana M.; Diez-Tejedor E.)
UNIVERSITY HOSPITAL la PAZ, Neurology, Madrid, Spain.
(Ximénez-Carrillo A.; Zapata-Wainberg G.; Vivancos-Mora J.) LA PRINCESA
UNIVERSITY HOSPITAL, Neurology, Madrid, Spain.
(Barriga F.J.; Castillo L.) FUNDACION ALCORCON UNIVERSITY HOSPITAL,
Neurology, Alcorcón, Spain.
(Carneado J.) PUERTA de HIERRO UNIVERSITY HOSPITAL, Neuroloǵia, Majadahonda,
Spain.
(Diaz-Guzmán J.; Ortega-Casarrubios M.A.) DOCE de OCTUBRE UNIVERSITY
HOSPITAL, Neurology, Madrid, Spain.
(Egido-Herrero J.; Gómez-Escalonilla C.) CLINICO SAN CARLOS UNIVERSITY
HOSPITAL, Neurology, Madrid, Spain.
(De Felipe-Mimbrera A.; Masjuán-Vallejo J.) RAMON y CAJAL UNIVERSITy
HOSPITAL, Neurology, Madrid, Spain.
(Fernández-Ferro J.C.; Guillan M.) REY JUAN CARLOS UNIVERSITY HOSPITAL,
Neurology, Móstoles, Spain.
(Garćia-Pastor A.; Gil-Núñez A.) GREGORIO MARANON UNIVERSITY HOSPITAL,
Neurology, Madrid, Spain.
CORRESPONDENCE ADDRESS
J. Rodriguez-Pardo, UNIVERSITY HOSPITAL la PAZ, Neurology, Madrid, Spain.
SOURCE
European Stroke Journal (2016) 1:1 Supplement 1 (433). Date of Publication:
1 May 2016
CONFERENCE NAME
2nd European Stroke Organisation Conference, ESOC 2016
CONFERENCE LOCATION
Barcelona, Spain
CONFERENCE DATE
2016-05-10 to 2016-05-12
ISSN
2396-9881
BOOK PUBLISHER
SAGE Publications Ltd
ABSTRACT
Background: Several studies have shown better outcome and lower mortality in
patients with large vessel occlusion undergoing Endovascular Treatment (ET)
with stent retrievers versus medical treatment alone. However, ET requires a
wide variety of specialized care, provided by Comprehensive Stroke Centers
(CSC). It remains unclear whether selected patients with acute stroke should
be directly transferred to the nearest CSC in order to avoid delay in ET
Clinical scales such as RACE have been developed recently to predict large
vessel occlusion, but were unable to rule out hemorrhagic stroke and their
predictive value for ET was low. We propose new criteria to identify
eligible patients for ET with higher accuracy. Methods: RACE-DIRECT criteria
were defined based on a retrospective cohort of 317 patients admitted at the
Stroke Unit of a CSC for over a year. Age, sex, RACE scale score and blood
pressure (BP) were registered for analysis. Cut-off points with the highest
association with ET were thereafter evaluated in a prospective cohort of 153
patients from 9 stroke centers comprising the Madrid Stroke Network.
Results: Patients meeting RACE score> =5, Systolic BP <190mmHg and Age<=80
showed a significantly higher probability of undergoing ET (OR 33 [IC 95%
12-93]). This association was confirmed in the prospective cohort with 68%
Sensitivity, 84% Specificity, 42% Positive and 94% Negative Predictive
Values for ET, ruling out 83% hemor-rhagic strokes. 78% of secondly
transferred patients met RACE-DIRECT criteria. Conclusions: RACE-DIRECT
criteria can be useful to identify patients suitable for ET and develop a
direct-to-CSC transfer system.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
artery occlusion
race
stroke unit
EMTREE MEDICAL INDEX TERMS
blood pressure monitoring
clinical trial
controlled clinical trial
controlled study
diagnostic test accuracy study
female
human
major clinical study
male
multicenter study
predictive value
probability
systolic blood pressure
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L616988334
DOI
10.1177/2396987316642909
FULL TEXT LINK
http://dx.doi.org/10.1177/2396987316642909
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 151
TITLE
Quantitative analysis of estimated burn size accuracy for transfer patients
AUTHOR NAMES
Armstrong J.R.
Willand L.
Gonzalez B.
Sandhu J.
Mosier M.J.
AUTHOR ADDRESSES
(Armstrong J.R.; Willand L.; Gonzalez B.; Sandhu J.; Mosier M.J.) Loyola
Stritch School of Medicine, Maywood, United States.
CORRESPONDENCE ADDRESS
J.R. Armstrong, Loyola Stritch School of Medicine, Maywood, United States.
SOURCE
Journal of Burn Care and Research (2016) 37 SUPPL. 1 (S259). Date of
Publication: May-June 2016
CONFERENCE NAME
48th Annual Meeting of the American Burn Association
CONFERENCE LOCATION
Las Vegas, NV, United States
CONFERENCE DATE
2016-05-03 to 2016-05-06
ISSN
1559-0488
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: Accurate burn size estimation (TBSA) is crucial for burn
patients. However, there is a widespread and stark difference between TBSA
reported by referring hospitals, and actual TBSA calculated at burn units.
Methods: We conducted a retrospective review of 735 burn patients admitted
over a 17-month period. Three hundred twenty-six patients fit the criteria
of transfers with recorded TBSA estimations from referring hospitals.
Referring TBSA was compared to actual TBSA, and the difference was expressed
as a percentage of actual TBSA [(Referring TBSA-Loyola TBSA)/ Loyola
TBSA]∗100. This was then used to group referring estimations as
Underestimated (<-25%), Satisfactory (between -25 and 25%) or Overestimated
(>25%). A paired T-Test was used to assess the paired differences for
significance. Secondary variables were assessed between groups including
mortality, length of stay, age, contiguity of burn, and referral volume.
When assessing associations of these clinical measures by estimation status,
a One-Way Anova was used for continuous variables and Pearson's Chi-Square
Test or Fisher's Exact Test was used. Results: Of the 326 patients analyzed,
13 were underestimated, 63 were satisfactory, and 250 were overestimated.
The ratio of overestimation to underestimation exceeded 19:1 and the ratio
of overestimation to satisfactory estimation was nearly 4:1, with a
statistically significant difference in referred TBSA and actual TBSA
(p<0.0001). Within the over and underestimated groups, there were
significant differences between referred TBSA and actual TBSA (p<0.0001).
Larger burns were more accurately estimated (p<0.0001). There was no
statistically significant link between contiguity of burn, age, or referral
volume to accuracy of burn estimation. Conclusions: There are significant
inaccuracies between referring hospital estimated TBSA and actual TBSA, that
consistently and grossly skew towards overestimation. Inaccuracy in burn
size estimation is systemic and can affect patient care and burn unit
efficiency. Applicability of Research to Practice: Using this data, it
should be possible to tailor existing education outreach programs to better
target the weaker areas of estimation at referring hospitals, pushing the
trend towards more satisfactory TBSA estimation. This targeted process could
then result in increasing efficiency of patient treatment and improving
patient care both before and after admission to the burn unit.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
American
human
patient
quantitative analysis
EMTREE MEDICAL INDEX TERMS
burn patient
burn unit
chi square test
education
Fisher exact test
hospital
length of stay
mortality
patient care
Student t test
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72281801
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 152
TITLE
The impact of resident holdover admissions on inpatient length of stay and
risk of transfer to an intensive care unit
AUTHOR NAMES
Ashana D.C.
Chan V.K.
Vangala S.
Bell D.S.
AUTHOR ADDRESSES
(Ashana D.C.; Chan V.K.; Vangala S.; Bell D.S.) UCLA, David Geffen School of
Medicine, Los Angeles, United States.
CORRESPONDENCE ADDRESS
D.C. Ashana, UCLA, David Geffen School of Medicine, Los Angeles, United
States.
SOURCE
Journal of General Internal Medicine (2016) 31:2 SUPPL. 1 (S424). Date of
Publication: May 2016
CONFERENCE NAME
39th Annual Meeting of the Society of General Internal Medicine, SGIM 2016
CONFERENCE LOCATION
Hollywood, FL, United States
CONFERENCE DATE
2016-05-11 to 2016-05-14
ISSN
1525-1497
BOOK PUBLISHER
Springer New York LLC
ABSTRACT
BACKGROUND: ACGME duty hour standards have led to the creation of novel
staffing systems such as the “holdover” system, whereby residents admit
patients at night and transfer care to daytime teams who provide
longitudinal care. Despite growing literature describing differences between
holdover and traditional staffing models, it remains unknown whether patient
outcomes are ultimately affected. Thus, we conducted this study to
investigate whether patients admitted by holdover teams at a large academic
health center experience worse outcomes than those admitted by traditional
teams that provide longitudinal care. In particular, we hypothesized that
these patients would have a longer length of stay (LOS) and higher rate of
transfer to the ICU within 72 h of admission. METHODS: We conducted a
retrospective cohort study including patients admitted to the general
internal medicine wards service at Ronald Reagan Medical Center at the
University of California, Los Angeles from July 1, 2013 to June 6, 2015.
Primary outcomes included LOS and transfer to an ICU within 72 h of
admission. Secondary outcomes were any transfer to an ICU, inpatient
mortality, discharge to home (versus discharge to post-acute care facility),
and inpatient readmission within 30 days of discharge. RESULTS: Five
thousand five hundred and eighteen patient encounters met criteria for
inclusion. Of these, 64 % were admitted by the holdover team. LOS was
significantly longer for holdover encounters, with a geometric mean LOS of
4.95 (4.78, 5.12) days for non-holdover patients and 5.18 (5.04, 5.31) days
for holdover patients (p = 0.037). Rates of 72 h ICU transfer (OR 1.30, CI
0.58-2.93), any ICU transfer (OR 1.29, CI 0.78-2.14), inpatient mortality
(OR 1.21, CI 0.27-5.37), home discharge (OR 1.27, CI 0.74-2.18), and 30-day
hospital readmission (OR 0.97, CI 0.83-1.12) were not statistically
different between study groups. CONCLUSIONS: The holdover system at our
institution results in longer LOS, perhaps due to inefficiencies and delays
in care delivery, but patient safety outcomes are not affected. Modest
increases in LOS, when aggregated, can have a substantial impact on bed
capacity, patient throughput, and hospital financial performance. Therefore,
additional work to understand the drivers of this increase should be
undertaken at hospitals that utilize a holdover staffing model.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital patient
human
intensive care unit
internal medicine
length of stay
risk
society
EMTREE MEDICAL INDEX TERMS
cohort analysis
emergency care
health center
hospital
hospital bed capacity
hospital readmission
model
mortality
night
outpatient department
patient
patient safety
United States
university
ward
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72288752
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 153
TITLE
Intrahospital Transport of the Critically Ill Adult: A Standardized
Evaluation Plan
AUTHOR NAMES
Jones H.M.
Zychowicz M.E.
Champagne M.
Thornlow D.K.
AUTHOR ADDRESSES
(Jones H.M.) Honey M. Jones, DNP, ACNP-BC, is an acute care nurse
practitioner at Duke University Medical Center and the University of North
Carolina at Chapel Hill. She also serves as clinical associate faculty for
the MSN program at the Duke University School of Nursing. Her primary role
is providing care for critically ill adults, and her clinical experience
includes neurocritical care, cardiothoracic surgery, electrophysiology, and
cardiac catheterization lab. She received her doctoral degree from Duke
University, and her research interests include intrahospital transport of
critically ill adults and neurocritical care practice issues. Michael E.
Zychowicz, DNP, ANP, ONP, FAANP, is an associate professor and director of
the MSN Program at DUSON. He is certified as both an adult nurse
practitioner and an orthopedic nurse practitioner. His specialty is
orthopedic nursing, with subspecialties in sports medicine, spine surgery,
and general orthopedics. He received his doctoral degree from Case Western
Reserve University. His research and clinical interests include occupational
back injuries and the impact of health beliefs on return to work time. Mary
Champagne, PhD, RN, FAAN, is Laurel Chadwick Distinguished Professor and
dean emerita of DUSON. She has a secondary appointment as professor in the
Department of Community and Family Medicine of the Duke University School of
Medicine and is also a Senior Fellow of the Duke Center for the Study of
Aging and Human Development. She received her doctoral degree from the
University of Texas at Austin. Her research interests involve improving
health in low-income seniors living locally in subsidized housing, quality
and safety in the Duke Healthcare system, wound and ostomy care and quality
of life of individuals with stomas, and the prevention of acute confusion in
hospitalized elderly patients. Deirdre K. Thornlow, PhD, RN, CPHQ, is an
assistant professor at DUSON, a John A. Hartford Foundation Claire M. Fagin
Fellow, and a Senior Fell
(Zychowicz M.E.; Champagne M.; Thornlow D.K.)
SOURCE
Dimensions of critical care nursing : DCCN (2016) 35:3 (133-146). Date of
Publication: 1 May 2016
ISSN
1538-8646 (electronic)
ABSTRACT
OBJECTIVE: The aim of this study is to evaluate the implementation of a
standardized evaluation plan for intrahospital transports to/from adult
intensive care units.METHODS: Nurses at a level I trauma/academic center
captured clinical data throughout transport. Outcome measures included
compliance with the organization's transport policy and unexpected
events.RESULTS: There were 502 transports audited. Most nurses were
compliant with the policy, except for the stabilization process (n = 174,
34.7%). Forty-one transports (8.2%) had an unexpected event, and 11 of these
transports (26.8%) were aborted. Most of the events were hemodynamic (12),
sedation (11), respiratory (10), and gastrointestinal (5). Fewer events
occurred with the transport team (P = .036) and among nurses with a bachelor
of science in nursing or higher degree (P = .002). Events were higher among
transporting nurses with only 0 to 2 years of intensive care unit experience
(P = .002), "stabilized" transports (P = .022), and patients with higher
Acute Physiology and Chronic Health Evaluation scores (P =
.009).CONCLUSIONS: Health care organizations should have a policy that
includes both transport and evaluation plans for intrahospital transport.
Guidelines should be revised with specific criteria for the stabilization
process and unexpected events. Revision should also have a standardized
evaluation plan that includes an audit tool to measure incidence of
unexpected events and a rapid change quality improvement method.BACKGROUND:
Intrahospital transport of the critically ill adult carries inherent risks
that can be manifested as unexpected events.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
clinical audit
critical illness
organization and management
patient care planning
EMTREE MEDICAL INDEX TERMS
emergency health service
human
intensive care nursing
intensive care unit
North Carolina
patient transport
statistics and numerical data
university hospital
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
27043399 (http://www.ncbi.nlm.nih.gov/pubmed/27043399)
PUI
L614915015
DOI
10.1097/DCC.0000000000000176
FULL TEXT LINK
http://dx.doi.org/10.1097/DCC.0000000000000176
COPYRIGHT
Copyright 2017 Medline is the source for the citation and abstract of this
record.
RECORD 154
TITLE
Transportation of children on extracorporeal membrane oxygenation: one-year
experience of the first neonatal and paediatric mobile ECMO team in the
north of France
AUTHOR NAMES
Rambaud J.
Léger P.L.
Larroquet M.
Amblard A.
Lodé N.
Guilbert J.
Jean S.
Guellec I.
Casadevall I.
Kessous K.
Walti H.
Carbajal R.
AUTHOR ADDRESSES
(Rambaud J., jerome.rambaud@aphp.fr; Léger P.L.; Amblard A.; Guilbert J.;
Jean S.; Guellec I.; Walti H.; Carbajal R.) Paediatric Intensive Care Unit,
Armand-Trousseau Hospital, APHP, UPMC University, 26 Avenue du Dr Arnold
Netter, Paris, France.
(Larroquet M.) Paediatric Surgery, Armand-Trousseau Hospital, APHP, UPMC
University, Paris, France.
(Lodé N.; Casadevall I.; Kessous K.) Emergency Transport Unit, Robert Debré
Hospital, Paris, France.
CORRESPONDENCE ADDRESS
J. Rambaud, Paediatric Intensive Care Unit, Armand-Trousseau Hospital, APHP,
UPMC University, 26 Avenue du Dr Arnold Netter, Paris, France. Email:
jerome.rambaud@aphp.fr
SOURCE
Intensive Care Medicine (2016) 42:5 (940-941). Date of Publication: 1 May
2016
ISSN
1432-1238 (electronic)
0342-4642
BOOK PUBLISHER
Springer Verlag, service@springer.de
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
extracorporeal oxygenation
EMTREE MEDICAL INDEX TERMS
blood flow velocity
blood pump
cannulation
child
health care access
hemodynamic parameters
high frequency ventilation
human
implantation
intensive care unit
letter
lung hemodynamics
lung transplantation
oxygenator
respiratory failure
survival rate
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Anesthesiology (24)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20151019355
MEDLINE PMID
26626061 (http://www.ncbi.nlm.nih.gov/pubmed/26626061)
PUI
L607221734
DOI
10.1007/s00134-015-4144-z
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-015-4144-z
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 155
TITLE
A critical analysis of unplanned transfer to the ICU within 48 hours of
admission from the ED
AUTHOR NAMES
Dahn C.M.
Manasco T.A.
Breaud A.H.
Kim S.
Nelson K.P.
Moin O.
Rumas N.
Baker W.
Mitchell P.
Feldman J.
AUTHOR ADDRESSES
(Dahn C.M.; Manasco T.A.; Breaud A.H.; Kim S.; Nelson K.P.; Moin O.; Rumas
N.; Baker W.; Mitchell P.; Feldman J.) Boston University, School of
Medicine, Boston, United States.
CORRESPONDENCE ADDRESS
C.M. Dahn, Boston University, School of Medicine, Boston, United States.
SOURCE
Academic Emergency Medicine (2016) 23 SUPPL. 1 (S236). Date of Publication:
May 2016
CONFERENCE NAME
2016 Annual Meeting of the Society for Academic Emergency Medicine, SAEM
2016
CONFERENCE LOCATION
New Orleans, LA, United States
CONFERENCE DATE
2016-05-10 to 2016-05-13
ISSN
1553-2712
BOOK PUBLISHER
Blackwell Publishing Inc.
ABSTRACT
Background: Unplanned intensive care unit (ICU) transfer (UIT) within 48
hours of ED admission increases morbidity and mortality. We hypothesized
that many UITs do not have critical interventions (CrI) and that CrI is
associated with worse outcomes. Objectives: Our objective was to
characterize all UITs (including dying prior to ICU), the proportion with
CrI, and the effect of having a CrI on length of stay (LOS) and mortality.
Methods: Single center, retrospective cohort study of UITs within 48 hours
from 6/1/2008 - 5/31/2013 at an urban, academic medical center. We queried
the hospital clinical data warehouse and included those ≥ 18 years and
without advanced directives (AD). We used a modified Delphi technique for
developing a CrI list. Trained MD chart abstractors extracted data and met
periodically to reach consensus. Data included demographics, comorbidities,
reason for UIT, total LOS, CrI, and mortality. We calculated descriptive
statistics with 95% confidence intervals. Blinded reviewers extracted a 10%
random sample of charts and chance-corrected agreement (Cohen's Simple
Kappa) was measured for key variables. Results: 837/179,787 (0.47%) non-ICU
admissions from the ED had a UIT within 48 hours and 86 admitted patients
died prior to ICU. We excluded: 23 AD, 117 post-operative transfers, 177
planned ICU transfers, and 4 with missing data. Of the 516 remaining, 65%
(95% CI 61% - 69%) had a CrI. UIT reasons: 33 medical errors, 90 had disease
processes not present on arrival, and 393 had clinical deterioration.
Mortality was 10.5% (95% CI 8%-14%) and mean LOS was 258 hours (95% CI
233-283) for those with a CrI, while the mortality was 2.8% (95% CI 1%-6%)
and mean LOS was 177 hours (95% CI 157-197) for those without a CrI.
Therefore, mean LOS for those receiving CrI was, on average, 80.7 hours
longer than for those receiving no CrI, with a margin of error of 32.0
hours. Cohen's Simple Kappa ranged from 0.81 and 0.84 for the exclusion and
admission criteria variables, respectively, and 0.67 for the transfer
category variable. Conclusion: We found UIT was rare over the study period,
and those who received a CrI (65%) had increased morbidity and mortality.
These results provide insight into our understanding of UITs within 48 hours
to an ICU following ED admission as a measure of quality care and screening
tool to detect adverse events.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency medicine
society
EMTREE MEDICAL INDEX TERMS
clinical study
cohort analysis
confidence interval
consensus
data base
Delphi study
deterioration
hospital
human
intensive care unit
length of stay
medical error
morbidity
mortality
patient
questionnaire
random sample
screening
statistics
university hospital
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72281265
DOI
10.1111/acem.12974
FULL TEXT LINK
http://dx.doi.org/10.1111/acem.12974
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 156
TITLE
Patients transferred to an intensive care unit within seven days of stroke:
Data from the ongoing tranexamic acid for hyperacute primary intracerebral
haemorrhage (TICH-2) trial
AUTHOR NAMES
Sprigg N.
Robson K.
Appleton J.
Bath P.
AUTHOR ADDRESSES
(Sprigg N.; Robson K.; Appleton J.; Bath P.) Division of Clinical
Neuroscience, University of Nottingham, Stroke, Nottingham, United Kingdom.
CORRESPONDENCE ADDRESS
N. Sprigg, Division of Clinical Neuroscience, University of Nottingham,
Stroke, Nottingham, United Kingdom.
SOURCE
European Stroke Journal (2016) 1:1 Supplement 1 (93-94). Date of
Publication: 1 May 2016
CONFERENCE NAME
2nd European Stroke Organisation Conference, ESOC 2016
CONFERENCE LOCATION
Barcelona, Spain
CONFERENCE DATE
2016-05-10 to 2016-05-12
ISSN
2396-9881
BOOK PUBLISHER
SAGE Publications Ltd
ABSTRACT
Background: Intracerebral haemorrhage is a medical emergency and can lead to
reduced consciousness. Some patients may require support in intensive care
units (ICU). Methods: TICH-2 records whether participants have been
transferred to ICU by day 7. Baseline characteristics and outcomes were
compared between those that had been transferred and those that had not.
Results: Of 1116 participants, at day 90, in TICH-2, 117 (10.5%) had been
transferred to ICU. The percentage of patients going to ICU ranged from 2%
to 100% across all centres, median [IQR] 14.3% [7.7%, 20%]. Patients going
to ICU were younger, male and had more severe strokes with lower GCS. Over
40% patients who went to ICU were also transferred for surgery and almost
60% received invasive ventilation. Day 90 modified Rankin Scale, Barthel
Index and Euroqol-5D were significantly worse for the people who were
transferred (all p-values < 0.0001); however, 11.1% of people that went to
ICU had a mRS of 2 or less and 16.2% were home alone or home with family/
carers at discharge. Deaths by day 90 were also signifi-cantly higher for
those who had been transferred (p-value: 0.0005). Conclusions: The
proportion of patients going to ICU varies widely across centres. Only half
have ventilation. Those going to ICU were more likely to have more severe
strokes and worse outcomes, but some patients survive and live
independently.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
tranexamic acid
EMTREE DRUG INDEX TERMS
endogenous compound
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
brain hemorrhage
intensive care unit
EMTREE MEDICAL INDEX TERMS
artificial ventilation
Barthel index
clinical trial
controlled study
death
family
human
information processing
major clinical study
male
Rankin scale
statistical significance
surgery
CAS REGISTRY NUMBERS
tranexamic acid (1197-18-8, 701-54-2)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L617000435
DOI
10.1177/2396987316642909
FULL TEXT LINK
http://dx.doi.org/10.1177/2396987316642909
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 157
TITLE
Airway Management: A Structured Curriculum for Critical Care Transport
Providers
AUTHOR NAMES
Kuszajewski M.L.
O'Donnell J.M.
Phrampus P.E.
Robey W.C.
Tuite P.K.
AUTHOR ADDRESSES
(Kuszajewski M.L., michele.kuszajewski@duke.edu) Duke University School of
Nursing, Center for Nursing Discovery, Durham, United States.
(O'Donnell J.M.) Department of Nurse Anesthesia, University of Pittsburgh
School of Nursing, Pittsburgh, United States.
(Phrampus P.E.) University of Pittsburgh School of Medicine, Pittsburgh,
United States.
(O'Donnell J.M.; Phrampus P.E.) Peter M. Winter Institute for Simulation,
Education, Research (WISER), University of Pittsburgh, Pittsburgh, United
States.
(Robey W.C.) East Carolina University Brody School of Medicine, Clinical
Simulation Program, Greenville, United States.
(Tuite P.K.) University of Pittsburgh School of Nursing, Pittsburgh, United
States.
CORRESPONDENCE ADDRESS
M.L. Kuszajewski, 8 Olde Union Court, Durham, United States. Email:
michele.kuszajewski@duke.edu
SOURCE
Air Medical Journal (2016) 35:3 (138-142). Date of Publication: 1 May 2016
ISSN
1532-6497 (electronic)
1067-991X
BOOK PUBLISHER
Mosby Inc., customerservice@mosby.com
ABSTRACT
Objective Airway assessment and management are vital skills for the critical
care transport provider. Nurses and paramedics often enter a transport
program with limited or no exposure to airway management. Many programs lack
a structured curriculum to show skill competence. Optimal methods in the
development of airway management competence and the frequency of training
needed to maintain skills have not been clearly defined. Because of this
lack of standardization, the actual level of competence in both new and
experienced critical care transport providers is unknown. Methods A pretest,
post-test repeated measures approach using an online curriculum combined
with a deliberate practice model was used. Competence in airway management
was measured using 3 evaluation points: static mannequin head, simulation
scenario, and the live patient. Results A convenience sample of critical
care transport providers participated (N = 9). Knowledge improvement was
significant, with a higher percentage of participants scoring above 85% on
the post-test compared with the pretest (P = .028). Mean scores in
completion of the airway checklist pre- versus postintervention were
significantly increased on all 3 evaluation points (P < .001 for all
comparisons). Significant changes were noted in the response profile
evaluating participants' confidence in their ability to verbalize
indications for endotracheal intubation (P < .05). Conclusion The
development of a standardized, blended learning curriculum combined with
deliberate simulation practice and rigorous assessment showed improvements
in multiple areas of airway assessment and management.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
curriculum
health care personnel
intensive care
respiration control
traffic and transport
EMTREE MEDICAL INDEX TERMS
article
competence
controlled study
convenience sample
endotracheal intubation
human
knowledge
manikin
online system
pretest posttest design
priority journal
simulation
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
Internal Medicine (6)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160304084
MEDLINE PMID
27255875 (http://www.ncbi.nlm.nih.gov/pubmed/27255875)
PUI
L609922007
DOI
10.1016/j.amj.2015.12.013
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2015.12.013
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 158
TITLE
When non-revascularized transfer patients come a-knocking at a stroke center
AUTHOR NAMES
Sands K.
Albright K.
Donnelly J.
Jones B.
Kaur M.
Sisson A.
Shiue H.
Lyerly M.
Gropen T.
AUTHOR ADDRESSES
(Sands K.; Albright K.; Donnelly J.; Jones B.; Kaur M.; Sisson A.; Shiue H.;
Lyerly M.; Gropen T.)
CORRESPONDENCE ADDRESS
K. Sands,
SOURCE
Neurology (2016) 86:16 SUPPL. 1. Date of Publication: 5 Apr 2016
CONFERENCE NAME
68th American Academy of Neurology Annual Meeting, AAN 2016
CONFERENCE LOCATION
Vancouver, BC, Canada
CONFERENCE DATE
2016-04-15 to 2016-04-21
ISSN
0028-3878
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Objective: Compare patient characteristics, adverse events (AEs), and short
term functional outcomes in patients directly presenting to and transferred
into a comprehensive stroke center (CSC). Background: Guidelines recommend
acute ischemic stroke (AIS) patients be transported rapidly to the closest
certified stroke center (SC). The impact of SC care on transfer patients who
do not receive acute revascularization therapy is not well understood.
Design/Methods: Retrospective review of consecutive AIS patients at our CSC
from March 2014-April 2015. We excluded patients who received tPA or
endovascular therapy. Demographic and clinical data were collected. We
compared AEs (hemorrhagic transformation [HT], DVT, PE, urinary tract
infection [UTI], pneumonia [PNA], bacteremia) and poor short term functional
outcome (modified Rankin scale score 36), among direct presenters and those
transferred into our CSC. Results: Of 589 patients who did not receive
revascularization therapy, 24.4[percnt] were transfers. Transfers were
disproportionately white (76.4 vs 57.8[percnt], p<0.001), had higher median
NIHSS (5 vs 4, p=0.028), were less often privately insured (40.1 vs
46.4[percnt]), and had less desirable ASPECTS scores on initial head CT
(810; 22.9 vs 44.0, p<0.001). Transfers had higher odds of having AEs (crude
OR 2.134, 95[percnt] 1.353-3.365). This association remained after adjusting
for age, stroke severity, and admission glucose (OR 2.103, 95[percnt] CI
1.276-3.466.004). Transfers more frequently developed HT on repeat imaging
(17.5 vs 7.0[percnt], p<0.001), clinical seizure during inpatient stay (4.9
vs 1.6[percnt], p=0.024), and PNA (7.6 vs 3.8[percnt], p=0.061). However,
transfer status was not associated with poor short-term functional outcome
(crude OR 1.453, 95[percnt] CI 0.986-2.141; adjusted OR 1.200, 95[percnt] CI
0.703-2.046). Conclusions: Despite having more severe strokes and higher
frequency of adverse events, patients transferred into our CSC did not have
worse short term functional outcomes. This highlights the importance of
specialized inpatient care provided in NICUs and stroke units by experienced
multidisciplinary teams.
EMTREE DRUG INDEX TERMS
glucose
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
American
cerebrovascular accident
human
neurology
patient
EMTREE MEDICAL INDEX TERMS
bacteremia
brain ischemia
clinical study
hospital patient
imaging
National Institutes of Health Stroke Scale
pneumonia
Rankin scale
revascularization
seizure
stroke patient
stroke unit
therapy
urinary tract infection
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72252309
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 159
TITLE
Adverse events encountered during the intra-hospital transport of ICU
patients
AUTHOR NAMES
Taggu A.
Thomas J.
Patil S.
Arun M.V.P.
AUTHOR ADDRESSES
(Taggu A.; Thomas J.; Patil S.; Arun M.V.P.) St. Johns Medical College,
Bangalore, India.
CORRESPONDENCE ADDRESS
A. Taggu, St. Johns Medical College, Bangalore, India.
SOURCE
Chest (2016) 149:4 SUPPL. 1 (A241). Date of Publication: 2016
CONFERENCE NAME
CHEST World Congress 2016 Annual Meeting
CONFERENCE LOCATION
Shanghai, China
CONFERENCE DATE
2016-04-15 to 2016-04-17
ISSN
0012-3692
BOOK PUBLISHER
American College of Chest Physicians
ABSTRACT
PURPOSE: To study the number and types of adverse events entered during
intra-hospital transport of ICU patients. Interventions provided along with
outcomes. METHODS: A prospective observational study of 438 intra-hospital
ICU patients of our hospital transported for diagnostic purposes during May
2012 - june 2013. The escorting intensivist completed the profoma charting
out the adverse events occuring during transport just after transport was
over. RESULTS: A total of 438 patients were enrolled in the study for
adverse events (AEs) during intra-hospital transfer of ICU patients. The
overall AEs documented were 250 among 110 patients. Amongst the AEs
encountered, the most common was miscellaneous causes (85.00%)] like SPO2
probe (45.6%) or rest were ECG lead displacement. Major events alarming the
physician were drop in spo2 >5% observed in 26.4% patients, MAP (mean
arterial pressure) variation >20% from baseline in 32% patients, altered
mental status in 7%, and symptomatic arrhythmias in 2% patients. Among 110
(100%) patients with AEs, 5% patients with symptomatic adverse events had to
be cancelled from the palnned transport. CONCLUSIONS: Adverse events are not
uncommon during transport of ICU patients especially critically ill.
Protocolised transport preferably escorted by intensivist as a part of
dedicated transport team will be safer for these patients. CLINICAL
IMPLICATIONS: AE's can be reduced when ICU patients are escorted by an
intensivist along with dedicated transport team as per guidelines.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital
human
patient
EMTREE MEDICAL INDEX TERMS
critically ill patient
diagnosis
electrocardiogram
heart arrhythmia
intensivist
mean arterial pressure
mental health
observational study
physician
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72268096
DOI
10.1016/j.chest.2016.02.250
FULL TEXT LINK
http://dx.doi.org/10.1016/j.chest.2016.02.250
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 160
TITLE
Adverse events and near-misses relating to intensive care unit-ward
transfer: A qualitative analysis of resident perceptions
AUTHOR NAMES
Lyons P.G.
Arora V.M.
Farnan J.M.
AUTHOR ADDRESSES
(Lyons P.G.; Arora V.M.; Farnan J.M.) University of Chicago, Chicago, United
States.
SOURCE
Annals of the American Thoracic Society (2016) 13:4 (570-572). Date of
Publication: 1 Apr 2016
ISSN
2325-6621
BOOK PUBLISHER
American Thoracic Society, malexander@thoracic.org
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
adverse outcome
intensive care unit
patient transport
perception
resident
ward
EMTREE MEDICAL INDEX TERMS
hospital patient
interpersonal communication
letter
patient monitoring
qualitative analysis
structured interview
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20160709959
MEDLINE PMID
27058186 (http://www.ncbi.nlm.nih.gov/pubmed/27058186)
PUI
L612501166
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 161
TITLE
Critical Care Resuscitation Unit: An Innovative Solution to Expedite
Transfer of Patients with Time-Sensitive Critical Illness
AUTHOR NAMES
Scalea T.M.
Rubinson L.
Tran Q.
Jones K.M.
Rea J.H.
Stein D.M.
Bartlett S.T.
O'Connor J.V.
AUTHOR ADDRESSES
(Scalea T.M., tscalea@umm.edu; Stein D.M.; Bartlett S.T.; O'Connor J.V.)
Department of Surgery, R Adams Cowley Shock Trauma Center, University of
Maryland, School of Medicine, 22 S Greene St, Baltimore, United States.
(Rubinson L.) Department of Medicine, R Adams Cowley Shock Trauma Center,
University of Maryland Medical Center, Baltimore, United States.
(Tran Q.; Jones K.M.; Rea J.H.) Department of Emergency Medicine, R Adams
Cowley Shock Trauma Center, University of Maryland Medical Center,
Baltimore, United States.
CORRESPONDENCE ADDRESS
T.M. Scalea, Department of Surgery, R Adams Cowley Shock Trauma Center,
University of Maryland, School of Medicine, 22 S Greene St, Baltimore,
United States. Email: tscalea@umm.edu
SOURCE
Journal of the American College of Surgeons (2016) 222:4 (614-621). Date of
Publication: 1 Apr 2016
ISSN
1879-1190 (electronic)
1072-7515
BOOK PUBLISHER
Elsevier Inc., usjcs@elsevier.com
ABSTRACT
Background Time-sensitive, critical surgical illnesses require care at
specialized centers. Trauma systems facilitate patient transport to
designated trauma centers, but formal systems for nontraumatic critical
illness do not exist. We created the critical care resuscitation unit to
expedite transfers of adult critically ill patients with time-sensitive
conditions to a quaternary academic medical center, hypothesizing that this
would decrease time to transfer, increase transfer volume, and improve
outcomes. Study Design Critical care transfers to the University of Maryland
Medical Center during the first year of the critical care resuscitation unit
(July 2013 to June 2014) were compared with a previous year (July 2011 to
June 2012). Times from transfer request to arrival and operating room and
hospital mortality were compared. Results There was a 64.5% increase in
transfers with a 93.6% increase in critically ill surgical patients. For
patients requiring operation, median time to arrival and operating room (118
vs 223 minutes and 1,113 vs 3,424 minutes, respectively; p < 0.001 for both)
and median hospital length of stay (13 vs 17 days; p < 0.001) were reduced
significantly. There was a nonsignificant trend toward lower mortality
(14.6% vs 16.5%; p = 0.27). Conclusions The critical care resuscitation unit
dramatically increased the volume of critically ill surgical patients. It
decreased transfer times, increased volume, and, for those who required
urgent operation, decreased time from initial referral to operating room.
This benefit seems to be most marked in patients needing urgent operation.
This might be a paradigm shift expediting the transfer of patients with
time-sensitive critical illness to an appropriately resourced specialty
center.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
patient transport
time sensitive critical illness
EMTREE MEDICAL INDEX TERMS
comparative study
conference paper
emergency care
emergency health service
heart surgery
human
intensive care
intensive care unit
length of stay
major clinical study
mortality
operating room
outcome assessment
priority journal
resuscitation
surgical patient
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160277280
MEDLINE PMID
26920992 (http://www.ncbi.nlm.nih.gov/pubmed/26920992)
PUI
L609629432
DOI
10.1016/j.jamcollsurg.2015.12.060
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jamcollsurg.2015.12.060
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 162
TITLE
Atypical presentation and nosocomial spread-intensifying the MERS mystery
and misery
AUTHOR NAMES
Fagbo S.
Hakawi A.M.
Mukahal M.
Skakni L.
Santos A.
Garbati M.
Alao K.
AUTHOR ADDRESSES
(Fagbo S.; Mukahal M.; Skakni L.; Santos A.; Garbati M.; Alao K.) King Fahad
Medical City, Riyadh, Saudi Arabia.
(Hakawi A.M.) KFMC, Riyadh, Saudi Arabia.
CORRESPONDENCE ADDRESS
S. Fagbo, King Fahad Medical City, Riyadh, Saudi Arabia.
SOURCE
International Journal of Infectious Diseases (2016) 45 SUPPL. 1 (209). Date
of Publication: April 2016
CONFERENCE NAME
17th International Congress on Infectious Diseases
CONFERENCE LOCATION
Hyderabad, India
CONFERENCE DATE
2016-03-02 to 2016-03-05
ISSN
1201-9712
BOOK PUBLISHER
Elsevier
ABSTRACT
Background: Infection control measures to prevent nosocomial transmission of
novel pathogens like the Middle East Respiratory Syndrome Coronavirus
(MERS-CoV) require strict adherence to guidelines. However, atypical
presentations may mislead unwary Emergency Department (ED) physicians, thus
posing challenges. Wepresent the investigation of a MERS case with atypical
presentation at the King Fahad Medical City (KFMC) in Riyadh in the summer
of 2015. Methods&Materials: The patient's charts and electronic health
records covering her two ED visits and subsequent intensive care unit (ICU)
admission were reviewed. Adhering to MOH protocols, health care workers
(HCWs) exposed to the patient were monitored for possible nosocomial MERS
CoV transmission. Results: The patient was a 77-year-old female with
Diabetes Mellitus, Hypertension, chronic kidney disease and chronic
myelocytic leukemia who presented twice at the ED, within 4 days. On her
first visit, she was febrile (37.9°C), had abdominal pain and distension
(ascites), nausea and vomiting. Four days earlier, she had visited her
primary hospital, known to be experiencing a MERS outbreak at that time, for
chemotherapy. Biochemical and microbiological testing of drained ascitic
fluid were unremarkable. She was discharged the same day after spending 10
hours in the ED. Three days later, she returned to the ED with progressive
abdominal distension, worsening fever (38.8°C) and deteriorating hepatic and
renal function. She developed pulseless electrical activity (PEA) and
asystole that required resuscitation for 19 minutes. She survived the arrest
but clinically worsened and died 4 days in the ICU. Despite 6 intra-hospital
transfers (5 prior to MERS CoV confirmation) during her second visit, none
of the exposed HCWs (n = 60) developed MERS; included are those who
performed high risk procedures (intubation and CPR) on her. However,
epidemiological investigation suggests she infected a post-mastectomy
patient that shared the waiting room with her while awaiting triage on her
first ED visit. Both patients died. Conclusion: This case of an atypical
MERS case with multiple exposures to several HCWs having varying levels of
protection on multiple occasions led to only one nosocomial case thus
further intensifying the mystery surrounding MERS CoV transmission.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
infection
EMTREE MEDICAL INDEX TERMS
abdominal distension
abdominal pain
ascites
ascites fluid
chemotherapy
chronic kidney failure
chronic myeloid leukemia
city
diabetes mellitus
electric activity
electronic medical record
emergency health service
emergency ward
exposure
female
fever
health care personnel
heart arrest
hospital
human
hypertension
infection control
intensive care unit
intubation
kidney function
mastectomy
Middle East respiratory syndrome coronavirus
nausea and vomiting
pathogenesis
patient
physician
procedures
protection
resuscitation
risk
summer
waiting room
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72245430
DOI
10.1016/j.ijid.2016.02.477
FULL TEXT LINK
http://dx.doi.org/10.1016/j.ijid.2016.02.477
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 163
TITLE
Acquired 16s methyl transferase associated high level aminoglycoside
resistance in Acinetobacter baumannii recovered from ICU patients from a
tertiary referral hospital of northeast India
AUTHOR NAMES
Upadhyay S.
Joshi S.R.
Khryiem A.B.
Bhattacharyya P.
AUTHOR ADDRESSES
(Upadhyay S.; Joshi S.R.) North Eastern Hill University, Shillong, India.
(Khryiem A.B.; Bhattacharyya P.) NEIGRIHMS, Shillong, India.
CORRESPONDENCE ADDRESS
S. Upadhyay, North Eastern Hill University, Shillong, India.
SOURCE
International Journal of Infectious Diseases (2016) 45 SUPPL. 1 (46). Date
of Publication: April 2016
CONFERENCE NAME
17th International Congress on Infectious Diseases
CONFERENCE LOCATION
Hyderabad, India
CONFERENCE DATE
2016-03-02 to 2016-03-05
ISSN
1201-9712
BOOK PUBLISHER
Elsevier
ABSTRACT
Background: Acinetobacter baumannii is an emerging pathogen associated with
hospital acquired infections across the globe. In last one decade the
therapeutic options against this pathogen became complicated due to
acquisition of multidrug resistant trait. Aminoglycoside, which have been
used successfully for treatment of hospital infection, is severely
compromised as the acquired 16S rRNA methylases have emerged as an important
mechanism of high-level resistance to aminoglycosides in clinical isolates
of A.baumannii. Current investigation deals with the occurrence of acquired
16s methyl transferase genes associated with high-level aminoglycoside
resistance (HLAR) in A. baumanni obtained from intensive care unit of a
tertiary referral hospital in north-east India. Methods & Materials: We
analysed a total of 164 multidrugresistant A. baumannii obtained from ICU
patients admitted in a referral hospital of Shillong, north-east India, from
April-September 2015. 16S rRNA methyl transferase genes; npmA, armA, rmtA,
rmtB, rmtC and rmtD, were amplified by PCR among the isolates resistant to
aminoglycosides by disk-diffusion method. To determine the HLAR [gentamicin
and amikacin≥512μg/ml], MIC against gentamicin and amikacin was recorded.
Horizontal transferability and plasmid stability were performed by
conjugation and serial passage. Plasmid elimination was performed by
treating the isolate with 10% SDS. Clonal dissemination/differentiation of
the isolates was analysed by REP-PCR. Results: A total of 157 (95.7%)
isolates were found to exhibit HLAR, among them carriage of acquired 16s
methyl transferase was observed in 109 (69.4%) isolates. ArmA was found to
be the predominant gene followed by rmtD and rmtA. All the gene types were
horizontally transferable. The isolates retained the resistance genes from
89th to 95th consecutive serial passages. Plasmids were eliminated with a
single treatment of SDS (4%). REP-PCR analysis indicated that 17 different
haplotypes were responsible for infection. Conclusion: The current study
underscores polyclonal spread of HLAR A. baumannii within ICU patients. The
study has revealed the presence of different acquired 16s methyl transferase
genes which is not being frequently reported from this geographical region.
Further, the study could predict stability of these resistance determinants
which is helpful in predicting a future treatment option and formulating
infection control strategy in this region.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
aminoglycoside
methyltransferase
EMTREE DRUG INDEX TERMS
amikacin
gentamicin
RNA 16S
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Acinetobacter baumannii
human
India
infection
patient
tertiary care center
EMTREE MEDICAL INDEX TERMS
conjugation
control strategy
disk diffusion
gene
haplotype
hospital
hospital infection
infection control
intensive care unit
minimum inhibitory concentration
pathogenesis
plasmid
virus culture
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72245101
DOI
10.1016/j.ijid.2016.02.144
FULL TEXT LINK
http://dx.doi.org/10.1016/j.ijid.2016.02.144
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 164
TITLE
Rates of ICU transfers after a scheduled night-shift interprofessional
huddle
AUTHOR NAMES
Newman R.E.
Bingler M.A.
Bauer P.N.
Lee B.R.
Mann K.J.
AUTHOR ADDRESSES
(Newman R.E., renewman@cmh.edu; Mann K.J.) Department of Pediatrics,
Sections of General Academic Pediatrics, Children's Mercy Hospital and
Clinics, 2401 Gillham Road, Kansas City, United States.
(Bingler M.A.) Cardiology, Kansas City, United States.
(Bauer P.N.) Critical Care Medicine, University of Missouri-Kansas City
School of Medicine, Children's Mercy Hospitals and Clinics, Kansas City,
United States.
(Lee B.R.) Center for Clinical Effectiveness, Quality Improvement,
Children's Mercy Hospitals and Clinics, Kansas City, United States.
CORRESPONDENCE ADDRESS
R.E. Newman, Department of Pediatrics, Sections of General Academic
Pediatrics, Children's Mercy Hospital and Clinics, 2401 Gillham Road, Kansas
City, United States. Email: renewman@cmh.edu
SOURCE
Hospital Pediatrics (2016) 6:4 (234-242). Date of Publication: 1 Apr 2016
ISSN
2154-1671 (electronic)
2154-1663
BOOK PUBLISHER
American Academy of Pediatrics, 141 Northwest Point Blvd, P.O. Box 927, Elk
Grove Village, United States.
ABSTRACT
OBJECTIVES: To evaluate a scheduled interprofessional huddle among pediatric
residents, nursing staff, and cardiologists on the number of high-risk
transfers to the ICU. METHODS: A daily, night-shift huddle intervention was
initiated between the in-house pediatric residents and nursing staff
covering the cardiology ward patients with the at-home attending
cardiologist. Retrospective cohort chart review identified high-risk
transfers from the inpatient floor to the ICU over a 24-month period (eg,
inotropic support, intubation, and/or respiratory support within 1 hour of
ICU transfer). Satisfaction with the intervention and the impact of the
intervention on team-based communication and resident education was
collected using a retrospective pre-post survey. RESULTS: Ninety-three
patients were identified as unscheduled transfers from the ward team to the
ICU. Overall, 21 preintervention transfers were considered high risk,
whereas only 8 patients were considered high risk after the intervention (P
=.004). During the night shift, high risk transfers decreased from 8 of 17
(47%) to 3 of 21 patients (14%) (P =.03). Interprofessional communication
improved with 12 of 14 nurses and 24 of 25 residents reporting effective
communication after the intervention (P <.0001) compared with only 1 nurse
and 15 residents reporting a positive experience before the intervention.
Overall, all 3 provider groups stated an improved experience covering a
high-risk cardiology patient population. CONCLUSIONS: Implementation of an
interprofessional huddle may contribute to decreasing high-risk transfers to
the ICU. Initiating a daily huddle was well received and allowed for open
lines of communication across all provider groups.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
night
EMTREE MEDICAL INDEX TERMS
cardiology
child
controlled study
doctor patient relation
education
human
major clinical study
resident
satisfaction
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160291554
MEDLINE PMID
26956424 (http://www.ncbi.nlm.nih.gov/pubmed/26956424)
PUI
L609721487
DOI
10.1542/hpeds.2015-0173
FULL TEXT LINK
http://dx.doi.org/10.1542/hpeds.2015-0173
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 165
TITLE
Universal acceptance of in-utero transfers between units within a regional
Maternity and Newborn Network
AUTHOR NAMES
Poniatowska E.
Jenkinson S.
Moore R.
Mulay A.
AUTHOR ADDRESSES
(Poniatowska E.; Jenkinson S.) Royal Wolverhampton NHS Trust, Wolverhampton,
United Kingdom.
(Moore R.) Staffordshire, Shropshire and Black Country Newborn and Maternity
Network, Stoke on Trent, United Kingdom.
(Mulay A.) Walsall Healthcare NHS Trust, Walsall, United Kingdom.
CORRESPONDENCE ADDRESS
E. Poniatowska, Royal Wolverhampton NHS Trust, Wolverhampton, United
Kingdom.
SOURCE
BJOG: An International Journal of Obstetrics and Gynaecology (2016) 123
SUPPL. 1 (99-100). Date of Publication: April 2016
CONFERENCE NAME
18th Annual Conference of the British Maternal and Fetal Medicine Society,
BMFMS 2016
CONFERENCE LOCATION
Birmingham, United Kingdom
CONFERENCE DATE
2016-04-21 to 2016-04-22
ISSN
1470-0328
BOOK PUBLISHER
Blackwell Publishing Ltd
ABSTRACT
Introduction The project was designed to explore the concept of easing
barriers to transfer and sharing of care for a small group of pregnancies
between local maternity units with a local neonatal unit and neonatal
intensive care unit. Methods All pregnancies that fulfilled the criteria of
preterm prelabour rupture of membranes between 23(+0) and 28(+0) weeks were
transferred into a unit containing a neonatal intensive care unit
unconditionally, irrespective of barriers. If undelivered following their
initial inpatient episode, outpatient care reverted to their unit of origin.
However, if they required further admission they were able to self refer
directly back to the neonatal intensive care unit. Results Over 6-month
period, eight women fulfilled the project criteria, six were unconditionally
accepted. Of those women, four were delivered in the accepting unit and two
were transferred back to their unit of origin undelivered. Conclusion As the
project progressed, barriers to transfer eased; the adapted pathway was felt
to be the 'norm' and attitudes of staff to the project became more
favourable. Although it was not necessary, it also allowed the project team
to consider how the available cots in the network could be used to ensure
unconditional acceptance of higher-risk cases to the neonatal intensive care
unit in the future. As only a small number of cases were involved,
consideration should be given to how a larger selection of cases could be
transferred and accommodated. Potential financial implications should also
be examined.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
newborn
society
EMTREE MEDICAL INDEX TERMS
female
hospital patient
human
intensive care unit
membrane
newborn intensive care
outpatient care
pregnancy
risk
rupture
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72280651
DOI
10.1111/14710528.13988
FULL TEXT LINK
http://dx.doi.org/10.1111/14710528.13988
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 166
TITLE
Shaping the Flight Paramedic Program
AUTHOR NAMES
Davids N.B.
AUTHOR ADDRESSES
(Davids N.B.) Center for Prehospital Medicine, Army Medical Department
Center and School, Joint Base San Antonio-Fort Sam Houston, San Antonio,
Texas
SOURCE
U.S. Army Medical Department journal (2016) :2-16 (48-51). Date of
Publication: 1 Apr 2016
ISSN
1946-1968 (electronic)
ABSTRACT
Over the past 14 years of conflict, the Department of Defense medical
community has made significant strides in patient care. As the conflicts
developed, many sources identified a critical gap in en route care,
specifically the need for critical care trained personnel for point of
injury and intrahospital transfers, as well as improved outcomes for
patients who received care from critical care trained providers. As stopgap
measures were implemented, the US Army instituted the Critical Care Flight
Paramedic Program in order to meet this need of life saving critical care
transport. Execution of both an institutional training model as well as a
home station training option allows for increased numbers of personnel
trained, as well as flexibility for National Guard and Army Reserve units to
keep personnel in their area. The Critical Care Flight Paramedic Program's
educational outcomes have been exceptional, with National Registry Paramedic
pass rates well above the national average. As the program develops,
recertification and sustainment of knowledge and skills will be challenges,
and novel approaches and flexibility will become critical for continued
success.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
education
patient transport
standards
EMTREE MEDICAL INDEX TERMS
human
intensive care
military medicine
paramedical personnel
procedures
soldier
United States
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
27215866 (http://www.ncbi.nlm.nih.gov/pubmed/27215866)
PUI
L615930384
COPYRIGHT
Copyright 2017 Medline is the source for the citation and abstract of this
record.
RECORD 167
TITLE
Preventable transfers in pediatric trauma: A 10-year experience at a level i
pediatric trauma center
AUTHOR NAMES
Fenton S.J.
Lee J.H.
Stevens A.M.
Kimbal K.C.
Zhang C.
Presson A.P.
Metzger R.R.
Scaife E.R.
AUTHOR ADDRESSES
(Fenton S.J., stephen.fenton@hsc.utah.edu; Lee J.H.,
justin.lee@hsc.utah.edu; Stevens A.M., austin.stevens@hsc.utah.edu; Metzger
R.R., metzger2020@gmail.com; Scaife E.R., eric.scaife@hsc.utah.edu) Division
of Pediatric Surgery, University of Utah School of Medicine, Primary,
Children's Hospital, Salt Lake City, United States.
(Kimbal K.C., kyle.kimbal@hsc.utah.edu) University of Utah School of
Medicine, Salt Lake City, United States.
(Zhang C., chong.zhang@hsc.utah.edu; Presson A.P.,
angela.presson@hsc.utah.edu) Division of Epidemiology, University of Utah
School of Medicine, Salt Lake City, United States.
CORRESPONDENCE ADDRESS
S.J. Fenton, Pediatric Surgery, University of Utah School of Medicine,
Primary Children's Hospital, 100 N. Mario Capecchi Drive, Salt Lake City,
United States. Email: stephen.fenton@hsc.utah.edu
SOURCE
Journal of Pediatric Surgery (2016) 51:4 (645-648). Date of Publication: 1
Apr 2016
ISSN
1531-5037 (electronic)
0022-3468
BOOK PUBLISHER
W.B. Saunders
ABSTRACT
Background Injured children are often treated at one facility then
transferred to another that specializes in pediatric trauma care. The
purpose of this study was to identify and characterize potentially
preventable transfers (PT) to a freestanding level-I pediatric trauma
center. Methods Children with traumatic injuries transferred between 2003
and 2013 were retrospectively analyzed. A PT was defined as a child who was
discharged within 36 hours of arrival without surgical intervention or
advanced imaging studies. Results During this period, 6380 children were
transferred, with head injury being the most common injury. 61% had CT
imaging performed before transfer. The mean age was 6.9 years, mean injury
severity score (ISS) 10.4, and median transfer distance 37 miles. 27% of
these transfers were classified as PT. Air transport was used in 15% at mean
charge of $18,574. 29% were discharged from the emergency department. When
compared, PTs were younger (6.0 vs. 7.2 years, p < 0.001), with lower median
ISS (5 vs. 9, p < 0.001), shorter median LOS (15 vs. 43.6 hours, p < 0.001),
and less PICU admissions (6% vs. 34%, p < 0.001). Conclusion A significant
number of pediatric trauma transfers can be classified as preventable.
Reducing preventable transfers could offer opportunities for improving value
in a trauma care system.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
childhood injury
patient transport
pediatric hospital
preventable transfer
EMTREE MEDICAL INDEX TERMS
child
computer assisted tomography
conference paper
emergency ward
female
head injury
hospital admission
hospital discharge
human
imaging
injury scale
intensive care unit
major clinical study
male
priority journal
retrospective study
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20151060552
MEDLINE PMID
26520697 (http://www.ncbi.nlm.nih.gov/pubmed/26520697)
PUI
L607397157
DOI
10.1016/j.jpedsurg.2015.09.020
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jpedsurg.2015.09.020
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 168
TITLE
Early detection of multidrug resistant (MDR) Mycobacterium tuberculosis in a
single tube with in-house designed fluorescence resonance energy transfer
(FRET) probes using real-time PCR
AUTHOR NAMES
Chauhan D.S.
Sharma R.
Parashar D.
Sharma P.
Das R.
Chahar M.
Singh A.V.
Singh P.K.
Katoch K.
Katoch V.M.
AUTHOR ADDRESSES
(Chauhan D.S.; Sharma R.; Parashar D.; Sharma P.; Das R.; Chahar M.; Singh
A.V.; Singh P.K.; Katoch K.; Katoch V.M.)
SOURCE
Indian journal of experimental biology (2016) 54:4 (229-236). Date of
Publication: 1 Apr 2016
ISSN
0019-5189
ABSTRACT
Rapid and correct diagnosis is crucial for the management of multidrug
resistance (MDR) in Mycobacterium tuberculosis (MTB). The present study aims
at rapid diagnosis for identification of multidrug resistance tuberculosis
(MDR-TB) using real-time PCR. FRET hybridization probes targeting most
prominent four selected codons for rpoB526 and 531 and for katG314 and 315
genes were designed and evaluated on 143 clinical MTB isolates and paired
sputa for rapid detection of MDR-TB. The results of real-time PCR were
compared with gold standard L-J proportion method and further validated by
DNA sequencing. Of the 143 MTB positive cultures, 85 and 58 isolates were
found to be 'MDR' and 'pan susceptible', respectively by proportion L-J
method. The sensitivity of real-time PCR for the detection of rifampicin
(RIF) and isoniazid (INH) were 85.88 and 94.11%, respectively, and the
specificity of method was found to be 98.27%. DNA sequencing of 31 MTB
isolates having distinct melting temperature (Tm) as compared to the
standard drug susceptible H37Rv strain showed 100% concordance with
real-time PCR results. DNA sequencing revealed the mutations at Ser531Leu,
His526Asp of rpoB gene and Ser315Thr, Thr314Pro of katG gene in RIF and INH
resistance cases. This real-time PCR assay that targets limited number of
loci in a selected range ensures direct and rapid detection of MDR-TB in
Indian settings. However, future studies for revalidation as well as
refinement are required to break the limitations of MDR-TB detection.
EMTREE DRUG INDEX TERMS
bacterial DNA
isoniazid (pharmacology)
rifampicin (pharmacology)
tuberculostatic agent (pharmacology)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
procedures
EMTREE MEDICAL INDEX TERMS
drug effects
fluorescence resonance energy transfer
genetics
human
isolation and purification
microbial sensitivity test
multidrug resistant tuberculosis (diagnosis)
Mycobacterium tuberculosis
real time polymerase chain reaction
sensitivity and specificity
CAS REGISTRY NUMBERS
isoniazid (54-85-3, 62229-51-0, 65979-32-0)
rifampicin (13292-46-1)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
27295919 (http://www.ncbi.nlm.nih.gov/pubmed/27295919)
PUI
L613678866
COPYRIGHT
Copyright 2016 Medline is the source for the citation and abstract of this
record.
RECORD 169
TITLE
Value of computed tomography of the chest in subjects with ARDS: A
retrospective observational study
AUTHOR NAMES
Simon M.
Braune S.
Laqmani A.
Metschke M.
Berliner C.
Kalsow M.
Klose H.
Kluge S.
AUTHOR ADDRESSES
(Simon M.; Braune S.; Metschke M.; Kalsow M.; Kluge S., s.kluge@uke.de)
Department of Intensive Care Medicine, University Medical Center
Hamburg-Eppendorf, Hamburg, Germany.
(Laqmani A.; Berliner C.) Department of Diagnostic and Interventional
Radiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
(Klose H.) Department of Respiratory Medicine, University Medical Center
Hamburg-Eppendorf, Hamburg, Germany.
CORRESPONDENCE ADDRESS
S. Kluge, Department of Intensive Care Medicine, University Medical Center
Hamburg-Eppendorf, Martinistr 52, Hamburg, Germany. Email: s.kluge@uke.de
SOURCE
Respiratory Care (2016) 61:3 (316-323). Date of Publication: 1 Mar 2016
ISSN
1943-3654 (electronic)
0020-1324
BOOK PUBLISHER
American Association for Respiratory Care
ABSTRACT
BACKGROUND: The value of computed tomography (CT) of the chest in the
management of patients with ARDS is poorly defined. The aim of this study
was to assess the clinical utility of thoracic CT scans in subjects with
ARDS using the Berlin definition. METHODS: This was a retrospective,
observational study in a university hospital ARDS center on all subjects
with ARDS in whom a CT scan of the chest was performed immediately before or
during an ICU stay between January 1, 2007 and June 30, 2013. RESULTS:
During the study period, a total of 1,781 thoracic CT scans were performed,
of which 204 cases met inclusion criteria. The most common pathologic
findings of the lung parenchyma were consolidations (94.1% of cases) and
ground glass opacities (85.3%). Furthermore, CT scans showed pleural
effusions (80.4%), mediastinal lymphadenopathy (66.7%), signs of right
ventricular strain and pulmonary hypertension (53.9%), pericardial effusion
(37.3%), emphysema of the chest wall (12.3%), pneumothorax (11.8%),
emphysema of the mediastinum (7.4%), and pulmonary embolism (2.5%). Results
of CT scans led to changes in management in 26.5% of cases. Mortality was
significantly increased in subjects with involvement of lung parenchyma of
>80% (P =.004). Intrahospital transport was associated with critical
incidents in 8.3% of cases. CONCLUSIONS: Systematic evaluation of thoracic
CT scans yielded information useful for making a diagnosis, predicting
prognosis, and recognizing concomitant disorders requiring therapeutic
interventions. Results obtained from CT scans led to changes in management
in 26.5% of cases.
EMTREE DRUG INDEX TERMS
glass
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
adult respiratory distress syndrome
computer assisted tomography
observational study
thorax
EMTREE MEDICAL INDEX TERMS
diagnosis
Germany
heart right ventricle
human
lung embolism
lung parenchyma
lymphadenopathy
major clinical study
mortality
pericardial effusion
pleura effusion
pneumomediastinum
pneumothorax
prognosis
pulmonary hypertension
thorax wall
university hospital
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160176678
MEDLINE PMID
26647453 (http://www.ncbi.nlm.nih.gov/pubmed/26647453)
PUI
L608718881
DOI
10.4187/respcare.04308
FULL TEXT LINK
http://dx.doi.org/10.4187/respcare.04308
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 170
TITLE
When non-revascularized transfer patients come A-knocking at a stroke center
AUTHOR NAMES
Sands K.A.
Albright K.C.
Donnelly J.P.
Jones B.A.
Kaur M.
Sisson A.
Shiue H.
Lyerly M.
Gropen T.
AUTHOR ADDRESSES
(Sands K.A.; Albright K.C.; Jones B.A.; Kaur M.; Sisson A.; Lyerly M.;
Gropen T.) Neurology, Univ of Alabama at Birmingham, Birmingham, United
States.
(Donnelly J.P.) Epidemiology/Emergency Medicine/Div of Preventive Medicine,
Univ of Alabama at Birmingham, Birmingham, United States.
(Shiue H.) Hosp Pharmacy, Univ of Alabama at Birmingham, Birmingham, United
States.
CORRESPONDENCE ADDRESS
K.A. Sands, Neurology, Univ of Alabama at Birmingham, Birmingham, United
States.
SOURCE
Stroke (2016) 47 SUPPL. 1. Date of Publication: February 2016
CONFERENCE NAME
American Heart Association/American Stroke Association 2016 International
Stroke Conference and State-of-the-Science Stroke Nursing Symposium
CONFERENCE LOCATION
Los Angeles, CA, United States
CONFERENCE DATE
2016-02-16 to 2016-02-19
ISSN
0039-2499
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Background: Guidelines recommend acute ischemic stroke (AIS) patients be
transported rapidly to the closest certified stroke center (SC). The impact
of SC care on transfer patients who do not receive acute revascularization
therapy is not well understood. We sought to compare patient
characteristics, adverse events (AEs), and short term functional outcomes in
patients directly presenting to and transferred into a comprehensive stroke
center (CSC). Methods: We conducted a retrospective review of consecutive
AIS patients transferred to our CSC from March 2014-April 2015. We excluded
patients who received tPA or endovascular therapy. Demographic and clinical
data were collected. We compared AEs (hemorrhagic transformation [HT], DVT,
PE, urinary tract infection [UTI], pneumonia [PNA], bacteremia) and poor
short term functional outcome, as defined by modified Rankin scale (mRS)
score 3-6, among patients directly admitted to our CSC and patients
transferred to our CSC. Results: Of 589 patients who did not receive
revascularization therapy, 24.4% were transfers. Transfers were
disproportionately white (76.4 vs 57.8%, p<0.001), had higher median NIHSS
(5 vs 4, p=0.028), were less often privately insured (40.1 vs 46.4%), and
had less desirable ASPECTS scores on initial head CT (8-10; 22.9 vs 44.0,
p<0.001). Transfers had higher odds of having AEs (crude OR 2.134, 95%
1.353-3.365). This association remained after adjusting for age, stroke
severity, and admission glucose (OR 2.103, 95% CI 1.276-3.466.004).
Transfers more frequently developed HT on repeat imaging (17.5 vs 7.0%,
p<0.001), clinical seizure during inpatient stay (4.9 vs 1.6%, p=0.024), and
PNA (7.6 vs 3.8%, p=0.061). However, transfer status was not associated with
poor short-term functional outcome (crude OR 1.453, 95% CI 0.986-2.141;
adjusted OR 1.200, 95% CI 0.703-2.046). Conclusion: Despite having more
severe strokes and higher frequency of adverse events, patients transferred
into our CSC for a higher level of care did not have worse short term
functional outcomes. This highlights the importance of specialized inpatient
care provided in NICUs and stroke units by experienced multidisciplinary
teams.
EMTREE DRUG INDEX TERMS
glucose
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
American
cerebrovascular accident
heart
human
nursing
patient
EMTREE MEDICAL INDEX TERMS
bacteremia
brain ischemia
clinical study
hospital patient
imaging
National Institutes of Health Stroke Scale
pneumonia
Rankin scale
revascularization
seizure
stroke patient
stroke unit
therapy
urinary tract infection
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72210741
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 171
TITLE
National trends in transfer of patients with intracerebral hemorrhage to
teaching hospitals
AUTHOR NAMES
Vahidy F.
Albright K.
Donnelly J.P.
Shapshak A.H.
Savitz S.I.
AUTHOR ADDRESSES
(Vahidy F.; Savitz S.I.) Neurology, UT-HSC, Houston, United States.
(Albright K.; Shapshak A.H.) Neurology, Univ of Alabama, Birmingham, United
States.
(Donnelly J.P.) Emergency Medicine, Univ of Alabama, Birmingham, United
States.
CORRESPONDENCE ADDRESS
F. Vahidy, Neurology, UT-HSC, Houston, United States.
SOURCE
Stroke (2016) 47 SUPPL. 1. Date of Publication: February 2016
CONFERENCE NAME
American Heart Association/American Stroke Association 2016 International
Stroke Conference and State-of-the-Science Stroke Nursing Symposium
CONFERENCE LOCATION
Los Angeles, CA, United States
CONFERENCE DATE
2016-02-16 to 2016-02-19
ISSN
0039-2499
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: The 2015 AHA guidelines for ICH management state that initial
care of ICH patients should take place in an “ICU or a dedicated stroke unit
with physician and nursing neuroscience acute care expertise”. This approach
entails transferring ICH patients from community hospitals to centers with
stroke expertise. Hypothesis: We explored national trends in transfer of ICH
patients to teaching hospitals, and evaluated the differences in
demographic, co-morbidity, resource utilization factors, and outcomes for
transferred patients (TP) vs. directly admitted patients (DAP). Methods:
From the National Inpatient Sample data for years 2006 to 2011, we
identified patients with primary diagnosis of ICH (ICD-9 431). We assessed
linear trends in the proportion of patients transferred over time using
logistic regression. We constructed multivariate logistic regression models
to explore the association of transfer status with inpatient mortality after
controlling for significant factors. All analyses were performed using
survey design variables, allowing us to report nationally-weighted
estimates. Results: Our analysis subpopulation comprised of 232,009
patients, and 48,097 (20.7%, 95% CI: 17.8 - 23.9) were TP. There was a
statistically significant increase in transfer over the 6 year period.
(Figure 1). TP were younger, and were more likely to be white and have
private insurance. The proportions of TP with hypertension, diabetes,
congestive heart failure, and renal failure were also significantly smaller
(Table 1). TP had lower adjusted odds of inpatient mortality as compared to
DAP (Table 2). Conclusion: There is an increasing trend of transferring ICH
patients to higher level of care. Care of transferred patients at
specialized centers is associated with greater resource utilization and
lower inpatient mortality. Evidence on optimal selection of patients
benefiting from transfer, and long term functional outcomes are needed for
policy planning.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
American
brain hemorrhage
cerebrovascular accident
heart
human
nursing
patient
teaching hospital
EMTREE MEDICAL INDEX TERMS
community hospital
congestive heart failure
diabetes mellitus
diagnosis
emergency care
hospital patient
hypertension
hypothesis
ICD-9
insurance
kidney failure
logistic regression analysis
model
morbidity
mortality
physician
planning
policy
stroke unit
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72211140
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 172
TITLE
Impact of Retrieval, Distance Traveled, and Referral Center on Outcomes in
Unplanned Admissions to a National PICU
AUTHOR NAMES
Moynihan K.
McSharry B.
Reed P.
Buckley D.
AUTHOR ADDRESSES
(Moynihan K.; McSharry B., BrentM@adhb.govt.nz; Buckley D.) Department of
Paediatric Intensive Care, Starship Children's Hospital, 2 Park Road,
Auckland Grafton, New Zealand.
(Moynihan K.) Occupational and Aviation Medicine Unit, University of Otago,
Dunedin, New Zealand.
(Reed P.) Children's Research Centre, Starship Children's Hospital,
Auckland, New Zealand.
CORRESPONDENCE ADDRESS
B. McSharry, Department of Paediatric Intensive Care, Starship Children's
Hospital, 2 Park Road, Auckland Grafton, New Zealand. Email:
BrentM@adhb.govt.nz
SOURCE
Pediatric Critical Care Medicine (2016) 17:2 (e34-e42). Date of Publication:
1 Feb 2016
ISSN
1947-3893 (electronic)
1529-7535
BOOK PUBLISHER
Lippincott Williams and Wilkins, kathiest.clai@apta.org
ABSTRACT
Objectives: Centralization of PICUs requires a transport system that
delivers patient outcomes equivalent to that of the same institution
admissions. Our aim was to evaluate how pediatric critical care retrieval,
distance traveled, and referral center level of ICU support impact on
outcomes in unplanned admissions. Design: Retrospective cohort study.
Setting: The national PICU in New Zealand. Patients: A total of 5,609 (45%
retrieved) unplanned pediatric admissions (< 15 yr) between January 1, 2004,
and January 1, 2014. Interventions: None. Measurements and Main Results:
Data analyzed included case-mix, source of admission, diagnostic category,
Pediatric Index of Mortality score, PICU-specific resource use, distance
traveled, transport duration, and referral hospital ICU level. Outcome
measures were crude and risk-adjusted PICU mortality and PICU length of
stay. Compared with nontransported admissions, retrieved children were
younger, more frequently admitted outside normal working hours, had higher
predicted mortality (median Pediatric Index of Mortality score, 4.7% vs
1.5%; p < 0.001) and PICU-specific resource use (respiratory support,
vasoactive infusions, and renal replacement therapy). The transport cohort
had greater crude mortality rates (8.6% vs 5.6%; p < 0.008) and a median of
29 hours longer PICU stay. There was no significant difference in
risk-adjusted mortality between the cohorts (observed/expected mortality
ratio for retrieved patients, 0.84 vs nontransported patients, 0.91; p =
0.73). Neither distance traveled (median, 135 km), transport duration
(median, 4.4 hr), nor the level of ICU at the referral center had a
significant effect on risk-adjusted PICU mortality in the retrieved cohort.
Conclusions: Children retrieved to the national PICU in New Zealand have
greater predicted mortality risk and PICU-specific resource use than
nontransported patients. There is no significant difference in risk-adjusted
mortality between retrieved and the same institution admissions. Critically
ill pediatric patients can be transported long distances by specially
trained and equipped transport teams, without an increase in risk-adjusted
PICU mortality.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital admission
intensive care
patient referral
patient transport
EMTREE MEDICAL INDEX TERMS
article
assisted ventilation
child
critically ill patient
female
hospitalization
human
intensive care unit
major clinical study
male
mortality
mortality rate
New Zealand
outcome assessment
priority journal
renal replacement therapy
school child
scoring system
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20151042448
PUI
L607321433
DOI
10.1097/PCC.0000000000000586
FULL TEXT LINK
http://dx.doi.org/10.1097/PCC.0000000000000586
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 173
TITLE
Embrace(TM) versus conventional care during transport of newborn > 15 0 0
grams : A randomized double blind controlled trial at tertiary care centre
in Gujarat, India
AUTHOR NAMES
Morgaonkar V.
Patel D.
Nimbalkar A.
Phatak A.
Nimbalkar S.
AUTHOR ADDRESSES
(Morgaonkar V.; Patel D.; Nimbalkar S.) Pramukhswami Medical College,
Department of Pediatrics, Karamsad, India.
(Nimbalkar A.) Pramukhswami Medical College, Department of Physiology,
Karamsad, India.
(Phatak A.) Charutar Arogya Mandal, Central Research Services, Karamsad,
India.
CORRESPONDENCE ADDRESS
V. Morgaonkar, Pramukhswami Medical College, Department of Pediatrics,
Karamsad, India.
SOURCE
European Journal of Pediatrics (2016) 175:11 (1666). Date of Publication:
2016
CONFERENCE NAME
6th Congress of the European Academy of Paediatric Societies
CONFERENCE LOCATION
Geneva, Switzerland
CONFERENCE DATE
2016-10-21 to 2016-10-25
ISSN
1432-1076
BOOK PUBLISHER
Springer Verlag
ABSTRACT
Background and aims Neonates are prone to develop hypothermia during
transport especially in resource poor settings. Embrace™ may be used to
prevent neonatal hypothermia during transport. We decided to assess
effectiveness of Embrace™ vs conventional care during transport from
emergency department (ED) to Neonatal Intensive Care Unit (NICU). Methods
All neonates weighing >1500 grams coming to ED were included. During stay in
ED, neonates were placed in open warmers. Neonate was placed in Embrace™ or
Warmed linen (Control) for transport to NICU. The embrace/linen was removed
and neonate was placed on radiant warmer in the NICU. Temperature was
recorded again (0 hour) and at 0.25, 0.5, 1, 2, 3, 6, 12 and 24 hours of the
NICU stay. The distance travelled by every neonate from the ED to NICU was
700 meter. Results Socio-demographic, clinical variables were similar.
Preterm were 7/20 (35%) in Embrace™, 5/20 (25%) in control. Females were
8/20 (40%)- embrace; 6/20 (30%) - control. Mean birth weight was 2.47 in
embrace, 2.57 in control. Average age at admission is 3.35 days (embrace)
2.9(control). Average time for transport was 11.65 mins in embrace and 12.75
mins in control. From ED to NICU, the mean(SD) temperature difference in
EMBRACE™ group was +0.03(0.71) (that is the temperature increased by +0.03
degree) whereas the same was -0.28(1.34) (that is the temperature dropped by
0.3 degrees on an average). However, this difference was not statistically
significant (p=0.38). Conclusions Use of Embrace™ may be a cost effective
way to maintain euthermia, especially for transport with longer duration.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Gujarat
tertiary care center
EMTREE MEDICAL INDEX TERMS
birth weight
clinical trial
comparative effectiveness
controlled clinical trial
controlled study
double blind procedure
emergency ward
female
human
neonatal intensive care unit
newborn
randomized controlled trial
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L613885821
DOI
10.1007/s00431-016-2785-8
FULL TEXT LINK
http://dx.doi.org/10.1007/s00431-016-2785-8
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 174
TITLE
Serotonin Transporter Gene (SLC6A4) Methylation Associates With Neonatal
Intensive Care Unit Stay and 3-Month-Old Temperament in Preterm Infants
AUTHOR NAMES
Montirosso R.
Provenzi L.
Fumagalli M.
Sirgiovanni I.
Giorda R.
Pozzoli U.
Beri S.
Menozzi G.
Tronick E.
Morandi F.
Mosca F.
Borgatti R.
AUTHOR ADDRESSES
(Montirosso R.; Provenzi L.; Giorda R.; Pozzoli U.; Beri S.; Menozzi G.;
Borgatti R.) IRCCS Eugenio Medea
(Fumagalli M.; Sirgiovanni I.; Mosca F.) University of Milan
(Tronick E.) University of Massachusetts and Division of Newborn Medicine
(Morandi F.) Sacra Famiglia Hospital
SOURCE
Child development (2016) 87:1 (38-48). Date of Publication: 1 Jan 2016
ISSN
1467-8624 (electronic)
ABSTRACT
Preterm birth and Neonatal Intensive Care Unit (NICU) stay are early adverse
stressful experiences, which may result in an altered temperamental profile.
The serotonin transporter gene (SLC6A4), which has been linked to infant
temperament, is susceptible to epigenetic regulation associated with early
stressful experience. This study examined a moderation model in which the
exposure to NICU-related stress and SLC6A4 methylation moderated infant
temperament at 3 months of age. SLC6A4 methylation at 20 CpG sites was
quantified in preterm infants (N = 48) and full-term infants (N = 30) from
Italian middle-class families. Results suggested that in preterm infants
NICU-related stress might be associated with alterations of serotonergic
tone as a consequence of SLC6A4 methylation, which in turn, might associate
with temperamental difficulties assessed at 3 months of age.
EMTREE DRUG INDEX TERMS
serotonin transporter
SLC6A4 protein, human
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
metabolism
neonatal intensive care unit
physiology
EMTREE MEDICAL INDEX TERMS
DNA methylation
female
follow up
genetics
human
infant
male
mental stress
newborn
prematurity
temperament
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
26822441 (http://www.ncbi.nlm.nih.gov/pubmed/26822441)
PUI
L616263138
DOI
10.1111/cdev.12492
FULL TEXT LINK
http://dx.doi.org/10.1111/cdev.12492
COPYRIGHT
Copyright 2017 Medline is the source for the citation and abstract of this
record.
RECORD 175
TITLE
Vascularized tissue transfer in head and neck defects - Postoperative
management without intensive care unit
ORIGINAL (NON-ENGLISH) TITLE
Vaskularisierter Gewebetransfer bei Kopf-Hals-Defekten - Postoperatives
Management ohne Intensivstation
AUTHOR NAMES
Eichhorn K.W.G.
Koscielny S.
AUTHOR ADDRESSES
(Eichhorn K.W.G., Klaus.Eichhorn@ukb.uni-bonn.de) Klinik und Poliklinik für
Hals-Nasen-Ohrenheilkunde, Chirurgie Universitätsklinikum Bonn,
Sigmund-Freud-Str. 25, Bonn, Germany.
(Koscielny S., sven.koscielny@med.uni-jena.de) Universitätsklinik und
Poliklinik für, HNO-Heilkunde, Universitätsklinikum Jena,
Friedrich-Schiller-Universität, Lessingstr. 2, Jena, Germany.
SOURCE
Laryngo- Rhino- Otologie (2016) 95:8 (526-527). Date of Publication: 2016
ISSN
1438-8685 (electronic)
0935-8943
BOOK PUBLISHER
Georg Thieme Verlag, kunden.service@thieme.de
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
head and neck disease (surgery)
intensive care unit
postoperative care
tissue transplantation
vascular tissue
EMTREE MEDICAL INDEX TERMS
note
priority journal
EMBASE CLASSIFICATIONS
Otorhinolaryngology (11)
LANGUAGE OF ARTICLE
English, German
EMBASE ACCESSION NUMBER
20170411407
PUI
L616602079
DOI
10.1055/s-0036-1585596
FULL TEXT LINK
http://dx.doi.org/10.1055/s-0036-1585596
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 176
TITLE
Association of hospital admission service structure with early transfer to
critical care, hospital readmission, and length of stay
AUTHOR NAMES
Smith G.R.
Ma M.
Hansen L.O.
Christensen N.
O'Leary K.J.
AUTHOR ADDRESSES
(Smith G.R., gsmith2@nm.org; Hansen L.O.; Christensen N.; O'Leary K.J.)
Division of Hospital MedicineFeinberg School of Medicine, Northwestern
UniversityChicago, Illinois
(Ma M.) Biostatistics Collaboration Center, Feinberg School of Medicine,
Northwestern UniversityChicago, Illinois
CORRESPONDENCE ADDRESS
G.R. Smith, Division of Hospital Medicine, Feinberg School of Medicine,
Northwestern University, 211 East Ontario Street, Suite 7-713, Chicago, IL
60611 Email: gsmith2@nm.org
SOURCE
Journal of Hospital Medicine (2016). Date of Publication: 2016
ISSN
1553-5606 (electronic)
1553-5592
BOOK PUBLISHER
John Wiley and Sons Inc., P.O.Box 18667, Newark, United States.
ABSTRACT
BACKGROUND: Hospital medical groups use various staffing models that may
systematically affect care continuity during the admission process.
OBJECTIVE: To compare the effect of 2 hospitalist admission service models
("general" and "admitter-rounder") on patient disposition and length of
stay. DESIGN: Retrospective observational cohort study with
difference-in-difference analysis. SETTING: Large tertiary academic medical
center in the United States. PARTICIPANTS: Patients (n = 19,270) admitted
from the emergency department to hospital medicine and medicine teaching
services from July 2010 to June 2013. INTERVENTIONS: Admissions to hospital
medicine staffed by 2 different service models, compared to teaching service
admissions. MEASUREMENTS: Incidence of transfer to critical care within the
first 24 hours of hospitalization, hospital and emergency department length
of stay, and hospital readmission rates ≤30 days postdischarge. RESULTS: The
change of hospitalist services to an admitter-rounder model was associated
with no significant change in transfer to critical care or hospital length
of stay compared to the teaching service (difference-in-difference P = 0.32
and P = 0.87, respectively). The admitter-rounder model was associated with
decreased readmissions compared to the teaching service on
difference-in-difference analysis (odds ratio difference: -0.21, P = 0.01).
Adoption of the hospitalist admitter-rounder model was associated with an
increased emergency department length of stay compared to the teaching
service (difference of +0.49 hours, P < 0.001). CONCLUSIONS: Rates of
transfer to intensive care and overall hospital length of stay between the
hospitalist admission models did not differ significantly. The hospitalist
admitter-rounder admission service structure was associated with extended
emergency department length of stay and a decrease in readmissions.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital admission
hospital readmission
intensive care
length of stay
EMTREE MEDICAL INDEX TERMS
adoption
cohort analysis
controlled study
emergency ward
hospital medicine
hospitalization
human
major clinical study
model
odds ratio
teaching
United States
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160319020
PUI
L610052187
DOI
10.1002/jhm.2592
FULL TEXT LINK
http://dx.doi.org/10.1002/jhm.2592
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 177
TITLE
Time Trends and Predictors of Abnormal Postoperative Body Temperature in
Infants Transported to the Intensive Care Unit
AUTHOR NAMES
Schroeck H.
Lyden A.K.
Benedict W.L.
Ramachandran S.K.
AUTHOR ADDRESSES
(Schroeck H., hedwig.schroeck@hitchcock.org) Department of Anesthesiology,
Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, United
States.
(Lyden A.K., alyden@med.umich.edu; Benedict W.L., wlb@med.umich.edu)
Department of Anesthesiology, University of Michigan Health System, 1500 E
Medical Center Drive, Ann Arbor, United States.
(Ramachandran S.K., rsatyak@med.umich.edu) Department of Anesthesia,
Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, 330
Brookline Avenue, Boston, United States.
CORRESPONDENCE ADDRESS
H. Schroeck, Department of Anesthesiology, Dartmouth-Hitchcock Medical
Center, 1 Medical Center Drive, Lebanon, United States. Email:
hedwig.schroeck@hitchcock.org
SOURCE
Anesthesiology Research and Practice (2016) 2016 Article Number: 7318137.
Date of Publication: 2016
ISSN
1687-6970 (electronic)
1687-6962
BOOK PUBLISHER
Hindawi Publishing Corporation, 410 Park Avenue, 15th Floor, 287 pmb, New
York, United States.
ABSTRACT
Background. Despite increasing adoption of active warming methods over the
recent years, little is known about the effectiveness of these interventions
on the occurrence of abnormal postoperative temperatures in sick infants.
Methods. Preoperative and postoperative temperature readings, patient
characteristics, and procedural factors of critically ill infants at a
single institution were retrieved retrospectively from June 2006 until May
2014. The primary endpoints were the incidence and trend of postoperative
hypothermia and hyperthermia on arrival at the intensive care units.
Univariate and adjusted analyses were performed to identify factors
independently associated with abnormal postoperative temperatures. Results.
2,350 cases were included. 82% were normothermic postoperatively, while
hypothermia and hyperthermia each occurred in 9% of cases. During the study
period, hypothermia decreased from 24% to 2% (p < 0.0001) while hyperthermia
remained unchanged (13% in 2006, 8% in 2014, p = 0.357). Factors
independently associated with hypothermia were higher ASA status (p = 0.02),
lack of intraoperative convective warming (p < 0.001) and procedure date
before 2010 (p < 0.001). Independent associations for postoperative
hyperthermia included lower body weight (p = 0.01) and procedure date before
2010 (p < 0.001). Conclusions. We report an increase in postoperative
normothermia rates in critically ill infants from 2006 until 2014. Careful
monitoring to avoid overcorrection and hyperthermia is recommended.
EMTREE DRUG INDEX TERMS
anesthetic agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
body temperature
hyperthermia (complication, etiology)
hypothermia (complication, etiology)
postoperative complication (complication, etiology)
time
EMTREE MEDICAL INDEX TERMS
article
controlled study
critically ill patient
disease association
female
human
infant
intensive care unit
major clinical study
male
patient transport
temperature measurement
thermostability
trend study
warming
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160746351
PUI
L612706418
DOI
10.1155/2016/7318137
FULL TEXT LINK
http://dx.doi.org/10.1155/2016/7318137
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 178
TITLE
A multidisciplinary initiative to standardize intensive care to acute care
transitions
AUTHOR NAMES
Halvorson S.
Wheeler B.
Willis M.
Watters J.
Eastman J.
O'Donnell R.
Merkel M.
AUTHOR ADDRESSES
(Halvorson S.; Wheeler B., wheelerb@ohsu.edu; Willis M.; Watters J.; Eastman
J.; O'Donnell R.; Merkel M.) Division of Hospital Medicine, Oregon Health
and Science University, 3181 SW Sam Jackson Park Road, Portland, United
States.
(Watters J.) Department of Surgery, Oregon Health and Science University,
3303 SW Bond Ave, Portland, United States.
(Merkel M.) Department of Anesthesiology and Perioperative Medicine, Oregon
Health and Science University, 3181 S.W. Sam Jackson Park Road, Portland,
United States.
CORRESPONDENCE ADDRESS
B. Wheeler, Division of Hospital Medicine, Oregon Health and Science
University, 3181 SW Sam Jackson Park Road, Portland, United States. Email:
wheelerb@ohsu.edu
SOURCE
International Journal for Quality in Health Care (2016) 28:5 (615-625). Date
of Publication: 2016
ISSN
1464-3677 (electronic)
1353-4505
BOOK PUBLISHER
Oxford University Press, jnl.info@oup.co.uk
ABSTRACT
Quality issue: Transfers from intensive care units to acute care units
represent a complex care transition for hospitalized patients. Within our
institution, variation in transfer practices resulted in unpredictable
processes in which patient safety concerns were raised. Initial assessment:
Key stakeholders were engaged across the institution. Patient safety
('incident') reports and a staff survey identified safety concerns. Choice
of a solution: Using lean methodology, current transfer processes were
mapped for the four adult intensive care units and waste was identified.
During a summit of key stakeholders an ideal transfer process was conceived
and a structured handoff tool (checklist) was developed. A daily management
system (DMS) was implemented to monitor adherence. Evaluation: The primary
process outcome was adherence to the standardized workflow. Audits at 4, 8,
and 12 months after implementation indicated that the checklist was used for
100% of transfers. Secondary outcomes included the percentage of transfers
completed within a pre-specified time window of 120 minutes, provider
notification of patient arrival on the acute care unit, and staff survey
responses assessing adequacy of transfer communication. Lessons learned:
Prior work has shown that structuring handoffs can improve patient safety,
but the novelty of this project was addressing the transfer process in its
entirety, across silos of care. Factors leading to the success of this
project were the involvement of key stakeholders across the entire
institution early in the project development phase, employment of lean
methodology, and implementation of tools to guide workflow adherence and
track causes of deviation from the workflow.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency care
intensive care
patient safety
patient transport
standardization
EMTREE MEDICAL INDEX TERMS
article
checklist
daily management system
health care delivery
health care management
health care planning
health survey
hospital patient
human
intensive care unit
interpersonal communication
patient compliance
trend study
workflow
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20170174337
MEDLINE PMID
27535085 (http://www.ncbi.nlm.nih.gov/pubmed/27535085)
PUI
L614698195
DOI
10.1093/intqhc/mzw076
FULL TEXT LINK
http://dx.doi.org/10.1093/intqhc/mzw076
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 179
TITLE
Rapid Response Team Calls and Unplanned Transfers to the Pediatric Intensive
Care Unit in a Pediatric Hospital
AUTHOR NAMES
Humphreys S.
Totapally B.R.
AUTHOR ADDRESSES
(Humphreys S.) Stacey Humphreys is a pediatric intensivist, Division of
Critical Care Medicine, Palmetto Health Children's Hospital, Columbia, South
Carolina. Balagangadhar R. Totapally is medical director of the pediatric
intensive care unit, Division of Critical Care Medicine, Miami Children's
Hospital, and a clinical professor of pediatrics, Herbert Wertheim College
of Medicine, Florida International University, Miami, Florida
(Totapally B.R.) Stacey Humphreys is a pediatric intensivist, Division of
Critical Care Medicine, Palmetto Health Children's Hospital, Columbia, South
Carolina. Balagangadhar R. Totapally is medical director of the pediatric
intensive care unit, Division of Critical Care Medicine, Miami Children's
Hospital, and a clinical professor of pediatrics, Herbert Wertheim College
of Medicine, Florida International University, Miami, Florida.
bala.totapally@mch.com
SOURCE
American journal of critical care : an official publication, American
Association of Critical-Care Nurses (2016) 25:1 (e9-e13). Date of
Publication: 1 Jan 2016
ISSN
1937-710X (electronic)
ABSTRACT
OBJECTIVE: To evaluate times and disposition of rapid response alerts and
outcomes for children transferred from acute care to intensive care.METHODS:
Deidentified data on demographics, time and disposition of the child after
activation of a rapid response, time of transfer to intensive care, and
patient outcomes were reviewed retrospectively. Data for rapid-response
patients on time of activation of the response and unplanned transfers to
the intensive care unit were compared with data on other patients admitted
to the unit.RESULTS: Of 542 rapid responses activated, 321 (59.2%) were
called during the daytime. Out of all rapid response activations, 323
children (59.6%) were transferred to intensive care, 164 (30.3%) remained on
the general unit, and 19 (3.5%) required resuscitation. More children were
transferred to intensive care after rapid response alerts (P = .048) during
the daytime (66%) than at night (59%). During the same period, 1313 patients
were transferred to intensive care from acute care units. Age, sex, risk of
mortality, length of stay, and mortality rate did not differ according to
the time of transfer. Mortality among unplanned transfers (3.8%) was
significantly higher (P < .001) than among other intensive care patients
(1.4%).CONCLUSION: Only 25% of transfers from acute care units to the
intensive care unit occurred after activation of a rapid response team. Most
rapid responses were called during daytime hours. Mortality was
significantly higher among unplanned transfers from acute care than among
other intensive care admissions.BACKGROUND: Variability in disposition of
children according to the time of rapid response calls is unknown.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
statistics and numerical data
EMTREE MEDICAL INDEX TERMS
child
hospital
hospital mortality
human
patient transport
pediatric intensive care unit
rapid response team
resuscitation
retrospective study
time factor
treatment outcome
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
26724305 (http://www.ncbi.nlm.nih.gov/pubmed/26724305)
PUI
L612305048
DOI
10.4037/ajcc2016329
FULL TEXT LINK
http://dx.doi.org/10.4037/ajcc2016329
COPYRIGHT
Copyright 2016 Medline is the source for the citation and abstract of this
record.
RECORD 180
TITLE
Facilitating a child's transfer from ICU to the medium care: A proposal for
change
AUTHOR NAMES
Verwijs-Van Den Heuvel I.
Cochius-Den Otter S.
Van Dijk M.
AUTHOR ADDRESSES
(Verwijs-Van Den Heuvel I.; Cochius-Den Otter S.; Van Dijk M.) Erasmus
MC-Sophia Children's Hospital, Intensive Care, Department of Pediatric
Surgery- Erasmus MC, Sophia Children's Hospital, Rotterdam, Netherlands.
CORRESPONDENCE ADDRESS
I. Verwijs-Van Den Heuvel, Erasmus MC-Sophia Children's Hospital, Intensive
Care, Department of Pediatric Surgery- Erasmus MC, Sophia Children's
Hospital, Rotterdam, Netherlands.
SOURCE
European Journal of Pediatrics (2016) 175:11 (1808). Date of Publication:
2016
CONFERENCE NAME
6th Congress of the European Academy of Paediatric Societies
CONFERENCE LOCATION
Geneva, Switzerland
CONFERENCE DATE
2016-10-21 to 2016-10-25
ISSN
1432-1076
BOOK PUBLISHER
Springer Verlag
ABSTRACT
Background and aims We regularly survey parents' opinions about the care
provided to their child and themselves in our PICU two weeks after
discharge. It appears that discharge often comes too sudden and is not well
communicated beforehand. We therefore introduced a bundle of interventions
to facilitate this transfer. The aim of this study is to summarize the first
results since the introduction in 2015. Methods The bundle for patients with
a length of stay of 5 days or more includes the following elements: 1. Give
parents a tour around the medium care early on 2. Ask parents to write their
own hand-over report 3. Take away the monitor devices as soon as safe 4.
Visit the parents and child the following day at the medium care We
implemented these interventions first in one of our 4 units and recorded
when the elements were indeed executed. Results In 2015, 132 admissions in
this unit were 5 days or longer. In 74 admissions (56.1%) the child was
transferred to a medium care unit in our hospital, the other children to
another PICU unit (22.0%) ,another hospital (13.6%), home (4.5%) or died
(3.8%). In 30 cases (40.5%) an ICU nurse visited the parents and child in
the medium care. Parents appreciated this and many told that the transfer
was quite overwhelming. In 8 cases parents wrote their own hand-over report
primarily explaining the child's daily routines. Conclusions Implementation
of our transfer bundle was far from optimal. However considering the impact
on parents we need to develop new guidelines to guarantee better compliance.
EMTREE MEDICAL INDEX TERMS
child
clinical article
consensus development
controlled study
hospital
human
length of stay
nurse
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L613885470
DOI
10.1007/s00431-016-2785-8
FULL TEXT LINK
http://dx.doi.org/10.1007/s00431-016-2785-8
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 181
TITLE
Pediatric specialty transport teams are not associated with decreased
48-hour pediatric intensive care unit mortality: A propensity analysis of
the VPS, LLC database
AUTHOR NAMES
Meyer M.T.
Mikhailov T.A.
Kuhn E.M.
Collins M.M.
Scanlon M.C.
AUTHOR ADDRESSES
(Meyer M.T., mtmeyer@mcw.edu; Mikhailov T.A.; Scanlon M.C.) Medical College
of Wisconsin, Division of Pediatric Critical Care Medicine, MS 681, 9000
West Wisconsin Avenue, Milwaukee, United States.
(Kuhn E.M.) Children's Hospital of Wisconsin, Milwaukee, United States.
(Collins M.M.) Curative Care Network, Inc, Milwaukee, United States.
CORRESPONDENCE ADDRESS
M.T. Meyer, Medical College of Wisconsin, Division of Pediatric Critical
Care Medicine, MS 681, 9000 West Wisconsin Avenue, Milwaukee, United States.
Email: mtmeyer@mcw.edu
SOURCE
Air Medical Journal (2016) 35:2 (73-78). Date of Publication: 2016
ISSN
1532-6497 (electronic)
1067-991X
BOOK PUBLISHER
Mosby Inc., customerservice@mosby.com
ABSTRACT
Objective The purpose of this study was to determine if pediatric specialty
pediatric team (SPT) interfacility-transported children from community
emergency departments to a pediatric intensive care unit (PICU) have
improved 48-hour mortality. Methods This is a multicenter, historic cohort
analysis of the VPS, LLC PICU clinical database (VPS, LLC, Los Angeles, CA)
for all PICU directly admitted pediatric patients ≤ 18 years of age from
January 1, 2007, to March 31, 2009. Categoric variables were analyzed by the
chi-square and Mann-Whitney tests for non-normally distributed continuous
variables. The propensity score was determined by multiple logistic
regression analysis. Nearest neighbor matching developed emergency medical
services SPT pairs by similar propensity score. Multiple regression analyses
of the matched pairs determined the association of SPT with 48-hour PICU
mortality. P values <.05 were considered significant. Results This study
included 3,795 PICU discharges from 12 hospitals. SPT-transported children
were more severely ill, younger in age, and more likely to have a
respiratory diagnosis (P <.0001). Unadjusted 48-hour PICU mortality was
statistically significantly higher for SPT transports (2.04% vs. 0.070%, P
=.0028). Multiple regressions adjusted for propensity score, illness
severity, and PICU site showed no significant difference in 48-hour PICU
mortality. Conclusion No significant difference in adjusted 48-hour PICU
mortality for children transported by transport team type was discovered.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
intensive care unit
EMTREE MEDICAL INDEX TERMS
article
child
disease severity
female
human
length of stay
major clinical study
male
mortality
patient transport
priority journal
propensity score
race
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160471084
PUI
L610934407
DOI
10.1016/j.amj.2015.12.003
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2015.12.003
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 182
TITLE
A quality improvement project to decrease emergency department and medical
intensive care unit transfer times
AUTHOR NAMES
Cohen R.I.
Kennedy H.
Amitrano B.
Dillon M.
Guigui S.
Kanner A.
AUTHOR ADDRESSES
(Cohen R.I.; Guigui S.) Department of Medicine, The Long Island Jewish
Medical Center, The Hofstra-North Shore LIJ School of Medicine, New Hyde
Park, United States.
(Kennedy H.; Amitrano B.; Dillon M.; Kanner A.) Department of Nursing, The
Long Island Jewish Medical Center, The Hofstra-North Shore LIJ School of
Medicine, New Hyde Park, United States.
CORRESPONDENCE ADDRESS
R.I. Cohen, The Division of Pulmonary, Critical Care and Sleep Medicine, The
North Shore-LIJ Health System, The Hofstra-NSLIJ School of Medicine, New
Hyde Park, United States.
SOURCE
Journal of Critical Care (2015) 30:6 (1331-1337) Article Number: 51895. Date
of Publication: 1 Dec 2015
ISSN
1557-8615 (electronic)
0883-9441
BOOK PUBLISHER
W.B. Saunders
ABSTRACT
Objective: To reduce transfer time of critically ill patients from the
emergency department (ED) to the medical intensive care unit (MICU). Design:
A prospective, observational study assessing preimplementation and
postimplementation of quality improvement interventions in a tertiary
academic medical center. Interventions: A team of frontline health care
professional including ED, MICU, and supporting services using the clinical
microsystems approach mapped out existing practice patterns, determined
causes for delays, and used the Plan-Do-Study-Act to test
changes.Measurements and Main Results. The team identified multiple issues
that contributed to delays. These included poor coordination between
transport services, respiratory therapy, and nursing in transferring
patients from the ED as well delays in identification and transfer of stable
MICU patients. These interventions reduced transfer time from 4.2 (3.4-5.7)
hours to 2.2 (1.4-3.1) hours (median [interquartile range]; P < .001).
Hospital length of stay decreased from 9.9 ± 9 to 8.3 ± 7 days (. P < .03).
Conclusion: A team made up of frontline health care professionals using a
structured quality improvement process and implementing multifaceted,
multistage interventions, reduced transfer delays, and length of stay. Added
benefits included engagement among members of the 2 microsystems and a more
cohesive approach to patient care.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency ward
intensive care unit
patient transport
total quality management
EMTREE MEDICAL INDEX TERMS
article
cooperation
health care personnel
health care quality
human
length of stay
observational study
patient care
patient referral
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2015369103
MEDLINE PMID
26365001 (http://www.ncbi.nlm.nih.gov/pubmed/26365001)
PUI
L605986960
DOI
10.1016/j.jcrc.2015.07.017
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jcrc.2015.07.017
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 183
TITLE
Acute cold and exercise training up-regulate similar aspects of fatty acid
transport and catabolism in house sparrows (Passer domesticus)
AUTHOR NAMES
Zhang Y.
Carter T.
Eyster K.
Swanson D.L.
AUTHOR ADDRESSES
(Zhang Y., yufeng.zhang@usd.edu; Carter T.; Swanson D.L.) Department of
Biology, University of South Dakota, Vermillion, SD 57069, USA
(Eyster K.) Basic Biomedical Sciences, Sanford School of Medicine,
University of South Dakota, Vermillion, SD 57105, USA
SOURCE
The Journal of experimental biology (2015) 218 (3885-3893). Date of
Publication: 1 Dec 2015
ISSN
1477-9145 (electronic)
ABSTRACT
Summit maximum thermoregulatory metabolic rate (Msum) and maximum exercise
metabolic rate (MMR) both increase in response to acute cold or exercise
training in birds. Because lipids are the main fuel supporting both
thermogenesis and exercise in birds, adjustments to lipid transport and
catabolic capacities may support elevated energy demands from cold and
exercise training. To examine a potential mechanistic role for lipid
transport and catabolism in organismal cross-training effects (exercise
effects on both exercise and thermogenesis, and vice versa), we measured
enzyme activities and mRNA and protein expression in pectoralis muscle for
several key steps of lipid transport and catabolism pathways in house
sparrows (Passer domesticus) during acute exercise and cold training. Both
training protocols elevated pectoralis protein levels of fatty acid
translocase (FAT/CD36), cytosolic fatty acid-binding protein, and citrate
synthase (CS) activity. However, mRNA expression of FAT/CD36 and both mRNA
and protein expression of plasma membrane fatty acid-binding protein did not
change for either training group. CS activities in supracoracoideus, leg and
heart, and carnitine palmitoyl transferase (CPT) and β-hydroxyacyl
CoA-dehydrogenase activities in all muscles did not vary significantly with
either training protocol. Both Msum and MMR were significantly positively
correlated with CPT and CS activities. These data suggest that up-regulation
of trans-sarcolemmal and intramyocyte lipid transport capacities and
cellular metabolic intensities, along with previously documented increases
in body and pectoralis muscle masses and pectoralis myostatin (a muscle
growth inhibitor) levels, are common mechanisms underlying the training
effects of both exercise and shivering in birds.
EMTREE DRUG INDEX TERMS
fatty acid
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
physiology
EMTREE MEDICAL INDEX TERMS
adaptation
animal
animal experiment
basal metabolic rate
cardiac muscle
cold
energy metabolism
gene expression
lipid metabolism
metabolism
skeletal muscle
sparrow
thermogenesis
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
26486368 (http://www.ncbi.nlm.nih.gov/pubmed/26486368)
PUI
L616636264
DOI
10.1242/jeb.126128
FULL TEXT LINK
http://dx.doi.org/10.1242/jeb.126128
COPYRIGHT
Copyright 2017 Medline is the source for the citation and abstract of this
record.
RECORD 184
TITLE
A critical analysis of unplanned transfer to the icu within 48 hours of
admission from the ED
AUTHOR NAMES
Dahn C.
Manasco A.
Breaud A.H.
Kim S.
Moin O.
Rumas N.
Baker W.
Feldman J.
AUTHOR ADDRESSES
(Dahn C.; Manasco A.; Breaud A.H.; Kim S.; Moin O.; Rumas N.; Baker W.;
Feldman J.)
CORRESPONDENCE ADDRESS
C. Dahn,
SOURCE
Critical Care Medicine (2015) 43:12 SUPPL. 1 (190-191). Date of Publication:
December 2015
CONFERENCE NAME
45th Critical Care Congress of the Society of Critical Care Medicine, SCCM
2015
CONFERENCE LOCATION
Orlando, FL, United States
CONFERENCE DATE
2016-02-20 to 2016-02-24
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Learning Objectives: Patients who experience unplanned ICU transfer (UIT),
within 48 hr of admission from the Emergency Department (ED), have a higher
mortality and increased LOS than directly admitted ICU patients. The study
purpose was to describe reasons for all UIT, proportion of critical
interventions (CrI) performed within 48 hr, length of stay (LOS) and
mortality. Methods: Single center, retrospective cohort study of ED patients
admitted to a non-ICU bed and had a UIT within 48 hr from 2008 - 2013 at an
urban academic medical center. We excluded those under 18 and those with 'do
not resuscitate' (DNR) and 'do not intubate' (DNI) on admission. Trained
investigators abstracted: demographics, comorbidities, time and reason for
UIT, total LOS, CrI's, and mortality. We used a modified Delphi process to
determine CrI. We calculated descriptive statistics with 95%CI for all
outcomes. Results: A total of 837/512,525 (0.17%) non-ICU admissions from
the ED had a UIT within 48 hr and 86 admitted patients died prior to
transfer. We excluded: 23 DNR/DNI, 117 post-operative transfers, 177 planned
ICU transfers, and 4 with missing data. Of the 516 patients remaining, 65%
(95% CI 61%-69%) received a CrI and transfer reasons included: 33 medical
errors, 90 disease processes not clearly present on arrival, and 393
deterioration of presenting symptoms. In patients who received a CrI, the
mortality rate was 10.5% (95% CI 8%-14%) and mean LOS was 258 hr (95% CI
233-283). Those without a CrI had a mortality rate of 2.8% (95% CI 1%-6%)
and mean LOS was 177 hr (95% CI 157-197). Conclusions: We found UIT (or
death prior to UIT) is a rare event and only 65% of UIT's, or died prior to
UIT, had a CrI. Although UIT is used as a screening tool for quality of
care, this measure does not include patients who die prior to UIT or
differentiate those who do not have a CrI performed from those patients who
have a CrI. Further research should determine whether post-hoc analysis of
UIT affects ED triage practices and the need to prospectively test and
develop validated tools to reduce UIT.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
society
EMTREE MEDICAL INDEX TERMS
cohort analysis
death
Delphi study
deterioration
emergency health service
emergency ward
human
learning
length of stay
medical error
mortality
patient
post hoc analysis
screening
statistics
university hospital
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72102277
DOI
10.1097/01.ccm.0000474585.42889.79
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000474585.42889.79
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 185
TITLE
Postresuscitation Care and Pretransport Stabilization of Newborns Using the
Principles of STABLE Transport
AUTHOR NAMES
Bellini S.
AUTHOR ADDRESSES
(Bellini S.)
SOURCE
Nursing for women's health (2015/2016) 19:6 (533-536). Date of Publication:
1 Dec 2015
ISSN
1751-486X (electronic)
ABSTRACT
The practice of perinatal regionalization is designed to ensure that
newborns are born in facilities with a care level designation that is
consistent with expected pregnancy outcomes. Regionalization practices have
resulted in lower neonatal mortality and morbidity rates. However, despite
regionalization efforts, approximately 10 percent of newborns will require
some level assistance with breathing, and a few (<1 percent) will require
resuscitation in the birthing room. After resuscitation, many of these
newborns require acute transport to a different facility. This column
provides an overview of principles from the STABLE Program, which guides
clinicians in providing postresuscitation care and pretransport
stabilization for compromised newborns.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
education
nursing
organization and management
EMTREE MEDICAL INDEX TERMS
female
human
in service training
male
neonatal intensive care unit
newborn
newborn nursing
patient care
patient transport
prematurity
program evaluation
resuscitation
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
26682660 (http://www.ncbi.nlm.nih.gov/pubmed/26682660)
PUI
L614452005
DOI
10.1111/1751-486X.12248
FULL TEXT LINK
http://dx.doi.org/10.1111/1751-486X.12248
COPYRIGHT
Copyright 2017 Medline is the source for the citation and abstract of this
record.
RECORD 186
TITLE
THE PRINCIPLES OF ORGANIZATION AND TREATMENT FOR SORTING OF WOUNDED PERSONS
WITH A COMBAT SURGICAL TRAUMA OF EXTREMITIES ON THE IV LEVEL OF THE MEDICAL
CARE PROVISION
AUTHOR NAMES
Korohl S.O.
Zherdev I.I.
Domanskiy A.M.
AUTHOR ADDRESSES
(Korohl S.O.; Zherdev I.I.; Domanskiy A.M.)
SOURCE
Klinichna khirurhiia / Ministerstvo okhorony zdorov'ia Ukraïny, Naukove
tovarystvo khirurhiv Ukraïny (2015) :12 (48-50). Date of Publication: 1 Dec
2015
ISSN
0023-2130
ABSTRACT
Experience of medical sorting of 434 injured persons with a gun-shot
woundings of extremities in 2014-2015 yrs is adduced. The principles of
organization and treatment for medical sorting of wounded persons were
elaborated. Prognostic intrahospital, diagnostic and evacuation--transport
sorting was introduced in wounded persons in the IV level hospital,
concerning severity of traumatic shock and prognosis of their survival.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
organization and management
EMTREE MEDICAL INDEX TERMS
emergency health service
gunshot injury (diagnosis, surgery)
human
injuries
injury scale
limb
mortality
pathology
prognosis
survival
traumatic shock (diagnosis, surgery)
LANGUAGE OF ARTICLE
Ukrainian
LANGUAGE OF SUMMARY
English
MEDLINE PMID
27025033 (http://www.ncbi.nlm.nih.gov/pubmed/27025033)
PUI
L609751205
COPYRIGHT
Copyright 2016 Medline is the source for the citation and abstract of this
record.
RECORD 187
TITLE
Response to "Where do we go from here? A small-scale observation of transfer
results from chronic to skilled ventilator facilities"
AUTHOR NAMES
Brandão da Silva N.
AUTHOR ADDRESSES
(Brandão da Silva N., nbrandao@portoweb.com.br) Department of Internal
Medicine, Universidade Federal das Ciências da Saúde de Porto Alegre, Rua Dr
Vale 651 ap 902, Porto Alegre, Brazil.
CORRESPONDENCE ADDRESS
N. Brandão da Silva, Department of Internal Medicine, Universidade Federal
das Ciências da Saúde de Porto Alegre, Rua Dr Vale 651 ap 902, Porto Alegre,
Brazil. Email: nbrandao@portoweb.com.br
SOURCE
Journal of Critical Care (2015) 30:6 (1404) Article Number: 51917. Date of
Publication: 1 Dec 2015
ISSN
1557-8615 (electronic)
0883-9441
BOOK PUBLISHER
W.B. Saunders
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
mechanical ventilator
patient transport
EMTREE MEDICAL INDEX TERMS
artificial ventilation
comorbidity
cost effectiveness analysis
critical illness
disease severity
elderly care
hospitalization
human
intensive care unit
length of stay
letter
outcome assessment
prognosis
quality of life
risk assessment
risk factor
scoring system
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2015396938
MEDLINE PMID
26395923 (http://www.ncbi.nlm.nih.gov/pubmed/26395923)
PUI
L606118275
DOI
10.1016/j.jcrc.2015.08.005
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jcrc.2015.08.005
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 188
TITLE
A pilot study to evaluate the effect of peep during transport to the ICU
following cardiac surgery
AUTHOR NAMES
Dempsey A.
Legault R.
Mehl J.
Steyn J.
Hatton K.
AUTHOR ADDRESSES
(Dempsey A.; Legault R.; Mehl J.; Steyn J.; Hatton K.)
CORRESPONDENCE ADDRESS
A. Dempsey,
SOURCE
Critical Care Medicine (2015) 43:12 SUPPL. 1 (28). Date of Publication:
December 2015
CONFERENCE NAME
45th Critical Care Congress of the Society of Critical Care Medicine, SCCM
2015
CONFERENCE LOCATION
Orlando, FL, United States
CONFERENCE DATE
2016-02-20 to 2016-02-24
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Learning Objectives: We hypothesized that the use of PEEP during transport
from the operating room to the ICU after cardiac surgery will decrease lung
derecruitment. The primary objectives of this pilot study were 1) to assess
the feasibility of performing a randomized controlled trial (RCT) to study
PEEP during transport in this patient population, 2) to assess the impact on
the change in PaO2/Fi02 ratio (P/F) and the time to extubation, and 3) if a
favorable trend was noted, to predict the number of patients that would be
needed to power a future and larger trial. Methods: This was a
single-center, blinded, randomized, controlled pilot study performed in 30
patients. Patients were randomized prior to surgery to one of three groups
to receive 0, 5, or 10 cm H2O of PEEP during transport. All OR and ICU
clinicians were blinded to the PEEP valve setting. Intraoperative,
transport, and postoperative ventilation was standardized according to the
ARDSnet protocol. The delta P/F of each patient was defined as the
difference in P/F immediately before and shortly after transport from the OR
to the ICU, based on ABG results. Results: No patients experienced
significant hemodynamic instability during transport. With the exception of
gender, there were no statistically significant differences in multiple
baseline patient and procedure characteristics. There was a
non-statistically significant trend toward increased mean delta P/F with
PEEP compared to no PEEP. The trend toward increased P/F was greatest with
PEEP=10. In addition, there was also a non-statistically significant trend
toward decreased time to extubation with PEEP compared to no PEEP.
Conclusions: The results of this pilot study demonstrate that the
methodology was feasible for a future RCT to study PEEP during transport in
this population. In addition, we were able to calculate group sample size
for a future trial using a two-tailed sample size calculation. According to
our data, we will need to enroll at least 132 patients in a future study to
detect a statistically significant difference when comparing 0 and 10 cm H2O
of PEEP.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
heart surgery
intensive care
pilot study
society
EMTREE MEDICAL INDEX TERMS
air conditioning
extubation
gender
human
learning
lung
methodology
operating room
patient
population
positive end expiratory pressure
procedures
randomized controlled trial
randomized controlled trial (topic)
sample size
surgery
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72101627
DOI
10.1097/01.ccm.0000473935.75901.6d
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000473935.75901.6d
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 189
TITLE
Predictors of rapid unplanned transfer to the PICU following admission from
the ED
AUTHOR NAMES
McMahon K.
Del Grippo E.
DePiero A.
AUTHOR ADDRESSES
(McMahon K.; Del Grippo E.; DePiero A.)
CORRESPONDENCE ADDRESS
K. McMahon,
SOURCE
Critical Care Medicine (2015) 43:12 SUPPL. 1 (201). Date of Publication:
December 2015
CONFERENCE NAME
45th Critical Care Congress of the Society of Critical Care Medicine, SCCM
2015
CONFERENCE LOCATION
Orlando, FL, United States
CONFERENCE DATE
2016-02-20 to 2016-02-24
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Learning Objectives: Admitting a patient from the emergency department (ED)
to a general unit who then quickly requires transfer to an ICU generates
stress and safety concerns. Our study sought to identify predictors at the
time of admission of patients likely to require rapid transfer. We evaluated
vital signs, Pediatric Early Warning Scores (PEWS), ED length of stay, time
from last ED vitals to admission and degree of respiratory support at
admission. Methods: We retrospectively reviewed patients requiring transfer
to the ICU within 10 hr of admission from the ED at a pediatric tertiary
care center from 3/09 to 10/13. These 73 case patients were then matched by
age and diagnosis with 73 control patients who never required ICU admission.
PEWS and vital signs were compared prior to ED departure, on admission to
the floor and, for cases, at time of ICU transfer. ED lengths of stay,
respiratory support and timing of last vitals were also recorded. Results:
The ED PEWS for case patients were higher than those for controls (median 2
vs 0, p=0.03). PEWS on admission remained higher for cases (median 3 vs 1).
At ICU transfer, PEWS for cases increased to a median of 4. No significant
differences in ED or admission vital signs were found between groups. ED
length of stay was slightly shorter for cases than controls (p=0.05), but
time from last set of vitals to admission did not differ. Case patients were
more likely to require high flow oxygen at admission. Conclusions: Patients
requiring ICU transfer within hr of admission had higher PEWS than control
patients at all time points, and PEWS increased from the ED to admission and
time of ICU transfer, but remained only a median of 4. We did not identify
any specific vital sign predictors, but case patients were more likely to
require high flow oxygen at admission emphasizing that respiratory distress
was the most likely reason for transfer. Shorter ED length of stay was noted
for case patients demonstrating that perhaps longer observation would help
determine disposition. Patient disposition remains a challenge with clinical
judgement paramount.
EMTREE DRUG INDEX TERMS
oxygen
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
society
EMTREE MEDICAL INDEX TERMS
assisted ventilation
decision making
diagnosis
emergency ward
human
learning
length of stay
patient
respiratory distress
safety
tertiary care center
vital sign
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72102318
DOI
10.1097/01.ccm.0000474626.02093.a3
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000474626.02093.a3
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 190
TITLE
Time out for sign out: Improved transfer of care from the operating room to
the ICU
AUTHOR NAMES
Prasad A.
Cios T.
Dziedzina C.
Staub-Juergens W.
Prasad S.R.
Singbartl K.
AUTHOR ADDRESSES
(Prasad A.; Cios T.; Dziedzina C.; Staub-Juergens W.; Prasad S.R.; Singbartl
K.)
CORRESPONDENCE ADDRESS
A. Prasad,
SOURCE
Critical Care Medicine (2015) 43:12 SUPPL. 1 (212). Date of Publication:
December 2015
CONFERENCE NAME
45th Critical Care Congress of the Society of Critical Care Medicine, SCCM
2015
CONFERENCE LOCATION
Orlando, FL, United States
CONFERENCE DATE
2016-02-20 to 2016-02-24
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Learning Objectives: Healthcare professionals strive to provide safe care,
yet an estimated 98,000 Americans die each year due to errors. Error rates
as high as 37% in ICUs occur during exchanges between nurses and physicians.
A quality project was initiated to improve the hand-off process from the OR
team to the ICU team following cardiac operating room (OR) cases. Methods:
The OR and ICU teams identified key components of a hand-off process. As a
result “Time Out for Sign Out” was created. Phase 1-planning- the OR nurse
calls the ICU when the patient is off bypass and when sternal wires are
being inserted. Phase 2- gathering- the OR nurse calls the ICU nurse when
the patient is being transferred to the ICU bed to prepare for arrival.
Phase 3-handoff- is our structured sign-out process from the OR team to the
ICU team and the transferring of care. The process was trialed for 3 mo. A
pre and post survey was collected using a Likert scale of 1-7 to assess the
perception of the new hand-off process. The questions assessed quality of
information, comfort and environment, efficiency, and the overall relevance.
Results: In all 4 areas, significant improvements were seen with the new,
standardized process. The new sign-out process rating increased from 4.2 ±
1.6 to 5.7 ± 0.9 (p=0.004) for information, from 3.8 ± 1.8 to 5.9 ± 0.7
(p<0.001) for comfort, from 3.8 ± 1.8 to 5.6 ± 1.1 (p<0.0001) for
efficiency, and from 3.9 ± 1.9 to 6.0 ± 0.9 (p=0.0001) for relevance. Linear
regression analysis demonstrated nurses with less than 4 yr of experience
felt that the non-standardized process needed improvement compared to nurses
with 5+ yr (1-2 year, p=0.003; 2-3 yr p=0.029; 3-4 yr p=0.015). Conclusions:
A standardized signout process significantly improved satisfaction with the
transfer of information given from the OR team to the ICU team. Initial
apprehension by experienced anesthesia providers was observed, but younger
ICU staff prefer a standardized sign-out. This new structured process holds
promise for a better handoff of patient care with improved communication
between OR and ICU providers.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
operating room
society
EMTREE MEDICAL INDEX TERMS
American
anesthesia
comfort
environment
health care personnel
human
interpersonal communication
learning
Likert scale
linear regression analysis
nurse
patient
patient care
physician
planning
satisfaction
sternal wire
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72102363
DOI
10.1097/01.ccm.0000474671.23178.65
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000474671.23178.65
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 191
TITLE
Outcomes of patients transferred to respiratory care unit (RCU) on
tracheotomy ventilation: A 4 year experience
AUTHOR NAMES
Nisar S.
Baluwala A.
Elliott M.W.
Ghosh D.
AUTHOR ADDRESSES
(Nisar S.; Baluwala A.; Elliott M.W.; Ghosh D.) St. James University
Hospital, Leeds, United Kingdom.
CORRESPONDENCE ADDRESS
S. Nisar, St. James University Hospital, Leeds, United Kingdom.
SOURCE
Thorax (2015) 70 SUPPL. 3 (A96). Date of Publication: December 2015
CONFERENCE NAME
British Thoracic Society Winter Meeting 2015
CONFERENCE LOCATION
London, United Kingdom
CONFERENCE DATE
2015-12-02 to 2015-12-04
ISSN
0040-6376
BOOK PUBLISHER
BMJ Publishing Group
ABSTRACT
Background RCU in Leeds admits patients who had tracheostomy in ICU as part
of acute admission and are slow to wean from ventilation. We looked at the
long-term outcomes of attempted weaning from ventilator support in terms of
survival and level of support at discharge. We also looked at length of stay
(LOS), underlying diagnosis and comorbidities. Methods Thirty one patients
admitted to RCU as a step-down from ICU between October 2011 and July 2014
were included. Patients were identified using database and data was
collected from electronic records and inpatient notes. Patients were
excluded if they had tracheostomy inserted on a previous admission. Results
The demographics, length of stay on RCU and primary diagnosis leading to
respiratory failure and intubation are described in Table 1. All except one
patient had significant other comorbidities including muscular dystrophies,
MND, COPD, IHD, etc. The average number of days spent in ICU after
tracheostomy prior to step-down was 19+/-15. Eight (26%) patients died in
hospital. Seventeen patients (55%) were discharged without any ventilatory
support after decanulation, 3 required overnight NIV and 3 were discharged
with tracheostomy ventilation. At 12 months post-discharge 16 (52%) patients
were dead; 11 (35%) were not on any ventilatory support; 3 were continuing
to be ventilated via tracheostomy, 1 remained on NIV. Discussion and
conclusion Patients coming for weaning from trachy-ventilation represent a
complex group with diverse aetiology and have multiple comorbidities. Their
stay in a high dependency area is unpredictable and the LOS varies
considerably. While a third of patients remained successfully weaned at one
year they carry a high in-hospital and 1 year mortality. LOS is influenced
by the complexity of discharge planning often including patients from
outside our catchment area. Our RCU like many others are not staffed to look
after more than 2 trachy-ventilated patients at any one time which combined
with prolonged stay slows down patient flow form ICU. This highlights the
need for dedicated units for weaning with a team that is able to look after
complex needs in hospital and coordinate complex discharges. (Table
Presented).
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air conditioning
human
intensive care unit
patient
society
tracheotomy
winter
EMTREE MEDICAL INDEX TERMS
catchment
data base
diagnosis
etiology
hospital
hospital discharge
hospital patient
intubation
length of stay
mortality
muscular dystrophy
respiratory failure
survival
tracheostomy
ventilated patient
ventilator
weaning
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72199623
DOI
10.1136/thoraxjnl-2015-207770.178
FULL TEXT LINK
http://dx.doi.org/10.1136/thoraxjnl-2015-207770.178
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 192
TITLE
Shock index as a predictor of icu transfer in patients admitted to the
medical ward with sepsis
AUTHOR NAMES
Biney I.
Amin R.
Mehari A.
AUTHOR ADDRESSES
(Biney I.; Amin R.; Mehari A.)
CORRESPONDENCE ADDRESS
I. Biney,
SOURCE
Critical Care Medicine (2015) 43:12 SUPPL. 1 (262-263). Date of Publication:
December 2015
CONFERENCE NAME
45th Critical Care Congress of the Society of Critical Care Medicine, SCCM
2015
CONFERENCE LOCATION
Orlando, FL, United States
CONFERENCE DATE
2016-02-20 to 2016-02-24
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Learning Objectives: Sepsis constitutes a significant health care burden in
the United States. A significant number of patients with sepsis are admitted
to a non-Intensive care unit (ICU) setting. Delayed ICU consults and
transfers have been associated with adverse events when critically ill
patients are not promptly identified. The Shock Index (SI) has been shown to
predict disease escalation in patients presenting to the emergency room with
sepsis. The purpose of this study was to determine whether the SI can be
used to help identify patients admitted to the medical ward who might
require a higher level of care. Methods: This was a retrospective study of
patients admitted to the medical ward with sepsis between April 2013 and
December 2014. The shock index was calculated for each set of vitals
recorded from time of admission till ICU transfer or hospital discharge
using a 7 day cut-off. A sustained SI elevation (SSIE) was defined as an SI
of 0.8 or more for at least 50% of the time. Results: A total of 206
patients were identified with 50.5% being male and 87% being African
American. The mean age was 56.4 ± 15.8. Sixty-eight (32.8%) patients had a
SSIE and there were 44 ICU transfers. For the ICU transfers, the average
length of stay on the floor was 3.8 days. Hospital mortality was 4.8%. The
rate of ICU transfer was higher in patients with a SSIE compared to patients
without a SSIE (47.8% vs 8.0%; p<0.001). A SSIE was also associated with
rapid response activation (19.1% vs 2.2%; p<0.001) and hyperlactatemia
(38.2% vs 21.1%; p=0.031). Patients with a SSIE had a higher mean number of
organ failures (2.97 ± 2.4 vs 1.65 ± 1.6; p<0.001), hospital length of stay
(13.6 ± 11.2 vs 8.6 ± 6.35, p<0.001) and had a higher mortality (10.1% vs
2.1%, p=0.012) compared to patients without a SSIE. Conclusions: A SSIE was
associated with higher rates of ICU transfers and worse patient outcomes.
The SI is a simple measure that may help identify patients with sepsis in a
non-ICU setting at risk of deterioration and guide clinicians to institute
early aggressive interventions when necessary.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
human
intensive care
patient
sepsis
shock
society
ward
EMTREE MEDICAL INDEX TERMS
African American
critically ill patient
deterioration
emergency ward
health care
hospital
hospital discharge
hyperlactatemia
intensive care unit
learning
length of stay
male
mortality
retrospective study
risk
United States
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72102563
DOI
10.1097/01.ccm.0000474874.57925.3e
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000474874.57925.3e
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 193
TITLE
Unplanned ICU Transfers from Inpatient Units: Examining the Prevalence and
Preventability of Adverse Events Associated with ICU Transfer in Pediatrics
AUTHOR NAMES
Miles A.H.
Spaeder M.C.
Stockwell D.C.
AUTHOR ADDRESSES
(Miles A.H., amiles8@jhmi.edu) Division of Pediatric Anesthesiology and
Critical Care Medicine, Johns Hopkins Hospital, Baltimore, United States.
(Spaeder M.C.; Stockwell D.C.) Division of Critical Care Medicine,
Children's National Health System, Washington, United States.
CORRESPONDENCE ADDRESS
A.H. Miles, Division of Pediatric Anesthesiology and Critical Care Medicine,
Johns Hopkins Hospital, Bloomberg Children's Center, 1800 Orleans Street
Suite 6321, Baltimore, United States. Email: amiles8@jhmi.edu
SOURCE
Journal of Pediatric Intensive Care (2015) 5:1 (21-27). Date of Publication:
30 Nov 2015
ISSN
2146-4626 (electronic)
2146-4618
BOOK PUBLISHER
Georg Thieme Verlag, kunden.service@thieme.de
ABSTRACT
Background: Adverse events have been associated with unplanned intensive
care unit (ICU) transfers in adults. Objective: To examine trends in
unplanned ICU transfers in pediatrics resulting from adverse events. Design,
Setting, Patients: Retrospective observational study of pediatric and
cardiac ICU transfers from acute care units during a 2-year period in a
tertiary care children's hospital. Methods: Transfers were identified via
electronic health record query and investigated for adverse events.
Predefined adverse events included ICU transfers within 12 hours of
admission to an acute care unit, readmissions to an ICU within 24 hours, and
cardiopulmonary arrest on an acute care unit. Other adverse events examined
were not predefined. Adverse events were evaluated for preventability and
categorized by type, diagnosis, time of day and weekday versus weekend
occurrence, and level of associated patient harm. Results: There were 1,008
ICU transfers during the study period; 67% were unplanned. Of the unplanned
transfers, 32% were attributed to adverse events, 35% of which were
preventable. Unplanned transfers associated with a high rate of preventable
adverse events included readmission to an ICU within 24 hours (58%, p =
0.002) and ICU transfer within 12 hours of acute care admission (34%).
Conclusions: We observed a high rate of preventable adverse events
associated with unplanned pediatric ICU transfers, many of which were due to
inappropriate triage. Readmission to an ICU within 24 hours of transfer to
an acute care unit was significantly associated with preventability.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency ward
patient harm
patient transport
pediatric intensive care unit
pediatric ward
EMTREE MEDICAL INDEX TERMS
adolescent
article
cardiopulmonary arrest
child
coronary care unit
electronic health record
emergency care
female
hospital patient
hospital readmission
human
infant
major clinical study
male
observational study
preschool child
priority journal
retrospective study
school child
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160942013
PUI
L613851679
DOI
10.1055/s-0035-1568150
FULL TEXT LINK
http://dx.doi.org/10.1055/s-0035-1568150
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 194
TITLE
Direct transfer of long-stay ICU patients to a nursing-home rehabilitation
unit: focus on functional dependency
AUTHOR NAMES
Vossenberg-Postma S.R.
Sikkema Y.T.
Drogt-Bilaseschi I.
Bruins-Lange N.A.
de Jager C.M.
van Maaren T.
van der Pol V.
Boerma E.C.
AUTHOR ADDRESSES
(Vossenberg-Postma S.R.; van Maaren T.; van der Pol V.) Elderly Care
Medicine, Zorggroep Noorderbreedte, Leeuwarden, Netherlands.
(Sikkema Y.T.) Department of Emergency Medicine, Medical Centre Leeuwarden,
Leeuwarden, Netherlands.
(Drogt-Bilaseschi I.; Bruins-Lange N.A.; de Jager C.M.; Boerma E.C.,
e.boerma@chello.nl) Department of Intensive Care, Medical Centre Leeuwarden,
P.O. Box 888, Leeuwarden, Netherlands.
CORRESPONDENCE ADDRESS
E.C. Boerma, Department of Intensive Care, Medical Centre Leeuwarden, P.O.
Box 888, Leeuwarden, Netherlands. Email: e.boerma@chello.nl
SOURCE
Intensive Care Medicine (2015) 41:11 (2031-2032). Date of Publication: 29
Nov 2015
ISSN
1432-1238 (electronic)
0342-4642
BOOK PUBLISHER
Springer Verlag, service@springer.de
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
length of stay
nursing home
patient transport
rehabilitation center
EMTREE MEDICAL INDEX TERMS
disability
hospital patient
hospital readmission
hospitalization
human
letter
ward
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2015326812
MEDLINE PMID
26306720 (http://www.ncbi.nlm.nih.gov/pubmed/26306720)
PUI
L605775189
DOI
10.1007/s00134-015-4029-1
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-015-4029-1
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 195
TITLE
Critical Care Transport: How Do We Measure Up?
AUTHOR NAMES
Oberender F.
AUTHOR ADDRESSES
(Oberender F.) Paediatric Intensive Care, Royal Children's Hospital and
Monash Medical Centre, Melbourne, Australia.
CORRESPONDENCE ADDRESS
F. Oberender, Paediatric Intensive Care, Royal Children's Hospital and
Monash Medical Centre, Melbourne, Australia.
SOURCE
Pediatric Critical Care Medicine (2015) 16:8 (775-776). Date of Publication:
11 Nov 2015
ISSN
1947-3893 (electronic)
1529-7535
BOOK PUBLISHER
Lippincott Williams and Wilkins, kathiest.clai@apta.org
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
anesthesiology
clinical decision making
critically ill patient
editorial
emergency medicine
endotracheal intubation
funding
health care personnel management
health care policy
health care quality
human
medical education
mortality
newborn intensive care
priority journal
resuscitation
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2015425144
MEDLINE PMID
26427809 (http://www.ncbi.nlm.nih.gov/pubmed/26427809)
PUI
L606281509
DOI
10.1097/PCC.0000000000000478
FULL TEXT LINK
http://dx.doi.org/10.1097/PCC.0000000000000478
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 196
TITLE
Parental presence at cardiac intensive care unit bedside transfer rounds
reduces parental anxiety: Results of a randomized controlled trial
AUTHOR NAMES
Anand V.
Williams E.
Elgendi M.
Meakins L.
Cunningham C.
McCrady H.
Tawfiq G.
Devlin N.
Shine K.
Larsen B.
Rebeyka I.
Adatia I.
AUTHOR ADDRESSES
(Anand V.; Williams E.; Shine K.; Larsen B.; Adatia I.) Pediatrics, Univ of
Alberta, Edmonton, Canada.
(Elgendi M.) Computer Sciences, Univ of Alberta, Edmonton, Canada.
(Meakins L.; Cunningham C.; McCrady H.; Devlin N.) Pediatrics, Stollery
Children's Hosp, Edmonton, Canada.
(Tawfiq G.) Pharmacy, Stollery Children's Hosp, Edmonton, Canada.
(Rebeyka I.) Cardiac Surgery, Univ of Alberta, Edmonton, Canada.
CORRESPONDENCE ADDRESS
V. Anand, Pediatrics, Univ of Alberta, Edmonton, Canada.
SOURCE
Circulation (2015) 132 SUPPL. 3. Date of Publication: 10 Nov 2015
CONFERENCE NAME
American Heart Association's 2015 Scientific Sessions and Resuscitation
Science Symposium
CONFERENCE LOCATION
Orlando, FL, United States
CONFERENCE DATE
2015-11-07 to 2015-11-11
ISSN
0009-7322
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: The transfer of children from the pediatric cardiac intensive
care unit (PCICU) to the ward is a time of great anxiety for the parents of
children and medical vulnerability for children who are receiving complex
therapies. Hypothesis: We assessed the hypothesis that parental presence at
bedside transfer rounds would reduce parental anxiety and improve patient
safety following transfer of children from PCICU to the ward. Methods: We
undertook a randomized controlled trial of children discharged from the
PCICU to the ward. Consenting parents were randomized to be absent (control
group) or present (intervention group) at multidisciplinary face to face
bedside transfer rounds. The primary outcome measure was parental stress
measured by the validated Spielberger's State -Trait Anxiety Inventory
(STAI) pre and post transfer. Secondary outcome measures included unplanned
readmission to the PCICU, medication errors and emergency calls to the ward.
We excluded patients being transferred between intensive care units.
Results: We enrolled 230 subjects (control group n=93, intervention group
n=91, failed to complete study n= 46). The 2 groups were matched with
respect to gender (male 46% control vs 54% intervention), age (median age
control 1.9 yrs (range 0.02 to 16.3) vs intervention 0.9 (0.02 to 17),
parental age 32 yrs (18-64) vs 33 (20-60), parental years of schooling 15.5
years ( 7-26) vs 15 (9-24), presence of medical co-morbidities (33% each
group). There was significantly greater reduction in trait (p=0.004, state
(p=0.01) and total anxiety (p=0.0012) pre and post transfer in the
intervention group vs the control group. There were no differences in minor
medication errors (36 vs 33), unplanned PCICU re-admissions (11 vs 12) and
emergency ward calls(7 vs 8) Conclusions: Parental presence at face to face
multidisciplinary transfer rounds from the PCICU is associated with reduced
parental anxiety without change in medication errors, readmission rates or
emergency calls to the ward. Reduced parental anxiety may improve parental
satisfaction with their child's care.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
anxiety
human
intensive care
intensive care unit
medical society
patient care
pediatric cardiology
randomized controlled trial
resuscitation
EMTREE MEDICAL INDEX TERMS
child
child care
control group
emergency
emergency ward
gender
hospital readmission
hypothesis
male
medication error
morbidity
parent
parental age
parental stress
patient
patient safety
satisfaction
school
State Trait Anxiety Inventory
therapy
ward
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72181275
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 197
TITLE
Risk of mishaps during intrahospital transport of critically ill patients
ORIGINAL (NON-ENGLISH) TITLE
Risque d’incidents lors des transports intra hospitaliers des patients de
réanimation
AUTHOR NAMES
Hajjej Z.
Gharsallah H.
Boussaidi I.
Daiki M.
Labbene I.
Ferjani M.
AUTHOR ADDRESSES
(Hajjej Z.; Gharsallah H.; Boussaidi I.; Daiki M.; Labbene I.; Ferjani M.)
Department of Critical Care Medicine and Anesthesiology Military Hospital of
Tunis, Université Tunis Elmana, Tunisia.
SOURCE
Tunisie Medicale (2015) 93:11 (708-713). Date of Publication: 1 Nov 2015
ISSN
0041-4131
BOOK PUBLISHER
Maison du Medicine, tunisie.medicale@planet.tn
ABSTRACT
Background: Mishaps are common during transport and may havemajor impacts on
patients.Aims: The main objectives of our study are: first to determine
theincidence of complications during intra hospital transports (IHT)
ofcritically ill patients, and second, to determine their risk
factors.Methods: All intra hospital transports for diagnostic and
therapeuticpurposes of patients consecutively admitted in an 18-bed
medicalsurgical intensive care unit in an university hospital, have
beenstudied prospectively during a period of six months (September 1st2012
to February 28th 2013).Results: Of 184 transports observed (164 patients),
85 (462%) wereassociated with mishaps. Eighty two mishaps were
patient-related(445%).Oxygen desaturation (30 cases), agitation (24 cases)
andhemodynamic instability (15 cases) were predominantly. One case ofcardiac
arrest and 3 cases of accidental extubation were occurredduring IHT. Seventy
three systems-based mishaps were noted(396%). Emergency transports,
mechanical ventilation and positiveend-expiratory pressure (PEEP) ≥ 6 cmH2O
were independent riskfactors for a higher rate of mishaps. In our study,
complications did notstatistically increase ventilator-associated
pneumonia.Conclusion: This study confirms that IHT of critically-ill
patients stillinvolves considerable risks and mishaps incidence remains
high.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
accident
patient transport
EMTREE MEDICAL INDEX TERMS
agitation
article
artificial ventilation
critically ill patient
heart arrest
human
intensive care unit
major clinical study
oxygen desaturation
positive end expiratory pressure
risk factor
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English, French
EMBASE ACCESSION NUMBER
20160055263
PUI
L607813574
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 198
TITLE
A retrospective review of the transfer of critically ill children to
tertiary care in KwaZulu-Natal, South Africa
AUTHOR NAMES
Royal C.
McKerrow N.H.
AUTHOR ADDRESSES
(Royal C., candiceroyal@gmail.com; McKerrow N.H.) Department of Paediatrics
and Child Health, Nelson R Mandela School of Medicine, University of
KwaZulu-Natal, Durban, South Africa.
(McKerrow N.H.) Department of Health, KwaZulu-Natal, South Africa.
CORRESPONDENCE ADDRESS
C. Royal, Department of Paediatrics and Child Health, Nelson R Mandela
School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
Email: candiceroyal@gmail.com
SOURCE
SAJCH South African Journal of Child Health (2015) 9:4 (112-118). Date of
Publication: 1 Nov 2015
ISSN
1994-3032
BOOK PUBLISHER
Health and Medical Publishing Group
ABSTRACT
Background. Obtaining care for an acutely ill child in specialised
paediatric services relies on referral from lower-level facilities. In South
Africa, it is common practice for acutely ill children to be transported far
distances by non-specialist teams with limited equipment, knowledge and
skills. Objectives. To describe the transfer of these children and to
determine whether they deteriorate from the time of referral to the time of
arrival at a tertiary centre. Furthermore, we sought to identify modifiable
factors that might improve outcomes during resuscitation and transfer.
Methods. The study was a retrospective review of emergency referrals of
children aged 1 month - 12 years to Grey’s Hospital paediatric ward or
paediatric intensive care unit (PICU), from lower-level facilities in
KwaZulu-Natal between January and June 2012. In conjunction with an
assessment by the receiving clinician at Grey’s Hospital, Triage Early
Warning Signs (TEWS) scores were obtained during telephonic referral and
compared with the TEWS score on arrival in order to determine if a
deterioration had occurred. Results. A total of 57 PICU referrals and 79
ward referrals were analysed. The mortality rate prior to transportation was
8.8%. Mean transfer distance was 131 km and mean transfer time 9 hours.
Advanced life support teams undertook transportation in 76.7% of PICU and
25% of ward transfers and few adverse events were reported in transfer logs.
However, 31.5% of PICU and 11.3% of ward referrals required immediate
resuscitation on arrival. When the TEWS scoring system was applied 78.5% of
PICU and 30.4% of ward referrals fell into the ‘very urgent’ and ‘emergency’
categories. Conclusion. Pretransport and in-transit care failed to stabilise
children and this may reflect lack of skill of attending healthcare workers,
transport delays or illness progression. Interventions to improve
resuscitation and transfer are needed, and the use of retrieval teams should
be investigated.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
patient referral
tertiary health care
EMTREE MEDICAL INDEX TERMS
age distribution
article
controlled study
diarrhea
female
gastrointestinal disease
human
infant
intensive care unit
major clinical study
male
mortality
neurologic disease
patient transport
pediatric advanced life support
pneumonia
resuscitation
retrospective study
scoring system
seizure
South Africa
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2015517690
MEDLINE PMID
25796080 (http://www.ncbi.nlm.nih.gov/pubmed/25796080)
PUI
L606936610
DOI
10.7196/SAJCH.2015.v9i4.913
FULL TEXT LINK
http://dx.doi.org/10.7196/SAJCH.2015.v9i4.913
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 199
TITLE
Risk factors for postoperative respiratory failure necessitating transfer to
the intensive care unit in orthopedic surgery patients
AUTHOR NAMES
Melamed R.
Boland L.
Normington J.
Prenevost R.
Hur L.
Maynard L.
McNaughton M.
Huguelet J.
AUTHOR ADDRESSES
(Melamed R.; Boland L.; Normington J.; Prenevost R.; Hur L.; Maynard L.;
McNaughton M.; Huguelet J.) Allina Health, Minneapolis, United States.
CORRESPONDENCE ADDRESS
R. Melamed, Allina Health, Minneapolis, United States.
SOURCE
Chest (2015) 148:4 MEETING ABSTRACT. Date of Publication: October 2015
CONFERENCE NAME
CHEST 2015
CONFERENCE LOCATION
Montreal, QC, Canada
CONFERENCE DATE
2015-10-24 to 2015-10-28
ISSN
0012-3692
BOOK PUBLISHER
American College of Chest Physicians
ABSTRACT
Purpose: To describe patient characteristics, care factors, and outcomes in
orthopedic surgery patients who developed postoperative respiratory failure
(RF) requiring transfer to the intensive care unit (ICU) and in control
patients who did not develop this complication. Methods: A retrospective
frequency-matched case control study was conducted among orthopedic surgery
patients treated at a single tertiary care facility between 2010 and 2013.
Cases were all patients who underwent elective or semi-elective orthopedic
surgery (knee, hip, shoulder, or spine) and developed postoperative RF
necessitating transfer to the ICU (n=51). Controls (n=153) were randomly
selected from among similar orthopedic surgery patients and frequency
matched to cases by gender, age, and surgical procedure. Patient and care
factors, length of stay, mortality, and cost of care were examined in the
two groups. Results: The mean age of patients was 66 years, 65% were female,
and the majority underwent knee (37%) or non-cervical spine (41%)
procedures. Transfer to the ICU occurred within 48 hours of surgery in 73%
of the cases, and 9 (18%) required mechanical ventilation. Body-mass index
was similar in cases and controls, but cases had a higher prevalence of
chronic obstructive pulmonary disease (COPD; 22% vs 3%, p<0.0001) and
obstructive sleep apnea (OSA; 35% vs 11%, p<0.001) than controls.
Postoperatively, cases were more likely to have received patient-controlled
analgesia (PCA; 51% vs 31%, p=0.01) and had more intravenous morphine
equivalents during the first 24 postoperative hours than controls (median
110 mg vs 73 mg, p=0.006). Cases had longer hospitalizations (9 days versus
3 days) and higher in-hospital mortality (6% vs 0%) than controls. The
average cost of hospitalization was significantly higher in cases ($46,456)
than controls Conclusions: Acute RF after elective orthopedic surgery is a
highly significant complication associated with extended hospitalization,
increased mortality and higher cost of care. Risk factors may include
preexisting COPD and OSA, use of PCA, and larger doses of opioid analgesics
in the initial 24-hr postoperative period. Clinical Implications:
Development of hospital protocols that include risk factor assessment as
well as enhanced monitoring and a cautious approach to opioid use in
patients deemed high-risk may reduce the frequency and cost of this
complication.
EMTREE DRUG INDEX TERMS
morphine
narcotic analgesic agent
opiate
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
human
intensive care unit
orthopedic surgery
respiratory failure
risk factor
surgical patient
EMTREE MEDICAL INDEX TERMS
artificial ventilation
body mass
case control study
cervical spine
chronic obstructive lung disease
female
gender
hip
hospital
hospitalization
knee
length of stay
monitoring
mortality
patient
patient controlled analgesia
postoperative period
prevalence
procedures
risk
shoulder
sleep disordered breathing
spine
surgery
surgical technique
tertiary care center
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72120199
DOI
10.1378/chest.2228884
FULL TEXT LINK
http://dx.doi.org/10.1378/chest.2228884
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 200
TITLE
Measuring intangibles: Defining predictors of non-technical skills in
critical care Air transport team trainees
AUTHOR NAMES
Jernigan P.L.
Wallace M.C.
Novak C.
Gerlach T.
Pritts T.A.
Davis B.R.
AUTHOR ADDRESSES
(Jernigan P.L.; Wallace M.C.; Novak C.; Gerlach T.; Pritts T.A.; Davis B.R.)
University of Cincinnati, Cincinnati, OH; University of Cincinnati Institute
of Military Medicine, Cincinnati, OH
CORRESPONDENCE ADDRESS
P.L. Jernigan,
SOURCE
Journal of the American College of Surgeons (2015) 221:4 SUPPL. 1 (S53).
Date of Publication: October 2015
CONFERENCE NAME
101st Annual Clinical Congress of the American College of Surgeons
CONFERENCE LOCATION
Chicago, IL, United States
CONFERENCE DATE
2015-10-04 to 2015-10-08
ISSN
1072-7515
BOOK PUBLISHER
Elsevier Inc.
ABSTRACT
INTRODUCTION: Critical Care Air Transport Teams (CCATTs) are an essential
component of the United States Air Force aeromedical evacuation paradigm.
Previous work by our group demonstrated that task saturation frequently
occurs in simulated CCATT training missions and is associated with worse
performance in non-technical skills. This study was conducted to evaluate
predictors of performance in non-technical skills. METHODS: Sixteen CCATTs
were assessed during simulated training missions. Biographical data were
gathered from participant surveys. Teams were assessed during critical
events to determine the presence or absence of task saturation.
Non-technical skills were scored using a validated tool assessing 8 domains
of performance. Cortisol levels were measured at baseline and pre- and
post-simulation. RESULTS: A total of 69 crisis events were identified, and
task saturation was observed in 42% of these events. There was an inverse
correlation between team performance score and task saturation during the
simulations (odds ratio 0.5, 95% CI, 0.32-0.80, p<0.01). In a multivariate
analysis, daily ICU experience (p<0.03) and previous deployment experience
(p<0.04) correlated with higher performance scores; previous participation
in the training course and in simulated missions did not. Average
pre-simulation cortisol levels increased significantly from baseline
(p=0.0002), suggesting appropriate suspension of disbelief during
simulations. Of note, cortisol levels did not correlate with performance
scores or biographical data. CONCLUSIONS: Task saturation is associated with
worse performance in non-technical skills. Previous real world experience
correlates with better non-technical skills, while simulated experience does
not. Further studies are needed to develop more effective strategies for
training non-technical skills.
EMTREE DRUG INDEX TERMS
hydrocortisone
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
American
college
human
intensive care
skill
student
surgeon
EMTREE MEDICAL INDEX TERMS
air force
multivariate analysis
risk
simulation
training
United States
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72170094
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 201
TITLE
Clinical consideration of surveillance cultures for out-born neonates
transferred to NICU
AUTHOR NAMES
Lee S.
Cho H.J.
AUTHOR ADDRESSES
(Lee S.; Cho H.J.) Wonkwang University, School of Medicine and Hospital,
Iksan (Neonatal Intensive Care Center), South Korea.
CORRESPONDENCE ADDRESS
S. Lee, Wonkwang University, School of Medicine and Hospital, Iksan
(Neonatal Intensive Care Center), South Korea.
SOURCE
Journal of Perinatal Medicine (2015) 43 SUPPL. 1. Date of Publication:
October 2015
CONFERENCE NAME
12th World Congress of Perinatal Medicine 2015
CONFERENCE LOCATION
Madrid, Spain
CONFERENCE DATE
2015-11-03 to 2015-11-06
ISSN
0300-5577
BOOK PUBLISHER
Walter de Gruyter GmbH
ABSTRACT
Objective: To identify trends in bacterial organisms and antimicrobial
susceptibilities for transmission by out-born neonates, it is important to
perform surveillance cultures. The aim of this study was to investigate
major organisms and any other clinical factors through surveillance cultures
of out-born neonates who transferred to NICU. Methods: This study is a
retrospective collected data among 189 out-born neonates admitted to NICU
from Mar. 1, 2012, to Feb. 31, 2014. Surveillance cultures were obtained
routinely from both nasal and axillary region and inoculated CHROM agar™
MRSA immediately. Bacterial culture identification and antibiotic
susceptibility were using Vitek II ID-GPI card. Results: The most prevalent
organisms isolated from the nasal surveillance cultures were MRSA and CoNS
(each 17 cases vs. 11 cases); both vancomycin and rifampin were susceptible.
Only 1 case of S. epidermidis has same result in blood and surveillance
culture. Demographic, clinical and healthcare related parameters according
to surveillance culture results were compared, but no obvious association
was apparent on above parameters. Nevertheless, positive surveillance
culture group showed lower birth weight and longer duration until
transferred to NICU. Conclusion: In our surveillance culture study showed
that MRSA and CoNS were the most common organisms in out-born neonates; both
were penicillin & oxacillin resistant on antibiotic susceptibility testing.
Although there is no statistical meaning, positive surveillance culture
group showed relatively lower birth weight and longer duration from birth to
NICU arrival. These findings contributed to obtain a reliable policy of the
transmission in NICU.
EMTREE DRUG INDEX TERMS
agar
oxacillin
penicillin derivative
rifampicin
vancomycin
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
newborn
perinatal care
EMTREE MEDICAL INDEX TERMS
antibiotic sensitivity
bacterium culture
birth weight
blood
health care
methicillin resistant Staphylococcus aureus
parameters
policy
Staphylococcus epidermidis
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72185360
DOI
10.1515/jpm-2015-2003
FULL TEXT LINK
http://dx.doi.org/10.1515/jpm-2015-2003
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 202
TITLE
Clinical uncertainty, near-misses, and adverse events relating to physician
handoffs during intensive care unit-ward transfer: A qualitative analysis
AUTHOR NAMES
Lyons P.G.
Farnan J.M.
Arora V.M.
AUTHOR ADDRESSES
(Lyons P.G.; Farnan J.M.; Arora V.M.) University of Chicago Medicine,
Chicago, United States.
CORRESPONDENCE ADDRESS
P.G. Lyons, University of Chicago Medicine, Chicago, United States.
SOURCE
American Journal of Respiratory and Critical Care Medicine (2015) 191
MeetingAbstracts. Date of Publication: 2015
CONFERENCE NAME
American Thoracic Society International Conference, ATS 2015
CONFERENCE LOCATION
Denver, CO, United States
CONFERENCE DATE
2015-05-15 to 2015-05-20
ISSN
1073-449X
BOOK PUBLISHER
American Thoracic Society
ABSTRACT
Rationale: Patients are vulnerable during care transitions, and significant
research has linked discontinuity in care transitions to adverse patient
outcomes. Despite focus on improving inpatient handoff quality, little is
known about physician communication when patients transfer from the ICU to
the wards. This study aims to describe resident handoff behaviors during
ICU-ward transfer and identify near-miss and adverse patient events
secondary to uncertainty related to these handoffs. Methods: All residents
completing inpatient general medicine, oncology, and cardiology rotations
between October 2013 and January 2014 were invited to participate.
Consenting residents were privately interviewed using critical incident
technique to elicit near-miss and adverse events due to ineffective handoffs
of patients transferring from the ICU to the wards. Interviews were audio
recorded and transcribed for analysis. A member of the research team coded
transcripts using the constant comparative method, with no a priori
hypotheses, to generate initial categories. A second member of the research
team independently reviewed 15% of the transcripts to ensure coder agreement
and reliability. Patient outcomes identified in the narrative examples were
evaluated to identify critical events. Results: 68 residents were approached
and 29 (43%) were interviewed. Residents reported spending an average of 8
minutes per patient per handoff. 24 residents (83%) reported receiving at
least one handoff in-person, and 13 residents (45%) reported receiving at
least one telephone handoff. 19 residents (66%) reported 27 adverse events
or near-misses experienced by patients due to communication failures from a
poor ICU-ward handoff. Three major domains of communication failure emerged
(Table 1): missing information (16), incorrect information (10), and unclear
responsibility for the patient peri-handoff (1). A representative narrative
comment for the domain of “incorrect information” in a handoff for a patient
transferring from the cardiac ICU: “we had been [incorrectly] told [the
electrophysiology consultants] wanted to keep holding [prophylactic
anticoagulation] she ended up developing PEs and subsequently died.” In
total, 4 incidents involved patient death or life-threatening adverse
events, and another 6 were near-misses with life-threatening potential, such
as failure to alert the receiving resident to a patient's active
disseminated intravascular coagulation. Conclusions: Residents report
spending little time on ICU-ward handoffs, and commonly encounter adverse
events or near-misses due to handoff communication failures. Our results
highlight the ubiquity of miscommunication and the risk of medical error
when patients transfer from the ICU to the wards. Interventions to improve
ICU-ward communication are needed.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
American
clinical handover
human
intensive care unit
qualitative analysis
society
ward
EMTREE MEDICAL INDEX TERMS
anticoagulation
cardiology
constant comparative method
consultation
death
disseminated intravascular clotting
electrophysiology
general practice
hospital patient
hypothesis
interpersonal communication
interview
medical error
narrative
oncology
patient
physician
reliability
responsibility
risk
telephone
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72048876
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 203
TITLE
Clinical implications and biases involved in inter-icu transfers
AUTHOR NAMES
Nadig N.R.
Goodwin A.J.
Simpson A.
Simpson K.N.
Ford D.W.
AUTHOR ADDRESSES
(Nadig N.R., nadig@musc.edu; Goodwin A.J.; Simpson A.; Simpson K.N.; Ford
D.W.) Medical University of South Carolina, Charleston, United States.
CORRESPONDENCE ADDRESS
N.R. Nadig, Medical University of South Carolina, Charleston, United States.
Email: nadig@musc.edu
SOURCE
American Journal of Respiratory and Critical Care Medicine (2015) 191
MeetingAbstracts. Date of Publication: 2015
CONFERENCE NAME
American Thoracic Society International Conference, ATS 2015
CONFERENCE LOCATION
Denver, CO, United States
CONFERENCE DATE
2015-05-15 to 2015-05-20
ISSN
1073-449X
BOOK PUBLISHER
American Thoracic Society
ABSTRACT
Rationale- Patients with ventilator-dependent respiratory failure (VDRF)
represent a population that is severely ill with high risk of morbidity and
mortality. Prior investigation has shown that patients with VDRF have
improved outcomes when treated at high volume centers sparking debate over
whether regionalized care is needed, which in theory involves inter-ICU
transfers. However, other studies report that transferred critically ill
patients have worse outcomes compared to patients who do not undergo
transfer. Thus, there are conflicting views about clinical implications of
inter-ICU transfer. In order to address this, we propose to characterize the
clinical impact and inherent biases involved in inter-ICU transfers among
patients with VDRF and compare it to a group that is not transferred.
Methods- We devised a retrospective cohort study utilizing the Healthcare
Cost and Utilization Project (HCUP) state inpatient database (SID) and
identified patients with ICD-9 codes of respiratory failure and mechanical
ventilation from Florida during the calendar year 2012. Inter-ICU transfers
were defined as readmission within 24 hours to another hospital. The
transfers and the non-transfers were compared for final analysis. Our
primary outcome was in-hospital mortality and secondary outcomes included
hospital length of stay and discharge destination. Results- We identified
55,631 admissions with VDRF diagnosis to Florida ICU's in 2012 to 48,252
unique patients. 4% or 1,831 of these patients were transferred to another
ICU. Of the transferred patients 1,325 (72%) had individual record
identifiers that enabled us to analyze them. Transfers were younger, more
likely to be male, Hispanic, and have Medicare or commercial insurance.
Inaddition, the transfers had lower mortality (16.1% vs 28.4%), but longer
length of stay (15.8 vs. 14.9) days, and were more likely to be discharged
to home (23.3% vs. 19.8%). In multivariable models controlling for age, sex,
race and insurance status, the risk of death in the hospital for transfers
was about half of the risk observed for non-transfers Conclusions- This is
an observational study of current practices and crude mortality associated
with inter-ICU transfers. It also helps us identify the patterns of inherent
biases of transfers in the current system. Transferred patients with VDRF
are more likely to be insured compared to non-transfers. Transferred
patients also have lower mortality than non-transferred patients. However,
the limitations include lack of robust measures to control for illness
severity which will need to be evaluated in future studies. (Table
Presented).
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
American
society
EMTREE MEDICAL INDEX TERMS
artificial ventilation
cohort analysis
critically ill patient
data base
death
diagnosis
disease severity
health care cost
Hispanic
hospital
hospital patient
hospital readmission
human
ICD-9
insurance
length of stay
male
medicare
model
morbidity
mortality
observational study
patient
population
respiratory failure
risk
United States
ventilator
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72051514
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 204
TITLE
Pre- and intra-transport neonatal care oxygen saturation hypoxemia among
referred neonate in a tertiary hospital in Nigeria
AUTHOR NAMES
Abdulraheem M.A.
Orimadegun A.E.
Tongo O.
AUTHOR ADDRESSES
(Abdulraheem M.A., ojomuhy@yahoo.com) Nagasaki University, Nagasaki, Japan.
(Orimadegun A.E.) University of Ibadan, Ibadan, Nigeria.
(Tongo O.) University College Hospital, Ibadan, Nigeria.
CORRESPONDENCE ADDRESS
M.A. Abdulraheem, Nagasaki University, Nagasaki, Japan. Email:
ojomuhy@yahoo.com
SOURCE
American Journal of Respiratory and Critical Care Medicine (2015) 191
MeetingAbstracts. Date of Publication: 2015
CONFERENCE NAME
American Thoracic Society International Conference, ATS 2015
CONFERENCE LOCATION
Denver, CO, United States
CONFERENCE DATE
2015-05-15 to 2015-05-20
ISSN
1073-449X
BOOK PUBLISHER
American Thoracic Society
ABSTRACT
Background: Large proportion of babies in Nigeria are delivered at home or
primary health care centers and many get referred to secondary or tertiary
health care level. Poorly organized transport practices often make the
condition of most of these referred neonates on arrival at neonatal
intensive care unit worse. Though hypoxaemia relating to respiratory and
non-respiratory causes is potential morbidity attributable to quality of
care received during neonatal transportation, its magnitude and related
consequences have not been studied in Nigeria. Methods: In this study, we
prospectively recruited 382 neonates referred to the University College
Hospital (UCH), Ibadan Nigeria. A structured form was used to record events
pre-transport, intra-transport and at presentation in UCH. Oxygen saturation
measured using pulse oximeter (Massimo® Rad 5 Pulse Oximeter, made in U.S.A)
Demographic and clinical features were recorded. Hypoxemia was defined as
hemoglobin saturation of less than 90%. Also, temperature, random plasma
glucose, serum bicarbonate and the weight of the babies were measured.
Descriptive and Chi-square statistics were used in data analyses with level
of significance set at p = 0.05. Logistic regression was used to determine
predictors of hypoxemia and outcome in 48-hour of admission. Results: Study
participants included 58.6% male and 41.2% female of which 67.1% were term,
31.4% preterm and 1.5% post term. Eighty-two percent were transported from
hospitals/maternity centres while 17.9% were from home. Less than 25%
received the expected pre-transport care for each item in STABLE program and
this care was continued intra-transport in <20%. Only 3 (0.2%) were
transported in an incubator. Morbidity detected at presentation included:
hypoxemia (66.2%), hypothermia (29.8%), hypoglycaemia (17.7%), metabolic
acidosis (36.1%) and apnoea (9.4%). At presentation, hypoxemia was
associated with failure to administer oxygen (OR = 3.44; 95% CI = 1.92,
6.16) while acidosis (OR = 2.07; 95% CI = 1.23, 3.47) and apnoea (OR = 4.16;
95% CI = 1.26, 21.65) were significantly associated with failure to feed
after adjusting for gestational age and other variables (Table 2). However,
these variables did not influence occurrence of hypoxemia in the first 48
hours of admission. Conclusion: Quality transport facilities are not
available in most referring centres, poor pre- transport care negatively
influenced oxygen saturation. There is the need for health care providers at
primary facilities to recognise the importance of pre-transport
stabilisation for referred neonates. Policy makers need to urgently regulate
perinatal care and make policies regarding the transfer of sick neonates.
EMTREE DRUG INDEX TERMS
hemoglobin
oxygen
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
American
hypoxemia
newborn
newborn care
Nigeria
oxygen saturation
society
tertiary care center
EMTREE MEDICAL INDEX TERMS
acidosis
apnea
baby
bicarbonate blood level
clinical feature
college
data analysis
female
gestational age
glucose blood level
health care personnel
hospital
human
hypoglycemia
hypothermia
incubator
intensive care unit
logistic regression analysis
male
metabolic acidosis
morbidity
newborn intensive care
perinatal care
policy
primary health care
pulse oximeter
statistics
temperature
tertiary health care
traffic and transport
university
weight
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72049701
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 205
TITLE
Analysis of clinical characteristics, rationale, and management of
critically ill obstetric patients transferred to ICU
AUTHOR NAMES
Yousuf N.
Shaikh S.N.
Soomro A.
Baloch R.
AUTHOR ADDRESSES
(Yousuf N., nymemon66@gmail.com; Shaikh S.N.; Baloch R.) Department of
OB/GY, SMBBMU, Larkana, Pakistan.
(Soomro A.) Department of Anaesthesia and ICU, CMC, SMBBMU, Larkana,
Pakistan.
CORRESPONDENCE ADDRESS
N. Yousuf, Department of OB/GY, SMBBMU, Larkana, Pakistan.
SOURCE
Journal of the Pakistan Medical Association (2015) 65:9 (959-962). Date of
Publication: 1 Sep 2015
ISSN
0030-9982
BOOK PUBLISHER
Pakistan Medical Association
ABSTRACT
Objective: To evaluate the clinical and demographic characteristics,
rationale for transfer of critically ill obstetric patients to intensive
care unit and their management therein. Methods: The observational
retrospective case series study was conducted at Shaheed Mohtarma Benazir
Bhutto Medical University, Larkana, Pakistan, and comprised critically ill
female patients transferred to intensive care unit from the department of
Obstetrics and Gynaecology between August 2011 and June 2013. The data was
collected on pre-designed proforma which included demographic
characteristics of patients, their symptomatology and initial diagnosis,
intervention in the department, continuing or subsequent
complications/reasons for admission to intensive care unit, management and
stay there and, finally, outcome. Data was analysed using SPSS 21. Results:
The mean age of 150 patients in the study was 30.3±5.047years,mean parity
was 2.49±2.207.The most common condition affecting women and leading to
their transfer to intensive care was eclampsia/pre-eclampsia in 80(53.33%)
followed by bleeding disorders in 25(16.65%) and septic shock in 24(16%).
The mean stay in intensive care was 4.47±2.53 days, and 38(25.3%) patients
required ventilator support, while 112(74.7%) were managed with oxygen and
inotropic support. The overallmaternalmortality rate was 41(27.3%), which
included 19(16.9%) patients managed without ventilator, and 22 (57.8%)
managed with ventilator (p<0.05). Conclusion: Hypertensive and bleeding
disorders were the main reasons for transfer of obstetric patients to
intensive care unit, and maternal mortality was high among patients treated
on ventilator support.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
clinical feature
intensive care unit
obstetric patient
EMTREE MEDICAL INDEX TERMS
abdominal hysterectomy
adolescent
adult
amenorrhea
antepartum hemorrhage
article
artificial ventilation
bleeding disorder
cesarean section
distress syndrome
dyspnea
female
hospitalization
human
hypertension
hypovolemic shock
laparotomy
lung edema
major clinical study
mortality
outcome assessment
peritonitis
preeclampsia
retrospective study
sepsis
septic shock
vagina bleeding
vagina discharge
EMBASE CLASSIFICATIONS
Obstetrics and Gynecology (10)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2015337006
MEDLINE PMID
26338741 (http://www.ncbi.nlm.nih.gov/pubmed/26338741)
PUI
L605821800
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 206
TITLE
Resuscitation During Critical Care Transportation in Afghanistan
AUTHOR NAMES
Tobin J.M.
Nordmann G.R.
Kuncir E.J.
AUTHOR ADDRESSES
(Tobin J.M.; Nordmann G.R.; Kuncir E.J.)
SOURCE
Journal of special operations medicine : a peer reviewed journal for SOF
medical professionals (2015) 15:3 (72-75). Date of Publication: 1 Sep 2015
ISSN
1553-9768
ABSTRACT
OBJECTIVE: These data describe the critical care procedures performed on,
and the resuscitation markers of, critically wounded personnel in
Afghanistan following point of injury (POI) transports and intratheater
transports. Providing this information may help inform discussion on the
design of critical care transportation platforms for future
conflicts.METHODS: The Department of Defense Trauma Registry (DoDTR) was
queried for descriptive data on combat casualties with Injury Severity Score
(ISS) greater than 15 who were transported in Operation Enduring Freedom
(OEF) from 1 January 2010 to 31 December 2010. Both POI transportation
events and interfacility transportation events were reviewed. Base deficit
(BD) was evaluated as a maker of resuscitation, and international normalized
ratio (INR) was evaluated as a measure of coagulopathy.RESULTS: There were
1198 transportation events that occurred during the study period--634 (53%)
transports from the POI and 564 (47%) intratheater transports. Critical care
interventions were performed during 147 (12.3%) transportation events,
including intubation, cricothyrotomy, double-lumen endotracheal tube
placement, needle or tube thoracostomy, central venous access placement, and
cardiopulmonary resuscitation. The mean BD on arrival in the emergency
department was -5.4 mEq/L for POI transports and 0.68 mEq/L intratheater
transports (ρ<.001). The mean INR on arrival in the emergency department was
1.48 for POI transports and 1.21 for intratheater transports
(ρ<.001).CONCLUSIONS: Critical care interventions were needed frequently
during evacuation of severely injured personnel. Furthermore, many troops
arrived acidotic and coagulopathic following initial transport from POI.
Together, these data suggest that a platform capable of damage control
resuscitation and critical care interventions may be warranted on longer
transports of more critically injured patients.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
soldier
statistics and numerical data
EMTREE MEDICAL INDEX TERMS
acidosis
adolescent
adult
battle injury (therapy)
blood
blood clotting disorder
blood gas analysis
central venous catheterization
decompression surgery
endotracheal intubation
human
injury scale
intensive care
international normalized ratio
middle aged
patient transport
register
resuscitation
thorax drainage
United States
utilization
war
young adult
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
26360357 (http://www.ncbi.nlm.nih.gov/pubmed/26360357)
PUI
L611005734
COPYRIGHT
Copyright 2016 Medline is the source for the citation and abstract of this
record.
RECORD 207
TITLE
Single embryo transfer of frozen-thawed embryos is associated with increased
maternal complications
AUTHOR NAMES
Shavit T.
Oron G.
Tulandi T.
Son W.
Holzer H.
Buckett W.
AUTHOR ADDRESSES
(Shavit T.) McGill University, MUHC Reproductive Center, Montreal, Canada.
(Oron G.; Son W.; Holzer H.) Department of Obstetrics and Gynecology, McGill
University, Montreal, Canada.
(Tulandi T.; Buckett W.) McGill University, Montreal, Canada.
CORRESPONDENCE ADDRESS
T. Shavit, McGill University, MUHC Reproductive Center, Montreal, Canada.
SOURCE
Fertility and Sterility (2015) 104:3 SUPPL. 1 (e196). Date of Publication:
September 2015
CONFERENCE NAME
71st Annual Meeting of the American Society for Reproductive Medicine, ASRM
2015
CONFERENCE LOCATION
Baltimore, MD, United States
CONFERENCE DATE
2015-10-17 to 2015-10-21
ISSN
0015-0282
BOOK PUBLISHER
Elsevier Inc.
ABSTRACT
OBJECTIVE: Cryopreservation of embryos allows transfer of a single embryo
(SET) and storage of supernumerary embryos maximizing the cumulative
pregnancy rates. It has been reported that IVF conceived singletons are
prone to pregnancy complications including low birth weight (LBW), preterm
deliveries (PTD) and small for gestational age (SGA). The purpose of our
study was to compare the pregnancy outcome in singletons born after fresh or
frozen-thawed single blastocyst transfer (SBT). DESIGN: A single center
retrospective cohort study, a reproductive unit of a tertiary university
health center. MATERIALS AND METHODS: We compared singleton live births
resulting from transfer of fresh or frozen-thawed single blastocyst embryo
(SBT). The primary outcomes were perinatal outcomes including SGA, LBW, very
LBW, PTD, early PTD, large for gestational age (LGA), hospitalization at the
neonatal intensive care unit, respiratory and gastrointestinal complications
and congenitalmal formations. Maternal complications included preeclampsia,
placenta previa, placental abruption, gestational diabetes mellitus (GDM)
and chorioamnionitis. Adjustment for confounding factors was done. RESULTS:
We studied 1886 fresh-SBT and 1200 FET-SBT cycles. SBT of fresh embryo
resulted in a clinical pregnancy rate of 52.2% and live birth rate of 31.3%
per embryo transfer (ET). These were significantly higher than 34.4%
clinical pregnancy rate and 13.7% live birth rate per ET in the FET group
(p<0.001). Demographic characteristics of the mothers were comparable. The
birth weight of neonate in the fresh embryo transfer group was lower
compared to those in the FET (3281±595 grams vs. 3381±756 grams P=0.003).
Mothers in the FET group had a higher rate of cesarean sections. Neonates in
the frozen embryo transfer had increase risk to be LGA. Mothers in the FET
had higher risk to develop preeclampsia (5.59% vs. 2.09% p=0.036) and GDM
(4.97% vs. 1.57% p=0.02). The incidence of group maternal complication was
higher in the frozen blastocyst transfer (14.29% vs. 8.17% p=0.03) whereas
group neonatal complications were comparable. CONCLUSIONS: FET of a single
blastocyst is associated with a higher rate of maternal complications.
Singleton pregnancies achieved after FETSBT should be considered high risk
pregnancies. Further studies are needed to assess the impact of freezing and
thawing of embryos on maternal safety during pregnancy.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
American
embryo
embryo transfer
reproduction
society
EMTREE MEDICAL INDEX TERMS
birth rate
birth weight
blastocyst
cesarean section
chorioamnionitis
cohort analysis
cryopreservation
demography
female
freezing
health center
high risk pregnancy
hospitalization
human
intensive care unit
large for gestational age
live birth
low birth weight
mother
newborn
newborn intensive care
placenta previa
preeclampsia
pregnancy
pregnancy complication
pregnancy diabetes mellitus
pregnancy outcome
pregnancy rate
premature labor
risk
safety
small for date infant
storage
thawing
university
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72025621
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 208
TITLE
Intubation in Pediatric/Neonatal Critical Care Transport: National
Performance
AUTHOR NAMES
Bigelow A.M.
Gothard M.D.
Schwartz H.P.
Bigham M.T.
AUTHOR ADDRESSES
(Bigelow A.M.; Gothard M.D.; Schwartz H.P.; Bigham M.T.)
SOURCE
Prehospital emergency care : official journal of the National Association of
EMS Physicians and the National Association of State EMS Directors (2015)
19:3 (351-357). Date of Publication: 1 Jul 2015
ISSN
1545-0066 (electronic)
ABSTRACT
OBJECTIVE: Respiratory interventions are a priority in pediatric and
neonatal critical care transport (PNCCT). A recent Delphi study identified
intubation performance as an important PNCCT quality metric, though data are
insufficient. The objective of the study is to determine multi-center rates
of first attempt intubation success in pediatric/neonatal transport and
identify practice processes associated with higher performing
centers.METHODS: Retrospective chart review where data was collected from
the 9 participating centers over a 6-month period from January-June 2013.
Data describing intubation training and practices were gathered using
SurveyMonkey® (Palo Alto, CA). Data were tabulated in Microsoft Excel
(Redmond, WA) and analyzed using descriptive statistics. Through the
determination of 1(st) intubation success rate across multiple
pediatric/neonatal critical care transport programs, we hypothesized that
the features of higher and lower performing centers can be identified to
inform practice.RESULTS: 9 of 14 invited institutions participated. The
median (IQR) 6-month transport volume for neonates(neo) was 289(35-646) and
pediatric (ped) 510(122-831). On average, 7%(+/-3.0) of neo and 1.6%(+/-0.7)
of ped transport patients required intubation. Individual centers had their
initial success rate calculated and a 95% confidence interval was determined
for those centers satisfying the np > 5 and n(1-p) > 5 sample size
requirement for normality assumption of proportions. Since the overall
success rate was 64%, it was determined that n = 14 initial intubation
attempts would be the minimum number needed per center in order to fulfill
the sample size requirement for normality assumption. Centers whose 95%
confidence interval did not contain the initial overall success rate were
identified.CONCLUSION: This represents the first multi-center neo/ped
intubation dataset in PNCCT. First attempt intubation success lags behind
reported anesthesia intubation rates but parallels pediatric emergency
department intubation success rates. Training and operational processes are
variable in PNCCT, though top performing teams require live-patient
intubation success to achieve initial intubation competency.BACKGROUND:
There are nearly 200,000 US infants/children transported annually for
specialty care and there are no published best practices in transport
intubation.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
standards
EMTREE MEDICAL INDEX TERMS
clinical audit
clinical trial
endotracheal intubation
human
multicenter study
newborn
retrospective study
United States
utilization
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
25664667 (http://www.ncbi.nlm.nih.gov/pubmed/25664667)
PUI
L609310568
DOI
10.3109/10903127.2014.980481
FULL TEXT LINK
http://dx.doi.org/10.3109/10903127.2014.980481
COPYRIGHT
Copyright 2016 Medline is the source for the citation and abstract of this
record.
RECORD 209
TITLE
Evaluation of effects of pneumatic tube transport on ROTEM® analyses
ORIGINAL (NON-ENGLISH) TITLE
Evaluatie van analytische variatie en het effect van buizenpost transport op
ROTEM® analyses
AUTHOR NAMES
Rotteveel-De Groot D.M.
Frenzel T.
Noorland J.
Kulk J.
Loof A.H.
Van Pampus E.C.M.
Van Zwam M.
Oosting J.D.
AUTHOR ADDRESSES
(Rotteveel-De Groot D.M., dorien.rotteveel-degroot@radboudumc.nl; Noorland
J.; Kulk J.; Loof A.H.; Van Pampus E.C.M.; Van Zwam M.; Oosting J.D.)
Radboudumc, Afdeling Laboratoriumgeneeskunde, Onderdeel LKC, Postbus 9101,
Nijmegen, Netherlands.
(Frenzel T.) Afdeling Intensive Care, Nijmegen, Netherlands.
CORRESPONDENCE ADDRESS
D.M. Rotteveel-De Groot, Radboudumc, Afdeling Laboratoriumgeneeskunde,
Onderdeel LKC, Postbus 9101, Nijmegen, Netherlands.
SOURCE
Nederlands Tijdschrift voor Klinische Chemie en Laboratoriumgeneeskunde
(2015) 40:3 (201-204). Date of Publication: 1 Jul 2015
ISSN
1570-8306
BOOK PUBLISHER
Nederlandse Vereniging voor Klinische Chemie, buro@nvkc.nl
ABSTRACT
Rotational tromboelastometry (ROTEM®) can be used for monitoring of the
blood coagulation status of patients in emergency situations. For a rapid
analysis the blood samples can be transported to the central laboratory in
our hospital via a pneumatic tube system. This study has been performed to
determine the analytical variation of the ROTEM® parameters INTEM, EXTEM,
FIBTEM and HEPTEM, and to evaluate possible effects of pneumatic tube
transport on ROTEM® parameters in blood samples of cardiothoracic surgery
patients of the Intensive Care Unit. Our results show that the ROTEM
parameters used in a newly defined ROTEM based protocol for hemostatic
therapy (EXTEM CT, EXTEM A10 and FIBTEM A10) have a within-run and
between-run analytical variation of less than 5% with the exception of EXTEM
CT (maximum of 8%), which is in accordance with the manufacturer's
specifications. Following pneumatic tube transport, these parameters have a
bias of less than 5%. In conclusion, the pneumatic tube system in our
hospital can be used to transport blood samples to the central laboratory
for ROTEM® analyses. In the future, this provides the possibility for
various other departments in our hospital to include ROTEM® analyses in
their treatment protocols. Future studies will have to elucidate whether
such treatment protocol will be beneficial.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
pneumatic tool
pneumatic tube transport
thromboelastograph
tube
EMTREE MEDICAL INDEX TERMS
article
blood sampling
clinical evaluation
hemostasis
human
intensive care unit
surgical patient
thorax surgery
DEVICE TRADE NAMES
ROTEM
EMBASE CLASSIFICATIONS
Hematology (25)
Biophysics, Bioengineering and Medical Instrumentation (27)
LANGUAGE OF ARTICLE
Dutch
LANGUAGE OF SUMMARY
English, Dutch
EMBASE ACCESSION NUMBER
2015292782
PUI
L605595112
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 210
TITLE
Apgar Score at 5 Minutes Is Associated with Mortality in Extremely Preterm
Infants even after Transfer to an All Referral NICU
AUTHOR NAMES
Bartman T.
Bapat R.
Martin E.M.
Shepherd E.G.
Nelin L.D.
Reber K.M.
AUTHOR ADDRESSES
(Bartman T.; Bapat R.; Shepherd E.G.; Nelin L.D.,
Leif.Nelin@nationwidechildrens.org; Reber K.M.) Division of Neonatology,
Department of Pediatrics, Ohio State University, Columbusa, United States.
(Bapat R.; Martin E.M.; Shepherd E.G.; Nelin L.D.,
Leif.Nelin@nationwidechildrens.org; Reber K.M.) Small Baby Program,
Nationwide Children's Hospital, Columbusa, United States.
(Nelin L.D., Leif.Nelin@nationwidechildrens.org) Center for Perinatal
Research, Research Institute at Nationwide Children's Hospital, 575
Children's Crossroads, Columbusa, United States.
CORRESPONDENCE ADDRESS
L.D. Nelin, Center for Perinatal Research, Research Institute at Nationwide
Children's Hospital, 575 Children's Crossroads, Columbusa, United States.
Email: Leif.Nelin@nationwidechildrens.org
SOURCE
American Journal of Perinatology (2015) 32:13 (1268-1272). Date of
Publication: 9 Jun 2015
ISSN
1098-8785 (electronic)
0735-1631
BOOK PUBLISHER
Thieme Medical Publishers, Inc., custserv@thieme.com
ABSTRACT
Objective The Apgar score has been shown to have utility in predicting
mortality in the extremely preterm infant in delivery hospital populations,
where most mortality occurs within 12 hours of birth. We tested the
hypothesis that the 5 minute Apgar score would remain associated with
mortality in extremely preterm infants after transfer from the delivery
hospital to an all referral neonatal intensive care unit at an average age
of 10 days. Study Design A retrospective analysis of 454 infants born at <
27 weeks gestation. Results The median Apgar score was 3 at 1 minute
(interquartile range [IQR] 2-6) and 6 at 5 minutes (IQR 4-7). The Apgar
score increased from 1 to 5 minutes by 2.0 ± 1.7 (p < 0.001). In logistic
regression modeling, an Apgar score of < 5 at 5 minutes was associated with
an increased mortality (odds ratio 1.76 [95% confidence interval 1.06-2.94],
p < 0.05), but not morbidities. Conclusion Infants born at < 27 weeks
gestation admitted to an all referral children's hospital at a mean age of
10 days with a 5 minute Apgar < 5 are at an increased risk of mortality. Our
findings continue to support the importance of the Apgar score given at
delivery even in the extremely preterm infant referred to a nondelivery
children's hospital.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Apgar score
newborn mortality
prematurity
EMTREE MEDICAL INDEX TERMS
age distribution
article
association
gestational age
human
infant
intermittent positive pressure ventilation
major clinical study
newborn intensive care
obstetric delivery
patient referral
patient transport
priority journal
retrospective study
risk factor
EMBASE CLASSIFICATIONS
Obstetrics and Gynecology (10)
Public Health, Social Medicine and Epidemiology (17)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2015123014
MEDLINE PMID
26058370 (http://www.ncbi.nlm.nih.gov/pubmed/26058370)
PUI
L604837709
DOI
10.1055/s-0035-1554803
FULL TEXT LINK
http://dx.doi.org/10.1055/s-0035-1554803
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 211
TITLE
Nurse knowledge of intrahospital transport
AUTHOR NAMES
Shields J.
Overstreet M.
Krau S.D.
AUTHOR ADDRESSES
(Shields J., john.shields@mtsa.edu) Cardiac Anesthesia Division, Department
of Anesthesiology, Vanderbilt University Medical Center, 1301 Medical Center
Drive, 4648 TVC, Nashville, TN 37232-5614, USA; Middle Tennessee School of
Anesthesia, 315 Hospital Drive, Madison, TN 37115, USA. Electronic address:
(Overstreet M.) Center for Clinical Simulation, Middle Tennessee School of
Anesthesia, Madison, TN 37115, USA; Vanderbilt School of Nursing, 1301
Medical Center Drive, 4648 TVC, Nashville, TN 37232-5614, USA
(Krau S.D.) Vanderbilt School of Nursing, 1301 Medical Center Drive, 4648
TVC, Nashville, TN 37232-5614, USA
SOURCE
The Nursing clinics of North America (2015) 50:2 (293-314). Date of
Publication: 1 Jun 2015
ISSN
1558-1357 (electronic)
ABSTRACT
Preventable adverse events and other medical errors occur to hundreds of
thousands of Americans every year. The financial burden of these preventable
events is estimated to be $29 billion. According to the World Health
Organization, reducing medical errors has become an international concern.
Protecting patients from harm is a primary responsibility of all nurses
regardless of whether the nurse works in the intensive care unit or
operating room. Adherence to policies to maintain patient safety can be
discerned once the level of knowledge of these policies among nurses is
determined.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
knowledge
nursing staff
patient transport
EMTREE MEDICAL INDEX TERMS
clinical handover
human
medical error
practice guideline
prevention and control
United States
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
25999072 (http://www.ncbi.nlm.nih.gov/pubmed/25999072)
PUI
L605433151
DOI
10.1016/j.cnur.2015.03.005
FULL TEXT LINK
http://dx.doi.org/10.1016/j.cnur.2015.03.005
COPYRIGHT
Copyright 2015 Medline is the source for the citation and abstract of this
record.
RECORD 212
TITLE
The effect of initiation of strict embryo transfer limits on neonatal
complications with in-vitro fertilization (IVF)
AUTHOR NAMES
Shaulov T.
Belisle S.
Dahan M.H.
AUTHOR ADDRESSES
(Shaulov T.) McGill University, Obstetrics and Gynecology, Montreal, Canada.
(Belisle S.) Université De Montreal, Obstetrics and Gynecology, Montreal,
Canada.
(Dahan M.H.) McGill University, Reproductive Services, Montreal, Canada.
CORRESPONDENCE ADDRESS
T. Shaulov, McGill University, Obstetrics and Gynecology, Montreal, Canada.
SOURCE
Human Reproduction (2015) 30 SUPPL. 1 (i363). Date of Publication: June 2015
CONFERENCE NAME
31st Annual Meeting of the European Society of Human Reproduction and
Embryology, ESHRE 2015
CONFERENCE LOCATION
Lisbon, Portugal
CONFERENCE DATE
2015-06-14 to 2015-06-17
ISSN
0268-1161
BOOK PUBLISHER
Oxford University Press
ABSTRACT
Study question: What is the effect of the initiation of a government funded
in-vitro fertilization (IVF) program with strict limits on numbers of
embryos which can be transferred on neonatal complication rates and
incidence? Summary answer: This first North American publicly funded IVF
program has decreased the multiple birth rates related to IVF. However, the
absolute numbers of IVF babies born prematurely or requiring admission have
slightly increased. Also, the average admission cost per IVF baby has seen a
substantial increase. What is known already: Multiple pregnancies carry with
them risks to both mothers and fetuses. Several international jurisdictions
have demonstrated that publicly funded fertility programs with a single
embryo transfer (SET) policy decrease multiple pregnancy rates. Also, IVF
pregnancies are generally associated with higher rates of complications than
spontaneous pregnancies, attributed partially to multiples. In August 2010,
Quebec started funding of IVF with SET, with a goal of decreasing neonatal
complications and their costs. Study design, size, duration: This a
retrospective study. Data compares outcomes of all IVF cycles performed in
Quebec from the 2009 to 2010 (last complete pre-coverage) to 2012-2013
(first complete post-coverage) fiscal years. This study is based on 168 602
spontaneous and IVF deliveries. In 2009-2010, 906 women conceived with IVF,
while in 2012-2013, 1746 conceived. Participants/materials, setting,
methods: Data was extracted from two reports by the Health and Welfare
Commissioner as well as the Ministry of Health and Social Services published
in June 2014 and October 2013, respectively. This data was collected from
all assisted reproduction centers in Quebec providing IVF services. Data was
compared using chi-squared tests. Main results and the role of chance: The
number of babies born from IVF increased 63% from 2009-2010 to 2012-2013
(1057-1723). Multiple pregnancy rates decreased from 24.06% in 2009-2010 to
9.45% in 2012-2013 (p < 0.0001). The proportions of IVF babies that were the
result of multiple births, were premature, or required intensive-care unit
(ICU) admission, decreased by 55% (p < 0.0001), 35.5% (p < 0.0001), and 37%
(p < 0.0001), respectively, from 2009-2010 to 2012-2013. These changes in
absolute numbers were a decrease from 407 to 297, an increase from 313 to
329 and an increase from 199 to 204 babies, respectively. The average ICU
admission costs for a baby conceived through IVF and spontaneously was
$19,990 and $14,563 in 2009-2010, respectively, and $28,418 and $17,155 in
2011-2012, respectively. Limitations, reason for caution: Retrospective data
concerning IVF cycles and clinical outcomes was gathered from several
sources. However this is a robust study on data collected from more than
160,000 women who underwent conceptions either spontaneously or through IVF.
Wider implications of the findings: Publicly funded IVF programs
substantially decrease multiple pregnancy rates. However, due to
substantially increased usage, neonatal complications increase.
Interestingly, the cost per IVF neonatal-ICU admission skyrocketed when the
cost of caring for multiples was reduced. This suggests that the singleton
IVF pregnancies which require neonatal-ICU care are much sicker than IVF
twins which end up in the ICU. Further research should be directed into
decreasing the rate of ICU admissions for singleton IVF conceptions.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
embryo transfer
embryology
European
human
in vitro fertilization
reproduction
society
EMTREE MEDICAL INDEX TERMS
baby
birth rate
Canada
embryo
female
fertility
fetus
funding
government
health
intensive care unit
mother
multiple pregnancy
North American
parthenogenesis
policy
pregnancy
pregnancy rate
retrospective study
risk
social work
study design
twins
welfare
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72005918
DOI
10.1093/humrep/30.Supplement-1.1
FULL TEXT LINK
http://dx.doi.org/10.1093/humrep/30.Supplement-1.1
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 213
TITLE
Mortality in children with respiratory failure transported using
high-frequency oscillatory ventilation
AUTHOR NAMES
Jones P.
Dauger S.
Leger P.-L.
Kessous K.
Casadevall I.
Maury I.
Mazeron P.
Lodé N.
AUTHOR ADDRESSES
(Jones P., sejjprj@live.ucl.ac.uk; Kessous K.; Casadevall I.; Maury I.;
Mazeron P.; Lodé N.) SMUR Pédiatrique, Hôpital Robert Debré, Assistance
publique–Hôpitaux de Paris (AP-HP), 48 Bd Sérurier, Paris, France.
(Jones P., sejjprj@live.ucl.ac.uk; Dauger S.) Réanimation Pédiatrique
(PICU), Hôpital Robert Debré, AP-HP, 48 Bd Sérurier, Paris, France.
(Jones P., sejjprj@live.ucl.ac.uk) Respiratory, Critical Care and
Anaesthesia Group, University College London (UCL) Institute of Child
Health, 30 Guilford Street, London, United Kingdom.
(Leger P.-L.) Réanimation Pédiatrique (PICU), Hôpital Robert Trousseau,
AP-HP, 26 avenue du Dr Arnold Netter, Paris, France.
CORRESPONDENCE ADDRESS
P. Jones, Respiratory, Critical Care and Anaesthesia Group, University
College London (UCL) Institute of Child Health, 30 Guilford Street, London,
United Kingdom.
SOURCE
Intensive Care Medicine (2015) 41:7 (1363-1364). Date of Publication: 14 May
2015
ISSN
1432-1238 (electronic)
0342-4642
BOOK PUBLISHER
Springer Verlag, service@springer.de
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
assisted ventilation
highthe frequency oscillatory ventilation
mortality
patient transport
respiratory failure (therapy)
EMTREE MEDICAL INDEX TERMS
airway pressure
blood oxygen tension
child
diaphragm hernia
diastolic blood pressure
extracorporeal membrane oxygenation device
heart rate
hemodynamics
human
intensive care unit
letter
respiratory function
survivor
systolic blood pressure
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2015053967
MEDLINE PMID
25971382 (http://www.ncbi.nlm.nih.gov/pubmed/25971382)
PUI
L604433887
DOI
10.1007/s00134-015-3808-z
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-015-3808-z
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 214
TITLE
A comprehensive method to develop a checklist to increase safety of
intra-hospital transport of critically ill patients
AUTHOR NAMES
Brunsveld-Reinders A.H.
Arbous M.S.
Kuiper S.G.
de Jonge E.
AUTHOR ADDRESSES
(Brunsveld-Reinders A.H., A.H.Brunsveld-Reinders@lumc.nl; Arbous M.S.,
marbous@lumc.nl; Kuiper S.G., sgkuiper89@gmail.com; de Jonge E.,
E.de_Jonge@lumc.nl) Leiden University Medical Center, Department of
Intensive Care, Albinusdreef 2, PO Box 9600, RC Leiden, Netherlands.
CORRESPONDENCE ADDRESS
A.H. Brunsveld-Reinders, Leiden University Medical Center, Department of
Intensive Care, Albinusdreef 2, PO Box 9600, RC Leiden, Netherlands.
SOURCE
Critical Care (2015) 19:1 Article Number: 214. Date of Publication: 7 May
2015
ISSN
1466-609X (electronic)
1364-8535
BOOK PUBLISHER
BioMed Central Ltd., info@biomedcentral.com
ABSTRACT
Introduction: Transport of critically ill patients from the Intensive Care
Unit (ICU) to other departments for diagnostic or therapeutic procedures is
often a necessary part of the critical care process. Transport of critically
ill patients is potentially dangerous with up to 70% adverse events
occurring. The aim of this study was to develop a checklist to increase
safety of intra-hospital transport (IHT) in critically ill patients. Method:
A three-step approach was used to develop an IHT checklist. First, various
databases were searched for published IHT guidelines and checklists.
Secondly, prospectively collected IHT incidents in the LUMC ICU were
analyzed. Thirdly, interviews were held with physicians and nurses over
their experiences of IHT incidents. Following this approach a checklist was
developed and discussed with experts in the field. Finally, feasibility and
usability of the checklist was tested. Results: Eleven existing guidelines
and five checklists were found. Only one checklist covered all three phases:
pre-, during- and post-transport. Recommendations and checklist items mostly
focused on the pre-transport phase. Documented incidents most frequently
related to patient physiology and equipment malfunction and occurred most
often during transport. Discussing the incidents with ICU physicians and ICU
nurses resulted in important recommendations such as the introduction of a
standard checklist and improved communication with the other departments.
This approach resulted in a generally applicable checklist, adaptable for
local circumstances. Feedback from nurses using the checklist were positive,
the fill in time was 4.5 minutes per phase. Conclusion: A comprehensive way
to develop an intra-hospital checklist for safe transport of ICU patients to
another department is described. This resulted in a checklist which is a
framework to guide physicians and nurses through intra-hospital transports
and provides a continuity of care to enhance patient safety. Other hospitals
can customize this checklist to their own situation using the methods
proposed in this paper.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
patient safety
patient transport
practice guideline
EMTREE MEDICAL INDEX TERMS
article
communication protocol
health care system
hospital equipment
human
intensive care unit
interview
nurse
patient assessment
patient care
physician
priority journal
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2015056775
PUI
L604437965
DOI
10.1186/s13054-015-0938-1
FULL TEXT LINK
http://dx.doi.org/10.1186/s13054-015-0938-1
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 215
TITLE
A comprehensive method to develop a checklist to increase safety of
intra-hospital transport of critically ill patients
AUTHOR NAMES
Brunsveld-Reinders A.H.
Arbous M.S.
Kuiper S.G.
de Jonge E.
AUTHOR ADDRESSES
(Brunsveld-Reinders A.H., A.H.Brunsveld-Reinders@lumc.nl; Arbous M.S.,
marbous@lumc.nl; Kuiper S.G., sgkuiper89@gmail.com) Department of Intensive
Care, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, 2300,
RC, Leiden, the Netherlands
(de Jonge E.) Department of Intensive Care, Leiden University Medical
Center, Albinusdreef 2, PO Box 9600, 2300, RC, Leiden, the Netherlands.
E.de_Jonge@lumc.nl
SOURCE
Critical care (London, England) (2015) 19 (214). Date of Publication: 7 May
2015
ISSN
1466-609X (electronic)
ABSTRACT
INTRODUCTION: Transport of critically ill patients from the Intensive Care
Unit (ICU) to other departments for diagnostic or therapeutic procedures is
often a necessary part of the critical care process. Transport of critically
ill patients is potentially dangerous with up to 70% adverse events
occurring. The aim of this study was to develop a checklist to increase
safety of intra-hospital transport (IHT) in critically ill patients.METHOD:
A three-step approach was used to develop an IHT checklist. First, various
databases were searched for published IHT guidelines and checklists.
Secondly, prospectively collected IHT incidents in the LUMC ICU were
analyzed. Thirdly, interviews were held with physicians and nurses over
their experiences of IHT incidents. Following this approach a checklist was
developed and discussed with experts in the field. Finally, feasibility and
usability of the checklist was tested.RESULTS: Eleven existing guidelines
and five checklists were found. Only one checklist covered all three phases:
pre-, during- and post-transport. Recommendations and checklist items mostly
focused on the pre-transport phase. Documented incidents most frequently
related to patient physiology and equipment malfunction and occurred most
often during transport. Discussing the incidents with ICU physicians and ICU
nurses resulted in important recommendations such as the introduction of a
standard checklist and improved communication with the other departments.
This approach resulted in a generally applicable checklist, adaptable for
local circumstances. Feedback from nurses using the checklist were positive,
the fill in time was 4.5 minutes per phase.CONCLUSION: A comprehensive way
to develop an intra-hospital checklist for safe transport of ICU patients to
another department is described. This resulted in a checklist which is a
framework to guide physicians and nurses through intra-hospital transports
and provides a continuity of care to enhance patient safety. Other hospitals
can customize this checklist to their own situation using the methods
proposed in this paper.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
standards
EMTREE MEDICAL INDEX TERMS
checklist
critical illness (therapy)
human
intensive care unit
patient safety
patient transport
procedures
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
25947327 (http://www.ncbi.nlm.nih.gov/pubmed/25947327)
PUI
L615646210
DOI
10.1186/s13054-015-0938-1
FULL TEXT LINK
http://dx.doi.org/10.1186/s13054-015-0938-1
COPYRIGHT
Copyright 2017 Medline is the source for the citation and abstract of this
record.
RECORD 216
TITLE
A comprehensive method to develop a checklist to increase safety of
intra-hospital transport of critically ill patients
AUTHOR NAMES
Brunsveld-Reinders A.H.
Arbous M.S.
Kuiper S.G.
de Jonge E.
AUTHOR ADDRESSES
(Brunsveld-Reinders A.H., A.H.Brunsveld-Reinders@lumc.nl; Arbous M.S.,
marbous@lumc.nl; Kuiper S.G., sgkuiper89@gmail.com; de Jonge E.,
E.de_Jonge@lumc.nl) Leiden University Medical Center, Department of
Intensive Care, Albinusdreef 2, PO Box 9600, Leiden, RC, 2300 the
Netherlands
CORRESPONDENCE ADDRESS
A.H. Brunsveld-Reinders, Leiden University Medical Center, Department of
Intensive Care, Albinusdreef 2, PO Box 9600, Leiden, RC, 2300 the
Netherlands
SOURCE
Critical Care (2015). Date of Publication: 7 May 2015
ISSN
1466-609X (electronic)
1364-8535
BOOK PUBLISHER
BioMed Central Ltd., info@biomedcentral.com
ABSTRACT
Introduction: Transport of critically ill patients from the Intensive Care
Unit (ICU) to other departments for diagnostic or therapeutic procedures is
often a necessary part of the critical care process. Transport of critically
ill patients is potentially dangerous with up to 70% adverse events
occurring. The aim of this study was to develop a checklist to increase
safety of intra-hospital transport (IHT) in critically ill patients. Method:
A three-step approach was used to develop an IHT checklist. First, various
databases were searched for published IHT guidelines and checklists.
Secondly, prospectively collected IHT incidents in the LUMC ICU were
analyzed. Thirdly, interviews were held with physicians and nurses over
their experiences of IHT incidents. Following this approach a checklist was
developed and discussed with experts in the field. Finally, feasibility and
usability of the checklist was tested. Results: Eleven existing guidelines
and five checklists were found. Only one checklist covered all three phases:
pre-, during- and post-transport. Recommendations and checklist items mostly
focused on the pre-transport phase. Documented incidents most frequently
related to patient physiology and equipment malfunction and occurred most
often during transport. Discussing the incidents with ICU physicians and ICU
nurses resulted in important recommendations such as the introduction of a
standard checklist and improved communication with the other departments.
This approach resulted in a generally applicable checklist, adaptable for
local circumstances. Feedback from nurses using the checklist were positive,
the fill in time was 4.5 minutes per phase. Conclusion: A comprehensive way
to develop an intra-hospital checklist for safe transport of ICU patients to
another department is described. This resulted in a checklist which is a
framework to guide physicians and nurses through intra-hospital transports
and provides a continuity of care to enhance patient safety. Other hospitals
can customize this checklist to their own situation using the methods
proposed in this paper.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
checklist
critically ill patient
hospital
human
safety
EMTREE MEDICAL INDEX TERMS
data base
diagnosis
feedback system
intensive care
intensive care unit
interpersonal communication
interview
nurse
patient
patient care
patient safety
physician
physiology
procedures
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2015056297
PUI
L604444437
DOI
10.1186/s13054-015-0938-1
FULL TEXT LINK
http://dx.doi.org/10.1186/s13054-015-0938-1
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 217
TITLE
Association between Hospital Volume and Within-Hospital Intensive Care Unit
Transfer for Sickle Cell Disease in Children's Hospitals
AUTHOR NAMES
Raphael J.L.
Richardson T.
Hall M.
Oyeku S.O.
Bundy D.G.
Kalpatthi R.V.
Shah S.S.
Ellison A.M.
AUTHOR ADDRESSES
(Raphael J.L., Raphael@bcm.edu) Department of Pediatrics, Baylor College of
Medicine, Houston, TX
(Richardson T.; Hall M.) Children's Hospital Association, Overland Park, KS
(Oyeku S.O.) Department of Pediatrics, Albert Einstein College of Medicine
of Yeshiva University, Bronx, NY
(Bundy D.G.) Department of Pediatrics, Medical University of South Carolina,
Charleston, SC
(Kalpatthi R.V.) Department of Pediatrics, The Children's Mercy Hospital and
Clinics, Kansas City, MO
(Shah S.S.) Department of Pediatrics, Cincinnati Children's Hospital Medical
Center, Cincinnati, OH
(Ellison A.M.) Department of Pediatrics, Perelman School of Medicine at The
University of Pennsylvania, Philadelphia, PA
CORRESPONDENCE ADDRESS
J.L. Raphael, Department of Pediatrics, Baylor College of Medicine, Texas
Children's Hospital, Suite D.1540.00, 6701 Fannin St, Houston, TX 77030
Email: Raphael@bcm.edu
SOURCE
Journal of Pediatrics (2015). Date of Publication: 6 Apr 2015
ISSN
1097-6833 (electronic)
0022-3476
BOOK PUBLISHER
Mosby Inc., customerservice@mosby.com
ABSTRACT
Objective: To assess the relationship between hospital volume and intensive
care unit (ICU) transfer among hospitalized children with sickle cell
disease (SCD). Study design: We conducted a retrospective cohort study of 83
477 SCD-related hospitalizations at children's hospitals (2009-2012) using
the Pediatric Health Information System database. Hospital-level all-cause
and SCD-specific volumes were dichotomized (low vs high). Outcomes were
within-hospital ICU transfer (primary) and length of stay (LOS) total
(secondary). Multivariable logistic/linear regressions assessed the
association of hospital volumes with ICU transfer and LOS. Results: Of 83
477 eligible hospitalizations, 1741 (2.1%) involving 1432 unique children
were complicated by ICU transfer. High SCD-specific volume (OR 0.77, 95% CI
0.64-0.91) was associated with lower odds of ICU transfer while high
all-cause hospital volume was not (OR 0.87, 95% CI 0.73-1.04). A
statistically significant interaction was found between all-cause and
SCD-specific volumes. When results were stratified according to all-cause
volume, high SCD-specific volume was associated with lower odds of ICU
transfer at low all-cause volume (OR 0.46, 95% CI 0.38-0.55). High hospital
volumes, both all-cause (OR 0.94, 95% CI 0.92-0.97) and SCD-specific (OR
0.86, 95% CI 0.84-0.88), were associated with shorter LOS. Conclusions:
Children's hospitals vary substantially in their transfer of children with
SCD to the ICU according to hospital volumes. Understanding the practices
used by different institutions may help explain the variability in ICU
transfer among hospitals caring for children with SCD.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital
intensive care unit
sickle cell anemia
EMTREE MEDICAL INDEX TERMS
child
cohort analysis
controlled study
data base
doctor patient relation
hospitalization
human
length of stay
linear regression analysis
major clinical study
medical information system
study design
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20151064273
MEDLINE PMID
26470686 (http://www.ncbi.nlm.nih.gov/pubmed/26470686)
PUI
L607411162
DOI
10.1016/j.jpeds.2015.09.007
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jpeds.2015.09.007
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 218
TITLE
Improving the safety of icu to floor transfers-“ticket to ride”
AUTHOR NAMES
Siddiqi F.
Jones M.
Axon R.N.
AUTHOR ADDRESSES
(Siddiqi F.; Axon R.N.) Charleston VAMC, Charleston, United States.
(Siddiqi F.; Jones M.; Axon R.N.) MUSC, Charleston, United States.
CORRESPONDENCE ADDRESS
F. Siddiqi, Charleston VAMC, Charleston, United States.
SOURCE
Journal of General Internal Medicine (2015) 30 SUPPL. 2 (S541). Date of
Publication: April 2015
CONFERENCE NAME
38th Annual Meeting of the Society of General Internal Medicine
CONFERENCE LOCATION
Toronto, ON, Canada
CONFERENCE DATE
2015-04-22 to 2015-04-25
ISSN
0884-8734
BOOK PUBLISHER
Springer New York LLC
ABSTRACT
STATEMENT OF PROBLEMOR QUESTION (ONE SENTENCE): Facilities with 'closed'
intensive care units (ICU) often experience delays in bed availability
spanning work shifts which complicate communication and can result in missed
patient handoffs. OBJECTIVES OF PROGRAM/INTERVENTION (NO MORE THAN THREE
OBJECTIVES): 1. Prevent delays in floor team notification when patients are
transferred from the ICU (i.e. missed handoffs). 2. Reduce delays in
initiating ICU transfer orders. 3. Prevent transfer of medically unstable
patients from ICU. DESCRIPTION OF PROGRAM/INTERVENTION, INCLUDING
ORGANIZATIONAL CONTEXT (E.G. INPATIENT VS. OUTPATIENT, PRACTICE OR COMMUNITY
CHARACTERISTICS): Patient handoffs have been the subject of increased study
in recent years. Nevertheless, handoff quality often remains poor; a recent
systematic review found a 13 % information error rate. Additionally,
handoffs are ineffective when they are simply not performed. Transfer of
patients from the ICU to ward is less well studied, but these handoffs are
arguably more important given patient complexity. In response to a series of
near-miss episodes where ICU patients were transferred from our ICU without
proper handoffs, we sought to improve facility performance. A
multi-stakeholder team of physicians, nurses, and clerical personnel mapped
transfer/handoff processes and analyzed performance gaps. Our Internal
Medicine program already had a well-established handoffs curriculum/system
in place, but a critical area of delay was identified between the time of
initial bed request and the actual time of bed assignment and patient
transfer. In some cases, this delay was over 12 h and spanned multiple work
shifts. There were also instances of delayed initiation of transfer orders
with the potential for missed medications or treatments. We devised a simple
checklist, called the “Ticket to Ride” (TtR), which forces a face-to-face,
standardized interaction between the transferring and accepting physicians
and other team members at the time of bed assignment. MEASURES OF SUCCESS
(DISCUSS QUALITATIVE AND/OR QUANTITATIVE METRICS WHICH WILL BE USED TO
EVALUATE PROGRAM/ INTERVENTION): We performed intermittent audits of TtR
forms to track implementation. We also reviewed charts of consecutive ICU
transfer patients comparing 3 months pre-intervention (n=71) to 3months post
(n=80). Mean times (inminutes) were examined using Students t test, and
proportions were compared using Pearson chi square. FINDINGS TODATE (IT
ISNOT SUFFICIENT TOSTATE FINDINGSWILL BE DISCUSSED): We observed no further
episodes of 'missed handoffs' after TtR implementation. Post implementation,
the proportion of accept notes written before transfer increased
significantly (41 vs. 22 %, p=0.01). Among transfer notes written after ICU
transfer, mean time to first accept was not significantly changed (113 vs.
103 min, p= 0.53). Only 2 patients required ICU readmission
pre-implementation, and none postimplementation. Finally, we observed a
significantly lower proportion of in-hospital deaths among ICU transfers (5
vs. 15 %, p=0.03) post-implementation. KEY LESSONS FOR DISSEMINATION (WHAT
CAN OTHERS TAKE AWAY FOR IMPLEMENTATION TO THEIR PRACTICE OR COMMUNITY?): 1.
Use of a standardized checklist requiring signatures is a simple, seemingly
effective means for prompting providers to complete patient handoffs at the
time of ICU transfer. 2. Early accept note completion improved post
implementation indicating more prompt ward team evaluations. 3. Observed
differences in mortality after implementation are intriguing and may be the
subject of future study. Nevertheless, we do not interpret these results as
causal as it relates to the TtR without analysis of a larger sample with
adjustment for potential confounders.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
internal medicine
safety
society
EMTREE MEDICAL INDEX TERMS
checklist
clinical audit
clinical handover
death
drug therapy
hospital
hospital patient
hospital readmission
human
intensive care unit
interpersonal communication
mortality
nurse
office worker
patient
patient transport
physician
student
Student t test
systematic review
ward
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71878619
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 219
TITLE
From clinical trials to bedside: Evaluating the transfer of scientific
insights to the “real-world” stroke care in Germany by comparison of
nation-wide administrative data
AUTHOR NAMES
Krogias C.
Bartig D.
Kitzrow M.
Weber R.
Eyding J.
AUTHOR ADDRESSES
(Krogias C.) Neurology St. Josef-Hospital, Ruhr University Bochum, Bochum,
Germany.
(Bartig D.) Drg Market, Osnabrück, Germany.
(Kitzrow M.) Neurology Bergmannsheil, Ruhr University Bochum, Bochum,
Germany.
(Weber R.) Neurology, Alfried-Krupp-Krankenhaus, Essen, Germany.
(Eyding J.) Neurology Knappschaftskrankenhaus, Ruhr University Bochum,
Bochum, Germany.
CORRESPONDENCE ADDRESS
C. Krogias, Neurology St. Josef-Hospital, Ruhr University Bochum, Bochum,
Germany.
SOURCE
International Journal of Stroke (2015) 10 SUPPL. 2 (118). Date of
Publication: April 2015
CONFERENCE NAME
European Stroke Organisation Annual Conference 2015
CONFERENCE LOCATION
Glasgow, United Kingdom
CONFERENCE DATE
2015-04-17 to 2015-04-19
ISSN
1747-4930
BOOK PUBLISHER
Blackwell Publishing Ltd
ABSTRACT
Background: Promising advances in stroke medicine have been reported
recently regarding specialized stroke unit (SU) care, expansion of the time
window of iv thrombolysis (IVT), mechanical thrombectomy (MT), and
decompressive hemicraniectomy (DHC) for malignant brain infarction. It
remains unclear to what extent new evidence of therapeutic procedures is
transferred to the “real-world” of everyday hospital care. Methods: We
analyzed epidemiologic and procedural therapeutic trends of hospitalized
acute stroke patients in Germany by the comparison of administrative
hospital data of the years 2008 (n = 219,359) and 2012 (n = 239,394).
Results: Proportion of specialized SU care rose from 43.4% to 56.9%. Rate of
IVT increased from 5.6% to 10.2%. 32% of IVT therapies in 2012 were
performed in patients over 80 years. Number of MT increased exponentially
from 298 to 3906 procedures. Number of DHC did not increase significantly
(2008 = 636; 2011 = 796). Conclusions: A strong momentum in transferring
scientific insights to the “real-world” stroke care in Germany was
documented. Increase of IVT therapy is largely due to the increase of
off-label treatment. Almost every 46 th patient <80 years was treated by MT
in 2012. Despite proven benefits in selected patients, utilization of DHC
remained almost stable.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cerebrovascular accident
clinical trial (topic)
European
Germany
organization
EMTREE MEDICAL INDEX TERMS
blood clot lysis
brain infarction
hospital
hospital care
human
mechanical thrombectomy
patient
procedures
stroke patient
stroke unit
therapy
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72034005
DOI
10.1111/ijs.12479
FULL TEXT LINK
http://dx.doi.org/10.1111/ijs.12479
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 220
TITLE
Are our patients safe during in-hospital transport
AUTHOR NAMES
Meenakshisundaram C.
Malakkla N.N.
Dandachi D.
Gopalakrishnan V.P.
Ganipisetti V.M.
AUTHOR ADDRESSES
(Meenakshisundaram C.; Malakkla N.N.; Dandachi D.; Gopalakrishnan V.P.)
Saint Francis Hospital, Evanston, United States.
(Ganipisetti V.M.) Presence Saint Francis, Evanston, United States.
CORRESPONDENCE ADDRESS
C. Meenakshisundaram, Saint Francis Hospital, Evanston, United States.
SOURCE
Journal of General Internal Medicine (2015) 30 SUPPL. 2 (S365-S366). Date of
Publication: April 2015
CONFERENCE NAME
38th Annual Meeting of the Society of General Internal Medicine
CONFERENCE LOCATION
Toronto, ON, Canada
CONFERENCE DATE
2015-04-22 to 2015-04-25
ISSN
0884-8734
BOOK PUBLISHER
Springer New York LLC
ABSTRACT
LEARNING OBJECTIVE #1: Importance of administering incremental doses of
sedatives in high risk individuals who are prone to develop respiratory
depression. LEARNING OBJECTIVE #2: To emphasize the importance of essential
monitoring during in-hospital transport of patients. Discuss the basic
strategies to decrease the adverse events and ensure safe transport. CASE:
Fifty-two year old obese AA female was brought by her sister to ED as she
sounded confused and her speech was slurring over phone. Her past medical
history included hypertension, DM, HLD, Sleep apnea and hypothyroidism. Her
medications were metformin, amlodipine, Lisinopril, metoprolol, synthroid
and fluoxetine. Vitals revealed tachycardia and SpO2 of 91 %. On physical
examination she appeared confused, agitated, had slurring speech but no
significant neurological deficit. Basic labs were significant for
leukocytosis, blood glucose of 685 mg/dl, ABG showed severe respiratory and
metabolic acidosis, negative serum and urine acetone. She received ativan
for agitation and placed on BiPAP support. She was given fluid boluses and
started on insulin infusion. During CT imaging of brain as she remained
agitated she received additional doses of ativan. Then she was transferred
to ICU with only cardiac monitor. On arrival to ICU, she was found to have
shallow respirations and saturated 60% with BiPAP. She had massive emesis
twice during intubation and was started on mechanical ventilatory support.
Next day her CXR showed increasing infiltrates in both lung fields and her
oxygen requirements were also increasing. ARDS protocol was initiated. Over
the next few days she also developed AKI and eventually became oliguric. She
also needed Hemodialysis for few weeks. Her TSH was elevated (30 mIU/ml) and
started on IV levothyroxine. She was successfully extubated and her renal
function returned to baseline in about a week. As she was deconditioned by
the complicated hospital stay of 48 days she was discharged to sub-acute
rehabilitation facility. DISCUSSION: Our patient had a prolonged and
complicated hospital stay that was not related to her presenting complaints
but due to insufficient monitoring during imaging that was least necessary
and during transport to intensive care unit after multiple doses of
benzodiazepine which is well known to cause respiratory depression. The
intra-hospital transport of patients is often performed by unlicensed
hospital personnel who encounter patient condition changes that require
immediate intervention. Risk reduction strategies include development of an
intra-hospital transport team, hand off communication using a specific tool
including written information facilitating clear communication before,
during and immediately following transport from the patient care unit to the
destination point and back. Also the transport personnels should have robust
educational and competency program including CPR certification to ensure
safe patient transport. All hospitals should develop a transport team model
with clear outline of specific responsibilities for each team member. Every
patient should be assessed for the basic level of monitoring needed, the
required equipment and the expected level of intervention if there is any
change in patient condition. Intra-hospital transport exposes patients to
potential periods of instability and increases the risk for complications,
morbidity and mortality. Physicians must evaluate the risk benefit ratio of
each transport, the need of urgency of diagnostic imaging or the therapeutic
procedures, and accurate information exchange will decrease the number of
adverse events.
EMTREE DRUG INDEX TERMS
acetone
amlodipine
benzodiazepine
fluoxetine
levothyroxine
levothyroxine sodium
lisinopril
lorazepam
metformin
metoprolol
sedative agent
thyrotropin
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital
human
internal medicine
patient
society
EMTREE MEDICAL INDEX TERMS
adult respiratory distress syndrome
agitation
brain
certification
diagnostic imaging
drug therapy
female
glucose blood level
hemodialysis
hospital patient
hospital personnel
hospitalization
hypertension
hypothyroidism
imaging
insulin infusion
intensive care unit
interpersonal communication
intubation
kidney function
leukocytosis
liquid
lung
medical history
metabolic acidosis
model
monitoring
morbidity
mortality
multiple drug dose
oxygen consumption
patient care
patient transport
personnel
physical examination
physician
procedures
rehabilitation
respiration depression
responsibility
risk
risk reduction
serum
sleep disordered breathing
speech
tachycardia
urine
vomiting
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71878174
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 221
TITLE
Transferring patient care: patterns of synchronous bidisciplinary
communication between physicians and nurses during handoffs in a critical
care unit
AUTHOR NAMES
McMullan A.
Parush A.
Momtahan K.
AUTHOR ADDRESSES
(McMullan A.; Parush A.; Momtahan K.)
SOURCE
Journal of perianesthesia nursing : official journal of the American Society
of PeriAnesthesia Nurses (2015) 30:2 (92-104). Date of Publication: 1 Apr
2015
ISSN
1532-8473 (electronic)
ABSTRACT
PURPOSE: The transfer of patient care from one health care worker to another
involves communication in high-pressure contexts that are often vulnerable
to error. This research project captured current practices for handoffs
during the critical care stage of surgical recovery in a hospital setting.
The objective was to characterize information flow during transfer and
identify patterns of communication between nurses and
physicians.CONCLUSIONS: Findings reflect positive and constructive patterns
of communication during handoffs in the observed hospital unit.DESIGN AND
METHODS: Observations were used to document communication exchanges. The
data were analyzed qualitatively according to the types of information
exchanged and verbal behavior types.FINDINGS: Reporting and questions were
the most common verbal behaviors, and retrospective medical information was
the focus of information exchange. The communication was highly interactive
when discussing patient status and future care plans. Nurses proactively
asked questions to capture a large proportion of the information they
needed.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
standards
EMTREE MEDICAL INDEX TERMS
doctor nurse relation
human
intensive care
interdisciplinary communication
patient care
patient transport
public relations
questionnaire
retrospective study
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
25813295 (http://www.ncbi.nlm.nih.gov/pubmed/25813295)
PUI
L616371854
DOI
10.1016/j.jopan.2014.05.009
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jopan.2014.05.009
COPYRIGHT
Copyright 2017 Medline is the source for the citation and abstract of this
record.
RECORD 222
TITLE
Transporting neonates to the NICU: A comparative study
AUTHOR NAMES
Rosin M.
Ehrlich L.
Margaret B.
AUTHOR ADDRESSES
(Rosin M.; Ehrlich L.; Margaret B.) Department of Neonatology, Centenary
Hospital for Women and Children, Australia.
(Margaret B.) Australian Catholic University, Australia.
CORRESPONDENCE ADDRESS
M. Rosin, Department of Neonatology, Centenary Hospital for Women and
Children, Australia.
SOURCE
Journal of Paediatrics and Child Health (2015) 51 SUPPL. 1 (52). Date of
Publication: April 2015
CONFERENCE NAME
19th Annual Meeting of the Perinatal Society of Australia and New Zealand,
PSANZ 2015
CONFERENCE LOCATION
Melbourne, VIC, Australia
CONFERENCE DATE
2015-04-19 to 2015-04-22
ISSN
1034-4810
BOOK PUBLISHER
Blackwell Publishing
ABSTRACT
Background: It is important during the transfer of a neonate to the Neonatal
Intensive Care Unit (NICU) the neonate's physiological status is maintained
within normal limits. At the Canberra NICU a variety of transport vehicles
(TV) are used to transport neonates to the NICU. In 2014 we trialled the
General Electric Shuttle (GES) to transport neonates to the NICU,
hypothesising the shuttle wouldn't have any significant effect on the
physiological state of neonates. Method: A prospective comparative study
comparing the physiological state of the neonates transported via the GES
and other TV was undertaken over three weeks. Data included: Gestation (GA),
Birthweight (BW), and vital signs (VS) on admission (OA) and for four hours
post transfer (PT). Data were analysed using one way ANOVA on SPSS version
20. Significance = p < 0.05 Results: Study numbers = GES (12) and TV(15).
There was no significant (ns) difference in weeks GA (34.0 ± 2.6, 33.5 ±
4.4, p = 0.723 respectively) or BW (2335 ± 681, 1948 ± 864 grams, p = 0.229
respectively) when comparing the two groups. Study results demonstrated a
higher diastolic mean blood pressure in the shuttle group (36 ± 8, 25 ±8 p<
0.05) but otherwise no ns between the two groups OA: Temperature (37.9 c ±
0.54, 37.0 c ± 0.58 c, p = 0.946 respectively) Heart Rate (152 ± 20, 156 ±
14, p = 0.588 respectively) Respiratory Rate (54 ± 9, 52 ± 6, p = 0.583
respectively) or the four hours PT. Conclusion: This study has shown the GES
is a safe method to transport neonates with the added benefit of not having
to relocate the neonate on arrival at the NICU.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Australia and New Zealand
comparative study
newborn
society
EMTREE MEDICAL INDEX TERMS
analysis of variance
birth weight
breathing rate
data analysis software
heart rate
intensive care unit
mean arterial pressure
newborn intensive care
pregnancy
temperature
vital sign
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71873911
DOI
10.1111/jpc.12884-3
FULL TEXT LINK
http://dx.doi.org/10.1111/jpc.12884-3
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 223
TITLE
Development of an in-house TomoTherapy transfer plan check
AUTHOR NAMES
Nundlall N.
Clifford C.
Tudor S.
Natarajan K.
AUTHOR ADDRESSES
(Nundlall N.; Natarajan K.) University Hospital Birmingham NHS Foundation
Trust, CCISS Radiotherapy Physics, Birmingham, United Kingdom.
(Clifford C.; Tudor S.) University Hospital Birmingham NHS Foundation Trust,
Radiotherapy Physics, Birmingham, United Kingdom.
CORRESPONDENCE ADDRESS
N. Nundlall, University Hospital Birmingham NHS Foundation Trust, CCISS
Radiotherapy Physics, Birmingham, United Kingdom.
SOURCE
Radiotherapy and Oncology (2015) 115 SUPPL. 1 (S902-S903). Date of
Publication: April 2015
CONFERENCE NAME
3 ESTRO Forum
CONFERENCE LOCATION
Barcelona, Spain
CONFERENCE DATE
2015-04-24 to 2015-04-28
ISSN
0167-8140
BOOK PUBLISHER
Elsevier Ireland Ltd
ABSTRACT
Purpose/Objective: At the UHB Radiotherapy department we have two
TomoTherapy HD units. The QA procedure for patients being treated on
TomoTherapy (Tomo) is that a patient specific delivery QA (DQA) must be
carried out prior to the patient beginning treatment, using out Delta4
phantom. For Category 1 patients, a secondary DQA must be carried out (known
as a transfer plan), so there is one plan for each of the two rooms in case
of a treatment delivery unit breakdown. The Tomo HD units have dynamic jaws
functionality (known as TomoEDGE) which speeds up the delivery time thus
enabling us to increase patient throughput. More throughput means more time
required on the machines to carry out DQA. The aim of this project is to
reduce the workload of patient specific QA on transfer plans. The solution
should be auditable, safe, secure, maintainable, not impact on already
deployed clinical software and present the required results in a presentable
format to attach to patient records in our Oncology Management System (OMS),
MOSAIQ. Materials and Methods: The two DICOM Tomo RT plan files were
validated and interpreted using dcm4chee library and private Tomo DICOM tags
compared using standard Java libraries. A web application was created using
the robust infrastructure of Enterprise Java Beans (EJB) to allow the user
to load the two plans for comparison. The sinogram from the two plans were
compared against each other by taking into account the latency differences
between the machines. As TomoEDGE functionality is used, the jaw positions
for each projection were also compared. The results of the comparison are
displayed in the Graphical User Interface (GUI) as a table and graph. The
entire program suite was developed using Netbeans. Results: A robust and
maintainable solution has been put in place through a web application
without interfering with any software medical devices. The table of values
that have been compared against tolerances can be attached as a PDF document
to the patient records in the OMS. The graphical user aspects of the
application have been tested with the automated testing package, Selenium.
This enables future modifications in the program to have the vast majority
of its user interface checked without user intervention. The developed
application had its business logic tested using JUnit4 with 23
representative datasets. This program has the capability of reducing the
time it takes to carry out patient specific QA by removing the need to
deliver the transfer plan on the second machine, which takes 40 minutes for
the first patient and 20 minutes for subsequent patients. Conclusions: An
application has been developed that meet the overarching requirements of
such medical software. It is a reliable independent check on transfer plans.
It has reduced the need to carry out transfer plan checks on the second
TomoTherapy machine. It will be running in parallel with the QA procedure of
checking patient transfer plans and then eventually integrated into the QA
workflow.
EMTREE DRUG INDEX TERMS
selenium
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
tomotherapy
EMTREE MEDICAL INDEX TERMS
bean
commercial phenomena
computer interface
digital imaging and communications in medicine
human
jaw
latent period
library
machine
medical device
medical record
oncology
outpatient
patient
patient transport
phantom
procedures
radiotherapy
software
velocity
workflow
workload
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71962185
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 224
TITLE
Pediatric critical care transport as a conduit to palliative care: A case
series and literature review
AUTHOR NAMES
Bernier M.
Noje C.
Costabile P.
Klein B.
Kudchadkar S.
AUTHOR ADDRESSES
(Bernier M.; Noje C.; Kudchadkar S.) Department of Anesthesia and Critical
Care, Johns Hopkins Hospital, Baltimore, United States.
(Costabile P.) Pediatric Nursing, Johns Hopkins Hospital, Baltimore, United
States.
(Klein B.) Pediatrics, Johns Hopkins Hospital, Baltimore, United States.
CORRESPONDENCE ADDRESS
M. Bernier, Department of Anesthesia and Critical Care, Johns Hopkins
Hospital, Baltimore, United States.
SOURCE
Journal of Investigative Medicine (2015) 63:3 (585-586). Date of
Publication: March 2015
CONFERENCE NAME
American Federation for Medical Research Eastern Regional Meeting, AFMR 2015
CONFERENCE LOCATION
Washington, DC, United States
CONFERENCE DATE
2015-04-16 to 2015-04-16
ISSN
1081-5589
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Purpose of Study: To present a series of three successful pediatric
palliative critical care transports from the Intensive Care Unit (ICU) of a
tertiary care facility to home and to provide an overview of the existing
literature on both pediatric and adult palliative critical care transports.
Methods Used: Cases were identified from the Johns Hopkins Hospital
Pediatric Transport database and the literature review was based on the
National Library of Medicine PubMed search from 1975 to present. All three
cases were terminally ill pediatric patients unable to separate from
lifesustaining medical devices in the ICU who were transported home for
terminal extubation and end of life care according to their families'
wishes. Review of transport and palliative care literature focusing on the
end of life transport process from ICU to home was then undertaken. All
pediatric and adult studies (case reports, case series and review articles)
were included. Summary of Results: All three cases presented similar
logistical challenges due to the patients' unstable medical condition and
urgent need for transport to facilitate the families' wishes for withdrawal
of care and death at home. These included the need to clarify resuscitation
status pre-transport and the limited time to organize the transport (mode of
transport and team composition), as well as to coordinate home palliative
care with the existent resources in the community. The literature review
identified a very limited number of case reports (1 in neonates, 2 in
children and 8 in the adult aging population) which shared our logistical
challenges. Conclusions: Palliative critical care transports pose a unique
set of challenges in both pediatric and adult populations. Limited data
exist in the literature surrounding this field. These data in combination
with our recent pediatric experience support the need for further research
and formal program development for end of life critical care transports.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
American
case study
intensive care
medical research
palliative therapy
EMTREE MEDICAL INDEX TERMS
adult
aging
case report
child
community
data base
death
extubation
hospital
human
intensive care unit
laryngeal mask
library
medical device
Medline
newborn
non implantable urine incontinence electrical stimulator
patient
population
program development
resuscitation
rigid telescope
terminal care
terminally ill patient
tertiary care center
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71820620
DOI
10.1097/JIM.0000000000000173
FULL TEXT LINK
http://dx.doi.org/10.1097/JIM.0000000000000173
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 225
TITLE
Goal directed intraoperative therapy for head and neck microvascular free
tissue transfer
AUTHOR NAMES
Hand W.R.
Stoll W.D.
McEvoy M.D.
AUTHOR ADDRESSES
(Hand W.R.; Stoll W.D.) Anesthesiology and Perioperative Medicine, Medical
University of South Carolina, Charleston, United States.
(McEvoy M.D.) Anesthesiology, Vanderbilt University, Nashville, United
States.
CORRESPONDENCE ADDRESS
W.R. Hand, Anesthesiology and Perioperative Medicine, Medical University of
South Carolina, Charleston, United States.
SOURCE
Anesthesia and Analgesia (2015) 120:3 SUPPL. 1 (S317). Date of Publication:
March 2015
CONFERENCE NAME
2015 Annual Meeting of the International Anesthesia Research Society, IARS
2015
CONFERENCE LOCATION
Honolulu, HI, United States
CONFERENCE DATE
2012-03-21 to 2012-03-24
ISSN
0003-2999
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
INTRODUCTION: Patients receiving free flap of the head and neck,
historically, large volumes of fluid have been administered to maintain
hemodynamic stability. This practice is due to an anecdotal belief that
vasoactive medications should be avoided due to microvascular anastomoses.
However, recent evidence suggests vasopressors are commonly used and have
minimal affect on human flap outcomes. In intermediate to high-risk
surgeries, utilizing Goal Directed Therapy (GDT) has been associated with
improved patient outcomes. Our study aims to show an intraoperative GDT
protocol decreases intensive care unit (ICU) length of stay (LOS) for
patients receiving a free tissue transfer reconstruction of the head and
neck. METHOD: 94 patients scheduled for a primary resection of the head and
neck with resultant free flap reconstruction were enrolled following
inclusion/exclusion criteria and randomized into treatment or control
protocols. Treatment group therapy followed a specific algorithm (Figure 1)
utilizing real-time values from arterial waveform analysis. These values
included blood pressure, stroke volume variation, cardiac index, and
systemic vascular resistance. Control group patients' therapy was limited to
judicious administration of fluids to maintain blood pressure within 20% of
baseline. Our primary endpoint was ICU length of stay (LOS) with secondary
endpoints included: flap failure, medical complications, and total fluid
administration. RESULTS: 94 patients were enrolled between April 2013 and
August 2014. The groups were similar in terms of age, race, gender, type of
flap, ASA classification, BMI, and smoking status. The ICU length of stay
was significantly shorter in the treatment group (32.2h vs 57.3h, p=0.025).
The total hospital length of stay was shorter, but did not reach statistical
significance (180.0h vs 258.4h, p=0.101). The incidence of major surgical
morbidity was higher in the control group for all categories, though none
reached statistical significance: flap failure (4.25% vs 6.38%), flap death
(4.25% vs 8.51%) or need for reoperation (8.51% vs 17.02%), Patients in both
groups received similar total volumes of fluid (5887 vs 6318mL, p=0.462).
CONCLUSION: Our results indicate patients treated with arterial
waveform-derived GDT had a decreased ICU LOS. This is a reasonable proxy for
several clinical events including adequate spontaneous ventilation,
hemodynamic stability, flap viability, and return of cognitive function.
Many GDT patients required vasoactive medication administration without a
measurable increase in flap failure or death. (Table Presented).
EMTREE DRUG INDEX TERMS
hypertensive factor
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
anesthesia
free tissue graft
neck
society
therapy
EMTREE MEDICAL INDEX TERMS
algorithm
anastomosis
blood pressure
breathing
cardiac index
classification
cognition
control group
death
drug therapy
gender
graft failure
group therapy
heart stroke volume
hospital
human
intensive care unit
length of stay
liquid
morbidity
patient
reoperation
risk
smoking
statistical significance
surgery
systemic vascular resistance
waveform
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72149151
DOI
10.1213/01.ane.0000470325.07465.0f
FULL TEXT LINK
http://dx.doi.org/10.1213/01.ane.0000470325.07465.0f
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 226
TITLE
Audit of intra-hospital inpatient transfers to the respiratory high
dependency unit at the princess alexandra hospital during 2013
AUTHOR NAMES
Baird T.
Hukins C.
Murphy M.
AUTHOR ADDRESSES
(Baird T.; Hukins C.; Murphy M.) Princess Alexandra Hospital, Australia.
CORRESPONDENCE ADDRESS
T. Baird, Princess Alexandra Hospital, Australia.
SOURCE
Respirology (2015) 20 SUPPL. 2 (133). Date of Publication: March 2015
CONFERENCE NAME
2015 Annual Scientific Meetings of the Thoracic Society of Australia and New
Zealand and the Australian and New Zealand Society of Respiratory Science,
TSANZSRS 2015
CONFERENCE LOCATION
Gold Coast, QLD, Australia
CONFERENCE DATE
2015-03-27 to 2015-04-01
ISSN
1323-7799
BOOK PUBLISHER
Blackwell Publishing
ABSTRACT
Aim: The PA Respiratory High Dependency Unit (RHDU) manages high acuity
respiratory patients. Although the majority of patients admitted to the RHDU
come through the Emergency Department (ED), a number of patients require
intra-hospital transfer from other treating teams. The aim was to compare
this cohort of patients to those admitted directly from ED to determine
whether there were differences in clinical features, management and
outcomes. Methods: Retrospective audit of patients admitted to the RHDU as
intrahospital transfers from non-respiratory treating teams during 2013.
Outcomes were compared to patients admitted to the RHDU directly from ED
during the same period. Results: 34 patients required intra-hospital
transfer, 26 (76%) from medical teams. The mean ± SD age was 64 ± 13.71
years. 12 patients (35%) had a respiratory diagnosis on hospital admission;
10 of these (29%) met criteria for admission under Respiratory Medicine and
4 (11%) met criteria for RHDU admission at initial presentation. 22 patients
(69%) were originally admitted though the ED outside of standard working
hours. 19 patients (56%) spent < 72 hours on the ward prior to RHDU
transfer. Compared to direct RHDU admissions, intra-hospital transfer
patients were more likely to have a higher acuity score (TISS 16 (IQR 14-18)
vs 14 (IQR 12-15), p < 0.001), die in RHDU (9% vs 0%, p = 0.008), or die in
hospital (24% vs 3.6%, p < 0.05). There was a trend toward higher rates of
respiratory failure (88.2% vs 70.3%, p = 0.06). There was no difference in
age, NIV requirement or RHDU length of stay. Conclusion: Compared to
patients admitted directly to the RHDU, those undergoing intra-hospital
transfer have worse outcomes. A significant number of patients that met
criteria for admission under Respiratory Medicine were admitted
inappropriately under other teams, often outside of standard working hours.
Stricter adherence to current Respiratory Medicine admission criteria may
improve outcomes.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Australia and New Zealand
Australian
clinical audit
hospital
hospital patient
human
New Zealand
society
EMTREE MEDICAL INDEX TERMS
clinical feature
diagnosis
emergency ward
hospital admission
length of stay
patient
patient transport
respiratory failure
ward
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71870941
DOI
10.1111/resp.12495
FULL TEXT LINK
http://dx.doi.org/10.1111/resp.12495
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 227
TITLE
“Patient-safety during the PICU transfer”
AUTHOR NAMES
Trigoso E.
Dolz C.
Riera V.
Alberola E.
Almodovar A.
AUTHOR ADDRESSES
(Trigoso E.; Dolz C.; Riera V.; Alberola E.; Almodovar A.) Hospital U y P LA
FE, Agencia Valenciana de Salud, Ribarroja del Turia, Spain.
CORRESPONDENCE ADDRESS
E. Trigoso, Hospital U y P LA FE, Agencia Valenciana de Salud, Ribarroja del
Turia, Spain.
SOURCE
Bone Marrow Transplantation (2015) 50 SUPPL. 1 (S515-S516). Date of
Publication: March 2015
CONFERENCE NAME
41st Annual Meeting of the European Society for Blood and Marrow
Transplantation, EBMT 2015
CONFERENCE LOCATION
Istanbul, Turkey
CONFERENCE DATE
2015-03-22 to 2015-03-25
ISSN
0268-3369
BOOK PUBLISHER
Nature Publishing Group
ABSTRACT
Introduction: Background: “It is generally agreed that patient's safety can
be defined as freedom for a patient from unnecessary or potential harm
associated with health care” ∗ Through the process and, due to the intensity
of the therapy, BMT is still associated with a variety of complications that
may require admission to paediatric intensive care. The average of HSCT
children admitted in PICU varies between 10% and 20%, although peaks of 44%
have been reported. The main causes were: Severe sepsis, fluid overload, and
respiratory distress. Paediatric Transplants Unit from Hospital
Universitario y Politécnico “La Fe” carries out an average of 25 HSCT a year
autologus, alogeneics (related and undreleated donors) and haplo. ∗ and the
average of patients who need to be transfer to PICU is similar to other
Centers. Objectives: - To increase the transplanted patient's safety during
the transfer from the HSCT ward to the PICU, by systematizing information,
developing a continuity of care report and following a checklist in order to
increase the quality and effectiveness of information transfer. - To avoid
the mistakes in the information transfers getting an efficient communication
among health care professionals. - Work team between both Units in order to
assure the continuity of the care and, therefore, this team work is vital
during all the transplant process. Method: METODOLOGY - Bibliography review
in order to know the scientific evidence about this topic. - We have also
valued our daily professional experience. - Periodic meetings among nurses
from both units have been established. - The Project aim is to elaborate a
standardized operating procedure with the information required in order to
guarantee the patient's safety during that process. It has been developed
based in the Human Needs Model from Virginia Henderson and the IDEAS
techniques. Conclusion: COMMENTS: Regarding the continuity of the cares and
the patient-safety periodically, we think that working parties among
intensivists physicians and nurses, hemato-oncologist nurses and physicians
as well as others health care professional, are of vital importance and
should be mandatory.
EMTREE DRUG INDEX TERMS
iron
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
blood
bone marrow
European
human
patient safety
society
transplantation
EMTREE MEDICAL INDEX TERMS
checklist
child
donor
error
health care
health care personnel
hospital
human needs
hypervolemia
intensive care
intensivist
interpersonal communication
model
nurse
oncologist
patient
patient care
physician
procedures
publication
respiratory distress
sepsis
teamwork
therapy
United States
ward
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71830633
DOI
10.1038/bmt.2015.32
FULL TEXT LINK
http://dx.doi.org/10.1038/bmt.2015.32
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 228
TITLE
Face-to-face handoff: improving transfer to the pediatric intensive care
unit after cardiac surgery
AUTHOR NAMES
Vergales J.
Addison N.
Vendittelli A.
Nicholson E.
Carver D.J.
Stemland C.
Hoke T.
Gangemi J.
AUTHOR ADDRESSES
(Vergales J., jvergales@virginia.edu; Addison N.; Vendittelli A.; Nicholson
E.; Carver D.J.; Stemland C.; Hoke T.; Gangemi J.) University of Virginia
Health System, Charlottesville, VA
SOURCE
American journal of medical quality : the official journal of the American
College of Medical Quality (2015) 30:2 (119-125). Date of Publication: 1 Mar
2015
ISSN
1555-824X (electronic)
ABSTRACT
The goal was to develop and implement a comprehensive, primarily
face-to-face handoff process that begins in the operating room and concludes
at the bedside in the intensive care unit (ICU) for pediatric patients
undergoing congenital heart surgery. Involving all stakeholders in the
planning phase, the framework of the handoff system encompassed a
combination of a formalized handoff tool, focused process steps that
occurred prior to patient arrival in the ICU, and an emphasis on
face-to-face communication at the conclusion of the handoff. The final
process was evaluated by the use of observer checklists to examine quality
metrics and timing for all patients admitted to the ICU following cardiac
surgery. The process was found to improve how various providers view the
efficiency of handoff, the ease of asking questions at each step, and the
overall capability to improve patient care regardless of overall surgical
complexity.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
interpersonal communication
pediatric intensive care unit
standards
thorax surgery
total quality management
EMTREE MEDICAL INDEX TERMS
checklist
clinical handover
human
patient care
patient transport
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
24443318 (http://www.ncbi.nlm.nih.gov/pubmed/24443318)
PUI
L615080815
DOI
10.1177/1062860613518419
FULL TEXT LINK
http://dx.doi.org/10.1177/1062860613518419
COPYRIGHT
Copyright 2017 Medline is the source for the citation and abstract of this
record.
RECORD 229
TITLE
Transferring the critically ill patient: Are we there yet?
AUTHOR NAMES
Droogh J.M.
Smit M.
Absalom A.R.
Ligtenberg J.J.M.
Zijlstra J.G.
AUTHOR ADDRESSES
(Droogh J.M., j.m.droogh@umcg.nl; Smit M., m.smit@umcg.nl; Zijlstra J.G.,
j.g.zijlstra@umcg.nl) University Medical Center Groningen, University of
Groningen, Department of Critical Care, Research Program for Critical Care,
Anesthesiology, Per-operative and Emergency medicine (CAPE), Hanzeplein 1,
Groningen, Netherlands.
(Absalom A.R., a.r.absalom@umcg.nl) University Medical Center Groningen,
University of Groningen, Department of Anesthesiology, Research Program for
Critical Care, Anesthesiology, Per-operative and Emergency medicine (CAPE),
Hanzeplein 1, Groningen, Netherlands.
(Ligtenberg J.J.M., j.j.m.ligtenberg@umcg.nl) University Medical Center
Groningen, University of Groningen, Emergency Department, Research Program
for Critical Care, Anesthesiology, Per-operative and Emergency medicine
(CAPE), Hanzeplein 1, Groningen, Netherlands.
CORRESPONDENCE ADDRESS
J.M. Droogh, University Medical Center Groningen, University of Groningen,
Department of Critical Care, Research Program for Critical Care,
Anesthesiology, Per-operative and Emergency medicine (CAPE), Hanzeplein 1,
Groningen, Netherlands.
SOURCE
Critical Care (2015) 19:1 Article Number: 62. Date of Publication: 20 Feb
2015
ISSN
1466-609X (electronic)
1364-8535
BOOK PUBLISHER
BioMed Central Ltd., info@biomedcentral.com
ABSTRACT
During the past few decades the numbers of ICUs and beds has increased
significantly, but so too has the demand for intensive care. Currently
large, and increasing, numbers of critically ill patients require transfer
between critical care units. Inter-unit transfer poses significant risks to
critically ill patients, particularly those requiring multiple organ
support. While the safety and quality of inter-unit and hospital transfers
appear to have improved over the years, the effectiveness of specific
measures to improve safety have not been confirmed by randomized controlled
trials. It is generally accepted that critically ill patients should be
transferred by specialized retrieval teams, but the composition, training
and assessment of these teams is still a matter of debate. Since it is
likely that the numbers and complexity of these transfers will increase in
the near future, further studies are warranted.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
patient transport
EMTREE MEDICAL INDEX TERMS
clinical effectiveness
health care quality
human
intensive care
intensive care unit
intermethod comparison
legal aspect
patient care
patient safety
priority journal
randomized controlled trial (topic)
review
risk factor
total quality management
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2015810755
MEDLINE PMID
25887575 (http://www.ncbi.nlm.nih.gov/pubmed/25887575)
PUI
L602649276
DOI
10.1186/s13054-015-0749-4
FULL TEXT LINK
http://dx.doi.org/10.1186/s13054-015-0749-4
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 230
TITLE
Posterior spinal postsurgical infection: Infection, obesity and transferring
to ICU as independent risk factors
AUTHOR NAMES
Na S.
Xu T.
Guo H.-L.
Sheng W.-B.
AUTHOR ADDRESSES
(Na S.; Xu T.; Guo H.-L.; Sheng W.-B.) Department of Spinal Surgery, The
First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
CORRESPONDENCE ADDRESS
W.-B. Sheng, Department of Spinal Surgery, The First Affiliated Hospital of
Xinjiang Medical University, Urumqi, China.
SOURCE
Chinese Journal of Tissue Engineering Research (2015) 19:7 (1127-1132). Date
of Publication: 12 Feb 2015
ISSN
1673-8225
BOOK PUBLISHER
Journal of Clinical Rehabilitative Tissue Engineering Research,
lei_0415@hotmail.com
ABSTRACT
BACKGROUND: With the application of new screw-rod system, fusion cage and
minimally invasive techniques, the amount of spinal surgeries becomes
gradually increasing, along with expanded surgical scope and increased
surgical difficulty. Meanwhile, postoperative infection rate is also
increasing. Postoperative infections after spinal surgery often lead to
increased length of stay and hospital costs, and cause neurological
deterioration, and even death. OBJECTIVE: To investigate the risk factors
and treatment strategies of posterior spinal postoperative infections.
METHODS: A retrospective analysis including 857 cases of posterior spinal
surgery from September 2012 to September 2013 in the Department of Spinal
Surgery, the First Affiliated Hospital of Xinjiang Medical University was
performed. These patients were divided into infection (n=34) and
non-infection (n=823) groups. We compared the preoperative, intraoperative,
postoperative factors affecting postoperative infection in the two groups,
and summarized the therapeutic strategies by analyzing the treatment methods
and therapeutic effects. RESULTS AND CONCLUSION: The infection rate after
posterior spinal surgery was 3.97% (34/857). There were significantly
differences between the two groups in terms of muscle strength ≤ 3 level,
preoperative immune dysfunction, acute or chronic infection, obesity,
preoperative and postoperative incontinence or catheterization time ≥ 3
days, operative time ≥180 minutes, intraoperative bleeding, allogeneic bone
grafting, standard use of antibiotics, postsurgical transferring to ICU, the
number of drainage pipes, and the time of indwelling drainage tube (P<0.05),
while other variables showed no statistical significance. Logistic
regression analysis showed that acute or chronic infections, obesity (bone
mass index>30 kg/m(2)), transfering to ICU after surgery were independent
risk factors for posterior spinal postoperative infections. In addition,
individual treatment is preferred for different patients with posterior
spinal postoperative infections. It is even more important to choose the
appropriate treatment.
EMTREE DRUG INDEX TERMS
antibiotic agent (drug therapy)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
obesity
postoperative infection (drug therapy, drug therapy)
risk factor
surgical infection (drug therapy, drug therapy)
EMTREE MEDICAL INDEX TERMS
antibiotic therapy
article
bone transplantation
catheterization
controlled study
human
incontinence
infection rate
muscle strength
operation duration
operative blood loss
retrospective study
spine surgery
therapy effect
EMBASE CLASSIFICATIONS
Orthopedic Surgery (33)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
Chinese
LANGUAGE OF SUMMARY
English, Chinese
EMBASE ACCESSION NUMBER
2015399610
PUI
L606127199
DOI
10.3969/j.issn.2095-4344.2015.07.026
FULL TEXT LINK
http://dx.doi.org/10.3969/j.issn.2095-4344.2015.07.026
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 231
TITLE
Helicopter versus ground emergency medical services for the transportation
of traumatically injured children
AUTHOR NAMES
Stewart C.L.
Metzger R.R.
Pyle L.
Darmofal J.
Scaife E.
Moulton S.L.
AUTHOR ADDRESSES
(Stewart C.L., Camille.Stewart@ucdenver.edu; Moulton S.L.,
Steven.Moulton@childrenscolorado.org) University of Colorado School of
Medicine, Department of Surgery, 12631 E. 17th Ave, Aurora, United States.
(Stewart C.L., Camille.Stewart@ucdenver.edu; Moulton S.L.,
Steven.Moulton@childrenscolorado.org) Children's Hospital Colorado, Division
of Pediatric Surgery, 13123 E. 16th Ave, Aurora, United States.
(Metzger R.R., metzger2020@gmail.com; Scaife E., Eric.Scaife@imail2.org)
Primary Children's Hospital, Division of Pediatric Surgery, 100 N Mario
Capecchi Dr, Salt Lake City, United States.
(Pyle L., Laura.Pyle@ucdenver.edu) University of Colorado School of
Medicine, Department of Pediatrics, 13001 E. 17th Place, Aurora, United
States.
(Darmofal J., Joe.Darmofal@childrenscolorado.org) Children's Hospital
Colorado, Department of Transport and EMS Outreach and Education, 13123 E.
16th Ave, Aurora, United States.
CORRESPONDENCE ADDRESS
C.L. Stewart, University of Colorado School of Medicine, Department of
Surgery, 12631 E. 17th Ave, Aurora, United States.
SOURCE
Journal of Pediatric Surgery (2015) 50:2 (347-352). Date of Publication: 1
Feb 2015
ISSN
1531-5037 (electronic)
0022-3468
BOOK PUBLISHER
W.B. Saunders
ABSTRACT
Background Helicopter emergency medical services (HEMS) are a common mode of
transportation for pediatric trauma patients. We hypothesized that HEMS
improve outcomes for traumatically injured children compared to ground
emergency medical services (GEMS). Methods We queried trauma registries of
two level 1 pediatric trauma centers for children 0-17 years, treated from
2003 to 2013, transported by HEMS or GEMS, with known transport starting
location and outcome. A geocoding service estimated travel distance and
time. Multivariate regression analyses were performed to adjust for injury
severity variables and travel distance/time. Results We identified 14,405
traumatically injured children; 3870 (26.9%) transported by HEMS and 10,535
(73.1%) transported by GEMS. Transport type was not significantly associated
with survival, ICU length of stay, or discharge disposition. Transport by
GEMS was associated with a 68.6%-53.1% decrease in hospital length of stay,
depending on adjustment for distance/time. Results were similar for children
with severe injuries, and with propensity score matched cohorts. Of note,
862/3850 (22.3%) of HEMS transports had an ISS < 10 and hospitalization < 1
day. Conclusions HEMS do not independently improve outcomes for
traumatically injured children, and 22.3% of children transported by HEMS
are not significantly injured. These factors should be considered when
requesting HEMS for transport of traumatically injured children.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
childhood injury
emergency health service
helicopter
EMTREE MEDICAL INDEX TERMS
adolescent
article
blunt trauma
child
comparative study
female
hospital discharge
hospitalization
human
infant
injury severity
intensive care unit
length of stay
major clinical study
male
newborn
priority journal
register
survival
time
travel
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2015751563
MEDLINE PMID
25638635 (http://www.ncbi.nlm.nih.gov/pubmed/25638635)
PUI
L602303696
DOI
10.1016/j.jpedsurg.2014.09.040
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jpedsurg.2014.09.040
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 232
TITLE
Scheduling pick-up and delivery jobs in a hospital to level ergonomic stress
AUTHOR NAMES
Elmbach A.F.
Boysen N.
Briskorn D.
Mothes S.
AUTHOR ADDRESSES
(Elmbach A.F.; Mothes S.) Friedrich-Schiller-Universität Jena, Lehrstuhl für
Management Science, Jena, Germany.
(Boysen N., nils.boysen@uni-jena.de) Friedrich-Schiller-Universität Jena,
Lehrstuhl für Operations Management, Jena, Germany.
(Briskorn D.) Bergische Universität Wuppertal, Professur für BWL,
insbesondere Produktion und Logistik, Wuppertal, Germany.
CORRESPONDENCE ADDRESS
N. Boysen, Friedrich-Schiller-Universität Jena, Lehrstuhl für Operations
Management, Jena, Germany.
SOURCE
IIE Transactions on Healthcare Systems Engineering (2015) 5:1 (42-53). Date
of Publication: 2 Jan 2015
ISSN
1948-8319 (electronic)
1948-8300
BOOK PUBLISHER
Taylor and Francis Inc., 325 Chestnut St, Suite 800, Philadelphia, United
States.
ABSTRACT
During a typical stay in a hospital patients visit multiple wards to receive
therapy and other treatment, so that a large number of intra-hospital
transportation jobs are to be accomplished each day. Transporting patients
in wheelchairs or beds causes ergonomic stress for the workforce, which
depends, for instance, on the conveyance vehicle, the tour length, and the
patient’s weight; excessive ergonomic strain, in turn, increases the risk of
musculoskeletal disorders. This article presents the case of a large-size
state-owned German hospital, where ergonomic aspects are to be integrated
into the scheduling of patient transports. We formalize the resulting
scheduling problem, settle computational complexity, provide exact and
heuristic solution procedures, and investigate managerial aspects in a
comprehensive computational study.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
ergonomic stress
health care management
patient scheduling
stress
EMTREE MEDICAL INDEX TERMS
algorithm
article
bed
body weight
decision making
health care personnel
hospital
hospitalization
human
manager
musculoskeletal disease
patient transport
priority journal
procedures
wheelchair
workflow
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2015837901
PUI
L603096619
DOI
10.1080/19488300.2014.996837
FULL TEXT LINK
http://dx.doi.org/10.1080/19488300.2014.996837
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 233
TITLE
Quality metrics in neonatal and pediatric critical care transport: A
national delphi project
AUTHOR NAMES
Schwartz H.P.
Bigham M.T.
Schoettker P.J.
Meyer K.
Trautman M.S.
Insoft R.M.
AUTHOR ADDRESSES
(Schwartz H.P.) Division of Emergency Medicine, Department of Pediatrics,
University of Cincinnati School of Medicine, Cincinnati, United States.
(Bigham M.T.) Division of Critical Care Medicine, Department of Pediatrics,
Northeast Ohio Medical University, Akron, United States.
(Schoettker P.J.) James M. Anderson Center for Health Systems Excellence,
Cincinnati Children's Hospital, Cincinnati, United States.
(Meyer K.) Division of Critical Care Medicine, Department of Pediatrics,
Miami Children's Hospital, Miami, United States.
(Trautman M.S.) Division of Neonatology, Department of Pediatrics, Indiana
University School of Medicine, Indianapolis, United States.
(Insoft R.M.) Department of Pediatrics, Brown University Alpert School of
Medicine, Providence, United States.
SOURCE
Pediatric Critical Care Medicine (2015) 16:8 (711-717). Date of Publication:
11 Nov 2015
ISSN
1947-3893 (electronic)
1529-7535
BOOK PUBLISHER
Lippincott Williams and Wilkins, LRorders@phl.lrpub.com
ABSTRACT
Objectives: The transport of neonatal and pediatric patients to tertiary
care facilities for specialized care demands monitoring the quality of care
delivered during transport and its impact on patient outcomes. In 2011,
pediatric transport teams in Ohio met to identify quality indicators
permitting comparisons among programs. However, no set of national consensus
quality metrics exists for benchmarking transport teams. The aim of this
project was to achieve national consensus on appropriate neonatal and
pediatric transport quality metrics. Design: Modified Delphi technique.
Setting: The first round of consensus determination was via electronic mail
survey, followed by rounds of consensus determination in-person at the
American Academy of Pediatrics Section on Transport Medicine's 2012 Quality
Metrics Summit. Subjects: All attendees of the American Academy of
Pediatrics Section on Transport Medicine Quality Metrics Summit, conducted
on October 21-23, 2012, in New Orleans, LA, were eligible to participate.
Measurements and Main Results: Candidate quality metrics were identified
through literature review and those metrics currently tracked by
participating programs. Participants were asked in a series of rounds to
identify "very important" quality metrics for transport. It was determined a
priori that consensus on a metric's importance was achieved when at least
70% of respondents were in agreement. This is consistent with other Delphi
studies. Eighty-two candidate metrics were considered initially. Ultimately,
12 metrics achieved consensus as "very important" to transport. These
include metrics related to airway management, team mobilization time,
patient and crew injuries, and adverse patient care events. Definitions were
assigned to the 12 metrics to facilitate uniform data tracking among
programs. Conclusions: The authors succeeded in achieving consensus among a
diverse group of national transport experts on 12 core neonatal and
pediatric transport quality metrics. We propose that transport teams across
the country use these metrics to benchmark and guide their quality
improvement activities.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health care quality
newborn intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
consensus
Delphi study
human
mobilization
patient care
priority journal
quality control
respiration control
tertiary care center
total quality management
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2015425134
MEDLINE PMID
26181297 (http://www.ncbi.nlm.nih.gov/pubmed/26181297)
PUI
L606281411
DOI
10.1097/PCC.0000000000000477
FULL TEXT LINK
http://dx.doi.org/10.1097/PCC.0000000000000477
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 234
TITLE
Rate of preventable early unplanned intensive care unit transfer for direct
admissions and emergency department admissions
AUTHOR NAMES
Reese J.
Deakyne S.J.
Blanchard A.
Bajaj L.
AUTHOR ADDRESSES
(Reese J., jennifer.reese@childrenscolorado.org) Section of Hospital
Medicine, Children's Hospital Colorado, 13123 E 16th Ave, Aurora, United
States.
(Deakyne S.J.) Department of Pediatrics, University of Colorado, Children's
Hospital Colorado, Aurora, United States.
(Blanchard A.) Research Informatics, Children's Hospital Colorado, Aurora,
United States.
(Bajaj L.) New York-Presbyterian Morgan Stanley Children's Hospital,
Columbia University Medical Center, New York, United States.
CORRESPONDENCE ADDRESS
J. Reese, Section of Hospital Medicine, Children's Hospital Colorado, 13123
E 16th Ave, Aurora, United States.
SOURCE
Hospital Pediatrics (2015) 5:1 (27-34). Date of Publication: 1 Jan 2015
ISSN
2154-1671 (electronic)
2154-1663
BOOK PUBLISHER
American Academy of Pediatrics, 141 Northwest Point Blvd, P.O. Box 927, Elk
Grove Village, United States.
ABSTRACT
BACKGROUND AND OBJECTIVE: Appropriate patient placement at the time of
admission to avoid unplanned transfers to the ICU and codes outside of the
ICU is an important safety goal for many institutions. The objective of this
study was to determine if the overall rate of unplanned ICU transfers within
12 hours of admission to the inpatient medical/surgical unit was higher for
direct admissions compared with emergency department (ED)
admissions.METHODS: This was a retrospective cohort study of all unplanned
ICU transfers within 12 hours of admission to an inpatient unit at a
tertiary care children's hospital from January 2010 to December 2012.
Proportions of preventable unplanned transfers from the ED and from direct
admission were calculated and compared.RESULTS: Over the study period, there
were a total of 46 998 admissions; 279 unplanned ICU transfers occurred
during the study period of which 101 (36%) were preventable. Preventable
unplanned transfers from each portal of entry were calculated and compared
with the total number of admissions from those portals. The portals of entry
evaluated included admissions from our internal ED versus all outside
facility transfers. The rates of early unplanned transfer (per 1000
admissions) by portal of entry were 3.50 for direct admissions and 3.18 for
ED. There was no difference between direct admissions and ED admissions
resulting in preventable unplanned transfers to the ICU (P =
.64).CONCLUSIONS: Rates of unplanned ICU transfers within 12 hours of
admission to an inpatient unit are not higher for direct admissions compared
with ED admissions. Further studies are required to determine clinical risk
factors associated with unplanned ICU transfer after admission, thus
allowing for more accurate initial patient placement.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency ward
hospital admission
intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
anaphylaxis
article
breath holding
child
clinical assessment
cohort analysis
comorbidity
controlled study
female
hospital management
hospital patient
human
major clinical study
male
medical error
medical history
practice guideline
preschool child
retrospective study
tertiary health care
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2015651156
MEDLINE PMID
25554756 (http://www.ncbi.nlm.nih.gov/pubmed/25554756)
PUI
L601136890
DOI
10.1542/hpeds.2013-0102
FULL TEXT LINK
http://dx.doi.org/10.1542/hpeds.2013-0102
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 235
TITLE
Prospective cohort study protocol to describe the transfer of patients from
intensive care units to hospital wards
AUTHOR NAMES
Buchner D.L.
Bagshaw S.M.
Dodek P.
Forster A.J.
Fowler R.A.
Lamontagne F.
Turgeon A.F.
Potestio M.
Stelfox H.T.
AUTHOR ADDRESSES
(Buchner D.L.) Faculty of Medicine, University of Calgary, Calgary, Canada.
(Bagshaw S.M.) Division of Critical Care Medicine, Faculty of Medicine and
Dentistry, University of Alberta, Edmonton, Canada.
(Dodek P.) Division of Critical Care Medicine, Center for Health Evaluation
and Outcome Sciences, St. Paul's Hospital, University of British Columbia,
Vancouver, Canada.
(Forster A.J.) Ottawa Hospital Research Institute, Department of Medicine,
University of Ottawa, Ottawa, Canada.
(Fowler R.A.) Department of Medicine, Department of Critical Care Medicine,
Sunnybrook Hospital, University of Toronto, Toronto, Canada.
(Lamontagne F.) Centre de Recherche du CHU de Sherbrooke, Universite de
Sherbrooke, Sherbrooke, Canada.
(Turgeon A.F.) Department of Anesthesiology and Critical Care Medicine, CHU
de Quebec Research Center, Quebec City, Canada.
(Potestio M.) Critical Care Strategic Clinical Network, Alberta Health
Services, Calgary, Canada.
(Stelfox H.T., tstelfox@ucalgary.ca) Department of Critical Care Medicine,
University of Calgary, Calgary, Canada.
CORRESPONDENCE ADDRESS
H.T. Stelfox, Department of Critical Care Medicine, University of Calgary,
Calgary, Canada. Email: tstelfox@ucalgary.ca
SOURCE
BMJ Open (2015) 5:7 Article Number: e007913. Date of Publication: 2015
ISSN
2044-6055 (electronic)
BOOK PUBLISHER
BMJ Publishing Group, subscriptions@bmjgroup.com
ABSTRACT
Introduction: The transfer of patient care between the intensive care unit
(ICU) and the hospital ward is associated with increased risk of medical
error and adverse events. This study will describe patient transfer from ICU
to hospital ward by documenting (1) patient, family and provider experiences
related to ICU transfer, (2) communication between stakeholders involved in
ICU transfer, (3) adverse events that follow ICU transfer and (4)
opportunities to improve ICU to hospital ward transfer. Methods: This is a
mixed methods prospective observational study of ICU to hospital ward
transfer practices in 10 ICUs across Canada. We will recruit 50 patients at
each site (n=500) who are transferred from ICU to hospital ward, and
distribute surveys to enrolled patients, family members, and healthcare
providers (ICU and ward physicians and nurses) after patient transfer. A
random sample of 6 consenting study participants (patients, family members,
healthcare providers) from each study site (n=60) will be offered an
opportunity to participate in interviews to further describe stakeholders'
experience with ICU to hospital ward transfer. We will abstract information
from patient health records to identify clinical data and use of transfer
tools, and identify adverse events that are related to the transfer. Ethics
and Dissemination: Research ethics board approval has been obtained at the
coordinating study centre (UofC REB13-0021) and 5 study sites (UofA
Pro00050646; UBC-PHC H14-01667; Sunnybrook 336-2014; QCH 14-07; Sherbrooke
14-172). Dissemination of the findings will provide a comprehensive
description of transfer from ICU to hospital ward in Canada including the
uptake of validated or local transfer tools, a conceptual framework of the
experiences and needs of stakeholders in the ICU transfer process, a summary
of adverse events experienced by patients after transfer from ICU to
hospital ward, and opportunities to guide quality improvement efforts.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
patient transport
ward
EMTREE MEDICAL INDEX TERMS
article
Canada
conceptual framework
family
health care personnel
human
interpersonal communication
major clinical study
medical error
total quality management
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2015203526
MEDLINE PMID
26155820 (http://www.ncbi.nlm.nih.gov/pubmed/26155820)
PUI
L605214819
DOI
10.1136/bmjopen-2015-007913
FULL TEXT LINK
http://dx.doi.org/10.1136/bmjopen-2015-007913
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 236
TITLE
Study of the condition and problems of the newborn infants before and during
transportation to mofid children's hospital NICU
AUTHOR NAMES
Kazemian M.
Hossein Fakhraee S.
Afjeh A.
Kosari K.
AUTHOR ADDRESSES
(Kazemian M.; Afjeh A.) Neonatologist, Shahid Beheshti University of Medical
Sciences, Tehran, Iran.
(Hossein Fakhraee S.) MD-FAAP, Neonatologist, Shahid Beheshti University of
Medical Sciences, Tehran, Iran.
(Kosari K., koroshkosari@yahoo.com) Neonatologist, AJA University of Medical
Sciences, Tehran, Iran.
CORRESPONDENCE ADDRESS
K. Kosari, Neonatologist, AJA University of Medical Sciences, Tehran, Iran.
SOURCE
Biosciences Biotechnology Research Asia (2015) 12:2 (1303-1309). Date of
Publication: 1 Aug 2015
ISSN
0973-1245
BOOK PUBLISHER
Oriental Scientific Publishing Company
ABSTRACT
Transportation of unstable newborn to well equiped NICU is very important in
managing such patients. So investigation the condition of transportation is
very important for revealing the probable problem. The aim of this study is
to investigate the condition and problems of the newborn infants before and
during transportation to Mofid children's Hospital NICU as a one of major
referal center in Iran. This is a cross sectional study conducted in Sep
2010 to Sep 2011. In this period all newborn transported to NICU ot Mofid
hospital were enrolled. For each newborn a questionnaire consisting of
question about demographic, condition of transportation, time of
transportation, drugs and other treatment measurs were filled. Totally 211
patients were enrolled. In 58(27.5%), 123 (58.5%), and 41 (19.4)% a MD, a
nurse or a technician respectively accompanied the newborn in
transportation. In 52(24.6%) cases had tracheal tube and In 159 (75.4) cases
did not have it. In 167(70.1%) were stable were reached to NICU. In 11 (5.2)
cases were hypothermic. In 31 (14.7%) cases were cyanotic. There were no
significant relation between person of transporter with stability of
newborn. Unstable newborn were transported by physician more than nurses and
technicians. In stable group more people passed the newborn CPR workshops
but this difference was not significant statistically. In spite of progress
in transportation condition recently, better specialized training for
newborn transportation can improve transportation yet. It is necessary to
register transportation data more precisely.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health care quality
newborn intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
anesthesiology
Apgar score
article
central venous catheter
cross-sectional study
diaphragm hernia
dystrophy
endotracheal tube
esophagus atresia
female
human
Iran
male
medical education
newborn care
nurse
physician
prematurity
private hospital
respiratory dystrophy
resuscitation
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Health Policy, Economics and Management (36)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2015334478
PUI
L605813334
DOI
10.13005/bbra/1785
FULL TEXT LINK
http://dx.doi.org/10.13005/bbra/1785
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 237
TITLE
Impact of Video Laryngoscopy on Advanced Airway Management by Critical Care
Transport Paramedics and Nurses Using the CMAC Pocket Monitor
AUTHOR NAMES
Boehringer B.
Choate M.
Hurwitz S.
Tilney P.V.R.
Judge T.
AUTHOR ADDRESSES
(Boehringer B., bradboehringer@gmail.com; Choate M., choatemi@gmail.com;
Tilney P.V.R., tilneype@cmhc.org; Judge T., tjudge@emhs.org) LifeFlight of
Maine, 13 Main Street, Camden, United States.
(Boehringer B., bradboehringer@gmail.com) Laurea University of Applied
Sciences, Uudenmaankatu 22, Hyvinkää, Finland.
(Hurwitz S., hurwitz@hms.harvard.edu) Brigham and Women's Biostatistics
Center, 5 Francis Street, Boston, United States.
CORRESPONDENCE ADDRESS
B. Boehringer, LifeFlight of Maine, 13 Main Street, Camden, United States.
SOURCE
BioMed Research International (2015) 2015 Article Number: 821302. Date of
Publication: 2015
ISSN
2314-6141 (electronic)
2314-6133
BOOK PUBLISHER
Hindawi Publishing Corporation, 410 Park Avenue, 15th Floor, 287 pmb, New
York, United States.
ABSTRACT
Accurate endotracheal intubation for patients in extremis or at risk of
physiologic decompensation is the gold standard for emergency medicine.
Field intubation is a complex process and time to intubation, number of
attempts, and hypoxia have all been shown to correlate with increases in
morbidity and mortality. Expanding laryngoscope technology which
incorporates active video, in addition to direct laryngoscopy, offers
providers improved and varied tools to employ in management of the advanced
airway. Over a nine-year period a helicopter emergency medical services
team, comprised of a flight paramedic and flight nurse, intended to intubate
790 patients. Comparative data analysis was performed and demonstrated that
the introduction of the CMAC video laryngoscope improved nearly every
measure of success in airway management. Overall intubation success
increased from 94.9% to 99.0%, first pass success rates increased from 75.4%
to 94.9%, combined first and second pass success rates increased from 89.2%
to 97.4%, and mean number of intubation attempts decreased from 1.33 to
1.08.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cmac pocket monitor video laryngoscope
intensive care
patient transport
respiration control
videolaryngoscope
EMTREE MEDICAL INDEX TERMS
adult
airplane crew
article
child
comparative study
data analysis
emergency health service
emergency medicine
endotracheal intubation
female
gold standard
human
hypoxia
infant
laryngoscopy
major clinical study
male
medical record review
morbidity
mortality
nurse
patient care
retrospective study
risk factor
total quality management
DEVICE TRADE NAMES
Video Laryngoscope Karl Storz
DEVICE MANUFACTURERS
Karl Storz
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Public Health, Social Medicine and Epidemiology (17)
Biophysics, Bioengineering and Medical Instrumentation (27)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2015173625
MEDLINE PMID
26167501 (http://www.ncbi.nlm.nih.gov/pubmed/26167501)
PUI
L605026536
DOI
10.1155/2015/821302
FULL TEXT LINK
http://dx.doi.org/10.1155/2015/821302
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 238
TITLE
Clinical outcomes of septic patients according to the elapsed time before
transfer to the intensive care unit
AUTHOR NAMES
Gonçalves Dias A.
Ribeiro Dos Santos E.
Faria Moura D.
Takao Lopes C.
Murata Murakami B.
AUTHOR ADDRESSES
(Gonçalves Dias A.; Ribeiro Dos Santos E.; Faria Moura D.; Murata Murakami
B.) Hospital Israelita Albert Einstein, São Paulo, Brazil.
(Takao Lopes C.) Universidade Federal de São Paulo, São Paulo, Brazil.
CORRESPONDENCE ADDRESS
B. Murata Murakami, Hospital Israelita Albert Einstein, São Paulo, Brazil.
SOURCE
Intensive Care Medicine Experimental (2015) 3 Supplement 1 Article Number:
A229. Date of Publication: 2015
ISSN
2197-425X (electronic)
BOOK PUBLISHER
SpringerOpen
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
patient transport
sepsis
EMTREE MEDICAL INDEX TERMS
clinical article
death
descriptive research
human
note
outcome assessment
priority journal
rapid response team
retrospective study
EMBASE CLASSIFICATIONS
Health Policy, Economics and Management (36)
Internal Medicine (6)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20160639940
PUI
L611852530
DOI
10.1186/2197-425X-3-S1-A229
FULL TEXT LINK
http://dx.doi.org/10.1186/2197-425X-3-S1-A229
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 239
TITLE
A two-site survey of clinicians to identify practices and preferences of
intensive care unit transfers to general medical wards
AUTHOR NAMES
Detsky M.E.
Ailon J.
Weinerman A.S.
Amaral A.C.
Bell C.M.
AUTHOR ADDRESSES
(Detsky M.E., mdetsky@mtsinai.on.ca; Ailon J., ailonj@smh.ca; Weinerman
A.S., weinerman@sunnybrook.ca; Amaral A.C.,
andrecarlos.amaral@sunnybrook.ca; Bell C.M., cbell@mtsinai.on.ca) Faculty of
Medicine, University of Toronto, Toronto, Canada.
(Bell C.M., cbell@mtsinai.on.ca) Institute of Health Policy, Management and
Evaluation, University of Toronto, Toronto, Canada.
(Detsky M.E., mdetsky@mtsinai.on.ca; Ailon J., ailonj@smh.ca; Weinerman
A.S., weinerman@sunnybrook.ca; Amaral A.C.,
andrecarlos.amaral@sunnybrook.ca; Bell C.M., cbell@mtsinai.on.ca) Department
of Medicine, University of Toronto, Toronto, Canada.
(Detsky M.E., mdetsky@mtsinai.on.ca; Bell C.M., cbell@mtsinai.on.ca)
Department of Medicine, Mount Sinai Hospital, Toronto, Canada.
(Amaral A.C., andrecarlos.amaral@sunnybrook.ca) Department of Critical Care
Medicine, Sunnybrook Health Sciences Centre, Toronto, Canada.
(Detsky M.E., mdetsky@mtsinai.on.ca) Perelman School of Medicine, University
of Pennsylvania, Philadelphia, United States.
(Detsky M.E., mdetsky@mtsinai.on.ca) Leonard Davis Institute, University of
Pennsylvania, Philadelphia, United States.
(Ailon J., ailonj@smh.ca) Department of Medicine, St Michael's Hospital,
Toronto, Canada.
(Weinerman A.S., weinerman@sunnybrook.ca) Department of Medicine, Sunnybrook
Health Sciences Center, Toronto, Canada.
CORRESPONDENCE ADDRESS
M.E. Detsky, Mount Sinai Hospital 600 University Ave, Suite 433, Toronto,
Canada.
SOURCE
Journal of Critical Care (2015) 30:2 (358-362). Date of Publication: 1 Apr
2015
ISSN
1557-8615 (electronic)
0883-9441
BOOK PUBLISHER
W.B. Saunders
ABSTRACT
Introduction: The transfer of patients from the intensive care unit (ICU) to
the general medical ward is high risk for adverse events and health care
provider dissatisfaction. We aimed to identify perceived practices, and what
information is important to communicate during an ICU transfer. Methods:
This study used a self-administered questionnaire that surveyed physicians
in 2 different hospitals. These physicians provide care in either the ICU or
the general medical ward. Responses were evaluated with Likert scales and
frequencies. Results: A total of 121 physicians (54% response rate)
completed the survey. Current practice most often includes written chart and
telephone communication. Most providers (63.3%) believed that the current
process is inadequate. Surprises are common (79% of respondents); and
reported adverse events include medication errors (60.4%), aspiration
(49.5%), and decreased level of consciousness requiring intervention
(44.6%). The use of an ICU transfer tool is one potential mechanism of
improving this process of care, and providers reported several items that
may be useful. Conclusion: Providers reported the current process of
transferring patients from the ICU to the general medical ward as
inadequate. We highlight data that physicians feel is important to
communicate at the time of transfer.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
general medical ward
intensive care unit
medical practice
patient transport
ward
EMTREE MEDICAL INDEX TERMS
article
aspiration
consciousness level
critically ill patient
death
hospital discharge
human
hypercapnia
hypotension
hypoxia
interpersonal communication
intervention study
Likert scale
medical education
medication error
outpatient
questionnaire
respiratory failure
seizure
self administration test
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2014959718
MEDLINE PMID
25499415 (http://www.ncbi.nlm.nih.gov/pubmed/25499415)
PUI
L600731498
DOI
10.1016/j.jcrc.2014.10.026
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jcrc.2014.10.026
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 240
TITLE
A national survey exploring views and experience of health professionals
about transferring patients from critical care home to die
AUTHOR NAMES
Darlington A.-S.E.
Long-Sutehall T.
Richardson A.
Coombs M.A.
AUTHOR ADDRESSES
(Darlington A.-S.E., a.darlington@soton.ac.uk; Long-Sutehall T.; Richardson
A.; Coombs M.A.) Faculty of Health Sciences, University of Southampton,
Highfield Campus, Southampton, United Kingdom.
(Coombs M.A.) Graduate School of Nursing, Midwifery and Health, Victoria
University of Wellington, Wellington, New Zealand.
CORRESPONDENCE ADDRESS
A.-S.E. Darlington, Faculty of Health Sciences, University of Southampton,
Highfield Campus, Southampton, United Kingdom.
SOURCE
Palliative Medicine (2015) 29:4 (363-370). Date of Publication: 25 Apr 2015
ISSN
1477-030X (electronic)
0269-2163
BOOK PUBLISHER
SAGE Publications Ltd, info@sagepub.co.uk
ABSTRACT
Background: Transferring critically ill patients home to die is poorly
explored in the literature to date. This practice is rare, and there is a
need to understand health care professionals' (HCP) experience and views.
Objectives: To examine (1) HCPs' experience of transferring patients home to
die from critical care, (2) HCPs' views about transfer and (3)
characteristics of patients, HCPs would hypothetically consider transferring
home to die. Design: A national study developing a web-based survey, which
was sent to the lead doctors and nurses in critical care units.
Setting/participants: Lead doctors and senior nurses (756 individuals)
working in 409 critical care units across the United Kingdom were invited to
participate in the survey. Results: In total, 180 (23.8%) completed surveys
were received. A total of 65 (36.1%) respondents had been actively involved
in transferring patients home to die and 28 (15.5%) had been involved in
discussions that did not lead to transfer. Respondents were supportive of
the idea of transfer home to die (88.8%). Patients identified by respondents
as unsuitable for transfer included unstable patients (61.8%), intubated and
ventilated patients (68.5%) and patients receiving inotropes (65.7%). There
were statistically significant differences in views between those with and
without experience and between doctors and nurses. Nurses and those with
experience tended to have more positive views. Conclusion: While
transferring patients home to die is supported in critical care, its
frequency in practice remains low. Patient stability and level of
intervention are important factors in decision-making in this area. Views
held about this practice are influenced by previous experience and the
professional role held.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
health care personnel
patient transport
terminal care
EMTREE MEDICAL INDEX TERMS
article
human
intensive care unit
major clinical study
nurse
patient identification
United Kingdom
ventilated patient
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2015866956
MEDLINE PMID
25656087 (http://www.ncbi.nlm.nih.gov/pubmed/25656087)
PUI
L603444783
DOI
10.1177/0269216315570407
FULL TEXT LINK
http://dx.doi.org/10.1177/0269216315570407
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 241
TITLE
Maternal colonization with group B streptococcus is associated with an
increased rate of infants transferred to the neonatal intensive care unit
AUTHOR NAMES
Brigtsen A.K.
Jacobsen A.F.
Dedi L.
Melby K.K.
Fugelseth D.
Whitelaw A.
AUTHOR ADDRESSES
(Brigtsen A.K., a.k.brigtsen@medisin.uio.no; Jacobsen A.F.; Melby K.K.;
Fugelseth D.; Whitelaw A.) Institute of Clinical Medicine, University of
Oslo, Kirkeveien 166, Oslo, Norway.
(Brigtsen A.K., a.k.brigtsen@medisin.uio.no; Fugelseth D.) Department of
Neonatal Intensive Care, Oslo University Hospital Ullevaal, Oslo, Norway.
(Jacobsen A.F.) Department of Obstetrics and Gynaecology, Oslo University
Hospital Ullevaal, Oslo, Norway.
(Dedi L.; Melby K.K.) Department of Microbiology, Oslo University Hospital
Ullevaal, Oslo, Norway.
CORRESPONDENCE ADDRESS
A.K. Brigtsen, Institute of Clinical Medicine, University of Oslo,
Kirkeveien 166, Oslo, Norway.
SOURCE
Neonatology (2015) 108:3 (157-163). Date of Publication: 18 Sep 2015
ISSN
1661-7819 (electronic)
1661-7800
BOOK PUBLISHER
S. Karger AG
ABSTRACT
Background:Streptococcus agalactiae (group B Streptococcus, GBS) is the most
common cause of early neonatal infection, but restricting the diagnosis to
culture-positive infants may underestimate the burden of GBS disease. Our
objective was to determine whether maternal GBS colonization was associated
with an increased risk of transfer of term infants to the neonatal intensive
care unit (NICU) and, if so, to estimate the incidence of probable
early-onset GBS disease. Methods: We conducted a prospective cohort study of
1,694 term infants whose mothers had vaginal-rectal swabs collected at
delivery. Data collected on each mother and infant included demographics,
clinical findings and laboratory investigations. The medical staff were
unaware of the maternal GBS colonization status. Results: A total of 26% of
the mothers were colonized. Infants born to colonized mothers did not differ
from infants born to non-colonized mothers with respect to birth weight or
Apgar score. Altogether, 30 (1.8%) of the term infants were transferred to
the NICU. Only 1 infant born to a colonized mother had culture-positive
early-onset GBS disease. Infants born to colonized mothers were more than 3
times as likely to be transferred to the NICU compared to infants of
non-colonized mothers (3.6 vs. 1.1%; OR 3.4, 95% CI 1.6-6.9, p = 0.001); 5
infants of colonized mothers had probable GBS disease with tachypnoea and
raised C-reactive protein (3.0/1,000 live term births). Conclusions:
Maternal GBS colonization is associated with increased risk of transfer to
the NICU in term infants. The burden of neonatal GBS disease may be greater
than indicated by the number of culture-positive cases.
EMTREE DRUG INDEX TERMS
C reactive protein (endogenous compound)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
bacterial colonization
group B streptococcal infection (etiology)
maternal colonization
newborn intensive care
Streptococcus agalactiae
EMTREE MEDICAL INDEX TERMS
adult
Apgar score
article
bacterium culture
birth weight
cohort analysis
female
gestational age
human
incidence
laboratory diagnosis
major clinical study
male
newborn
newborn infection (etiology)
Norway
onset age
outcome assessment
priority journal
prospective study
rectal swab
risk assessment
tachypnea
term birth
vagina smear
CAS REGISTRY NUMBERS
C reactive protein (9007-41-4)
EMBASE CLASSIFICATIONS
Obstetrics and Gynecology (10)
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2015456033
MEDLINE PMID
26182960 (http://www.ncbi.nlm.nih.gov/pubmed/26182960)
PUI
L606512392
DOI
10.1159/000434716
FULL TEXT LINK
http://dx.doi.org/10.1159/000434716
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 242
TITLE
Outcomes of preterm neonates transferred between tertiary perinatal centers
AUTHOR NAMES
Longhini F.
Jourdain G.
Ammar F.
Mokthari M.
Boithias C.
Romain O.
Letamendia E.
Tissieres P.
Chabernaud J.L.
De Luca D.
AUTHOR ADDRESSES
(Longhini F.; Jourdain G.; Ammar F.; Romain O.; Letamendia E.; Chabernaud
J.L.; De Luca D.) Division of Pediatrics and Neonatal Critical Care, FAME
Department, South Paris University Hospitals, Paris, France.
(Longhini F.) Anesthesia and Intensive Care, Sant'Andrea Hospital, ASL VC,
Vercelli, Italy.
(Mokthari M.; Boithias C.; Tissieres P.) Division of Paediatric Critical
Care and Neonatal Medicine, FAME Department, South Paris University
Hospitals, Paris, France.
SOURCE
Pediatric Critical Care Medicine (2015) 16:8 (733-738). Date of Publication:
11 Nov 2015
ISSN
1947-3893 (electronic)
1529-7535
BOOK PUBLISHER
Lippincott Williams and Wilkins, LRorders@phl.lrpub.com
ABSTRACT
Objective: To verify if preterm neonates transferred between tertiary
referral centers have worse outcomes than matched untransferred infants.
Design: Cohort study with a historically matched control group. Setting: Two
tertiary-level neonatal ICUs. Patients: Seventy-five neonates per group.
Interventions: Transfer between tertiary-level neonatal ICUs carried out by
a fully equipped transportation team. Measurements and Main Results: We
measured in-hospital mortality, frequency of intraventricular hemorrhage
greater than 2nd grade, periventricular leukomalacia, necrotizing
enterocolitis greater than or equal to grade 2, bronchopulmonary dysplasia,
composite outcomes (in-hospital mortality/bronchopulmonary dysplasia,
in-hospital mortality/intraventricular hemorrhage 2nd grade, and
bronchopulmonary dysplasia/periventricular leukomalacia/intraventricular
hemorrhage 2nd grade), length of neonatal ICU stay, weight at discharge, and
time spent on ventilatory support. Seventy-five similar (except for
antenatal steroids administration) neonates were enrolled in each cohort.
Cohorts did not differ in mortality, bronchopulmonary dysplasia,
intraventricular hemorrhage greater than 2nd grade, periventricular
leukomalacia, necrotizing enterocolitis greater than or equal to grade 2,
any composite outcomes, neonatal ICU stay, weight at discharge, and duration
of respiratory support. Results were unchanged adjusting for antenatal
steroids. Conclusions: Neonatal transfer between tertiary-level centers does
not impact on clinical outcomes, if performed under optimal conditions.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient transport
prematurity (epidemiology)
tertiary care center
EMTREE MEDICAL INDEX TERMS
anemia
Apgar score
article
assisted ventilation
birth weight
body weight
brain hemorrhage
cohort analysis
controlled study
encephalomalacia
female
gestational age
hospital discharge
human
hypoglycemia
hypotension
hypothermia
intensive care unit
lung dysplasia
major clinical study
male
necrotizing enterocolitis
neutropenia
newborn
newborn intensive care
newborn morbidity
newborn mortality
outcome assessment
perinatal care
priority journal
respiratory distress syndrome
thrombocytopenia
treatment duration
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2015425137
MEDLINE PMID
26132742 (http://www.ncbi.nlm.nih.gov/pubmed/26132742)
PUI
L606281427
DOI
10.1097/PCC.0000000000000482
FULL TEXT LINK
http://dx.doi.org/10.1097/PCC.0000000000000482
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 243
TITLE
Early transfer of cases from emergency (ER) to ICU (≤1 hour) - Does it
really make a big difference in outcome? An analysis
AUTHOR NAMES
Kar A.
Datta A.
Ahmed A.
AUTHOR ADDRESSES
(Kar A.; Datta A.; Ahmed A.) Medica Superspecialty Hospital, Medica
Institute of Critical Care (MICC), Kolkata, India.
CORRESPONDENCE ADDRESS
A. Kar, Medica Superspecialty Hospital, Medica Institute of Critical Care
(MICC), Kolkata, India.
SOURCE
Intensive Care Medicine Experimental (2015) 3 Supplement 1 Article Number:
A363. Date of Publication: 2015
ISSN
2197-425X (electronic)
BOOK PUBLISHER
SpringerOpen
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency ward
intensive care
turnaround time
EMTREE MEDICAL INDEX TERMS
APACHE
controlled study
human
mortality
mortality rate
note
priority journal
tertiary care center
EMBASE CLASSIFICATIONS
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20160632693
PUI
L611852679
DOI
10.1186/2197-425X-3-S1-A363
FULL TEXT LINK
http://dx.doi.org/10.1186/2197-425X-3-S1-A363
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 244
TITLE
Specialist teams for neonatal transport to neonatal intensive care units for
prevention of morbidity and mortality
AUTHOR NAMES
Chang A.S.
Berry A.
Jones L.J.
Sivasangari S.
AUTHOR ADDRESSES
(Chang A.S.; Berry A.; Jones L.J.; Sivasangari S.) Department of
Neonatology, KK Women's and Children's Hospital, 100 Bukit Timah Road,
Singapore, Singapore, 229899
SOURCE
The Cochrane database of systematic reviews (2015) 10 (CD007485). Date of
Publication: 2015
ISSN
1469-493X (electronic)
ABSTRACT
BACKGROUND: Maternal antenatal transfers provide better neonatal outcomes.
However, there will inevitably be some infants who require acute transport
to a neonatal intensive care unit (NICU). Because of this, many institutions
develop services to provide neonatal transport by specially trained health
personnel. However, few studies report on relevant clinical outcomes in
infants requiring transport to NICU.OBJECTIVES: To determine the effects of
specialist transport teams compared with non-specialist transport teams on
the risk of neonatal mortality and morbidity among high-risk newborn infants
requiring transport to neonatal intensive care.SEARCH METHODS: We used the
standard search strategy of the Cochrane Neonatal Review Group to search the
Cochrane Central Register of Controlled Trials (CENTRAL 2015, Issue 7),
MEDLINE (1966 to 31 July 2015), EMBASE (1980 to 31 July 2015), CINAHL (1982
to 31 July 2015), conference proceedings, and the reference lists of
retrieved articles for randomised controlled trials and quasi-randomised
trials.STUDY DESIGN: randomised, quasi-randomised or cluster randomised
controlled trials.POPULATION: neonates requiring transport to a neonatal
intensive care unit.INTERVENTION: transport by a specialist team compared to
a non-specialist team.OUTCOMES: any of the following outcomes - death;
adverse events during transport leading to respiratory compromise; and
condition on admission to the neonatal intensive care unit.DATA COLLECTION
AND ANALYSIS: The methodological quality of the trials was assessed using
the information provided in the studies and by personal communication with
the author. Data on relevant outcomes were extracted and the effect size
estimated and reported as risk ratio (RR), risk difference (RD), number
needed to treat for an additional beneficial outcome (NNTB) or number needed
to treat for an additional harmful outcome (NNTH) and mean difference (MD)
for continuous outcomes. Data from cluster randomised trials were not
combined for analysis.MAIN RESULTS: One trial met the inclusion criteria of
this review but was considered ineligible owing to serious bias in the
reporting of the results.AUTHORS' CONCLUSIONS: There is no reliable evidence
from randomised trials to support or refute the effects of specialist
neonatal transport teams for neonatal retrieval on infant morbidity and
mortality. Cluster randomised trial study designs may be best suited to
provide us with answers on effectiveness and clinical outcomes.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
newborn intensive care
organization and management
specialization
EMTREE MEDICAL INDEX TERMS
human
infant
infant mortality
newborn
patient care
patient transport
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
26508087 (http://www.ncbi.nlm.nih.gov/pubmed/26508087)
PUI
L611484528
DOI
10.1002/14651858.CD007485.pub2
FULL TEXT LINK
http://dx.doi.org/10.1002/14651858.CD007485.pub2
COPYRIGHT
Copyright 2016 Medline is the source for the citation and abstract of this
record.
RECORD 245
TITLE
Improving quality of data extractions for the computation of patient-days
and admissions
AUTHOR NAMES
Fortin É.
Gonzales M.
Fontela P.S.
Platt R.W.
Buckeridge D.L.
Quach C.
AUTHOR ADDRESSES
(Fortin É.; Platt R.W.; Buckeridge D.L.; Quach C., caroline.quach@mcgill.ca)
Department of Epidemiology, Biostatistics and Occupational Health, McGill
University, Montréal, Canada.
(Fortin É.; Quach C., caroline.quach@mcgill.ca) Direction des Risques
Biologiques et de la Santé Au Travail, Institut National de Santé Publique
du Québec, Québec and Montréal, Canada.
(Gonzales M.; Fontela P.S.; Quach C., caroline.quach@mcgill.ca) Department
of Pediatrics, Montréal Children's Hospital, McGill University, Montréal,
Canada.
CORRESPONDENCE ADDRESS
C. Quach, Montreal Children's Hospital of the MUHC, C1242 - 2300 Tupper St,
Montreal, Canada.
SOURCE
American Journal of Infection Control (2015) 43:2 (174-176). Date of
Publication: 1 Feb 2015
ISSN
1527-3296 (electronic)
0196-6553
BOOK PUBLISHER
Mosby Inc., customerservice@mosby.com
ABSTRACT
We describe how admissions/discharges/transfers datasets were carefully
reviewed for the computation of patient days and admissions used to monitor
resistance and antimicrobial use in 9 intensive care units. A visual
inspection of datasets and comparisons with other data sources improved
accuracy, completeness, and consistency of computations.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
data extraction
hospital admission
hospital discharge
patient transport
EMTREE MEDICAL INDEX TERMS
antimicrobial therapy
article
human
intensive care unit
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2014616983
MEDLINE PMID
25530553 (http://www.ncbi.nlm.nih.gov/pubmed/25530553)
PUI
L601001444
DOI
10.1016/j.ajic.2014.10.024
FULL TEXT LINK
http://dx.doi.org/10.1016/j.ajic.2014.10.024
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 246
TITLE
Critical Care Transport Training: New Strides in Simulating the Austere
Environment
AUTHOR NAMES
Alfes C.M.
Steiner S.L.
Manacci C.F.
AUTHOR ADDRESSES
(Alfes C.M.) Learning Resource Center, Frances Payne Bolton School of
Nursing, Case Western Reserve University in Cleveland, United States.
(Steiner S.L.; Manacci C.F.) Dorothy Ebersbach Academic Center for Flight
Nursing, Frances Payne Bolton School of Nursing, Case Reserve Western
University, United States.
SOURCE
Air Medical Journal (2015) 34:4 (186-187). Date of Publication: 1 Jul 2015
ISSN
1532-6497 (electronic)
1067-991X
BOOK PUBLISHER
Mosby Inc., customerservice@mosby.com
ABSTRACT
The air medical transport arena requires the practitioner to develop
clinical and diagnostic reasoning abilities to manage the dynamic needs of
the patient in unstructured, uncertain, and often unforgiving environments.
High-fidelity simulation can be instrumental in training interprofessional
flight teams to improve competency through quality and safe patient care
during medical transport that may otherwise take years to learn because of
the inconsistency in real-world experiences. Because of the suboptimal
circumstantial conditions inherent to critical care transport, a helicopter
simulator designed to discretely replicate the phases of flight and train
teams in air medical transport scenarios has been developed at the Dorothy
Ebersbach Academic Center for Flight Nursing at the Frances Payne Bolton
School of Nursing in Cleveland, OH. The goal is to prepare interdisciplinary
critical care transport flight teams in collaborative practice, research,
and leadership through measurable and highly structured learning activities.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
intensive care
training
EMTREE MEDICAL INDEX TERMS
article
feedback system
flight nursing
helicopter
human
leadership
medical education
patient care
patient safety
priority journal
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2015225702
MEDLINE PMID
26206542 (http://www.ncbi.nlm.nih.gov/pubmed/26206542)
PUI
L605364563
DOI
10.1016/j.amj.2015.03.006
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2015.03.006
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 247
TITLE
Mishaps during intrahospital transport of patients from emergency department
- A mixed bag of patients
AUTHOR NAMES
Taggu A.
Murthy S.
Krishna B.
Varma M.K.M.
AUTHOR ADDRESSES
(Taggu A.; Krishna B.) St. Johns Medical College Hospital, Critical Care
Medicine, Bangalore, India.
(Murthy S.; Varma M.K.M.) St. Johns Medical College Hospital, Emergency
Medicine, Bangalore, India.
CORRESPONDENCE ADDRESS
A. Taggu, St. Johns Medical College Hospital, Critical Care Medicine,
Bangalore, India.
SOURCE
Intensive Care Medicine Experimental (2015) 3 Supplement 1 Article Number:
A69. Date of Publication: 2015
ISSN
2197-425X (electronic)
BOOK PUBLISHER
SpringerOpen
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency ward
patient transport
EMTREE MEDICAL INDEX TERMS
arterial line
device failure
electrocardiography lead displacement
health care availability
human
hypoglycemia
hypotension
infusion interruption
intensive care
major clinical study
medical error
note
observational study
oxygen desaturation
oxygen saturation probe displacement
oxygen therapy
power cord tangle
priority journal
prospective study
resuscitation
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20160639363
PUI
L611853036
DOI
10.1186/2197-425X-3-S1-A69
FULL TEXT LINK
http://dx.doi.org/10.1186/2197-425X-3-S1-A69
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 248
TITLE
Evaluation of effects of pneumatic tube transport on ROTEM® analyses
AUTHOR NAMES
Rotteveel-De Groot D.
Frenzel T.
Noorland J.
Kulk J.
Van Zwam M.
Oosting J.
AUTHOR ADDRESSES
(Rotteveel-De Groot D., Dorien.Rotteveel-deGroot@radboudumc.nl; Noorland J.;
Kulk J.; Van Zwam M.; Oosting J.) Department of Laboratory Medicine, Radboud
UMC, Nijmegen, Netherlands.
(Frenzel T.) Department of Intensive Care, Radboud UMC, Nijmegen,
Netherlands.
CORRESPONDENCE ADDRESS
D. Rotteveel-De Groot, Department of Laboratory Medicine, Radboud UMC,
Nijmegen, Netherlands. Email: Dorien.Rotteveel-deGroot@radboudumc.nl
SOURCE
Clinical Chemistry and Laboratory Medicine (2015) 53:4 (eA16-eA17). Date of
Publication: Marh 2015
CONFERENCE NAME
3rd EFLM-BD European Conference on Preanalytical Phase
CONFERENCE LOCATION
Porto, Portugal
CONFERENCE DATE
2015-03-20 to 2015-03-21
ISSN
1434-6621
BOOK PUBLISHER
Walter de Gruyter GmbH
ABSTRACT
Background: Rotational tromboelastometry (ROTEM®) can be used for quick
monitoring of the blood coagulation status of patients in emergency
situations. For a rapid analysis the blood samples can be transported to the
central laboratory in our hospital via a pneumatic tube system. This study
has been performed to evaluate possible effects of pneumatic tube transport
on several ROTEM® parameters in blood samples of cardiothoracic surgery
patients of the Intensive Care Unit. Materials and methods: Blood samples of
30 patients were transported to the central laboratory either by pneumatic
tube system or by walking. All samples were used for ROTEM® INTEM, EXTEM,
FIBTEM and HEPTEM analyses. Results: Our results show that the ROTEM
parameters that are included in the in house protocol for hemostatic therapy
(EXTEM CT, EXTEM A10 and FIBTEM A10) have a bias of less than 5%. The
measured within-run and between-run analytical variation of these parameters
was less than 5% with the exception of EXTEM CT (maximum of 8%), which is in
accordance with the manufacturer's specifications. Conclusions: In
conclusion, the pneumatic tube system in our hospital can be used to
transport blood samples to the central laboratory for ROTEM® analyses. In
the future, this provides the opportunity for various other departments in
our hospital to include ROTEM® analyses in their treatment protocols.
EMTREE DRUG INDEX TERMS
hemostatic agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
European
thromboelastograph
tube
EMTREE MEDICAL INDEX TERMS
blood clotting
blood sampling
emergency
hospital
human
intensive care unit
laboratory
monitoring
parameters
patient
surgical patient
therapy
thorax surgery
walking
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71915294
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 249
TITLE
A cost-effectiveness analysis of maternal transfer for spontaneous preterm
labor at 24 weeks
AUTHOR NAMES
Jansen S.
Savitsky L.
Caughey A.
AUTHOR ADDRESSES
(Jansen S.; Savitsky L.; Caughey A.) Oregon Health and Science University,
Portland, United States.
CORRESPONDENCE ADDRESS
S. Jansen, Oregon Health and Science University, Portland, United States.
SOURCE
American Journal of Obstetrics and Gynecology (2015) 212:1 SUPPL. 1 (S347).
Date of Publication: January 2015
CONFERENCE NAME
35th Annual Meeting of the Society for Maternal-Fetal Medicine: The
Pregnancy Meeting
CONFERENCE LOCATION
San Diego, CA, United States
CONFERENCE DATE
2015-02-02 to 2015-02-07
ISSN
0002-9378
BOOK PUBLISHER
Mosby Inc.
ABSTRACT
OBJECTIVE: There has been extensive research documenting the decrease in
mortality at high volume NICU vs. low volume NICU in early preterm neonates.
This study evaluates the cost-effectiveness of transferring women presenting
with spontaneous preterm labor at 24 weeks gestational age. STUDY DESIGN: A
decision-analytic model was built using TreeAge 2014 software. Probabilities
and costs were derived from the literature. Outcomes were compared with
regards to transferring women presenting with spontaneous preterm labor to
tertiary care hospitals or delivering at low-volume centers. Outcomes
compared included: delivery at 24 weeks with mild, moderate, severe, or no
neurodevelopmental delay (NDD), as well as delivery at 37 weeks. A cost
effectiveness threshold was set at $100,000 per quality adjusted life year
(QALY). Univariate sensitivity analyses were used to vary model inputs to
investigate the impact of interventions with varying effectiveness. RESULTS:
From the model there is demonstrated benefit to transferring women before
delivery. Given the differing rates of mortality at high volume vs. low
volume neonatal intensive care units for preterm neonates, there was a
theoretical 5,000 QALYs saved by transferring women prior to delivery (Table
1). Overall there was an incremental cost-effectiveness ratio of $50.3 per
QALY. Sensitivity analysis showed that by decreasing the probability of
delivery from 66% to 30%, there was still benefit to maternal transfer to a
tertiary care facility prior to delivery. CONCLUSION: This model shows that
it is cost-effective to transfer women presenting with spontaneous preterm
labor at 24 weeks to tertiary care facilities for delivery. (Table
Presented).
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cost effectiveness analysis
pregnancy
premature labor
society
EMTREE MEDICAL INDEX TERMS
female
gestational age
human
intensive care unit
model
mortality
newborn
newborn intensive care
prematurity
quality adjusted life year
sensitivity analysis
software
tertiary care center
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71743161
DOI
10.1016/j.ajog.2014.10.918
FULL TEXT LINK
http://dx.doi.org/10.1016/j.ajog.2014.10.918
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 250
TITLE
A standard handoff improves cardiac surgical patient transfer: operating
room to intensive care unit
AUTHOR NAMES
Dixon J.L.
Stagg H.W.
Wehbe-Janek H.
Jo C.
Culp W.C.
Shake J.G.
AUTHOR ADDRESSES
(Dixon J.L.; Stagg H.W.; Wehbe-Janek H.; Jo C.; Culp W.C.; Shake J.G.)
SOURCE
Journal for healthcare quality : official publication of the National
Association for Healthcare Quality (2015) 37:1 (22-32). Date of Publication:
1 Jan 2015
ISSN
1945-1474 (electronic)
ABSTRACT
BACKGROUND: Patient handoffs are high-risk times associated with sentinel
events. Effective handoff processes may enhance patient safety and team
member communication. This study assesses the impact of a standardized
protocol for handoffs from the cardiac surgery operating room to intensive
care unit (ICU).METHODS: Using a prospective pre-post study design, a
formalized handoff process was developed including critical handoff elements
and a standardized handoff procedure, script, and checklist. Data were
collected from 60 handoff observations (30 pre and 30 post), evaluating 52
unique parameters, and survey of providers on perspectives of the handoff
process. Results were compared by chi-square test, two sample t-test, or
nonparametric Mann-Whitney test. Statistical significance was defined as P ≤
.05.RESULTS: Provider's perspectives showed improved satisfaction with the
standardized handoff process through improved responses in 19 of 22 survey
items (P < .001). Median time until ventilator connection, ICU monitor
transfer, first cardiac index, and chest radiograph were reduced after
implementation. Completion of handoff process components also improved after
implementation for 36 of 47 nontime parameters.CONCLUSIONS: A standard
checklist-driven handoff process can dramatically improve key data
transmission and reduce time of critical patient care steps during the
high-risk period of patient handoff in a cardiac surgical ICU.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
heart surgery
organization and management
standards
EMTREE MEDICAL INDEX TERMS
checklist
clinical handover
hospital personnel
human
information dissemination
intensive care unit
operating room
patient safety
patient transport
prospective study
questionnaire
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
26042374 (http://www.ncbi.nlm.nih.gov/pubmed/26042374)
PUI
L615678841
DOI
10.1097/01.JHQ.0000460123.91061.b3
FULL TEXT LINK
http://dx.doi.org/10.1097/01.JHQ.0000460123.91061.b3
COPYRIGHT
Copyright 2017 Medline is the source for the citation and abstract of this
record.
RECORD 251
TITLE
Diagnostic yield and safety of CT scans in ICU
AUTHOR NAMES
Aliaga M.
Forel J.-M.
De Bourmont S.
Jung B.
Thomas G.
Mahul M.
Bisbal M.
Nougaret S.
Hraiech S.
Roch A.
Chaumoitre K.
Jaber S.
Gainnier M.
Papazian L.
AUTHOR ADDRESSES
(Aliaga M., marinealiaga@hotmail.com; Forel J.-M.; Thomas G.; Hraiech S.;
Roch A.; Papazian L.) Réanimation des Détresses Respiratoires et des
Infections Sévères, Assistance Publique-Hôpitaux de Marseille, Hôpital Nord,
Chemin des Bourrely, Marseille, France.
(Forel J.-M.; Thomas G.; Hraiech S.; Roch A.; Papazian L.) Faculté de
Médecine, Aix-Marseille Université, URMITE UMR CNRS 7278, Marseille, France.
(De Bourmont S.; Bisbal M.; Gainnier M.) Réanimation des Urgences Médicales,
Assistance Publique-Hôpitaux de Marseille, Hôpital la Timone, Marseille,
France.
(Jung B.; Mahul M.; Jaber S.) Départ d’Anesthésie-Réanimation B (DAR B),
Réanimation et Transplantation, CHU de Montpellier, Hôpital Saint-Eloi,
Montpellier, France.
(Nougaret S.) Départ d’Imagerie Abdominale, CHU de Montpellier, Hôpital
Saint-Eloi, Montpellier, France.
(Chaumoitre K.) Département d’Imagerie Médicale, Assistance
Publique-Hôpitaux de Marseille, Hôpital Nord, Marseille, France.
CORRESPONDENCE ADDRESS
M. Aliaga, Réanimation des Détresses Respiratoires et des Infections
Sévères, Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, Chemin des
Bourrely, Marseille, France.
SOURCE
Intensive Care Medicine (2015) 41:3 (436-443). Date of Publication: 2015
ISSN
1432-1238 (electronic)
0342-4642
BOOK PUBLISHER
Springer Verlag, service@springer.de
ABSTRACT
Purpose: Critically ill patients often require CT scans. Adverse events (AE)
can occur during intra-hospital transport (IHT). The aim of this prospective
study was to determine the diagnostic and therapeutic yield and the safety
of CT scans in ICU patients.Methods: All ICU patients having a CT scan for
diagnostic purposes were eligible. Diagnostic yield was evaluated by the
agreement (full, partial or disagreement) between the physician main
diagnostic hypothesis before the CT scan and the diagnosis established after
the CT scan. Therapeutic yield was assessed by therapeutic changes after the
CT scan. The safety was determined by the AE rate during IHT.Results: A
total of 533 CT scans were performed on 359 patients in three teaching
hospital ICUs. The diagnostic yield of CT scan showed 40.7 % of full
agreement, 5.6 % of partial agreement and 53.7 % of disagreement with the
main diagnostic hypothesis formulated before the CT scan. The CT-scan
brought new elements to the diagnosis in 22.9 % of the cases. There was
54.4 % of therapeutic change after CT scan, while 22.3 % of AE occurred
during IHT, including 6.7 % of life-threatening events. AE occurred more
frequently in the first 48 h after ICU admission, in the most severely ill
patients (higher SAPS II at admission), and when there was a large amount of
equipment required for transport.Conclusions: The CT scan as a diagnostic
procedure invalidated a diagnostic hypothesis and led to a therapeutic
change in more than half of the cases.
EMTREE DRUG INDEX TERMS
iodinated contrast medium (adverse drug reaction)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
computer assisted tomography
critically ill patient
diagnostic value
intensive care
patient safety
EMTREE MEDICAL INDEX TERMS
adverse outcome
article
atelectasis (diagnosis)
bleeding (diagnosis)
brain disease (diagnosis)
contrast induced nephropathy (side effect)
controlled study
diagnostic test accuracy study
heart arrest (complication)
human
infection (diagnosis)
major clinical study
malignant neoplasm (diagnosis)
mortality
observational study
patient transport
pleura effusion (diagnosis)
prospective study
risk benefit analysis
teaching hospital
venous thromboembolism (diagnosis)
EMBASE CLASSIFICATIONS
Radiology (14)
Anesthesiology (24)
Drug Literature Index (37)
Adverse Reactions Titles (38)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2014979796
MEDLINE PMID
25518950 (http://www.ncbi.nlm.nih.gov/pubmed/25518950)
PUI
L600867635
DOI
10.1007/s00134-014-3592-1
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-014-3592-1
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 252
TITLE
Efficiency of hematocrit, lymphocyte, C-reactive protein and transferrin
levels in predicting mortality in intensive care unit patients
ORIGINAL (NON-ENGLISH) TITLE
Yoğun bakım hastalarında hematokrit, lenfosit, C-reaktif protein ve
transferrin düzeylerinin mortalite tahmininde etkinliği
AUTHOR NAMES
Palabiyik O.
Isik Y.
Cegin M.B.
Goktas U.
Kati I.
AUTHOR ADDRESSES
(Palabiyik O., mdpalabiyikonur@yahoo.com) Sakarya University Training and
Research Hospital, Department of Anesthesiology and Reanimation, Turkey.
(Isik Y.) Izmir Katip Celebi University, Department of Anesthesiology and
Reanimation, Izmir, Turkey.
(Cegin M.B.; Goktas U.) Yuzuncu Yil University, Department of Anesthesiology
and Reanimation, Van, Turkey.
(Kati I.) Gazi University, Department of Anesthesiology and Reanimation,
Ankara, Turkey.
CORRESPONDENCE ADDRESS
O. Palabiyik, Sakarya Üniversitesi Eğitim ve Araştırma Hastanesi, Merkez
Kampüsü Anesteziyoloji, , Turkey.
SOURCE
European Journal of General Medicine (2015) 12:3 (222-226). Date of
Publication: 16 Sep 2015
ISSN
1304-3889
BOOK PUBLISHER
TIP ARASTIRMALARI DERNEGI, journal@ejgm.org
ABSTRACT
The effectiveness of many physiological parameters and laboratory tests was
investigated in predicting mortality. In this study, we investigated
hematocrit, C-reactive protein, transferrin and total lymphocyte count along
with Acute Physiology and Chronic Health Evaluation II and Glasgow Coma
Scores of patients who were hospitalized in the intensive care unit. The
data were retrospectively analyzed from hospital information management
system, doctors' records and nurse observing forms. The mortality rate was
42.6%. The Acute Physiology and Chronic Health Evaluation II scores were
significantly higher in cases with mortality compared to those without
mortality. The admission and discharge Glasgow Coma Scores were
significantly lower in patients who showed mortality compared with patients
without mortality. Admission and discharge hematocrit and transferrin values
were significantly lower in cases with mortality compared to those without
mortality. Discharge C-reactive protein values were significantly higher in
cases with mortality compared to those without mortality. Discharge total
lymphocyte count values were significantly lower in cases with mortality
compared to those without mortality. Consequently, we believe that
hematocrit and transferrin values at the time of admission to the intensive
care unit and total lymphocyte count and C-reactive protein at the time of
discharge from the intensive care unit can be effective in predicting
mortality.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
C reactive protein
protein
transferrin
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hematocrit
human
intensive care unit
lymphocyte
lymphocyte count
mortality
patient
EMTREE MEDICAL INDEX TERMS
APACHE
coma
hospital
information system
laboratory test
nurse
parameters
physician
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English, Turkish
EMBASE ACCESSION NUMBER
2015377864
PUI
L606022959
DOI
10.15197/sabad.1.12.47
FULL TEXT LINK
http://dx.doi.org/10.15197/sabad.1.12.47
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 253
TITLE
Air medical transport system vasanthi pinto anuja abayadeera
AUTHOR NAMES
Pinto V.
Abayadeera A.
AUTHOR ADDRESSES
(Pinto V.; Abayadeera A.)
SOURCE
Sri Lankan Journal of Anaesthesiology (2015) 23:2 (47-49). Date of
Publication: 2015
ISSN
1391-8834
BOOK PUBLISHER
College of Anaesthesiologists of Sri Lanka, 44/5A, Gnanartha
Pradeepaya,Mawatha,, Colombo, Sri Lanka. anujaa@sltnet.lk
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
emergency health service
EMTREE MEDICAL INDEX TERMS
article
coronary care unit
health care delivery
health care personnel
human
intensive care
medical decision making
nursing care
patient care
patient transport
rapid response team
respiratory care
Sri Lanka
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2015226613
PUI
L605368520
DOI
10.4038/slja.v23i2.8098
FULL TEXT LINK
http://dx.doi.org/10.4038/slja.v23i2.8098
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 254
TITLE
23rd Critical Care Transport Medicine Conference Preview
AUTHOR NAMES
Newman M.
Petersen P.
Good N.
AUTHOR ADDRESSES
(Newman M.; Petersen P.; Good N.)
SOURCE
Air Medical Journal (2015) 34:1 (26-28). Date of Publication: 1 Jan 2015
ISSN
1532-6497 (electronic)
1067-991X
BOOK PUBLISHER
Mosby Inc., customerservice@mosby.com
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
EMTREE MEDICAL INDEX TERMS
certification
clinical research
conference paper
headache
human
hypotension
medical education
patient care
priority journal
ultrasound
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20160086462
PUI
L607895498
DOI
10.1016/j.amj.2014.10.010
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2014.10.010
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 255
TITLE
Natural caesarean delivery
ORIGINAL (NON-ENGLISH) TITLE
La césarienne naturelle
AUTHOR NAMES
Benhamou D.
AUTHOR ADDRESSES
(Benhamou D., dan.benhamou@bct.aphp.fr) Groupe Hospitalier, Université
Paris-Sud, Département d'Anesthésie-réanimation, 78, rue du Général-Leclerc,
Le Kremlin-Bicêtre cedex, France.
CORRESPONDENCE ADDRESS
D. Benhamou, Groupe Hospitalier, Université Paris-Sud, Département
d'Anesthésie-réanimation, 78, rue du Général-Leclerc, Le Kremlin-Bicêtre
cedex, France.
SOURCE
Anesthesie et Reanimation (2015) 1:4 (313-317). Date of Publication: 2015
ISSN
2352-5819 (electronic)
2352-5800
BOOK PUBLISHER
Elsevier Masson s.r.l.
ABSTRACT
Although the use of postoperative enhanced recovery after caesarean delivery
is still incompletely implemented in France today, the concept of natural
caesarean delivery is a logical addition in a patient-centred outcome vision
of care. The anaesthetist may be seen as playing a minor role in this new
step, but his (her) positive and proactive attitude will facilitate
implementation. Components of this new concept are really innovative. In the
preoperative period, detailed information (aided by written or
electronic/video material) and patient's adherence to the process are
required. The patient may enter the operating room in a standing position
and walking, simplifying intra-hospital transportation and creating an
ambiance of reducing invasiveness. In the operating room, while medical care
maintains a high degree of safety, monitoring (EKG electrodes, oxygen
saturation probe and blood pressure cuff) is positioned differently to
facilitate mother-infant contact at birth. The father's presence is highly
encouraged. At the time of birth, drapes are lowered (not necessary if
transparent drapes are used) and allow parents to directly visualise neonate
delivery. The obstetrician only accompanies birth without any traction by
placing his (her) hands in the neonate axillas, delivery occurring under the
influence of spontaneous uterine contractions which start after uterine
incision. Duration of surgery is only slightly altered. Skin-to-skin contact
is immediately started and maintained as long as possible. Facilitation in
early mother (and father) relationship with the neonate is a well
established of skin-to-skin contact, as well as the safety of this approach.
The natural caesarean delivery concept is a really innovative approach of
care for both healthcare professionals and parents. Implementing such a
concept requires both validations by the obstetrical team and appropriate
information to the parents in order to alleviate any concern they may have.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cesarean section
EMTREE MEDICAL INDEX TERMS
anesthesist
France
health care personnel
human
kangaroo care
medical care
mother child relation
patient care
patient compliance
patient transport
preoperative period
review
EMBASE CLASSIFICATIONS
Obstetrics and Gynecology (10)
LANGUAGE OF ARTICLE
French
LANGUAGE OF SUMMARY
English, French
EMBASE ACCESSION NUMBER
2015072870
PUI
L604531056
DOI
10.1016/j.anrea.2015.04.002
FULL TEXT LINK
http://dx.doi.org/10.1016/j.anrea.2015.04.002
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 256
TITLE
The lethargic diabetic: Cerebral edema in pediatric patients in diabetic
ketoacidosis
AUTHOR NAMES
Gee S.W.
AUTHOR ADDRESSES
(Gee S.W., Samantha.Gee@nationwidechildrens.org) Nationwide Children's
Hospital, Ohio State University, 700 Children's Drive, Columbus, United
States.
CORRESPONDENCE ADDRESS
S.W. Gee, Nationwide Children's Hospital, Ohio State University, 700
Children's Drive, Columbus, United States.
SOURCE
Air Medical Journal (2015) 34:2 (109-112). Date of Publication: 2015
ISSN
1532-6497 (electronic)
1067-991X
BOOK PUBLISHER
Mosby Inc., customerservice@mosby.com
ABSTRACT
Diabetic ketoacidosis (DKA) is the leading cause of hospitalizations for
pediatric patients with diabetes mellitus. The most severe complication of
DKA is cerebral edema that may lead to brain herniation. We present a case
report that highlights the subclinical presentation of DKA-related cerebral
edema in a pediatric patient and review the acute care management of
suspected cerebral edema during transport. Diabetes mellitus is a health
care problem that has been coined an "epidemic." The estimated incidence of
diabetes in the United States is 24.3 per 100,000 children per year; this
approximates to 15,000 children being newly diagnosed annually. The
observation that children younger than 12 months of age are being diagnosed
with new-onset diabetes is also alarming because diabetes is a chronic
disease into adulthood and currently is the seventh leading cause of death
in the US.1 There are 2 distinct classifications of diabetes.
Type 1 diabetes describes those patients who are inherently insulin
deficient and must rely on lipolysis for fuel needs during times of stress.
Most patients with type 1 diabetes present during childhood. Type 2 diabetes
is characterized by variable degrees of peripheral insulin resistance, but
these patients have inadequate cellular glucose uptake during times of
stress. Patients with type 2 diabetes classically present later in life
although the problem of youth obesity has been associated with earlier
diagnoses during adolescence. The most serious complication of diabetes is
diabetic ketoacidosis (DKA). In children with diabetes, DKA is the leading
cause of hospitalizations, morbidity, and mortality.2,3 A single
episode of DKA can place a pediatric patient at risk for developing cerebral
edema with subsequent brain herniation. The occurrence of cerebral edema is
rare, approximately 0.5% to 1% of all pediatric DKA cases. However, there is
an estimated 40% to 90% mortality from DKA-related cerebral
edema.2-6 Risk factors for cerebral edema include first
presentation, younger age, aggressive fluid administration, administration
of sodium bicarbonate or bolus insulin doses, and precipitous drops in blood
glucose (> 100 mg/dL/h). Additional metabolic abnormalities at presentation,
namely an elevated blood urea nitrogen and low partial pressure of arterial
CO2, are also considered to be risk factors.7,8 Medical
management can be lifesaving when initiated at the time of presentation and
during transport. We present a case of a 4-year-old patient with previously
diagnosed type 1 diabetes who presented at a local emergency department (ED)
with severe DKA. The management of this child's acidosis was complicated by
the clinical presentation of cerebral edema, which was later confirmed by
computed tomographic imaging of the brain upon arrival at our institution.
The goal is to encourage a high index of suspicion for the presence of
cerebral edema and to provide clinicians a review of the management
strategies for cerebral edema during the transport process.
EMTREE DRUG INDEX TERMS
bicarbonate (endogenous compound)
creatinine (endogenous compound)
glucose (endogenous compound)
infusion fluid (intravenous drug administration)
insulin (drug therapy)
mannitol (intravenous drug administration)
sodium (endogenous compound)
sodium chloride (intravenous drug administration)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
brain edema (complication)
diabetic ketoacidosis (drug therapy, drug therapy)
emergency care
patient transport
EMTREE MEDICAL INDEX TERMS
acid base balance
article
bicarbonate blood level
case report
child
computer assisted tomography
creatinine blood level
drug dose reduction
dyspnea
fluid resuscitation
fluid therapy
glucose blood level
gray matter
helicopter
human
insulin dependent diabetes mellitus
intensive care
intensive care unit
male
pH
preschool child
priority journal
sodium blood level
urea nitrogen blood level
vomiting
white matter
CAS REGISTRY NUMBERS
bicarbonate (144-55-8, 71-52-3)
creatinine (19230-81-0, 60-27-5)
glucose (50-99-7, 84778-64-3)
insulin (9004-10-8)
mannitol (69-65-8, 87-78-5)
sodium (7440-23-5)
sodium chloride (7647-14-5)
EMBASE CLASSIFICATIONS
Drug Literature Index (37)
Pediatrics and Pediatric Surgery (7)
Neurology and Neurosurgery (8)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2015159369
MEDLINE PMID
25733118 (http://www.ncbi.nlm.nih.gov/pubmed/25733118)
PUI
L605006448
DOI
10.1016/j.amj.2014.10.009
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2014.10.009
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 257
TITLE
Doctors' and nurses' views and experience of transferring patients from
critical care home to die: A qualitative exploratory study
AUTHOR NAMES
Coombs M.
Long-Sutehall T.
Darlington A.-S.
Richardson A.
AUTHOR ADDRESSES
(Coombs M.) Graduate School of Nursing, Midwifery and Health, Victoria
University of Wellington, Wellington, New Zealand.
(Coombs M.; Long-Sutehall T., T.Long@soton.ac.uk; Darlington A.-S.;
Richardson A.) Faculty of Health Sciences, University of Southampton,
Highfield, Southampton, United Kingdom.
CORRESPONDENCE ADDRESS
T. Long-Sutehall, Faculty of Health Sciences, University of Southampton,
Highfield, Southampton, United Kingdom.
SOURCE
Palliative Medicine (2015) 29:4 (354-362). Date of Publication: 25 Apr 2015
ISSN
1477-030X (electronic)
0269-2163
BOOK PUBLISHER
SAGE Publications Ltd, info@sagepub.co.uk
ABSTRACT
Background: Dying patients would prefer to die at home, and therefore a goal
of end-of-life care is to offer choice regarding where patients die.
However, whether it is feasible to offer this option to patients within
critical care units and whether teams are willing to consider this option
has gained limited exploration internationally. Aim: To examine current
experiences of, practices in and views towards transferring patients in
critical care settings home to die. Design: Exploratory two-stage
qualitative study Setting/participants: Six focus groups were held with
doctors and nurses from four intensive care units across two large hospital
sites in England, general practitioners and community nurses from one
community service in the south of England and members of a Patient and
Public Forum. A further 15 nurses and 6 consultants from critical care units
across the United Kingdom participated in follow-on telephone interviews.
Findings: The practice of transferring critically ill patients home to die
is a rare event in the United Kingdom, despite the positive view of health
care professionals. Challenges to service provision include patient care
needs, uncertain time to death and the view that transfer to community
services is a complex, highly time-dependent undertaking. Conclusion: There
are evidenced individual and policy drivers promoting high-quality care for
all adults approaching the end of life encompassing preferred place of
death. While there is evidence of this choice being honoured and delivered
for some of the critical care population, it remains debatable whether this
will become a conventional practice in end of life in this setting.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
dying
homebound patient
intensive care
nurse attitude
personal experience
physician attitude
EMTREE MEDICAL INDEX TERMS
article
critically ill patient
general practitioner
human
information processing
palliative therapy
qualitative research
terminal care
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2015866953
MEDLINE PMID
25519147 (http://www.ncbi.nlm.nih.gov/pubmed/25519147)
PUI
L603444748
DOI
10.1177/0269216314560208
FULL TEXT LINK
http://dx.doi.org/10.1177/0269216314560208
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 258
TITLE
A randomized clinical trial of therapeutic hypothermia mode during transport
for neonatal encephalopathy
AUTHOR NAMES
Akula V.P.
Joe P.
Thusu K.
Davis A.S.
Tamaresis J.S.
Kim S.
Shimotake T.K.
Butler S.
Honold J.
Kuzniewicz M.
DeSandre G.
Bennett M.
Gould J.
Wallenstein M.B.
Van Meurs K.
AUTHOR ADDRESSES
(Akula V.P.; Gould J.; Wallenstein M.B.; Van Meurs K.) Department of
Pediatrics, Stanford University School of Medicine, Lucile Packard
Children's Hospital Stanford, Palo Alto, United States.
(Joe P.) Division of Neonatology, Children's Hospital and Research Center,
Oakland, United States.
(Thusu K.) Division of Neonatology, Children's Hospital Central California,
Madera, United States.
(Davis A.S.) Pediatrix Medical Group, San Jose, United States.
(Tamaresis J.S.) Department of Pediatrics, Stanford University School of
Medicine, Palo Alto, United States.
(Kim S.) Division of Neonatology, Loma Linda University Children's Hospital,
Loma Linda, United States.
(Shimotake T.K.) Division of Neonatology, University of California San
Francisco (UCSF) Medical Center, San Francisco, United States.
(Butler S.) Division of Neonatology, Sutter Medical Center, Sacramento,
United States.
(Honold J.) Division of Neonatology, Rady Children's Hospital, San Diego,
United States.
(Kuzniewicz M.) Division of Neonatology, Kaiser Permanente, Oakland, United
States.
(DeSandre G.) Division of Neonatology, Santa Clara Valley Medical Center,
San Jose, United States.
(Bennett M.; Gould J.) California Perinatal Quality Care Collaborative
(CPQCC), Palo Alto, United States.
SOURCE
Journal of Pediatrics (2015) 166:4 (856-861.e2). Date of Publication: 2015
ISSN
1097-6833 (electronic)
0022-3476
BOOK PUBLISHER
Mosby Inc., customerservice@mosby.com
ABSTRACT
Objective To determine if temperature regulation is improved during neonatal
transport using a servo-regulated cooling device when compared with standard
practice. Study design We performed a multicenter, randomized, nonmasked
clinical trial in newborns with neonatal encephalopathy cooled during
transport to 9 neonatal intensive care units in California. Newborns who met
institutional criteria for therapeutic hypothermia were randomly assigned to
receive cooling according to usual center practices vs device
servo-regulated cooling. The primary outcome was the percentage of
temperatures in target range (33°-34°C) during transport. Secondary outcomes
included percentage of newborns reaching target temperature any time during
transport, time to target temperature, and percentage of newborns in target
range 1 hour after cooling initiation. Results One hundred newborns were
enrolled: 49 to control arm and 51 to device arm. Baseline demographics did
not differ with the exception of cord pH. For each subject, the percentage
of temperatures in the target range was calculated. Infants cooled using the
device had a higher percentage of temperatures in target range compared with
control infants (median 73% [IQR 17-88] vs 0% [IQR 0-52], P < .001). More
subjects reached target temperature during transport using the
servo-regulated device (80% vs 49%, P <.001), and in a shorter time period
(44 ± 31 minutes vs 63 ± 37 minutes, P = .04). Device-cooled infants reached
target temperature by 1 hour with greater frequency than control infants
(71% vs 20%, P < .001). Conclusions Cooling using a servo-regulated device
provides more predictable temperature management during neonatal transport
than does usual care for outborn newborns with neonatal encephalopathy.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
brain disease
induced hypothermia
neonatal encephalopathy
newborn disease
patient transport
EMTREE MEDICAL INDEX TERMS
adult
article
artificial ventilation
assisted ventilation
controlled study
extracorporeal oxygenation
female
human
intensive care unit
intention to treat analysis
male
multicenter study
newborn
newborn mortality
priority journal
rectal temperature
thermoregulation
time to treatment
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2015753369
MEDLINE PMID
25684087 (http://www.ncbi.nlm.nih.gov/pubmed/25684087)
PUI
L602311277
DOI
10.1016/j.jpeds.2014.12.061
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jpeds.2014.12.061
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 259
TITLE
Post operative complications in a dedicated elective orthopaedic hospital:
Transfers requiring specialist critical care support
AUTHOR NAMES
Dawson P.
Daly A.
Lui D.
Butler J.S.
Cashman J.
AUTHOR ADDRESSES
(Dawson P., peterhughdawson@gmail.com; Daly A.; Lui D.; Butler J.S.; Cashman
J.) Department of Trauma and Orthopaedics, Cappagh National Orthopaedic
Hospital, Finglas, Dublin 11, Ireland.
CORRESPONDENCE ADDRESS
P. Dawson, Department of Trauma and Orthopaedics, Cappagh National
Orthopaedic Hospital, Finglas, Dublin 11, Ireland.
SOURCE
Irish Medical Journal (2015) 108:5. Date of Publication: 1 May 2015
ISSN
0332-3102 (electronic)
0332-3102
BOOK PUBLISHER
Irish Medical Association
ABSTRACT
We aim to report our experience with out of hospital transfers for
postoperative complications in a stand-alone elective orthopaedic hospital.
We aim to describe the cohort of patients transferred, the rate of transfer
and assess the risk factors for transfer. Patients were identified who were
transferred out of the hospital to another acute hospital for management of
non-routine medical problems. Patient data was collected relating to age,
BMI, ASA, type of surgery, nature of the complication, timing and the
outcome of transfer. In 2012, 2,853 inpatient surgical procedures were
carried out, 51 patients (1.8%) developed a postoperative complication that
required out of hospital transfer. Mean age of patients transferred was 67
(12-86) years, mean age of the overall case mix 58 years (0-96) (p=0.01).
37.7% of the overall case mix of surgeries was made up of primary hip and
knee arthroplasty procedures, these patients made up 63.7% of patients
transferred out (p=0.001). Mean BMI recorded was 31.7 (22-48) compared to
the mean BMI of the total arthroplasty case mix of 28.8 (20-44) (p=0.02).
59% of all patients at our institution were ASA category II or III. 76% of
patients transferred were ASA category II or III (p=0.005). We can conclude
that patients requiring transfer are typically older. Arthroplasty patients
are more likely to require transfer than patients undergoing other
orthopaedic procedures. Among the arthroplasty cohort transferred patients
will typically have a higher BMI than average. Patients with ASA category II
or III make up nearly three quarters of those patients transferred. The mean
age of patients transferred is typically older by 9 years.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
orthopedics
postoperative complication
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
article
body mass
child
follow up
hip arthroplasty
human
knee arthroplasty
major clinical study
medical record review
middle aged
patient transport
retrospective study
risk factor
treatment outcome
very elderly
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Orthopedic Surgery (33)
Surgery (9)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2015050741
MEDLINE PMID
26062246 (http://www.ncbi.nlm.nih.gov/pubmed/26062246)
PUI
L604420165
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 260
TITLE
Critical care nurses' experiences of helicopter transfers
AUTHOR NAMES
Senften J.
Engström Å.
AUTHOR ADDRESSES
(Senften J.) J Senften, RN, CCN, MSc, Critical Care Nurse, Intensive Care
Unit, Gällivare Hospital, Gällivare, Sweden
(Engström Å.)
SOURCE
Nursing in critical care (2015) 20:1 (25-33). Date of Publication: 1 Jan
2015
ISSN
1478-5153 (electronic)
ABSTRACT
BACKGROUND: Intensive care is conducted in intensive care units (ICUs), and
also during the transportation of critically ill people.AIM: The aim of the
study was to describe critical care nurses' (CCNs) experiences of nursing
critically ill patients during helicopter transport.PARTICIPANTS: Seven
CCNs, five women and two men participated in this study.DESIGN: Seven
participants from two centres in Sweden were recruited. The design uses an
inductive, qualitative approach with data collected by means of qualitative
interviews with seven CCNs.METHODS: The interviews were transcribed verbatim
and subjected to qualitative thematic content analysis.RESULTS: The analysis
resulted in one theme which is safe nursing care, but sometimes feeling
afraid and six categories as follows: experiencing the care environment as
an ICU with limited space; a loud environment complicates communication;
planning and checking to minimize risks; experience and good co-operation;
facing the dilemma of allowing relatives to accompany the patient or not;
feeling the patient's and their own fear.CONCLUSION: CCNs plan for the
transportation and control of patients to improve patient safety, but can
sometimes feel afraid. Good co-operation is necessary.RELEVANCE TO CLINICAL
PRACTICE: The possibilities for CCNs to provide effective nursing care in
helicopters are good, although in some cases limited by the environmental
conditions.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
clinical competence
organization and management
procedures
EMTREE MEDICAL INDEX TERMS
air medical transport
critical illness
female
human
intensive care
intensive care nursing
intensive care unit
interview
male
nursing
patient transport
qualitative research
Sweden
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
24238003 (http://www.ncbi.nlm.nih.gov/pubmed/24238003)
PUI
L615282077
DOI
10.1111/nicc.12063
FULL TEXT LINK
http://dx.doi.org/10.1111/nicc.12063
COPYRIGHT
Copyright 2017 Medline is the source for the citation and abstract of this
record.
RECORD 261
TITLE
Acinetobacter Baumannii: Trends in antimicrobial resistance after relocation
of an intensive care unit in Tunisia
AUTHOR NAMES
Koubaji S.
Kamoun S.
Ben Souissi A.
Haddad F.
Ben Aicha Y.
Mebazaa M.S.
AUTHOR ADDRESSES
(Koubaji S.; Kamoun S.; Ben Souissi A.; Haddad F.; Ben Aicha Y.; Mebazaa
M.S.) Mongi Slim University Hospital La Marsa, Anesthesiology and ICU
Department, Sidi Daoued, Tunisia.
CORRESPONDENCE ADDRESS
S. Koubaji, Mongi Slim University Hospital La Marsa, Anesthesiology and ICU
Department, Sidi Daoued, Tunisia.
SOURCE
Intensive Care Medicine Experimental (2015) 3 Supplement 1 Article Number:
A135. Date of Publication: 2015
ISSN
2197-425X (electronic)
BOOK PUBLISHER
SpringerOpen
EMTREE DRUG INDEX TERMS
amikacin
carbapenem
colistin (drug combination)
fosfomycin
imipenem (drug combination)
quinolone
rifampicin (drug combination)
tigecycline (drug combination)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Acinetobacter infection (drug resistance)
antibiotic resistance
EMTREE MEDICAL INDEX TERMS
antibiotic sensitivity
antibiotic therapy
assisted ventilation
catheterization
hospital hygiene
hospital infection
human
intensive care unit
major clinical study
mortality rate
note
prevalence
priority journal
retrospective study
risk factor
septic shock
treatment outcome
Tunisia
CAS REGISTRY NUMBERS
amikacin (37517-28-5, 39831-55-5)
carbapenem (83200-96-8)
colistin (1066-17-7, 1264-72-8)
fosfomycin (23155-02-4)
imipenem (64221-86-9)
rifampicin (13292-46-1)
tigecycline (220620-09-7)
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Drug Literature Index (37)
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20160632857
PUI
L611852415
DOI
10.1186/2197-425X-3-S1-A135
FULL TEXT LINK
http://dx.doi.org/10.1186/2197-425X-3-S1-A135
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 262
TITLE
Outcome is associated with type of neurologic disease during specialized
transport of children
AUTHOR NAMES
Newmyer R.
Kuch B.
Fink E.
Kochanek P.
Orr R.
AUTHOR ADDRESSES
(Newmyer R.) Children's Hospital of Pittsburgh of UPMC, Pittsburgh, United
States.
(Kuch B.; Fink E.; Orr R.) Children's Hospital of Pittsburgh, Pittsburgh,
United States.
(Kochanek P.) Safar Center for Resuscitation Research, Pittsburgh, United
States.
CORRESPONDENCE ADDRESS
R. Newmyer, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, United
States.
SOURCE
Critical Care Medicine (2014) 42:12 SUPPL. 1 (A1498). Date of Publication:
December 2014
CONFERENCE NAME
Critical Care Congress 2015
CONFERENCE LOCATION
Phoenix, AZ, United States
CONFERENCE DATE
2015-01-17 to 2015-01-21
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Learning Objectives: Children with neurologic disease represent ∼20% of
interfacility transports by our pediatric transport team but few data exist
that describe outcomes. We aim to compare the neurocritical care provided
and outcomes of children on transport by type of neurologic disease.
Methods: Children ages 1 mo-21 y requiring interfacility transport by our
team during 1997-2013 (n=1,991) were grouped by neurologic disease: seizure
(1, n=1,404), infection (2, n=243), anatomic abnormality (3, n=154), anoxia
(4, n=106), and stroke (5, n=84). Epochs began in 1997, 2003, and 2008.
Multivariate regressions were created for intensive care unit (ICU)
admission and hospital mortality using pediatric risk of mortality (PRISM)
score, and patient and transport variables. Results: Overall, 37% children
were comatose (initial GCS<9), 37% were intubated, 51% required ICU
admission, and 5.6% died. Group 4 were most frequently in coma (93% with
initial Glasgow Coma Scale < 9) (p<0.05). More children in Groups 3 and 4
were admitted to the ICU (82% and 75%) and died (16% and 76%) (p<0.05).
Interventions were performed in 35% overall including peripheral venous
access (PIV) (10%), antiseizure medication (6%), intubation (6%), and
intracranial hypertension treatment (2%). Group 4 required vasoactive
medications most frequently (47%) and had most adverse events compared to
the other diseases (28% vs. 6% overall) (p<0.05). Older age, higher PRISM,
more recent epoch, intubation, fluid bolus, antiepileptics, and longer
transport time were associated with ICU admission (p<0.05). Placement of a
PIV, higher PRISM, oldest epoch, and vasoactive medications were associated
with mortality while Group 1 and longer bedside time were associated with
survival (p<0.05). Conclusions: Children requiring interfacility transport
require specialized neurocritical care that varies by disease and severity.
Our long term objective is to use these findings to inform quality
improvement of treatment protocols that optimize outcomes.
EMTREE DRUG INDEX TERMS
recombinant erythropoietin
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child
human
intensive care
neurologic disease
EMTREE MEDICAL INDEX TERMS
anoxia
cerebrovascular accident
coma
diseases
drug therapy
Glasgow coma scale
infection
intensive care unit
intracranial hypertension
intubation
learning
liquid
mortality
patient
risk
seizure
survival
total quality management
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71707283
DOI
10.1097/01.ccm.0000458073.17365.3f
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000458073.17365.3f
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 263
TITLE
Predicting PICU admission and team composition from transport risk
assessment in pediatrics score
AUTHOR NAMES
Esperanza M.
Darcy J.
Keizer C.
Schneider J.
AUTHOR ADDRESSES
(Keizer C.)
(Esperanza M.; Darcy J.; Schneider J.) Cohen Children's Medical Center, New
Hyde Park, United States.
CORRESPONDENCE ADDRESS
M. Esperanza, Cohen Children's Medical Center, New Hyde Park, United States.
SOURCE
Critical Care Medicine (2014) 42:12 SUPPL. 1 (A1382). Date of Publication:
December 2014
CONFERENCE NAME
Critical Care Congress 2015
CONFERENCE LOCATION
Phoenix, AZ, United States
CONFERENCE DATE
2015-01-17 to 2015-01-21
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Learning Objectives: Emergency room providers are uncomfortable with the
triage and care of pediatric patients. The accurate and timely disposition
of pediatric transports rely on the accuracy of their assessments. The use
of a scoring system may facilitate timely and appropriate decision making by
medical control. We hypothesize that the Transport Risk Assessment in
Pediatrics Score (TRAP) at the time of transport intake may be utilized to
predict the admission location, transport team composition, and required
urgency of response. Methods: A retrospective chart review was performed on
patients transported into a tertiary children's hospital from May to July
2013. Patient demographics, clinical information, and transport data were
collected. Using the data provided at the time of referral, the TRAP scores
were calculated by the investigators. Results were analyzed using Mood's
Median Test and logistic regression analysis. Results: A total of 388
transports were analyzed. Median age is 8 years (interquartile range [IQR]
3, 13). 61% (n=235) were males. The referring diagnoses are as follows:
gastrointestinal (26%), neurologic (18%), trauma-related (17%) and
respiratory (11%). Overall median TRAP score is 1 (IQR 0,2). The TRAP scores
by receiving location were statistically significant, with those requiring
critical care higher than those less severely ill; (PICU-3 [IQR 1,5];
Medical Floor-1 [IQR 0,2]; ED-1[IQR 0,2] (p value < 0.001). The TRAP scores
by team composition were also statistically significantly higher for those
with a full team including an ICU physician and nurse; EMS-0[IQR 0,2];
EMS/RN-1.5[IQR 1,3]; EMS/RN/MD/RT 6 [IQR 3,7] (p value < 0.001). The TRAP
scores by transport category (emergent -3 [IQR 1,7]; urgent -2 [IQR 0.2];
non-emergent -2 [IQR 0,2]) were not statistically significant (p value =
0.087). Regression analysis of TRAP scores and likelihood of PICU admission
had a p value of 0.000 and an R-squared adjusted value of 17.1%.
Conclusions: The TRAP score at the time of the intake can predict the
likelihood to require ICU admission and the use of an advanced practice
transport team.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
pediatrics
risk assessment
EMTREE MEDICAL INDEX TERMS
decision making
diagnosis
emergency health service
emergency ward
human
injury
learning
logistic regression analysis
male
median test
medical record review
mood
non implantable urine incontinence electrical stimulator
nurse
patient
pediatric hospital
physician
regression analysis
scoring system
statistical significance
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71706799
DOI
10.1097/01.ccm.0000457589.31339.5b
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000457589.31339.5b
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 264
TITLE
Improved oxygenation after critical care transport in patients with
hypoxemic respiratory failure
AUTHOR NAMES
Wilcox S.
Saia M.
Waden H.
Gates J.
McGahn S.
Cocchi M.
Genthon A.
Richards J.
AUTHOR ADDRESSES
(Saia M.)
(Wilcox S.) Massachusetts General Hospital, Boston, United States.
(Waden H.) Grafton, United States.
(Gates J.) Brigham and Women's Hospital, Brookline, United States.
(McGahn S.) Boston MedFlight, Bedford, United States.
(Cocchi M.; Richards J.) Beth Israel Deaconess Medical Center, Boston,
United States.
(Genthon A.) Brigham and Women's Hospital, Boston, United States.
CORRESPONDENCE ADDRESS
S. Wilcox, Massachusetts General Hospital, Boston, United States.
SOURCE
Critical Care Medicine (2014) 42:12 SUPPL. 1 (A1532-A1533). Date of
Publication: December 2014
CONFERENCE NAME
Critical Care Congress 2015
CONFERENCE LOCATION
Phoenix, AZ, United States
CONFERENCE DATE
2015-01-17 to 2015-01-21
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Learning Objectives: Critically ill patients, especially hypoxemic patients,
have a high rate of deterioration in vital signs when transported. Although
the benefits of transporting patients with respiratory failure to ECMO
centers are known, little is known about the risk attributable to transport.
We designed this physiologic retrospective study to measure the rate and
magnitude of changes in oxygenation that occur during and after a transport
by a critical care transport team for patients with severe hypoxemic
respiratory failure. Methods: We analyzed oxygenation data for patients with
severe hypoxemic respiratory failure with a FiO2 > 50%, transported from
referring hospitals to tertiary care hospitals from October 2009 to May
2011. The primary outcome was the change in PaO2/FiO2 ratio from the sending
to the receiving hospital. We also compared the PaO2 and SpO2 before and
after transport. We compared initial SpO2 measurements with the lowest SpO2
en route. A subgroup analysis of patients from each division of oxygenation,
100-90%, 89-80%, and < 80%, prior to transport, to determine the incidence
of desaturation in each group. Results: We identified 161 charts for review.
The primary outcome, the mean change in PaO2/FiO2 ratio from the sending to
the receiving hospital, was an increase of 22.56mmHg [CI 8.56 - 36.54, p=
0.012]. The mean change in PaO2 was an increase in 29.93mmHg [CI 14.71 -
39.14, p= 0.0004]. The mean SpO2 was not significantly increased at 0.69%
[CI -0.38 - 1.76, p= 0.92]. Despite the improvement in the PaO2/ FiO2 ratio
and the stable saturation on arrival at the tertiary hospitals, 35.8% of
patients experienced a desaturation event in transport, and 11.9% had a
critical desaturation. Patients with initial saturations of < 80% were the
only group to show a decrease in PaO2 on arrival, while all other groups had
an increase in PaO2. Conclusions: In this cohort of critically ill patients
with severe hypoxemic respiratory failure, PaO2/FiO2 ratios and PaO2 ratios
increased after transport by a CCT team, despite 35% of patients having a
desaturation episode in transit.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
human
intensive care
oxygenation
patient
respiratory failure
EMTREE MEDICAL INDEX TERMS
critically ill patient
deterioration
fatty acid desaturation
hospital
learning
retrospective study
risk
tertiary care center
vital sign
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71707423
DOI
10.1097/01.ccm.0000458213.66197.6e
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000458213.66197.6e
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 265
TITLE
Outcomes of delayed rrt activation in patients transferring to the ICU
AUTHOR NAMES
Barwise A.
Thongprayoon C.
Herasevich V.
Pickering B.
Gajic O.
Jensen J.
AUTHOR ADDRESSES
(Barwise A.; Thongprayoon C.; Herasevich V.; Jensen J.) Mayo Clinic,
Rochester, United States.
(Pickering B.) Mayo Clinic - College of Medicine, Rochester, United States.
(Gajic O.) Mayo Graduate School of Medicine(Rochester), Rochester, United
States.
CORRESPONDENCE ADDRESS
A. Barwise, Mayo Clinic, Rochester, United States.
SOURCE
Critical Care Medicine (2014) 42:12 SUPPL. 1 (A1417). Date of Publication:
December 2014
CONFERENCE NAME
Critical Care Congress 2015
CONFERENCE LOCATION
Phoenix, AZ, United States
CONFERENCE DATE
2015-01-17 to 2015-01-21
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Learning Objectives: The Rapid Response Team (RRT) was designed to reduce
serious adverse events such as cardiac arrest on the floor by activating a
“critical care team” to the bedside of the deteriorating patient. To date
there has been mixed evidence about the effectiveness of rapid response
teams in decreasing patient mortality and in reducing adverse outcomes. To
be most effective, the RRT should be activated early in the course of
physiological deterioration. This study examines the effect of delay on RRT
activation on hospital mortality and morbidity. It was hypothesized that
delay in RRT activation would result in worse patient outcomes. Methods: A
retrospective cohort study of all the Rapid Response Team (RRT) activations
taking place between January 2012 and December 2012 was performed in a
tertiary academic center. The subjects were patients admitted to the ICU
following a RRT activation. Data was compared between those patients who had
a timely RRT activation (60 minutes), after adjustment for patient
characteristics using multivariate Cox proportional regression analysis. The
primary outcome was 30-Day mortality after RRT activation. The secondary
outcomes were hospital and ICU length of stay, mechanical ventilator and
vasopressor use in ICU. Results: Of 1120 patients who required ICU admission
after RRT call, 698 (62%) had >60 minute delay in RRT activation. Patients
who experienced delay in RRT activation after meeting physiologic RRT
criteria had increased mortality (adjusted hazard ratio 1.5 (95% 1.05-2.2):
p=0.02. Mortality was positively correlated with increased time in hours
from first abnormal vital sign to RRT activation (adjusted Hazards Ratio
1.03) (95% 1.01-1.04): p=0.001. Patients with delayed activation had
increased ICU length of stay, p=0.004, increased ventilator use, p= 0.04 and
vasopressor use, p < 0.001. Conclusions:Delayed RRT activation occurred
frequently and was independently associated with increased mortality and ICU
resource utilization.
EMTREE DRUG INDEX TERMS
hypertensive factor
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
human
intensive care
patient
EMTREE MEDICAL INDEX TERMS
adverse outcome
cohort analysis
deterioration
hazard
hazard ratio
heart arrest
hospital
learning
length of stay
mechanical ventilator
morbidity
mortality
rapid response team
regression analysis
ventilator
vital sign
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71706940
DOI
10.1097/01.ccm.0000457730.99332.4f
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000457730.99332.4f
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 266
TITLE
Comparing the monitoring of patients transferred from a critical care unit
to hospital wards at after-hours with day transfers: an exploratory,
prospective cohort study
AUTHOR NAMES
Wood S.D.
Coster S.
Norman I.
AUTHOR ADDRESSES
(Wood S.D.; Coster S.; Norman I.) Cardiff University Hospital Trust, UK
SOURCE
Journal of advanced nursing (2014) 70:12 (2757-2766). Date of Publication: 1
Dec 2014
ISSN
1365-2648 (electronic)
ABSTRACT
AIMS: To investigate possible factors related to patient monitoring to
explain the higher mortality rates associated with after-hours transfers
compared with daytime transfers from critical care units to the
wards.BACKGROUND: International research suggests that patients transferred
from critical care units after-hours have a higher mortality rate than
transfers during daytime, although the reasons remain unknown.DESIGN: A
prospective exploratory study.METHODS: Twenty-nine patients transferred from
a UK critical care unit to a ward within the same hospital after-hours for
10 weeks beginning April 2009 were compared with 29 transfers during daytime
hours matched on potentially confounding characteristics. UK Critical Care
Unit transfer guidelines have remained unchanged since data collection.
Outcomes were as follows: (i) frequency of nursing observations; (ii) time
periods from transfer to first medical review; (iii) time period from
transfer to first clinical observations; (iv) frequency of transfer to an
inappropriate ward; (v) delayed transfers from Critical Care Unit to
ward.RESULTS: Using Wilcoxon's Rank test (two tail) to compare paired data
from the matched groups, observations were recorded significantly less
frequently within the first 12 hours for after-hours transfers. Time from
transfer to first clinical observations was significantly longer for
after-hour transfer patients. The delay from when the patient was ready for
ward care and actual transfer was also longer for the after-hours transfer
group.CONCLUSIONS: Surveillance differences, including time to the first set
of observations and frequency of observations in the first 12 hours, are
potential factors that may explain the differential mortality associated
with after-hours transfers.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
mortality
statistics and numerical data
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
cohort analysis
comparative study
female
health care delivery
human
intensive care
intensive care unit
male
middle aged
patient transport
physiologic monitoring
prospective study
time
United Kingdom
very elderly
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
24702103 (http://www.ncbi.nlm.nih.gov/pubmed/24702103)
PUI
L609225299
DOI
10.1111/jan.12410
FULL TEXT LINK
http://dx.doi.org/10.1111/jan.12410
COPYRIGHT
Copyright 2016 Medline is the source for the citation and abstract of this
record.
RECORD 267
TITLE
Shock index to assess outcomes on pediatric interfacility transport
AUTHOR NAMES
Jennings R.
Felmet K.
Carcillo J.
Orr R.
Kuch B.
Fink E.
AUTHOR ADDRESSES
(Jennings R.) University of Pittsburgh School of Medicine, Pittsburgh,
United States.
(Felmet K.; Carcillo J.; Orr R.; Kuch B.; Fink E.) Children's Hospital of
Pittsburgh, Pittsburgh, United States.
CORRESPONDENCE ADDRESS
R. Jennings, University of Pittsburgh School of Medicine, Pittsburgh, United
States.
SOURCE
Critical Care Medicine (2014) 42:12 SUPPL. 1 (A1384). Date of Publication:
December 2014
CONFERENCE NAME
Critical Care Congress 2015
CONFERENCE LOCATION
Phoenix, AZ, United States
CONFERENCE DATE
2015-01-17 to 2015-01-21
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Learning Objectives: Shock Index (SI), the ratio of heart rate to systolic
blood pressure, is useful in assessing prehospital mortality risk and
guiding interventions in adults. Increased SI was associated with mortality
among children with sepsis in intensive care units (ICU). In children,
adherence to treatment guidelines decreased SI and improved outcomes prior
to interfacility transport, but the effect of transport interventions is
unknown. Methods: We reviewed the Children's Hospital of Pittsburgh (CHP)
transport database of children aged 1 mo - 21 y transported to CHP from
another facility with at least 2 sets of vital signs recorded. Subjects were
divided into 4 age groups: group 1 (< 1 y), group 2 (1-3 y), group 3 (4-11
y), and group 4 (≥ 12 y). Suspected sepsis was defined based on referring
facility classification and diagnosed sepsis was defined based on discharge
diagnosis. The primary outcomes, ICU admission and survival, were evaluated
with multivariate logistic regression analysis to determine associated
variables. Results:We studied 3,519 children (56% male, age 75 ± 65 mos).
Overall, 1,819 (52%) were admitted to an ICU, 1,572 (45%) had suspected
sepsis, and 493 (14%) had diagnosed sepsis. Initial transport SI decreased
with age: group 1: 1.45 ± 0.42 (mean ± standard deviation), group 2: 1.36 ±
0.32, group 3: 1.20 ± 0.34, group 4: 1.00 ± 0.32 (p<0.001). Change in
initial and final transport SI was not associated with survival (p=0.647).
Increased initial SI, age > 1 y, suspected and confirmed sepsis, and longer
transport times were independently associated with ICU admission while
increased initial SI and longer transport times were associated with
mortality (p<0.05). Conclusions:Increased initial SI may be a good indicator
for need for ICU resources and in identifying children at increased risk of
mortality requiring interfacility transport.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
shock
EMTREE MEDICAL INDEX TERMS
adult
child
classification
data base
diagnosis
groups by age
heart rate
human
intensive care unit
learning
male
mortality
multivariate logistic regression analysis
patient compliance
pediatric hospital
risk
sepsis
survival
systolic blood pressure
vital sign
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71706807
DOI
10.1097/01.ccm.0000457597.54209.1d
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000457597.54209.1d
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 268
TITLE
STRESS (subjective transfer risk evaluation severity score) accurately
predicts ICU readmission
AUTHOR NAMES
Pisa M.
Collins T.
Saucier J.
Holena D.
Sicoutris C.
Reilly P.
Kohl B.
Martin N.
AUTHOR ADDRESSES
(Pisa M.; Collins T.; Saucier J.; Holena D.; Sicoutris C.; Reilly P.; Martin
N.) Hospital of The University of Pennsylvania, Philadelphia, United States.
(Kohl B.) University of Pennsylvania, Philadelphia, United States.
CORRESPONDENCE ADDRESS
M. Pisa, Hospital of The University of Pennsylvania, Philadelphia, United
States.
SOURCE
Critical Care Medicine (2014) 42:12 SUPPL. 1 (A1553). Date of Publication:
December 2014
CONFERENCE NAME
Critical Care Congress 2015
CONFERENCE LOCATION
Phoenix, AZ, United States
CONFERENCE DATE
2015-01-17 to 2015-01-21
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Learning Objectives: Re-admission to an ICU is associated with increased
morbidity & mortality. Effectively designing a tool that accurately
identifies patients at high risk for readmission can aid in the design of
subsequent directed interventions. We hypothesize that practitioners in a
surgical ICU using the Subjective Transfer Risk Evaluation Severity Score
(STRESS) can accurately identify high risk patients. Subsequent directed
interventions can be optimized by assessing outcomes of the STRESS
stratification. Methods: STRESS was implemented at our large, urban,
university-based medical center in October 2013. The discharging ICU Nurse
Practitioner assigned a risk of adverse event on a subjective 3 point scale
(low, intermediate, and high) to all patients at ICU discharge. All
subsequent ICU re-admissions were noted. The correlation of readmission with
initial STRESS was measured. Further, STRESS was used to stratify timing of
a post-ICU discharge follow-up by the critical care team. Efficacy of the
timing of follow-up was measured by noting the temporal relationship between
ICU readmission and follow-up visit. Results: During the initial 9 months of
STRESS implementation, there were 1396 discharges from the ICU; these
included 443, 527, 222, and 204 patients for STRESS of low, intermediate,
and high, and no score, respectively. No scores included transfers to other
institutions, deaths, discharges home, and transfers to a non-surgical
service. There were 54 re-admissions, with rates of 2.7, 4.7, and 7.7% for
STRESS low, intermediate, and high, respectively, p<0.01. Four of the 17
high STRESS re-admissions were re-admitted prior to the follow-up visit.
Conclusions: STRESS accurately predicts the potential for ICU readmission.
This finding should be used to more efficiently direct post ICU
interventions to optimize outcomes in high risk patients. Timing of
follow-up visits should be adjusted based on these findings.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital readmission
human
intensive care
risk
EMTREE MEDICAL INDEX TERMS
death
follow up
high risk patient
learning
morbidity
mortality
nurse practitioner
patient
physician
stratification
surgery
university
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71707510
DOI
10.1097/01.ccm.0000458300.77731.43
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000458300.77731.43
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 269
TITLE
Medical readiness for transfer does not predict actual picu length of stay
AUTHOR NAMES
Ambati S.R.
Brandwein A.
Bredin G.
Cohn M.
Falco J.
Hong J.
Sweberg T.
Schneider J.
AUTHOR ADDRESSES
(Ambati S.R.; Cohn M.; Hong J.; Sweberg T.) Cohen Children's Medical Center
of New York, New Hyde Park, United States.
(Brandwein A.) Cohen Children's Medical Center of New York, New York, United
States.
(Bredin G.) Hospital for Sick Children, Toronto, Canada.
(Falco J.) Mercy Children's Hospital and Clinics, Des Moines, United States.
(Schneider J.) Cohen's Children's Medical Center, Hyde Park, United States.
CORRESPONDENCE ADDRESS
S.R. Ambati, Cohen Children's Medical Center of New York, New Hyde Park,
United States.
SOURCE
Critical Care Medicine (2014) 42:12 SUPPL. 1 (A1569). Date of Publication:
December 2014
CONFERENCE NAME
Critical Care Congress 2015
CONFERENCE LOCATION
Phoenix, AZ, United States
CONFERENCE DATE
2015-01-17 to 2015-01-21
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Learning Objectives: Delays in patient transfer from the Pediatric Intensive
Care Unit (PICU) can result in significant health care costs. PICU services
are expensive and delayed discharges affect the efficiency of the PICU team.
The purpose of our study was to determine if there are any significant
delays in transferring patients out of the PICU. We hypothesized that there
would be a significant difference between the medical length of stay (MLOS)
and the actual LOS (ALOS) for patient hospitalized in the PICU. Methods:
This was a single-center, prospective, observational study of all children
admitted to the PICU over a 4 month period. For each patient we recorded the
time of admission and discharge from the PICU. Additionally, we documented
the time of medical discharge (when the PICU team determined that the
patient no longer needed ICU care). We then calculated the MLOS and the ALOS
for each patient. Final disposition was recorded as floor, home or extended
care facility. Results: A total of 400 patients were included. Patients were
classified into subgroups based upon diagnostic category. Mann-Whitney and
Kruskal-Wallis tests were used as appropriate. Median MLOS was significantly
shorter than ALOS (1.82 vs 2.55 days, p<0.001). Neurosurgical patients had a
shorter MLOS-ALOS gap when compared to the rest of the patients (0.2 vs 0.3
days, p=0.048), and general surgical patients had a larger gap (0.77 vs 0.3,
p=0.038). Patients transferred to the floor had a longer gap than those
patients discharged directly to home (0.31 vs 0.23 days, p=0.015).
Conclusions: Our results suggest that delays in patient transfer from the
PICU are substantial. The reasons are likely multifactorial ranging from
issues such as hospital bed availability to medical insurance approval. This
gap in discharge time can potentially result in increasing hospital costs
and patient morbidity. Further studies should be aimed at evaluating
possible mechanisms to improve patient throughput in the PICU and thus
minimizing delays in discharge.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
length of stay
EMTREE MEDICAL INDEX TERMS
child
diagnosis
health care cost
health insurance
hospital bed
hospital cost
hospital patient
human
intensive care unit
Kruskal Wallis test
learning
morbidity
neurosurgery
nursing home
observational study
patient
patient transport
surgical patient
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71707576
DOI
10.1097/01.ccm.0000458366.35973.36
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000458366.35973.36
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 270
TITLE
Parents' experience of the transition with their child from a pediatric
intensive care unit (PICU) to the hospital ward: searching for comfort
across transitions
AUTHOR NAMES
Berube K.M.
Fothergill-Bourbonnais F.
Thomas M.
Moreau D.
AUTHOR ADDRESSES
(Berube K.M., kristyn.berube@gmail.com) MacEwan University, Edmonton, AB,
Canada
(Fothergill-Bourbonnais F.; Moreau D.) University of Ottawa, Ottawa, ON,
Canada
(Thomas M.) Children's Hospital of Eastern Ontario Research Institute,
Ottawa, ON, Canada
SOURCE
Journal of pediatric nursing (2014) 29:6 (586-595). Date of Publication: 1
Nov 2014
ISSN
1532-8449 (electronic)
ABSTRACT
Parents of children in pediatric intensive care units (PICUs) have many
needs and stressors, but research has yet to examine their experience of
their child's transfer from PICU to the hospital ward. Ten parents were
interviewed following transfer from PICU to a hospital ward at a children's
hospital in Canada. Parents' experience involved a search for comfort
through transitions. The themes were: 'being a parent with a critically ill
child is exhausting', 'being kept in the know', 'feeling supported by
others', and 'being transferred'. Findings from this study can help nurses
and health professionals working with parents during transitions.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient transport
pediatric intensive care unit
psychology
EMTREE MEDICAL INDEX TERMS
adolescent
child
female
human
infant
male
parent
preschool child
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
25023951 (http://www.ncbi.nlm.nih.gov/pubmed/25023951)
PUI
L615278074
DOI
10.1016/j.pedn.2014.06.001
FULL TEXT LINK
http://dx.doi.org/10.1016/j.pedn.2014.06.001
COPYRIGHT
Copyright 2017 Medline is the source for the citation and abstract of this
record.
RECORD 271
TITLE
Predictors of intensive care unit (ICU) transfer in hospitalized patients
with decompensated cirrhosis
AUTHOR NAMES
Valentin T.
Forde K.
Hao D.
Reddy K.R.
Bahirwani R.
AUTHOR ADDRESSES
(Valentin T.) Department of Internal Medicine, Hospital of the University of
Pennsylvania, Philadelphia, United States.
(Forde K.; Hao D.; Reddy K.R.; Bahirwani R.) Division of Gastroenterology,
Hospital of the University of Pennsylvania, Philadelphia, United States.
CORRESPONDENCE ADDRESS
T. Valentin, Department of Internal Medicine, Hospital of the University of
Pennsylvania, Philadelphia, United States.
SOURCE
American Journal of Gastroenterology (2014) 109 SUPPL. 2 (S170). Date of
Publication: October 2014
CONFERENCE NAME
79th Annual Scientific Meeting of the American College of Gastroenterology
CONFERENCE LOCATION
Philadelphia, PA, United States
CONFERENCE DATE
2014-10-17 to 2014-10-22
ISSN
0002-9270
BOOK PUBLISHER
Nature Publishing Group
ABSTRACT
Introduction: Patients with end-stage liver disease frequently require
intensive care for management of the acute complications of their disease,
and the use of emergent life-sustaining interventions such as endotracheal
intubation can negatively impact liver transplant candidacy. Understanding
that mortality rates are extremely high in critically ill patients with
cirrhosis, the aim of this study is to determine predictors of early ICU
transfer in order to identify potentially preventable decompensations in
patients with advanced liver disease. Methods: Retrospective cohort study of
142 patients with cirrhosis admitted to the Hospital of the University of
Pennsylvania and subsequently transferred to the intensive care unit from a
medicine floor between January 2007 and March 2012. Logistic regression was
performed to determine predictors of ICU transfer within 5 days of the
hospital admission date. Results: The median age of our population was 60
years old; 58% were male and 65% were white. Median BMI was 28 kg/m2. Median
length of hospital stay was 15 days with 66% of patients transferred to the
ICU by hospital day 5. Median MELD scores on the day of admission, and at
72, 48, and 24 hours prior to ICU transfer were 24, 27, 29, and 30,
respectively. The median MELD score on the day of ICU transfer was 29.
Thirty-seven percent were listed for liver transplant. Six percent of
patients had bacteremia, 15% had a documented urinary tract infection, 24%
had findings suspicious for pneumonia on chest radiograph, and 11% had
spontaneous bacterial peritonitis (SBP). Fifteen percent had a prior history
of SBP and only 48% were on appropriate antibiotic prophylaxis. The median
serum creatinine on admission was 1.7 mg/dL. Hepatorenal syndrome (HRS) was
diagnosed or suspected in 25% of patients, and 29% of the 142 included
patients received intravenous albumin. Of those who received intravenous
albumin, 47% had HRS. Sixty percent of patients requiring ICU transfer
within 5 days of admission had acute kidney injury (AKI). Mean arterial
blood pressure and SIRS criteria were not predictive of early ICU transfer
in our study. Interestingly, a rise in serum creatinine was associated with
a lower incidence of ICU transfer within 5 days of hospital admission (OR
0.72, 95% CI 0.55-0.96). Conclusion: Over half of patients with end-stage
liver disease transferred to the ICU had AKI. However a rising creatinine
was found to be protective against ICU transfer within 5 days of hospital
admission. We hypothesize that increasing awareness of acute kidney injury
as a harbinger of poor outcomes in cirrhosis and early aggressive
interventions including intravenous albumin administration and cessation of
diuretics curtailed the ICU trajectory of these patients.
EMTREE DRUG INDEX TERMS
albumin
creatinine
diuretic agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
American
college
decompensated liver cirrhosis
gastroenterology
hospital patient
human
intensive care unit
EMTREE MEDICAL INDEX TERMS
acute kidney failure
antibiotic prophylaxis
bacteremia
bacterial peritonitis
cohort analysis
creatinine blood level
critically ill patient
end stage liver disease
endotracheal intubation
hepatorenal syndrome
hospital
hospital admission
hospitalization
intensive care
liver cirrhosis
liver disease
liver graft
logistic regression analysis
male
mean arterial pressure
mortality
patient
pneumonia
population
thorax radiography
United States
university
urinary tract infection
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71749506
DOI
10.1038/ajg.2014.277
FULL TEXT LINK
http://dx.doi.org/10.1038/ajg.2014.277
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 272
TITLE
Assessing mortality in the medical intensive care unit of interfacility
transferred MICU patients
AUTHOR NAMES
Patel N.
Damaghi N.
Stephen M.
AUTHOR ADDRESSES
(Patel N.; Damaghi N.; Stephen M.) Drexel University, School of Medicine,
Philadelphia, United States.
CORRESPONDENCE ADDRESS
N. Patel, Drexel University, School of Medicine, Philadelphia, United
States.
SOURCE
Chest (2014) 146:4 MEETING ABSTRACT. Date of Publication: October 2014
CONFERENCE NAME
CHEST 2014
CONFERENCE LOCATION
Austin, TX, United States
CONFERENCE DATE
2014-10-25 to 2014-10-30
ISSN
0012-3692
BOOK PUBLISHER
American College of Chest Physicians
ABSTRACT
PURPOSE: The purpose of this study was to asses outcomes in patients in an
academic MICU that were transferred from an outside hospital MICU.
Transferring a patient to a tertiary care MICU is costly and the risks of
the transfer may outweigh the benefits. This study assessed mortality of
transferred patients. Furthermore, it assesses if patients have met their
primary purpose post transfer, whether it was an improvement in their
condition, or if the patients received an organ transplantation (Liver/
kidney). METHODS: A retrospective single center study of inter-facility MICU
transferred patients within the last year (1/8/2013 to 1/1/2014) was
performed. Each patient's records were examined over the course of their ICU
stay. Gathered data included APACHE score, demographics, medical condition,
and outcomes of their illness RESULTS: The over-all mortality of 48 patients
transferred was 39% (19/48) with an average ICU stay of nine days. Sixteen
of the 48 patients transferred were due to liver transplant evaluations. Ten
out of 16 liver patients died in the hospital or in the ICU with a mortality
of 63%. One patient received a liver during their hospital course. The rest
of the patients either died, were removed from transplant list, or
transferred to hospice care. Mortality rate was 42% of the hepatology
patients transferred for specific interventions (banding, TACE, or NAC
protocol). Lowest mortality rate were from patients transferred due to
respiratory failure (29%) and status epilepticus (16.7%). There were no
significant changes in vitals post transfer within 48 hours. CONCLUSIONS:
The highest mortality was seen among liver failure patients transferred
specifically for a transplant evaluation. Patients with Non-cirrhotic/acute
hepatitis, respiratory failure, and status epilepticus had more noticeable
better outcomes. CLINICAL IMPLICATIONS: Many patients admitted to the MICU
in community hospitals may not have the proper resources or specialized care
needed to treat such complicated medical conditions. There are many studies
that have recommended structured guidelines for optimal inter-facility
transfer of critically ill patients but few have assessed clinical outcomes
post transfer.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
human
intensive care unit
mortality
patient
EMTREE MEDICAL INDEX TERMS
APACHE
community hospital
critically ill patient
diseases
donkey
epileptic state
hepatitis
hospice care
hospital
kidney
liver
liver failure
liver graft
medical record
organ transplantation
respiratory failure
risk
tertiary health care
transplantation
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71780646
DOI
10.1378/chest.1991775
FULL TEXT LINK
http://dx.doi.org/10.1378/chest.1991775
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 273
TITLE
In-flight blood administration is not associated with pre-flight hemoglobin
levels in patients evacuated out of combat by U.S. Air force critical care
air transport teams
AUTHOR NAMES
Mora A.
Ervin A.
Ganem V.
Bebarta V.
AUTHOR ADDRESSES
(Mora A.; Ervin A.; Ganem V.; Bebarta V.) 59th MDW/ST-USAISR, Fort Sam
Houston, United States.
CORRESPONDENCE ADDRESS
A. Mora, 59th MDW/ST-USAISR, Fort Sam Houston, United States.
SOURCE
Annals of Emergency Medicine (2014) 64:4 SUPPL. 1 (S70). Date of
Publication: October 2014
CONFERENCE NAME
American College of Emergency Physicians, ACEP 2014 Research Forum
CONFERENCE LOCATION
Chicago, IL, United States
CONFERENCE DATE
2014-10-27 to 2014-10-28
ISSN
0196-0644
BOOK PUBLISHER
Mosby Inc.
ABSTRACT
Study Objectives: Traumatically injured troops suffer blood loss that often
requires blood transfusions. These patients are frequently evacuated via
Critical Care Air Transport Teams (CCATT) to hospitals that can provide a
higher level of specialized care. There is limited research that describes
the use of blood products during flight. Current guidelines recommend a
hemoglobin (Hgb) ≥ 9-10 g/dL prior to airevacuation for CCATT. Previously we
reported long-term patient outcomes with a Hgb >8 g/dL were similar to a Hgb
≤8 g/dL. Our objective was to compare the inflight adverse clinical events
of patients who received blood transfusion during flight with a pre-flight
Hgb >8 g/dL versus ≤8 g/dL. Methods: We conducted an IRB-approved
retrospective review of CCATT medical records. In-flight hemodynamics, lab
values, procedures, vital signs, administration of blood to include units
transfused, and incidence of pre-defined adverse events were recorded.
Patients were grouped based on a pre-flight Hgb>8 g/dL versus ≤8 g/dL.
Adverse clinical events were compared between groups. Patients who have a
hemoglobin ≤8 g/dL or received blood products are more likely to have higher
acuity of injury; thus, we performed an analysis on a subset of patients
(blast-related injuries only) to equalize injuries between groups and adjust
for covariates. ANOVAs and Kruskal-Wallis were used for continuous data and
chi-square or Fisher's exact tests were performed as appropriate (P values)
in this interim analysis. Logistic regressions were conducted to evaluate
associations between pre-flight hemoglobin levels, in-flight blood
administration, and en route patient status. Results: Of 531 abstracted
patients, 368 had a pre-flight Hgb>8 g/dL and 46 had a Hgb≤8 g/dL (others
had no Hgb recorded). Demographics were similar. Primary injury was
blast-related (68%),17% penetrating, and 9% blunt-related injuries. Hgb >8
g/dL and ≤8 g/dL groups were similar in percent of ventilated patients, lab
values, vital signs, and rates of in-flight adverse events (to include
coagulopathy, and bleeding). Hgb >8 g/dL group was more likely to have MAP
in normal range than ≤8 g/dL (84% versus 67%, P=.01). Patients who received
blood were more likely to have clinically significant changes in temperature
measures (P=.02), MAP values (P=.0005), and hemodynamics (P<.0001) in both
Hgb >8 g/dL and ≤8 g/dL groups. Likewise, in the subset analysis of patients
with blast-related injuries only (n=285), patients that received blood
inflight were associated with adverse temperature measures (P=.007), poor
MAP values (P<.001), and significant changes in hemodynamics (P<.0001)
regardless of pre-flight Hgb values. Patients with a pre-flight Hgb >8 g/dL
who received blood products were more likely to have clinically significant
changes in respiratory (P=.04), abnormal CBC values (P<.0001), and to
receive paralytics in-flight (P=.03). Those with a pre-flight Hgb>8 g/dL who
did not receive blood in-flight were more likely to be ventilated (P=.03).
Conclusion: In combat-injured patients evacuated by CCATT, in-flight adverse
events were similar between low and high Hgb groups. Patients who were
transfused blood during flight were likely to have adverse hemodynamics
regardless of pre-flight hemoglobin levels.
EMTREE DRUG INDEX TERMS
hemoglobin
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air force
blood
college
emergency physician
flight
hemoglobin blood level
human
intensive care
patient
United States
EMTREE MEDICAL INDEX TERMS
bleeding
blood clotting disorder
blood transfusion
chronic patient
Fisher exact test
hemodynamics
hospital
implantable cardioverter defibrillator
injury
logistic regression analysis
medical record
procedures
spinal spacer
statistical significance
temperature
ventilated patient
vital sign
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71668116
DOI
10.1016/j.annemergmed.2014.07.219
FULL TEXT LINK
http://dx.doi.org/10.1016/j.annemergmed.2014.07.219
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 274
TITLE
Therapeutic hypothermia on transport: providing safe and effective cooling
therapy as the link between birth hospital and the neonatal intensive care
unit
AUTHOR NAMES
Schierholz E.
AUTHOR ADDRESSES
(Schierholz E.) Rady Children's Hospital San Diego, California
SOURCE
Advances in neonatal care : official journal of the National Association of
Neonatal Nurses (2014) 14 Supplement 5 (S24-S31). Date of Publication: 1 Oct
2014
ISSN
1536-0911 (electronic)
ABSTRACT
Therapeutic hypothermia as a neuroprotective strategy in neonates is an
established standard of care for infants with hypoxic-ischemic
encephalopathy (HIE) in tertiary care neonatal intensive care units (NICUs).
To maximize the neuroprotective effect in infants with HIE, hypothermia is
initiated as soon as possible after birth. Many infants who would benefit
from therapeutic hypothermia are not born at centers that have intensive
care units or offer therapeutic hypothermia and are thus transported to a
tertiary care center with a NICU, offering specialty services of therapeutic
hypothermia and pediatric neurology. The neonatal transport team plays a
significant role in the management of these critically ill infants. Clinical
research provides data for safe and effective management of these infants
during therapeutic hypothermia in the NICU; however, there are no
evidence-based clinical guidelines for management before and during
transport. The establishment of evidence-based guidelines for cooling before
and during transport will facilitate early recognition of infants who would
benefit from therapeutic hypothermia therapy, and decrease delay in
initiation of therapy. Careful assessment, monitoring, and intervention by
the transport team are critical to provide appropriate care and ensure safe
transport of these infants.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
procedures
EMTREE MEDICAL INDEX TERMS
human
hypoxic ischemic encephalopathy (therapy)
induced hypothermia
newborn
newborn intensive care
patient transport
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
25136751 (http://www.ncbi.nlm.nih.gov/pubmed/25136751)
PUI
L604356578
DOI
10.1097/ANC.0000000000000121
FULL TEXT LINK
http://dx.doi.org/10.1097/ANC.0000000000000121
COPYRIGHT
Copyright 2015 Medline is the source for the citation and abstract of this
record.
RECORD 275
TITLE
Role of the anaesthetic team in paediatric critical care transfers in the
North West of UK
AUTHOR NAMES
Sefton G.
Puppala N.K.
Phatak R.
Campbell N.
AUTHOR ADDRESSES
(Sefton G.) Alder Hey Children's NHS Foundation Trust, Liverpool, United
Kingdom.
(Puppala N.K.; Campbell N.) Anaesthesia, Countess of Chester Hospital NHS
Foundation Trust, Chester, United Kingdom.
(Phatak R.) Paediatric Intensive Care, North West and North Wales Paediatric
Transport Service, Warrington, United Kingdom.
CORRESPONDENCE ADDRESS
G. Sefton, Alder Hey Children's NHS Foundation Trust, Liverpool, United
Kingdom.
SOURCE
Archives of Disease in Childhood (2014) 99 SUPPL. 2 (A338). Date of
Publication: October 2014
CONFERENCE NAME
5th Congress of the European Academy of Paediatric Societies, EAPS 2014
CONFERENCE LOCATION
Barcelona, Spain
CONFERENCE DATE
2014-10-17 to 2014-10-21
ISSN
0003-9888
BOOK PUBLISHER
BMJ Publishing Group
ABSTRACT
Background and aims Critically ill children in the UK are stabilised in the
district general hospitals (DGH) and transferred to tertiary paediatric
intensive care units (PICU). The North West and North Wales Paediatric
transport Service (NWTS) is a specialist paediatric retrieval service, which
transports sick children and also provides expert advice to DGH staff.
However, in the DGHs, anaesthetic teams (AT) provide the initial
resuscitation and undertake the time-critical transfers. Countess of Chester
hospital (COCH) is one of the 29 DGHs in the north-west. The aim of this
project was to review the role of AT in resuscitation, stabilisation and
transfer of critically ill children from COCH to PICUs. Methods
Retrospective review of patient notes, NWTS- transport documentation and
discharge summaries of the patients at tertiary PICUs over 2.5 years between
November 2010 to August 2013. Results Of the 43 transfers from COCH 11
transfers were undertaken by AT. Major proportion of interventions were
performed by the AT and the NWTS stabilisation time at COCH was similar to
that in the rest of the DGHs. (See Table and Figure). Conclusions
Anaesthetic teams at DGH play a significant role in the resuscitation,
stabilisation and transfer of critically ill children. Effective
communication with the transport service and shared protocols enhance the
performance of the DGH staff. (Table Presented).
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
anesthetic agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
organization
United Kingdom
EMTREE MEDICAL INDEX TERMS
child
critically ill patient
documentation
general hospital
hospital
human
information retrieval
intensive care unit
interpersonal communication
medical specialist
patient
resuscitation
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71667182
DOI
10.1136/archdischild-2014-307384.938
FULL TEXT LINK
http://dx.doi.org/10.1136/archdischild-2014-307384.938
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 276
TITLE
A pre-operative screening program for obstructive sleep apnea decreases the
transfers to the ICU and hospital costs in elective hip and knee arthoplasty
AUTHOR NAMES
Freeman K.
Enfield K.
Truwit J.D.
Suratt P.
Brown C.D.
AUTHOR ADDRESSES
(Freeman K., cb5am@virginia.edu; Enfield K.; Truwit J.D.; Suratt P.; Brown
C.D.) University of Virginia, Charlottesville, United States.
CORRESPONDENCE ADDRESS
K. Freeman, University of Virginia, Charlottesville, United States. Email:
cb5am@virginia.edu
SOURCE
American Journal of Respiratory and Critical Care Medicine (2014) 189
MeetingAbstracts. Date of Publication: 2014
CONFERENCE NAME
American Thoracic Society International Conference, ATS 2014
CONFERENCE LOCATION
San Diego, CA, United States
CONFERENCE DATE
2014-05-16 to 2014-05-21
ISSN
1073-449X
BOOK PUBLISHER
American Thoracic Society
ABSTRACT
RATIONALE Obstructive sleep apnea (OSA) has been shown to be associated with
an increase in postoperative complications and is an independent risk factor
for increased morbidity and mortality. However, limited data exists
regarding whether treating OSA reduces a patient's perioperative risk. We
hypothesized that improved preoperative diagnosis and treatment of OSA would
be associated with a decreased incidence of certain perioperative
complications, decreased length of stay, and decreased hospital cost.
METHODS On April 1, 2010, the UVA Orthopedics clinic began screening
patients scheduled for elective surgery with a modified STOP-BANG
questionnaire (1/2 rather than 1 point for male gender and for older than
55), and individuals with a score > 3 were recommended to be evaluated by
polysomnography prior to surgery. We identified patients > 18 years old who
had undergone knee or hip arthroplasty using the UVA Clinical Database
Repository from 10/1/09 - 9/30/10. Charts were reviewed for comorbidities,
polysomnography results, and perioperative complications. In addition,
hospital length of stay and cost were recorded for each patient. Differences
between the groups were compared by Fisher's exact test or Mann-Whitney U
test. P-values of less than 0.05 were considered statistically significant.
RESULTS During the period of interest, 418 patients had 439 encounters.
Sixty eight patients were excluded due to a pre-existing OSA, hypoxemia, or
incomplete records. There were 199 encounters in the control period and 167
encounters in the intervention period. Baseline demographics were similar
between the two groups. In the control period 65% of patients had a
STOP-BANG performed. Of those, 32% had a score > 3 and 11% were referred for
polysomnography. In the intervention period, 79% of patients had a STOP-BANG
performed. Of those, 34% had a score of > 3, and 57% were referred for
polysomnography. The control group had significantly more transfers to the
ICU than the intervention group ( 7 vs. 0, p< 0.017). The control group also
had higher median hospital costs than the intervention group ($23,905 vs.
$17,782, p <0.001). The median hospital length of stay was 3 days for both
groups, and there was no difference in other perioperative complications
(table 1). CONCLUSIONS Preoperative screening for OSA decreased hospital
cost and ICU transfers although there were no differences in perioperative
complications. (Table Presented).
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
American
hip
hospital cost
knee
screening
sleep disordered breathing
society
EMTREE MEDICAL INDEX TERMS
control group
data base
diagnosis
elective surgery
Fisher exact test
gender
hip arthroplasty
hospital
human
hypoxemia
length of stay
male
morbidity
mortality
orthopedics
patient
peroperative complication
polysomnography
postoperative complication
questionnaire
rank sum test
risk
risk factor
statistical significance
surgery
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72047607
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 277
TITLE
Trauma patients evacuated by critical care air transport teams out of the
combat zones (2007-2013): A preliminary descriptive report
AUTHOR NAMES
Mora A.
Ervin A.
Ganem V.
Bebarta N.
AUTHOR ADDRESSES
(Mora A.; Ervin A.; Ganem V.; Bebarta N.) 59th MDW/ST-USAISR, Fort Sam
Houston, United States.
CORRESPONDENCE ADDRESS
A. Mora, 59th MDW/ST-USAISR, Fort Sam Houston, United States.
SOURCE
Annals of Emergency Medicine (2014) 64:4 SUPPL. 1 (S41). Date of
Publication: October 2014
CONFERENCE NAME
American College of Emergency Physicians, ACEP 2014 Research Forum
CONFERENCE LOCATION
Chicago, IL, United States
CONFERENCE DATE
2014-10-27 to 2014-10-28
ISSN
0196-0644
BOOK PUBLISHER
Mosby Inc.
ABSTRACT
Study Objectives: In the combat setting, casualties sustain injuries that
can be severe and require specialized treatment not readily available at the
point of injury. Critical Care Air Transport Teams (CCATT) evacuate severely
injured and critically ill patients to higher levels of care. Limited data
has been reported about the care provided to this population en route or
procedures performed by CCATT providers. Further, no study has described the
clinical status of these patients. Our objective is to in-flight events and
procedures that occur during the transport of combat-wounded patients being
evacuated by CCATT, and to provide evidence for new clinical practice
guidelines and validation of existing guidelines. Methods: We conducted an
IRB-approved retrospective review of CCATT medical records of patients with
traumatic injuries transported out of the combat setting to Landstuhl
Regional Medical Center (LRMC) between 2007 and 2013. Along with sending
facility location we collected patient demographics, injury description,
in-flight vital signs, hemodynamics, laboratory values, medications, blood
products administered, and procedures performed en route. Clinical adverse
events were pre-defined such as clinically significant respiratory changes,
hemodynamics check, hemostasis, and neurologic events were recorded.
Percentages and frequencies were reported along with mean ± SD in this
interim analysis. Results: Five hundred thirty-one flight medical records
have been reviewed to date. Most aeromedical transports were from Bagram
(64%) or Balad (22%). Mean age was 27 ± 7 years and 98% males. The majority
were US military (87%) and sustained combat-related injuries (88%). A
portion of CCATT transports (8%) sustained >20% TBSA burn or inhalation
injury. Medications administered were 94% IV analgesia, 62% sedatives, 13%
vasopressors (n=13 started in-flight), 4% oral opioids, and 4% paralytics.
Patients were on PCA (23%), epidurals (9%), received ketamine (4%), or
ketamine/propofol (1%). In addition to IV maintenance fluids, 27% received
fluid boluses and 15% blood products (mean units of red cells, 2; plasma, 2;
and platelets, 1). Three percent received 3% NaCl, while 57% were
mechanically ventilated, 6% had a tracheostomy, and 89% had chest tubes.
Mean FiO2 was 40%. The mean lowest heart rate was 88±20, beats per minute
(bpm) and highest 105±20 bpm. The mean lowest systolic blood pressure was
111±16 mmHg and highest 135±19 mmHg. The mean lowest mean arterial pressure
(MAP) was 74±10 and highest 88±12. About 3% had a hypoxic episode and 1% had
a bleeding event en route. Predefined major clinical events were rare or did
not occur-neurologic event (n=29); medication reaction (n=1), cardiac event
(n=0), and transfusion reaction (n=0). Conclusion: The majority of trauma
patients transported by CCATT from the combat setting were ventilated,
received analgesics, and had additional fluids or blood products
administered in-flight. In spite of the severity of injuries, CCATT patients
had stable hemodynamic values and rarely experienced adverse clinical
events.
EMTREE DRUG INDEX TERMS
analgesic agent
hypertensive factor
ketamine
nitrogen 13
sedative agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
college
emergency physician
human
injury
intensive care
patient
EMTREE MEDICAL INDEX TERMS
accident
air medical transport
analgesia
army
bleeding
blood
blood transfusion reaction
chest tube
critically ill patient
drug therapy
epidural drug administration
erythrocyte
flight
heart rate
hemodynamics
hemostasis
inhalation
injury severity
laboratory
liquid
male
mean arterial pressure
medical record
plasma
population
practice guideline
procedures
systolic blood pressure
thrombocyte
tracheostomy
vital sign
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71668038
DOI
10.1016/j.annemergmed.2014.07.140
FULL TEXT LINK
http://dx.doi.org/10.1016/j.annemergmed.2014.07.140
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 278
TITLE
Mortality after transfer to medical ICU with and without a proceeding rapid
response or cardiac arrest Code
AUTHOR NAMES
Eshak D.S.A.
Tibb A.S.
AUTHOR ADDRESSES
(Eshak D.S.A.; Tibb A.S.) Jacobi Medical Center, Albert Einstein College of
Medicine, Bronx, United States.
CORRESPONDENCE ADDRESS
D.S.A. Eshak, Jacobi Medical Center, Albert Einstein College of Medicine,
Bronx, United States.
SOURCE
American Journal of Respiratory and Critical Care Medicine (2014) 189
MeetingAbstracts. Date of Publication: 2014
CONFERENCE NAME
American Thoracic Society International Conference, ATS 2014
CONFERENCE LOCATION
San Diego, CA, United States
CONFERENCE DATE
2014-05-16 to 2014-05-21
ISSN
1073-449X
BOOK PUBLISHER
American Thoracic Society
ABSTRACT
Introduction Medical intensive care unit (MICU) patients may be directly
admitted from the emergency room (ER), or can transfer into MICU after
admission to a general medicine floor. MICU transfer can occur after a
scheduled critical care consult, or after a Rapid Response Team (RRT)
activation or Cardiac Arrest Code (CAC). Presuming optimal triage into MICU,
it is hypothesized that there is no mortality difference (on that admission)
between patients directly admitted to MICU versus those who transfer into
MICU, regardless of RRT or CAC activation prior to MICU transfer. Methods
This study was conducted at Jacobi Medical Center, a municipal teaching
hospital in the Bronx, NY with a 12-bed MICU and >400 total beds. Decisions
to admit or transfer to MICU are finalized by a critical care attending or
fellow. The RRT/CAC team is composed entirely of internal medicine
housestaff. Any hospital staff can trigger RRT/CAC activation. A
retrospective analysis was performed by reviewing the EMR of all patients
admitted or transferred into MICU over one year (07/01/2011-06/30/2012).
Exclusion criteria included patients transferred to or from an outside
institution, or from another intensive care unit. Results There were 528
total admissions to MICU, including 100 transfers. Among the 100 transfers,
44 patients underwent an RRT or CAC prior to transfer. There was no
significant difference between overall MICU mortality (18.56%), mortality of
patients directly admitted to MICU (17.99%), and mortality of patients
transferred to MICU (21.00%). Patients with a Rapid Response proceeding MICU
transfer had significantly greater mortality versus patients directly
admitted to MICU (30.00% vs. 17.99%, Odds Ratio 2.1273, 95% CI 1.0770 to
4.2017, p value = 0.0297). Among transfers to MICU, patients who had a Rapid
Response or CAC proceeding their transfer had a significantly greater
mortality versus patients who transferred directly to MICU without an
RRT/CAC (31.82% vs. 12.50%, Odds Ratio = 3.2667, 95% CI 1.1842 to 9.0115, p
value = 0.022). Conclusions In this center, patients who transfer to MICU
following a Rapid Response have higher mortality than patients admitted
directly to MICU. This compels further study to determine why this
population is at risk for worse outcome. Possibilities include: (1.) Higher
severity of illness among the patients who underwent RRT, (2.) Sub-optimal
triage in the ER, (3.) Sub-optimal evaluation on the medicine floor, (4.)
Sup-optimal effectiveness of the RRT. There may be a potential role for
improved education of frontline providers. (Table Presented).
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
American
heart arrest
mortality
society
EMTREE MEDICAL INDEX TERMS
diseases
education
emergency health service
emergency ward
general practice
hospital personnel
human
intensive care
intensive care unit
internal medicine
patient
population
rapid response team
risk
statistical significance
teaching hospital
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72042325
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 279
TITLE
En route use of opioids, ketamine, and epidural analgesia to treat pain in
awake patients transported out of combat zones by us air force critical care
air transport teams
AUTHOR NAMES
Mora A.
Ervin A.
Ganem V.
Bebarta V.
AUTHOR ADDRESSES
(Mora A.; Ervin A.; Ganem V.; Bebarta V.) 59th MDW/ST-USAISR, Fort Sam
Houston, United States.
CORRESPONDENCE ADDRESS
A. Mora, 59th MDW/ST-USAISR, Fort Sam Houston, United States.
SOURCE
Annals of Emergency Medicine (2014) 64:4 SUPPL. 1 (S130). Date of
Publication: October 2014
CONFERENCE NAME
American College of Emergency Physicians, ACEP 2014 Research Forum
CONFERENCE LOCATION
Chicago, IL, United States
CONFERENCE DATE
2014-10-27 to 2014-10-28
ISSN
0196-0644
BOOK PUBLISHER
Mosby Inc.
ABSTRACT
Study Objectives: Critical Care Air Transport Teams (CCATT) transport
critically injured patients with acute pain. Methods such as epidural and
regional anesthetics, and ketamine are used alone or in combination with
parenteral opioids. Limited data has been reported about analgesic
administration en route, and no study has reported analgesic use and
in-flight adverse events for CCATT. Our objective was to describe analgesic
use and adverse events on CCATT for non-intubated, awake, critically injured
trauma patients during evacuation from a combat setting. Methods: We
conducted an IRB-approved, retrospective review of CCATT medical records.
Inclusion criteria were non-intubated critically injured trauma patients who
were evacuated out of combat zones between 2007 and 2012 and received
analgesics in-flight.Data collected included demographics, injury type,
analgesics and anesthetics administered. Analgesic doses were compared using
morphine equivalence. Pre-defined clinical adverse events such as clinically
significant respiratory changes, hemodynamic variations, and worsening pain
were recorded. In additional analysis, patients were grouped based on
analgesics to include combinations of ketamine and opioid (Ket+O) versus
epidural/regional anesthetic (Anst+O) and opioid versus opioid only (O). For
this interimstatistical analysis we compared the incidence with chi-square
or Fisher's exact tests where appropriate. Wilcoxon test was used for
non-parametric variables. A P<.05 was considered significant. Results: Of
the 531 patients evaluated, 193 were non-intubated and included in this
interim analysis. Mean age was 26 (SD±5) years, 97% male, with 68% blast
related trauma, 20% penetrating, 10% blunt, and 2% sustained burns and
inhalation injuries. Eighty-four percent of patients received one type of
parenteral analgesia and 16% received a combination of two or more. Common
opioids were morphine (51%), hydromorphone (41%), and fentanyl (14%). Mean
morphine equivalent dose per hour was 6.3 mg (SD±8.8). 61% had a PCA and 10%
received oral opioids. Three percent received ketamine (n=6), 22% had an
epidural (n=42), and 7% a regional block (n=13). Twelve percent received a
combination of IV opioid and epidural therapy. Hypoxia occurred in 3% of
patients, hypocarbia in 12%, and hypercarbia in 10%. There was a significant
change in FiO2 for 5%. Patients with morphine are more likely to have a
change in systolic blood pressure (9% versus 2%; P=.04) as compared to those
who did not receive morphine. In additional analysis, Ket+O patients
received less morphine equivalent dose (P=.01) in comparison to Anst+O or O
(0.7±0 mg, 5±8.7 mg, 7±6.5 mg, respectively). Incidence of other respiratory
and hemodynamic events were similar between IV opioids, ketamine, epidural,
and regional anesthetic block. In addition, the occurrences of clinical
adverse events were similar between Ket+O, Anst+O, and O. Conclusion: Most
awake combat injured patients transported by CCATT received IV analgesics
in-flight and half of these received morphine. Twenty-two percent of
patients had an epidural. Patients that received morphine were more likely
to develop hypotension. Hypoxia was rarely experienced by patients in spite
of critical injuries, limited oxygenation support, and analgesics.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
ketamine
EMTREE DRUG INDEX TERMS
analgesic agent
anesthetic agent
fentanyl
hydromorphone
morphine
nitrogen 13
opiate
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air force
college
emergency physician
epidural anesthesia
human
intensive care
pain
patient
EMTREE MEDICAL INDEX TERMS
analgesia
epidural drug administration
Fisher exact test
flight
hypercapnia
hypocapnia
hypotension
hypoxia
inhalation
injury
male
medical record
oxygenation
rank sum test
systolic blood pressure
therapy
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71668286
DOI
10.1016/j.annemergmed.2014.07.393
FULL TEXT LINK
http://dx.doi.org/10.1016/j.annemergmed.2014.07.393
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 280
TITLE
Tertiary care transfer experience: One month of emergency department
transfers
AUTHOR NAMES
Black K.P.
Ko P.Y.
Grant W.D.
AUTHOR ADDRESSES
(Black K.P.; Ko P.Y.; Grant W.D.) SUNY Upstate Medical University, Evans
Mills, United States.
CORRESPONDENCE ADDRESS
K.P. Black, SUNY Upstate Medical University, Evans Mills, United States.
SOURCE
Annals of Emergency Medicine (2014) 64:4 SUPPL. 1 (S134-S135). Date of
Publication: October 2014
CONFERENCE NAME
American College of Emergency Physicians, ACEP 2014 Research Forum
CONFERENCE LOCATION
Chicago, IL, United States
CONFERENCE DATE
2014-10-27 to 2014-10-28
ISSN
0196-0644
BOOK PUBLISHER
Mosby Inc.
ABSTRACT
Study Objectives: Transfers to tertiary care emergency department (ED)
centers provide beneficial effects to patient care due to the increased
availability of medical specialists and services. Are there characteristics
which help determine the appropriateness of these transfers? The objective
of this study was to describe the nature of outside facility transfers to a
tertiary care center ED. Methods: The charts of all hospital transfers to a
tertiary care ED during August 2013 were examined. The orders and diagnosis
of the transferring emergency physician were extracted from the electronic
medical record. The orders and diagnosis of the emergency physician at the
tertiary care center were also extracted. Results: There were 296 patients
transferred from 30 different facilities (60.5% male, mean age 36.5 years,
SD 27.2 years, 95% CI 33.4 to 39.6 years, range 3 months to 99 years). The
primary diagnosis was related to injury or trauma for 167 patients (58.4%).
The primary diagnosis was in a specialty surgical field 65.6% of the time
(orthopedics 25.7%, Otolaryngology 17.6, trauma surgery 11.8% and
neurosurgery 10.5%), with general surgery 7.4%, neurology 5.7%, general
medicine 4.1%, and gastroenterology 3.4%. At the outside EDs, each patient
had an average of 7.1 orders, 3.8 of which were labs and 2.2 radiographs.
The tertiary care emergency physician had an average of 4.7 orders, 1.9
labs, 1.1 radiographs and 1.1 consults. The vast majority of tertiary ED
repeated tests were on patients from three outside facilities (28.4% of
patients). Within this group there were 17 patients with repeated complete
blood count (CBC), 12 with repeated basic metabolic panel (BMPs) and 6 with
repeated electrocardiogram (EKG). There were 10 patients with repeated
radiographs. Overall there was an average of 1.0 repeated tests per patient,
0.79 labs and 0.14 radiographs. In only 20 cases (6.7%) there was mention of
the outside ED directly consulting a specialist at the accepting tertiary
center, who advised ED to ED transfer. Thirty patients did not receive
specialist consults in the ED of which 19 were discharged (13 to follow-up
with PCP and 6 to followup with a specialist). The tertiary care emergency
physician significantly disagreed with the referring diagnosis in 28 cases
(9.8%). The patients' dispositions were: floor 39.5%, discharged with
specialist follow-up 29.4%, discharged with primary care physician (PCP)
follow-up 11.8%, intensive care unit 8.8%, Operating room 5.4%, step-down
unit 4.3%, with one patient going to interventional Radiology and one
leaving against medical advice. Conclusion: The majority of patients in this
study required surgical specialty care due to injuries. However, several
cases may not have benefitted from transfer, as they neither required
specialist care nor admission, as well as select cases that were
“over-called” by the referring physician. Only for a small proportion of
cases did the outside ED attempt to consult a specialist before
transferring. Better communication and cooperation with outside referring
EDs is needed to assure the most appropriate care for all patients.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
college
emergency physician
emergency ward
human
tertiary health care
EMTREE MEDICAL INDEX TERMS
blood cell count
diagnosis
electrocardiogram
electronic medical record
follow up
gastroenterology
general practice
general practitioner
general surgery
hospital
injury
intensive care unit
interpersonal communication
interventional radiology
male
medical specialist
neurology
neurosurgery
operating room
orthopedics
otorhinolaryngology
patient
patient care
physician
surgery
tertiary care center
traumatology
X ray film
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71668296
DOI
10.1016/j.annemergmed.2014.07.403
FULL TEXT LINK
http://dx.doi.org/10.1016/j.annemergmed.2014.07.403
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 281
TITLE
In-house validation and technology transfer of the GARD assay for prediction
of sensitizing compounds
AUTHOR NAMES
Forreryd A.
Johansson H.
Rydnert F.
-Sofie Albrekt A.
Borrebaeck C.
Lindstedt M.
AUTHOR ADDRESSES
(Forreryd A.; Johansson H.; Rydnert F.; -Sofie Albrekt A.; Borrebaeck C.;
Lindstedt M.) Department of Immunotechnology, Lund, Sweden.
CORRESPONDENCE ADDRESS
A. Forreryd, Department of Immunotechnology, Lund, Sweden.
SOURCE
Toxicology Letters (2014) 229 SUPPL. 1 (S135-S136). Date of Publication: 10
Sep 2014
CONFERENCE NAME
50th Congress of the European Societies of Toxicology, EUROTOX 2014
CONFERENCE LOCATION
Edinburgh, United Kingdom
CONFERENCE DATE
2014-09-07 to 2014-09-10
ISSN
0378-4274
BOOK PUBLISHER
Elsevier Ireland Ltd
ABSTRACT
Background: Allergic contact dermatitis is caused by an adverse immune
response towards chemical haptens. The disease affects a significant
proportion of the population, leading to a substantial economic burden for
society. New legislations on the registration and use of chemicals within
cosmetic industry require development of high-throughput, in vitro assays
for the prediction of sensitization, to replace current animal-based
experiments. Methods: We have developed a cell-based assay for prediction of
sensitizing chemicals, called Genomic Allergen Rapid Detection, GARD.
Analyzing the transcriptome of the MUTZ-3 cell line after 24 h stimulation,
using well characterized skin sensitizing chemicals and controls, we
identified a genomic biomarker signature with potent discriminatory ability.
To further adapt the assay to high-throughput screening mode, we evaluated
the performance of three non-array based platforms using a restricted set of
probes from the biomarker signature. Results: Prediction accuracy of the
assay was assessed in three separate in-house, validation studies, and is
thus far 89%. Results from the evaluation of platforms mimicked previous
data from genome wide transcriptome analysis in terms of reproducibility
while alternative platforms proved to be superior in terms of cost
efficiency, sample throughput and simplified protocols. Conclusions: GARD
was demonstrated to have potent ability to predict sensitization. Changing
the technical platform for gene expression analysis, we retained robustness
and discriminatory power of GARD and at the same time simplified assay
procedures, reduced assay cost and increased sample throughput. This
provided a step towards formal validation and adaptation of the assay for
industrial screening of potential sensitizers.
EMTREE DRUG INDEX TERMS
allergen
biological marker
hapten
transcriptome
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
assay
organization
prediction
technology
toxicology
EMTREE MEDICAL INDEX TERMS
adaptation
cell line
cosmetic industry
gene expression
genome
high throughput screening
immune response
implantable cardioverter defibrillator
in vitro study
law
population
procedures
registration
reproducibility
screening
sensitization
skin allergy
skin sensitization
society
stimulation
validation study
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71631300
DOI
10.1016/j.toxlet.2014.06.479
FULL TEXT LINK
http://dx.doi.org/10.1016/j.toxlet.2014.06.479
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 282
TITLE
Investigation into standards of discharge summary completeness on patient
transfer from the intensive care unit (ICU) to the general ward
AUTHOR NAMES
Skorko A.
Sivasubramaniam G.
Kakar V.
Hopkins P.
AUTHOR ADDRESSES
(Skorko A.) Guy's and St Thomas' Hospital, Department of Anaesthetics,
London, United Kingdom.
(Sivasubramaniam G.; Kakar V.; Hopkins P.) King's College Hospital,
Intensive Care Unit, London, United Kingdom.
CORRESPONDENCE ADDRESS
A. Skorko, Guy's and St Thomas' Hospital, Department of Anaesthetics,
London, United Kingdom.
SOURCE
Intensive Care Medicine (2014) 40:1 SUPPL. 1 (S39). Date of Publication:
September 2014
CONFERENCE NAME
27th Annual Congress of the European Society of Intensive Care Medicine,
ESICM 2014
CONFERENCE LOCATION
Barcelona, Spain
CONFERENCE DATE
2014-09-27 to 2014-10-01
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag
ABSTRACT
Discharge from the Intensive Care Unit (ICU) is a period fraught with
potential risks and good handover is a vital tool in minimising this. To
this end, In 2007 the National Institute for Clinical Excellence (NICE)
published guidelines outlining the information that should be handed over
when a patient leaves the ICU1. This states that there should be a formal
structured handover of care from ICU to ward staff on the parts of both the
medical and nursing staff, which should be supported by written plans. The
handover should include: a summary of the ICU stay including diagnosis and
treatment, a monitoring and investigation plan, a plan for ongoing
treatment, current drugs and therapies, a nutrition plan, infection status,
agreed limitations of treatment, physical and rehabilitation needs,
psychological and emotional needs and communication/language needs. There is
no nationally standardised discharge protocol in the UK. In our tertiary
centre ICU once a decision to discharge is made an ICU doctor telephones the
accepting team to verbally handover the patient. A discharge proforma is
completed electronically and uploaded to the patient's electronic notes. The
nursing staff fill in a paper proforma which they file in the paper hospital
notes and use to handover face-to-face on transfer to the ward. In order to
assess our unit's adherence to the NICE standards we audited the
completeness of the summaries produced by doctors and nurses for every
patient discharged from the ICU. We excluded patients who were transferred
out of the hospital, to another ICU or who died. A 4 week audit period in
February 2013 captured 106 discharges (100 % of eligible discharges). The
results were presented to the department at a training meeting. A re-audit
occurred in June 2013 and 110 discharges were audited (100 % of eligible
discharges). Comparison of each data field in the initial audit and re-audit
periods are presented in table 1. In summary, the standard of paperwork
completeness did not meet those set out by NICE. Although the vast majority
of patients had written documentation, very few were verbally handed over by
medical staff. Additionally, the holistic aspects of patient care such as
psychological, emotional and communication needs were very poorly
documented. (Table Presented).
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
human
intensive care
intensive care unit
patient transport
society
ward
EMTREE MEDICAL INDEX TERMS
clinical audit
diagnosis
documentation
hospital
implantable cardioverter defibrillator
infection
interpersonal communication
medical staff
monitoring
nurse
nursing staff
nutrition
patient
patient care
physician
plant leaf
rehabilitation
risk
telephone
Tertiary (period)
therapy
United Kingdom
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71629976
DOI
10.1007/s00134-013-3451-5
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-013-3451-5
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 283
TITLE
An analysis of the reasons for transfer of patients from general ward to
high dependency/intensive care unit within 24 hours of admission from the
emergency department
AUTHOR NAMES
Sooi W.X.
Chiu L.Q.
AUTHOR ADDRESSES
(Sooi W.X.) National University of Singapore, Singapore, Singapore.
(Chiu L.Q.) Tan Tock Seng Hospital, Singapore, Singapore.
CORRESPONDENCE ADDRESS
W.X. Sooi, National University of Singapore, Singapore, Singapore.
SOURCE
Annals of the Academy of Medicine Singapore (2014) 43:9 SUPPL. 1 (S165).
Date of Publication: September 2014
CONFERENCE NAME
Singapore Health and Biomedical Congress, SHBC 2014
CONFERENCE LOCATION
Singapore, Singapore
CONFERENCE DATE
2014-09-26 to 2014-09-27
ISSN
0304-4602
BOOK PUBLISHER
Academy of Medicine Singapore
ABSTRACT
Background & Hypothesis: The emergency department (ED) is the first
recipient of most admitted patients in a hospital. Errors involving ED
triage, management and disposition have adverse patient outcomes. Studies
have shown that unplanned transfers from general ward (GW) to high
dependency (HD)/intensive care units (ICU) are associated with increased
morbidity and mortality. Primary aims are to determine the number of
unplanned transfers among ED patients from GW to HD/ICU within 24 hours of
admission and the mortality rate of such patients. The secondary aim is to
evaluate the reasons for these unplanned transfers. Methods: We conducted a
retrospective review of ED admission summaries and inpatient discharge
summaries from October 2013 to March 2014. Information collected included
demographics, admitting and final diagnosis, time to transfer, reason(s) for
transfer and outcome. Data was analysed by SPSS v19. Results: There were
23,401 patients admitted from ED to GW with 326 (1.39%) unplanned transfers
to HD/ICU within 24 hours of admission. The mortality rate was 11.0%. The
most frequent diagnoses were acute coronary syndrome (15.0%) and pneumonia
(14.1%). The top reasons for transfer were disease progression (27.6%) and
postoperative monitoring (27.6%). Other reasons included admission to HD for
monitoring (10.4%), HD/ICU requested but denied by inpatient team (7.1%),
development of new unrelated problem(s) (5.0%) and misinterpretation of
investigations (4.8%). Discussion & Conclusion: There is a low rate and
mortality of unplanned transfers to HD/ICU. Qualitative analyses of cases
should be done to guide and improve current ED protocols in order to
decrease morbidity, mortality and healthcare costs.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency ward
health
human
patient
Singapore
ward
EMTREE MEDICAL INDEX TERMS
acute coronary syndrome
data analysis software
diagnosis
disease course
emergency health service
health care cost
hospital
hospital patient
hypothesis
intensive care unit
monitoring
morbidity
mortality
pneumonia
qualitative analysis
recipient
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71796420
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 284
TITLE
Re-location of a critical care unit-specific challenges and patient outcomes
AUTHOR NAMES
O'Leary R.A.
O'Loughlin C.
Marsh B.
AUTHOR ADDRESSES
(O'Leary R.A.; O'Loughlin C.; Marsh B.) Mater Misericordiae University
Hospital, Intensive Care Medicine, Dublin, Ireland.
CORRESPONDENCE ADDRESS
R.A. O'Leary, Mater Misericordiae University Hospital, Intensive Care
Medicine, Dublin, Ireland.
SOURCE
Intensive Care Medicine (2014) 40:1 SUPPL. 1 (S79). Date of Publication:
September 2014
CONFERENCE NAME
27th Annual Congress of the European Society of Intensive Care Medicine,
ESICM 2014
CONFERENCE LOCATION
Barcelona, Spain
CONFERENCE DATE
2014-09-27 to 2014-10-01
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag
ABSTRACT
INTRODUCTION. Intrahospital transport (IHT) of critically ill patients is
associated with increased morbidity. Overall complication rates are as high
as 70 %. Re-location of critical care units is associated with mass transfer
of critically ill patients. OBJECTIVES. The aim of our study was to describe
the process of relocating our intensive care unit (ICU) and assess impact on
patient outcomes. METHODS. In February 2014 our ICU relocated to a facility
in a new building. The estimated transfer time was 17 min, including transit
in 2 lifts. Preparations prior to transfer included staff orientation and
provision of extra portering, nursing and medical engineering staff. A rest
station was provided on the transfer route in case of patient instability or
equipment failure. Data was collected on 21 patients. Transfer times and
complications associated with transport were recorded prospectively. We
followed patients until hospital discharge and collected details of their
critical care course, including adverse events. RESULTS. 21 patients were
transferred over a 7 h period. 71.4 % of patients were ventilated (15/21),
33 % of patients required inotropes (7/21) and 1 patient required
extracorporeal life support (ECLS). 2 consultant intensivists managed
patients in the old ICU and 2 consultant intensivists received care in the
new ICU. A dedicated transport team of 6 non-consultant hospital doctors
with anaesthesia and intensive care medicine training managed all patient
transfers. Average transfer time was 11 min 14 s, 2 transfers required
interruption for equipment failure and 1 transfer was delayed by lift
malfunction. No patient suffered significant haemodynamic or respiratory
deterioration during or after transfer. There was no statistically
significant increase in mortality and 30-day mortality was 14.3 % (3/21
patients). CONCLUSIONS. IHT in critically ill patients has an associated
morbidity. Our experience shows that this can be minimised with planning and
adequately skilled personnel. We propose that IHT with a high level of
organisation allows necessary interventions, such as radiology, to proceed
in a timely manner with minimal risk and avoids patient risks associated
with delay.
EMTREE DRUG INDEX TERMS
inotropic agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
human
intensive care
patient
society
EMTREE MEDICAL INDEX TERMS
anesthesia
biomedical engineering
consultation
critically ill patient
deterioration
device failure
hospital discharge
hospital physician
intensive care unit
intensivist
morbidity
mortality
nursing
patient risk
patient transport
personnel
planning
radiology
risk
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71630115
DOI
10.1007/s00134-013-3451-5
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-013-3451-5
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 285
TITLE
In-house validation and technology transfer of the GARD assay for prediction
of sensitising compounds
AUTHOR NAMES
Forreryd A.
Johansson H.
Rydnert F.
Albrekt A.S.
Borrebaeck C.A.K.
Lindstedt M.
AUTHOR ADDRESSES
(Forreryd A.; Johansson H.; Rydnert F.; Albrekt A.S.; Borrebaeck C.A.K.;
Lindstedt M.) Department of Immunotechnology, Lund University, Lund, Sweden.
CORRESPONDENCE ADDRESS
A. Forreryd, Department of Immunotechnology, Lund University, Lund, Sweden.
SOURCE
Allergy: European Journal of Allergy and Clinical Immunology (2014) 69
SUPPL. 99 (43). Date of Publication: September 2014
CONFERENCE NAME
33rd Congress of the European Academy of Allergy and Clinical Immunology
CONFERENCE LOCATION
Copenhagen, Denmark
CONFERENCE DATE
2014-06-07 to 2014-06-11
ISSN
0105-4538
BOOK PUBLISHER
Blackwell Publishing Ltd
ABSTRACT
Background: Allergic contact dermatitis is caused by an adverse immune
response towards chemical haptens. The disease affects a significant
proportion of the population, with increasing incidences, which leads to a
substantial economic burden for society. New legislations on the
registration and use of chemicals within chemical and cosmetic industries
require development of alternative, high-throughput, in vitro assays for the
prediction of sensitisation, to replace current animal-based experiments.
Method: We have developed a human cellbased assay for the prediction of
sensitising chemicals, called Genomic Allergen Rapid Detection, GARD. By
analyzing the transcriptome of the MUTZ-3 cell line after 24 h stimulation,
using well characterised skin sensitising chemicals (N = 20) and controls (N
= 20), we have identified a genomic biomarker signature with potent
discriminatory ability. In order to further adapt the assay to a
high-throughput screening mode, we evaluated the performance of three
nonarray based platforms using a restricted set of probes from the biomarker
signature. Results: The prediction accuracy of the assay has been assessed
in three separate in-house, partially blinded, validation studies (N = 37),
and is thus far 89%. Results from the evaluation of platforms mimicked
previous data from genome wide transcriptome analysis in terms of
reproducibility and robustness while alternative platforms proved to be
superior in terms of cost efficiency, increased sample throughput and
simplified protocols. Conclusion: The GARD assay was demonstrated to have
potent ability to predict sensitisation. By changing the technical platform
for gene expression analysis, we could retain the robustness and
discriminatory power of GARD and at the same time simplify assay procedures,
reduce assay cost and increase sample throughput providing a first step
towards formal validation and adaption of the assay for industrial screening
of potential sensitisers.
EMTREE DRUG INDEX TERMS
allergen
biological marker
hapten
transcriptome
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
allergy
assay
clinical immunology
prediction
technology
EMTREE MEDICAL INDEX TERMS
cell line
cosmetic industry
gene expression
genome
high throughput screening
human
immune response
implantable cardioverter defibrillator
in vitro study
law
population
procedures
registration
reproducibility
screening
skin
skin allergy
society
stimulation
validation study
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71612431
DOI
10.1111/all.12491
FULL TEXT LINK
http://dx.doi.org/10.1111/all.12491
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 286
TITLE
An audit of the accuracy of drug prescription information on transfer
letters from the paediatric intensive care unit
AUTHOR NAMES
Kokoskova A.
Fletcher P.
AUTHOR ADDRESSES
(Kokoskova A.; Fletcher P.) St Mary's Hospital, Imperial College Healthcare
NHS Trust, United Kingdom.
CORRESPONDENCE ADDRESS
A. Kokoskova, St Mary's Hospital, Imperial College Healthcare NHS Trust,
United Kingdom.
SOURCE
Archives of Disease in Childhood (2014) 99:8 (e3). Date of Publication:
August 2014
CONFERENCE NAME
19th Annual Conference of the Neonatal and Paediatric Pharmacists Group,
NPPG 2013
CONFERENCE LOCATION
London, United Kingdom
CONFERENCE DATE
2013-11-08 to 2013-11-10
ISSN
0003-9888
BOOK PUBLISHER
BMJ Publishing Group
ABSTRACT
Aim To audit the accuracy of prescribing following transfer from a
Paediatric Intensive Care Unit using electronic prescribing. Methods
Historical data: Transfer from PICU letters sent to both external Trusts and
wards within the same hospital were randomly selected pre and post the
electronic prescribing system upgrade ( July 2012) and compared with the
final prescription screen of the inpatient electronic prescription record
(EPR). Current data: For patients transferred to a ward of the same hospital
between 17 December 2012 and 28th January 2013, the first handwritten drug
chart after transfer from PICU was also reviewed for accuracy in comparison
to the PICU EPR. Audit standard: 100% of patients transferred from PICU have
correct transfer from PICU letters with regard to prescribed medicines. 100%
of patients transferred from PICU to a ward within the hospital have correct
transfer from PICU letters and correct first inpatient drug chart. Results
Data were collected for 16 patients pre-upgrade: 6 had correct transfer
letters, 10 (63%) had errors. Among the 85 drugs prescribed, there were 12
errors involving 12 drugs (14% of drugs). After the July 2012 upgrade 14
patients were analysed, 10 had correct transfer letters, 4 (29%) had errors.
Of the 80 drugs prescribed there were 8 errors (10% of drugs documented in
the letters were wrong). Data were collected for 13 patients transferred to
wards within the hospital; 9 (69%) had correct transfer letters and a
correct first inpatient drug chart. Two patients had errors on their
transfer letter and first drug chart, and two had errors on the transfer
letter but the drug chart was correct (due to ward pharmacist intervention).
There were 6 errors in total for these 4 patients. Errors included incorrect
gentamicin and vancomycin doses and incorrect information about whether
patients still required morphine, azithromycin and ceftriaxone. Following
this audit a meeting was held with senior PICU consultants. The EPR software
company have been contacted to improve the automated transfer letter system.
Meanwhile the automated transfer letter has been modified to exclude drugs
and junior doctors are requested to input this data manually. The signing
consultant is reminded to check the prescription section carefully to
prevent errors. Discussions are ongoing for nurses to be part of the
checking process. Conclusion Transfer letters are not being thoroughly
checked before being sent with the patient on transfer from PICU. Some
errors were due to a system failure where dose changes were not pulled
across to the transfer letter. This did not resolve after the July 2012
upgrade. Errors appear to have reduced over the data collection period
however this is anecdotally due to a raised awareness of the system failures
and some junior doctors writing their own drug list rather than relying on
the system to generate it. In order to meet expected standards of 100%
correct information on transfer letters much closer attention must be paid
to final accuracy checks.
EMTREE DRUG INDEX TERMS
azithromycin
ceftriaxone
gentamicin
morphine
vancomycin
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
clinical audit
human
intensive care unit
pharmacist
prescription
EMTREE MEDICAL INDEX TERMS
consultation
electron spin resonance
electronic prescribing
hospital
hospital patient
implantable cardioverter defibrillator
information processing
nurse
patient
physician
software
ward
writing
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71562149
DOI
10.1136/archdischild-2014-306798.22
FULL TEXT LINK
http://dx.doi.org/10.1136/archdischild-2014-306798.22
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 287
TITLE
Effective teamwork and communication mitigate task saturation in simulated
critical care air transport team missions
AUTHOR NAMES
Davis B.
Welch K.
Walsh-Hart S.
Hanseman D.
Petro M.
Gerlach T.
Dorlac W.
Collins J.
Pritts T.
AUTHOR ADDRESSES
(Davis B.) Department of Surgery and Institute for Military Medicine,
University of Cincinnati, 231 Albert Sabin Way, ML 0558, Cincinnati, OH
45267
(Welch K.) Department of Surgery and Institute for Military Medicine,
University of Cincinnati, 231 Albert Sabin Way, ML 0558, Cincinnati, OH
45267
(Walsh-Hart S.) United States Air Force Center for Sustainment of Trauma and
Readiness Skills, 234 Goodman Avenue, Cincinnati, OH 45213
(Hanseman D.) Department of Surgery and Institute for Military Medicine,
University of Cincinnati, 231 Albert Sabin Way, ML 0558, Cincinnati, OH
45267
(Petro M.) United States Air Force Center for Sustainment of Trauma and
Readiness Skills, 234 Goodman Avenue, Cincinnati, OH 45213
(Gerlach T.) United States Air Force Center for Sustainment of Trauma and
Readiness Skills, 234 Goodman Avenue, Cincinnati, OH 45213
(Dorlac W.) Department of Surgery and Institute for Military Medicine,
University of Cincinnati, 231 Albert Sabin Way, ML 0558, Cincinnati, OH
45267
(Collins J.) Department of Surgery and Institute for Military Medicine,
University of Cincinnati, 231 Albert Sabin Way, ML 0558, Cincinnati, OH
45267
(Pritts T.) Department of Surgery and Institute for Military Medicine,
University of Cincinnati, 231 Albert Sabin Way, ML 0558, Cincinnati, OH
45267
SOURCE
Military medicine (2014) 179:8 Supplement (19-23). Date of Publication: 1
Aug 2014
ISSN
1930-613X (electronic)
ABSTRACT
BACKGROUND: Critical Care Air Transport Teams (CCATTs) are a critical
component of the United States Air Force evacuation paradigm. This study was
conducted to assess the incidence of task saturation in simulated CCATT
missions and to determine if there are predictable performance
domains.METHODS: Sixteen CCATTs were studied over a 6-month period.
Performance was scored using a tool assessing eight domains of performance.
Teams were also assessed during critical events to determine the presence or
absence of task saturation and its impact on patient care.RESULTS: Sixteen
simulated missions were reviewed and 45 crisis events identified. Task
saturation was present in 22/45 (49%) of crisis events. Scoring demonstrated
that task saturation was associated with poor performance in teamwork (odds
ratio [OR] = 1.96), communication (OR = 2.08), and mutual performance
monitoring (OR = 1.9), but not maintenance of guidelines, task management,
procedural skill, and equipment management. We analyzed the effect of task
saturation on adverse patient outcomes during crisis events. Adverse
outcomes occurred more often when teams were task saturated as compared to
non-task-saturated teams (91% vs. 23%; RR 4.1, p < 0.0001).CONCLUSIONS: Task
saturation is observed in simulated CCATT missions. Nontechnical skills
correlate with task saturation. Task saturation is associated with worsening
physiologic derangements in simulated patients.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
cooperation
interpersonal communication
patient care
soldier
EMTREE MEDICAL INDEX TERMS
group process
human
intensive care
patient safety
simulation training
task performance
United States
workload
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
25102544 (http://www.ncbi.nlm.nih.gov/pubmed/25102544)
PUI
L612093149
DOI
10.7205/MILMED-D-13-00240
FULL TEXT LINK
http://dx.doi.org/10.7205/MILMED-D-13-00240
COPYRIGHT
Copyright 2016 Medline is the source for the citation and abstract of this
record.
RECORD 288
TITLE
Improved outcomes of transported neonates in Beijing: the impact of
strategic changes in perinatal and regional neonatal transport network
services
AUTHOR NAMES
Kong X.-Y.
Liu X.-X.
Hong X.-Y.
Liu J.
Li Q.-P.
Feng Z.-C.
AUTHOR ADDRESSES
(Kong X.-Y.; Hong X.-Y.; Liu J.; Li Q.-P.; Feng Z.-C., zhjfengzc@126.com)
Newborn Care Center, Bayi Children’s Hospital, the Military General Hospital
of Beijing, the People’s Liberation Army, Beijing, China.
(Liu X.-X.) Department of Pediatrics, Hospital of Binzhou Medical
University, Binzhou, Shandong, China.
(Feng Z.-C., zhjfengzc@126.com) Bayi Children’s Hospital, the Military
General Hospital of Beijing, the People’s Liberation Army, 5 Nanmen Chang,
Dongcheng District, Beijing, China.
CORRESPONDENCE ADDRESS
Z.-C. Feng, Bayi Children’s Hospital, the Military General Hospital of
Beijing, the People’s Liberation Army, 5 Nanmen Chang, Dongcheng District,
Beijing, China.
SOURCE
World Journal of Pediatrics (2014) 10:3 (251-255). Date of Publication: 1
Aug 2014
ISSN
1867-0687 (electronic)
1708-8569
BOOK PUBLISHER
Institute of Pediatrics of Zhejiang University, wjpch@zju.edu.cn
ABSTRACT
Background: Infants born outside perinatal centers may have compromised
outcomes due to the transfer speed and efficiency to an appropriate tertiary
center. This study aimed to evaluate the impact of regional coordinated
changes in perinatal supports and retrieval services on the outcome of
transported neonates in Beijing, China.Methods: Information about
transported newborns between phase 1 (July 1, 2004 to June 30, 2006) and
phase 2 (July 1, 2007 to June 30, 2009) was collected. The strategic changes
during phase 2 included standardized neonatal transport procedures, skilled
attendants, a perinatal consulting service, and preferential admission of
transported neonates to the intensive care unit of the tertiary care center.
Data from phase 2 (after-strategic changes) were compared with those of
phase 1 (the period of pre-strategic changes) after a 12-month washout
period, especially regarding the reduction in mortality and selected
morbidity.Results: There was a large increase in the number of transported
infants in phase 2 compared with phase 1 (2797 vs. 567 patients). The
average monthly rate of increase of transported infants was 383.3% (from 24
infants per month to 116 infants per month). The mortality rate of
transported neonates reduced significantly from phase 1 to phase 2 (5.11%
vs. 2.82%; P=0.005), particularly for preterm infants (8.47% vs. 4.34%;
P=0.006). In addition, transported neonates during phase 2 had significantly
decreased morbidities.Conclusions: Regional coordinated strategies
optimizing the perinatal services and transport of outborn sick and preterm
infants to tertiary care centers improved survival outcomes considerably.
These findings have vital implications for health outcomes and resource
planning.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health service
newborn care
patient transport
perinatal care
EMTREE MEDICAL INDEX TERMS
adult
Apgar score
article
female
high risk infant
human
intensive care unit
major clinical study
male
newborn
newborn morbidity
newborn mortality
prematurity
survival rate
tertiary care center
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2015881213
MEDLINE PMID
25124977 (http://www.ncbi.nlm.nih.gov/pubmed/25124977)
PUI
L603481650
DOI
10.1007/s12519-014-0501-1
FULL TEXT LINK
http://dx.doi.org/10.1007/s12519-014-0501-1
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 289
TITLE
A population-based evaluation of severity and mortality among transferred
patients with acute pancreatitis
AUTHOR NAMES
Anand G.
Hutfless S.M.
Akshintala V.S.
Khashab M.A.
Lennon A.M.
Makary M.A.
Hirose K.
Andersen D.K.
Kalloo A.N.
Singh V.K.
AUTHOR ADDRESSES
(Anand G.; Hutfless S.M.; Akshintala V.S.; Khashab M.A.; Lennon A.M.; Makary
M.A.; Hirose K.; Andersen D.K.; Kalloo A.N.; Singh V.K.)
CORRESPONDENCE ADDRESS
G. Anand,
SOURCE
Pancreas (2014). Date of Publication: 23 Jul 2014
ISSN
0885-3177
1536-4828 (electronic)
BOOK PUBLISHER
Lippincott Williams & Wilkins.
ABSTRACT
OBJECTIVES: This study aimed to compare severity of acute pancreatitis (AP)
and mortality rates between transferred and nontransferred patients and to
determine the factors that influence the decision to transfer. METHODS: A
retrospective analysis coding a statewide administrative database in
Maryland was conducted. Severity was defined by presence of organ failure
(OF), need for intensive care unit (ICU), mechanical ventilation (MV), or
hemodialysis. RESULTS: There were 71,035 discharges for AP, with 1657 (2.3%)
patient transfers. Transferred patients had more multisystem OF (5.6% vs
1.2%), need for ICU (22.8% vs 4.3%), MV (13.1% vs 1.4%), hemodialysis (4.2%
vs 2.7%), and higher mortality (6.1% vs 1.1%) compared with nontransferred
patients (P < 0.0001). After adjusting for disease severity, mortality was
similar between the transferred patients and the nontransferred patients
(OR, 1.37; 95% confidence interval, 0.96-1.97). Younger (OR, 0.99), African
American (OR, 0.55), and uninsured (OR, 0.46) patients were less likely to
be transferred, whereas patients with multisystem OF (OR, 3.5), need for ICU
(OR, 2.3), or MV (OR, 2.1) were more likely to be transferred (P < 0.0001).
CONCLUSIONS: Transferred patients with AP have more severe disease and
higher overall mortality. Mortality is similar after adjusting for disease
severity. Disease severity, insurance status, race, and age all influence
the decision to transfer patients with AP.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
acute pancreatitis
human
mortality
patient
population
EMTREE MEDICAL INDEX TERMS
African American
artificial ventilation
confidence interval
data base
disease severity
hemodialysis
insurance
intensive care unit
medically uninsured
patient transport
United States
LANGUAGE OF ARTICLE
English
PUI
L53256249
DOI
10.1097/MPA.0000000000000179
FULL TEXT LINK
http://dx.doi.org/10.1097/MPA.0000000000000179
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 290
TITLE
Parents' experiences of their premature infants' transportation from a
university hospital NICU to the NICU at two local hospitals
AUTHOR NAMES
Granrud M.D.
Ludvigsen E.
Andershed B.
AUTHOR ADDRESSES
(Granrud M.D.) Department of Nursing, Hedmark University College, Elverum,
Norway; Neonatal Intensive Care Unit, Innlandet Hospital Trust, Norway
(Ludvigsen E.) Neonatal Intensive Care Unit, Innlandet Hospital Trust,
Norway
(Andershed B., birgitta.andershed@hig.no) Department of Nursing, Gjøvik
University College, Norway, and Department of Palliative Research Centre,
Ersta Sköndal University College and Ersta Hospital, Stockholm, Sweden.
Electronic address:
SOURCE
Journal of pediatric nursing (2014) 29:4 (e11-e18). Date of Publication: 1
Jul 2014
ISSN
1532-8449 (electronic)
ABSTRACT
The aim of this study was to describe how the parents of premature infants
experience the transportation of their baby from the neonatal intensive care
unit at a university hospital (NICU-U) to such a unit at a local hospital
(NICU-L). This descriptive qualitative study comprises interviews with nine
sets of parents and two mothers. The qualitative content analysis resulted
in one theme: living in uncertainty about whether the baby will survive, and
three categories: being distanced from the baby; fearing that something
would happen to the baby during transportation; and experiencing closeness
to the baby. The results also revealed that the parents experienced
developmental, situational and health-illness transitions.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
community hospital
newborn intensive care
organization and management
prematurity
psychology
university hospital
EMTREE MEDICAL INDEX TERMS
adaptive behavior
child parent relation
comparative study
evaluation study
female
human
interview
male
mental stress
newborn
parent
patient transport
qualitative research
Sweden
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
24582644 (http://www.ncbi.nlm.nih.gov/pubmed/24582644)
PUI
L611478307
DOI
10.1016/j.pedn.2014.01.014
FULL TEXT LINK
http://dx.doi.org/10.1016/j.pedn.2014.01.014
COPYRIGHT
Copyright 2016 Medline is the source for the citation and abstract of this
record.
RECORD 291
TITLE
Automatic protective ventilation using the ARDSNet protocol with the
additional monitoring of electrical impedance tomography
AUTHOR NAMES
Pomprapa A.
Schwaiberger D.
Pickerodt P.
Tjarks O.
Lachmann B.
Leonhardt S.
AUTHOR ADDRESSES
(Pomprapa A., pomprapa@hia.rwth-aachen.de; Leonhardt S.,
leonhardt@hia.rwth-aachen.de) Philips Chair of Medical Information
Technology, Helmholtz-Institute for Biomedical Engineering, RWTH Aachen
University, Pauwelsstrasse 20, Aachen, Germany.
(Schwaiberger D., David.Schwaiberger@charite.de; Pickerodt P.,
Philipp.Pickerodt@charite.de; Tjarks O., Onno.Tjarks@charite.de; Lachmann
B., burkhard.lachmann@gmail.com) Department of Anesthesiology and Intensive
Care Medicine, Campus Charite´ Mitte and Campus Virchow-Klinikum, Charite´ -
University Medicine Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1,
Berlin, Germany.
CORRESPONDENCE ADDRESS
A. Pomprapa, Philips Chair of Medical Information Technology,
Helmholtz-Institute for Biomedical Engineering, RWTH Aachen University,
Pauwelsstrasse 20, Aachen, Germany.
SOURCE
Critical Care (2014) 18:3 Article Number: R128. Date of Publication: 23 Jun
2014
ISSN
1466-609X (electronic)
1364-8535
BOOK PUBLISHER
BioMed Central Ltd., info@biomedcentral.com
ABSTRACT
Introduction: Automatic ventilation for patients with respiratory failure
aims at reducing mortality and can minimize the workload of clinical staff,
offer standardized continuous care, and ultimately save the overall cost of
therapy. We therefore developed a prototype for closed-loop ventilation
using acute respiratory distress syndrome network (ARDSNet) protocol, called
autoARDSNet.Methods: A protocol-driven ventilation using goal-oriented
structural programming was implemented and used for 4 hours in seven pigs
with lavage-induced acute respiratory distress syndrome (ARDS). Oxygenation,
plateau pressure and pH goals were controlled during the automatic
ventilation therapy using autoARDSNet. Monitoring included standard
respiratory, arterial blood gas analysis and electrical impedance tomography
(EIT) images. After 2-hour automatic ventilation, a disconnection of the
animal from the ventilator was carried out for 10 seconds, simulating a
frequent clinical scenario for routine clinical care or intra-hospital
transport.Results: This pilot study of seven pigs showed stable and robust
response for oxygenation, plateau pressure and pH value using the automated
system. A 10-second disconnection at the patient-ventilator interface caused
impaired oxygenation and severe acidosis. However, the automated
protocol-driven ventilation was able to solve these problems. Additionally,
regional ventilation was monitored by EIT for the evaluation of ventilation
in real-time at bedside with one prominent case of pneumothorax.Conclusions:
We implemented an automatic ventilation therapy using ARDSNet protocol with
seven pigs. All positive outcomes were obtained by the closed-loop
ventilation therapy, which can offer a continuous standard protocol-driven
algorithm to ARDS subjects.
EMTREE DRUG INDEX TERMS
carbon dioxide
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
adult respiratory distress syndrome (therapy)
artificial ventilation
computer assisted impedance tomography
EMTREE MEDICAL INDEX TERMS
acidosis
alkalosis
animal experiment
arterial carbon dioxide tension
arterial gas
arterial oxygen saturation
arterial oxygen tension
article
atelectasis
female
mechanical ventilator
nonhuman
oxygenation
pH
pig
pilot study
positive end expiratory pressure
thoracic cavity
CAS REGISTRY NUMBERS
carbon dioxide (124-38-9, 58561-67-4)
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Anesthesiology (24)
Biophysics, Bioengineering and Medical Instrumentation (27)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2014701247
PUI
L600011330
DOI
10.1186/cc13937
FULL TEXT LINK
http://dx.doi.org/10.1186/cc13937
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 292
TITLE
Automatic protective ventilation using the ARDSNet protocol with the
additional monitoring of electrical impedance tomography
AUTHOR NAMES
Pomprapa A.
Schwaiberger D.
Pickerodt P.
Tjarks O.
Lachmann B.
Leonhardt S.
AUTHOR ADDRESSES
(Pomprapa A., pomprapa@hia.rwth-aachen.de; Leonhardt S.,
leonhardt@hia.rwth-aachen.de) Philips Chair of Medical Information
Technology, Helmholtz-Institute for Biomedical Engineering, RWTH Aachen
University, Pauwelsstrasse 20, Aachen 52074, Germany.
(Schwaiberger D., David.Schwaiberger@charite.de; Pickerodt P.,
Philipp.Pickerodt@charite.de; Tjarks O., Onno.Tjarks@charite.de; Lachmann
B., burkhard.lachmann@gmail.com) Department of Anesthesiology and Intensive
Care Medicine, Campus Charité Mitte and Campus Virchow-Klinikum, Charité -
University Medicine Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1,
Berlin 13353, Germany.
CORRESPONDENCE ADDRESS
A. Pomprapa, Philips Chair of Medical Information Technology,
Helmholtz-Institute for Biomedical Engineering, RWTH Aachen University,
Pauwelsstrasse 20, Aachen 52074, Germany. Email: pomprapa@hia.rwth-aachen.de
SOURCE
Critical Care (2014) 18:3 Article Number: R128. Date of Publication: 23 Jun
2014
ISSN
1466-609X (electronic)
1364-8535
ABSTRACT
Introduction: Automatic ventilation for patients with respiratory failure
aims at reducing mortality and can minimize the workload of clinical staff,
offer standardized continuous care, and ultimately save the overall cost of
therapy. We therefore developed a prototype for closed-loop ventilation
using acute respiratory distress syndrome network (ARDSNet) protocol, called
autoARDSNet.Methods: A protocol-driven ventilation using goal-oriented
structural programming was implemented and used for 4 hours in seven pigs
with lavage-induced acute respiratory distress syndrome (ARDS). Oxygenation,
plateau pressure and pH goals were controlled during the automatic
ventilation therapy using autoARDSNet. Monitoring included standard
respiratory, arterial blood gas analysis and electrical impedance tomography
(EIT) images. After 2-hour automatic ventilation, a disconnection of the
animal from the ventilator was carried out for 10 seconds, simulating a
frequent clinical scenario for routine clinical care or intra-hospital
transport.Results: This pilot study of seven pigs showed stable and robust
response for oxygenation, plateau pressure and pH value using the automated
system. A 10-second disconnection at the patient-ventilator interface caused
impaired oxygenation and severe acidosis. However, the automated
protocol-driven ventilation was able to solve these problems. Additionally,
regional ventilation was monitored by EIT for the evaluation of ventilation
in real-time at bedside with one prominent case of pneumothorax.Conclusions:
We implemented an automatic ventilation therapy using ARDSNet protocol with
seven pigs. All positive outcomes were obtained by the closed-loop
ventilation therapy, which can offer a continuous standard protocol-driven
algorithm to ARDS subjects. © 2014 Pomprapa et al.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
adult respiratory distress syndrome (therapy)
artificial ventilation
automatic ventilation
automation
computer assisted impedance tomography
EMTREE MEDICAL INDEX TERMS
animal experiment
animal model
arterial gas
arterial oxygen saturation
article
capnometer
capnometry
controlled study
female
mechanical ventilator
monitoring
nonhuman
oxygenation
patient monitor
pH
pig
pilot study
pneumothorax (complication)
priority journal
pulse oximetry
spectrophotometer
standard
DEVICE TRADE NAMES
CeVOX , GermanyPulsion
CO2SMO+ , GermanyPhilips Respironics
GOE-MF II , GermanyDrager
KPCMCIA-12AI-C , United Stateskeithley instruments
PCMDA12B , United Statessuperlogics
Sirecust , GermanySiemens
DEVICE MANUFACTURERS
(Germany)Drager
(Germany)Philips Respironics
(Germany)Pulsion
(Germany)Siemens
(United States)keithley instruments
(United States)superlogics
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Biophysics, Bioengineering and Medical Instrumentation (27)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2014518414
PUI
L53202325
DOI
10.1186/cc13937
FULL TEXT LINK
http://dx.doi.org/10.1186/cc13937
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 293
TITLE
Is it always reasonable to transfer babies with necrotizing enterocolitis to
neonatal surgical units?
AUTHOR NAMES
Molnar E.
Fukari-Irvine E.
King C.
Kawa B.
Ratnavel N.
AUTHOR ADDRESSES
(Molnar E.; Fukari-Irvine E.; King C.; Kawa B.; Ratnavel N.) Neonatal
Transfer Service, London, United Kingdom.
CORRESPONDENCE ADDRESS
E. Molnar, Neonatal Transfer Service, London, United Kingdom.
SOURCE
Journal of Maternal-Fetal and Neonatal Medicine (2014) 27 SUPPL. 1 (239).
Date of Publication: June 2014
CONFERENCE NAME
24th European Congress of Perinatal Medicine
CONFERENCE LOCATION
Florence, Italy
CONFERENCE DATE
2014-06-04 to 2014-06-07
ISSN
1476-7058
BOOK PUBLISHER
Informa Healthcare
ABSTRACT
Brief Introduction: Necrotising Enterocolitis (NEC) is the most common
gastrointestinal emergency and a major cause of morbidity and mortality in
preterm infants. Based on severity of the disease, treatment can involve a
medical approach or surgical intervention. Whilst babies requiring medical
treatment can be managed in a nonsurgical neonatal intensive care unit
(NICU), patients that require surgery need to be transferred to a tertiary
surgical NICU. In recent years, the sense that an increasing number of
patients transferred to surgical centres had no clear surgical indication
has arisen. In addition neonatal surgical bed capacity is under constant
strain. Materials & Methods: Our aim was to quantify the number of babies
referred for NEC who were transferred directly to neonatal surgical units in
London and to see what proportion of these had a clear need for surgery and
proceeded to have surgical intervention. The Neonatal Transfer Service (NTS)
provides neonatal transfers across London. In this observational
retrospective study, we collected data from 66 babies who were transferred
with the diagnosis or suspicion of necrotising enterocolitis between July
2012 and June 2013. We recorded if the receiving hospital was a tertiary
level medical NICU or a tertiary surgical unit, the clinical and abdominal
X-ray findings in the referring hospital, the transport events, whether the
baby needed surgical treatment and the mortality. We also compared the
referral patterns between 2 epochs; July 2012-June 2013 versus January
2011-December 2011. Clinical Cases or Summary Results: All babies (100%)
with suspected NEC were transferred to tertiary surgical NICUs. 31/66 (47%)
did not require surgical intervention and were successfully managed with
medical treatment only. 35/66 (53%) underwent surgery in the receiving
hospital. Conclusions: We have noted a high number of transfers into
surgical units of infants with confirmed or suspected NEC that had no
indication for surgery at the time of referral or transfer and did not go on
to have surgery. Our results suggest that referral patterns could be
modified to optimize surgical cot usage. In recent years clinicians have
started referring patients with NEC who may not necessarily have indications
for surgery into surgical units for joint medical and surgical oversight.
However surgical bed pressure has increased as a consequence. Depending on
careful clinical assessment and review of the abdominal X-ray, a more
informed decision can be made as to whether an infant with suspected NEC
needs to be transferred to a tertiary medical or surgical unit. Guidelines
on indication for transfer in surgical patients could be effective in
avoiding unnecessary transports to surgical centres.
EMTREE DRUG INDEX TERMS
recombinant erythropoietin
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
baby
necrotizing enterocolitis
perinatal care
EMTREE MEDICAL INDEX TERMS
abdominal radiography
clinical assessment
diagnosis
emergency
enterocolitis
hospital
hospital bed capacity
human
infant
intensive care unit
morbidity
mortality
newborn intensive care
patient
prematurity
retrospective study
surgery
surgical patient
therapy
United Kingdom
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71505022
DOI
10.3109/14767058.2014.924236
FULL TEXT LINK
http://dx.doi.org/10.3109/14767058.2014.924236
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 294
TITLE
Transferring critically ill patients home to die: Scoping the potential
population
AUTHOR NAMES
Darlington A.-S.
Long-Sutehall T.
Richardson A.
Coombs M.
AUTHOR ADDRESSES
(Darlington A.-S.; Long-Sutehall T.; Richardson A.; Coombs M.) University of
Southampton, Faculty of Health Sciences, Southampton, United Kingdom.
(Coombs M.) Victoria University, Wellington, New Zealand.
CORRESPONDENCE ADDRESS
A.-S. Darlington, University of Southampton, Faculty of Health Sciences,
Southampton, United Kingdom.
SOURCE
Palliative Medicine (2014) 28:6 (570). Date of Publication: June 2014
CONFERENCE NAME
8th World Research Congress of the European Association for Palliative Care,
EAPC 2014
CONFERENCE LOCATION
Lleida, Spain
CONFERENCE DATE
2014-06-05 to 2014-06-07
ISSN
0269-2163
BOOK PUBLISHER
SAGE Publications Ltd
ABSTRACT
Aims: Transfer home to die from critical care is rare, despite policy
supporting the implementation of patient choice regarding preferred place of
care at end of life. A retrospective 12-month audit of patients, who died in
critical care, was undertaken to determine the size and profile of the
population who could potentially, if they wished, be transferred home to
die. Methods: A cohort of patients from ten critical care areas (Intensive
Care Units (ICU) and High Dependency Units (HDU)) from 2 hospitals in
England who died in 2011 was investigated. A proforma was developed,
collecting data on physiological (e.g sudden death, clinical stability) and
care variables (e.g. intense manual handling, high gastrointestinal losses).
Results: From an original sample of patients (n=7844) 422 were decedents.
The majority of the deceased were judged as being unsuitable for transfer
home due to: sudden death (14.7%), clinical instability (53.3%) or requiring
complex care (8.3%). 100 (23.7%) patients were identified as potentially
eligible for transfer: 53% of patients were conscious, and 20% were
ventilated via an endotracheal tube. The majority of patients had been
diagnosed with respiratory (41%), neurological (19%) or cardiac disease
(19%). The mean time between discussion about withdrawal of treatment with
family and time of death was 36.4 hours. Patients judged eligible for
transfer were statistically significantly more likely to be treated in HDU
than ITU compared to patients who were excluded (Chi2=19.80, p=0.00) and had
less intensive nursing care needs. Conclusions: This is the first study to
establish the potential size and profile of patients who might possibly be
suitable for transfer home to die from critical care. Although patient and
family wishes were not ascertained, the data gives an indication of the
potential population for transfer. For those patients who express a wish to
be transferred home mechanisms need to be in place to facilitate this
practice.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
human
palliative therapy
population
EMTREE MEDICAL INDEX TERMS
book
clinical audit
endotracheal tube
heart disease
hospital
intensive care
intensive care unit
nursing care
patient
policy
sudden death
time of death
United Kingdom
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71484246
DOI
10.1177/0269216314532748
FULL TEXT LINK
http://dx.doi.org/10.1177/0269216314532748
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 295
TITLE
Direct admission to a pacing centre of patients who present urgently for
pacing: Retrospective modelling study of feasibility, potential savings and
indicators of suitability for direct transfer
AUTHOR NAMES
Dewhurst M.
Di Marco L.
McComb J.
AUTHOR ADDRESSES
(Dewhurst M.; McComb J.) Freeman Hospital, United Kingdom.
(Di Marco L.) INSIGNIO Institute for In silico Medicine, United Kingdom.
CORRESPONDENCE ADDRESS
M. Dewhurst, Freeman Hospital, United Kingdom.
SOURCE
Heart (2014) 100 SUPPL. 3. Date of Publication: June 2014
CONFERENCE NAME
British Cardiovascular Society Annual Conference 2014
CONFERENCE LOCATION
Manchester, United Kingdom
CONFERENCE DATE
2014-06-02 to 2014-06-04
ISSN
1355-6037
BOOK PUBLISHER
BMJ Publishing Group
ABSTRACT
Introduction Patients with symptoms consistent with bradycardia suggesting
the need for permanent pacing who present to the emergency department in our
city are admitted to a coronary care unit in one hospital and then
transferred to a pacing centre in another. We investigated the potential for
direct admission to our regional pacing centre and indicators of
suitability. Methods We undertook a retrospective observational study of
patients who were referred urgently for pacing from one referring hospital
to a pacing centre within the same city. Hospital records were reviewed for
138 consecutive patients over a 3 year period from April 2009-12 to
determine indicators for suitability for direct admission to the pacing
centre (based on symptoms, initial electrocardiogram and comorbidities). We
also estimated potential hospital bed day savings, and in hospital
complications that might have been avoided if the patient had been admitted
directly to the pacing centre, and paced within 24 h. Results 134/138
patients had sufficient data for analysis. The indication for pacing was AV
block (AVB) in 60%, atrial fibrillation (AF) in 23%, sinus node disease
(SND) in 16% and carotid hypersensitivity in 1. 87 patients had bradycardia
<50 bpm on presentation; 75 (86%) were suitable for direct admission; 12 had
co-morbidities, the majority either injury or infection, precluding early
pacing, and the pacing indication was not immediately obvious in 3. 45 had a
HR >50 bpm; 7 (16%) were suitable for direct admission, 5 had co-morbidity
and in 33 diagnosis was not obvious. The heart rate at presentation was
unknown in 6; 1 was suitable for direct admission, 1 had an infection and
the diagnosis was not obvious in 4. Overall, 60% were considered suitable
for direct admission from an emergency department to a pacing centre. Had
these patients been admitted directly, 4.2 bed days per patient could have
been saved, in addition to avoiding 4 temporary pacing wire placements and a
bradycardia-related VT arrest. Predictors of suitability for direct transfer
are shown in Tables 1 and 2. Significant indicators of suitability for
direct transfer to a pacing centre Odds ratios of heart rate <47 bpm and
high grade AV block on presenting ECG predicting The predictive ability of
the clinical variables used according to multivariable linear regression
analysis was 91.7%. Conclusions The indication for pacing is obvious at
presentation in the majority of patients who undergo non elective pacing.
Triage to a pacing centre should be possible at presentation to an emergency
department, using criteria including initial heart rate (≤50 bpm), high
grade AVB and lack of co-morbidity, particularly infection or trauma,
requiring urgent management in two thirds of patients. (Table Presented).
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
human
model
patient
society
EMTREE MEDICAL INDEX TERMS
atrial fibrillation
atrioventricular block
bradycardia
carotid artery
city
coronary care unit
diagnosis
electrocardiogram
emergency health service
emergency ward
heart rate
hospital
hospital bed
hypersensitivity
infection
injury
linear regression analysis
medical record
morbidity
non implantable urine incontinence electrical stimulator
observational study
risk
sinus node disease
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71560965
DOI
10.1136/heartjnl-2014-306118.25
FULL TEXT LINK
http://dx.doi.org/10.1136/heartjnl-2014-306118.25
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 296
TITLE
Has the implementation of network antenatal referral pathways decreased
ex-utero transfers of the extreme preterm infant?
AUTHOR NAMES
Kumar R.
Philpott A.
AUTHOR ADDRESSES
(Kumar R.; Philpott A.) West Midlands Neonatal Transfer Service, West
Midlands, United Kingdom.
CORRESPONDENCE ADDRESS
R. Kumar, West Midlands Neonatal Transfer Service, West Midlands, United
Kingdom.
SOURCE
Archives of Disease in Childhood: Fetal and Neonatal Edition (2014) 99
SUPPL. 1 (A69-A70). Date of Publication: June 2014
CONFERENCE NAME
Perinatal Medicine 2014
CONFERENCE LOCATION
Harrogate, United Kingdom
CONFERENCE DATE
2014-06-09 to 2014-06-11
ISSN
1359-2998
BOOK PUBLISHER
BMJ Publishing Group
ABSTRACT
Background The West Midlands Neonatal Transfer Service (WMNTS) is
commissioned to transfer babies between designated neonatal intensive care
(NICU), local neonatal (LNU) and special care units (SCU) in two
neighbouring operational delivery networks (ODNs). The DoH Toolkit (2009)
recommended that extreme preterm babies of less than 27 weeks gestation
should not be delivered in LNUs or SCUs unless there are extenuating
circumstances. This recommendation had been in place in the region since
2007. Aims •To report on transfer activity of extremely preterm infants (<27
weeks gestation) since implementation of antenatal care pathways •To compare
ex-utero transfers between networks. Data Collection: Retrospective data
analysis of WMNTS Excel© database (2009-2013) by a single investigator
Results There has been no significant decrease in the number of extreme
preterm infants transferred by WMNTS from LNUs and SCUs over the 5 year
period (Figure 1). Analysing by ODNs we report a decrease in ex-utero
transfer in ODN 1 compared with ODN 2 over the study period (Figure 2).
(Figure presented) Conclusion In the study period there is no overall
decrease in ex-utero referrals numbers. However, there is a difference in
the change of referral rates between the two networks and further work is
necessary to understand this. Possible hypotheses include lack of maternity
and obstetric capacity in NICUs, lack of understanding of referral patterns,
and different rates of antenatal complications, preventing in-utero
transfers.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
human
infant
perinatal care
prematurity
EMTREE MEDICAL INDEX TERMS
baby
data analysis
data base
hypothesis
information processing
intensive care unit
newborn intensive care
pregnancy
prenatal care
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71561371
DOI
10.1136/archdischild-2014-306576.199
FULL TEXT LINK
http://dx.doi.org/10.1136/archdischild-2014-306576.199
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 297
TITLE
Intrafacility transportation of patients with acute brain injury
AUTHOR NAMES
Tu H.
AUTHOR ADDRESSES
(Tu H., hsinfentu@yahoo.com) Questions or comments about this article may be
directed to Hsinfen Tu, RN MSN MSN-Ed, at . She is a Staff Nurse at the
Neurotrauma Intensive Care Unit, Hartford Hospital, and Clinical Instructor
at Capital Community College, Hartford, CT
SOURCE
The Journal of neuroscience nursing : journal of the American Association of
Neuroscience Nurses (2014) 46:3 (E12-E16). Date of Publication: 1 Jun 2014
ISSN
1945-2810 (electronic)
ABSTRACT
Patients with acute brain injury (ABI) frequently require diagnostic and
therapeutic procedures in the areas located outside of the intensive care
unit. Transports can be risky for critically ill patients with ABI.
Secondary brain injury can occur during the transport from causes such as
ischemia, hypotension, hypoxia, hypercapnia, and cerebral edema. Preparation
and implementation of preventive procedures including pretransport
assessment, monitoring during transport, and posttransport examination and
documentation for transports of patients with ABI deem to be necessary. The
purpose of this article is to review the typical risks associated with the
transports of the patients with ABI out of the intensive care unit and to
propose the strategies that can be used to minimize the risks of secondary
brain injury.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
standards
EMTREE MEDICAL INDEX TERMS
brain injury (therapy)
critical illness
human
intensive care unit
neuroscience nursing
nursing
organization and management
patient transport
risk assessment
risk management
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
24796477 (http://www.ncbi.nlm.nih.gov/pubmed/24796477)
PUI
L601988756
DOI
10.1097/JNN.0000000000000055
FULL TEXT LINK
http://dx.doi.org/10.1097/JNN.0000000000000055
COPYRIGHT
Copyright 2015 Medline is the source for the citation and abstract of this
record.
RECORD 298
TITLE
Exploration of transfer anxiety of patients transferred from a hyper acute
stroke unit to a stroke ward: A pilot study of participants following the
London Stroke Care Pathway
AUTHOR NAMES
Brooke J.M.
Lusher J.
AUTHOR ADDRESSES
(Brooke J.M.) University of Greenwich, London, United Kingdom.
(Lusher J.) London Metropolitan University, London, United Kingdom.
CORRESPONDENCE ADDRESS
J.M. Brooke, University of Greenwich, London, United Kingdom.
SOURCE
Cerebrovascular Diseases (2014) 37 Supplement 1 (315). Date of Publication:
1 May 2014
CONFERENCE NAME
23th European Stroke Conference
CONFERENCE LOCATION
Nice, France
CONFERENCE DATE
2014-05-06 to 2014-05-09
ISSN
1421-9786
BOOK PUBLISHER
S. Karger AG
ABSTRACT
Background The psychological and physical problems experienced by patients
and their family members on transferring from a critical care setting to a
general ward have been well defined and termed 'transfer anxiety'.
Interventions to reduce transfer anxiety have been successfully implemented
for patients and their family members. Currently there is no data available
on transfer anxiety for patients following transfer from a hyper acute
stroke unit to a stroke ward. This study set out to explore this issue.
Methods Data were collected from a purposive pilot sample (n=6) from a
London stroke ward. Semi-structured interviews were carried out to determine
stroke survivors' experience of transfer from a hyper acute stroke unit to a
stroke ward. The interview schedule was based on published literature and
revised by a stroke patient and a clinical nurse specialist. Interviews were
conducted during October-December 2012. Participants were interviewed within
48 hours of admission to a stroke ward. Data were analysed using
Interpretative Phenomenological Analysis. Results: Two participants reported
receiving explicit information from doctors on the reason for their transfer
to the stroke ward; the remaining participants reported receiving no
information. All participants had cognitively explored their transfer to
understand the process. Four emergent themes from IPA included; attachment
to staff on the hyper acute stroke unit, lack of empowerment regarding the
transfer process, need for physiotherapy as a form of acceptance of transfer
and isolation from staff following transfer. Discussion: Elements of
transfer anxiety were identified, including emotional attachment to and then
isolation from the nurses. This study suggests transfer anxiety may differ
from patients being transfer from a critical care setting because of the
need for and extensive completion of physiotherapy.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
anxiety
England
pilot study
stroke patient
stroke unit
EMTREE MEDICAL INDEX TERMS
clinical article
clinical nurse specialist
doctor patient relation
emotional attachment
empowerment
human
physiotherapy
semi structured interview
survivor
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L614325868
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 299
TITLE
Criteria for transfer to tertiary trauma centers: Validation phase based on
the severity of cases treated in tertiary centers
AUTHOR NAMES
Le Sage N.
Lavoie A.
Moore L.
Verreault R.
Emond M.
AUTHOR ADDRESSES
(Le Sage N.; Lavoie A.; Moore L.; Verreault R.; Emond M.) Université Laval,
Québec, Canada.
CORRESPONDENCE ADDRESS
N. Le Sage, Université Laval, Québec, Canada.
SOURCE
Canadian Journal of Emergency Medicine (2014) 16 SUPPL. 1 (S21). Date of
Publication: May 2014
CONFERENCE NAME
2014 CAEP/ACMU
CONFERENCE LOCATION
Ottawa, ON, Canada
CONFERENCE DATE
2014-05-31 to 2014-06-04
ISSN
1481-8035
BOOK PUBLISHER
Decker Publishing
ABSTRACT
Introduction: Recently, a consensus on the indications for transfer to a
tertiary trauma center was obtained from 83 experts representing four
disciplines (emergency medicine, surgery, neurosurgery and intensive care)
who are involved within the integrated trauma system. This study aims to
statistically validate these indications for patient transfer. Methods: Each
criteria was converted into a consensus indicator in order to enable a
statistical validation using a trauma registry. The study population
consisted of all patients in the registry who were directly transported to a
tertiary care center between 1998 and 2008. We compared the rate of
intrahospital death, admission to intensive care unit and intrahospital
complications in patients responding to either of the criteria over those
not meeting the criteria. Results: Data from 27 480 major trauma patients
were analyzed. The risk of death, ICU admission and severe complications [CI
95%] of patients responding to either of the criteria of consensus is higher
than that of patients with no criteria (respectively RR = 6.1 [5.5-6.7], 3.9
[3.8-4.1] and 2.8 [2.6-2.9]). Each individual criteria significantly
increases the risk of death (p < 0.001) with the exception of spinal injury,
an entity that is most often a single trauma not putting the patient's life
in danger. Conclusion: These results suggest that the criteria are valid
injury severity indicators and that these patients require a higher level of
care. However, they also need to be validated on the ability of transfer to
improve the prognosis of these patients.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
injury
EMTREE MEDICAL INDEX TERMS
consensus
death
emergency medicine
human
injury severity
intensive care
intensive care unit
neurosurgery
patient
patient transport
population
prognosis
register
risk
spine injury
surgery
tertiary care center
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71929674
DOI
10.1017/S1481803500003171
FULL TEXT LINK
http://dx.doi.org/10.1017/S1481803500003171
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 300
TITLE
Criteria for transfer to tertiary trauma centers: validation phase based on
the severity of cases treated in tertiary centers
AUTHOR NAMES
Sage N. L.
Lavoie A.
Moore L.
Verreault R.
Emond M.
AUTHOR ADDRESSES
(Sage N. L.; Lavoie A.; Moore L.; Verreault R.; Emond M.) Université Laval,
Québec, Canada.
SOURCE
Canadian Journal of Emergency Medicine (2014) 16 Suppl1 (S21). Date of
Publication: May 2014
CONFERENCE NAME
2014 CAEP/ACMU Scientific Abstracts, CAEP 2014
CONFERENCE LOCATION
Ottawa, ON, Canada
CONFERENCE DATE
2014-05-31 to 2014-06-04
ISSN
1481-8035
1481-8043 (electronic)
ABSTRACT
Introduction: Recently, a consensus on the indications for transfer to a
tertiary trauma center was obtained from 83 experts representing four
disciplines (emergency medicine, surgery, neurosurgery and intensive care)
who are involved within the integrated trauma system. This study aims to
statistically validate these indications for patient transfer. Methods: Each
criteria was converted into a consensus indicator in order to enable a
statistical validation using a trauma registry. The study population
consisted of all patients in the registry who were directly transported to a
tertiary care center between 1998 and 2008. We compared the rate of
intrahospital death, admission to intensive care unit and intrahospital
complications in patients responding to either of the criteria over those
not meeting the criteria. Results: Data from 27 480 major trauma patients
were analyzed. The risk of death, ICU admission and severe complications [CI
95%] of patients responding to either of the criteria of consensus is higher
than that of patients with no criteria (respectively RR = 6.1 [5.5-6.7], 3.9
[3.8-4.1] and 2.8 [2.6-2.9]). Each individual criteria significantly
increases the risk of death (p < 0.001) with the exception of spinal injury,
an entity that is most often a single trauma not putting the patient’s life
in danger. Conclusion: These results suggest that the criteria are valid
injury severity indicators and that these patients require a higher level of
care. However, they also need to be validated on the ability of transfer to
improve the prognosis of these patients.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
EMTREE MEDICAL INDEX TERMS
consensus
death
emergency medicine
human
injury
injury severity
intensive care
intensive care unit
neurosurgery
patient
patient transport
population
prognosis
register
risk
spine injury
surgery
tertiary care center
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L75006827
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 301
TITLE
The utility of tracking patients transferred within 24 hours of admission
from a hospital ward to an intensive care unit as a marker for emergency
department quality of care
AUTHOR NAMES
Solano J.J.
Anderson P.
Wolfe R.E.
Dubosh N.
Edlow J.
Grossman S.
AUTHOR ADDRESSES
(Solano J.J.; Anderson P.; Wolfe R.E.; Dubosh N.; Edlow J.; Grossman S.)
Beth Israel Deaconess Medical Center, Boston, United States.
CORRESPONDENCE ADDRESS
J.J. Solano, Beth Israel Deaconess Medical Center, Boston, United States.
SOURCE
Academic Emergency Medicine (2014) 21:5 SUPPL. 1 (S288-S289). Date of
Publication: May 2014
CONFERENCE NAME
2014 Annual Meeting of the Society for Academic Emergency Medicine, SAEM
2014
CONFERENCE LOCATION
Dallas, TX, United States
CONFERENCE DATE
2014-05-13 to 2014-05-17
ISSN
1069-6563
BOOK PUBLISHER
Blackwell Publishing Ltd
ABSTRACT
Background: Prior studies suggest 4% of hospitalized patients suffer adverse
events of which 60% are preventable. However, metrics of error and adverse
events are lacking. Markers, such as 72-hour returns to the ED resulting in
admission, have shown error rates ranging from 0.2 to 4%, with 0.4 to 1%
resulting in changes in outcome. Unplanned transfer to the ICU has been
implicated as a possible source of preventable error, with an error rate of
up to 19%. Objectives: To investigate the utility of tracking patients
transferred to the ICU <24 hours after admission from the ED as a marker of
preventable errors and adverse events. Methods: From 11/11-3/13, we
prospectively collected data for all patients presenting to an urban,
tertiary care academic ED (annual volume of 57,000 patients) using an
automated electronic tracking system to identify ED patients who were
admitted to a hospital ward and then transferred to the ICU within 24 hours.
Cases were randomly assigned to physicians not involved with the patients'
care for review. We designed a structured tool with an eight-point Likert
scale to determine presence of error and adverse events. If a reviewer felt
that a possible error and adverse event resulted in the need for
intervention, additional treatment, or caused patient harm, a 20-member QA
committee of ED physicians and nurses met to determine definitively whether
an error and adverse event had occurred. Results: Of 29,925 ward admissions,
325 (1%) patients were subsequently transferred to the ICU within 24 hours
of ED presentation. The mean age of these patients was 64 and 50.5% were
male; (18%) were then referred to the QA committee for review. Total rate of
adverse events regardless of whether or not an error occurred was 4.3%,
14/325 (95% CI 2.09% to 6.51%). Preventable error on the part of the ED was
3.7%, 12/325 (95% CI 1.65 to 5.75%) and associated with an ED-triggered
adverse event in 1.8%, 6/325 (95% CI 0.35% to 3.25%). Remaining preventable
errors were considered to be “near misses.” Conclusion: Tracking patients
admitted to the hospital from the ED who are transferred to the ICU <24
hours after admission may be a valuable marker for adverse events and
preventable errors in the ED. Additional studies may better understand the
lower rates of error found in our study and differentiate types of clinical
error which put patients most at risk for transfer.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
marker
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency medicine
emergency ward
human
intensive care unit
patient
society
ward
EMTREE MEDICAL INDEX TERMS
hospital
hospital patient
Likert scale
male
nurse
patient harm
physician
risk
tertiary health care
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71470004
DOI
10.1111/acem.12365
FULL TEXT LINK
http://dx.doi.org/10.1111/acem.12365
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 302
TITLE
Validation of the children's hospital early warning scoring system for
identifying hospitalized children at risk for arrest or ICU transfer
AUTHOR NAMES
McLellan M.
Gauvreau K.
Connor J.A.
AUTHOR ADDRESSES
(McLellan M.; Gauvreau K.; Connor J.A.) Cardiovascular Program, Boston
Children's Hospital, Boston, United States.
CORRESPONDENCE ADDRESS
M. McLellan, Cardiovascular Program, Boston Children's Hospital, Boston,
United States.
SOURCE
Pediatric Critical Care Medicine (2014) 15:4 SUPPL. 1 (30). Date of
Publication: May 2014
CONFERENCE NAME
7th World Congress on Pediatric Intensive and Critical Care, PICC 2014
CONFERENCE LOCATION
Istanbul, Turkey
CONFERENCE DATE
2014-05-04 to 2014-05-07
ISSN
1529-7535
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Background and aims: Most inpatient pediatric arrests are preventable
through early recognition/treatment of deterioration. Early warning scoring
systems provide early identification of at risk children. The CHEWS system
was developed, implemented and validated at a single academic pediatric
hospital. Nurses assess patients' CHEWS scores during vital signs. Based
upon score, an algorithm directs: routine care (score 0-2), increased
assessment/intervention (3-4), or ICU consult/transfer (≥5). Aims: To
validate the Children's Hospital Early Warning Score (CHEWS) tool and
algorithm for identifying hospitalized children at risk for cardiopulmonary
arrest or ICU transfer. Methods: A retrospective chart review was performed
on a patient cohort admitted to inpatient units over 12 months who
experienced arrest / unplanned ICU transfer (n=360) and a randomly selected
comparison sample (n=776). Documented CHEWS scores and abstracted Brighton
Pediatric Early Warning Scores (PEWS) were used to calculate sensitivity,
specificity, negative and positive predictive values and area under the
receiver operating characteristic curves (ROC) to measure discrimination.
IRB approval was obtained. Results: The ROC for CHEWS was 0.902 compared to
PEWS 0.798. The mean lead time prior to event was 3.8 hours for CHEWS versus
0.6 hours for PEWS (p < 0.001). CHEWS algorithm sensitivity was 97.8 (for
score ≥2), 84.2 (≥4) and 75.6 (≥5) versus PEWS of 82.8 (≥2), 54.4 (≥4), and
38.9 (≥5). CHEWS specificity was 52.5 (≥2), 80.9 (≥4), and 88.5 (≥5) versus
PEWS of 63.7 (≥ 2), 85.3 (≥4) and 93.9 (≥5). Conclusions: The CHEWS system
demonstrated higher discrimination, higher sensitivity and longer lead time
than PEWS for identifying hospitalized children at risk for arrest or
unplanned ICU transfer.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospitalized child
human
intensive care
pediatric hospital
risk
scoring system
EMTREE MEDICAL INDEX TERMS
algorithm
cardiopulmonary arrest
child
deterioration
hospital patient
medical record review
nurse
patient
predictive value
receiver operating characteristic
vital sign
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71625928
DOI
10.1097/01.pcc.0000448836.27923.e3
FULL TEXT LINK
http://dx.doi.org/10.1097/01.pcc.0000448836.27923.e3
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 303
TITLE
Specialized pediatric critical care vs rapid EMS transport of trauma
patients
AUTHOR NAMES
Garlick J.
Melguizo-Castro M.
Keen P.
Nick T.
Stroud M.
AUTHOR ADDRESSES
(Garlick J.; Melguizo-Castro M.; Keen P.; Nick T.; Stroud M.) Critical Care,
Arkansas Childrens Hospital, Little Rock, United States.
CORRESPONDENCE ADDRESS
J. Garlick, Critical Care, Arkansas Childrens Hospital, Little Rock, United
States.
SOURCE
Pediatric Critical Care Medicine (2014) 15:4 SUPPL. 1 (175-176). Date of
Publication: May 2014
CONFERENCE NAME
7th World Congress on Pediatric Intensive and Critical Care, PICC 2014
CONFERENCE LOCATION
Istanbul, Turkey
CONFERENCE DATE
2014-05-04 to 2014-05-07
ISSN
1529-7535
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Background and aims: The use of specialized pediatric transport teams has
been shown to reduce adverse events and lower mortality rates in children
with medical illness. Rapid transport of trauma patients requiring surgical
intervention to tertiary care centers is intuitive; however, the specialized
care provided by pediatric transport teams may be beneficial in subsets of
trauma patients. Aims: Improved care during transport may be more
advantageous than rapid transport in pediatric trauma patients not requiring
immediate surgical intervention. Methods: Data was collected on all
pediatric trauma patients transported between January2007-December2011 to
Arkansas Children's Hospital (ACH). Demographic data, vital signs, mortality
scores, required interventions, and injury-severity scores (ISS) were
compared between patients transported by a specialized pediatric team at ACH
and state EMS services. Results: Univariate analysis showed that trauma
patients transported by a specialized team had shorter Length of Stay (LOS),
shorter ED LOS, and a higher probability of survival. Multivariate analysis,
adjusting for age and ISS, revealed a significantly different ED LOS with
patients transported by EMS teams spending an average of 0.67 (95% CI
0.65-0.68) hours longer in the ED. Conclusions: Trauma patients transported
by a specialized team spent significantly less time in the ED prior to
admission [2.5h(3.2 } 3.9) vs 2.3h(2.6 } 2.2) P<0.001], Improved care during
transport, resulting in enhanced resuscitation, may decrease time spent in
the ED, thus expediting appropriate ongoing care and rationing ED resources.
Future evaluations will determine if differences exist in subsets of trauma
patients and if the number of interventions during transport differs among
specialized pediatric teams versus EMS teams.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
human
injury
intensive care
patient
EMTREE MEDICAL INDEX TERMS
child
childhood injury
diseases
injury scale
length of stay
mortality
multivariate analysis
pediatric hospital
resuscitation
surgery
survival
tertiary care center
United States
univariate analysis
vital sign
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71626602
DOI
10.1097/01.pcc.0000449510.15567.6e
FULL TEXT LINK
http://dx.doi.org/10.1097/01.pcc.0000449510.15567.6e
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 304
TITLE
Characteristics and disposition of children who undergo intraosseous
placement before transport
AUTHOR NAMES
Reuter-Rice K.
AUTHOR ADDRESSES
(Reuter-Rice K.) Nursing Medicine Dept. of Pediatrics, Duke University,
Durham, United States.
CORRESPONDENCE ADDRESS
K. Reuter-Rice, Nursing Medicine Dept. of Pediatrics, Duke University,
Durham, United States.
SOURCE
Pediatric Critical Care Medicine (2014) 15:4 SUPPL. 1 (186). Date of
Publication: May 2014
CONFERENCE NAME
7th World Congress on Pediatric Intensive and Critical Care, PICC 2014
CONFERENCE LOCATION
Istanbul, Turkey
CONFERENCE DATE
2014-05-04 to 2014-05-07
ISSN
1529-7535
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Background and aims: The use of intraosseous (IO) needles as an access for
resuscitation in pediatric advance life support has led to more pediatric
patients being transported with IO needles in place. It would be reasonable
to expect that the disposition of these patients would be admission to the
intensive care unit, but to date there have been no studies to support this
supposition. Aims: To determine the characteristics and disposition of
children following IO needle placement referred for transport from an
outlying facility. Methods: A retrospective review of the transport database
from 1993-2009 of pediatric patients who had an IO as a part of their care.
The IRB waived the need for consent. Results: 143 children were transported
to a level 1 trauma tertiary care children's hospital from 25 referral
facilities. Patients were 65% male and 35% female with a mean age of 1.20
years (range 0.01-13 years). All had IO's placed placed by pre-hospital
providers, the referral facility, or the transport team. Of the 143 patients
transported, 53% were placed for no intravenous access and 34% were placed
for no perfusing rhythm. Most common reason for admission to the hospital
was combined system failure with 79% of patients admitted to the pediatric
intensive care. Of those hospitalized, 58% were discharged home.
Conclusions: IO placement is a life-saving measure with most IOs placed by
referring facilities prior to transport and few reported complications.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child
human
intensive care
EMTREE MEDICAL INDEX TERMS
aspiration needle
data base
female
hospital
injury
intensive care unit
male
needle
patient
pediatric hospital
resuscitation
rhythm
tertiary health care
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71626652
DOI
10.1097/01.pcc.0000449560.90017.56
FULL TEXT LINK
http://dx.doi.org/10.1097/01.pcc.0000449560.90017.56
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 305
TITLE
Usage of osmotherapy during paediatric critical care transport
AUTHOR NAMES
Clarke A.
Lutman D.
Ramnarayan P.
AUTHOR ADDRESSES
(Clarke A.; Lutman D.; Ramnarayan P.) Childrens Acute Transport Service,
Great Ormond Street Hospital, London, United Kingdom.
CORRESPONDENCE ADDRESS
A. Clarke, Childrens Acute Transport Service, Great Ormond Street Hospital,
London, United Kingdom.
SOURCE
Pediatric Critical Care Medicine (2014) 15:4 SUPPL. 1 (72). Date of
Publication: May 2014
CONFERENCE NAME
7th World Congress on Pediatric Intensive and Critical Care, PICC 2014
CONFERENCE LOCATION
Istanbul, Turkey
CONFERENCE DATE
2014-05-04 to 2014-05-07
ISSN
1529-7535
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Background and aims: Administration of high osmolarity solutions (hypertonic
saline (HS) or mannitol) is one of a number of interventions to treat raised
intracranial pressure. These are commonly used in an intensive care
environment with intracranial monitoring to assess response, but this is
rarely available in a retrieval setting. Aims: We report the usage of
hyperosmotic solutions by a dedicated critical care transport team in the
UK. Methods: Retrospective audit of all patients who received either
hypertonic saline or mannitol for treatment of raised intracranial pressure.
The local audit department approved data collection. Results: Between April
2009 and June 2013, 168 patients received 235 doses of osmotherapy. The mean
age and weight was 5.8 yrs (range 1 day-16yrs) and 23.0kg (2.4-70kg). Common
diagnoses were meningoencephalitis, traumatic brain injury (TBI) and
diabetic ketoacidosis (DKA) (27%, 22% and 12% of doses respectively).
Different agents are preferred with different diagnoses, and there appear to
have been temporal changes in use over the last 4 years (figure). In
patients requiring multiple doses, both agents are initially used equally,
but hypertonic saline is preferred for subsequent doses (Mannitol vs HS: 1st
dose 51% vs 49%, 2nd dose 18% vs 81%, 3rd dose 31% vs 69%). Conclusions:
This audit describes use of osmotherapy in an exclusively retrieval setting
in the UK. In TBI, HS is the preferred agent, practice having changed in
2010. In meningoencephalitis and DKA, although there may have been
preferences previously, most currently both agents are used equally. There
were no adverse incidents associated with osmotherapy in this audit.
EMTREE DRUG INDEX TERMS
mannitol
sodium chloride
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
EMTREE MEDICAL INDEX TERMS
clinical audit
diabetic ketoacidosis
diagnosis
environment
human
information processing
intracranial pressure
meningoencephalitis
monitoring
multiple drug dose
osmolarity
patient
traumatic brain injury
United Kingdom
weight
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71626123
DOI
10.1097/01.pcc.0000449031.74556.01
FULL TEXT LINK
http://dx.doi.org/10.1097/01.pcc.0000449031.74556.01
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 306
TITLE
Neonatal pain and COMT RS4680 genotype in relation to serotonin transporter
(SLC6A4) promoter methylation in very preterm children at school age
AUTHOR NAMES
Chau C.M.Y.
Ranger M.
Devlin A.
Oberlander T.F.
Grunau R.E.
AUTHOR ADDRESSES
(Chau C.M.Y.; Ranger M.; Oberlander T.F.; Grunau R.E.) Developmental
Neurosciences and Child Health, Child and Family Research Institute,
Vancouver, Canada.
(Ranger M.; Devlin A.; Oberlander T.F.; Grunau R.E.) Pediatrics, University
of British Columbia, Vancouver, Canada.
(Devlin A.) Diabetes, Nutrition and Metabolism, Child and Family Research
Institute, Vancouver, Canada.
CORRESPONDENCE ADDRESS
C.M.Y. Chau, Developmental Neurosciences and Child Health, Child and Family
Research Institute, Vancouver, Canada.
SOURCE
Pain Research and Management (2014) 19:3 (e67-e68). Date of Publication:
May-June 2014
CONFERENCE NAME
35th Annual Scientific Meeting of the Canadian Pain Society
CONFERENCE LOCATION
Quebec City, QC, Canada
CONFERENCE DATE
2014-05-20 to 2014-05-23
ISSN
1203-6765
BOOK PUBLISHER
Pulsus Group Inc.
ABSTRACT
AIM: Children born very preterm are exposed to repeated neonatal procedural
pain-related stress during Hospitalization in the neonatal intensive care
unit (NICU). The COMT rs4680 genotype is involved with pain sensitivity, and
early life stress is implicated in altered methylation level of the
serotonin transporter. We examined: (1) whether methylation of serotonin
transporter (SLC6A4) promoter differs between very preterm children and
full-term controls at school age, (2) relationships with child behavior
problems, and (3) the extent of COMT rs4680 genotypes modulated the
association between neonatal pain exposure and SLC6A4 methylation at seven
years in the very preterm children. METHODS: Participants comprised n=111
children, 61 born very preterm (24 to 32 weeks gestation), and 50 control
children born full-term, all seen at mean age 7.8 years (SD 0.65 years).
SLC6A4 and COMT rs4680 were genotyped from saliva DNA. SLC6A4 methylation
was quantified by bisulfite pyrosequencing. Generalized linear modeling was
used to examine associations between the COMT genotypes, neonatal pain
exposure (adjusted for medical confounders), SLC6A4 methylation, and child
behavioral problems. RESULTS: Very preterm children had higher methylation
at 7 of 10 CpG sites in the SLC6A4 promoter compared to full-terms at age
seven years. Greater neonatal pain (adjusted for medical confounders) was
associated with higher Total child behavior problem score on the Child
Behavior Checklist (CBCL) questionnaire (adjusted for concurrent stressors
and 5HTTLPR genotype) (P=0.035). Higher CBCL total problem was associated
with greater SLC6A4 methylation in very preterm children (P=0.01). In COMT
Met/Met children, greater neonatal pain (adjusted for medical confounders)
was associated with reduced methylation of SLC6A4 promoter (P=0.001).
CONCLUSIONS: We demonstrated a complex relationship between early exposure
to highly stressful environmental events that induce repeated pain, child
genotype reflecting pain sensitivity, and epigenetic modifications in
children born during a critically sensitive developmental period. These
findings provide evidence that both genetic predisposition and early
environment need to be considered in understanding susceptibility for
developing behavioral problems in this vulnerable population.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
serotonin transporter
EMTREE DRUG INDEX TERMS
bisulfite
DNA
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child
genotype
human
methylation
pain
prematurity
promoter region
school
society
EMTREE MEDICAL INDEX TERMS
behavior disorder
child behavior
Child Behavior Checklist
early life stress
environment
exposure
female
genetic predisposition
hospitalization
intensive care unit
model
newborn intensive care
nociception
pregnancy
pyrosequencing
questionnaire
saliva
vulnerable population
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71607057
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 307
TITLE
Remote paediatric critical care transport consultations: A review
AUTHOR NAMES
Tijssen J.
Parshuram C.
AUTHOR ADDRESSES
(Tijssen J.) Paediatric Critical Care Medicine, Children's Hospital London,
Health Sciences Centre, London, Canada.
(Parshuram C.) Critical Care Medicine, Hospital for Sick Children, Toronto,
Canada.
CORRESPONDENCE ADDRESS
J. Tijssen, Paediatric Critical Care Medicine, Children's Hospital London,
Health Sciences Centre, London, Canada.
SOURCE
Pediatric Critical Care Medicine (2014) 15:4 SUPPL. 1 (218-219). Date of
Publication: May 2014
CONFERENCE NAME
7th World Congress on Pediatric Intensive and Critical Care, PICC 2014
CONFERENCE LOCATION
Istanbul, Turkey
CONFERENCE DATE
2014-05-04 to 2014-05-07
ISSN
1529-7535
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Background and aims: Formal evaluation of our provincial critical care
telephone consultation system has not been performed. Aims: To describe the
process of providing advice, the content of the advice, and the planned
disposition for patients for which calls were placed to the ICU at Toronto's
Hospital for Sick Children. Methods: We retrospectively reviewed 100
consecutive consultations in January 2012 and December 2011. Descriptive
analyses (SAS v9.3) were performed for patient demographic data, time of day
and duration of consultations, interruptions, clinical information
discussed, and advice provided to describe the individual impact of timing,
primary system, and planned disposition on the duration of calls,
interruptions, and information discussed. Results: Patients with a mean (SD)
age of 3.1 (4.6) years were from 30 hospitals, a mean (SD) of 62.2 (102.8)
km away. Half of calls were made during the day. The median (IQR) duration
of consultations was 15 (11-21) minutes. The primary problem system was
respiratory in 42. Interruptions occurred in 94% of calls. Recommendations
were made in more than 75% of consultations and 55 patients had a planned
disposition to the ICU. The number of interruptions, time to disposition
decision, and the total duration of calls were not associated with planned
disposition and the primary system involved. Duration of calls during the
night were shorter (p<0.001) but the number of interruptions was unchanged.
Conclusions: The content, flow and duration of calls, and disposition
decision were not affected by the patient's problem system or ICU admission
plan. This demonstrates a consistent service despite many consulting
physicians.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
consultation
intensive care
EMTREE MEDICAL INDEX TERMS
child
hospital
human
night
patient
physician
teleconsultation
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71626807
DOI
10.1097/01.pcc.0000449715.59042.84
FULL TEXT LINK
http://dx.doi.org/10.1097/01.pcc.0000449715.59042.84
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 308
TITLE
Frequency and reasons of “Futile” interhospital transfer for endovascular
recanalization treatment in acute ischemic stroke. The madrid stroke network
AUTHOR NAMES
Fuentes B.
Alonso De Leciñana M.
Ximenez-Carrillo A.
Martínez-Sánchez P.
Cruz-Culebras A.
Zapata G.
Ruiz-Ares G.
García-Pastor A.
Gil-Nuñez A.
Vivancos J.
Masjuan J.
Diez-Tejedor E.
AUTHOR ADDRESSES
(Fuentes B.; Martínez-Sánchez P.; Ruiz-Ares G.; Diez-Tejedor E.) La Paz
University Hospital, IdiPAZ Health Research Institute, Madrid, Spain.
(Alonso De Leciñana M.; Cruz-Culebras A.; Masjuan J.) Ramón y Cajal
University Hospital, IRYCIS Reasearch Institute, Madrid, Spain.
(Ximenez-Carrillo A.; Zapata G.; Vivancos J.) La Princesa University
Hospital, IIS-Princesa Research Institute, Madrid, Spain.
(García-Pastor A.; Gil-Nuñez A.) Gregorio Marañón University Hospital, IiSGM
Health Research Institute, Madrid, Spain.
CORRESPONDENCE ADDRESS
B. Fuentes, La Paz University Hospital, IdiPAZ Health Research Institute,
Madrid, Spain.
SOURCE
Cerebrovascular Diseases (2014) 37 Supplement 1 (98). Date of Publication: 1
May 2014
CONFERENCE NAME
23th European Stroke Conference
CONFERENCE LOCATION
Nice, France
CONFERENCE DATE
2014-05-06 to 2014-05-09
ISSN
1421-9786
BOOK PUBLISHER
S. Karger AG
ABSTRACT
Objectives: The complexity of endovascular revascularization treatment (ERT)
in acute ischemic stroke (IS) and the small number of patients eligible to
that treatment justifies the development of Stroke Center networks with
interhospital transfers. But it is possible that this approach generate
“futile” transfers generating unnecessary costs. Our aim is to analyze the
frequency of this fact, the reasons for rejection for ERT and to identify
the possible associated factors. Methods: We analyzed a prospective registry
of ERT from a Stroke Network integrated by three hospitals with a common
stroke treatment protocol and a weekly rotatory shift with interhospital
transference to the on-call center for ERT in those patients in whom this
therapy is indicated. We analyzed: demographic data, vascular risk factors,
stroke severity, frequency of prior intravenous thrombolysis, time from
stroke onset and reasons for rejection. Results: ERT protocol was activated
in 199 patients, receiving ERT 129 (64.8%). 120 (60.3%) patients required
hospital transfer, of which 50 (41%) were not followed by ERT (futile
transfer). There were no differences in age, vascular risk factors, times
from stroke onset or times of interhospital transfer, baseline NIHSS,
baseline ASPECTS or rates of prior intravenous thrombolysis compared
transferred patients treated with ERT. Reasons for rejection were: clinical
improvement or arterial recanalization (42%), findings in neuroimaging
(ASPECTS <7 or no mismatch; 38%), clinical deterioration (9%), delay in
shipment (2%), and revocation of consent (1%). There were no complications
during intrahospital transfer. Conclusions: 40% of shipments for ERT are
“futile”. None of the baseline patient characteristics predict this fact,
being arterial recanalization and findings in neuroimaging test done in the
hospital receiving the main reasons for ERT rejection.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
brain ischemia
recanalization
EMTREE MEDICAL INDEX TERMS
artery
blood clot lysis
call center
cardiovascular risk
clinical protocol
clinical trial
controlled clinical trial
controlled study
demography
deterioration
hospital
human
major clinical study
multicenter study
National Institutes of Health Stroke Scale
neuroimaging
patient transport
register
revascularization
transference
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L614325636
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 309
TITLE
To transfer or not transfer-the ethical and resources implications for
transferring infants with a high risk of early death
AUTHOR NAMES
William Ibrahim T.M.
Broster S.
Kelsall W.
AUTHOR ADDRESSES
(William Ibrahim T.M.) Neonatal Intensive Care Unit and Acute Neonatal
Transport Service, Cambridge University, Hospitals NHS Foundation Trust,
Cambridge, United Kingdom.
(Broster S.) Acute Neonatal Transport Service, Cambridge University,
Hospitals NHS Foundation Trust, Cambridge, United Kingdom.
(Kelsall W.) Neonatal Intensive Care Unit, Cambridge University, Hospitals
NHS Foundation Trust, Cambridge, United Kingdom.
CORRESPONDENCE ADDRESS
T.M. William Ibrahim, Neonatal Intensive Care Unit and Acute Neonatal
Transport Service, Cambridge University, Hospitals NHS Foundation Trust,
Cambridge, United Kingdom.
SOURCE
Archives of Disease in Childhood (2014) 99 SUPPL. 1 (A54). Date of
Publication: April 2014
CONFERENCE NAME
Annual Conference of the Royal College of Paediatrics and Child Health,
RCPCH 2014
CONFERENCE LOCATION
Birmingham, United Kingdom
CONFERENCE DATE
2014-04-08 to 2014-04-10
ISSN
0003-9888
BOOK PUBLISHER
BMJ Publishing Group
ABSTRACT
Background Over the last decade neonatal transport services (TS) have
developed significantly as networks have been established. The
responsibility of the TS is to transfer sick neonates for specialist care
usually to level III units for medical or surgical treatment.1 Medical and
nursing expertise in network units varies, with staff on neonatal tertiary
intensive care units managing neonatal deaths more frequently. This study
aims to review deaths across a single network particularly considering cases
that were referred for transfer. Methods A retrospective review of neonatal
deaths and the infants referred to the TS between January 2011 and December
2012. Data was collected from the network SEND and TS databases. Results
Over 2 years there were approximately 150,000 live births in the network,
with 1445 (1%) infants referred as an emergency for neonatal TS. There were
219 deaths with an overall mortality rate of 1.46 deaths per 1000 live
births. The gestational age of babies who died was median 28 (range 23-41)
weeks and birth weight 900 (400-3500) gram. Of these 219 babies 107 (49%)
were referred for neonatal transfer. Of the referrals, 73 (68%) transfers
were completed with 14 (19%) of these babies dying within 24 h, 13 (18%)
dying between 24 - 48 h and 46 (63%) dying more than 48 h after transfer. Of
the 34 cases that were not transferred 15 (44%) died before the TS was
despatched, 18 (53%) were deemed too sick to transfer by the TS after
arrival in the referring unit and 1 (3%) transfer was declined by the
parents. Conclusion The study demonstrates that careful communication
between TS and local consultants has avoided the unnecessary transfer of a
small number of neonates in whom it was felt that death was inevitable. A
small but significant number of transferred infants die within 24 h of
transfer. It could be argued that these babies should not have been moved.
However the reasons for transfer may be more complicated: with parents
wanting everything possible done or local clinicians wanting to work with
specialist centres in managing all aspects of care including a neonatal
death.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child health
college
death
infant
pediatrics
risk
EMTREE MEDICAL INDEX TERMS
baby
birth weight
consultation
data base
emergency
gestational age
human
intensive care unit
interpersonal communication
live birth
medical specialist
mortality
newborn
newborn death
nursing expertise
parent
responsibility
surgery
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71566126
DOI
10.1136/archdischild-2014-306237.128
FULL TEXT LINK
http://dx.doi.org/10.1136/archdischild-2014-306237.128
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 310
TITLE
Virulence and transferability of resistance determinants in a novel
klebsiella pneumoniae sequence type 1137 in China
AUTHOR NAMES
Liu Y.
Li X.-Y.
Wan L.-G.
Jiang W.-Y.
Yang J.-H.
Li F.-Q.
AUTHOR ADDRESSES
(Liu Y., ly13767160474@sina.com; Wan L.-G.) Department of Bacteriology,
First Affiliated Hospital of Nanchang University, Nanchang University, Yong
Wai Zheng Jie No. 17, Nanchang 330006, China.
(Li X.-Y.; Jiang W.-Y.; Yang J.-H.; Li F.-Q.) Department of Clinical
Microbiology, Second Affiliated Hospital of Wenzhou Medical College, Wenzhou
Medical College, Wenzhou, China.
CORRESPONDENCE ADDRESS
Y. Liu, Department of Bacteriology, First Affiliated Hospital of Nanchang
University, Nanchang University, Yong Wai Zheng Jie No. 17, Nanchang 330006,
China. Email: ly13767160474@sina.com
SOURCE
Microbial Drug Resistance (2014) 20:2 (150-155). Date of Publication: 1 Apr
2014
ISSN
1931-8448 (electronic)
1076-6294
BOOK PUBLISHER
Mary Ann Liebert Inc., info@liebertpub.com
ABSTRACT
A study was designed to characterize three carbapenemase-producing
Klebsiella pneumoniae isolated from pediatric patients in China. Molecular
characterization was done using polymerase chain reaction and sequencing for
bla(VIM), bla(NDM), bla(IMP), bla(KPC), bla(CTX-Ms), bla(OXAs), bla(TEMs),
and bla (SHV); plasmid-mediated quinolone resistance determinants;
aminoglycoside resistance determinants; multilocus sequencing typing;
plasmid replicon typing; addiction; and virulence factors. Kp32 belonged to
the newly described sequence type 1137, were positive for aac(6′)-Ib-suzhou,
qnrA1, qnrB4, qnrS1, aac(6′)-Ib, rmtB, armA, bla(SHV-12), bla (CTX-M-15),
bla(KPC-2), and bla(IMP-4); contained IncA/C plasmids that tested positive
for K1 capsular antigens, the ccdAB (coupled cell division locus) addiction
system and the wabG, ureA, rmpA, magA, allS, fimH, and the aerobactin
virulence factors. However, the others belonged to clone ST11, and were
positive for aac(6′)-Ib-cr, qnrB4, bla (CTX-M-14), bla(SHV-11), aac(6′)-Ib,
rmtB, and bla (KPC-2); contained IncFIA plasmids that tested positive for K2
capsular antigens, the vagCD addiction system and the uge, wabG, ureA,
kfuBC, rpmA, and fimH virulence factors. ST1137 had more virulence factors
than the comparative strains ST11. The bla(KPC-2) gene was located on the
IncFIA and IncA/C replicon groups of plasmids. An analysis of the genetic
environment of bla (KPC-2) gene has demonstrated that the bla(KPC-2) gene
was always associated with one of the Tn4401 isoforms (a or b). Our study
suggested that K. pneumoniae carbapenemases being found in virulent K.
pneumoniae should be emphasized, as this will eventually become a global
health threat. © 2014, Mary Ann Liebert, Inc.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
carbapenemase
EMTREE DRUG INDEX TERMS
aerobactin
amikacin
aminoglycoside
amoxicillin plus clavulanic acid
aztreonam (drug therapy)
beta lactamase
cefoxitin
ceftazidime
ceftriaxone
ciprofloxacin
cotrimoxazole
ertapenem
etimicin (drug therapy)
gentamicin
imipenem
meropenem (drug therapy)
piperacillin plus tazobactam
quinolone
tobramycin
virulence factor
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
antibiotic resistance
bacterial gene
bacterial virulence
gene sequence
Klebsiella pneumoniae
Klebsiella pneumoniae sequence type 1137
EMTREE MEDICAL INDEX TERMS
abdominal pain
allele
antibiotic sensitivity
antibiotic therapy
article
bacteremia
bacterial strain
bacterium culture
bacterium detection
bacterium identification
bacterium isolation
blood culture
burn unit
case report
central venous catheter
child
child hospitalization
childhood disease (drug therapy)
China
communicable disease (drug therapy)
emergency ward
epsilometer test
fever
gene duplication
gene locus
hospital admission
hospital infection
hospitalization
human
indwelling catheter
intensive care unit
inverted repeat
length of stay
male
mechanical ventilator
minimum inhibitory concentration
multilocus sequence typing
nonhuman
outcome assessment
plasmid
polymerase chain reaction
preschool child
priority journal
pulsed field gel electrophoresis
replicon
restriction fragment length polymorphism
sepsis (drug therapy)
urinary tract infection
urine culture
CAS REGISTRY NUMBERS
aerobactin (26198-65-2)
amikacin (37517-28-5, 39831-55-5)
amoxicillin plus clavulanic acid (74469-00-4, 79198-29-1)
aztreonam (78110-38-0)
beta lactamase (9073-60-3)
cefoxitin (33564-30-6, 35607-66-0)
ceftazidime (72558-82-8)
ceftriaxone (73384-59-5, 74578-69-1)
ciprofloxacin (85721-33-1)
cotrimoxazole (8064-90-2)
ertapenem (153773-82-1, 153832-38-3, 153832-46-3)
etimicin (172450-93-0, 59711-96-5)
gentamicin (1392-48-9, 1403-66-3, 1405-41-0)
imipenem (64221-86-9)
meropenem (96036-03-2)
tobramycin (32986-56-4)
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Urology and Nephrology (28)
Drug Literature Index (37)
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2014210004
MEDLINE PMID
24236613 (http://www.ncbi.nlm.nih.gov/pubmed/24236613)
PUI
L372686260
DOI
10.1089/mdr.2013.0107
FULL TEXT LINK
http://dx.doi.org/10.1089/mdr.2013.0107
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 311
TITLE
Infections with resistant bacteria in hospitalized cirrhotic patients cause
longer hospital stay and frequent ICU transfer
AUTHOR NAMES
Çelik G.
Köksal R.
Bedir F.
Ata G.
Özer M.
Sancar S.
Kilic¸ S.
Özdoʇan O.C.
AUTHOR ADDRESSES
(Çelik G.; Bedir F.; Ata G.; Özer M.; Sancar S.; Kilic¸ S.) Marmara
University, Medical School, Istanbul, Turkey.
(Köksal R.; Özdoʇan O.C., osmanozdogan@yahoo.com) Gastroenterology and
Hepatology, Marmara University, Medical School, Istanbul, Turkey.
CORRESPONDENCE ADDRESS
G. Çelik, Marmara University, Medical School, Istanbul, Turkey.
SOURCE
Journal of Hepatology (2014) 60:1 SUPPL. 1 (S216). Date of Publication:
April 2014
CONFERENCE NAME
49th Annual Meeting of the European Association for the Study of the Liver,
International Liver Congress 2014
CONFERENCE LOCATION
London, United Kingdom
CONFERENCE DATE
2014-04-09 to 2014-04-13
ISSN
0168-8278
BOOK PUBLISHER
Elsevier
ABSTRACT
Background and Aims: The aim of this present study is to evaluate the
bacterial resistance profiles and their effects on clinical situations and
hospitalization duration in hospitalized cirrhotic patients. Methods: A
total of 114 cirrhotic patients hospitalized in our unit between 2012 and
2013 were recruited from our Database. Demographic, clinical, laboratory
data and culture results and resistance profiles, mortalities and
hospitalization durations were included into the evaluation. Results:
Forty-nine out of 114 (43.9%) patients were female, median age 58, main
etiologies were HBV, HCV, alcohol and, cryptogenic. Forty-eight
hospitalizations were related to infections inwhich 15 (31%) were
“health-care related”, 21 (43%) were hospital-acquired infections.
Thirty-six of 167 (21%)cultures were positive inwhich 18 cultures (50%) were
resistant to at least two antibiotic groups. Main infection sides for the
resistant bacteria were urinary (44%), blood (17%), sputum (11%), ascitic
fluid (11%), and catheter (6%). Logistic regression analysis showed that
male gender and oral nonabsorbable antibiotic prophylaxis have positive, and
daily use of lactulose have negative impact on the development of the
bacterial resistance (p < 0.05). Patients with resistance infections had
more frequent signs of systemic inflammatory response, transfer to ICU and
prolonged hospital stay when compared the patients without having resistant
infections (p < 0.05). There was no mortality difference between the
patients who have resistant or non-resistant bacterial infections.
Conclusions: In our series of hospitalized cirrhotic patients, infections
with resistant bacteria found to be half of the positive cultures which is
associated with the extended duration of hospitalization and frequent
transfer to intensive care unit. Daily lactulose usage seems to decrease the
resistant bacterial infections.
EMTREE DRUG INDEX TERMS
alcohol
antibiotic agent
lactulose
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
bacterium
hospitalization
human
infection
liver
patient
EMTREE MEDICAL INDEX TERMS
antibiotic prophylaxis
antibiotic resistance
ascites fluid
bacterial infection
blood
catheter
clinical laboratory
data base
etiology
female
gender
health care
hospital
infection resistance
inflammation
intensive care unit
logistic regression analysis
male
mortality
sputum
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71443983
DOI
10.1016/S0168-8278(14)60605-X
FULL TEXT LINK
http://dx.doi.org/10.1016/S0168-8278(14)60605-X
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 312
TITLE
Comparison of three different timeframes for pediatric index of mortality
data collection in transported intensive care admissions*
AUTHOR NAMES
Rahiman S.
Sadasivam K.
Ridout D.A.
Tasker R.C.
Ramnarayan P.
AUTHOR ADDRESSES
(Rahiman S.; Sadasivam K.) Paediatric Intensive Care Unit, Great Ormond
Street Hospital, London, United Kingdom.
(Ridout D.A.) Centre for Paediatric Epidemiology and Biostatistics,
Institute of Child Health, University College London, London, United
Kingdom.
(Tasker R.C.) Departments of Neurology and Anaesthesia (Pediatrics), Boston
Children's Hospital and Harvard Medical School, Boston, MA, United States.
(Ramnarayan P., p.ramnarayan@gosh.nhs.uk) Children's Acute Transport
Service, Great Ormond Street Hospital, London, United Kingdom.
CORRESPONDENCE ADDRESS
Paediatric Intensive Care Unit, Great Ormond Street Hospital, London, United
Kingdom.
SOURCE
Pediatric Critical Care Medicine (2014) 15:3 (e120-e127). Date of
Publication: March 2014
ISSN
1529-7535
1947-3893 (electronic)
BOOK PUBLISHER
Lippincott Williams and Wilkins, 530 Walnut Street,P O Box 327,
Philadelphia, United States.
ABSTRACT
OBJECTIVE:: To identify the most appropriate timeframe for Pediatric Index
of Mortality-2 data collection in patients transported to PICUs by
specialist teams. DESIGN:: Retrospective cohort study. SETTING:: A regional
PICU transport team in London, United Kingdom. PATIENTS:: Children admitted
for intensive care to a tertiary children's hospital PICU following
transport by a PICU transport team between January 1, 2007, and December 31,
2008. INTERVENTIONS:: None. MEASUREMENTS AND MAIN RESULTS:: Data on case mix
and outcome from children transferred to the tertiary PICU during the study
period were analyzed. The "standard" timeframe used in calculating Pediatric
Index of Mortality-2 was compared with Pediatric Index of Mortality-2
calculated using data from two other 1-hour timeframes (during "retrieval"
and during "admission"). A total of 759 transported admissions were studied.
Eighty-three children died (mortality rate, 10.9%). Data were missing in up
to 42.7% of admissions for some Pediatric Index of Mortality-2 variables
from transport. However, missing data persisted even after the first hour of
PICU admission in most cases. There was significant improvement in some
physiological variables following transport (p < 0.01), but Pediatric Index
of Mortality-2 did not change significantly. Pediatric Index of Mortality-2
from all three timeframes exhibited good discrimination (area under the
receiver-operating characteristic curve ≥ 0.77). Calibration across deciles
of mortality risk was poor for the "admission" Pediatric Index of
Mortality-2 (Hosmer-Lemeshow goodness-of-fit test p = 0.04) but good for the
other two calculated Pediatric Index of Mortality-2 models (p > 0.20).
CONCLUSIONS:: The findings of our single-center study do not support the
need for different timeframes for Pediatric Index of Mortality-2 data
collection in transported and direct PICU admissions. Uniformity in scoring
procedure may simplify data collection and improve data quality. © 2014 by
the Society of critical care medicine.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
assessment of humans
intensive care
pediatric index of mortality 2
EMTREE MEDICAL INDEX TERMS
article
child
female
hospital admission
human
information processing
major clinical study
male
mortality
preschool child
priority journal
United Kingdom
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2014191488
MEDLINE PMID
24395001 (http://www.ncbi.nlm.nih.gov/pubmed/24395001)
PUI
L52947317
DOI
10.1097/PCC.0000000000000058
FULL TEXT LINK
http://dx.doi.org/10.1097/PCC.0000000000000058
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 313
TITLE
Improving alcohol withdrawal outcomes in acute care
AUTHOR NAMES
Melson J.
Kane M.
Mooney R.
Mcwilliams J.
Horton T.
AUTHOR ADDRESSES
(Melson J.) Nurse Practitioner in the Stepdown Unit at Christiana Care
Health System in Wilmington, DE. jmelson@christianacare.org
(Kane M.) Medicine Outcomes Coordinator in the Performance Improvement
Department at Christiana Care Health System in Newark, DE.
mikane@christianacare.org
(Mooney R.) Research Facilitator for the Christiana Care Health System in
Newark, DE. rmooney@christianacare.org
(Mcwilliams J.) Nurse Practitioner with the Healthstar Physicians of Hot
Springs, AR. polonius47@gmail.com
(Horton T.) Chief of the Division of Addiction Medicine for the Christiana
Care Health System in Newark, DE. thorton@christianacare.org
SOURCE
The Permanente journal (2014) 18:2 (e141-e145). Date of Publication: 1 Mar
2014
ISSN
1552-5775 (electronic)
ABSTRACT
CONTEXT: Excessive alcohol consumption is the nation's third leading cause
of preventable deaths. If untreated, 6% of alcohol-dependent patients
experience alcohol withdrawal, with up to 10% of those experiencing delirium
tremens (DT), when they stop drinking. Without routine screening, patients
often experience DT without warning.OBJECTIVE: Reduce the incidence of
alcohol withdrawal advancing to DT, restraint use, and transfers to the
intensive care unit (ICU) in patients with DT.DESIGN: In October 2009, the
alcohol withdrawal team instituted a care management guideline used by all
disciplines, which included tools for screening, assessment, and symptom
management. Data were obtained from existing datasets for three quarters
before and four quarters after implementation. Follow-up data were analyzed
and showed a great deal of variability in transfers to the ICU and restraint
use. Percentage of patients who developed DT showed a downward trend.MAIN
OUTCOME MEASURES: Incidence of alcohol withdrawal advancing to DT and, in
patients with DT, restraint use and transfers to the ICU.RESULTS: Initial
data revealed a decrease in percentage of patients with alcohol withdrawal
who experienced DT (16.4%-12.9%). In patients with DT, restraint use
decreased (60.4%-44.4%) and transfers to the ICU decreased (21.6%-15%).
Follow-up data indicated a continued downward trend in patients with DT.
Changes were not statistically significant. Restraint use and ICU transfers
maintained postimplementation levels initially but returned to
preimplementation levels by third quarter 2012.CONCLUSION: Early
identification of patients for potential alcohol withdrawal followed by a
standardized treatment protocol using symptom-triggered dosing improved
alcohol withdrawal management and outcomes.
EMTREE DRUG INDEX TERMS
alcohol (adverse drug reaction)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
exercise
intensive care unit
patient transport
standards
EMTREE MEDICAL INDEX TERMS
alcoholic delirium (prevention, therapy)
alcoholism
clinical protocol
follow up
human
intensive care
mass screening
treatment outcome
withdrawal syndrome (therapy)
CAS REGISTRY NUMBERS
alcohol (64-17-5)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
24867561 (http://www.ncbi.nlm.nih.gov/pubmed/24867561)
PUI
L604689008
DOI
10.7812/TPP/13-099
FULL TEXT LINK
http://dx.doi.org/10.7812/TPP/13-099
COPYRIGHT
Copyright 2015 Medline is the source for the citation and abstract of this
record.
RECORD 314
TITLE
Centralisation of paediatric intensive care and a 24-hour retrieval service.
AUTHOR NAMES
Roussak P.
AUTHOR ADDRESSES
(Roussak P.) Staff Nurse, Rays of Sunshine Ward, Kings College Hospital,
London.
CORRESPONDENCE ADDRESS
P. Roussak, Staff Nurse, Rays of Sunshine Ward, Kings College Hospital,
London.
SOURCE
British journal of nursing (Mark Allen Publishing) (2014) 23:1 (25-29). Date
of Publication: 2014 Jan 9-22
ISSN
0966-0461
ABSTRACT
This article aims to analyse the effects of the centralisation of paediatric
intensive care (PIC) and the requirement for a 24-hour retrieval service, as
outlined in Standards for the Care of Critically Ill Children (Paediatric
Intensive Care Society, 2010). It affects staff at district general
hospitals (DGHs) and has an impact on the critically ill children who
present there. Although the centralisation of PIC has shown better outcomes,
there have been concerns that, coupled with relocation of elective surgery
to tertiary centres, it has resulted in the deskilling of staff in DGHs. The
introduction of more paediatric high-dependency care units in DGHs is
presented as a solution to the increased burden on the retrieval service and
the deskilling of staff.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
article
clinical competence
United Kingdom
LANGUAGE OF ARTICLE
English
MEDLINE PMID
24406493 (http://www.ncbi.nlm.nih.gov/pubmed/24406493)
PUI
L372466242
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 315
TITLE
Arterial blood pressure changes induced by acceleration during mobile
intensive care unit patient transport are not patient related: Beware of
misinterpretation
AUTHOR NAMES
Droogh J.M.
Reinke L.
Snel G.J.
Mouthaan B.
Struys M.M.R.F.
Ligtenberg J.J.M.
Keus F.
Zijlstra J.G.
AUTHOR ADDRESSES
(Droogh J.M., j.m.droogh@umcg.nl; Reinke L.; Keus F.; Zijlstra J.G.)
Department of Critical Care, University Medical Center Groningen, University
of Groningen, Hanzeplein 1, 9700 RB Groningen, Netherlands.
(Reinke L.; Snel G.J.; Mouthaan B.) Technical Medicine, University of
Twente, Drienerlolaan 5, 7500 AE Enschede, Netherlands.
(Struys M.M.R.F.) Department of Anesthesiology, University Medical Center
Groningen, University of Groningen, Hanzeplein 1, 9700 RB Groningen,
Netherlands.
(Ligtenberg J.J.M.) Emergency Department, University Medical Center
Groningen, University of Groningen, Hanzeplein 1, 9700 RB Groningen,
Netherlands.
CORRESPONDENCE ADDRESS
J.M. Droogh, Department of Critical Care, University Medical Center
Groningen, University of Groningen, Hanzeplein 1, 9700 RB Groningen,
Netherlands. Email: j.m.droogh@umcg.nl
SOURCE
Intensive Care Medicine (2014) 40:3 (460-461). Date of Publication: 2014
ISSN
1432-1238 (electronic)
0342-4642
BOOK PUBLISHER
Springer Verlag, service@springer.de
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
arterial pressure
intensive care unit
mobile intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
acceleration
blood pressure transducer
critically ill patient
deceleration
human
letter
mean arterial pressure
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Cardiovascular Diseases and Cardiovascular Surgery (18)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2014280165
PUI
L52953508
DOI
10.1007/s00134-013-3195-2
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-013-3195-2
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 316
TITLE
Critical care paramedics - A missing component for safe interfacility
transport in the United States
AUTHOR NAMES
Kupas D.F.
Wang H.E.
AUTHOR ADDRESSES
(Kupas D.F., dkupas@geisinger.edu) Department of Emergency Medicine,
Geisinger Health System, Danville, PA, United States.
(Wang H.E.) Department of Emergency Medicine, University of Alabama School
of Medicine, Birmingham, AL, United States.
CORRESPONDENCE ADDRESS
D.F. Kupas, Department of Emergency Medicine, Geisinger Health System,
Danville, PA, United States. Email: dkupas@geisinger.edu
SOURCE
Annals of Emergency Medicine (2014) 64:1 (17-18). Date of Publication: July
2014
ISSN
1097-6760 (electronic)
0196-0644
BOOK PUBLISHER
Mosby Inc., customerservice@mosby.com
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health care facility
intensive care
paramedical personnel
patient transport
EMTREE MEDICAL INDEX TERMS
critically ill patient
emergency health service
health care system
health insurance
human
note
priority journal
United States
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2014422892
MEDLINE PMID
24721717 (http://www.ncbi.nlm.nih.gov/pubmed/24721717)
PUI
L53092890
DOI
10.1016/j.annemergmed.2014.03.010
FULL TEXT LINK
http://dx.doi.org/10.1016/j.annemergmed.2014.03.010
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 317
TITLE
Developing and evaluating a machine learning based algorithm to predict the
need of pediatric intensive care unit transfer for newly hospitalized
children
AUTHOR NAMES
Zhai H.
Brady P.
Li Q.
Lingren T.
Ni Y.
Wheeler D.S.
Solti I.
AUTHOR ADDRESSES
(Zhai H.; Li Q.; Lingren T.; Ni Y.; Solti I., imre.solti@cchmc.org) Division
of Biomedical Informatics, Cincinnati Children's Hospital Medical Center,
Cincinnati, OH, United States.
(Brady P.) Division of Hospital Medicine, Cincinnati Children's Hospital
Medical Center, Cincinnati, OH, United States.
(Wheeler D.S.) Division of Critical Care Medicine, Cincinnati Children's
Hospital Medical Center, Cincinnati, OH, United States.
(Brady P.; Solti I., imre.solti@cchmc.org) James M. Anderson Center for
Health Systems Excellence, Cincinnati Children's Hospital Medical Center,
Cincinnati, OH, United States.
CORRESPONDENCE ADDRESS
I. Solti, Cincinnati Children's Hospital Medical Center, Division of
Biomedical Informatics, 3333 Burnet Avenue, MLC 7024, Cincinnati, OH
45229-3039, United States. Email: imre.solti@cchmc.org
SOURCE
Resuscitation (2014) 85:8 (1065-1071). Date of Publication: August 2014
ISSN
1873-1570 (electronic)
0300-9572
BOOK PUBLISHER
Elsevier Ireland Ltd
ABSTRACT
Background: Early warning scores (EWS) are designed to identify early
clinical deterioration by combining physiologic and/or laboratory measures
to generate a quantified score. Current EWS leverage only a small fraction
of Electronic Health Record (EHR) content. The planned widespread
implementation of EHRs brings the promise of abundant data resources for
prediction purposes. The three specific aims of our research are: (1) to
develop an EHR-based automated algorithm to predict the need for Pediatric
Intensive Care Unit (PICU) transfer in the first 24. h of admission; (2) to
evaluate the performance of the new algorithm on a held-out test data set;
and (3) to compare the effectiveness of the new algorithm's with those of
two published Pediatric Early Warning Scores (PEWS). Methods: The cases were
comprised of 526 encounters with 24-h Pediatric Intensive Care Unit (PICU)
transfer. In addition to the cases, we randomly selected 6772 control
encounters from 62516 inpatient admissions that were never transferred to
the PICU. We used 29 variables in a logistic regression and compared our
algorithm against two published PEWS on a held-out test data set. Results:
The logistic regression algorithm achieved 0.849 (95% CI 0.753-0.945)
sensitivity, 0.859 (95% CI 0.850-0.868) specificity and 0.912 (95% CI
0.905-0.919) area under the curve (AUC) in the test set. Our algorithm's AUC
was significantly higher, by 11.8 and 22.6% in the test set, than two
published PEWS. Conclusion: The novel algorithm achieved higher sensitivity,
specificity, and AUC than the two PEWS reported in the literature. © 2014
The Authors.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health needs
human needs
intensive care unit
machine learning
patient transport
EMTREE MEDICAL INDEX TERMS
algorithm
article
automation
child
childhood disease
clinical assessment tool
controlled study
electronic medical record
hospital admission
hospital patient
human
major clinical study
newborn
pediatric early warning score
preschool child
priority journal
retrospective study
school child
sensitivity and specificity
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2014450290
MEDLINE PMID
24813568 (http://www.ncbi.nlm.nih.gov/pubmed/24813568)
PUI
L53143177
DOI
10.1016/j.resuscitation.2014.04.009
FULL TEXT LINK
http://dx.doi.org/10.1016/j.resuscitation.2014.04.009
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 318
TITLE
Analysis of serum γ-glutamyl transferase levels in neonatal intensive care
unit patients
AUTHOR NAMES
Hirfanoglu I.M.
Unal S.
Onal E.E.
Beken S.
Turkyilmaz C.
Pasaoglu H.
Koc E.
Ergenekon E.
Atalay Y.
AUTHOR ADDRESSES
(Hirfanoglu I.M., imhirfanoglu@yahoo.com; Unal S.; Onal E.E.; Beken S.;
Turkyilmaz C.; Koc E.; Ergenekon E.; Atalay Y.) Department of Pediatrics,
Division of Neonatology, Gazi University Medical School, Turgutreis cad.
Serefli sok. no: 4/4, Mebusevleri, Ankara 06500, Turkey.
(Pasaoglu H.) Department of Biochemistry, Gazi University Medical School,
Ankara, Turkey.
CORRESPONDENCE ADDRESS
I.M. Hirfanoglu, Department of Pediatrics, Division of Neonatology, Gazi
University Medical School, Turgutreis cad. Serefli sok. no: 4/4,
Mebusevleri, Ankara 06500, Turkey. Email: imhirfanoglu@yahoo.com
SOURCE
Journal of Pediatric Gastroenterology and Nutrition (2014) 58:1 (99-101).
Date of Publication: January 2014
ISSN
0277-2116
1536-4801 (electronic)
BOOK PUBLISHER
Lippincott Williams and Wilkins, 530 Walnut Street,P O Box 327,
Philadelphia, United States.
ABSTRACT
Objectives: Gamma-glutamyl transferase (GGT) is commonly measured in newborn
infants as a sensitive liver function test; however, reference ranges are
mostly based on early studies, including relatively small number of
patients. The aim of this study was to emphasise recently changed GGT values
because of changed newborns profile admitted to neonatal intensive care
units (NICUs) and establish new cross-sectional reference ranges for the
serum GGT levels in a cohort of neonates between 26 and 42 weeks'
gestational age in 1 centre. METHODS: From January 1, 2010 to December 31,
2012, liver function tests including serum GGT measurements were performed
in 705 newborns who were admitted to NICUs because of different aetiologies
at Gazi University School of Medicine Hospital, Ankara, Turkey. Infants with
Apgar score <8 at the fifth minute, any metabolic or liver disease,
cholestasis, congenital infection, culture-proven sepsis, elevated serum
aminotransferases, and who were treated with phenobarbital were excluded.
Clinical and laboratory data of 583 neonates were analysed retrospectively.
GGT was measured by enzymatic method using the Abbott Architect C16000
autoanalyser. Mean, 2.5th, and 97.5th percentiles were used to express the
reference range data. RESULTS: Four hundred sixty-one GGT values of 200
preterm infants and 501 GGT values of 383 term infants during the first 28
days after birth were analysed. Serum GGT levels of preterm infants in the
first 7 days and between 8 and 28 days after delivery were (mean±standard
deviation; 141.81±88.56 U/L and 131.17±85.53 U/L) similar to term infants
(139.90±86.46 U/L and 144.56±86.51 U/L), respectively (P=0.649 and P=0.087).
Serum GGT levels were found to be significantly higher in male infants (no
need of query) (145.98±93.68 U/L) than female infants (132.18±78.97 U/L)
(P=0.035), and infants born vaginally (152.24±90.71 U/L) also had higher
serum GGT activity than those born by caesarean section (135.38±85.37 U/L)
(P=0.005). CONCLUSIONS: A new reference range for serum GGT levels that is
higher than previous reference values can identify neonates with truly
abnormal results and prevent unnecessary interventions. © 2013 by European
Society for Pediatric Gastroenterology,Hepatology, and Nutrition and North
American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
gamma glutamyltransferase (endogenous compound)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
gamma glutamyl transferase blood level
liver function test
newborn intensive care
EMTREE MEDICAL INDEX TERMS
article
cesarean section
female
gestational age
human
major clinical study
male
newborn
prematurity
priority journal
reference value
CAS REGISTRY NUMBERS
gamma glutamyltransferase (85876-02-4)
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Anesthesiology (24)
Gastroenterology (48)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2014071337
MEDLINE PMID
23969532 (http://www.ncbi.nlm.nih.gov/pubmed/23969532)
PUI
L52741981
DOI
10.1097/MPG.0b013e3182a907f2
FULL TEXT LINK
http://dx.doi.org/10.1097/MPG.0b013e3182a907f2
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 319
TITLE
22nd critical care transport medicine conference
AUTHOR NAMES
Newman M.
Petersen P.
Wojdyla K.
AUTHOR ADDRESSES
(Newman M.) International Association of Flight and Critical Care
Paramedics, United States.
(Petersen P.) Air Medical Physician Association, United States.
(Wojdyla K.) Air and Surface Transport Nurses Association, United States.
CORRESPONDENCE ADDRESS
International Association of Flight and Critical Care Paramedics, United
States.
SOURCE
Air Medical Journal (2014) 33:1 (22-24). Date of Publication:
January-February 2014
ISSN
1067-991X
1532-6497 (electronic)
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
intensive care
EMTREE MEDICAL INDEX TERMS
conference paper
critically ill patient
emergency care
human
priority journal
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2014009621
PUI
L372038935
DOI
10.1016/j.amj.2013.11.003
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2013.11.003
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 320
TITLE
Patient safety and prevention of unexpected events occurring during the
intra-hospital transport of critically ill ICU patients
AUTHOR NAMES
Shweta K.
Kumar S.
AUTHOR ADDRESSES
(Shweta K.) Department of Hospital Administration, All India Institute of
Medical Sciences (AIIMS), New Delhi, India.
(Kumar S.) Department of Pulmonary Medicine, Institute of Liver and Biliary
Sciences (ILBS), New Delhi, India.
SOURCE
Indian Journal of Critical Care Medicine (2014) 18:9 (636). Date of
Publication: 1 Sep 2014
ISSN
1998-359X (electronic)
0972-5229
BOOK PUBLISHER
Medknow Publications, B9, Kanara Business Centre, off Link Road, Ghatkopar
(E), Mumbai, India.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
hospital
human
patient
patient safety
prevention
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2014795722
PUI
L600028601
DOI
10.4103/0972-5229.140156
FULL TEXT LINK
http://dx.doi.org/10.4103/0972-5229.140156
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 321
TITLE
Erratum to Antimicrobial stewardship in patients recently transferred to a
ward from the ICU (Rev Esp Quimioter, (2014), 27, 1 (46-50))
ORIGINAL (NON-ENGLISH) TITLE
Erratum to Asesoramiento antibiótico en pacientes tras estancia en cuidados
intensivos (Rev Esp Quimioter, (2014), 27, 1 (46-50))
AUTHOR NAMES
Ramos A.
Benitez-Gutierrez L.
Asensio A.
Ruiz-Antorán B.
Folguera C.
Sanchez-Romero I.
Muñez E.
AUTHOR ADDRESSES
(Ramos A., aramos220@gmail.com; Benitez-Gutierrez L.; Muñez E.) Department
of Internal Medicine (Infectious Disease Unit), Hospital Universitario
Puerta de Hierro, Majadahonda. Madrid, Spain.
(Asensio A.) Department of Preventive Medicine, Hospital Universitario
Puerta de Hierro, Majadahonda. Madrid, Spain.
(Ruiz-Antorán B.) Department of Pharmacology, Hospital Universitario Puerta
de Hierro, Majadahonda. Madrid, Spain.
(Folguera C.) Department of Pharmacy, Hospital Universitario Puerta de
Hierro, Majadahonda. Madrid, Spain.
(Sanchez-Romero I.) Department of Microbiology, Hospital Universitario
Puerta de Hierro, Majadahonda. Madrid, Spain.
CORRESPONDENCE ADDRESS
A. Ramos, Department of Internal Medicine (Infectious Diseases Unit),
Hospital Universitario Puerta de Hierro, Universidad Autónoma de Madrid,
Maestro Rodrigo no 2, 28222 Majadahonda. Madrid, Spain. Email:
aramos220@gmail.com
SOURCE
Revista Espanola de Quimioterapia (2014) 27:2 (134-139). Date of
Publication: 2014
ISSN
0214-3429
BOOK PUBLISHER
Sociedad Espanola de Quiminoterapia, luisalou@med.ucm.es
ABSTRACT
This paper is a corrigendum to the previously published paper:
"Antimicrobial stewardship in patients recently transferred to a ward from
the ICU" [Rev Esp Quimioter. 2014 Mar;27(1):46-50.] This corrigendum was
prepared in order to correct some erroneous comments included in the
discussion section. First, it should be pointed out that there could have
been several suitable options for treating many infections and that,
therefore, the word "inadequate" was not the most appropriate in this
situation. In addition, some comments about the interpretation of
microbiological results made by ICU physicians have been removed from the
first article because this variable was not included in the study. Finally,
another change made to the discussion was to clarify the ICU physicians'
alleged low level of compliance with advice given by infectious disease
specialists. This has been suggested in previous studies it cannot be
substantiated when analyzing the results of the study. Purpose.
Inappropriate use of antibiotics is an important health problem that is
related to increasing bacterial resistance. Despite its relevance, many
health institutions assign very limited resources to improving prescribing
practices. An antimicrobial stewardship programme (APS) centred on patients
discharged from the ICU could efficiently undertake this task. Methods.
During this six month study the main activity was performing a programmed
review of antimicrobial prescriptions in patients transferred to the ward
from the ICU. In the case of amendable antimicrobial treatment, a
recommendation was included in the medical record. Results. A total of 437
antimicrobial prescriptions for 286 patients were revised during a six month
period and a total of 271 prescriptions (62%) in 183 patients were
considered to be amendable. In most of these cases, treatment could have
been reduced taking into consideration each patient's clinical improvement
and their location in a hospital area with a lower risk of infection due to
resistant bacteria. The most common advice was antimicrobial withdrawal
(64%), antimicrobial change (20%) and switching to oral route (12%).
Proposed recommendations were addressed in 212 cases (78%). There was no
significant difference in adherence with respect to the type of
recommendation (p=0.417). There was a 5% lower use of antibiotics during the
year the study was conducted compared to the previous one. Conclusions. ASPs
centred on patients discharged from the ICU may be an efficient strategy to
ameliorate antimicrobial use in hospitals.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
error
EMTREE MEDICAL INDEX TERMS
erratum
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
English, Spanish
LANGUAGE OF SUMMARY
English, Spanish
EMBASE ACCESSION NUMBER
2014445097
PUI
L373435951
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 322
TITLE
[Hemodynamics, oxygen transport and perioperative intensive care evaluation
in newborns with surgical pathology].
AUTHOR NAMES
Kurochkin M.I.
Davydova A.H.
Chemerys I.O.
AUTHOR ADDRESSES
(Kurochkin M.I.; Davydova A.H.; Chemerys I.O.)
CORRESPONDENCE ADDRESS
M.I. Kurochkin,
SOURCE
Likars'ka sprava / Ministerstvo okhorony zdorov'ia Ukraïny (2014) :1-2
(45-50). Date of Publication: 2014 Jan-Feb
ISSN
1019-5297
ABSTRACT
The aim of the work was to develop criteria of perioperative intensive
therapy efficiency in surgical neonates by hemodynamic, acid--base status,
oxygen transport and pulmonary hydration studying and evaluating. The study
of hemodynamics, oxygen transport, pulmonary hydration was performed in 69
infants with surgical pathology. In 36 children neuroaxial central blockades
were used on the background of general anesthesia. The criteria of
preoperative preparation effectiveness--balanced oxygen regime--3-3.5 units;
positive central venous pressure--3-4 sm w. c.; hourly urine output of at
least 1 ml/(kg x h); transthoracic impedance is not less than 19 ohms
(prevention of pulmonary edema). In group I hemodynamic variations were
minimal compared with infants of the II groups that is associated with
better analgesic effect of caudal-epidural blockades.
EMTREE DRUG INDEX TERMS
oxygen
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
digestive system malformation (surgery)
hemodynamics
oxygen consumption
perioperative period
physiologic monitoring
EMTREE MEDICAL INDEX TERMS
article
blood
devices
epidural anesthesia
general anesthesia
heart function test
human
impedance cardiography
lung function test
methodology
newborn
physiology
signal processing
CAS REGISTRY NUMBERS
oxygen (7782-44-7)
LANGUAGE OF ARTICLE
Ukrainian
MEDLINE PMID
24908959 (http://www.ncbi.nlm.nih.gov/pubmed/24908959)
PUI
L373619269
COPYRIGHT
Copyright 2014 Medline is the source for the citation and abstract of this
record.
RECORD 323
TITLE
Automatic protective ventilation using the ARDSNet protocol with the
additional monitoring of electrical impedance tomography
AUTHOR NAMES
Pomprapa A.
Schwaiberger D.
Pickerodt P.
Tjarks O.
Lachmann B.
Leonhardt S.
AUTHOR ADDRESSES
(Pomprapa A.; Schwaiberger D.; Pickerodt P.; Tjarks O.; Lachmann B.;
Leonhardt S.)
SOURCE
Critical care (London, England) (2014) 18:3 (R128). Date of Publication:
2014
ISSN
1466-609X (electronic)
ABSTRACT
INTRODUCTION: Automatic ventilation for patients with respiratory failure
aims at reducing mortality and can minimize the workload of clinical staff,
offer standardized continuous care, and ultimately save the overall cost of
therapy. We therefore developed a prototype for closed-loop ventilation
using acute respiratory distress syndrome network (ARDSNet) protocol, called
autoARDSNet.METHODS: A protocol-driven ventilation using goal-oriented
structural programming was implemented and used for 4 hours in seven pigs
with lavage-induced acute respiratory distress syndrome (ARDS). Oxygenation,
plateau pressure and pH goals were controlled during the automatic
ventilation therapy using autoARDSNet. Monitoring included standard
respiratory, arterial blood gas analysis and electrical impedance tomography
(EIT) images. After 2-hour automatic ventilation, a disconnection of the
animal from the ventilator was carried out for 10 seconds, simulating a
frequent clinical scenario for routine clinical care or intra-hospital
transport.RESULTS: This pilot study of seven pigs showed stable and robust
response for oxygenation, plateau pressure and pH value using the automated
system. A 10-second disconnection at the patient-ventilator interface caused
impaired oxygenation and severe acidosis. However, the automated
protocol-driven ventilation was able to solve these problems. Additionally,
regional ventilation was monitored by EIT for the evaluation of ventilation
in real-time at bedside with one prominent case of pneumothorax.CONCLUSIONS:
We implemented an automatic ventilation therapy using ARDSNet protocol with
seven pigs. All positive outcomes were obtained by the closed-loop
ventilation therapy, which can offer a continuous standard protocol-driven
algorithm to ARDS subjects.
EMTREE DRUG INDEX TERMS
carbon dioxide
oxygen
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
procedures
EMTREE MEDICAL INDEX TERMS
adult respiratory distress syndrome (therapy)
animal
blood
female
impedance
lung ventilation
male
pathophysiology
pH
physiologic monitoring
pig
pilot study
positive end expiratory pressure
tidal volume
tomography
CAS REGISTRY NUMBERS
carbon dioxide (124-38-9, 58561-67-4)
oxygen (7782-44-7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
24957974 (http://www.ncbi.nlm.nih.gov/pubmed/24957974)
PUI
L604409028
DOI
10.1186/cc13937
FULL TEXT LINK
http://dx.doi.org/10.1186/cc13937
COPYRIGHT
Copyright 2015 Medline is the source for the citation and abstract of this
record.
RECORD 324
TITLE
Failure to wake up
AUTHOR NAMES
James P.
Mehrotra P.
Sperry D.
AUTHOR ADDRESSES
(James P.; Mehrotra P.; Sperry D.) Nottingham,University Hospitals NUS
Trust, United Kingdom.
CORRESPONDENCE ADDRESS
P. James, Nottingham,University Hospitals NUS Trust, United Kingdom.
SOURCE
Journal of the Intensive Care Society (2014) 15:1 SUPPL. 1 (S21). Date of
Publication: January 2014
CONFERENCE NAME
State of the Art 2013 Meeting
CONFERENCE LOCATION
London, United Kingdom
CONFERENCE DATE
2013-12-16 to 2013-12-18
ISSN
1751-1437
BOOK PUBLISHER
Stansted News Ltd
ABSTRACT
Sedation facilitates ventilatory support in critically ill patients.
Patients occasionally fail to wake appropriately following cessation of
sedation. Where failure to wake is prolonged computed tomography of the head
(CTH) is frequently undertaken to exclude intracranial pathology. Published
yields from CTH are between 37% and 57%1,2 but anecdotal feeling was that
the yield was low within our unit. Inherent risks of Intra hospital
transfer3 and radiation dose are associated with this practice. Our aim was
to evaluate the local incidence of CTH for failure to wake against published
data and look for factors associated with new pathology on CTH. Using the
picture archiving and communication system (PACS) (IMPAX 6.5.2.657 Agfa
healthcare) we retrieved every CTH on ICU patients for two years commencing
on 1st January 2011. Each request was reviewed and scans performed for
“failure to wake” were included in the data analysis. Reports were
scrutinised and compared to previous scans, looking for new or evolving
abnormalities. We also collected demographic data, reason for admission,
admitting team, duration off sedation, renal function, the presence of
neurological deficit on examination and seizure activity. A total of 35
scans were performed for failure to wake; 17 (48%) of the CT scans were
positive for new pathology, nine out of 17 (52%) were positive if the
patient admission was for intracerebral pathology. Six of 14 (42%) patients
admitted under neurosurgery had positive scans. Median time from cessation
of sedation to scan was 30.7 hours, positive scans 26.43 hours and negative
scans 38.61 hours. Neurological deficit was documented in 48%. Seven
patients (41%) with positive scans had document deficit as did 44% of the
negative scans (sensitivity of 0.47 (95% confidence intervals 0.22-0.73) and
specificity of 0.5 (95%, 0.33-0.69), positive predictive value (PPV) of
0.47). Seizure activity preceded scans in four patients, three had new
pathology. Patients with new neurology and seizure always had new pathology.
This study was conducted as it was believed that CTH was not picking up many
significant abnormalities when the indication was early failure to wake. Our
yield for new pathology from CTH was high at 48% and contradicted this
belief. It was found to be in line with high yields in published data. CTH
abnormalities were almost as high in non- Neurosurgical patients as those
with previous intracranial pathology. Neurological deficit did not predict
the presence of new pathology well but seizure activity alone or combined
with neurological deficit significantly increased the likelihood of a
positive CTH. Quality and documentation of pre-CTH neurological examination
needs improvement. Recommendations: • CT of the head should continue to be
used as an investigation where there is clinical concern that the patient is
not waking after cessation of sedation • Neurological examination should be
completed and documented prior to CT head request • Evidence of seizure and
of seizure and neurological deficit on examination should prompt urgent CT
scan • Prospective review of this cohort of patients to assess the impact of
CT on immediate and long-term care.
EMTREE MEDICAL INDEX TERMS
computer assisted tomography
confidence interval
critically ill patient
data analysis
documentation
examination
health care
hospital
hospital admission
human
intracerebral drug administration
kidney function
long term care
neurologic examination
neurology
neurosurgery
non implantable urine incontinence electrical stimulator
pathology
patient
picture archiving and communication system
predictive value
radiation dose
risk
sedation
seizure
wakefulness
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71773088
DOI
10.1177/17511437140151S105
FULL TEXT LINK
http://dx.doi.org/10.1177/17511437140151S105
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 325
TITLE
Interface hospital discharge: Active transfer of information on in-house
productions to public pharmacies
ORIGINAL (NON-ENGLISH) TITLE
Aktive Weitergabe von Informationen zu Eigenherstellungen an öffentliche
Apotheken
AUTHOR NAMES
Ober M.
Rosenhagen M.
Sauer S.
Hoppe-Tichy T.
AUTHOR ADDRESSES
(Ober M., michael.ober@med.uni-heidelberg.de; Rosenhagen M.; Sauer S.;
Hoppe-Tichy T.) Universität, Im Neuenheimer Feld 670, 69120 Heidelberg,
Germany.
SOURCE
Krankenhauspharmazie (2014) 35:6 (243-244). Date of Publication: June 2014
ISSN
0173-7597
BOOK PUBLISHER
Deutscher Apotheker Verlag, Birkenwaldstr.44,, Stuttgart, Germany.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital discharge
information system
pharmacy
EMTREE MEDICAL INDEX TERMS
article
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
German
LANGUAGE OF SUMMARY
German
EMBASE ACCESSION NUMBER
2014444039
PUI
L373431530
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 326
TITLE
Clostridium difficile: Transferring C. difficile spores causes an infection
that leads to 14,000 deaths annually in the U.S.
AUTHOR NAMES
Barzoloski-O'Connor B.
AUTHOR ADDRESSES
(Barzoloski-O'Connor B.) Howard County General Hospital, Columbia, MD,
United States.
CORRESPONDENCE ADDRESS
B. Barzoloski-O'Connor, Howard County General Hospital, Columbia, MD, United
States.
SOURCE
Nursing Critical Care (2014) 9:4 (30-34). Date of Publication: July 2014
ISSN
1558-447X
EMTREE DRUG INDEX TERMS
alcohol
antibiotic agent (drug therapy)
antidiarrheal agent
cefotaxime (drug therapy)
exotoxin (endogenous compound)
gatifloxacin (drug therapy)
intestine contraction stimulating agent
levofloxacin (drug therapy)
metronidazole (drug therapy, intravenous drug administration, oral drug
administration)
moxifloxacin (drug therapy)
piperacillin plus tazobactam (drug therapy)
probiotic agent (adverse drug reaction, drug therapy)
proton pump inhibitor
quinoline derived antiinfective agent
vancomycin (drug therapy, intravenous drug administration)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Clostridium difficile infection (drug therapy, diagnosis, drug therapy,
epidemiology, etiology)
prevalence
EMTREE MEDICAL INDEX TERMS
abdominal pain
acute kidney failure
age
antibiotic resistance
article
bacterial colonization
bacterial transmission
biological therapy
colon perforation
contamination
critically ill patient
dehydration
diarrhea
differential diagnosis
disease severity
disease transmission
drug contraindication
drug efficacy
electrolyte disturbance
fecal bacteriotherapy
feces culture
fever
fungemia (side effect)
glove
hand washing
hospital infection (prevention)
hospitalization
human
hypoalbuminemia
infection risk
intensive care
intensive care unit
leukocytosis
mortality
muscle cramp
nonhuman
Peptoclostridium difficile
polymerase chain reaction
prescription
priority journal
protective clothing
pseudomembranous colitis
rectum hemorrhage
recurrent disease
risk factor
Saccharomyces boulardii
safety
sanitation
sepsis
symptomatology
systemic inflammatory response syndrome
toxic megacolon
treatment duration
CAS REGISTRY NUMBERS
alcohol (64-17-5)
cefotaxime (63527-52-6, 64485-93-4)
gatifloxacin (112811-59-3, 180200-66-2)
levofloxacin (100986-85-4, 138199-71-0)
metronidazole (39322-38-8, 443-48-1)
moxifloxacin (151096-09-2)
vancomycin (1404-90-6, 1404-93-9)
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
Drug Literature Index (37)
Adverse Reactions Titles (38)
General Pathology and Pathological Anatomy (5)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2014542137
PUI
L373756680
DOI
10.1097/01.CCN.0000451020.07574.3c
FULL TEXT LINK
http://dx.doi.org/10.1097/01.CCN.0000451020.07574.3c
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 327
TITLE
The effect of unit-based simulation on nurses' identification of
deteriorating patients
AUTHOR NAMES
Disher J.
Burgum A.
Desai A.
Fallon C.
Hart P.L.
Aduddell K.
AUTHOR ADDRESSES
(Disher J.; Burgum A.; Desai A.; Fallon C.; Hart P.L.; Aduddell K.) Jocelyn
Disher, MSN RN, is Nurse Educator for Preventive Cardiology, Saint Joseph's
Hospital, Atlanta, Georgia. Angela Burgum, RN, is Critical Care Float Nurse
specializing in Cardiovascular ICU, Saint Joseph's Hospital, Atlanta,
Georgia. Anisha Desai, BSN, RN, is Unit Nurse Educator for a Cardiovascular
Step-down unit, Saint Joseph's Hospital, Atlanta, Georgia. Cynthia Fallon,
BSN, RN, ONC, is Shift Nurse Manager for Outpatient Infusion, Saint Joseph's
Hospital, Atlanta, Georgia. Patricia L. Hart, PhD, RN, is Assistant
Professor of Nursing at Kennesaw State University, Georgia. Kathie Aduddell,
EdD, RN, is Associate Professor of Nursing at Kennesaw State University,
Georgia
SOURCE
Journal for nurses in professional development (2014) 30:1 (21-28). Date of
Publication: 1 Jan 2014
ISSN
2169-981X (electronic)
ABSTRACT
Patients are admitted to healthcare organizations with multiple, complex
conditions that can lead to acute deterioration events. It is imperative
that nurses are adequately trained to recognize and respond appropriately to
these events to ensure positive patient outcomes. The purpose of this pilot
research study was to examine the effects of a unit-based, high-fidelity
simulation initiative on cardiovascular step-down unit registered nurses'
identification and management of deteriorating patients.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
audiovisual equipment
nursing
nursing assessment
pathophysiology
patient transport
rapid response team
EMTREE MEDICAL INDEX TERMS
chronic obstructive lung disease
clinical competence
disease course
human
intensive care unit
pilot study
questionnaire
respiratory failure
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
24045408 (http://www.ncbi.nlm.nih.gov/pubmed/24045408)
PUI
L605239057
DOI
10.1097/NND.0b013e31829e6c83
FULL TEXT LINK
http://dx.doi.org/10.1097/NND.0b013e31829e6c83
COPYRIGHT
Copyright 2015 Medline is the source for the citation and abstract of this
record.
RECORD 328
TITLE
Transporting critically ill children
AUTHOR NAMES
Fortune P.-M.
Parkins K.
Playfor S.
AUTHOR ADDRESSES
(Fortune P.-M.; Playfor S.) Royal Manchester Children's Hospital,
Manchester, UK
(Parkins K.) Newton House, Birchwood Park, Warrington, UK
SOURCE
Anaesthesia and Intensive Care Medicine (2014). Date of Publication: 2014
ISSN
1878-7584 (electronic)
1472-0299
BOOK PUBLISHER
Elsevier Ltd
ABSTRACT
Increasing centralization of paediatric intensive care services and a
reduction in the numbers of children cared for in adult intensive care units
over the last 15-20 years has led to an increase in the numbers of
critically ill children being transferred between clinical centres
throughout the UK. Eighty percent of these retrievals are conducted by a
specialist paediatric intensive care unit (PICU) team, 13% by a specialist
non-PICU team, and only 7% by an ad-hoc, non-specialist team. Various
pressures have made it increasingly difficult for PICUs to facilitate the
timely retrieval of critically ill children whilst maintaining the quality
of care being provided to patients already under their care. This situation
has led to the development of regional, stand-alone transport teams
throughout the UK over the last 5-10 years. A typical example of such a team
is the North West & North Wales Paediatric Transport Service (NWTS).
Utilizing the highly structured approaches advocated by the Paediatric and
Neonatal Safe Transfer and Retrieval (PaNSTaR) and the Adult STaR courses;
focussing on the SCRUMP (Shared assessment, Clinical isolation, Resource
limitations, Unfamiliar equipment, Movement and Safety and Physiology) and
the ACCEPT (Assessment, Control, Communication, Evaluation,
Preparation/Packaging, Transportation) approach, regional transport teams
have delivered significant measurable benefits in terms of patient outcomes
and experiences when compared to previous models of service delivery.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child
critically ill patient
human
intensive care
pediatrics
EMTREE MEDICAL INDEX TERMS
adult
centralization
health care delivery
intensive care unit
interpersonal communication
medical specialist
model
movement (physiology)
patient
physiology
safety
traffic and transport
United Kingdom
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2015760121
PUI
L602403317
DOI
10.1016/j.mpaic.2014.09.001
FULL TEXT LINK
http://dx.doi.org/10.1016/j.mpaic.2014.09.001
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 329
TITLE
Toxic epidermal necrolysis and early transfer to a regional burn unit: Is it
time to reevaluate what we teach?
AUTHOR NAMES
Kaffenberger B.H.
Rosenbach M.
AUTHOR ADDRESSES
(Kaffenberger B.H.) Dermatology, Ohio State University College of Medicine,
Columbus, OH, United States.
(Rosenbach M., misha.rosenbach@uphs.upenn.edu) Dermatology, University of
Pennsylvania Hospital, Philadelphia, PA, United States.
CORRESPONDENCE ADDRESS
M. Rosenbach, Perelman Center for Advanced Medicine, South Pavilion, 3400
Civic Center Boulevard, Philadelphia, PA 19104, United States. Email:
misha.rosenbach@uphs.upenn.edu
SOURCE
Journal of the American Academy of Dermatology (2014) 71:1 (195-196). Date
of Publication: July 2014
ISSN
1097-6787 (electronic)
0190-9622
BOOK PUBLISHER
Mosby Inc., customerservice@mosby.com
EMTREE DRUG INDEX TERMS
antibiotic agent
corticosteroid
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
burn unit
patient transport
toxic epidermal necrolysis
EMTREE MEDICAL INDEX TERMS
antibiotic prophylaxis
antibiotic therapy
corticosteroid therapy
human
letter
priority journal
EMBASE CLASSIFICATIONS
Dermatology and Venereology (13)
Public Health, Social Medicine and Epidemiology (17)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2014426038
MEDLINE PMID
24947692 (http://www.ncbi.nlm.nih.gov/pubmed/24947692)
PUI
L373372945
DOI
10.1016/j.jaad.2013.12.048
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jaad.2013.12.048
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 330
TITLE
Risk of incident mental health conditions among critical care air transport
team members
AUTHOR NAMES
Tvaryanas A.P.
Maupin G.M.
AUTHOR ADDRESSES
(Tvaryanas A.P., anthony.tvaryanas@wpafb.af.mil; Maupin G.M.) 711th Human
Performance Wing, Wright-Patterson Air Force Base, OH, United States.
CORRESPONDENCE ADDRESS
A.P. Tvaryanas, 711th Human Performance Wing, 2510 5 th St., Bldg 840,
Wright-Patterson AFB, OH 45433-7913, United States. Email:
anthony.tvaryanas@wpafb.af.mil
SOURCE
Aviation Space and Environmental Medicine (2014) 85:1 (30-38). Date of
Publication: January 2014
ISSN
0095-6562
BOOK PUBLISHER
Aerospace Medical Association, 320 S. Henry Street, Alexandria, United
States.
ABSTRACT
Background: This study investigated whether Critical Care Air Transport Team
(CCATT) members are at increased risk for incident post-deployment mental
health conditions. Methods: We conducted a retrospective cohort study of 604
U.S. Air Force medical personnel without preexisting mental health
conditions who had at least one deployment as a CCATT member during
2003-2012 as compared to a control group of 604 medical personnel, frequency
matched based on job role, with at least one deployment during the same
period, but without CCATT experience. Electronic health record data were
used to ascertain the diagnosis of a mental health condition. Results: The
incidence of post-deployment mental health conditions was 2.1 per 1000 mo
for the CCATT group versus 2.2 per 1000 mo for the control group. The six
most frequent diagnoses were the same in both groups: adjustment reaction
not including posttraumatic stress disorder (PTSD), anxiety, major
depressive disorder, specific disorders of sleep of nonorganic origin, PTSD,
and depressive disorder not elsewhere classified. Women were at marginally
increased risk and nurses and technicians were at twice the risk of
physicians. The distribution of the time interval from end of the most
recent deployment to diagnosis of incident mental health condition was
positively skewed with a median greater than 6 mo. Conclusions: CCATT
members were at no increased risk for incident post-deployment mental health
conditions as compared to non-CCATT medical service members. Nearly
two-thirds of incident post-deployment mental health conditions were
diagnosed outside the standard 6-mo medical surveillance period, a finding
warranting further study. © by the Aerospace Medical Association,
Alexandria, VA.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
aviation
health care personnel
mental disease (diagnosis, epidemiology)
soldier
EMTREE MEDICAL INDEX TERMS
adolescent
adult
article
female
human
incidence
male
middle aged
psychological aspect
risk
sex difference
United States (epidemiology)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
24479256 (http://www.ncbi.nlm.nih.gov/pubmed/24479256)
PUI
L370560510
DOI
10.3357/ASEM.3782.2014
FULL TEXT LINK
http://dx.doi.org/10.3357/ASEM.3782.2014
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 331
TITLE
Should mechanical ventilation care be centralized and should we thus
transfer all ventilated patients to high volume units? Take a breath first
AUTHOR NAMES
Schultz M.J.
Spronk P.E.
AUTHOR ADDRESSES
(Schultz M.J., marcus.j.schultz@gmail.com; Spronk P.E.) Department of
Intensive Care C3-415, Academic Medical Center, University of Amsterdam,
Meibergdreef 9, 1105 AZ Amsterdam, Netherlands.
(Schultz M.J., marcus.j.schultz@gmail.com) Laboratory of Experimental
Intensive Care and Anesthesiology, Academic Medical Center, University of
Amsterdam, Amsterdam, Netherlands.
(Spronk P.E.) Department of Intensive Care, Gelre Hospitals, Apeldoorn,
Netherlands.
CORRESPONDENCE ADDRESS
M.J. Schultz, Department of Intensive Care C3-415, Academic Medical Center,
University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands.
Email: marcus.j.schultz@gmail.com
SOURCE
Intensive Care Medicine (2014) 40:3 (453-455). Date of Publication: 2014
ISSN
1432-1238 (electronic)
0342-4642
BOOK PUBLISHER
Springer Verlag, service@springer.de
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
artificial ventilation
hospital management
intensive care unit
EMTREE MEDICAL INDEX TERMS
adult respiratory distress syndrome
blood transfusion
fluid resuscitation
human
intensive care
length of stay
mortality
patient transport
review
sedation
ventilated patient
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2014280177
PUI
L52994807
DOI
10.1007/s00134-014-3216-9
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-014-3216-9
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 332
TITLE
Have a safe journey
AUTHOR NAMES
Sampath S.
AUTHOR ADDRESSES
(Sampath S., sriram.sampath123@gmail.com) Department of Critical Care
Medicine, St John's Medical College and Hospital, Bangalore - 560 034,
India.
CORRESPONDENCE ADDRESS
S. Sampath, Department of Critical Care Medicine, St John's Medical College
and Hospital, Bangalore - 560 034, India. Email: sriram.sampath123@gmail.com
SOURCE
Indian Journal of Critical Care Medicine (2014) 18:6 (343-344). Date of
Publication: June 2014
ISSN
1998-359X (electronic)
0972-5229
BOOK PUBLISHER
Medknow Publications, B9, Kanara Business Centre, off Link Road, Ghatkopar
(E), Mumbai, India.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
medical education
patient transport
EMTREE MEDICAL INDEX TERMS
editorial
human
incident report
India
intensive care
interpersonal communication
mortality
residency education
ventilated patient
ventilator associated pneumonia
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2014406993
PUI
L373310273
DOI
10.4103/0972-5229.133865
FULL TEXT LINK
http://dx.doi.org/10.4103/0972-5229.133865
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 333
TITLE
Interventions employed to improve intrahospital handover: A systematic
review
AUTHOR NAMES
Robertson E.R.
Morgan L.
Bird S.
Catchpole K.
McCulloch P.
AUTHOR ADDRESSES
(Robertson E.R., eleanor.robertson@nds.ox.ac.uk; Morgan L.; McCulloch P.)
Quality, Reliability, Safety and Teamwork Unit, Nuffield Department of
Surgical Sciences, University of Oxford, Oxford, United Kingdom.
(Bird S.) University of Oxford Medical School, John Radcliffe Hospital,
Oxford, United Kingdom.
(Catchpole K.) Department of Surgery, Cedars- Sinai Medical Center, Los
Angeles, CA, United States.
CORRESPONDENCE ADDRESS
E.R. Robertson, Nuffield Department of Surgical Sciences, University of
Oxford, John Radcliffe Hospital, Headington, Oxford, Oxfordshire OX3 9DU,
United Kingdom. Email: eleanor.robertson@nds.ox.ac.uk
SOURCE
BMJ Quality and Safety (2014) 23:7 (600-607). Date of Publication: July 2014
ISSN
2044-5415
BOOK PUBLISHER
BMJ Publishing Group, subscriptions@bmjgroup.com
ABSTRACT
Background: Modern medical care requires numerous patient
handovers/handoffs. Handover error is recognised as a potential hazard in
patient care, and the information error rate has been estimated at 13%.
While accurate, reliable handover is essential to high quality care,
uncertainty exists as to how intrahospital handover can be improved. This
systematic review aims to evaluate the effectiveness of interventions aimed
at improving the quality and/or safety of the intrahospital handover
process. Methods: We searched for articles on handover improvement
interventions in EMBASE, MEDLINE, HMIC and CINAHL between January 2002 and
July 2012. We considered studies of: staff knowledge and skills, staff
behavioural change, process change or patient outcomes. Results: 631
potentially relevant papers were identified from which 29 papers were
selected for inclusion (two randomised controlled trials and 27 uncontrolled
studies). Most studies addressed shift-change handover and used a median of
three outcome measures, but there was no outcome measure common to all. Poor
study design and inconsistent reporting methods made it difficult to reach
definite conclusions. Information transfer was improved in most relevant
studies, while clinical outcome improvement was reported in only two of 10
studies. No difference was noted in the likelihood of success across four
types of intervention. Conclusions: The current literature does not confirm
that any methodology reliably improves the outcomes of clinical handover,
although information transfer may be increased. Better study designs and
consistency of the terminology used to describe handover and its improvement
are urgently required.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
clinical handover
health care quality
patient safety
EMTREE MEDICAL INDEX TERMS
behavior change
data base
human
knowledge
outcome assessment
randomized controlled trial (topic)
review
skill
study design
systematic review
total quality management
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2014409970
MEDLINE PMID
24811239 (http://www.ncbi.nlm.nih.gov/pubmed/24811239)
PUI
L373319075
DOI
10.1136/bmjqs-2013-002309
FULL TEXT LINK
http://dx.doi.org/10.1136/bmjqs-2013-002309
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 334
TITLE
Evacuation of the ICU: Care of the critically ill and injured during
pandemics and disasters: CHEST consensus statement
AUTHOR NAMES
King M.A.
Niven A.S.
Beninati W.
Fang R.
Einav S.
Rubinson L.
Kissoon N.
Devereaux A.V.
Christian M.D.
Grissom C.K.
AUTHOR ADDRESSES
(King M.A., maryking@uw.edu) University of Washington, Harborview Medical
Center, Seattle, United States.
(Niven A.S.) Madigan Army Medical Center, Uniformed Services University of
Health Sciences, Tacoma, United States.
(Beninati W.) Intermountain Tele-Critical Care, University of Utah School of
Medicine, Salt Lake City, United States.
(Fang R.) University of Maryland Medical Center, Baltimore, United States.
(Einav S.) Shaare Zedek Medical Center, Hebrew University Faculty of
Medicine, Jerusalem, Israel.
(Rubinson L.) R. Adams Cowley Shock Trauma Center, University of Maryland
School of Medicine, Baltimore, United States.
(Kissoon N.) BC Children's Hospital, Sunny Hill Health Centre, University of
British Columbia, Vancouver, Canada.
(Devereaux A.V.) Sharp Hospital, Coronado, United States.
(Christian M.D.) Royal Canadian Medical Service, Canadian Armed Forces,
Mount Sinai Hospital, Toronto, Canada.
(Grissom C.K.) Intermountain Medical Center, University of Utah, Salt Lake
City, United States.
(King M.A., maryking@uw.edu) Pediatric Trauma Intensive Care Unit,
Harborview Medical Center, 325 9th Ave, Box 359774, Seattle, United States.
()
CORRESPONDENCE ADDRESS
M.A. King, Pediatric Trauma Intensive Care Unit, Harborview Medical Center,
325 9th Ave, Box 359774, Seattle, United States.
SOURCE
Chest (2014) 146 Supplement 4 (e44S-e60S). Date of Publication: 1 Oct 2014
ISSN
1931-3543 (electronic)
0012-3692
BOOK PUBLISHER
American College of Chest Physicians
ABSTRACT
BACKGROUND: Despite the high risk for patient harm during unanticipated ICU
evacuations, critical care providers receive little to no training on how to
perform safe and effective ICU evacuations. We reviewed the pertinent
published literature and offer suggestions for the critical care provider
regarding ICU evacuation. The suggestions in this article are important for
all who are involved in pandemics or disasters with multiple critically ill
or injured patients, including front-line clinicians, hospital
administrators, and public health or government officials. METHODS: The
Evacuation and Mobilization topic panel used the American College of Chest
Physicians (CHEST) Guidelines Oversight Committee's methodology to develop
seven key questions for which specific literature searches were conducted to
identify studies upon which evidence-based recommendations could be made. No
studies of sufficient quality were identified. Therefore, the panel
developed expert opinion-based suggestions using a modified Delphi process.
RESULTS: Based on current best evidence, we provide 13 suggestions outlining
a systematic approach to prepare for and execute an effective ICU evacuation
during a disaster. Interhospital and intrahospital collaboration and
functional ICU communication are critical for success. Pre-event planning
and preparation are required for a no-notice evacuation. A Critical Care
Team Leader must be designated within the Hospital Incident Command System.
A three-stage ICU Evacuation Timeline, including (1) no immediate threat,
(2) evacuation threat, and (3) evacuation implementation, should be used.
Detailed suggestions on ICU evacuation, including regional planning,
evacuation drills, patient transport preparation and equipment, patient
prioritization and distribution for evacuation, patient information and
tracking, and federal and international evacuation assistance systems, are
also provided. CONCLUSIONS: Successful ICU evacuation during a disaster
requires active preparation, participation, communication, and leadership by
critical care providers. Critical care providers have a professional
obligation to become better educated, prepared, and engaged with the
processes of ICU evacuation to provide a safe continuum of critical care
during a disaster.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
disaster
emergency care
intensive care
intensive care unit
pandemic
patient transport
EMTREE MEDICAL INDEX TERMS
article
cooperation
critically ill patient
evidence based medicine
government
health care personnel
health care quality
human
interpersonal communication
leadership
medical decision making
medical literature
patient information
public health
simulation
strategic planning
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2014876686
MEDLINE PMID
25144509 (http://www.ncbi.nlm.nih.gov/pubmed/25144509)
PUI
L600342635
DOI
10.1378/chest.14-0735
FULL TEXT LINK
http://dx.doi.org/10.1378/chest.14-0735
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 335
TITLE
Correlation between bacterial pathogens transfer in healthcare workers and
patients: A study from paediatric ICU and nursery of a tertiary care
hospital
AUTHOR NAMES
Lavanya J.
Jais M.
Rakshit P.
Kumar V.
Dutta R.
Gupta R.K.
AUTHOR ADDRESSES
(Lavanya J.; Jais M.; Dutta R.) Department of Microbiology, Lady Hardinge
Medical College, New Delhi-110001, India.
(Kumar V.) Department of Paediatrics, Kalawati Saran Children Hospital, New
Delhi-110001, India.
(Rakshit P.; Gupta R.K., rkgupta08@gmail.com) Central Research Institute,
Kasauli- 173204. H.P, India.
CORRESPONDENCE ADDRESS
R.K. Gupta, Central Research Institute, Kasauli- 173204. H.P, India. Email:
rkgupta08@gmail.com
SOURCE
Journal of Microbial and Biochemical Technology (2014) 6:1 (035-037). Date
of Publication: January 2014
ISSN
1948-5948 (electronic)
BOOK PUBLISHER
OMICS Publishing Group, 5716 Corsa Ave., Suite 110,, Westlake, Los Angeles,,
United States.
ABSTRACT
Background: Cross transmission of microorganisms by the hands of healthcare
workers is the main route of spread of health care associated infections
(HCAI) as they provide essential services to the patients. HCAI has
increased the morbidity and mortality of hospitalized patients especially
the ones admitted in Paediatric ICU and nursery. Objectives: The present
study was undertaken to isolate bacteria from hands of resident doctors and
nursing staff from Paediatric ICU and nursery and to correlate them with the
patients sample isolates from same Paediatric ICU and Nursery during the
same time period. Material and Methods: Fingertips of subjects were directly
stabbed on MacConkey agar and Blood agar plates. Antibiogram of isolated
pathogens was also determined by standard methods. Observations: Hands of
60% healthcare workers were culture positive. Predominant isolate were
Coagulase negative Staphylococcus spp. (73.3%), followed by Staphylococcus
aureus (10%), Enterococcus and Acinetobacter spp. (each 6.6%). Methicillin
resistant Staphylococcus aureus (50%) were also observed. Conclusion:
Implementation and improving the compliance to hand hygiene may result in
order to reduce cross infection from health care workers to patients. © 2014
Lavanya J, et al.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health care personnel
intensive care unit
nursery
tertiary care center
EMTREE MEDICAL INDEX TERMS
Acinetobacter
article
bacterial strain
bacterial transmission
bacterium identification
bacterium isolate
bacterium isolation
clinical practice
coagulase negative Staphylococcus
correlation analysis
Enterococcus
hand washing
human
methicillin resistant Staphylococcus aureus
patient care
Staphylococcus aureus
EMBASE CLASSIFICATIONS
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2014069118
PUI
L372200390
DOI
10.4172/1948-5948.1000118
FULL TEXT LINK
http://dx.doi.org/10.4172/1948-5948.1000118
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 336
TITLE
2014 critical care transport workplace and salary survey
AUTHOR NAMES
Greene M.J.
AUTHOR ADDRESSES
(Greene M.J., mgreene@fitchassoc.com) Fitch and Associ. LLC, Platte City,
United States.
CORRESPONDENCE ADDRESS
M.J. Greene, Fitch and Associ. LLC, Platte City, United States.
SOURCE
Air Medical Journal (2014) 33:6 (257-264). Date of Publication: 1 Nov 2014
ISSN
1532-6497 (electronic)
1067-991X
BOOK PUBLISHER
Mosby Inc., customerservice@mosby.com
ABSTRACT
This 2014 survey polled critical care transport industry leaders, programs,
and caregivers about workplace and salary information. Beyond descriptive
information and salary data, the article details specific experience,
education, and scope of practice within the critical care transport
industry.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
critical care transport
intensive care
salary
workplace
EMTREE MEDICAL INDEX TERMS
employment
health care industry
health care policy
health care system
human
medical care
medical education
medical practice
medical service
medical society
review
scope of practice
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Occupational Health and Industrial Medicine (35)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2014946374
MEDLINE PMID
25441517 (http://www.ncbi.nlm.nih.gov/pubmed/25441517)
PUI
L600663446
DOI
10.1016/j.amj.2014.09.008
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2014.09.008
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 337
TITLE
Traumatic brain injury: Initial resuscitation and transfer
AUTHOR NAMES
John R.
Appleby I.
AUTHOR ADDRESSES
(John R.; Appleby I.) National Hospital for Neurology and Neurosurgery,
London, United Kingdom.
SOURCE
Anaesthesia and Intensive Care Medicine (2014) 15:4 (161-163). Date of
Publication: April 2014
ISSN
1878-7584 (electronic)
1472-0299
BOOK PUBLISHER
Elsevier BV
ABSTRACT
Traumatic brain injury (TBI) is common and carries a high morbidity and
mortality. Initial management of the traumatic brain injury patient is
directed toward preventing and limiting secondary brain injury while
facilitating rapid transport to an appropriate facility capable of providing
definitive neurocritical care. During resuscitation of the TBI patient,
management is directed at correcting and maintaining mean arterial pressure
(MAP), blood glucose, PaO(2) and PaCO(2) within their normal ranges. After
the initial resuscitation, management is directed at limiting secondary
damage to the brain that occurs in response to inflammatory changes,
expanding haematomas, cellular swelling, seizures, and systemic
complications such as haemodynamic or pulmonary changes, fever and pain. The
transport of critically ill brain injured patients carries inherent risks.
Although both intrahospital and interhospital transport must comply with
regulations, patient safety is enhanced during transport by establishing an
organised, efficient process supported by appropriate equipment and
personnel. This review examines the evidence base for the initial
resuscitation and transfer of head-injured patients. © 2014 Published by
Elsevier Ltd.
EMTREE DRUG INDEX TERMS
metaraminol
noradrenalin
vitamin K group
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
resuscitation
traumatic brain injury (disease management)
EMTREE MEDICAL INDEX TERMS
air conditioning
analgesia
anesthesia
article
brain injury
brain perfusion
cell swelling
cervical spine
computer assisted tomography
critically ill patient
fever
glucose blood level
hematoma
human
hypothermia
mean arterial pressure
pain
patient referral
patient safety
patient transport
priority journal
prophylaxis
radiology department
respiration control
seizure
CAS REGISTRY NUMBERS
metaraminol (33402-03-8, 54-49-9)
noradrenalin (1407-84-7, 51-41-2)
vitamin K group (12001-79-5)
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Health Policy, Economics and Management (36)
Neurology and Neurosurgery (8)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2014243778
PUI
L372781206
DOI
10.1016/j.mpaic.2014.01.010
FULL TEXT LINK
http://dx.doi.org/10.1016/j.mpaic.2014.01.010
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 338
TITLE
AMPA's mission: Advancing air & ground critical care transport medicine
AUTHOR NAMES
Hinckley W.
AUTHOR ADDRESSES
(Hinckley W.)
CORRESPONDENCE ADDRESS
W. Hinckley,
SOURCE
Air Medical Journal (2014) 33:3 (102-103). Date of Publication: May-June
2014
ISSN
1532-6497 (electronic)
1067-991X
BOOK PUBLISHER
Mosby Inc., customerservice@mosby.com
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
medical society
EMTREE MEDICAL INDEX TERMS
critically ill patient
human
medical education
medical research
note
occupational safety
patient safety
priority journal
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2014298866
PUI
L372982251
DOI
10.1016/j.amj.2014.03.006
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2014.03.006
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 339
TITLE
Feasibility of using the predisposition, insult/infection, physiological
response, and organ dysfunction concept of sepsis to predict the risk of
deterioration and unplanned intensive care unit transfer after emergency
department admission
AUTHOR NAMES
Tsai J.C.H.
Weng S.-J.
Huang C.-Y.
Yen D.H.T.
Chen H.-L.
AUTHOR ADDRESSES
(Tsai J.C.H., erdr2181@gmail.com; Chen H.-L.) Department of Emergency
Medicine, Cheng-Ching General Hospital, Taichung, Taiwan.
(Tsai J.C.H., erdr2181@gmail.com; Weng S.-J.) Department of Industrial
Engineering and Enterprise Information, Tunghai University, Taichung,
Taiwan.
(Tsai J.C.H., erdr2181@gmail.com) Department of Emergency Medicine, China
Medical University Hospital, Taichung, Taiwan.
(Huang C.-Y.) Program of Health Administration, Tunghai University,
Taichung, Taiwan.
(Yen D.H.T.) Institute of Emergency and Critical Care Medicine, College of
Medicine, National Yang-Ming University, Taipei, Taiwan.
CORRESPONDENCE ADDRESS
J.C.H. Tsai, Department of Emergency Medicine, China Medical University
Hospital, 2, Yu-Der Road, Taichung 404, Taiwan. Email: erdr2181@gmail.com
SOURCE
Journal of the Chinese Medical Association (2014) 77:3 (133-141). Date of
Publication: March 2014
ISSN
1728-7731 (electronic)
1726-4901
BOOK PUBLISHER
Elsevier Ltd
ABSTRACT
Background: Recognizing patients at risk for deterioration and in need of
critical care after emergency department (ED) admission may prevent
unplanned intensive care unit (ICU) transfers and decrease the number of
deaths in the hospital. The objective of this research was to study if the
predisposition, insult, response, and organ dysfunction (PIRO) concept of
sepsis can be used to predict the risk of unplanned ICU transfer after ED
admission. Methods: The ICU transfer group included 313 patients with
unplanned transfer to the ICU within 48 hours of ED admission, and the
control (non-transfer) group included 736 randomly sampled patients who were
not transferred to the ICU. Two-thirds of the total 1049 patients in this
study were randomly assigned to a derivation group, which was used to
develop the PIRO model, and the remaining patients were assigned to a
validation group. Results: Independent predictors of deterioration within 48
hours after ED admission were identified by the PIRO concept. PIRO scores
were higher in the ICU transfer group than in the non-transfer group, both
in the derivation group [median (mean±SD), 5 (5.7±3.7) vs. 2 (2.5±2.5);
p<0.001], and in the validation group [median (mean±SD), 6 (6.0±3.4) vs. 2
(2.4±2.6); p<0.001]. The proportion of ICU transfer patients with a PIRO
score of 0-3, 4-6, 7-9, and ≥10 was 14.1%, 46.5%, 57.3%, and 83.8% in the
derivation group (p<0.001) and 12.8%, 37.3%, 68.2%, and 70.0% in the
validation group (p<0.001), respectively. The proportion of inpatient
mortality in patients with a PIRO score of 0-3, 4-6, 7-9, and ≥10 was 2.6%,
10.1%, 23.2%, and 45.9% in the derivation group (p<0.001) and 3.3%, 12.0%,
18.2%, and 20.5% in the validation group (p<0.001), respectively.
Conclusion: The PIRO concept of sepsis may be used in undifferentiated
medical ED patients as a prediction system for unplanned ICU transfer after
admission. © 2014 .
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
conceptual framework
emergency ward
hospital admission
intensive care unit
predisposition insult response and organ dysfunction concept
sepsis
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
article
body temperature
breathing rate
controlled study
feasibility study
female
general condition deterioration
heart rate
hematologic disease
human
hypotension
kidney dysfunction
leukocyte count
liver dysfunction
major clinical study
male
metabolic disorder
middle aged
observational study
patient transport
prediction
randomized controlled trial
respiratory failure
risk assessment
very elderly
young adult
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2014148397
MEDLINE PMID
24495529 (http://www.ncbi.nlm.nih.gov/pubmed/24495529)
PUI
L52987225
DOI
10.1016/j.jcma.2013.12.001
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jcma.2013.12.001
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 340
TITLE
PEWS score predicts the need for PICU transfer and critical care
interventions
AUTHOR NAMES
Hopkins M.
Rowan C.
Rigby M.
Tori A.
AUTHOR ADDRESSES
(Hopkins M.) Indiana University, Riley Hospital for Children, Indiapoilis,
United States.
(Rowan C.; Rigby M.; Tori A.) Riley Hospital for Children, Indianapolis,
United States.
CORRESPONDENCE ADDRESS
M. Hopkins, Indiana University, Riley Hospital for Children, Indiapoilis,
United States.
SOURCE
Critical Care Medicine (2013) 41:12 SUPPL. 1 (A168). Date of Publication:
December 2013
CONFERENCE NAME
43rd Critical Care Congress of the Society of Critical Care Medicine, SCCM
2014
CONFERENCE LOCATION
San Francisco, CA, United States
CONFERENCE DATE
2014-01-09 to 2014-01-13
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: The 7-component pediatric early warning system (PEWS) score
was developed as an objective means by which children at risk for clinical
deterioration can be identified sooner. It is largely objective and easily
integrated into the electronic medical record. However, this system has not
been formally evaluated in additional institutions. Methods: To determine if
the peak PEWS score at a large tertiary care pediatric center is a reliable
predictor for PICU transfer and critical care interventions, a retrospective
chart review was conducted. We identified 288 code blue or rapid response
team (RRT) events that occurred between January 1, 2012 and December 31,
2012. We then compared the PEWS scores for those patients requiring PICU
transfer with those who remained on the general ward. Additionally, we
compared PEWS scores for those patients requiring critical care
interventions with those who did not, regardless of transfer status.
Results: A preliminary analysis was conducted for 113 events, as data
collection is ongoing and will be complete by October 2013. Of all events,
58.4% required transfer to the PICU. The mean PEWS score was significantly
higher for those patients requiring ICU transfer (9.95 [5.30] vs. 5.87
[3.90], p<0.0001). Of those requiring PICU transfer, 93.6% needed critical
care interventions. A peak PEWS score of >7 within 12 hours of RRT or code
blue event has PPV of 0.875 for requiring critical care interventions. Of
those requiring PICU transfer for respiratory instability, 91.8% required
respiratory support (32.7% required high-flow nasal cannula, 10.2% required
continuous albuterol nebulization and 49.0% required positive pressure
ventilation). Of those with hemodynamic instability, 90% required
cardiovascular support. Conclusions: The modified 7-component PEWS score is
a reliable predictor of both the need for transfer to ICU and the need for
critical care interventions.
EMTREE DRUG INDEX TERMS
salbutamol
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
society
EMTREE MEDICAL INDEX TERMS
assisted ventilation
child
deterioration
electronic medical record
human
information processing
medical record review
nasal cannula
nebulization
patient
pediatric hospital
positive end expiratory pressure
rapid response team
risk
tertiary health care
ward
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71533862
DOI
10.1097/01.ccm.0000439922.90559.23
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000439922.90559.23
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 341
TITLE
Improving efficacy and safety of pediatric intensive care unit patient
transfers
AUTHOR NAMES
Patel B.
Miller K.
Salas A.
AUTHOR ADDRESSES
(Patel B.) Drexel University College of Medicine, Dept. of Pediatrics, St.
Christopher's Hospital for Children, Philadelphia, United States.
(Patel B.) Children's Hospital at Montefiore, Bronx, United States.
(Miller K.; Salas A.) St. Christopher's Hospital for Children, Philadelphia,
United States.
CORRESPONDENCE ADDRESS
B. Patel, Drexel University College of Medicine, Dept. of Pediatrics, St.
Christopher's Hospital for Children, Philadelphia, United States.
SOURCE
Critical Care Medicine (2013) 41:12 SUPPL. 1 (A25). Date of Publication:
December 2013
CONFERENCE NAME
43rd Critical Care Congress of the Society of Critical Care Medicine, SCCM
2014
CONFERENCE LOCATION
San Francisco, CA, United States
CONFERENCE DATE
2014-01-09 to 2014-01-13
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: Patient transfers from the Pediatric ICU were largely
inefficient, which can compromise patient safety. After the PICU team
decided that the patient was stable for transfer to the regular floor, it
would take several hours to days for the bed assignment to the floor. This
provided the floor teams with inaccurate sign out and orders on the patient
as plan of care might have changed at the actual time of transfer. While
awaiting bed placement, patients might have been discharged home from the
PICU which was not relayed to floor teams and these patients were continued
to be counted in the floor team census. The aim of this study is to decrease
the time lapse between the notification of PICU transfer to the floor to
actual arrival of the patient to the floor to 120 minutes within one year.
Methods: Initially, pre-intervention data was collected for 3 months to
determine the length of time for PICU patient transfer to the regular floor.
Data was collected by retrospective review of admission list by noting the
time PICU resident called the admitting resident and time of the first vital
sign recorded on the regular floor. Intervention was conducted in a
multidisciplinary team approach by creating a hospital wide policy to only
notify the admitting resident about the PICU transfer after the patient
already has a bed assignment on the regular floor. After the implementation
of the intervention, post-intervention data was collected for 4 months in
the similar fashion to the collection of the pre intervention data. Data was
analyzed via control charts. Results: The average length of time for PICU
transfers pre-intervention was 11.5 hours and post-intervention was 1.88
hours (113 minutes). There was a 9.62 hour reduction in the length of time
for PICU transfers postinterventional. Pre-interventional, there were 8
discharges from the PICU prior to transfer; whereas, there were 0 discharges
noted post-interventional. The C-charts showed sustained and improving
decrease in length of time lapse for transfers over time after the
intervention. Conclusions: We conclude that the aim statement was achieved;
the average length of time of PICU transfer was under 120 minutes in less
than one year. The efficiency of the PICU transfer also improved over time
after the intervention implementation as involved team players had increased
familiarity and acceptance of the new hospital policy. Accurate and timely
sign out of the patient to the floor team with better understanding of the
management leads to improvement in resident satisfaction and stress
reduction as well as enhancement of patient safety.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
human
intensive care
intensive care unit
patient transport
safety
society
EMTREE MEDICAL INDEX TERMS
hospital
hospital policy
patient
patient safety
policy
population research
satisfaction
vital sign
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71533313
DOI
10.1097/01.ccm.0000439273.18488.33
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000439273.18488.33
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 342
TITLE
Intubation in pediatric/neonatal critical care transport: A national
benchmark
AUTHOR NAMES
Bigham M.
Bigelow A.
Schwartz H.
Gothard M.
AUTHOR ADDRESSES
(Bigham M.; Bigelow A.) Akron Children's Hospital, Akron, United States.
(Schwartz H.) Cincinnati Children'S Hospital, Cincinnati, United States.
(Gothard M.) BIOSTATS, East Canton, United States.
CORRESPONDENCE ADDRESS
M. Bigham, Akron Children's Hospital, Akron, United States.
SOURCE
Critical Care Medicine (2013) 41:12 SUPPL. 1 (A96). Date of Publication:
December 2013
CONFERENCE NAME
43rd Critical Care Congress of the Society of Critical Care Medicine, SCCM
2014
CONFERENCE LOCATION
San Francisco, CA, United States
CONFERENCE DATE
2014-01-09 to 2014-01-13
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: Nearly 200,000 US infants/children are transported annually
for specialty care. Respiratory interventions are a priority in pediatric
and neonatal critical care transport(PNCCT). A recent Delphi study
identified intubation performance as an important PNCCT quality metric,
though data are insufficient. Establishing performance benchmarks around
transport intubation is necessary and permits evaluation of intubation
practices that result in higher performance. Methods: This multi-center
study seeks to determine 1st attempt intubation success and describe
intubation practices in PNCCT. Data from participating centers regarding
infants/children intubated by the PNCCT team were tracked over a 6-month
period (Jan-June 2013). Data describing intubation training and practices
were gathered using SurveyMonkey® (Palo Alto, CA). Data were tabulated in
Microsoft Excel (Redmond, WA) and analyzed using descriptive statistics and
ANOVA. Results: 8 of 14 invited institutions participated. The median(IQR)
6-month transport volume for neonates(neo) was 217.5(178-397) and
pediatric(ped) 510.5(179-608). On average, 6.9%(±2.6) of neo and 1.7%(±0.8)
of ped transport patients required intubation. The mean(±SD) 1st intubation
attempt success rate in neo was 67.9%(±18.7) and in ped 60.6%(±32.1).
Respiratory therapists(RT) were the primary intubator at 63% of programs.
Initial intubation competency requires live intubations at 88% of programs.
For ongoing intubation competency, 63% of programs require live intubations
while all programs incorporate simulated intubations. The top-performing
transport team with neo (88%) and ped (100%) 1st attempt intubation success
requires successful live-patient intubations for initial competency and
reports primary intubation responsibilities shared amongst nurse and RT.
Conclusions: This represents the first multi-center neo/ped intubation
dataset in PNCCT. First attempt intubation success lags behind reported
anesthesia intubation rates but parallels pediatric emergency department
intubation success rates. Training and operational processes are variable in
PNCCT, though top performing teams require livepatient intubation success to
achieve initial intubation competency.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
intubation
society
EMTREE MEDICAL INDEX TERMS
analysis of variance
anesthesia
Delphi study
emergency ward
human
implantable cardioverter defibrillator
multicenter study
newborn
nurse
patient
respiratory therapist
responsibility
statistics
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71533585
DOI
10.1097/01.ccm.0000439545.87244.b3
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000439545.87244.b3
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 343
TITLE
Prediction of intensive care unit transfer or death in emergency department
patients with suspected
AUTHOR NAMES
Jessen M.K.
Mackenhauer J.
Hvass A.M.
Ødorf K.
Skibsted S.
Kirkegaard H.
AUTHOR ADDRESSES
(Jessen M.K.; Mackenhauer J.; Ødorf K.; Skibsted S.; Kirkegaard H.) Research
Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark.
(Hvass A.M.) Department of Infectious Diseases, Aarhus University Hospital,
Aarhus, Denmark.
(Ødorf K.; Skibsted S.) Department of Emergency Medicine, Beth Israel
Deaconess Medical Center, Boston, United States.
CORRESPONDENCE ADDRESS
M.K. Jessen, Research Center for Emergency Medicine, Aarhus University
Hospital, Aarhus, Denmark.
SOURCE
Critical Care Medicine (2013) 41:12 SUPPL. 1 (A262). Date of Publication:
December 2013
CONFERENCE NAME
43rd Critical Care Congress of the Society of Critical Care Medicine, SCCM
2014
CONFERENCE LOCATION
San Francisco, CA, United States
CONFERENCE DATE
2014-01-09 to 2014-01-13
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: A challenge faced by emergency physicians is determining which
patients with suspected infection will deteriorate. The purpose of this
study is to compare patients with suspected infection who die or are
transferred to an ICU within 48 hours to those remaining at primary wards,
and creating a prediction model of ICU transfer or death. Methods: A
retrospective case-control study. Inclusion criteria were: 1) age >18 years
and 2) having a blood culture drawn upon admission to the ED at Aarhus
University Hospital, Jan 1st to Dec 31st 2011. Patients were grouped by
in-hospital course within the first 48 hours. Cases were defined as the
composite endpoint of death or ICU-transfer within 48 hours of admission.
Controls were defined as those not meeting the composite endpoint. Matching
was performed 1:3, where possible, by age and admission month. Laboratory
results, type of antibiotics and clinical data from within the first 4 hours
of admission were collected. We constructed a model predicting death or
transfer to ICU within 2 days using backward, stepwise logistic regression.
Fractional polynomial-transformations were performed. In order to evaluate
the quality of the model we measured its sensitivity, specificity, Positive
Predictive Value and Negative Predictive Value as well as its ability to
discriminate cases from non-cases by estimating the area under the
ROC-curve. Results: 1578 patients had a blood culture drawn in the ED.
Overall in-hospital mortality was 9%. 140 cases were matched to 401
controls. Independent predictors of ICU-transfer or death included
respiratory rate, temperature and number of failing organs. A prediction
model containing these independent predictors had a good predictive accuracy
with an area under the curve of 0.89 (95% CI 0.8403- 0.9296). Sensitivity
was 63%, specificity 93 %, positive predictive value 72% and negative
predictive value 90%. Conclusions: Readily available clinical and laboratory
variables at arrival in the ED can aid in the prediction of the outcome
within two days of admission.
EMTREE DRUG INDEX TERMS
antibiotic agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
death
emergency ward
human
intensive care
intensive care unit
patient
prediction
society
EMTREE MEDICAL INDEX TERMS
area under the curve
blood culture
breathing rate
case control study
clinical study
emergency physician
hospital
infection
laboratory
logistic regression analysis
model
mortality
predictive value
receiver operating characteristic
temperature
university hospital
ward
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71534219
DOI
10.1097/01.ccm.0000440279.77880.4d
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000440279.77880.4d
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 344
TITLE
Predicto rs and outco mes of unplanned transfers to the PICU among children
with respirato ry distress
AUTHOR NAMES
Collins C.
Daley S.
Goodman D.
AUTHOR ADDRESSES
(Collins C.) Seattle Children's Hospital and Medical Center, Seattle, United
States.
(Daley S.) Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago,
United States.
(Goodman D.) Ann and Robert H Lurie Children's Hospital, Chicago, United
States.
CORRESPONDENCE ADDRESS
C. Collins, Seattle Children's Hospital and Medical Center, Seattle, United
States.
SOURCE
Critical Care Medicine (2013) 41:12 SUPPL. 1 (A134-A135). Date of
Publication: December 2013
CONFERENCE NAME
43rd Critical Care Congress of the Society of Critical Care Medicine, SCCM
2014
CONFERENCE LOCATION
San Francisco, CA, United States
CONFERENCE DATE
2014-01-09 to 2014-01-13
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: Transfers from the ward to the Intensive Care Unit (ICU) may
delay therapy and are disruptive to patient care. Studies in adults show
that patients who have unplanned transfers to the ICU have worse outcomes
compared to those directly admitted to the ICU. Studies in adult patients
have identified predictors for unplanned ICU transfers. There is a paucity
of data in pediatric patients regarding predictors of unplanned transfers or
outcomes of patients with unplanned transfers. Methods: A retrospective
case-control chart review from January 2010 through January 2012 was
performed. Patients admitted or discharged with a single-system respiratory
disease were included. Cases were those patients admitted to the ward and
transferred to the ICU within 24 hours. Controls were matched on age and
date of admission. Patients directly admitted to the ICU were compared to
cases and controls. Results: 51 cases, 95 controls, and 71 ICU admissions
were reviewed. Demographics were similar between the groups. Differences in
respiratory rate, heart rate, and temperature were not significant between
cases and controls. Oxygen saturation was lower for cases than controls (93%
vs. 95%, p = .0019) and similar between cases and direct ICU admissions (93%
vs. 92%, p = .4204). Cases required an intermediate amount of oxygen
compared to controls and direct ICU admissions (FiO2 mean 0.27 vs. 0.23 vs.
0.49 respectively, p<.0001). Cases had longer hospitalizations compared to
controls and direct ICU admissions respectively (6.1 days vs. 1.8 days vs.
3.9 days respectively, p < .0001). Cases were intubated more than direct ICU
admissions (14% vs. 3%, p = 0.0337). There was no statistically significant
difference in rates of Non-Invasive Positive Pressure Ventilation (NIPPV)
between cases and direct ICU admissions (24% vs. 13%, p = .0579).
Conclusions: Patients with respiratory distress requiring unplanned transfer
have lower saturations upon arrival to the ED compared to patients who do
not require transfer and similar saturations compared to patients directly
admitted to the ICU. Respiratory rate, heart rate, and temperature do not
discriminate between those who require transfer and those who do not.
Patients who require unplanned transfers have longer hospitalizations and
require intubation more often than patients directly admitted to the ICU.
EMTREE DRUG INDEX TERMS
oxygen
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child
human
intensive care
society
EMTREE MEDICAL INDEX TERMS
adult
breathing rate
heart rate
hospitalization
intensive care unit
intubation
medical record review
oxygen saturation
patient
patient care
positive end expiratory pressure
respiratory distress
respiratory tract disease
temperature
therapy
ward
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71533733
DOI
10.1097/01.ccm.0000439793.73556.a2
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000439793.73556.a2
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 345
TITLE
Classification of inpatient adverse dru g reactions leading to intensive
care unit transfer
AUTHOR NAMES
Sejnowski C.
Saber S.
AUTHOR ADDRESSES
(Sejnowski C.; Saber S.) UPMC Hamot, Erie, United States.
CORRESPONDENCE ADDRESS
C. Sejnowski, UPMC Hamot, Erie, United States.
SOURCE
Critical Care Medicine (2013) 41:12 SUPPL. 1 (A136-A137). Date of
Publication: December 2013
CONFERENCE NAME
43rd Critical Care Congress of the Society of Critical Care Medicine, SCCM
2014
CONFERENCE LOCATION
San Francisco, CA, United States
CONFERENCE DATE
2014-01-09 to 2014-01-13
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: Research has shown that there is an incidence of adverse drug
reactions in 10-13% of all hospitalized patients. There are no published
studies that review adverse drug reactions that lead to intensive care unit
transfer. Methods: This study was approved by the Institutional Review
Board. All patients transferred to one of the three intensive care units
from November 2012 through February 2013 were reviewed retrospectively using
the electronic medical record and paper charts. Patients were included in
the study if an adverse drug reaction occurred causing transfer to an ICU
from a non-ICU inpatient unit. Patients were excluded if admitted to the ICU
from the emergency department, directly admitted from another facility or
doctor's office, or directly admitted from the operating room (OR) or
post-anesthesia care unit (PACU). Probability, preventability, severity,
type, and cause of the adverse drug reaction were evaluated. Logistic
regression was used to determine factors associated with preventability.
Data was evaluated for patterns among ICU admissions caused by adverse drug
reactions. Results: A total of 315 patients were reviewed that were
transferred to the ICU during the study period, and twenty patients met the
inclusion criteria. Of the twenty patients included in the study, 35% (7
patients) were female and 45% (9 patients) had no known drug allergies.
Three adverse drug reactions were deemed preventable. The results of this
study suggest that female gender may be a predictor of preventable ADRs, but
the sample size is too small to make any conclusions. Opioids alone and
anticoagulants caused 45% of the ADRs leading to ICU admission. Conclusions:
Although it is difficult to make generalized suggestions for improvement due
to the small sample size, one problem area was the use of benzodiazepines
and opioids within a short time frame in two cases. Further studies looking
at risk factors for preventable adverse drug reactions leading to ICU
admission are needed.
EMTREE DRUG INDEX TERMS
anticoagulant agent
benzodiazepine derivative
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
classification
hospital patient
human
intensive care
intensive care unit
society
EMTREE MEDICAL INDEX TERMS
adverse drug reaction
drug hypersensitivity
electronic medical record
emergency ward
female
gender
institutional review
logistic regression analysis
operating room
patient
physician
recovery room
risk factor
sample size
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71533741
DOI
10.1097/01.ccm.0000439801.88803.88
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000439801.88803.88
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 346
TITLE
A novel policy to assure safe inter-hospital ICU to ICU transport: A review
of the literature
AUTHOR NAMES
Pakula A.
Gannon J.
Mundy L.
Berns K.
Stoltenberg A.
Ballinger B.
AUTHOR ADDRESSES
(Pakula A.; Gannon J.; Mundy L.; Berns K.; Stoltenberg A.; Ballinger B.)
Mayo Clinic, Rochester, United States.
CORRESPONDENCE ADDRESS
A. Pakula, Mayo Clinic, Rochester, United States.
SOURCE
Critical Care Medicine (2013) 41:12 SUPPL. 1 (A149). Date of Publication:
December 2013
CONFERENCE NAME
43rd Critical Care Congress of the Society of Critical Care Medicine, SCCM
2014
CONFERENCE LOCATION
San Francisco, CA, United States
CONFERENCE DATE
2014-01-09 to 2014-01-13
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: Transfer of patients from quaternary centers will increase in
frequency as care becomes increasingly regionalized and resources
concentrated. These patients can convalesce in their home institutions' ICU.
We performed a literature review on Interhospital transport from ICU to ICU
of critically ill patients. However, the majority of literature addresses
intrahospital transports for procedures. Also, it describes only incidence
of adverse events and risk factors for complication. There is paucity of
data on policies to assure safe interhospital ICU transport. A transport
policy coordinated with a multidisciplinary transport team (MTT) is
indicated. Methods: A PubMed search was performed and keywords included
“interhospital transport”, “critically ill patients”, “ICU transfers”, and
“transport policy”. All information and recommendations were considered and
our own institution's process was evaluated before establishing a policy.
Results: Adverse events have been reported to occur from 30-70% of
transports. These include changes in vital signs, respiratory status,
increased vasopressor need, oxygen support and interventions. At our
institution we created a policy to guide future interhospital transport.
Elements include: 1) primary service determines ICU patient medically safe
for transfer 2) physician will request Transport Team Meeting be arranged.
Team includes the primary physician, members of nursing staff: Clinical
Nurse Specialist (CNS) and most recent nurses caring for patient, social
worker/discharge planner, transport/flight team manager and transport
respiratory therapist 3) transport elements to be determined include level
of care, mode of transport required to meet patient's medical needs,
equipment resources and personnel expertise set needed. Also included is
summary of patient's hospitalization 4) recommendations for these needs
determined at the MTT meeting will be placed in the EMR, using a newly
created template document which can be readily accessed for review 5) a
referral will be submitted to our hospital transfer and communication center
who will use this information to secure a transport provider who has all of
these resources. Conclusions: Transparent policies can be created across all
institutional ICUs for safe transport of critically ill patients. As a
result of this literature review we found that there is data expressing the
need for these policies but the policies themselves scarcely exist. To our
knowledge this is the first description of an institutional policy for
inter-hospital ICU to ICU transport of patents.
EMTREE DRUG INDEX TERMS
hypertensive factor
oxygen
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital
intensive care
policy
society
EMTREE MEDICAL INDEX TERMS
clinical nurse specialist
critically ill patient
hospitalization
human
interpersonal communication
manager
Medline
nurse
nursing staff
patent
patient
personnel
physician
procedures
respiratory therapist
risk factor
vital sign
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71533789
DOI
10.1097/01.ccm.0000439849.82896.de
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000439849.82896.de
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 347
TITLE
Utility of surveillance cultures for antimicrobial resistant organisms in
infants transferred to the neonatal intensive care unit
AUTHOR NAMES
Macnow T.
O'Toole D.
DeLaMora P.
Murray M.
Rivera K.
Whittier S.
Ross B.
Jenkins S.
Saiman L.
Duchon J.
AUTHOR ADDRESSES
(Macnow T.; O'Toole D.; Rivera K.; Saiman L.; Duchon J.,
jmd2116@columbia.edu) Department of Pediatrics, Columbia University Medical
Center, 3959 Broadway, New York, NY 10032, United States.
(DeLaMora P.) Department of Pediatrics, Cornell University, New York, NY,
United States.
(Murray M.) Columbia University School of Nursing, Columbia University
Medical Center, New York, NY, United States.
(Whittier S.) Department of Pathology, Columbia University Medical Center,
New York, NY, United States.
(Whittier S.) Department of Clinical Microbiology, New York-Presbyterian
Hospital, Columbia University Medical Center, New York, NY, United States.
(Ross B.; Saiman L.) Department of Infection Prevention and Control, New
York-Presbyterian Hospital, New York, NY, United States.
(Jenkins S.) Department of Pathology, Weill Cornell Medical Center, New
York, NY, United States.
(Jenkins S.) Department of Clinical Microbiology, New York-Presbyterian
Hospital, Weill Cornell Medical Center, New York, NY, United States.
CORRESPONDENCE ADDRESS
J. Duchon, Department of Pediatrics, Columbia University Medical Center,
3959 Broadway, New York, NY 10032, United States. Email:
jmd2116@columbia.edu
SOURCE
Pediatric Infectious Disease Journal (2013) 32:12 (e443-e450). Date of
Publication: 2013
ISSN
0891-3668
1532-0987 (electronic)
BOOK PUBLISHER
Lippincott Williams and Wilkins, 530 Walnut Street,P O Box 327,
Philadelphia, United States.
ABSTRACT
Background: Infections with antibiotic resistant organisms (AROs) are an
important source of morbidity and mortality among infants hospitalized in
the neonatal intensive care unit (NICU). To identify potential reservoirs of
AROs in the NICU, active surveillance strategies have been adopted by many
NICUs to detect infants colonized with AROs. However, the yield, risks,
benefits and costs of different strategies have not been fully evaluated.
Methods: We conducted a retrospective study in 2 level III NICUs from 2004
to 2010 to investigate the yield of surveillance cultures obtained from
infants transferred to the NICU from other hospitals. Cultures were
processed for methicillin-resistant Staphylococcus aureus,
vancomycin-resistant enterococci and antibiotic-resistant gram-negative
rods. Risk factors, selected outcomes and laboratory costs associated with
ARO colonization were assessed. Results: Among 1751 infants studied, the
rate of colonization for methicillin-resistant S. aureus,
vancomycin-resistant enterococci and antibioticresistant gram-negative rods
was 3%, 1.7% and 1%, respectively. Age at transfer was the strongest
predictor of ARO colonization; infants transferred at.7 days of life had 5.8
increased odds of ARO colonization compared with infants <7 days of age.
Transferred infants who were colonized had similar rates of mortality, ARO
infection and duration of hospitalization compared with those who were not
colonized. The laboratory cost of surveillance cultures during the study
period was $58,425. Conclusions: The rate of colonization with AROs at
transfer was low particularly in infants <7 days old. Future studies should
examine the safety of targeted surveillance strategies focused on older
infants. © 2013 Lippincott Williams &Wilkins.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
antibiotic resistant organism
bacterium
bacterium culture
infant disease
newborn intensive care
EMTREE MEDICAL INDEX TERMS
article
bacterial colonization
bacterial infection
birth weight
congenital heart disease
female
gastrointestinal disease
gestational age
Gram negative bacterium
health care cost
human
infant
infant mortality
length of stay
major clinical study
male
methicillin resistant Staphylococcus aureus
patient transport
priority journal
retrospective study
risk factor
vancomycin resistant Enterococcus
EMBASE CLASSIFICATIONS
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2014013661
MEDLINE PMID
23811747 (http://www.ncbi.nlm.nih.gov/pubmed/23811747)
PUI
L52653196
DOI
10.1097/INF.0b013e3182a1d77f
FULL TEXT LINK
http://dx.doi.org/10.1097/INF.0b013e3182a1d77f
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 348
TITLE
Use of simulation/checklist to improve safety during intra-hospital
transport of the critically ill
AUTHOR NAMES
Bangar M.
Durst M.
Venegas-Borsellino C.
Eisen L.
Lizano D.
Dudaie R.
Carlese A.
Shiloh A.
AUTHOR ADDRESSES
(Lizano D.)
(Bangar M.; Durst M.; Venegas-Borsellino C.; Eisen L.; Dudaie R.) Montefiore
Medical Center, Bronx, United States.
(Carlese A.) Montefiore Medical Center, Albert Einstein College of Medicine,
Bronx, United States.
(Shiloh A.) Albert Einstein College of Medicine, Montefiore Medical Center,
Bronx, United States.
CORRESPONDENCE ADDRESS
M. Bangar, Montefiore Medical Center, Bronx, United States.
SOURCE
Critical Care Medicine (2013) 41:12 SUPPL. 1 (A2). Date of Publication:
December 2013
CONFERENCE NAME
43rd Critical Care Congress of the Society of Critical Care Medicine, SCCM
2014
CONFERENCE LOCATION
San Francisco, CA, United States
CONFERENCE DATE
2014-01-09 to 2014-01-13
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: Intra-hospital transport of critically ill patients is often
necessary for patient care. However, such transport also puts patients at
risk for adverse events. Some arise from preventable sources such as human
error and poor communication. Safe intra-hospital transport depends on the
anticipation of complications and appropriate handling complications when
they arise. Methods: After Institutional Review Board approval, an
observational, prospective, before-after study design was used on 23 PAs in
the Critical Care Medicine environment. Each PA completed a total of 6
simulated scenarios using a HFS (SimMan - Laerdal). During each case the
group was evaluated on a 20-point performance checklist including
transport-specific items including: understanding principles of safe
transport, knowing physiologic effects of transport, knowing transport
equipment, planning for potential transport problems, using pre-transport
checklist, identifying patient needs during transfer, assuming leadership
role during transfer, providing handover. After the first 2 cases the PAs
were given a training session and a pre-transport safety checklist was
introduced. Then the PAs participated in 2 more cases for penetrating
education and finally they participated in 2 more cases evaluated and scored
as post-training cases. Scores between pre and post training cases were
compared. Analysis was performed using STATA/IC 11.2. Results: The overall
clinical performance comparing a pre vs. post training combined score
improved from 61.9%+17% to 96.45%+8% (delta +34.55%, p<0.01). The knowledge
required for a level 1 transport (stable condition) improved from 65.6%+14%
to 98.7%+11% (+33.1% p=0.12); and for a level 2 or 3 transport (critical
condition) from 61.3%+22% to 100%+0% (delta +38.6% p<0.01). The core
competences with the most significant improvement were: understanding the
benefit of pre-transfer check lists in clinical practice (+83%), using a
structured approach for assessment of critically ill patients prior to
transfer (+50%), identifying potential patient needs prior to and during
transfer (+50%), and providing a clear and precise structured handover to
the receiving unit (+100%). Conclusions: Complications related to the
transport of critically ill patients can potentially be avoided with proper
pre-transport preparation and training to handle adverse events. The
implementation of a pre-transport safety checklist and simulation training
are valuable educational tools for preparing PAs to oversee the
intra-hospital transport of critically ill patients.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
hospital
human
intensive care
safety
society
EMTREE MEDICAL INDEX TERMS
checklist
clinical practice
competence
CPR manikin
education
environment
error
institutional review
interpersonal communication
leadership
patient
patient care
planning
risk
simulation
study design
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71533232
DOI
10.1097/01.ccm.0000439192.75425.bb
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000439192.75425.bb
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 349
TITLE
Implementation of a structured information transfer checklist improves
postoperative data transfer after congenital cardiac surgery
AUTHOR NAMES
Karakaya A.
Moerman A.T.
Peperstraete H.
François K.
Wouters P.F.
De Hert S.G.
AUTHOR ADDRESSES
(Karakaya A.; Moerman A.T., annelies.moerman@UGent.be; Wouters P.F.; De Hert
S.G.) Department of Anaesthesiology, Ghent University Hospital, De Pintelaan
185, 9000 Gent, Belgium.
(Peperstraete H.) Department of Intensive Care, Ghent University Hospital,
Gent, Belgium.
(François K.) Department of Cardiac Surgery, Ghent University Hospital,
Gent, Belgium.
CORRESPONDENCE ADDRESS
A.T. Moerman, Department of Anaesthesiology, Ghent University Hospital, De
Pintelaan 185, 9000 Gent, Belgium. Email: annelies.moerman@UGent.be
SOURCE
European Journal of Anaesthesiology (2013) 30:12 (764-769). Date of
Publication: December 2013
ISSN
0265-0215
1365-2346 (electronic)
BOOK PUBLISHER
Lippincott Williams and Wilkins, 250 Waterloo Road, London, United Kingdom.
ABSTRACT
BACKGROUND During one hospital stay, a patient can be cared for by five
different units. With patient transfer from one unit to another, it is of
prime importance to convey a complete picture of the patient's situation to
minimise the risk of medical errors and to provide optimal patient care.
OBJECTIVE(S) This study was designed to test the hypothesis that the
implementation of a standardised checklist used during verbal patient
handover could improve postoperative data transfer after congenital cardiac
surgery. DESIGN Prospective, pre/postinterventional clinical study. SETTING
Cardiac centre of a university hospital. PATIENTS Forty-eight patients
younger than 16 years undergoing heart surgery. INTERVENTIONS A standardised
checklist was developed containing all data that, according to the
investigators, should be communicated during the handover of a paediatric
cardiac surgery patient from the operating room to the ICU. MAIN OUTCOME
MEASURES Data transfer during the postoperative handover before and after
implementation of the checklist was evaluated. Duration of handover, number
of interruptions, number of irrelevant data and number of confusing pieces
of information were noted. Assessment of the handover process by ICU medical
and nursing staff was quantified. RESULTS After implementation of the
information transfer checklist, the overall data transfer increased from 48
to 73% (P<0.001). The duration of data transfer decreased from a median
(range) of 6 (2 to 16) to 4 min (2 to 19) (P=0.04). The overall handover
assessment by the intensive care nursing staff improved significantly after
implementation of the checklist. CONCLUSION Implementation of an information
transfer checklist in postoperative paediatric cardiac surgery patients
resulted in a more complete transfer of information, with a decrease in the
handover duration. © 2013 Copyright European Society of Anaesthesiology.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
congenital heart disease (congenital disorder, surgery)
medical information system
EMTREE MEDICAL INDEX TERMS
article
checklist
child
clinical article
clinical handover
female
human
intensive care unit
male
medical error
medical staff
nursing staff
operating room
patient care
patient transport
postoperative period
surgical patient
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Cardiovascular Diseases and Cardiovascular Surgery (18)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2013745271
MEDLINE PMID
23736091 (http://www.ncbi.nlm.nih.gov/pubmed/23736091)
PUI
L370339210
DOI
10.1097/EJA.0b013e328361d3bb
FULL TEXT LINK
http://dx.doi.org/10.1097/EJA.0b013e328361d3bb
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 350
TITLE
Specialized pediatric critical care vs rapid EMS transport of trauma
patients
AUTHOR NAMES
Garlick J.
Melguizo-Castro M.
Keen P.
Nick T.
Stroud M.
AUTHOR ADDRESSES
(Garlick J.) University of Arkansas for Medical Sciences, Little Rock,
United States.
(Melguizo-Castro M.; Keen P.; Nick T.) Arkansas Childrens Hospital, Little
Rock, United States.
(Stroud M.) University of Arkansas For Medical Sciences, Arkansas Children's
Hospital, Little Rock, United States.
CORRESPONDENCE ADDRESS
J. Garlick, University of Arkansas for Medical Sciences, Little Rock, United
States.
SOURCE
Critical Care Medicine (2013) 41:12 SUPPL. 1 (A58-A59). Date of Publication:
December 2013
CONFERENCE NAME
43rd Critical Care Congress of the Society of Critical Care Medicine, SCCM
2014
CONFERENCE LOCATION
San Francisco, CA, United States
CONFERENCE DATE
2014-01-09 to 2014-01-13
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: Purpose: The purpose of this study was to determine if
differences exist between care provided by specialized pediatric transport
teams and EMS services with respect to trauma patient outcomes. The use of
specialized pediatric transport teams has been shown to reduce adverse
events and lower mortality rates in children with medical illness. No
studies have evaluated if a difference exists in pediatric trauma patients.
The Golden Hour concept has emphasized expeditious transport of trauma
patients by EMS Services. Rapid transport of trauma patients requiring
surgical intervention to tertiary care centers is intuitive; however, the
specialized care provided by pediatric transport teams may be beneficial in
subsets of trauma patients. Improved care during transport may be more
advantageous than rapid transport in pediatric trauma patients not requiring
immediate surgical intervention. Methods: Retrospective data was collected
on all pediatric trauma patients transported between (Jan 2007 - Dec 2011)
to Arkansas Children's Hosptial (ACH), the only tertiary care children's
hospital in the state. Demographic information, initial vital signs,
predicted mortality scores, interventions performed by the transport teams,
mechanism of injury, and injury severity scores (ISS) were collected and
compared between patients transported by a specialized pediatric transport
team at ACH and state EMS services. Final disposition, Emergency Department
(ED) length of stay (LOS), hospital LOS, and time to the operating room (OR)
were compared between group. Demographic characteristics and baseline
clinical variables were assessed with two sample t-tests for continuous
variables (with appropriate log transformations of the skewed variables) and
Pearson test for categorical variables. Multivariate linear models using
ordinary least squares was used to assess whether the differences in LOS
between EMS and specialized teams remained significant after adjusting for
age, gender, race and ISS. Results: There were significant differences
between specialized transport team and EMS groups for demographic variables;
in particular median age of the specialized team group was lower; [EMS team
10.4y (9.6 ± 5.6) vs. Specialized team 6.2y (7.4 ± 5.8) median (mean ± SD)]
and ISS scores were lower in the specialized transport group. For outcome
variables, un-adjusted differences in ED disposition were different, LOS was
shorter, ED LOS was shorter, and the probability of survival was higher in
patients transported by a specialized pediatric team. Multivariate analysis,
adjusting for age and ISS revealed a significantly different ED LOS with
patients transported by EMS teams spending an average of 0.67 (95% CI 0.65
to 0.68) hours longer in the ED. Conclusions: The age difference between
groups was expected as specialized teams are more often called upon to
transport younger patients. The difference in ED LOS [EMS Team 2.5 (3.2 ±
3.9) vs Specialized Team 2.3h (2.6 ± 2.2) P<0.001] suggests that improved
care provided by specialized pediatric teams may result in enhanced
resuscitation during transport, decreasing time spent in the ED. In turn,
patients are transferred to ICUs or ORs more quickly, thus expediting
appropriate ongoing care and rationing ED resources more efficiently. Future
evaluations will determine if differences exist in subsets of trauma
patients and if the number of interventions during transport differs among
specialized pediatric teams versus EMS teams. Specialized pediatric
transport teams may provide better care and shorten ED LOS in trauma
patients transported to tertiary care children's hospitals.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
human
injury
intensive care
patient
society
EMTREE MEDICAL INDEX TERMS
child
childhood injury
demography
diseases
emergency ward
gender
hospital
injury scale
length of stay
mortality
multivariate analysis
operating room
outcome variable
pediatric hospital
regression analysis
resuscitation
statistical model
Student t test
surgery
survival
tertiary care center
tertiary health care
United States
vital sign
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71533443
DOI
10.1097/01.ccm.0000439403.36902.cb
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000439403.36902.cb
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 351
TITLE
Televisitation: virtual transportation of family to the bedside in an acute
care setting.
AUTHOR NAMES
Nicholas B.
AUTHOR ADDRESSES
(Nicholas B.) Thunder Bay Regional Health Sciences Centre in Ontario,
Canada.
CORRESPONDENCE ADDRESS
B. Nicholas, Thunder Bay Regional Health Sciences Centre in Ontario, Canada.
Email: nicholab@tbh.net
SOURCE
The Permanente journal (2013) 17:1 (50-52). Date of Publication: 2013 Winter
ISSN
1552-5775 (electronic)
ABSTRACT
Televisitation is the virtual transportation of a patient's family to the
bedside, regardless of the patient's location within an acute care setting.
This innovation in the Telemedicine Program at Thunder Bay Regional Health
Sciences Centre (TBRHSC) in Ontario, Canada, embraces the concept of
patient- and family-centered care and has been identified as a leading
practice by Accreditation Canada. The need to find creative ways to link
patients to their family and friend supports hundreds of miles away was
identified more than ten years ago. The important relationship between
health outcomes and the psychosocial needs of patients and families has been
recognized more recently. TBRHSC's patient- and family-centered model of
care focuses on connecting patients with their families. First Nations renal
patients with family in remote communities were some of the earliest users
of videoconferencing technology for this purpose.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
patient
videoconferencing
EMTREE MEDICAL INDEX TERMS
article
Canada
economics
human
human relation
organization and management
patient satisfaction
LANGUAGE OF ARTICLE
English
MEDLINE PMID
23596369 (http://www.ncbi.nlm.nih.gov/pubmed/23596369)
PUI
L369862065
DOI
10.7812/TPP/12-013
FULL TEXT LINK
http://dx.doi.org/10.7812/TPP/12-013
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 352
TITLE
Intrahospital transport of patients with severe lung disease
ORIGINAL (NON-ENGLISH) TITLE
Transporte intrahospitalario del paciente con enfermedad pulmonar grave
AUTHOR NAMES
Portela Ortiz J.M.
Delgadillo Arauz C.
AUTHOR ADDRESSES
(Portela Ortiz J.M.) HospitaL Ángeles Pedregal, Mexico.
(Delgadillo Arauz C.) HospitaL Ángeles Pedregal, Universidad La Salle,
Mexico.
CORRESPONDENCE ADDRESS
HospitaL Ángeles Pedregal, Mexico.
SOURCE
Revista Mexicana de Anestesiologia (2013) 36:SUPPL.1 (S23-S27). Date of
Publication: 2013
ISSN
0185-1012
BOOK PUBLISHER
Colegio Mexicano de Anestesiologia A.C., CP 03810, Mexico D.F., Mexico.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
lung disease
patient transport
EMTREE MEDICAL INDEX TERMS
human
note
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English, Spanish
EMBASE ACCESSION NUMBER
2014008821
PUI
L372036641
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 353
TITLE
Interfacility specialized transport care of children with neurologic disease
AUTHOR NAMES
Newmyer R.
Kuch B.
Fink E.
AUTHOR ADDRESSES
(Newmyer R.) Children's Hospital of Pittsburgh of UPMC, Pittsburgh, United
States.
(Kuch B.; Fink E.) Children's Hospital of Pittsburgh, Pittsburgh, United
States.
CORRESPONDENCE ADDRESS
R. Newmyer, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, United
States.
SOURCE
Critical Care Medicine (2013) 41:12 SUPPL. 1 (A171). Date of Publication:
December 2013
CONFERENCE NAME
43rd Critical Care Congress of the Society of Critical Care Medicine, SCCM
2014
CONFERENCE LOCATION
San Francisco, CA, United States
CONFERENCE DATE
2014-01-09 to 2014-01-13
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: Neurologic diagnoses (ND), in particular traumatic brain
injury, account for significant morbidity and mortality in hospitalized
children. Data on interfacility transport of patients with non-traumatic ND
are lacking. The purposed of the study is to describe interfacility
transport of children with and without ND by a specialized pediatric
transport team. The long term objective is to use findings to inform
treatment protocols and improve patient outcomes. Methods: Patients aged 1
month to 21 years that underwent interfacility transport by a non-trauma
pediatric critical care transport team between October 1997 and February
2013 were studied from a prospectively collected database. Patients were
categorized as having ND versus other diagnosis (OD) using data at hospital
discharge. Groups were compared using Mann-Whitney U test. Univariate
analysis identified variables that predict survival and a multivariate
regression model was used to determine association with survival. Results:
12,855 patients met inclusion criteria. 2,155 with a ND, and 10,730 with OD.
Children with ND were older (36m (IQR 83) vs 20 m (IQR 70)), had a higher
median pre-hospital PRISM (6 (IQR 10) vs 0 (IQR 4)), a lower median GCS (10
(IQR 8) vs 14 (IQR 3)). In transport, children with ND had longer scene time
in minutes (25 (IQR 22) vs 18 (IQR15)), were more likely to receive IV
access (91 vs 80% (OR=2.6 [2.2-3.1])), interosseous access (5.2 vs 2.1%
(OR=2.5 [2.0-3.2])) or intubation (36.3 vs 18.5% (OR 2.5 [2.3-2.8])), and
were more likely to be admitted to the intensive care unit (ICU) (47.9 vs
36.7 % (OR 1.7 [1.5-1.8])) compared with children with OD. Children with ND
had longer ICU and hospital length of stay and were more likely to die in
the hospital (6.5 vs 4.4% (OR=1.5 [1.2-1.8])) than children with OD (all
p<0.001). After accounting for variables that predicted survival in
univariate analyses (PRISM, GCS, intubation status), a multivariate
regression model showed that ND is associated with worse survival (negative
coefficient) while transport time and mode of transport were not related to
survival. The most frequent ND were seizure (66%), infection (11.5%) and
anatomic abnormality (8.5%). Conclusions: In a population of children with
non-traumatic ND, children with ND received more critical care interventions
in transport, used more hospital resources and had worse outcomes than
children with OD. Future directions include identifying interventions that
may improve prehospital care and outcomes.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child
human
intensive care
neurologic disease
society
EMTREE MEDICAL INDEX TERMS
data base
diagnosis
emergency care
hospital
hospital discharge
hospitalized child
infection
injury
intensive care unit
intubation
length of stay
model
morbidity
mortality
patient
population
prism
rank sum test
seizure
survival
traumatic brain injury
univariate analysis
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71533874
DOI
10.1097/01.ccm.0000439934.45710.d0
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000439934.45710.d0
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 354
TITLE
Use of an ICU discharge checklist results in an increased transfer to
rehabilitation facilities
AUTHOR NAMES
Chirumamilla N.
Schmidt U.
Lemovitz A.
Johnson D.
Ryan C.
Dunn P.
Lee J.
AUTHOR ADDRESSES
(Chirumamilla N.; Schmidt U.; Lemovitz A.; Ryan C.; Dunn P.; Lee J.)
Massachusetts General Hospital, Boston, United States.
(Johnson D.) University of Nebraska Medical Center, Omaha, United States.
CORRESPONDENCE ADDRESS
N. Chirumamilla, Massachusetts General Hospital, Boston, United States.
SOURCE
Critical Care Medicine (2013) 41:12 SUPPL. 1 (A23). Date of Publication:
December 2013
CONFERENCE NAME
43rd Critical Care Congress of the Society of Critical Care Medicine, SCCM
2014
CONFERENCE LOCATION
San Francisco, CA, United States
CONFERENCE DATE
2014-01-09 to 2014-01-13
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: We have previously reported that 22% of patients in a surgical
ICU experience non-medical transfer delays from the ICU. The average delay
to transfer for the patients in the study was 1.5 days. Checklists have been
shown to improve care coordination in numerous clinical settings. Methods:
We introduced checklists for patients in a 20 bed surgical ICU who were
medically cleared for transfer to the floor for longer than 24 hours. These
checklists were used by intensivists, nurses, case management, social
workers, physical therapists and nutritionists to create a multi
disciplinary approach to the patient's discharge planning. We compared the
six months of data after implementation of the checklist to the baseline
data from our previously published dataset. Proportions were analyzed by
chi-square and length-of-stay by log-rank time analysis. Results: Out of the
1204 admissions in the ICU from Jan 1, 2013 to June 30, 2013 there were 69
discharge checklists used for 52 patients. During the study period the rate
of transfer of patients from the ICU directly to rehabilitation facilities
increased from 5.0 per 100 (8 patients in 160 discharges) admissions to 28.8
per 100 (15 patients for 52 discharges) admissions (p<0.001,
ChiSquare=23.1). Median LOS in the ICU before and after introduction of the
checklists remained at 3 days (p=0.37). The median Hospital LOS before
introducing the checklists was 9 days compared to 8 days following the use
of the checklists (p=0.88). Conclusions: Implementation of checklists
resulted in more patients being discharged to rehabilitation facilities
directly, but did not affect ICU nor hospital length of stay.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
checklist
intensive care
rehabilitation
society
EMTREE MEDICAL INDEX TERMS
case management
dietitian
hospital
hospital discharge
human
intensivist
length of stay
nurse
patient
physiotherapist
social worker
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71533306
DOI
10.1097/01.ccm.0000439266.03241.46
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000439266.03241.46
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 355
TITLE
Successful pediatric intubations by non-physicians in a children's critical
care transport team
AUTHOR NAMES
Dugan M.
Leong T.
Petrillo-Albarano T.
AUTHOR ADDRESSES
(Dugan M.) Emory University, School of Medicine, Atlanta, United States.
(Leong T.) Emory School of Public Health, Atlanta, United States.
(Petrillo-Albarano T.) Children's Healthcare of Atlanta, Atlanta, United
States.
CORRESPONDENCE ADDRESS
M. Dugan, Emory University, School of Medicine, Atlanta, United States.
SOURCE
Critical Care Medicine (2013) 41:12 SUPPL. 1 (A34). Date of Publication:
December 2013
CONFERENCE NAME
43rd Critical Care Congress of the Society of Critical Care Medicine, SCCM
2014
CONFERENCE LOCATION
San Francisco, CA, United States
CONFERENCE DATE
2014-01-09 to 2014-01-13
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: Prior research on physician and non-physician endotracheal
intubation (ETI) of pediatric patients demonstrates highly variable success
rates. To assess the performance of a single children's critical care
transport team (CCT), we analyzed data from 2.5 years of pediatric ETI
encounters. Methods: A retrospective review encompassed pediatric ETI
encounters from 127 patient charts from the rotorcraft and ground emergency
CCT of a large quaternary referral children's hospital with an average of
greater than 5000 patient transports annually. Pediatric patients were cared
for by the CCT between January 1, 2011, and July 31, 2013. We included all
patients between 1 day and 20 years of age in our analysis, without
exclusion. A single ETI attempt was defined by the insertion of a
laryngoscope. We characterized first-attempt intubation success and overall
intubation success with descriptive statistics and calculated 95% confidence
intervals. Results: For our cohort, demographics indicated a mean patient
age of 3.68 years (median age = 0.8 years, SD = 5.3 years), mean patient
weight of 17.9kg (median weight = 8.5kg, SD = 23.9kg), and 60.6% of patients
were male. For pediatric ETIs performed, overall success of pediatric ETI
was confirmed in 125/127 patients (98.4%, 95% CI 93.9%-99.7%). First-attempt
success over 2.5 years of patient encounters was 70.6% (95% CI 63.2%-77.1%).
Both failures of ETI were managed successfully with a laryngeal mask airway
(LMA) device. Operator inexperience was not a consistent feature in the two
ETI failures. Patients successfully intubated on a first attempt were
significantly older than patients requiring multiple attempts (p=.049, two
sample t test). For the 89 successful first attempt intubations, average age
was 4.2 yrs in contrast with an average of 2.4 yrs for the patients who
required multiple attempts. Patient weight was not significantly different
between patients who required a single attempt versus multiple attempts
(p=.391), nor did success rates vary by patient sex (p=1.0; Fisher's exact
test). Conclusions: Pediatric ETI performed by an experienced children's CCT
is a safe and successful procedure. Failures can be expertly managed with
extra-glottic devices, such as the LMA. Younger patient age is associated
with higher likelihood of initial intubation failure and may require
multiple attempts for successful definitive airway placement. Further
evaluation may be used to further characterize the likelihood of
first-attempt success based on patient demographics and diagnosis, in
addition to providing a risk profile for those patients less likely to be
amenable to first-attempt success.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child
human
intensive care
intubation
physician
society
EMTREE MEDICAL INDEX TERMS
airway
confidence interval
devices
diagnosis
emergency
endotracheal intubation
Fisher exact test
laryngeal mask
laryngoscope
male
patient
patient transport
pediatric hospital
procedures
risk
soft contact lens
statistics
Student t test
weight
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71533347
DOI
10.1097/01.ccm.0000439307.31880.52
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000439307.31880.52
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 356
TITLE
Evaluation of ventilators used during transport of critically Ill patients:
A bench study
AUTHOR NAMES
Boussen S.
Gainnier M.
Michelet P.
AUTHOR ADDRESSES
(Boussen S., michelsalah.boussen@ap-hm.fr; Gainnier M.; Michelet P.)
Réanimation des Urgences et Médicale, Hôpital de la Timone, Marseille,
France.
CORRESPONDENCE ADDRESS
S. Boussen, Réanimation des Urgences et Médicale, Hôpital de la Timone, 254
Rue Saint Pierre, Marseille, 13005, France. Email:
michelsalah.boussen@ap-hm.fr
SOURCE
Respiratory Care (2013) 58:11 (1911-1922). Date of Publication: 1 Nov 2013
ISSN
0020-1324
1943-3654 (electronic)
BOOK PUBLISHER
American Association for Respiratory Care, 9425 N. MacArthur Blvd. Suite
100, Irving, United States.
ABSTRACT
Objective: To evaluate the most recent transport ventilators' operational
performance regarding volume delivery in controlled mode, trigger function,
and the quality of pressurization in pressure support mode. Methods: Eight
recent transport ventilators were included in a bench study in order to
evaluate their accuracy to deliver a set tidal volume under normal
resistance and compliance conditions, ARDS conditions, and obstructive
conditions. The performance of the triggering system was assessed by the
measure of the decrease in pressure and the time delay required to open the
inspiratory valve. The quality of pressurization was obtained by computing
the integral of the pressure-time curve for the first 300 ms and 500 ms
after the onset of inspiration. Results: For the targeted tidal volumes of
300, 500, and 800 mL the errors ranged from -3% to 48%, -7% to 18%, and -5%
to 25% in the normal conditions, -4% to 27%, -2% to 35%, and -3% to 35% in
the ARDS conditions, and -4% to 53%, -6% to 30%, and -30% to 28% in the
obstructive conditions. In pressure support mode the pressure drop range was
0.4 -1.7 cm H(2)O, the trigger delay range was 68-198 ms, and the
pressurization performance (percent of ideal pressurization, as measured by
pressure-time product at 300 ms and 500 ms) ranges were -9% to 44% at 300 ms
and 6%-66% at 500 ms (P <.01). Conclusions: There were important differences
in the performance of the tested ventilators. The most recent turbine
ventilators outperformed the pneumatic ventilators. The best performers
among the turbine ventilators proved comparable to modern ICU ventilators. ©
2013 Daedalus Enterprises.
EMTREE DRUG INDEX TERMS
Medumat Transport WM28400
unclassified drug
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
patient transport
ventilator
EMTREE MEDICAL INDEX TERMS
adult respiratory distress syndrome (therapy)
article
comparative study
controlled study
electric battery
gas powered ventilator
human
inhalation
intensive care unit
measurement accuracy
medical parameters
obstructive airway disease (therapy)
positive end expiratory pressure
pressure time product
tidal volume
trigger delay time
turbine ventilator
DRUG TRADE NAMES
Medumat Transport WM28400 , GermanyWeinmann Medical Technology
DRUG MANUFACTURERS
(Germany)Weinmann Medical Technology
DEVICE TRADE NAMES
Carina , GermanyDrager
Elisee 350 , United StatesResMed
Hamilton C1 , United Stateshamilton medical
Hamilton T1 , United Stateshamilton medical
Monnal T60 , FranceAir Liquide Medical System
Osiris 3 , FranceAir Liquide Medical System
Oxylog 3000+ , GermanyDrager
DEVICE MANUFACTURERS
(France)Air Liquide Medical System
(Germany)Drager
(United States)hamilton medical
(United States)ResMed
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Anesthesiology (24)
Biophysics, Bioengineering and Medical Instrumentation (27)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2013674176
MEDLINE PMID
23592785 (http://www.ncbi.nlm.nih.gov/pubmed/23592785)
PUI
L370104884
DOI
10.4187/respcare.02144
FULL TEXT LINK
http://dx.doi.org/10.4187/respcare.02144
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 357
TITLE
Predictors of transfer to rehabilitation for trauma patients admitted to a
level 1 trauma centre - A model derivation and internal validation study
AUTHOR NAMES
Dinh M.
Bein K.J.
Byrne C.
Nair I.
Petchell J.
Gabbe B.
Ivers R.
AUTHOR ADDRESSES
(Dinh M., dinh.mm@gmail.com; Bein K.J., kendallbein@tpg.com.au; Byrne C.,
chrisbyrne@hotmail.com) Emergency Department, Royal Prince Alfred Hospital,
Australia.
(Dinh M., dinh.mm@gmail.com) Department of Trauma Services, Royal Prince
Alfred Hospital, Australia.
(Byrne C., chrisbyrne@hotmail.com; Petchell J., jfpetchell@aapt.net.au)
Division of Surgery, Royal Prince Alfred Hospital, Australia.
(Nair I., Indu.Nair@sswahs.nsw.gov.au) Rehabilitation Medicine, Royal Prince
Alfred Hospital, Australia.
(Gabbe B., belinda.gabbe@monash.edu) Department of Epidemiology and
Preventive Medicine, Monash University, Australia.
(Ivers R., rivers@georgeinstitute.org.au) Injury Division, George Institute
for Global Health, Australia.
CORRESPONDENCE ADDRESS
M. Dinh, Department of Trauma Services, Royal Prince Alfred Hospital,
Australia. Email: dinh.mm@gmail.com
SOURCE
Injury (2013) 44:11 (1551-1555). Date of Publication: November 2013
ISSN
0020-1383
1879-0267 (electronic)
BOOK PUBLISHER
Elsevier Ltd, Langford Lane, Kidlington, Oxford, United Kingdom.
ABSTRACT
Objective: Determine the predictors of transfer to rehabilitation in a
cohort of trauma patients and derive a risk score based clinical prediction
tool to identify such patients during the acute phase of injury management.
Methods: Trauma registry data at a single level one trauma centre were
obtained for all patients aged between 15 and 65 years admitted due to
injury between 2007 and 2011. Multivariable logistic regression with
stepwise selection was performed to derive a prediction model for transfer
to rehabilitation. The model was tested on a validation dataset using
receiver operator characteristic analyses and bootstrap cross validation on
the entire dataset. A clinical prediction risk score was developed based on
the final model. Results: There were 4900 patients included in the study.
Variables found to be the strongest predictors of rehabilitation after
logistic regression with stepwise selection were pelvic injuries (OR 12.6
95% CI 6.2, 25.2 p < 0.001), need for intensive care unit admission (OR 7.2
95% CI 4.2, 12.3 p < 0.001) and neurosurgical operation (OR 10.5 95% CI 4.7,
23.1 p < 0.001). After bootstrap cross validation the mean AUC was 0.86 (95%
CI 0.84, 0.89). The model had a sensitivity of 89% and specificity of 64%.
Conclusion: Intensive unit admission, neurosurgical operation, pelvic
injuries and other lower limb injuries were the most important predictors of
the need for rehabilitation after trauma. The prediction model has good
overall sensitivity, discrimination and could be further validated for use
in clinical practice. © 2013 Elsevier Ltd. All rights reserved.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
injury
rehabilitation care
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
area under the curve
arm injury
article
female
hospital admission
human
intensive care unit
leg injury
major clinical study
male
neurosurgery
pelvis injury
prediction
priority journal
sensitivity and specificity
validation study
EMBASE CLASSIFICATIONS
Orthopedic Surgery (33)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2013637382
MEDLINE PMID
23669140 (http://www.ncbi.nlm.nih.gov/pubmed/23669140)
PUI
L52577965
DOI
10.1016/j.injury.2013.04.005
FULL TEXT LINK
http://dx.doi.org/10.1016/j.injury.2013.04.005
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 358
TITLE
Multidisciplinary Decision Making Needed for Patient Transfers
AUTHOR NAMES
Baggs J.
AUTHOR ADDRESSES
(Baggs J.)
CORRESPONDENCE ADDRESS
J. Baggs,
SOURCE
American Journal of Critical Care (2013) 22:6 (464). Date of Publication: 1
Nov 2013
ISSN
1062-3264
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
length of stay
mortality
patient transport
EMTREE MEDICAL INDEX TERMS
female
human
letter
male
organization and management
statistics
LANGUAGE OF ARTICLE
English
MEDLINE PMID
24186812 (http://www.ncbi.nlm.nih.gov/pubmed/24186812)
PUI
L1370362532
DOI
10.4037/ajcc2013116
FULL TEXT LINK
http://dx.doi.org/10.4037/ajcc2013116
COPYRIGHT
Copyright 2014 Medline is the source for the citation and abstract of this
record.
RECORD 359
TITLE
Response
AUTHOR NAMES
Garland A.
AUTHOR ADDRESSES
(Garland A.)
CORRESPONDENCE ADDRESS
A. Garland,
SOURCE
American Journal of Critical Care (2013) 22:6 (464). Date of Publication: 1
Nov 2013
ISSN
1062-3264
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
length of stay
mortality
patient transport
EMTREE MEDICAL INDEX TERMS
female
human
letter
male
organization and management
statistics
LANGUAGE OF ARTICLE
English
MEDLINE PMID
24186813 (http://www.ncbi.nlm.nih.gov/pubmed/24186813)
PUI
L1370362533
DOI
10.4037/ajcc2013593
FULL TEXT LINK
http://dx.doi.org/10.4037/ajcc2013593
COPYRIGHT
Copyright 2014 Medline is the source for the citation and abstract of this
record.
RECORD 360
TITLE
Treat and transfer: Efficacy and safety of the telestroke approach in
Salzburg, Austria
AUTHOR NAMES
Deak I.
Mutzenbach J.S.
Johansson T.
Trinka E.
Sellner J.
AUTHOR ADDRESSES
(Deak I.; Mutzenbach J.S.; Johansson T.; Trinka E.; Sellner J.) Department
of Neurology, Christian-Doppler Klinik, Paracelsus Medical University,
Salzburg, Austria.
CORRESPONDENCE ADDRESS
I. Deak, Department of Neurology, Christian-Doppler Klinik, Paracelsus
Medical University, Salzburg, Austria.
SOURCE
Journal of the Neurological Sciences (2013) 333 SUPPL. 1 (e258). Date of
Publication: 15 Oct 2013
CONFERENCE NAME
21st World Congress of Neurology
CONFERENCE LOCATION
Vienna, Austria
CONFERENCE DATE
2013-09-21 to 2013-09-26
ISSN
0022-510X
BOOK PUBLISHER
Elsevier
ABSTRACT
Background: Five hospitals without 24 h neurology coverage in the Austrian
state of Salzburg are connected to a stroke hub via videoconferencing.
Prompt transfer to the comprehensive stroke center (20-129 km distance) is
carried out after administration of recombinant tissue plasminogen activator
(rt-PA). Objective: To assess efficacy and safety of teleconference-assisted
thrombolysis for acute ischemic stroke and instant transfer to the stroke
center. Patients and methods: Retrospective chart review of patients treated
with acute ischemic stroke from 2006-2009. Inclusion criteria: rt-PA
administration within 4.5 h from symptom onset, age ≥18 years. Exclusion
criteria: arrival at the stroke center beyond 24 h from symptom onset,
initial NIHSS >25, and previous stroke. The measures for efficacy were
mortality, NIHSS and mRS at 3-month follow-up. Results: Forty-seven patients
were moved to the stroke center after rt-PA treatment. The control group
consisted of 304 patients who received rt-PA directly at the stroke center.
Mean time till admission to the stroke unit was 231 and 108 min,
respectively (P < 0.001). Patient demographics, NIHSS on admission and
door-to-needle time did not differ between the groups. No transfer-related
complications were reported. The rate of complications during stroke unit
care did differ between the groups. There were no differences in the outcome
measures. Conclusion: This study confirms that the efficacy of
telemedicineassisted systemic thrombolysis is comparable to in-house
administration at a comprehensive stroke center. Importantly, rapid patient
relocation was safe and provides the added benefit of care at a stroke unit
and interdisciplinary management in case of complications.
EMTREE DRUG INDEX TERMS
alteplase
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Austria
neurology
safety
EMTREE MEDICAL INDEX TERMS
blood clot lysis
brain ischemia
cerebrovascular accident
control group
follow up
hospital
human
medical record review
mortality
National Institutes of Health Stroke Scale
needle
onset age
patient
stroke unit
teleconference
videoconferencing
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71188563
DOI
10.1016/j.jns.2013.07.992
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jns.2013.07.992
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 361
TITLE
Severe neurological impairment and problematic emergency recourses: The
construction of a non-transferable patient
AUTHOR NAMES
Le Fort M.
Ville I.
Perrouin-Verbe B.
AUTHOR ADDRESSES
(Le Fort M., marc.lefort@chu-nantes.fr; Perrouin-Verbe B.) Service de
Médecine Physique et de Réadaptation Neurologique, CHU de Nantes, 85, rue
Saint-Jacques, Nantes cedex 01, France.
(Ville I.) École des Hautes-Études en Sciences Sociales, Cermes 3, France.
CORRESPONDENCE ADDRESS
M. Le Fort, Service de Médecine Physique et de Réadaptation Neurologique,
CHU de Nantes, 85, rue Saint-Jacques, Nantes cedex 01, France. Email:
marc.lefort@chu-nantes.fr
SOURCE
Annals of Physical and Rehabilitation Medicine (2013) 56 SUPPL. 1 (e269).
Date of Publication: October 2013
CONFERENCE NAME
28e Congres de Medecine Physique et de Readaptation
CONFERENCE LOCATION
Reims, France
CONFERENCE DATE
2013-10-17 to 2013-10-19
ISSN
1877-0657
BOOK PUBLISHER
Elsevier Masson SAS
ABSTRACT
Objective.- The ministerial circular of June 2004, the 18th, described the
«good conditions» of a multidisciplinary organization for neuro-traumatic
healthcare networks. Difficulties for an upstream return in case of acute
complication during a stay in a PRM department constituted the basis of this
study. Some patients' transfers from PRM were not executed in a convenient
way. The aim of this study was to determine the causes of these problematic
transfers. Patients and method.- Six severe handicap cases with a history of
problematic upstream transfer during an hospitalisation in the neurological
PRM department of Nantes' University Hospital (F) between 2006 and 2012:
semi-structured interviews, first of the six patients and of their closer
family circle, secondly of 16 acute healthcare professionals (emergency
medical service and transport, respiratory intensive care unit,
resuscitation departments). Analysis with the support of literature in
social sciences and humanities. Results.- Several explanations of transfer
difficulties, structural (notably a lack of beds in the upstream units) or
linked to the confidence from the acute healthcare departments (anticipation
of various «risks» at the PRM department level: turning back of the patient,
tracheotomy and future dependency towards an artificial breathing apparatus,
the question of active treatments limitation or cessation). A third level of
explanation directly related to the patients' functional status: an a priori
unfavourable opinion in case of cognitive impairment, especially for
born-native pathologies, multiple sclerosis or brain injury in case of lack
of perceived improvement since the admission in the PRM department.
Discussion.- Two essential findings appeared: a misunderstanding of the
professional practice between PRM and acute healthcare units, in spite of
common practices, and an imperfect perception of the patients' future by the
upstream departments practitioners. A kind of disabled patient who could be
transferred with difficulty was especially constructed in case of cognitive
impairment within precisely defined pathologies. The final goal of our
«action sociology» study is to make clearer the daily medical practices
within the framework of emergency transfers of severely impaired patients in
order to promote a renewed fluidity within our healthcare networks.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
adaptation
disability
emergency
health care
hospital organization
human
patient
EMTREE MEDICAL INDEX TERMS
brain injury
breathing circuit
cognitive defect
disabled person
emergency health service
functional status
health care personnel
humanities
intensive care unit
medical practice
multiple sclerosis
pathology
physician
professional practice
resuscitation
risk
semi structured interview
sociology
tracheotomy
university hospital
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71224923
DOI
10.1016/j.rehab.2013.07.698
FULL TEXT LINK
http://dx.doi.org/10.1016/j.rehab.2013.07.698
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 362
TITLE
Clinical information transfer and data capture in the acute myocardial
infarction pathway: An observational study
AUTHOR NAMES
Kesavan S.
Kelay T.
Collins R.E.
Cox B.
Bello F.
Kneebone R.L.
Sevdalis N.
AUTHOR ADDRESSES
(Kesavan S.; Kelay T.; Collins R.E.; Bello F.; Kneebone R.L.; Sevdalis N.,
n.sevdalis@imperial.ac.uk) Department of Surgery and Cancer, Imperial
College London, St Mary's Hospital Campus, Norfolk Place, London, W2 1PG,
United Kingdom.
(Cox B.) Business School, Imperial College London, London, United Kingdom.
CORRESPONDENCE ADDRESS
N. Sevdalis, Department of Surgery and Cancer, Imperial College London, St
Mary's Hospital Campus, Norfolk Place, London, W2 1PG, United Kingdom.
Email: n.sevdalis@imperial.ac.uk
SOURCE
Journal of Evaluation in Clinical Practice (2013) 19:5 (805-811). Date of
Publication: October 2013
ISSN
1356-1294
1365-2753 (electronic)
BOOK PUBLISHER
Blackwell Publishing Ltd, 9600 Garsington Road, Oxford, United Kingdom.
ABSTRACT
Rationale, aims and objectives Acute myocardial infarctions (MIs) or heart
attacks are the result of a complete or an incomplete occlusion of the lumen
of the coronary artery with a thrombus. Prompt diagnosis and early coronary
intervention results in maximum myocardial salvage, hence time to treat is
of the essence. Adequate, accurate and complete information is vital during
the early stages of admission of an MI patient and can impact significantly
on the quality and safety of patient care. This study aimed to record how
clinical information between different clinical teams during the journey of
a patient in the MI care pathway is captured and to review the flow of
information within this care pathway. Method A prospective, descriptive,
structured observational study to assess (i) current clinical information
systems (CIS) utilization and (ii) real-time information availability within
an acute cardiac care setting was carried out. Completeness and availability
of patient information capture across four key stages of the MI care pathway
were assessed prospectively. Results Thirteen separate information systems
were utilized during the four phases of the MI pathway. Observations
revealed fragmented CIS utilization, with users accessing an average of six
systems to gain a complete set of patient information. Data capture was
found to vary between each pathway stage and in both patient cohort risk
groupings. The highest level of information completeness (100%) was observed
only in the discharge stage of the MI care pathway. The lowest level of
information completeness (58%) was observed in the admission stage.
Conclusion The study highlights fragmentation, CIS duplication, and
discrepancies in the current clinical information capture and data transfer
across the MI care pathway in an acute cardiac care setting. The development
of an integrated and user-friendly electronic data capture and transfer
system would reduce duplication and would facilitate efficient and complete
information provision at the point of care. © 2012 John Wiley & Sons Ltd.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
acute heart infarction
EMTREE MEDICAL INDEX TERMS
article
clinical article
coronary care unit
female
high risk patient
human
information system
male
medical information system
observational study
patient information
priority journal
prospective study
EMBASE CLASSIFICATIONS
Cardiovascular Diseases and Cardiovascular Surgery (18)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2013624273
MEDLINE PMID
22587539 (http://www.ncbi.nlm.nih.gov/pubmed/22587539)
PUI
L52017406
DOI
10.1111/j.1365-2753.2012.01853.x
FULL TEXT LINK
http://dx.doi.org/10.1111/j.1365-2753.2012.01853.x
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 363
TITLE
Bouncing back with SWIFT (Stability and Workload Index for Transfer Score):
Is It applicable to ICUs in urban America?
AUTHOR NAMES
Vaquera K.
Newcomb R.
Amaransingham R.
Ma Y.
Wilhoite S.
Girod C.
Ruggiero R.
AUTHOR ADDRESSES
(Vaquera K.; Newcomb R.; Amaransingham R.; Ma Y.; Wilhoite S.; Girod C.;
Ruggiero R.) UT Southwestern Medical Center, Dallas, United States.
CORRESPONDENCE ADDRESS
K. Vaquera, UT Southwestern Medical Center, Dallas, United States.
SOURCE
Chest (2013) 144:4 MEETING ABSTRACT. Date of Publication: October 2013
CONFERENCE NAME
CHEST 2013
CONFERENCE LOCATION
Chicago, IL, United States
CONFERENCE DATE
2013-10-26 to 2013-10-31
ISSN
0012-3692
BOOK PUBLISHER
American College of Chest Physicians
ABSTRACT
PURPOSE: Over the past few decades, the number of patients surviving
critical illness has improved. However, ICU readmission rates have remained
unchanged. The armamentarium has been relatively empty regarding discharge
criteria from the ICU for physicians. In 2008, investigators from the Mayo
Clinic developed and validated a new protocol scoring system -The Stability
and Workload Index for Transfer (SWIFT) score. A standardized prediction
tool is an ideal premise to optimize patient outcomes. The SWIFT scoring
system has value in that it is the first predictive tool for intensive care
readmission. Is this scoring system to applicable to their ICU? The purpose
of this study is to assess the validity of the SWIFT Scoring System at an
ICU in an urban public hospital. METHODS: This is a retrospective
observational cohort study comprising the medical intensive care units at
Parkland Hospital. The cohort for this study consists of consecutive
patients discharged alive from the medical ICUs at Parkland Hospital from
June 1, 2010 to May 31, 2011. The primary outcome variables paralleled the
SWIFT study, measuring unplanned ICU readmission or unexpected death within
7 days of ICU discharge. The performance of the SWIFT Score was assessed
amongst our cohort for its accuracy in predicting ICU readmissions. RESULTS:
Our cohort included 2,054 patients admitted to the medical ICU at Parkland
Hospital over 1 year. Patients were excluded for ICU stay <24hrs or planned
admissions (499), those discharged home or transferred to another
hospital/ICU within 7 days (358), those discharged to comfort care (14) and
those who died during their ICU stay (141). 1,042 patients were discharged
alive and evaluated as our baseline patient population. Fifty-two patients
(5%) were readmitted to an ICU at our institution and six (0.5%) patients
died unexpectedly within 7 days; the combined readmission and unexpected
death rate was 5.5%. The sensitivity of the SWIFT score for predicting ICU
readmissions was 0.21 and specificity was 0.83. This compares with original
data showing sensitivity of 0.56 and specificity of 0.83. CONCLUSIONS: While
the specificity of the SWIFT score remained robust in our study, the
sensitivity was lacking at predicting ICU readmission.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Western Hemisphere
workload
EMTREE MEDICAL INDEX TERMS
cohort analysis
comfort
critical illness
death
hospital
hospital readmission
human
intensive care
intensive care unit
mortality
outcome variable
patient
physician
population
prediction
public hospital
scoring system
validity
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71269487
DOI
10.1378/chest.1704419
FULL TEXT LINK
http://dx.doi.org/10.1378/chest.1704419
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 364
TITLE
Discussants
AUTHOR NAMES
Inabnet W.B.
Sheetz K.H.
AUTHOR ADDRESSES
(Inabnet W.B.)
(Sheetz K.H.)
SOURCE
Annals of Surgery (2013) 258:4 (618). Date of Publication: October 2013
ISSN
0003-4932
1528-1140 (electronic)
BOOK PUBLISHER
Lippincott Williams and Wilkins, 530 Walnut Street,P O Box 327,
Philadelphia, United States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient transport
tertiary health care
EMTREE MEDICAL INDEX TERMS
emergency care
falling
intensive care unit
medical information
mortality
note
outcome assessment
priority journal
statistics
survival
United States
university hospital
EMBASE CLASSIFICATIONS
Surgery (9)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2013596306
PUI
L369865197
DOI
10.1097/SLA.0b013e3182a5021d
FULL TEXT LINK
http://dx.doi.org/10.1097/SLA.0b013e3182a5021d
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 365
TITLE
Functional analysis of choline transporter in glioma cells: Effect of
propofol on cell proliferation and choline uptake
AUTHOR NAMES
Taguchi C.
Ishida Y.
Hara N.
Ogihara Y.
Uchino H.
Inazu M.
AUTHOR ADDRESSES
(Taguchi C.; Ishida Y.; Hara N.; Ogihara Y.; Uchino H.) Department of
Anesthesiology, Tokyo Medical University, Tokyo, Japan.
(Inazu M.) Institute of Medical Science, Tokyo Medical University, Tokyo,
Japan.
CORRESPONDENCE ADDRESS
C. Taguchi, Department of Anesthesiology, Tokyo Medical University, Tokyo,
Japan.
SOURCE
Journal of Neurosurgical Anesthesiology (2013) 25:4 (512). Date of
Publication: October 2013
CONFERENCE NAME
17th Annual Meeting of the Japanese Society of Neuroanesthesia and Critical
Care, JSNACC 2013
CONFERENCE LOCATION
Tokyo, Japan
CONFERENCE DATE
2013-04-12 to 2013-04-13
ISSN
0898-4921
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Propofol is a sedative and anesthetic drug commonly used for induction and
intravenous maintenance in the operating room, for short-term procedural
sedation, and for long-term sedation in the intensive care unit.
Interestingly, previous studies suggest that propofol has neuroprotective
effects or neurotoxicity. Although, there are some studies that revealed
propofol at clinically relevant concentrations promoted the proliferation of
cancer cells. However, the mechanisms involved in its cell proliferation
remain unclear. Choline is essential for the synthesis of the major membrane
phospholipid phosphatidylcholine and the neurotransmitter acetylcholine.
Elevated levels of choline and upregulated choline kinase activity have been
detected in cancer cells. However, the uptake system for choline and the
functional expression of choline transporters are unknown. We examined the
molecular and functional characterization of choline uptake in the glioma
cell line A-172, and effect of propofol at clinically relevant
concentrations on cell proliferation and choline uptake. Choline uptake was
Na+-independent, and mediated by 2 transport systems. Choline uptake was
inhibited by the choline analogue hemicholinium-3, and decreased by
acidification of the extracellular medium. In addition, A-172 cells mainly
express mRNA and protein for choline transporter-like protein 1 (CTL1) and
CTL2, but not expressed high-affinity choline transporter 1 and organic
cation transporters. Propofol at clinically relevant concentrations
increased choline uptake and cell proliferation. These data indicated that
CTL1 and CTL2 are functionally expressed in A-172 cells and is responsible
for choline uptake, and this choline transport system uses a directed H+
gradient as a driving force. Propofol is considered to stimulate cell
proliferation by enhancing the choline uptake through the CTL2 and CTL1.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
choline
propofol
EMTREE DRUG INDEX TERMS
acetylcholine
anesthetic agent
choline kinase
hemicholinium 3
membrane phospholipid
messenger RNA
neurotransmitter
organic cation transporter
phosphatidylcholine
protein
sedative agent
synapsin I
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
anesthesia
cell proliferation
choline uptake
glioma cell
intensive care
Japanese (people)
society
EMTREE MEDICAL INDEX TERMS
acidification
cancer cell
cell line
intensive care unit
neurotoxicity
operating room
sedation
synthesis
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71215410
DOI
10.1097/ANA.0b013e3182a4d750
FULL TEXT LINK
http://dx.doi.org/10.1097/ANA.0b013e3182a4d750
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 366
TITLE
Factors affecting the threshold transfer of sick parturients to higher
levels of care
AUTHOR NAMES
James A.
Endacott R.
Stenhouse E.
AUTHOR ADDRESSES
(James A.; Endacott R.; Stenhouse E.) Plymouth University, School of Nursing
and Midwifery, Plymouth, United Kingdom.
(Endacott R.) Monash University, School of Nursing and Midwifery, Melbourne,
Australia.
CORRESPONDENCE ADDRESS
A. James, Plymouth University, School of Nursing and Midwifery, Plymouth,
United Kingdom.
SOURCE
Intensive Care Medicine (2013) 39 SUPPL. 2 (S227). Date of Publication:
October 2013
CONFERENCE NAME
26th Annual Congress of the European Society of Intensive Care Medicine,
ESICM 2013
CONFERENCE LOCATION
Paris, France
CONFERENCE DATE
2013-10-05 to 2013-10-09
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag
ABSTRACT
Introduction. Current maternal mortality rate directly or indirectly due to
pregnancy in the United Kingdom currently stands at 11.39 per 100,000
maternities (CMACE, 2011) and suboptimal care is frequently identified as a
contributing factor in these deaths. The appropriate and timely escalation
of care for maternity patients is vital in order to ensure they receive the
appropriate level of care and have safe clinical outcomes (CMACE, 2011).
This may include the need for maternity high dependency care (MHDC),
transfer to an intensive care unit (ICU) or other specialist unit. The
thresholds at which transfers to higher levels of care happen appear
variable (Maternal Critical Care Working Group, 2011). OBJECTIVES. The aim
of the research was to determine what constitutes high dependency care in
the maternity unit setting. Research questions: 1. How do clinicians define
MHDC? 2. Is there any difference in the definition of MHDC between
professional groups? 3. Does the size and type of hospital/ maternity unit
influence the definition of MHDC? METHODS. A three-round Delphi study was
used to seek consensus across experts currently involved either
directly/indirectly in the provision of/transfer to MHDC. Participants were
drawn from seven maternity units in the UK, birth rates ranging from 1,700
to 5,000. Sixty-seven doctors and midwives completed all 3 rounds. Responses
to a question about what constitutes MHDC (Round 1) were grouped into themes
and participants rated agreement on a 5 point Likert scale (Round 2).
Statements that didn't achieve consensus were presented again in Round 3,
and participants were also asked if they were familiar with the UK Intensive
Care Society levels of care. RESULTS. Four themes were identified in R1
(conditions, vigilance, interventions and service delivery), common across
anaesthetists, obstetricians and midwives. However, midwives were more
likely than doctors to request ICU admission for continuous ECG monitoring
(63.3 vs. 36.4 %) and arterial line monitoring (73.5 vs. 53.1 %). Smaller
maternity units were less likely to provide MHDC and had a more liberal
policy of transferring women to ICU. Qualitative comments indicated that a
lack of necessary equipment, facilities and skilled midwifery staff were
contributing factors. The extent of familiarity with the ICS levels of care
(14.3-57.1 % familiarity) tended to correspond with the size of Unit
(1,700-4,500 birth rate). CONCLUSIONS. Whilst it may be seen as accountable
and safe practice, this 'early' escalation of care to intensive care or HDC
has workload implications for ICUs and may also impact on the bonding
process between the mother and her baby.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
society
EMTREE MEDICAL INDEX TERMS
alertness
anesthesist
arterial line
baby
birth rate
consensus
death
Delphi study
electrocardiogram
electrocardiography monitoring
female
health care delivery
human
intensive care unit
Likert scale
maternal mortality
medical specialist
midwife
monitoring
mortality
mother
obstetric patient
obstetrician
physician
policy
pregnancy
United Kingdom
workload
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71446003
DOI
10.1007/s00134-013-3095-5
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-013-3095-5
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 367
TITLE
Evacuation of critically ill combat patients by military critical care air
transport teams with a restricted transfusion approach is safe and may have
higher return to duty rates
AUTHOR NAMES
Bebarta V.S.
Mora A.
Ervin A.
AUTHOR ADDRESSES
(Bebarta V.S.; Mora A.; Ervin A.) Air Force Enroute Care Research Center,
San Antonio Military Medical Center, San Antonio, TX; Air Force Enroute Care
Research Center, San Antonio, TX
CORRESPONDENCE ADDRESS
V.S. Bebarta,
SOURCE
Annals of Emergency Medicine (2013) 62:4 SUPPL. 1 (S30). Date of
Publication: October 2013
CONFERENCE NAME
American College of Emergency Physicians, ACEP Research Forum 2013
CONFERENCE LOCATION
Seattle, WA, United States
CONFERENCE DATE
2013-10-14 to 2013-10-15
ISSN
0196-0644
BOOK PUBLISHER
Mosby Inc.
ABSTRACT
Study Objectives: Military Critical Care Transport Teams (CCATT) rapidly
evacuate critically ill and injured patients out of theater for tertiary
care and treatment. Teams are led by a critical care physician (emergency
physician commonly), nurse, and respiratory technician. Current guidelines
require a hemoglobin (Hgb) of >= 9 g/dl to evacuate. Studies in civilian
critical care hospitals have reported fewer adverse events with a lower
hemoglobin. Our objective was to compare short term and 30-day patient
outcomes for CCATT patients evacuated out of theater with a Hgb <= 8 g/dl to
those with >8 g/dl. Methods: We conducted an IRB-approved, retrospective
medical record review of all traumatically injured patients evacuated from
Theater by CCATT between March 2007 and December 2011. We recorded
demographics, injury descriptions, vital signs, and labs and obtained
outcome data including predefined complications, procedures, and
mortality/hospital discharge status at 30 days. Patients were separated into
pre-flight Hgb≤8.0 g/dl (L-Hgb) vs. >8.0 g/dl (H-Hgb). Continuous data were
analyzed using Student's t-tests or Wilcoxon tests when appropriate and
reported as mean ± SD. Chi-square or fisher's exact tests were performed as
appropriate. Stepwise, multifactorial regression models were employed to
assess associations between demographics, injury, and outcomes. Statistical
significance was set at p<0.05. Results: Of 1257 enrolled, 219 had a
pre-flight Hgb≤8.0 (L-Hgb) and 1033 Hgb>8.0 (H-Hgb). Groups were similar in
age and gender proportions. Injury Severity Score (ISS, 24 SD ± 12.6) were
similar and the L-Hgb group had more blast injuries (76% vs. 68%, p=0.01).
Pre-flight vital signs and Post-flight vital signs and lab values were
similar. In regression model analysis no associations were identified
between pre-flight hemoglobin levels and adverse outcomes including
pneumonia, kidney injury, ARDS, sepsis, DVT/PE, MI, mechanical ventilation,
hemodialysis, or transfusions. Mortality and discharge status at 30 days
were similar. We also compared a pre-flight Hgb ≤7 g/dl versus >7 g/dl (n=45
vs 1212), and the higher Hgb group had a greater incidence of patients at 30
days receiving in-patient care (79% vs 90%, p=0.04). The group with Hgb ≤ 7
g/dl had more subjects discharged home or returning to duty (21% vs. 10%,
p=0.04). In addition there was a non-significant increase incidence of
infection in those with Hgb >7.0 g/dl (11% vs 23%, p=0.06). Conclusions:
Evacuating CCATT patients with Hgb ≤ 8 g/dl had similar serious adverse
outcomes and mortality at 30 days as compared to Hgb > 8 g/dl. Patients with
a Hgb ≤ 7 g/dl has a higher rate of return to duty and less incidence of
in-hospital care at 30 days.
EMTREE DRUG INDEX TERMS
hemoglobin
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
army
college
critically ill patient
emergency physician
human
intensive care
patient
transfusion
EMTREE MEDICAL INDEX TERMS
adult respiratory distress syndrome
adverse outcome
artificial ventilation
blast injury
Fisher exact test
flight
gender
hemodialysis
hemoglobin blood level
hospital
hospital care
hospital patient
infection
injury
injury scale
kidney injury
medical record review
model
mortality
nurse
patient care
physician
pneumonia
procedures
rank sum test
sepsis
statistical significance
Student t test
tertiary health care
vital sign
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71190143
DOI
10.1016/j.annemergmed.2013.07.361
FULL TEXT LINK
http://dx.doi.org/10.1016/j.annemergmed.2013.07.361
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 368
TITLE
Measure, report, improve: The quest for best practices for high-quality care
in critical care transport
AUTHOR NAMES
Bigham M.T.
Schwartz H.P.
AUTHOR ADDRESSES
(Bigham M.T., mbigham@chmca.org) Department of Pediatrics, Division of
Critical Care Medicine, Akron Children's Hospital, Akron, OH, United States.
(Schwartz H.P.) Department of Pediatrics, Division of Emergency Medicine,
Cincinnati Children's Hospital, Cincinnati, OH, United States.
CORRESPONDENCE ADDRESS
M.T. Bigham, Department of Pediatrics, Division of Critical Care Medicine,
One Perkins Square, Akron, OH 44308, United States. Email: mbigham@chmca.org
SOURCE
Clinical Pediatric Emergency Medicine (2013) 14:3 (171-179). Date of
Publication: September 2013
ISSN
1522-8401
1558-2310 (electronic)
BOOK PUBLISHER
W.B. Saunders Ltd, 32 Jamestown Road, London, United Kingdom.
ABSTRACT
There has been increasing attention nationally to the quality of care
provided by critical care transport teams. Much of this has been fostered by
benchmarking work done in overlapping fields of medicine. Another important
catalyst has been the landmark work by the Institute of Medicine-. Crossing
the Quality Chasm. Organizations such as the Cystic Fibrosis Foundation have
mature and transparent processes for measuring quality of care at different
hospital systems, allowing these programs to compare themselves to others
and learn from the high performers. The field of pediatric and neonatal
critical care transport strives to do the same but has only recently begun
to develop the performance measures and benchmarking strategies necessary to
do this work. This article describes examples of quality improvement
measurement and benchmarking, reviews important concepts related to
continuous quality improvement, and introduces the reader to the consensus
quality metrics established by the Ohio Neonatal/Pediatric Transport Quality
Improvement Collaborative and by the American Academy of Pediatrics' Section
on Transport Medicine. © 2013 Elsevier Inc.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
clinical practice
health care quality
intensive care
patient transport
total quality management
EMTREE MEDICAL INDEX TERMS
access to information
accreditation
article
child health care
Cystic Fibrosis Foundation Model
data base
Delphi study
electronic medical record
endotracheal intubation
evidence based medicine
human
nonbiological model
performance measurement system
practice guideline
simulation
staff training
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2013639912
PUI
L369991587
DOI
10.1016/j.cpem.2013.08.003
FULL TEXT LINK
http://dx.doi.org/10.1016/j.cpem.2013.08.003
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 369
TITLE
[Care for multi-trauma patients, from the transfer to the operating theatre
to intensive care].
ORIGINAL (NON-ENGLISH) TITLE
Les soins au patient polytraumatisé du départ au bloc à la réanimation.
AUTHOR NAMES
Dhollande N.
Vigani S.
Angot N.
Sirabella J.
AUTHOR ADDRESSES
(Dhollande N., noemie.dhollande@ap-hm.fr) Service de réanimation
traumatologique, CHU Nord Marseille, AP-HM, Chemin des Bourrely 13915
Marseille cedex 20, France.
(Vigani S.; Angot N.; Sirabella J.)
CORRESPONDENCE ADDRESS
N. Dhollande, Service de réanimation traumatologique, CHU Nord Marseille,
AP-HM, Chemin des Bourrely 13915 Marseille cedex 20, France. Email:
noemie.dhollande@ap-hm.fr
SOURCE
Soins; la revue de référence infirmière (2013) :778 (38-40). Date of
Publication: Sep 2013
ISSN
0038-0814
ABSTRACT
Nurses caring for multi-trauma patients returning from the operating theatre
need to have extensive knowledge. Their role is to prevent and detect any
complications, and namely respiratory and neurological complications, and
act efficiently to keep the patient's condition from deteriorating.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cooperation
intensive care unit
interdisciplinary communication
multiple trauma (surgery)
patient transport
postoperative complication (diagnosis)
EMTREE MEDICAL INDEX TERMS
article
France
Glasgow coma scale
human
methodology
nursing
nursing diagnosis
pain assessment
resuscitation
risk factor
vital sign
LANGUAGE OF ARTICLE
French
MEDLINE PMID
24218920 (http://www.ncbi.nlm.nih.gov/pubmed/24218920)
PUI
L563026663
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 370
TITLE
Planning for the predictable emergency admission & improving the patient
transfer process between a neuro-trauma ICU and ward
AUTHOR NAMES
Butorac L.
Chalklin K.
Manoel A.L.
AUTHOR ADDRESSES
(Butorac L.; Manoel A.L.) St. Michael's Hospital, University of Toronto,
Neurocritical Care, Toronto, Canada.
(Chalklin K.) St. Michael's Hospital, Trauma Neurosurgery and Mobility
Programs, Toronto, Canada.
CORRESPONDENCE ADDRESS
L. Butorac, St. Michael's Hospital, University of Toronto, Neurocritical
Care, Toronto, Canada.
SOURCE
Neurocritical Care (2013) 19:1 SUPPL. 1 (S162). Date of Publication:
September 2013
CONFERENCE NAME
11th Annual Meeting of the Neurocritical Care Society
CONFERENCE LOCATION
Philadelphia, PA, United States
CONFERENCE DATE
2013-10-01 to 2013-10-04
ISSN
1541-6933
BOOK PUBLISHER
Humana Press
ABSTRACT
Introduction The complex needs of neurosurgical patients present unique
challenges across the continuum of care. The Trauma/Neurosurgery (TN)
Program endeavored to improve patient access to care by planning for
unexpected overnight admissions and enhancing the patient transfer process
from the Neuro-Trauma Intensive Care Unit (TN ICU) to the TN Ward. Methods
The TN program see 5 admissions overnight more than 50% of the time. In
order to accommodate the Emergency patient, two less acute TN ward
inpatients were bedspaced to alternate units prior to night shift to create
two flow beds. The project also aimed to support an early morning patient
transfer process between the TNICU and TN ward. Multidisciplinary
brainstorming was held to identify processes required to discharge two
patients by 09:00h from the TN ward, to be able to accommodate two patients
by 10:00h from the TNICU. Process maps were developed to show the necessary
communication, action items and transfer points that would support
discharging patients earlier from the TN ward to accommodate TNICU
transfers. Results Flow beds were successfully created over 85% of time by
proactively bedspacing patients within the hospital. This reduced overnight
bedspacing of patients by 50% increasing staff and patient satisfaction.
Emergency department metrics including length of stay and time from
admission to bed were improved by 25% and 43% respectively at the 90th
percentile. Both changes were statistically significant at the 1% level.
Total inpatient length of stay was reduced by over 10%. Conclusions
Processes that focus on proactively planning for predictable demand,
combined with strategies for demand and capacity matching, allowed for
smoother flow through the TN program and an improved patient experience.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency
human
injury
patient transport
planning
society
ward
EMTREE MEDICAL INDEX TERMS
brainstorming
emergency patient
emergency ward
hospital
hospital patient
intensive care unit
interpersonal communication
length of stay
neurosurgery
night
patient
patient satisfaction
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71194617
DOI
10.1007/s12028-013-9895-1
FULL TEXT LINK
http://dx.doi.org/10.1007/s12028-013-9895-1
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 371
TITLE
Implementation of a standard handoff process facilitates transfer of care of
cardiac surgical patients from operating room to ICU
AUTHOR NAMES
Dixon J.
Stagg H.W.
Wehbe-Janek H.
Jo C.
Culp W.C.
Shake J.G.
AUTHOR ADDRESSES
(Dixon J.; Stagg H.W.; Wehbe-Janek H.; Jo C.; Culp W.C.; Shake J.G.) Scott
and White Memorial Hospital, Temple, United States.
CORRESPONDENCE ADDRESS
J. Dixon, Scott and White Memorial Hospital, Temple, United States.
SOURCE
Journal of the American College of Surgeons (2013) 217:3 SUPPL. 1 (S75).
Date of Publication: September 2013
CONFERENCE NAME
99th Annual Clinical Congress of the American College of Surgeons
CONFERENCE LOCATION
Washington, DC, United States
CONFERENCE DATE
2013-10-06 to 2013-10-10
ISSN
1072-7515
BOOK PUBLISHER
Elsevier Inc.
ABSTRACT
INTRODUCTION: Patient handoffs are high-risk times associated with sentinel
events. Effective handoff processes may enhance patient safety and
communication between team members. This study assesses impact of a
standardized, checklist-driven protocol for the cardiac surgery OR-to-ICU
handoff, using a prospective pre-post study design. METHODS: A formalized
handoff process was developed including critical handoff elements and a
standardized handoff procedure, script, and checklist. Implementation of the
process was preceded by a three month education period. Data was collected
two months prior to education (Pre) and three months following
implementation (Post). Data was collected from (A) sixty handoff
observations (30 Pre and 30 Post) evaluating 52 unique parameters, and (B)
surveys from OR and ICU providers on perspectives of the handoff process.
Results were tabulated by percentages or descriptive statistics and compared
by chi-square test, two sample t-test, or nonparametric Mann-Whitney test.
Statistical significance was defined as P<0.05. RESULTS: Median time until
ventilator connection, ICU monitor transfer, first cardiac index, and chest
radiograph were reduced after implementation (respectively Pre vs Post, 60s
vs 30s, 210s vs 160s, 708s vs 690s, and 1980s vs 1235s, P<0.05). The
completion of handoff process components improved posteimplementation for 36
of 47 non-time parameters (Table represents 7 items). Providers'
perspectives of the process improved in 19 of 23 survey items (P<0.001).
CONCLUSIONS: A standard checklist-driven handoff process can dramatically
improve key data transmission and reduce time of critical patient care steps
during the high risk period of patient handoff in a cardiac surgical ICU.
(Table Presented).
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
college
human
operating room
surgeon
surgical patient
EMTREE MEDICAL INDEX TERMS
cardiac index
checklist
chi square test
clinical handover
education
heart surgery
interpersonal communication
parameters
patient care
patient safety
procedures
rank sum test
risk
sentinel event
statistical significance
statistics
Student t test
study design
thorax radiography
ventilator
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71167342
DOI
10.1016/j.jamcollsurg.2013.07.163
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jamcollsurg.2013.07.163
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 372
TITLE
Patient transport experience in our institution following open heart surgery
ORIGINAL (NON-ENGLISH) TITLE
Enstitümüzde açik kalp cerrahisi sonrasi hasta transport deneyimimiz
AUTHOR NAMES
Sivrikoz N.
Savran Karadeniz M.
Kurnaz P.
Altun D.
Sungur Ülke Z.
Tuǧrul M.
Pempeci K.
AUTHOR ADDRESSES
(Sivrikoz N., ntsz06@gmail.com; Savran Karadeniz M.; Altun D.; Sungur Ülke
Z.; Tuǧrul M.; Pempeci K.) I.Ü. Istanbul Tip Fakültesi, Anesteziyoloji ve
Reanimasyon Anabilim Dali, Çapa / Istanbul, Turkey.
(Kurnaz P.) Tekirdaǧ Malkara Devlet Hastanesi, Anesteziyoloji Kliniǧi,
Turkey.
CORRESPONDENCE ADDRESS
N. Sivrikoz, I.Ü. Istanbul Tip Fakültesi, Anesteziyoloji ve Reanimasyon
Anabilim Dali, Çapa / Istanbul, Turkey. Email: ntsz06@gmail.com
SOURCE
Gogus-Kalp-Damar Anestezi ve Yogun Bakim Dernegi Dergisi (2013) 19:3
(127-131). Date of Publication: September 2013
ISSN
1305-5550
BOOK PUBLISHER
Turkish Anaesthesiology and Intensive Care Society, Yildiz Posta Caddesi,
Sinan Apt. No; 36 D: 66/67, Gayrettepe-Istanbul, Turkey.
ABSTRACT
Objective: Transporting critically ill patients is very often associated
with problems and complications. Previous reports studied incidence of
complications with associated factors for different patients groups. The aim
of our study is to investigate complications during an in-hospital transport
of highly special group as postoperative cardiac surgical patients. Material
and Methods: All patients undergoing elective open heart surgery between
January-September 2013 were included in the study. The commencement of the
patient transport was determined as transfer of the patients from inbuilt to
portable ventilator and ventilator. The transport was terminated wheren
patients were again attached to ventilator and monitor of ICU. Hemodynamic
parameters (blood pressures, heart rate, oxygen saturation) were all noted
with arterial gas analysis on admission into ICU. All complications during
transport were also recorded. Results: During the study period 240 subjects,
including 108 adults and 132 children were enrolled in the study. Most
frequent complication was respiratory alkalosis due to hyperventilation
(13,75%). Other problems were hypotension (2,5%), arterial decannulation
(2,5%), difficult ventilation (1,66%), respiratory acidosis (0,82%),
inadvertent removal of central venous catheter (0,4%). One patient had
cardiac arrest and was successfully resuscitated. Conclusion: Postoperative
cardiac surgery patients could be transported with minor complications. We
think that reduced incidence of adverse events was related to short
transport time as well as to experienced transport team.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
open heart surgery
patient transport
EMTREE MEDICAL INDEX TERMS
adult
arterial decannulation
artery disease
article
catheter removal
central venous catheter
child
dyspnea
heart arrest
hemodynamics
human
hyperventilation
hypotension
intensive care unit
major clinical study
respiratory acidosis
respiratory alkalosis
resuscitation
ventilator
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Cardiovascular Diseases and Cardiovascular Surgery (18)
LANGUAGE OF ARTICLE
Turkish
LANGUAGE OF SUMMARY
English, Turkish
EMBASE ACCESSION NUMBER
2013759383
PUI
L370377092
DOI
10.5222/GKDAD.2013.127
FULL TEXT LINK
http://dx.doi.org/10.5222/GKDAD.2013.127
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 373
TITLE
Multi-institutional comparison of helicopter transfers directly to the
operating room versus the pit stop in the emergency department
AUTHOR NAMES
Van Der Wilden G.M.
Janjua S.
Wedel S.K.
Agarwal S.
Shapiro M.L.
Andersen N.D.
Odom S.R.
Gates J.D.
Frakes M.A.
Chang Y.
Velmahos G.C.
Alam H.B.
King D.R.
De Moya M.A.
AUTHOR ADDRESSES
(Van Der Wilden G.M., gvanderwilden@gmail.com; Janjua S.; Chang Y.; Velmahos
G.C.; Alam H.B.; King D.R.; De Moya M.A.) Clinical Research Fellow, Surgery,
Massachusetts General Hospital and Harvard Medical School, 165 Cambridge
Street, Boston, MA 02114, United States.
(Wedel S.K.; Frakes M.A.) Boston MedFlight, Boston, MA, United States.
(Agarwal S.) Boston Medical Center and Boston University, Boston, MA, United
States.
(Shapiro M.L.; Andersen N.D.) Duke University Medical Center and Duke
University, Durham, NC, United States.
(Odom S.R.) Beth Israel Deaconess Medical Center and Harvard Medical School,
Boston, MA, United States.
(Gates J.D.) Brigham and Women's Hospital and Harvard Medical School,
Boston, MA, United States.
CORRESPONDENCE ADDRESS
G.M. Van Der Wilden, Clinical Research Fellow, Surgery, Massachusetts
General Hospital and Harvard Medical School, 165 Cambridge Street, Boston,
MA 02114, United States. Email: gvanderwilden@gmail.com
SOURCE
American Surgeon (2013) 79:9 (939-943). Date of Publication: September 2013
ISSN
0003-1348
BOOK PUBLISHER
Southeastern Surgical Congress, 141 West Wieuca Road, Suite B100, Atlanta,
United States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency ward
operating room
patient transport
EMTREE MEDICAL INDEX TERMS
accidental injury
adult
aged
child
comparative study
conference paper
controlled study
female
helicopter
hospital cost
human
intensive care unit
length of stay
major clinical study
male
mortality
outcome assessment
school child
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2013564299
MEDLINE PMID
24069995 (http://www.ncbi.nlm.nih.gov/pubmed/24069995)
PUI
L369768141
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 374
TITLE
[Care for multi-trauma patients, from the transfer to the operating theatre
to intensive care]
ORIGINAL (NON-ENGLISH) TITLE
Les soins au patient polytraumatisé du départ au bloc à la réanimation
AUTHOR NAMES
Dhollande N.
Vigani S.
Angot N.
Sirabella J.
AUTHOR ADDRESSES
(Dhollande N.; Vigani S.; Angot N.; Sirabella J.) Service de réanimation
traumatologique, CHU Nord Marseille, AP-HM, Chemin des Bourrely 13915
Marseille cedex 20, France. noemie.dhollande@ap-hm.fr
SOURCE
Soins; la revue de référence infirmière (2013) :778 (38-40). Date of
Publication: 1 Sep 2013
ISSN
0038-0814
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cooperation
intensive care unit
interdisciplinary communication
nursing
procedures
EMTREE MEDICAL INDEX TERMS
France
Glasgow coma scale
human
multiple trauma (surgery)
nursing diagnosis
pain measurement
patient transport
postoperative complication (diagnosis)
resuscitation
risk factor
vital sign
LANGUAGE OF ARTICLE
French
LANGUAGE OF SUMMARY
French
MEDLINE PMID
24218920 (http://www.ncbi.nlm.nih.gov/pubmed/24218920)
PUI
L603392954
COPYRIGHT
Copyright 2015 Medline is the source for the citation and abstract of this
record.
RECORD 375
TITLE
Impact of telemedicine on hospital transport, length of stay, and medical
outcomes in infants with suspected heart disease: A multicenter study
AUTHOR NAMES
Webb C.L.
Waugh C.L.
Grigsby J.
Busenbark D.
Berdusis K.
Sahn D.J.
Sable C.A.
AUTHOR ADDRESSES
(Webb C.L., webbcl@med.umich.edu) University of Michigan Congenital Heart
Center, C.S. Mott Children's Hospital, 1540 East Medical Center Drive, Ann
Arbor, MI 48109, United States.
(Waugh C.L.; Berdusis K.) Ann and Robert H. Lurie Children's Hospital,
Chicago, IL, United States.
(Grigsby J.; Busenbark D.) University of Colorado Denver, Denver, CO, United
States.
(Sahn D.J.) Oregon Health Sciences University, Portland, OR, United States.
(Sable C.A.) Children's National Medical Center, Washington, DC, United
States.
CORRESPONDENCE ADDRESS
C.L. Webb, University of Michigan Congenital Heart Center, C.S. Mott
Children's Hospital, 1540 East Medical Center Drive, Ann Arbor, MI 48109,
United States. Email: webbcl@med.umich.edu
SOURCE
Journal of the American Society of Echocardiography (2013) 26:9 (1090-1098).
Date of Publication: September 2013
ISSN
0894-7317
1097-6795 (electronic)
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
ABSTRACT
Background Previous single-center studies have shown that telemedicine
improves care in newborns with suspected heart disease. The aim of this
study was to test the hypothesis that telemedicine would shorten time to
diagnosis, prevent unnecessary transports, reduce length of stay, and
decrease exposure to invasive treatments. Methods Nine pediatric cardiology
centers entered data prospectively on patients aged <6 weeks, matched by
gestational age, weight, and diagnosis. Subjects born at hospitals with and
without access to telemedicine constituted the study group and control
groups, respectively. Data from patients with mild or no heart disease were
analyzed. Results Data were obtained for 337 matched pairs with mild or no
heart disease. Transport to a tertiary care center (4% [n = 15] vs 10% [n =
32], P =.01), mean time to diagnosis (100 vs 147 min, P <.001), mean length
of stay (1.0 vs 26 days, P =.005) and length of intensive care unit stay
(0.96 vs 2.5 days, P =.024) were significantly less in the telemedicine
group. Telemedicine patients were significantly farther from tertiary care
hospitals than control subjects. The use of inotropic support and
indomethacin was significantly less in the telemedicine group. By
multivariate analysis, telemedicine patients were less likely to be
transported (odds ratio, 0.44; 95% confidence interval, 0.23-0.83) and less
likely to be placed on inotropic support (odds ratio, 0.16; 95% confidence
interval, 0.10-0.28). Conclusions Telemedicine shortened the time to
diagnosis and significantly decreased the need for transport of infants with
mild or no heart disease. The length of hospitalization and intensive care
stay and use of indomethacin and inotropic support were less in telemedicine
patients.
EMTREE DRUG INDEX TERMS
indometacin
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child hospitalization
heart disease (diagnosis)
infant disease (diagnosis)
length of stay
patient transport
telemedicine
treatment outcome
EMTREE MEDICAL INDEX TERMS
artificial ventilation
body weight
brain hemorrhage (complication)
child death
cohort analysis
controlled study
drug use
extracorporeal oxygenation
female
gestational age
heart arrest (complication)
human
infant
inotropism
intensive care unit
invasive procedure
male
multicenter study
pediatric cardiology
pediatric hospital
prospective study
review
tertiary health care
CAS REGISTRY NUMBERS
indometacin (53-86-1, 74252-25-8, 7681-54-1)
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
Cardiovascular Diseases and Cardiovascular Surgery (18)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2013568341
MEDLINE PMID
23860093 (http://www.ncbi.nlm.nih.gov/pubmed/23860093)
PUI
L52680203
DOI
10.1016/j.echo.2013.05.018
FULL TEXT LINK
http://dx.doi.org/10.1016/j.echo.2013.05.018
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 376
TITLE
Safety of intrahospital transport in ventilated critically III patients: A
multicenter cohort study
AUTHOR NAMES
Schwebel C.
Clec'h C.
Magne S.
Minet C.
Garrouste-Orgeas M.
Bonadona A.
Dumenil A.-S.
Jamali S.
Kallel H.
Goldgran-Toledano D.
Marcotte G.
Azoulay E.
Darmon M.
Ruckly S.
Souweine B.
Timsit J.-F.
AUTHOR ADDRESSES
(Schwebel C., cschwebel@chu-grenoble.fr; Minet C.; Bonadona A.; Timsit
J.-F.) Medical ICU, Albert Michallon Teaching Hospital, University Joseph
Fourier, Grenoble, France.
(Clec'h C.) Medical-Surgical ICU, Avicenne University Hospital, Bobigny,
France.
(Magne S.; Garrouste-Orgeas M.; Ruckly S.; Timsit J.-F.) University Grenoble
1 Integrated Research Center U 823, Albert Bonniot Institute, Rond Point de
la Chantourne, La Tronche cedex, France.
(Garrouste-Orgeas M.) Polyvalent ICU, Groupe Hospitalier St Joseph, Paris,
France.
(Dumenil A.-S.) Surgical ICU, University Hospital, Antoine Beclere, Clamart,
France.
(Jamali S.) Medical Surgical ICU, General Hospital, Dourdan, France.
(Kallel H.) Medical Surgical ICU, General Hospital, Cayenne, France.
(Goldgran-Toledano D.) Medical Surgical ICU, General Hospital, Gonesse,
France.
(Marcotte G.) Surgical ICU, Edouard Herriot Teaching Hospital, Lyon, France.
(Azoulay E.) Medical ICU, University Hospital St Louis, Paris, France.
(Darmon M.) Medical ICU, University Hospital St Etienne, St Etienne, France.
(Souweine B.) Medical ICU, Gabriel Montpied University Hospital,
Clermont-Ferrand, France.
CORRESPONDENCE ADDRESS
Medical ICU, Albert Michallon Teaching Hospital, University Joseph Fourier,
Grenoble, France.
SOURCE
Critical Care Medicine (2013) 41:8 (1919-1928). Date of Publication: August
2013
ISSN
0090-3493
1530-0293 (electronic)
BOOK PUBLISHER
Lippincott Williams and Wilkins, 530 Walnut Street,P O Box 327,
Philadelphia, United States.
ABSTRACT
Objectives: To describe intrahospital transport complications in critically
ill patients receiving invasive mechanical ventilation. Design: Prospective
multicenter cohort study. Setting: Twelve French ICUs belonging to the
OUTCOMEREA study group. Patients: Patients older than or equal to 18 years
old admitted in the ICU and requiring invasive mechanical ventilation
between April 2000 and November 2010 were included. Interventions: None.
Measurements and Main Results: Six thousand two hundred forty-two patients
on invasive mechanical ventilation were identified in the OUTCOMEREA
database. The statistical analysis included a description of demographic and
clinical characteristics of the cohort, identification of risk factors for
intrahospital transport and construction of an intrahospital transport
propensity score, and an exposed/unexposed study to compare complication of
intrahospital transport (excluding transport to the operating room) after
adjustment on the propensity score, length of stay, and confounding factors
on the day before intrahospital transport. Three thousand and six
intrahospital transports occurred in 1,782 patients (28.6%) (1-17
intrahospital transports/patient). Transported patients had higher admission
Simplified Acute Physiology Score II values (median [interquartile range],
51 [39-65] vs 46 [33-62], p < 10(-4)) and longer ICU stay lengths (12 [6-23]
vs 5 [3-11] d, p < 10(-4)). Post-intrahospital transport complications were
recorded in 621 patients (37.4%). We matched 1,659 intrahospital transport
patients to 3,344 nonintrahospital transport patients according to the
intrahospital transport propensity score and previous ICU stay length. After
adjustment, intrahospital transport patients were at higher risk for various
complications (odds ratio = 1.9; 95% CI, 1.7-2.2; p < 10(-4)), including
pneumothorax, atelectasis, ventilator-associated pneumonia, hypoglycemia,
hyperglycemia, and hypernatremia. Intrahospital transport was associated
with a longer ICU length of stay but had no significant impact on mortality.
Conclusions: Intrahospital transport increases the risk of complications in
ventilated critically ill patients. Continuous quality improvement programs
should include specific procedures to minimize intrahospital
transport-related risks. Copyright © 2013 by the Society of Critical Care
Medicine and Lippincott Williams & Wilkins.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
patient safety
patient transport
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
article
artificial ventilation
atelectasis (complication)
child
cohort analysis
female
human
hyperglycemia (complication)
hypernatremia (complication)
hypoglycemia (complication)
infant
intensive care unit
length of stay
major clinical study
male
multicenter study
newborn
pneumothorax (complication)
preschool child
priority journal
propensity score
prospective study
risk factor
school child
Simplified Acute Physiology Score
ventilator associated pneumonia (complication)
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2013482723
MEDLINE PMID
23863225 (http://www.ncbi.nlm.nih.gov/pubmed/23863225)
PUI
L369460254
DOI
10.1097/CCM.0b013e31828a3bbd
FULL TEXT LINK
http://dx.doi.org/10.1097/CCM.0b013e31828a3bbd
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 377
TITLE
Reducing the risks of intrahospital transport among critically III patients
AUTHOR NAMES
Nuckols T.K.
AUTHOR ADDRESSES
(Nuckols T.K.) Division of General Internal Medicine and Health Services
Research, Department of Medicine, David Geffen School of Medicine at UCLA,
Los Angeles, CA, United States.
CORRESPONDENCE ADDRESS
T.K. Nuckols, Division of General Internal Medicine and Health Services
Research, Department of Medicine, David Geffen School of Medicine at UCLA,
Los Angeles, CA, United States.
SOURCE
Critical Care Medicine (2013) 41:8 (2044-2045). Date of Publication: August
2013
ISSN
0090-3493
1530-0293 (electronic)
BOOK PUBLISHER
Lippincott Williams and Wilkins, 530 Walnut Street,P O Box 327,
Philadelphia, United States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
patient transport
EMTREE MEDICAL INDEX TERMS
critical illness
editorial
hospital care
human
intensive care
intensive care unit
priority journal
risk reduction
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2013482744
MEDLINE PMID
23863242 (http://www.ncbi.nlm.nih.gov/pubmed/23863242)
PUI
L369460271
DOI
10.1097/CCM.0b013e31828fd714
FULL TEXT LINK
http://dx.doi.org/10.1097/CCM.0b013e31828fd714
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 378
TITLE
Physician order discrepancies during patient transfer from the intensive
care unit to medical and surgical wards
AUTHOR NAMES
Maraschiello M.A.
Fowler R.
Amaral A.C.
Xiong W.
Pinto R.
AUTHOR ADDRESSES
(Maraschiello M.A.; Fowler R.; Amaral A.C.; Xiong W.; Pinto R.) Sunnybrook
Hospital, University of Toronto, Toronto, Canada.
CORRESPONDENCE ADDRESS
M.A. Maraschiello, Sunnybrook Hospital, University of Toronto, Toronto,
Canada.
SOURCE
American Journal of Respiratory and Critical Care Medicine (2013) 187
MeetingAbstracts. Date of Publication: 2013
CONFERENCE NAME
American Thoracic Society International Conference, ATS 2013
CONFERENCE LOCATION
Philadelphia, PA, United States
CONFERENCE DATE
2013-05-17 to 2013-05-22
ISSN
1073-449X
BOOK PUBLISHER
American Thoracic Society
ABSTRACT
Rationale: The transition of care in hospitals from one service to another
represents a patient safety threat due to the loss or misinterpretation of
information. The objective of this study was to evaluate the rate of
omissions in transfer orders of patients from the ICU to an in-patient ward.
Methods: A retrospective chart review of 100 ICU patient discharges to an
in-hospital non-ICU service from January 1 to August 31 2011 at Sunnybrook
Health Sciences Centre, a tertiary care university teaching hospital in
Toronto, Canada. Transfer orders were abstracted from charts for the
recording of: (1) accepting service and attending physician (primary
outcome) and (2) antibiotic medication stop dates (secondary outcome). These
variables were compared across three groups: the ICU service writing the
orders (versus the accepting service), the use of pre-printed orders (versus
de novo hand-generated orders), and orders written during an ' on call'
period (versus daytime period, 0900-1700h). These outcomes were first
described in a univariate analysis with three explanatory groups, and the
primary outcome was also described in a multivariate analysis. Results:
Orders written by the accepting service were significantly more likely to
correctly record the attending physician and accepting service when compared
to orders written by the ICU. These effect persisted after multivariable
adjustment, with an Odds Ratio of 0.38 (95% CI 0.147-0.983, p=0.046). There
was no difference in the primary outcome (recorded attending physician and
accepting service) when comparing pre printed and hand written orders, or on
call vs daytime orders. Orders completed with the use of a pre printed
document were significantly more likely to record antibiotic stop dates when
compared to orders written by hand but there was no difference when
comparing ICU and accepting service written orders, or on call and daytime
written orders. Conclusions: The receiving service and attending are
incorrectly recorded for 33% of patient transfers from ICU. Antibiotic stop
dates are incorrectly ordered for 47.5% of patient transfers from ICU. When
the accepting service writes transfer orders, it is more likely that the
accepting attending and service are recorded. When pre-printed transfer
orders are used, it is more likely that correct antibiotic stop dates will
be recorded. Further work is needed before recommendations can be made about
the most appropriate service and process to write transfer orders from the
ICU to in-patient wards. (Table Presented).
EMTREE DRUG INDEX TERMS
antibiotic agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
American
human
intensive care unit
patient transport
physician
society
surgical ward
EMTREE MEDICAL INDEX TERMS
Canada
drug therapy
health science
hospital
hospital discharge
hospital patient
medical record review
multivariate analysis
patient
patient safety
recording
risk
teaching hospital
tertiary health care
univariate analysis
university
ward
writing
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71983392
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 379
TITLE
A preliminary study of the impact of a handover cognitive aid on clinical
reasoning and information transfer
AUTHOR NAMES
Weiss M.J.
Bhanji F.
Fontela P.S.
Razack S.I.
AUTHOR ADDRESSES
(Weiss M.J.; Bhanji F.; Fontela P.S.; Razack S.I.) Division of Pediatric
Critical Care, McGill University, Montréal, Québec, Canada.
matthew-john.weiss@mail.chuq.qc.ca
SOURCE
Medical education (2013) 47:8 (832-841). Date of Publication: 1 Aug 2013
ISSN
1365-2923 (electronic)
ABSTRACT
OBJECTIVES: To assess the impact of a written cognitive aid on expressed
clinical reasoning and quantity and the accuracy of information transfer
during resident doctor handover.METHODS: This study was a randomised
controlled trial in an academic paediatric intensive care unit (PICU) of 20
handover events (10 events per group) from residents in their first PICU
rotation using a written handover cognitive aid (intervention) or standard
practice (control). Before rounds, an investigator generated a reference
standard of the handover event by completing a handover aid. Resident
handovers were then audio-recorded and transcribed by a blinded research
assistant. The content of this transcript was inserted into a blank handover
aid. A blinded content expert scored the quantity and accuracy of the
information in this aid according to predetermined criteria and these
information scores (ISs) were compared with the reference standard. The same
expert also blindly scored the transcripts in five domains of clinical
reasoning and effectiveness: (i) effective summary of events; (ii) expressed
understanding of the care plan; (iii) presentation clarity; (iv)
organisation; (v) overall handover effectiveness. Differences between
intervention and control groups were assessed using the Mann-Whitney test
and multivariate linear regression.RESULTS: The intervention group had total
ISs that more closely approximated the reference standard (81% versus 61%;
p < 0.01). The intervention group had significantly higher clinical
reasoning scores when compared by total score (21.1 versus 15.9 points;
p = 0.01) and in each of the five domains. No difference was observed in the
duration of handover between groups (7.4 versus 7.7 minutes; p =
0.97).CONCLUSIONS: Using a novel scoring system, our simple handover
cognitive aid was shown to improve information transfer and resident
expression of clinical reasoning without prolonging the handover duration.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
psychology
standards
EMTREE MEDICAL INDEX TERMS
Canada
child
clinical competence
clinical handover
controlled study
health personnel attitude
human
intensive care unit
interpersonal communication
medical student
patient transport
randomized controlled trial
regression analysis
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
23837430 (http://www.ncbi.nlm.nih.gov/pubmed/23837430)
PUI
L602258014
DOI
10.1111/medu.12212
FULL TEXT LINK
http://dx.doi.org/10.1111/medu.12212
COPYRIGHT
Copyright 2015 Medline is the source for the citation and abstract of this
record.
RECORD 380
TITLE
Severe sepsis and septic shock: Worse outcomes seen in patients transferred
to icu from wards compared to emergency department
AUTHOR NAMES
Garcia-Diaz J.
Traugott K.
Seoane L.
Pavlov A.
Briski D.
Nash T.
Winterbottom F.
Dornelles A.
Shum L.
Sundell E.
AUTHOR ADDRESSES
(Garcia-Diaz J.; Traugott K., ktraugott@ochsner.org; Seoane L.; Nash T.;
Winterbottom F.; Dornelles A.; Shum L.; Sundell E.) Ochsner Clinic
Foundation, New Orleans, United States.
(Pavlov A.; Briski D.) University of Queensland, New Orleans, United States.
CORRESPONDENCE ADDRESS
K. Traugott, Ochsner Clinic Foundation, New Orleans, United States. Email:
ktraugott@ochsner.org
SOURCE
American Journal of Respiratory and Critical Care Medicine (2013) 187
MeetingAbstracts. Date of Publication: 2013
CONFERENCE NAME
American Thoracic Society International Conference, ATS 2013
CONFERENCE LOCATION
Philadelphia, PA, United States
CONFERENCE DATE
2013-05-17 to 2013-05-22
ISSN
1073-449X
BOOK PUBLISHER
American Thoracic Society
ABSTRACT
Background: Sepsis is a leading cause of death in the United States.
In-hospital transfer of admitted patients to the ICU has been associated
with higher mortality and length of stay (LOS) compared to patients directly
admitted to ICU from the emergency department (ED). We evaluated the
difference in mortality between patients admitted to the ICU from the
general medical/surgical wards and ED with severe sepsis and septic shock
(SS&SH) who were treated with bundled order sets. Methods: This prospective
study enrolled 902 consecutive patients admitted to the MICU from July 1,
2008 to March 31, 2012 with a diagnosis of SS&SH as part of a quality
improvement initiative. The quality improvement project involved ED and ICU
sepsis bundles that focused on early goal directed therapy including rapid
delivery of broad spectrum antibiotics. Program success was measured by
number of patients receiving perfect care (PC), defined as meeting all
“goals” in process of care for patients with SS&SH. Results: 767 patients
were evaluated for the outcome of in-hospital mortality stratified by
location, ED vs general medical/surgical ward. 606 (79%) patients were
diagnosed in the ED compared to 161 (21%) on the ward. Baseline
characteristics were similar between groups including average APACHE scores
(ED, 23.4±8.7 vs floor, 23.9±7.4, p=0.56). In-hospital mortality was lower
in patients diagnosed in ED vs floor (17.3% vs 24.8%, p=0.03). Additionally,
significantly shorter LOS was demonstrated in the ED group (9.3±8.5 vs
13.9±11.4 days, p<0.001). Goals met at 6 hours (71.3% vs 57.8%, p<0.001) and
antibiotics within 2 hours of diagnosis (81% vs 41%, p<0.001) occurred
significantly more frequently in patients diagnosed in ED. Consequently,
more patients received PC in the ED group compared to floor patients (50% vs
0.62%; p<0.001). Conclusion: Patients who develop SS&SH on the wards have an
increased in-hospital mortality and hospital LOS. These patients also
experience less streamlined process of care prior to ICU admission as
demonstrated by a delay in time to antibiotics and less PC. Improved
processes to identify these patients earlier and improve timely
resuscitation and time to antibiotics may improve outcomes for this cohort.
EMTREE DRUG INDEX TERMS
antibiotic agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
American
emergency ward
human
patient
sepsis
septic shock
society
ward
EMTREE MEDICAL INDEX TERMS
APACHE
cause of death
diagnosis
hospital
length of stay
mortality
prospective study
resuscitation
therapy
total quality management
United States
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71980932
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 381
TITLE
Delayed intensive care unit transfer is associated with increased mortality
in ward patients
AUTHOR NAMES
Churpek M.M.
Yuen T.C.
Edelson D.P.
AUTHOR ADDRESSES
(Churpek M.M., Matthew.Churpek@uchospitals.edu; Yuen T.C.; Edelson D.P.)
University of Chicago, Chicago, United States.
CORRESPONDENCE ADDRESS
M.M. Churpek, University of Chicago, Chicago, United States. Email:
Matthew.Churpek@uchospitals.edu
SOURCE
American Journal of Respiratory and Critical Care Medicine (2013) 187
MeetingAbstracts. Date of Publication: 2013
CONFERENCE NAME
American Thoracic Society International Conference, ATS 2013
CONFERENCE LOCATION
Philadelphia, PA, United States
CONFERENCE DATE
2013-05-17 to 2013-05-22
ISSN
1073-449X
BOOK PUBLISHER
American Thoracic Society
ABSTRACT
RATIONALE: Early intervention improves outcomes in many conditions that are
indications for intensive care unit (ICU) transfer, such as septic shock and
respiratory failure. However, the impact of delayed ICU transfer on the
mortality of critically ill ward patients is poorly characterized. We
investigated the impact of delayed transfer by using the Cardiac Arrest Risk
Triage (CART) score, a previously published vital sign-based early warning
score, as an objective measure of critical illness. METHODS: We performed a
cohort study at an academic hospital that included all patients admitted to
the medical-surgical wards between November 2008 and January 2011. CART
scores were calculated for all patients on the wards and the score cut-off
corresponding to a specificity of 95% for ICU transfer was defined as the
value denoting critical illness a priori. Time from when a patient first
reached this CART score value until transfer to the ICU was calculated for
each patient, up to a maximum of 24 hours. Patients who suffered a cardiac
arrest on the wards with attempted resuscitation were counted as ICU
transfers at the time of arrest. Logistic regression was used to calculate
the change in odds of death in the ICU for each one-hour delay in ICU
transfer time. RESULTS: A total of 54,032 admissions to the hospital wards
occurred during the study period, including 2,166 patients transferred from
the wards to the ICU. The median time from first critical CART score value
to ICU transfer was 2.7 hours (n=403), and ICU mortality for these patients
was 28%. ICU transfer was delayed for greater than six hours in 39% of these
patients. Comparisons of patient characteristics between delayed (greater
than six hours) and non-delayed transfers who reached the critical CART
score are shown in the Table below. CONCLUSIONS: Delayed transfer to the ICU
is associated with a significant increase in ICU and hospital mortality.
Real-time use of an evidence-based early warning score, such as the CART
score, could identify critically ill patients on the wards earlier and
potentially decrease preventable in-hospital death.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
American
human
intensive care unit
mortality
patient
society
ward
EMTREE MEDICAL INDEX TERMS
cohort analysis
critical illness
critically ill patient
death
early intervention
emergency health service
evidence based practice
heart arrest
hospital
logistic regression analysis
respiratory failure
resuscitation
risk
septic shock
surgical ward
vital sign
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71984707
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 382
TITLE
T(3) Trial protocol: A CRCT evaluating an organisational intervention to
improve triage, treatment and transfer of stroke patients in EDs
AUTHOR NAMES
Middleton S.
Levi C.R.
D'Este C.
Grimshaw J.
Cadilhac D.A.
Considine J.
Cheung W.
McInnes L.
Dale S.
Gerraty R.P.
Fitzgerald M.
AUTHOR ADDRESSES
(Middleton S.; McInnes L.; Dale S.) National Centre for Clinical Outcomes
Research, Australian Catholic University, Sydney, Australia.
(Middleton S.; McInnes L.; Dale S.) Nursing Research Institute, St Vincent's
Hospital, Sydney, Australia.
(Cheung W.) Department of Diabetes and Endocrinology, Westmead Hospital,
Sydney, Australia.
(Levi C.R.) Priority Centre for Brain and Mental Health Research, Australia.
(D'Este C.) University of Newcastle, Australia.
(Cadilhac D.A.) National Stroke Research Institute, Melbourne, Australia.
(Considine J.) Deakin University-Eastern Health, Melbourne, Australia.
(Gerraty R.P.) Epsworth Centre, Melbourne, Australia.
(Fitzgerald M.) Alfred Hospital, Melbourne, Australia.
(Grimshaw J.) Ottawa Health Research Institute, Ottawa, Canada.
CORRESPONDENCE ADDRESS
S. Middleton, National Centre for Clinical Outcomes Research, Australian
Catholic University, Sydney, Australia.
SOURCE
International Journal of Stroke (2013) 8 SUPPL. 1 (10). Date of Publication:
August 2013
CONFERENCE NAME
24th Annual Scientific Meeting of the Stroke Society of Australia - STROKE
2013
CONFERENCE LOCATION
Darwin, NT, Australia
CONFERENCE DATE
2013-07-31 to 2013-08-02
ISSN
1747-4930
BOOK PUBLISHER
Blackwell Publishing Ltd
ABSTRACT
Background: The QASC trial showed significant benefits for patients cared
for in stroke units who received assistance to implement evidence-based
treatment protocols to manage fever, hyperglycaemia and swallowing. Building
on these results, this NHMRC-funded trial will rigorously implement and
evaluate initiatives to improve triage, treatment and transfer of stroke
patients in Emergency Departments (EDs). Methods: Design: cluster randomised
control trial. EDs at 26 hospitals in three Australian states will be
randomised to receive either usual care or the T3 intervention comprising:
rapid Triage; Treatment with thrombolysis where appropriate, fever,
hyperglycaemia and swallowing management; rapid Transfer from ED to stroke
units. The intervention will consist of: multidisciplinary team building
workshops; interactive education program; and sustained engagement of ED and
stroke unit champions to embed collaborations. Our primary outcome is 90-day
death and dependency (modified Rankin Score). We also will measure
functional dependency (Barthel Index); Health Status (SF-36) and undertake
medical record audits to examine quality of care outcomes and implementation
efficacy. Results: A between-group, intention-to-treat analysis will be
conducted adjusting for clustering. A separate process analysis will examine
contextual factors that may influence successful intervention uptake.
Conclusion: We will provide evidence for the effectiveness of a behaviour
change intervention in emergency departments to improve stroke outcomes.
Stroke is common and its costs large if not treated according to
evidence-based guidelines during all phases of hospital admission. To
improve the 'whole pathway' in stroke, care between EDs and stroke units
must be more collaborative and evidence-based.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Australia
cerebrovascular accident
emergency health service
human
society
stroke patient
EMTREE MEDICAL INDEX TERMS
Barthel index
behavior change
blood clot lysis
clinical audit
death
education program
emergency ward
evidence based practice
fever
health status
hospital
hospital admission
hyperglycemia
intention to treat analysis
medical record
patient
stroke unit
swallowing
team building
workshop
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71565038
DOI
10.1111/ijs.12141
FULL TEXT LINK
http://dx.doi.org/10.1111/ijs.12141
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 383
TITLE
Primary versus secondary transport of STEMI patients: Impact on transport
times and mortality
AUTHOR NAMES
Al Mawiri A.
Vojacek J.F.
Bis J.
Sitina M.
Stasek J.
AUTHOR ADDRESSES
(Al Mawiri A.; Sitina M.) Emergency Medical Service, Hradec Kralove, Czech
Republic.
(Vojacek J.F.; Bis J.; Stasek J.) Charles University Prague, Faculty of
Medicine in Hradec Kralove, 1st Department of Medicine, Hradec Kralove,
Czech Republic.
CORRESPONDENCE ADDRESS
A. Al Mawiri, Emergency Medical Service, Hradec Kralove, Czech Republic.
SOURCE
European Heart Journal (2013) 34 SUPPL. 1 (1025). Date of Publication:
August 2013
CONFERENCE NAME
European Society of Cardiology, ESC Congress 2013
CONFERENCE LOCATION
Amsterdam, Netherlands
CONFERENCE DATE
2013-08-31 to 2013-09-04
ISSN
0195-668X
BOOK PUBLISHER
Oxford University Press
ABSTRACT
Background: The door-balloon time (DBT) is linked to morbidity and mortality
of patients with ST segment elevation myocardial infarction (STEMI). Despite
preferable direct transport to catheterization laboratory (PT), still
significant proportion of STEMI patients is transported via non-PCI regional
hospitals or Coronary Care Units (ST) prior to percutaneous coronary
intervention (PCI). This study assessed to what extent PT vs ST affects the
DBT and mortality. Methods: Our region with 600 000 inhabitants uses well
elaborated 24hours/365 days system of immediate transport of all patients
with STEMI lasting less than 12 hours to referral catheterization
laboratories in the tertiary University Hospital Cardiac Center for more
than 15 years. We prospectively recorded DBT of 677 consecutive patients
with STEMI, treated by PCI in the years 2008-2009. Consequent follow-up was
obtained in all patients. Results: Median of DBT was 34±15.9 mins for PT
patients (n=354) and 100±28.8 mins for patients with ST (n=323) (p<0.005).
One-month mortality was 4% vs 9.5% (p=0.002) in the PT vs ST group,
respectively. One-year mortality in the PT and ST groups was 7.3 vs 20.5%
(p<0.005), respectively. (Figure presented) Conclusion: The admission of
patients with STEMI to regional hospitals or Coronary Care Units instead of
direct transport to catheterization laboratory significantly prolongs the
DBT and increases mortality.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cardiology
human
mortality
patient
society
ST segment elevation myocardial infarction
EMTREE MEDICAL INDEX TERMS
catheterization
coronary care unit
follow up
hospital
laboratory
morbidity
percutaneous coronary intervention
university hospital
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71261313
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 384
TITLE
Investigation of outcomes among icu transfers from the floors triggered
through a rapid response team
AUTHOR NAMES
Magaspi C.V.
Kanna B.
Schori M.
Loganathan R.
AUTHOR ADDRESSES
(Magaspi C.V., Crischelle.Magaspi@nychhc.org; Kanna B.; Schori M.;
Loganathan R.) Lincoln Medical and Mental Health Center, Bronx, United
States.
CORRESPONDENCE ADDRESS
C.V. Magaspi, Lincoln Medical and Mental Health Center, Bronx, United
States. Email: Crischelle.Magaspi@nychhc.org
SOURCE
American Journal of Respiratory and Critical Care Medicine (2013) 187
MeetingAbstracts. Date of Publication: 2013
CONFERENCE NAME
American Thoracic Society International Conference, ATS 2013
CONFERENCE LOCATION
Philadelphia, PA, United States
CONFERENCE DATE
2013-05-17 to 2013-05-22
ISSN
1073-449X
BOOK PUBLISHER
American Thoracic Society
ABSTRACT
Rationale: ICU admissions from inpatient floors have been reported to have a
longer length of stay (LOS) and higher mortality compared to those admitted
directly from the emergency room. Rapid Response Teams (RRTs) are designed
to identify deteriorating patients on inpatient floors and transfer patients
to a higher level of care when indicated. The impact of RRTs on ICU
transfers from inpatient floors has not been described. This study compared
the outcomes among RRT-initiated ICU admissions compared to ICU admissions
from the floor triggered by the primary team in a University affiliated
center staffed 24/ 7 by intensivists and hospitalists. Methods: A
retrospective study of all admissions to the medical ICU between July 2011
and June 2012 was performed. RRT activations on the medical/ surgical units,
time to ICU admissions from floors, APACHE-II scores and hospital mortality
were analyzed by an independent investigator. Chi square test for
differences in proportion was used and p-value < 0.05 was considered
significant. Results: Of 1489 ICU admissions (median APACHE-II 17.8), 245
(16.4%) patients who were admitted from the inpatient floors with a median
APACHE II 16.9. Hospital mortality for ICU admissions from floor was
26(10.6%) compared to 70 (5.6%) from ER. There were 284 RRT activations on
the floor, 96 (33.8%) of whom were transferred to the ICU. Among ICU
admissions from the floor, 96/ 245 (39.1%) were RRT-initiated, while 149
were referred directly by the primary team. The median time to ICU referral
among RRT-ICU transfers was 2.7 days compared to 4.1 days among the
non-RRT-ICU group. Average APACHE-II scores in RRT-ICU group was 16.5
compared to 17.4 in non-RRT-ICU group. Hospital mortality in the RRT-ICU
group was significantly higher, 18(18.7%) compared to 12(8%) in the
non-RRT-ICU group [p= 0.013] Conclusion: There was a significantly higher
mortality in RRT-initiated ICU admissions from the medical floor as compared
to patients whose deterioration were recognized by the primary team and
subsequently referred to the ICU. There were no differences in APACHE-II
scores on admissions or the time to referral after admission to the
inpatient floors. This is the first study to report this interesting
observation in an era of widespread RRT implementation. Similar to
RRT-initiated floor transfers to ICU could serve as an important variable
for ICU prognostic scores and warrants additional investigation.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
American
rapid response team
society
EMTREE MEDICAL INDEX TERMS
APACHE
Apache (people)
chi square test
deterioration
emergency ward
hospital patient
human
intensivist
length of stay
medical staff
mortality
patient
retrospective study
statistical significance
university
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71984863
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 385
TITLE
The role of equilibrative nucleoside transporter in regulating adeonsine
signaling during acute lung injury
AUTHOR NAMES
Weng T.
Karmouty-Quintana H.
Chen N.-Y.
Molina J.G.
Pedroza M.
Eltzschig H.
Blackburn M.R.
AUTHOR ADDRESSES
(Weng T.; Blackburn M.R.) UTHSC-Houston, Houston, United States.
(Karmouty-Quintana H.; Chen N.-Y.; Molina J.G.; Pedroza M.) University of
Texas, Health Science Center-Houston, Houston, United States.
(Eltzschig H.) University of Colorado, Denver, United States.
CORRESPONDENCE ADDRESS
T. Weng, UTHSC-Houston, Houston, United States.
SOURCE
American Journal of Respiratory and Critical Care Medicine (2013) 187
MeetingAbstracts. Date of Publication: 2013
CONFERENCE NAME
American Thoracic Society International Conference, ATS 2013
CONFERENCE LOCATION
Philadelphia, PA, United States
CONFERENCE DATE
2013-05-17 to 2013-05-22
ISSN
1073-449X
BOOK PUBLISHER
American Thoracic Society
ABSTRACT
Acute lung injury (ALI) is one of the most common causes of death in
intensive care units due to the limited clinical management of these
disorders. Endothelial cell injury is frequently observed in ALI, which
normally results in widespread capillary leakage, pulmonary edema and
reduced lung compliance. However, the detailed mechanisms involved remain
elusive. Better understanding of the molecular pathways promoting
endothelial barrier dysfunction could provide new candidate targets for ALI
therapy. Adenosine is a small nucleoside which is generated following
hypoxia and/or cellular stress and serves beneficial functions during acute
injuries. The levels of extracellular adenosine can be tightly regulated by
equilibrative nucleoside transporters (ENTs), which transport adenosine
through the plasma membrane and deplete adenosine in the extracellular
space. In our study, we found that Ent2 is negatively regulated by hypoxia
following tissue injury and is one of the major mechanisms by which
extracellular adenosine is accumulated. Inhibition of Ents with
dipyridamole, a pharmacologic reagent, or genetic deletion of Ent2 in mice
resulted in selective protection from bleomycin-induced ALI by enhancing
extracellular adenosine, damping inflammation and decreasing vascular
leakage. We also observed that mice pretreated with the adenosine A2B
receptor (ADORA2B) agonist BAY 60-6583 were protected from bleomycin-induced
ALI, while genetically modified mice lacking ADORA2B were no longer
protected by dipyridamole in bleomycin-induced ALI, suggesting ADORA2B as
the major adenosine receptor contributing to the protective effects of
dipyridamole. Interestingly, by enhancing adenosine levels with BAY 60-6583
or dipyridamole at a time when bleomycin-induced ALI had already been
established, we demonstrated for the first time that adenosine signaling
through ADORA2B has a therapeutic effect on already established ALI. In
summary, we have highlighted a role of adenosine signaling in preventing or
treating ALI and identified Ent2 and ADORA2B as key mediators in
establishing pulmonary protection from bleomycin-induced ALI. Our results
may provide important pre-clinical information for the use of dipyridamole
and adenosine receptor agonists in the treatment of ALI.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
equilibrative nucleoside transporter
EMTREE DRUG INDEX TERMS
adenosine
adenosine receptor
adenosine receptor stimulating agent
bleomycin
dipyridamole
nucleoside
receptor
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
acute lung injury
American
society
EMTREE MEDICAL INDEX TERMS
agonist
capillary leak syndrome
cell damage
cell membrane
cell stress
death
diseases
endothelium cell
extracellular space
gene deletion
genetically engineered mouse strain
hypoxia
inflammation
injury
intensive care unit
lung compliance
lung edema
mouse
protection
therapy
therapy effect
tissue injury
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71983673
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 386
TITLE
A clinical audit of the transfer of stroke patients from a non-tertiary
hospital to a tertiary hospital: Who, why, and how?
AUTHOR NAMES
Do-Nguyen D.
Granger A.
AUTHOR ADDRESSES
(Do-Nguyen D.; Granger A.) Osborne Park Hospital, Perth, Australia.
(Do-Nguyen D.; Granger A.) Sir Charles Gairdner Hospital, Perth, Australia.
CORRESPONDENCE ADDRESS
D. Do-Nguyen, Osborne Park Hospital, Perth, Australia.
SOURCE
International Journal of Stroke (2013) 8 SUPPL. 1 (36). Date of Publication:
August 2013
CONFERENCE NAME
24th Annual Scientific Meeting of the Stroke Society of Australia - STROKE
2013
CONFERENCE LOCATION
Darwin, NT, Australia
CONFERENCE DATE
2013-07-31 to 2013-08-02
ISSN
1747-4930
BOOK PUBLISHER
Blackwell Publishing Ltd
ABSTRACT
Background: The National Stroke Foundation (NSF) recommends “all patients
with stroke should be treated in a stroke unit (level-A)”[1]. Non-tertiary
hospitals such as Joondalup Health Campus (JHC) do not have a dedicated
stroke unit or neurosurgical services; therefore patients may be transferred
to the nearest tertiary hospital, Sir Charles Gairdner Hospital (SCGH).
There are no formal patient selection guidelines or transfer protocols to
guide this process. Aims: To review the transfer of stroke patients from JHC
to SCGH and formulate a transfer protocol. Methods: A retrospective case
note audit reviewed patients with an ICD-10 diagnosis of stroke who were
transferred from JHC to SCGH between June 2010 and July 2011. Results: Of
183 stroke patients identified at JHC, nine were transferred to SCGH. The
most common indication was for stroke unit management, followed by
neurosurgical review. All cases were discussed with the accepting neurology
team with neurosurgery consulted when indicated. Discussion: Although it is
recommended all stroke patients be managed in a stroke unit, it is not
feasible to transfer all stroke patients from JHC to SCGH. In keeping with
NSF recommendations that hospitals admitting >100 stroke patients per year
have a dedicated stroke unit, guidelines would suggest a stroke unit be
established at JHC [1]. This requires further feasibility analysis. Our
interim solution involves developing guidelines to rationalise stroke
patient selection for transfer. Transfer indications are based on existing
protocols and reviewing the evidence for each indication. Formalising
transfer guidelines also included developing communication and transfer
process protocols.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Australia
cerebrovascular accident
clinical audit
human
society
stroke patient
tertiary care center
EMTREE MEDICAL INDEX TERMS
diagnosis
health
hospital
ICD-10
interpersonal communication
neurology
neurosurgery
non profit organization
patient
patient selection
stroke unit
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71565128
DOI
10.1111/ijs.12143
FULL TEXT LINK
http://dx.doi.org/10.1111/ijs.12143
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 387
TITLE
T3 stroke trial protocol: Triage, treatment and transfer of patients with
stroke emergency departments
AUTHOR NAMES
Middleton S.
Levi C.
D'Este C.
Grimshaw J.
Cadilhac D.
Considine J.
Cheung W.
McInnes L.
Dale S.
Gerraty R.
Fitzgerald M.
Cadigan G.
Denisenko S.
Longworth M.
McElduff P.
Quinn C.
AUTHOR ADDRESSES
(Middleton S.; McInnes L.; Dale S.) National Centre for Clinical Outcomes
Research, Australian Catholic University, Australia.
(Middleton S.; McInnes L.; Dale S.) Nursing Research Institute, St Vincent's
Hospital, Australia.
(Levi C.) University of Newcastle, Priority Centre for Brain, Mental Health
Research, Australia.
(D'Este C.; McElduff P.) University of Newcastle, Australia.
(Grimshaw J.) Ottawa Health Research Institute, Ottawa, Canada.
(Cadilhac D.) National Stroke Research Institute, Australia.
(Considine J.) Deakin University-Eastern Health, Australia.
(Cheung W.) Department of Diabetes and Endocrinology, Westmead Hospital,
Australia.
(Gerraty R.) Epsworth Centre, Australia.
(Fitzgerald M.) Alfred Hospital, Australia.
(Cadigan G.) Statewide Stroke and Dementia Clinical Networks, Australia.
(Denisenko S.) Victorian Stroke Clinical Network, Australia.
(Longworth M.) Statewide Stroke Services, Agency for Clinical Innovation,
Australia.
(Quinn C.) Speech Pathology Department, Prince of Wales Hospital, Australia.
CORRESPONDENCE ADDRESS
S. Middleton, National Centre for Clinical Outcomes Research, Australian
Catholic University, Australia.
SOURCE
International Journal of Stroke (2013) 8 SUPPL. 2 (18). Date of Publication:
August 2013
CONFERENCE NAME
9th Australasian Nursing and Allied Health Stroke Conference, Smart Strokes
2013
CONFERENCE LOCATION
Brisbane, QLD, Australia
CONFERENCE DATE
2013-08-22 to 2013-08-23
ISSN
1747-4930
BOOK PUBLISHER
Blackwell Publishing Ltd
ABSTRACT
Background: Building on results from the Quality in Acute Stroke Trial, this
NHMRC-funded trial will rigorously implement and evaluate initiatives to
improve triage, treatment and transfer of patients with stroke in Emergency
Departments (EDs) in three Australian states. Aims: To evaluate a
nurse-initiated multidisciplinary organisational intervention to improve the
Triage, Treatment and Transfer of stroke patients in Emergency Departments
(ED) Methods: Design: cluster randomised control trial Hospitals in ACT,
NSW, QLD and VIC with Emergency departments, pre-existing stroke units and
who currently perform thrombolysis will be randomised to receive either
usual care or the T3 Intervention comprising: Ë Triage: Rapid triage Ë
Treatment: Thrombolysis where appropriate; fever, hyperglycaemia and
swallowing management Ë Transfer: Collaboration between ED and stroke unit
staff for rapid transfer from ED to stroke units The intervention will
consist of multidisciplinary team building workshops, an interactive
education program and sustained engagement of ED and stroke unit champions
to embed collaborations. Our primary outcome is 90-day death and dependency
(modified Rankin Score). We also will measure functional dependency (Barthel
Index); Health Status (SF-36) and undertake medical record audits to examine
quality of care outcomes and implementation efficacy. Results: An
intention-to-treat analysis will be conducted adjusting for clustering. A
separate process analysis will examine contextual factors that may influence
successful intervention uptake. Conclusion: We will provide evidence for the
effectiveness of a behaviour change intervention in EDs to improve stroke
outcomes. To improve the 'whole pathway' in stroke, care between EDs and
stroke units must be more collaborative and evidence-based.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cerebrovascular accident
emergency health service
emergency ward
health
human
nursing
patient
EMTREE MEDICAL INDEX TERMS
Barthel index
behavior change
blood clot lysis
clinical audit
death
education program
evidence based practice
fever
health status
hospital
hyperglycemia
intention to treat analysis
medical record
nurse
stroke patient
stroke unit
swallowing
team building
workshop
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71227177
DOI
10.1111/ijs.12172
FULL TEXT LINK
http://dx.doi.org/10.1111/ijs.12172
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 388
TITLE
Lightning and thunder! the field of tension between emergency and the
sekundärtransport. Angelö stes a problem?
ORIGINAL (NON-ENGLISH) TITLE
Blitz und donner! das spannungsfeld zwischen notfall- und sekundärtransport.
ein gelöstes problem?
AUTHOR NAMES
Peter C.
Popp E.
AUTHOR ADDRESSES
(Peter C., christoph.peter@med.uni-heidelberg.de; Popp E.) Sektion
Notfallmedizin, Klinik für Anästhesiologie, Universitätsklinikum Heidelberg,
Germany.
CORRESPONDENCE ADDRESS
C. Peter, Sektion Notfallmedizin, Klinik für Anästhesiologie,
Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, D-69120
Heidelberg, Germany. Email: christoph.peter@med.uni-heidelberg.de
SOURCE
Intensiv- und Notfallbehandlung (2013) 38:2 (69-77). Date of Publication:
2013
ISSN
0947-5362
BOOK PUBLISHER
Dustri-Verlag Dr. Karl Feistle, Bajuwarenring 4, Oberhaching, Germany.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency medicine
patient transport
EMTREE MEDICAL INDEX TERMS
human
intensive care unit
physician
preventive health service
review
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English, German
EMBASE ACCESSION NUMBER
2013419285
PUI
L369244413
DOI
10.5414/IBX00397
FULL TEXT LINK
http://dx.doi.org/10.5414/IBX00397
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 389
TITLE
Delay of transfer from the intensive care unit: A prospective observational
study of incidence, causes, and financial impact
AUTHOR NAMES
Johnson D.W.
Schmidt U.H.
Bittner E.A.
Christensen B.
Levi R.
Pino R.M.
AUTHOR ADDRESSES
(Johnson D.W., danielwj77@gmail.com) Department of Anesthesiology,
University of Nebraska Medical Center, 984455 Nebraska Medical Center,
Omaha, NE 68198-4455, United States.
(Schmidt U.H., uschmidt@partners.org; Bittner E.A., ebittner@partners.org;
Pino R.M., rpino@partners.edu) Department of Anesthesia, Critical Care and
Pain Medicine, Massachusetts General Hospital, Harvard Medical School, 55
Fruit St, Boston, MA 02114, United States.
(Christensen B., benjc@mit.edu; Levi R., retsef@mit.edu) Sloan School of
Management, Massachusetts Institute of Technology, 50 Memorial Dr,
Cambridge, MA 02142, United States.
CORRESPONDENCE ADDRESS
D.W. Johnson, Department of Anesthesiology, University of Nebraska Medical
Center, 984455 Nebraska Medical Center, Omaha, NE 68198-4455, United States.
Email: danielwj77@gmail.com
SOURCE
Critical Care (2013) 17:4 Article Number: R128. Date of Publication: 4 Jul
2013
ISSN
1364-8535
1466-609X (electronic)
BOOK PUBLISHER
BioMed Central Ltd., Floor 6, 236 Gray's Inn Road, London, United Kingdom.
ABSTRACT
Introduction: A paucity of literature exists regarding delays in transfer
out of the intensive care unit. We sought to analyze the incidence, causes,
and costs of delayed transfer from a surgical intensive care unit
(SICU).Methods: An IRB-approved prospective observational study was
conducted from January 24, 2010, to July 31, 2010, of all 731 patients
transferred from a 20-bed SICU at a large tertiary-care academic medical
center. Data were collected on patients who were medically ready for
transfer to the floor who remained in the SICU for at least 1 extra day.
Reasons for delay were examined, and extra costs associated were
estimated.Results: Transfer to the floor was delayed in 22% (n = 160) of the
731 patients transferred from the SICU. Delays ranged from 1 to 6 days
(mean, 1.5 days; median, 2 days). The extra costs associated with delays
were estimated to be $581,790 during the study period, or $21,547 per week.
The most common reasons for delay in transfer were lack of available
surgical-floor bed (71% (114 of 160)), lack of room appropriate for
infectious contact precautions (18% (28 of 160)), change of primary service
(Surgery to Medicine) (7% (11 of 160)), and lack of available patient
attendant ("sitter" for mildly delirious patients) (3% (five of 160)). A
positive association was found between the daily hospital census and the
daily number of SICU beds occupied by patients delayed in transfer (Spearman
rho = 0.27; P < 0.0001).Conclusions: Delay in transfer from the SICU is
common and costly. The most common reason for delay is insufficient
availability of surgical-floor beds. Delay in transfer is associated with
high hospital census. Further study of this problem is necessary. © 2013
Johnson et al.; licensee BioMed Central Ltd.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
article
cost benefit analysis
delirium
hospitalization
human
major clinical study
observational study
priority journal
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2013527318
MEDLINE PMID
23826830 (http://www.ncbi.nlm.nih.gov/pubmed/23826830)
PUI
L52674805
DOI
10.1186/cc12807
FULL TEXT LINK
http://dx.doi.org/10.1186/cc12807
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 390
TITLE
Perceived Patient Safety Culture in a Critical Care Transport Program
AUTHOR NAMES
Erler C.
Edwards N.E.
Ritchey S.
Pesut D.J.
Sands L.
Wu J.
AUTHOR ADDRESSES
(Erler C., cerler@iupui.edu) School of Nursing, Indiana University, 1111
Middle Drive, NU 425, Indianapolis, IN 46202, United States.
(Edwards N.E.; Sands L.) School of Nursing, Purdue University, West
Lafayette, IN, United States.
(Ritchey S.) LifeLine Critical Care Transport, Indiana University Health,
Terre Haute, IN, United States.
(Pesut D.J.) School of Nursing, University of Minnesota, Minneapolis, MN,
United States.
(Wu J.) School of Medicine, Indiana University, Indianapolis, IN, United
States.
CORRESPONDENCE ADDRESS
C. Erler, School of Nursing, Indiana University, 1111 Middle Drive, NU 425,
Indianapolis, IN 46202, United States. Email: cerler@iupui.edu
SOURCE
Air Medical Journal (2013) 32:4 (208-215). Date of Publication: July-August
2013
ISSN
1067-991X
1532-6497 (electronic)
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
ABSTRACT
Background The purpose of this study was to examine the association among
selected safety culture dimensions and safety outcomes in the context of a
critical care transport (CCT) program. Methods A descriptive cross-sectional
correlational design used the Agency for Healthcare Research and Quality
Hospital Survey on Patient Safety Culture to validate perceived safety
culture among personnel (n = 76) in a large Midwestern CCT program. Results
Findings revealed significant associations between 1) teamwork and frequency
of error reporting (r =.428, P <.001), overall perception of safety (r
=.745, P <.001), and perceived patient safety grade (r = -.681, P <.001); 2)
between perception of manager actions promoting safety and frequency of
error reporting (r =.521, P <.001), overall perception of safety (r =.779, P
<.001), and perceived patient safety grade (r = -.756, P <.001); and 3)
between communication openness and frequency of error reporting (r =.575, P
<.001), overall perception of safety (r =.588, P <.001), and perceived
patient safety grade (r = -.627, P <.001). Conclusion The study supports
other literature showing significant associations among safety culture
dimensions and safety outcomes and provides a framework for future research
on safety culture in CCT programs. © 2013 Air Medical Journal Associates.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical care transport
emergency health service
patient safety
EMTREE MEDICAL INDEX TERMS
article
cross-sectional study
health care personnel
health program
human
intensive care
intensive care unit
patient transport
priority journal
questionnaire
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2013416822
MEDLINE PMID
23816215 (http://www.ncbi.nlm.nih.gov/pubmed/23816215)
PUI
L369232460
DOI
10.1016/j.amj.2012.11.002
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2012.11.002
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 391
TITLE
Screening for congenital hypothyroidism in newborns transferred to neonatal
intensive care
AUTHOR NAMES
Korzeniewski S.J.
Kleyn M.
Young W.I.
Chaiworapongsa T.
Schwartz A.G.
Romero R.
AUTHOR ADDRESSES
(Korzeniewski S.J., sKorzeni@med.wayne.edu; Chaiworapongsa T.; Schwartz
A.G.; Romero R.) National Institute of Child Health and Human Development,
Perinatology Research Branch, NICHD/NIH/DHHS, Detroit, MI, United States.
(Korzeniewski S.J., sKorzeni@med.wayne.edu; Chaiworapongsa T.) Department of
Obstetrics and Gynecology, Wayne State University School of Medicine, Hutzel
Women's Hospital, 3990 John R., Detroit, MI 48201, United States.
(Kleyn M.; Young W.I.) Michigan Department of Community Health, Newborn
Screening Follow-up, Lansing, MI, United States.
CORRESPONDENCE ADDRESS
S.J. Korzeniewski, Perinatal Epidemiology Unit, Perinatology Research Branch
(NICHD/NIH), United States. Email: sKorzeni@med.wayne.edu
SOURCE
Archives of Disease in Childhood: Fetal and Neonatal Edition (2013) 98:4
(F310-F315). Date of Publication: July 2013
ISSN
1359-2998
1468-2052 (electronic)
BOOK PUBLISHER
BMJ Publishing Group, Tavistock Square, London, United Kingdom.
ABSTRACT
Objective: To evaluate the effectiveness of four dried blood spot testing
protocols used in newborn screening for congenital hypothyroidism (CH) among
newborns transferred to the neonatal intensive care unit (NICU). Design,
setting and patients: Michigan newborns transferred to the NICU from 1998 to
2011 and screened for CH are included in this population-based retrospective
cohort study. Main outcome measures: Screening performance metrics are
computed and logistic regression is used to test for differences in the
likelihood of detection across four periods characterised by different
testing protocols. Results: Primary thyrotropin (TSH) plus retest at 30 days
of life or discharge achieved the greatest detection rate (2.6: 1000 births
screened). The odds of detection was also significantly greater in this
period compared with the tandem thyroxine (T4) and TSH testing period and
separately compared with TSH testing alone, adjusted for birth weight, sex
and race (OR 1.5; CI 1.0 to 2.2; p=0.046, and OR 2.2; CI 1.5 to 3.4,
respectively). Approximately half of the cases detected during primary TSH
plus serial testing periods were identified by retest. Conclusions: Primary
TSH testing programmes that do not incorporate serial screening may fail to
identify approximately half of newborns with congenital thyroid hormone
deficiency transferred to the NICU. Tandem T4 and TSH testing programmes
also likely miss cases who otherwise would receive treatment if serial
testing were conducted. Further research is necessary to determine the
optimal newborn screening protocol for CH; strategies combining tandem T4
and TSH with serial testing conditional on birthweight may be useful.
EMTREE DRUG INDEX TERMS
thyrotropin (endogenous compound)
thyroxine (endogenous compound)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
congenital hypothyroidism (congenital disorder)
newborn intensive care
newborn screening
EMTREE MEDICAL INDEX TERMS
article
birth weight
cohort analysis
dried blood spot testing
female
follow up
human
major clinical study
male
newborn
priority journal
retrospective study
United States
CAS REGISTRY NUMBERS
thyrotropin (9002-71-5)
thyroxine (7488-70-2)
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2013405961
MEDLINE PMID
23183553 (http://www.ncbi.nlm.nih.gov/pubmed/23183553)
PUI
L52328782
DOI
10.1136/archdischild-2012-302192
FULL TEXT LINK
http://dx.doi.org/10.1136/archdischild-2012-302192
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 392
TITLE
A network-based approach using intra-hospital patient transfers to identify
high-risk wards during nosocomial outbreaks
AUTHOR NAMES
Ciccolini M.
Arends J.
Grundmann H.
Friedrich A.W.
AUTHOR ADDRESSES
(Ciccolini M.; Arends J.; Grundmann H.; Friedrich A.W.) Medical Microbiology
and Infection Control, University Medical Center Groningen, University of
Groningen, Groningen, Netherlands.
CORRESPONDENCE ADDRESS
M. Ciccolini, Medical Microbiology and Infection Control, University Medical
Center Groningen, University of Groningen, Groningen, Netherlands.
SOURCE
Antimicrobial Resistance and Infection Control (2013) 2 SUPPL. 1. Date of
Publication: June 20, 2013
CONFERENCE NAME
2nd International Conference on Prevention and Infection Control, ICPIC 2013
CONFERENCE LOCATION
Geneva, Switzerland
CONFERENCE DATE
2015-06-25 to 2015-06-28
ISSN
2047-2994
BOOK PUBLISHER
BioMed Central Ltd.
ABSTRACT
Introduction: Initial detection of a nosocomial outbreak can sometimes occur
only after a considerable time has passed since the appearance of the index
case(s). During this high-risk period from emergence to detection,
within-hospital patient movements can disseminate the nosocomial pathogen to
different admission wards. Following outbreak detection, a rapid, robust
estimate of potentially exposed wards is of crucial importance in order to
focus the implementation of infection prevention measures. Methods: We
employ a mathematical approach, together with detailed patient location data
and information on suspected cases, to estimate the potential number of
exposed wards during an outbreak high-risk period. The model allows for
different patient-to-patient transmission probability depending on time
since last exposure, relative order in the transmission chain (first, or
higher order contact), and on whether patients were located in the same
room. Model output consists of a risk score associated with each ward, and
an exposure network, defined as all the exposed wards, together with precise
information on dangerous contacts between them. Standard software was
employed to visualize the exposure network growth throughout time. Results:
This framework was successfully applied during a recent multiresistant K.
pneumoniae outbreak at a large university hospital in the Netherlands. A 4
month high-risk period resulted in 35 (out of 59) potentially exposed wards.
The 10 wards with the highest modelcalculated risk score were selected for
post-exposure microbiological screening, which resulted in 154 additional
screened patients. Further patients were screened, as controls, on other
wards not included in the calculation. The complete exposure network was
reconstructed, and the potential maximum reach of the outbreak was
estimated. No additional positive patients were found and the outbreak was
stopped. Conclusion: Due to the high level of patient exchange between
different admission wards, determining their level of exposure during a
prolonged high risk period rapidly becomes a complex task. Our network-based
approach has been a valuable tool in reducing this complexity, focusing
infection control interventions during an ongoing outbreak.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital patient
human
infection control
patient transport
prevention
risk
ward
EMTREE MEDICAL INDEX TERMS
exposure
infection prevention
Klebsiella pneumoniae
model
Netherlands
pathogenesis
patient
screening
software
university hospital
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72036230
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 393
TITLE
Adverse events during intrahospital transport of critically ill patients:
Incidence and risk factors
AUTHOR NAMES
Parmentier-Decrucq E.
Poissy J.
Favory R.
Nseir S.
Onimus T.
Guerry M.-J.
Durocher A.
Mathieu D.
AUTHOR ADDRESSES
(Parmentier-Decrucq E., erika.parmentier@chru-lille.fr; Poissy J.; Favory
R.; Nseir S.; Onimus T.; Guerry M.-J.; Durocher A.; Mathieu D.) Service
d'Urgence Respiratoire, Réanimation Médicale et Medecine Hyperbare,
Université de Lille II et Centre Hospitalier et Universitaire de Lille,
Lille 59037, France.
CORRESPONDENCE ADDRESS
E. Parmentier-Decrucq, Service d'Urgence Respiratoire, Réanimation Médicale
et Medecine Hyperbare, Université de Lille II et Centre Hospitalier et
Universitaire de Lille, Lille 59037, France. Email:
erika.parmentier@chru-lille.fr
SOURCE
Annals of Intensive Care (2013) 3:1 (1-10). Date of Publication: 2013
ISSN
2110-5820 (electronic)
BOOK PUBLISHER
Springer Verlag, Tiergartenstrasse 17, Heidelberg, Germany.
ABSTRACT
Background: Transport of critically ill patients for diagnostic or
therapeutic procedures is at risk of complications. Adverse events during
transport are common and may have significant consequences for the patient.
The objective of the study was to collect prospectively adverse events that
occurred during intrahospital transports of critically ill patients and to
determine their risk factors. Methods: This prospective, observational study
of intrahospital transport of consecutively admitted patients with
mechanical ventilation was conducted in a 38-bed intensive care unit in a
university hospital from May 2009 to March 2010. Results: Of 262 transports
observed (184 patients), 120 (45.8%) were associated with adverse events.
Risk factors were ventilation with positive end-expiratory pressure >6
cmH(2)O, sedation before transport, and fluid loading for intrahospital
transports. Within these intrahospital transports with adverse events, 68
(26% of all intrahospital transports) were associated with an adverse event
affecting the patient. Identified risk factors were: positive end-expiratory
pressure >6 cmH(2)O, and treatment modification before transport. In 44
cases (16.8% of all intrahospital transports), adverse event was considered
serious for the patient. In our study, adverse events did not statistically
increase ventilator-associated pneumonia, time spent on mechanical
ventilation, or length of stay in the intensive care unit. Conclusions: This
study confirms that the intrahospital transports of critically ill patients
leads to a significant number of adverse events. Although in our study
adverse events have not had major consequences on the patient stay, efforts
should be made to decrease their incidence. © 2013 Parmentier-Decrucq et
al.; licensee Springer.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
iatrogenic disease (complication)
patient transport
risk assessment
EMTREE MEDICAL INDEX TERMS
article
artificial ventilation
controlled study
disease association
female
human
incidence
intensive care unit
length of stay
major clinical study
male
observational study
positive end expiratory pressure
priority journal
prospective study
risk factor
ventilator associated pneumonia (complication)
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2013366187
PUI
L369082254
DOI
10.1186/2110-5820-3-10
FULL TEXT LINK
http://dx.doi.org/10.1186/2110-5820-3-10
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 394
TITLE
Discussion: Inter- and intra-hospital transport of the critically ill
AUTHOR ADDRESSES
SOURCE
Respiratory Care (2013) 58:6 (1021-1023). Date of Publication: 1 Jun 2013
ISSN
0020-1324
1943-3654 (electronic)
BOOK PUBLISHER
American Association for Respiratory Care, 9425 N. MacArthur Blvd. Suite
100, Irving, United States.
EMTREE DRUG INDEX TERMS
activated carbon
anticonvulsive agent
antihypertensive agent
antiinfective agent
atropine
bicarbonate
bronchodilating agent
calcium
epinephrine
furosemide
gluconate calcium
glucose
heparin
infusion fluid
mannitol
naloxone
narcotic analgesic agent
neuromuscular blocking agent
nitric oxide (drug therapy)
paracetamol
sedative agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
patient transport
EMTREE MEDICAL INDEX TERMS
abnormal laboratory result
article
artificial ventilation
blood gas analysis
bradycardia (complication)
capnometry
cardiopulmonary insufficiency (drug therapy)
chest tube
child health care
computer assisted tomography
cyanosis (complication)
defibrillator
device failure
electrocardiograph
endotracheal tube
extracorporeal oxygenation
health care access
heart arrest (complication)
heart infarction
heart muscle revascularization
human
hypotension (complication)
hypothermia (complication)
incidence
intensive care unit
laryngeal mask
laryngoscope
mechanical ventilator
medical specialist
nasal cannula
nasogastric tube
nuclear magnetic resonance imaging
outcome assessment
oxygen saturation
patient care
patient monitoring
patient safety
portable equipment
pulmonary hypertension
pulse oximetry
radiodiagnosis
resuscitation
risk assessment
risk benefit analysis
risk reduction
tachycardia (complication)
tracheostomy tube
treatment planning
ventilator associated pneumonia (complication)
CAS REGISTRY NUMBERS
activated carbon (64365-11-3, 82228-96-4)
adrenalin (51-43-4, 55-31-2, 6912-68-1)
atropine (51-55-8, 55-48-1)
bicarbonate (144-55-8, 71-52-3)
calcium (14092-94-5, 7440-70-2)
furosemide (54-31-9)
gluconate calcium (299-28-5)
glucose (50-99-7, 84778-64-3)
heparin (37187-54-5, 8057-48-5, 8065-01-8, 9005-48-5)
mannitol (69-65-8, 87-78-5)
naloxone (357-08-4, 465-65-6)
nitric oxide (10102-43-9)
paracetamol (103-90-2)
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
Biophysics, Bioengineering and Medical Instrumentation (27)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2013345063
PUI
L369024656
DOI
10.4187/respcare.02404
FULL TEXT LINK
http://dx.doi.org/10.4187/respcare.02404
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 395
TITLE
Quality metrics in neonatal and pediatric critical care transport: a
consensus statement.
AUTHOR NAMES
Bigham M.T.
Schwartz H.P.
AUTHOR ADDRESSES
(Bigham M.T., mbigham@chmca.org) Department of Pediatrics, Akron Children's
Hospital, Akron, OH, USA.
(Schwartz H.P.)
CORRESPONDENCE ADDRESS
M.T. Bigham, Department of Pediatrics, Akron Children's Hospital, Akron, OH,
USA. Email: mbigham@chmca.org
SOURCE
Pediatric critical care medicine : a journal of the Society of Critical Care
Medicine and the World Federation of Pediatric Intensive and Critical Care
Societies (2013) 14:5 (518-524). Date of Publication: Jun 2013
ISSN
1529-7535
ABSTRACT
The transport of neonatal and pediatric patients to tertiary care medical
centers for specialized care demands monitoring the quality of care
delivered during transport and its impact on patient outcomes. Accurate
assessment of quality indicators and patient outcomes requires the use of a
standard language permitting comparisons among transport programs. No
consensus exists on a set of quality metrics for benchmarking transport
teams. The aim of this project was to achieve consensus on appropriate
neonatal and pediatric transport quality metrics. Candidate quality metrics
were identified through literature review and those metrics currently
tracked by each program. Consensus was governed by nominal group technique.
Metrics were categorized in two dimensions: Institute of Medicine quality
domains and Donabedian's structure/process/outcome framework. Two-day Ohio
statewide quality metrics conference. Nineteen transport leaders and staff
representing six statewide neonatal/pediatric specialty programs convened to
achieve consensus. Two hundred fifty-seven performance metrics relevant to
neonatal/pediatric transport were identified. Eliminating duplicate and
overlapping metrics resulted in 70 candidate metrics. Nominal group
methodology yielded 23 final quality metrics, the largest portion
representing Donabedian's outcome category (n = 12, 52%) and the Institute
of Medicine quality domains of effectiveness (n = 7, 30%) and safety (n = 9,
39%). Sample final metrics include measurement of family presence, pain
management, intubation success, neonatal temperature control, use of lights
and sirens, and medication errors. Lastly, a definition for each metric was
established and agreed upon for consistency among institutions. This project
demonstrates that quality metrics can be achieved through consensus building
and provides the foundation for benchmarking among neonatal and pediatric
transport programs and quality improvement projects.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
quality control
EMTREE MEDICAL INDEX TERMS
child
conference paper
consensus
consensus development
cooperation
human
infant
methodology
newborn
organization and management
patient safety
preschool child
standard
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
23867429 (http://www.ncbi.nlm.nih.gov/pubmed/23867429)
PUI
L563043529
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 396
TITLE
Demographics of ventilated infants with bronchiolitis transferred to
paediatric intensive care in yorkshire and humber in 2010/2011 and 2011/2012
AUTHOR NAMES
Kelly A.B.
Rajah F.
AUTHOR ADDRESSES
(Kelly A.B.; Rajah F.) Embrace,Yorkshire and Humber Infant and Children's
Transport Service, Sheffield Children's Hospital, Barnsley, United Kingdom.
CORRESPONDENCE ADDRESS
A.B. Kelly, Embrace,Yorkshire and Humber Infant and Children's Transport
Service, Sheffield Children's Hospital, Barnsley, United Kingdom.
SOURCE
Intensive Care Medicine (2013) 39 SUPPL. 1 (S159-S160). Date of Publication:
June 2013
CONFERENCE NAME
24th Annual Meeting of the European Society of Paediatric and Neonatal
Intensive Care, ESPNIC 2013
CONFERENCE LOCATION
Rotterdam, Netherlands
CONFERENCE DATE
2013-06-12 to 2013-06-15
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag
ABSTRACT
Viral Bronchiolitis is the most common cause of acute respiratory failure in
Paediatric Intensive Care (PIC) admissions in the United Kingdom. The risk
factors for the development of severe bronchiolitis include prematurity, age
of<2 months, low birth weight and rapid onset of severe respiratory
symptoms. In 2011/2012 it had been observed that bronchiolitis infants
requiring ventilation and transfer to PIC were smaller, with a higher
incidence of prematurity than previous years. Aims: To determine the
demographics of infants with bronchiolitis requiring ventilation and
transfer by Embrace, Yorkshire and Humber Infant and Children's Transport
Service, in 2010/2011 and 2011/2012; comparing groups with respect to
weight; age; gestational age at birth and referral; co-morbidity; severity
of illness on admission to hospital. Method: Retrospective data collected
from transfer records over 2 seasons; 1 November to 30 March 2010/2011 and
2011/2012. Results: 120 infants required ventilation and transfer to PIC; 55
in 2010/2011 and 65 in 2011/2012. Patients transferred in 2011/2012 were
smaller and younger. Incidence of prematurity increased markedly, 49 % in
2010/2011 compared to 60 % in 2011/2012 with a doubling of late preterm
33-37 weeks from 20 to 40 %. Over 40 % required ventilation on the day of
admission to hospital; 42 % in 2010/2011 and 49 % in 2011/2012. Conclusions:
The results reflect findings of other studies and staff perceptions. The
increase in late preterm infants may reflect changing neonatal care, with
earlier discharge or an annual variation.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
bronchiolitis
infant
intensive care
newborn intensive care
society
EMTREE MEDICAL INDEX TERMS
acute respiratory failure
air conditioning
child
diseases
gestational age
hospital
human
low birth weight
morbidity
newborn care
patient
prematurity
risk factor
season
United Kingdom
viral bronchiolitis
weight
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71440251
DOI
10.1007/s00134-013-2950-8
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-013-2950-8
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 397
TITLE
Peri-intubation events in critically sick infants (<1year) presenting to
district general hospitals (DGH's) prior to transfer to a regional picu
AUTHOR NAMES
Bendon A.A.
Asghar R.
Sundar T.
Barber R.
Parkins K.
Phatak R.
Grainger D.
AUTHOR ADDRESSES
(Bendon A.A.) Paediatric Anaesthetics, Manchester, United Kingdom.
(Asghar R.; Parkins K.; Phatak R.) North West and North Wales Retrieval
Service(NWTS), Royal Manchester Children's Hospital NHS Trust, Manchester,
United Kingdom.
(Sundar T.) Paediatric Intensive Care Unit, Alder Hey Children's NHS
Foundation Trust, Liverpool, United Kingdom.
(Barber R.; Grainger D.) Paediatric Intensive Care Unit, Royal Manchester
Children's Hospital NHS Trust, Manchester, United Kingdom.
CORRESPONDENCE ADDRESS
A.A. Bendon, Paediatric Anaesthetics, Manchester, United Kingdom.
SOURCE
Intensive Care Medicine (2013) 39 SUPPL. 1 (S170). Date of Publication: June
2013
CONFERENCE NAME
24th Annual Meeting of the European Society of Paediatric and Neonatal
Intensive Care, ESPNIC 2013
CONFERENCE LOCATION
Rotterdam, Netherlands
CONFERENCE DATE
2013-06-12 to 2013-06-15
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag
ABSTRACT
Background: NWTS is a regional retrieval team (RRT)commissioned for
stabilisation, retrieval of sick children to PICU in Northwest England and
Wales. There is paucity of data on emergency intubation of critically ill
infants. Aims: To Highlight: 1. DGH team dynamics in managing critically ill
infants 2. Induction agents 3. “Peri-induction” complications 4. NWTS (RRT)
role Methods: Retrospective data from retrieval forms in infants intubated
in DGH between 1st December 2011 and 30th November 2012, referred to NWTS
for transfer. Results: 230 infants met the inclusion criteria. Discussion:
230/604 (40 %) children, transferred by the RRT were infants, 42 % aged 1
week-6 weeks. These pose a challenge to DGH anaesthetists, with mainly adult
practice and Paediatricians, with limited airway experience. 11 % were
intubated in extremis, anaesthetists present in<50 % of intubations(73 % in
infants>6 months), much lower than other age groups. RRT facilitated ENT
management of difficult airway in four cases. Our data suggests, optimal
team resource utilisation when managing critically ill infants will minimise
adverse events. A prospective multi-centric study including outcome data is
warranted. (Table Presented).
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
general hospital
infant
intubation
newborn intensive care
society
EMTREE MEDICAL INDEX TERMS
adult
airway
anesthesia induction
anesthesist
child
critically ill patient
dynamics
emergency
groups by age
human
otorhinolaryngology
pediatrician
United Kingdom
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71440281
DOI
10.1007/s00134-013-2950-8
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-013-2950-8
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 398
TITLE
Safe travels: Transporting critically ill patients from PICU to MRI
AUTHOR NAMES
Durning S.
AUTHOR ADDRESSES
(Durning S.) Radiology/Sedation/Vascular Access, Children's Hospital of
Philadelphia, West Chester, United States.
CORRESPONDENCE ADDRESS
S. Durning, Radiology/Sedation/Vascular Access, Children's Hospital of
Philadelphia, West Chester, United States.
SOURCE
Journal of Radiology Nursing (2013) 32:2 (103). Date of Publication: June
2013
CONFERENCE NAME
2013 Annual Convention of the Association for Radiologic and Imaging
Nursing, ARIN 2013
CONFERENCE LOCATION
New Orleans, LA, United States
CONFERENCE DATE
2013-04-14 to 2013-04-17
ISSN
1546-0843
BOOK PUBLISHER
Elsevier Inc.
ABSTRACT
Establishing a synergistic relationship between the Pediatric Intensive Care
Unit (PICU) staff and the Magnetic Resonance Imaging (MRI) staff is
supported by the overwhelming amount of research that describes the risks
involved in transporting a critically ill patient out of the Intensive Care
Unit (ICU), as well as an increased trend of using MRI more often as a
diagnostic tool. The purpose of our work is to develop standard practices
around transporting critically ill patients to MRI, and to enhance the
safety and efficiency during patient transport. Our improvement plan is
multifaceted and includes standardized transport set-up, improved timeliness
of when PICU patients arrive to MRI, enhanced matching of
acuity/resources/time of day, a communication and planning tool to
efficiently schedule patients, and a standardized metal screening plan.
Metrics that are currently being tracked include the timing of transport
(the PICU arrival time in MRI as well as stretcher-to-table time), and the
PICU patients that are scheduled prior to 5 p.m. Objectives are as follows:
Objective 1: Identify risks involved in transporting critically ill
pediatric patients from the ICU to MRI. Objective 2: Identify strategies to
minimize risks of adverse patient events during intrahospital transport from
the ICU to MRI. Objective 3: Describe metrics used to track outcomes.
Objective 4: Identify potential cost savings with improved efficiency.
EMTREE DRUG INDEX TERMS
metal
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
human
imaging
nuclear magnetic resonance imaging
nursing
travel
EMTREE MEDICAL INDEX TERMS
cost control
diagnosis
intensive care unit
interpersonal communication
patient
patient transport
planning
risk
safety
screening
stretcher
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71111492
DOI
10.1016/j.jradnu.2013.04.009
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jradnu.2013.04.009
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 399
TITLE
Quality metrics in neonatal and pediatric critical care transport: a
consensus statement
AUTHOR NAMES
Bigham M.T.
Schwartz H.P.
AUTHOR ADDRESSES
(Bigham M.T.; Schwartz H.P.) Department of Pediatrics, Akron Children's
Hospital, Akron, OH, USA. mbigham@chmca.org
()
SOURCE
Pediatric critical care medicine : a journal of the Society of Critical Care
Medicine and the World Federation of Pediatric Intensive and Critical Care
Societies (2013) 14:5 (518-524). Date of Publication: 1 Jun 2013
ISSN
1529-7535
ABSTRACT
OBJECTIVES: The transport of neonatal and pediatric patients to tertiary
care medical centers for specialized care demands monitoring the quality of
care delivered during transport and its impact on patient outcomes. Accurate
assessment of quality indicators and patient outcomes requires the use of a
standard language permitting comparisons among transport programs. No
consensus exists on a set of quality metrics for benchmarking transport
teams. The aim of this project was to achieve consensus on appropriate
neonatal and pediatric transport quality metrics.DESIGN: Candidate quality
metrics were identified through literature review and those metrics
currently tracked by each program. Consensus was governed by nominal group
technique. Metrics were categorized in two dimensions: Institute of Medicine
quality domains and Donabedian's structure/process/outcome
framework.SETTING: Two-day Ohio statewide quality metrics
conference.SUBJECTS: Nineteen transport leaders and staff representing six
statewide neonatal/pediatric specialty programs convened to achieve
consensus.MEASUREMENT AND MAIN RESULTS: Two hundred fifty-seven performance
metrics relevant to neonatal/pediatric transport were identified.
Eliminating duplicate and overlapping metrics resulted in 70 candidate
metrics. Nominal group methodology yielded 23 final quality metrics, the
largest portion representing Donabedian's outcome category (n = 12, 52%) and
the Institute of Medicine quality domains of effectiveness (n = 7, 30%) and
safety (n = 9, 39%). Sample final metrics include measurement of family
presence, pain management, intubation success, neonatal temperature control,
use of lights and sirens, and medication errors. Lastly, a definition for
each metric was established and agreed upon for consistency among
institutions.CONCLUSIONS: This project demonstrates that quality metrics can
be achieved through consensus building and provides the foundation for
benchmarking among neonatal and pediatric transport programs and quality
improvement projects.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
organization and management
standards
EMTREE MEDICAL INDEX TERMS
child
consensus
consensus development
cooperation
human
infant
intensive care
newborn
patient safety
patient transport
preschool child
procedures
quality control
United States
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
23867429 (http://www.ncbi.nlm.nih.gov/pubmed/23867429)
PUI
L602286267
DOI
10.1097/PCC.0b013e31828a7fc1
FULL TEXT LINK
http://dx.doi.org/10.1097/PCC.0b013e31828a7fc1
COPYRIGHT
Copyright 2015 Medline is the source for the citation and abstract of this
record.
RECORD 400
TITLE
Inter- and intra-hospital transport of the critically ill
AUTHOR NAMES
Blakeman T.C.
Branson R.D.
AUTHOR ADDRESSES
(Blakeman T.C., Thomas.Blakeman@uc.edu; Branson R.D.) Division of Trauma and
Critical Care, Department of Surgery, University of Cincinnati College of
Medicine, Cincinnati, OH, United States.
CORRESPONDENCE ADDRESS
T. C. Blakeman, Division of Trauma and Critical Care, Department of Surgery,
University of Cincinnati College of Medicine, 231 Albert Sabin Way,
Cincinnati OH 45267-0558, United States. Email: Thomas.Blakeman@uc.edu
SOURCE
Respiratory Care (2013) 58:6 (1008-1023). Date of Publication: 1 Jun 2013
ISSN
0020-1324
1943-3654 (electronic)
BOOK PUBLISHER
American Association for Respiratory Care, 9425 N. MacArthur Blvd. Suite
100, Irving, United States.
ABSTRACT
Intra- and inter-hospital transport is common due to the need for advanced
diagnostics and procedures, and to provide access to specialized care. Risks
are inherent during transport, so the anticipated benefits of transport must
be weighed against the possible negative outcome during the transport.
Adverse events are common in both in and out of hospital transports, the
most common being equipment malfunctions. During inter-hospital transport,
increased transfer time is associated with worse patient outcomes. The use
of specialized teams with the transport of children has been shown to
decrease adverse events. Intra-hospital transports often involve critically
ill patients, which increases the likelihood of adverse events. Radiographic
diagnostics are the most common in-hospital transport destination and the
results often change the course of care. It is recommended that portable
ventilators be used for transport, because studies show that use of a manual
resuscitator alters blood gas values due to inconsistent ventilation. The
performance of new generation transport ventilators has improved greatly and
now allows for seamless transition from ICU ventilators. Diligent planning
for and monitoring during transport may decrease adverse events and reduce
risk. © 2013 Daedalus Enterprises.
EMTREE DRUG INDEX TERMS
activated carbon
antiarrhythmic agent
anticonvulsive agent
antihypertensive agent
antiinfective agent
atropine
bicarbonate
bronchodilating agent
calcium
cimetidine
diphenhydramine
dobutamine
dopamine
epinephrine
furosemide
gluconate calcium
glucose
heparin
infusion fluid
insulin
lidocaine
mannitol
naloxone
narcotic analgesic agent
neuromuscular blocking agent
paracetamol
sedative agent
sodium chloride
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
patient transport
EMTREE MEDICAL INDEX TERMS
article
artificial ventilation
assisted ventilation
bradycardia
capnometry
cyanosis
device failure
diagnostic equipment
evidence based practice
health care personnel
health care utilization
heart arrest
hospital equipment
human
hypotension
hypothermia
mechanical ventilator
medication error
nonhuman
nuclear magnetic resonance imaging
patient monitoring
patient safety
pediatrics
portable equipment
practice guideline
preventive medicine
tachycardia
DEVICE TRADE NAMES
EMV , United StatesImpact Instrumentation
HT70 , United StatesNewport
LTV 1200 , United StatesCareFusion
T1 , United StatesHamilton
DEVICE MANUFACTURERS
(United States)CareFusion
(United States)Hamilton
(United States)Impact Instrumentation
(United States)Newport
CAS REGISTRY NUMBERS
activated carbon (64365-11-3, 82228-96-4)
adrenalin (51-43-4, 55-31-2, 6912-68-1)
atropine (51-55-8, 55-48-1)
bicarbonate (144-55-8, 71-52-3)
calcium (14092-94-5, 7440-70-2)
cimetidine (51481-61-9, 70059-30-2)
diphenhydramine (147-24-0, 58-73-1)
dobutamine (34368-04-2, 49745-95-1, 52663-81-7, 61661-06-1)
dopamine (51-61-6, 62-31-7)
furosemide (54-31-9)
gluconate calcium (299-28-5)
glucose (50-99-7, 84778-64-3)
heparin (37187-54-5, 8057-48-5, 8065-01-8, 9005-48-5)
insulin (9004-10-8)
lidocaine (137-58-6, 24847-67-4, 56934-02-2, 73-78-9)
mannitol (69-65-8, 87-78-5)
naloxone (357-08-4, 465-65-6)
paracetamol (103-90-2)
sodium chloride (7647-14-5)
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
Biophysics, Bioengineering and Medical Instrumentation (27)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2013345062
MEDLINE PMID
23709197 (http://www.ncbi.nlm.nih.gov/pubmed/23709197)
PUI
L369024655
DOI
10.4187/respcare.02404
FULL TEXT LINK
http://dx.doi.org/10.4187/respcare.02404
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 401
TITLE
Prevention of corneal abrasions in critical care transport
AUTHOR NAMES
Kent R.
Rajah F.
AUTHOR ADDRESSES
(Kent R.; Rajah F.) Embrace, Sheffield Childrens' NHS Trust, Barnsley,
United Kingdom.
CORRESPONDENCE ADDRESS
R. Kent, Embrace, Sheffield Childrens' NHS Trust, Barnsley, United Kingdom.
SOURCE
Intensive Care Medicine (2013) 39 SUPPL. 1 (S140). Date of Publication: June
2013
CONFERENCE NAME
24th Annual Meeting of the European Society of Paediatric and Neonatal
Intensive Care, ESPNIC 2013
CONFERENCE LOCATION
Rotterdam, Netherlands
CONFERENCE DATE
2013-06-12 to 2013-06-15
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag
ABSTRACT
Background: Corneal abrasion is a concern for all children who are deeply
sedated or receiving neuromuscular blocking agents whilst being ventilated.
It is possible that the risks are increased during the transport process due
the increased frequency of patient intervention and patient movement during
this time. A variation in practice has been observed in corneal abrasion
prevention strategies within Embrace Transport Service∗. There are no
guidelines within this area of practice. Objectives: To establish the
incidence and type of corneal abrasion strategy use within critical care
transport. Provide evidence for the formation of guidelines. Method: All
Embrace medical and nursing staff were given a questionnaire to complete
consisting of 10 questions. Results: There were 39 replies (100 % response
rate). 97 % of staff can list corneal abrasion strategies, but currently
only 3 % consider it for neonates and 18 % consider it for children they
transfer ventilated. For both neonates and paediatrics six different
varieties of eye protection are currently used including passive closure, no
eye protection, Geliperm, lacrilube, tape and eye drops. No consultants or
medical trainees had received education on corneal abrasion prevention.
Conclusions: Inadequate eye protection is used in both neonatal and
paediatric transport. Guidelines are required for consistency. Education and
training is required within this area. ∗Embrace is Yorkshire and Humber
Infant and Children's Transport Service.
EMTREE DRUG INDEX TERMS
eye drops
neuromuscular blocking agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
abrasion
intensive care
newborn intensive care
prevention
society
EMTREE MEDICAL INDEX TERMS
child
consultation
education
eye protection
human
infant
newborn
nursing staff
patient
pediatrics
questionnaire
risk
student
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71440192
DOI
10.1007/s00134-013-2950-8
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-013-2950-8
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 402
TITLE
Paediatric intensive care transport in victoria: What has changed over the
last ten years?
AUTHOR NAMES
Cooke A.
Oberender F.
AUTHOR ADDRESSES
(Cooke A.; Oberender F.) Paediatric Intensive Care, Royal Children's
Hospital, Melbourne, Australia.
CORRESPONDENCE ADDRESS
A. Cooke, Paediatric Intensive Care, Royal Children's Hospital, Melbourne,
Australia.
SOURCE
Intensive Care Medicine (2013) 39 SUPPL. 1 (S199-S200). Date of Publication:
June 2013
CONFERENCE NAME
24th Annual Meeting of the European Society of Paediatric and Neonatal
Intensive Care, ESPNIC 2013
CONFERENCE LOCATION
Rotterdam, Netherlands
CONFERENCE DATE
2013-06-12 to 2013-06-15
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag
ABSTRACT
Objectives: The Victorian Paediatric Emergency Transport Service (PETS)
provides advice on management and performs retrieval of critically ill
children throughout Victoria, Tasmania and Southern New South Wales. This
study aimed to evaluate changes in referrals and retrievals over the past 10
years. Methods: Data was extracted from the PETS database for 2002-2011,
inclusive. Severity of illness was categorised by the level of organ-support
required during retrieval and the data obtained analysed for proportions and
trends over time (z-test). Results: There were 7,281 referrals to PETS
resulting in 6,377 transfers (88 %) of which 3,338 (46 %) were performed by
the PETS team, 35 % by air. There was a highly significant increase in the
number of referrals and PETS transfers per year (p<0.01). There was a small
but significant increase in the proportion of referrals from regional
hospitals and children transferred with non-invasive ventilation (p<0.01).
The rate of PETS referrals is significantly higher in non-metropolitan
communities (1.1/1,000 children) compared with metropolitan communities
(0.37/1,000 children, p<0.01, z-test). Conclusions: Over the last 10 years
there has been a marked increase in the overall activity of PETS. However,
the proportion of children referred for critical illness requiring invasive
mechanical ventilation and/or circulatory support has not changed suggesting
that the increased activity is not due to a change in referral patterns.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
newborn intensive care
society
EMTREE MEDICAL INDEX TERMS
artificial ventilation
assisted circulation
Australia
child
community
critical illness
critically ill patient
data base
diseases
emergency
hospital
human
noninvasive ventilation
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71440366
DOI
10.1007/s00134-013-2950-8
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-013-2950-8
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 403
TITLE
Established and proven catheter-related bloodstream infection precautions
for paediatric intensive care patients are transferable to extracorporeal
membrane oxygenation
AUTHOR NAMES
Harry C.
MacFarlane L.
Wylie G.
Davidson M.
Spenceley N.
AUTHOR ADDRESSES
(Harry C.; MacFarlane L.; Davidson M.; Spenceley N.) Paediatric Intensive
Care Unit, Royal Hospital for Sick Children, Glasgow, United Kingdom.
(Wylie G.; Davidson M.; Spenceley N.) Extracorporeal Life Support
Organisation, Royal Hospital for Sick Children, Glasgow, United Kingdom.
(Davidson M.; Spenceley N.) Faculty of Health Sciences and Medicine,
University of Glasgow, United Kingdom.
CORRESPONDENCE ADDRESS
C. Harry, Paediatric Intensive Care Unit, Royal Hospital for Sick Children,
Glasgow, United Kingdom.
SOURCE
Pediatric Critical Care Medicine (2013) 14:5 SUPPL. 1 (S117). Date of
Publication: June 2013
CONFERENCE NAME
9th International Conference of the Pediatric Cardiac Intensive Care Society
CONFERENCE LOCATION
Miami Beach, FL, United States
CONFERENCE DATE
2012-12-09 to 2012-12-12
ISSN
1529-7535
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Background: Catheter-related bloodstream infections (CR-BSI) impact on
patient morbidity, mortality and healthcare expenditure. We aimed to
identify if well-established interventions to reduce CR-BSI in routine
paediatric intensive care patients could be effective in paediatric patients
supported on extracorporeal membrane oxygenation (ECMO). Methods: A
retrospective observational study was performed in a national, tertiary
level paediatric intensive care unit (PICU) with a mixed general and cardiac
population. Patients supported on ECMO in PICU were studied in four epochs
between January 2006 and April 2012. Practice change was implemented,
including staff education and introduction of central line insertion and
maintenance 'bundles.' Weekly consultant led microbiology 'joint rounds'
were also instigated. Results: Local surveillance data reported a 50%
incidence of CR-BSI in patients supported on ECMO in PICU between January
2006 and August 2008 (55.3BSI/1000 ECMO days). There was an initial
reduction to 35% incidence (45BSI/1000 ECMO days) between July 2009 and
March 2010. There have been further reductions in CR-BSI incidence in
subsequent epochs 26BSI/1000 ECMO days (20% incidence) from April 2010 -
2011 and 25BSI/1000 ECMO days (incidence 21%) from April 2011 - 2012.
Conclusions: CR-BSI have a significant impact on the paediatric population,
including children supported on ECMO. Following a multi-faceted practice
change, we have successfully reduced our incidence and impact of BSI on our
ECMO cohort in our institution. The active review of infection incidence and
identifying strategies to reduce sepsis in any ECMO cohort is essential and
forms an important element of our patient safety program.
EMTREE DRUG INDEX TERMS
recombinant erythropoietin
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
catheter infection
extracorporeal oxygenation
human
intensive care
patient
society
EMTREE MEDICAL INDEX TERMS
central venous catheter
child
consultation
health care cost
infection
intensive care unit
microbiology
morbidity
mortality
observational study
patient safety
population
sepsis
staff training
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71160702
DOI
10.1097/PCC.0b013e318292b29c
FULL TEXT LINK
http://dx.doi.org/10.1097/PCC.0b013e318292b29c
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 404
TITLE
Obstetric and perinatal follow-up in an oocyte donation program: Why should
we transfer only one embryo
AUTHOR NAMES
Clua Obradó E.
Rodríguez Barredo D.
Latre Navarro L.
Vázquez Rodríguez A.
Barri Ragué P.N.
Coroleu Lletget B.
Tur Padró R.
AUTHOR ADDRESSES
(Clua Obradó E.; Rodríguez Barredo D.; Latre Navarro L.; Vázquez Rodríguez
A.; Barri Ragué P.N.; Coroleu Lletget B.; Tur Padró R.) Institut
Universitari Dexeus, Medicina de la Reproducción, Barcelona, Spain.
CORRESPONDENCE ADDRESS
E. Clua Obradó, Institut Universitari Dexeus, Medicina de la Reproducción,
Barcelona, Spain.
SOURCE
Human Reproduction (2013) 28 SUPPL. 1 (i286-i287). Date of Publication: June
2013
CONFERENCE NAME
29th Annual Meeting of the European Society of Human Reproduction and
Embryology, ESHRE 2013
CONFERENCE LOCATION
London, United Kingdom
CONFERENCE DATE
2013-07-07 to 2013-07-10
ISSN
0268-1161
BOOK PUBLISHER
Oxford University Press
ABSTRACT
Study question: To analyze the incidence of obstetric and perinatal
complications in oocyte recipients,whoperformed the cycle and were monitored
(pregnancyand delivery) in the same center, in order to inform about the
real risk of complications and to assess about the number of embryos to
transfer. Summary answer: Our results show a higher incidence of gestational
diabetes and Cesarean sections in older women. Multiple pregnancy is the
main cause of the higher obstetric and perinatal complications.
Additionally, the advanced age in these patients determines increased
obstetric complications. Preconceptional counseling and transfer of a single
embryo is highly recommended. What is known already: There is a widespread
belief that pregnancy outcome is worse in oocyte donation than in autologous
IVF. There is a general consensus on the fact that such pregnancies tend to
be at increased risk of obstetric and perinatal complications. However,
there is no general agreement on whether this increased risk is due to the
advanced age of these patients or to their tendency to multiple pregnancy as
a result of the number of embryos transferred. Study design, size, duration:
Retrospective descriptive study of the pregnancies and deliveries achieved
with a total of 183 cycles of donor oocytes (DO) that were performed and
monitored in our center between 2000 and 2009. Participants/materials,
setting, methods: Participants: 183 oocyte recipients/ 243 live births.
Outcome measures: preeclampsia (PE), gestational diabetes, premature rupture
of membranes (PROM), preterm birth, cesarean section rate, low birthweight,
admission to neonatal intensive care unit and perinatal mortality.
Chi-square test was used to compare the groups according to type of
gestation and to age. Main results and the role of chance: The recipient's
age was 40.1 ± 5.3 years (46% < 40 years/54% ≥ 40 years). Sixty-nine percent
were singletons (124/ 183) and 32% were multiples (59/183). By age:
Gestational diabetes (8.2% vs 28.6%) and cesarean section rate (65.9% vs
81.6%) were statistically higher (p < 0.05) in patients ≥40 years. By type
of gestation: PE (5.6% vs 22%), PROM(3.2% vs 13.6%), preterm and very
preterm birth (at < 28, 34 and 37 weeks), cesarean section rate (70.2% vs
83.1%), admission to neonatal intensive care unit (2.4 vs 13.4%), low birth
weight (5.6% vs 59.7%) and very low birth weight (0 vs 6.7%), were
statistically higher (p < 0.05) in multiples. By age plus gestation:
diabetes is related only to age (≥40 years) and PE and preterm birth are
associated with multiple pregnancy. Limitations, reason for caution: When we
observe the results related to both variables (age and type of gestation)
they seem clinically relevant although statistically significant differences
cannot be confirmed because the sample is too fragmented thus not having
enough statistical power. Wider implications of the findings:
Preconceptional counseling in oocyte donation programs before the process is
highly recommended. It seems necessary to advise the patients about the
risks associated with multiple pregnancy and advanced maternal age before
starting the cycle, as well as to transfer a single embryo in good prognosis
patients with good quality embryos in order to avoid multiple pregnancy and
the risk of the complications involved.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
embryo
embryology
follow up
human
oocyte donation
reproduction
society
EMTREE MEDICAL INDEX TERMS
cesarean section
chi square test
consensus
counseling
diabetes mellitus
donor
female
intensive care unit
live birth
low birth weight
maternal age
membrane
multiple pregnancy
newborn disease
newborn intensive care
oocyte
patient
perinatal mortality
preeclampsia
pregnancy
pregnancy diabetes mellitus
pregnancy outcome
premature labor
prognosis
recipient
risk
rupture
study design
very low birth weight
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71335692
DOI
10.1093/humrep/det219
FULL TEXT LINK
http://dx.doi.org/10.1093/humrep/det219
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 405
TITLE
The significance of genetic polymorphisms of glutathione s-transferase
family in the development of pneumonia in premature born babies
AUTHOR NAMES
Shunko E.Y.
Gorovenko N.G.
Kovalova O.M.
Rossokha Z.
Goncharova J.
AUTHOR ADDRESSES
(Shunko E.Y.) Neonatology, National Medical Academy of Postgraduate
Education, Kiev, Ukraine.
(Gorovenko N.G.; Rossokha Z.) National Medical Academy of Post-Graduate
Education named after P.L. Shupik, Kiev, Ukraine.
(Kovalova O.M.; Goncharova J.) Ukrainian Medical Dental Academy, Poltava,
Ukraine.
CORRESPONDENCE ADDRESS
E.Y. Shunko, Neonatology, National Medical Academy of Postgraduate
Education, Kiev, Ukraine.
SOURCE
Intensive Care Medicine (2013) 39 SUPPL. 1 (S94). Date of Publication: June
2013
CONFERENCE NAME
24th Annual Meeting of the European Society of Paediatric and Neonatal
Intensive Care, ESPNIC 2013
CONFERENCE LOCATION
Rotterdam, Netherlands
CONFERENCE DATE
2013-06-12 to 2013-06-15
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag
ABSTRACT
Background and aims: To investigate associations between polymorphism of
GSTM1, GSTT1, GSTP1 genes and the development of pneumonia in premature born
babies during their treatment in neonatal intensive care units. Methods: We
investigated associations between polymorphisms of GSTM1, GSTT1 and GSTP1
genes and the development of pneumonia amongst 120 premature newborns at <36
weeks gestation (median birthweight 1,475 g, range 700-2,480 g; gestation
30.8 weeks, range 27-36; 68 male). In these children we measured the rate of
use of oxygen support, CPAP, and mechanical ventilation. Differences between
groups were determined by parametric (independent t test) or non-parametric
techniques (Mann-Whitney U test) depending on their distribution. Analysis
was performed using SPSS. Results:The AG and GG GSTP1 genotypes were
associated with the development of pneumonia in premature newborns. In
premature born babies with genotype GG gene GSTR1 the duration of mechanical
ventilation was significantly greater than in newborns with AG or AA
genotypes (Me = 8.0 and 4.4, 3.5 days). Babies with a combination of
non-functional alleles of the GSTM1 gene and the A313G single nucleotide
change of GSTP1 gene required the use of oxygen support significantly more
than babies with functional genotypes (51.5 and 4.8 %, p<0.01). Conclusions:
These data to support a role of polymorphism of GSTP1 in the development of
pneumonia in premature newborns.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
glutathione transferase
EMTREE DRUG INDEX TERMS
nucleotide
oxygen
silver
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
baby
genetic polymorphism
newborn intensive care
pneumonia
society
EMTREE MEDICAL INDEX TERMS
allele
artificial ventilation
birth weight
child
gene
genotype
human
intensive care unit
male
newborn
positive end expiratory pressure
pregnancy
prematurity
rank sum test
Student t test
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71440052
DOI
10.1007/s00134-013-2950-8
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-013-2950-8
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 406
TITLE
Transport risk index of physiologic stability, version II (TRIPS-II): A
simple and practical neonatal illness severity score
AUTHOR NAMES
Lee S.
Aziz K.
Dunn M.
Clarke M.
Kovacs L.
Ojah C.
Ye X.
AUTHOR ADDRESSES
(Lee S., sklee@mtsinai.on.ca; Dunn M.) Department of Paediatrics, University
of Toronto, 600 University Avenue, Toronto, ON M5G 1X5, Canada.
(Lee S., sklee@mtsinai.on.ca; Ye X.) Maternal-Infant Care Research Centre,
Mount Sinai Hospital, Toronto, ON, Canada.
(Aziz K.) Department of Pediatrics, University of Alberta, Edmonton, AB,
Canada.
(Clarke M.) Department of Pediatrics, Queen's University, Kingston, ON,
Canada.
(Kovacs L.) Department of Pediatrics, McGill University, Montreal, QC,
Canada.
(Ojah C.) Department of Pediatrics, Saint John Regional Hospital, Saint
John, NB, Canada.
CORRESPONDENCE ADDRESS
S. Lee, Department of Paediatrics, University of Toronto, 600 University
Avenue, Toronto, ON M5G 1X5, Canada. Email: sklee@mtsinai.on.ca
SOURCE
American Journal of Perinatology (2013) 30:5 (395-400). Date of Publication:
2013
ISSN
0735-1631
1098-8785 (electronic)
BOOK PUBLISHER
Thieme Medical Publishers, Inc., 333 7th Avenue, New York, United States.
ABSTRACT
Objective Derive and validate a practical assessment of infant illness
severity at admission to neonatal intensive care units (NICUs). Study Design
Prospective study involving 17,075 infants admitted to 15 NICUs in 2006 to
2008. Logistic regression was used to derive a prediction model for
mortality comprising four empirically weighted items (temperature, blood
pressure, respiratory status, response to noxious stimuli). This Transport
Risk Index of Physiologic Stability, version II (TRIPS-II) was then
validated for prediction of 7-day and total NICU mortality. Results TRIPS-II
discriminated 7-day (receiver operating curve [ROC] area, 0.90) and total
NICU mortality (ROC area, 0.87) from survival. Furthermore, there was a
direct association between changes in TRIPS-II at 12 and 24 hours and
mortality. There was good calibration across the full range of TRIPS-II
scores and the gestational age at birth, and addition of TRIPS-II improved
performance of prediction models that use gestational age and baseline
population risk variables. Conclusion TRIPS-II is a validated benchmarking
tool for assessing infant illness severity at admission and for up to 24
hours after. © 2013 by Thieme Medical Publishers, Inc.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
disease severity
infant disease
EMTREE MEDICAL INDEX TERMS
article
blood pressure
female
gestational age
human
infant
intensive care unit
major clinical study
male
mortality
priority journal
risk assessment
survival
temperature
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2013310278
MEDLINE PMID
23023554 (http://www.ncbi.nlm.nih.gov/pubmed/23023554)
PUI
L52233070
DOI
10.1055/s-0032-1326983
FULL TEXT LINK
http://dx.doi.org/10.1055/s-0032-1326983
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 407
TITLE
Unexpected events occuring during the intrahospital transport of critically
ill ICU patients
AUTHOR NAMES
Pradeep M.V.
Rao S.M.
AUTHOR ADDRESSES
(Pradeep M.V.; Rao S.M.) Department of Critical Care Medicine, Yashoda
Hospital, Somajiguda, Hyderbad, India.
CORRESPONDENCE ADDRESS
M.V. Pradeep, Department of Critical Care Medicine, Yashoda Hospital,
Somajiguda, Hyderbad, India.
SOURCE
Indian Journal of Critical Care Medicine (2013) 17 SUPPL. 2 (25). Date of
Publication: May 2013
CONFERENCE NAME
19th Annual Conference of ISCCM, Criticare 2013
CONFERENCE LOCATION
Kolkata, India
CONFERENCE DATE
2013-03-01 to 2013-03-06
ISSN
0972-5229
BOOK PUBLISHER
Medknow Publications and Media Pvt. Ltd
ABSTRACT
Objectives: 1. To observe the number and types of unexpected-events(UEs)
occurring during intrahospital transport of critically ill ICU patients. 2.
Interventions provided along with outcome. Methods: This was a prospective
observational study of 100 intrahospital critically ill ICU patients of our
hospital transported for diagnostic purposes during april 2012-September
2012. The escorting Intensivist completed the data during transport. Major
Unexpected-events (UEs) were defined as fall in saturation >5% from
baseline, BP variation > 20% from baseline, cardiac arrest, accidental
extubation and arrhythmias. Minor UEs were Nasogastric tube and
IV/Central-Line displacement. Miscellaneous UEs were oxygen probe/ECG lead
displacement, Arterial line/IV line/ventilator tube tangling and transport
related issues. The interventions provided and outcome were documented.
Results: A total of 100 patients were observed prospectively for UEs during
intrahospital transfer of critically ill patients. The overall UEs observed
were 109 among 64 patients. Among the UEs which occurred the maximum were
miscellaneous causes 79 (72.47%) like oxygen probe 28 (25.68%) or ECG lead
displacement 29 (26.60%), major events like fall in spo2 >5% observed in 8
(7.33%) patients, BP variation >20% from baseline in 14 (12.84%) patients,
Altered mental status in 3 (2.75%) and arrhythmias in 3 (2.75%) patients.
Among 64 (100%) patients with UEs, 3 (2.75%) patients with serious adverse
events have been aborted from transport. Conclusion: Unexpected-events(UEs)
are commonly seen in critically ill ICU patients who are transported from
one place to other, but these major unexpected adverse events can be reduced
when critically ill patients are accompanied by Intensivist/ Medically
qualified person during transport and following strict transport guidelines.
EMTREE DRUG INDEX TERMS
oxygen
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
human
patient
EMTREE MEDICAL INDEX TERMS
diagnosis
electrocardiogram
extubation
heart arrest
heart arrhythmia
hospital
intensivist
mental health
nasogastric tube
observational study
patient transport
tube
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71239374
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 408
TITLE
Intrahospital transport of high risk ICU patients on manual ventilation: An
audit from a University Hospital
AUTHOR NAMES
Chakraborty N.
Gurjar M.
K Baronia A.
Azim A.
Poddar B.
Singh R.K.
AUTHOR ADDRESSES
(Chakraborty N.; Gurjar M.; K Baronia A.; Azim A.; Poddar B.; Singh R.K.)
Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
CORRESPONDENCE ADDRESS
N. Chakraborty, Sanjay Gandhi Postgraduate Institute of Medical Sciences,
Lucknow, India.
SOURCE
Indian Journal of Critical Care Medicine (2013) 17 SUPPL. 2 (28). Date of
Publication: May 2013
CONFERENCE NAME
19th Annual Conference of ISCCM, Criticare 2013
CONFERENCE LOCATION
Kolkata, India
CONFERENCE DATE
2013-03-01 to 2013-03-06
ISSN
0972-5229
BOOK PUBLISHER
Medknow Publications and Media Pvt. Ltd
ABSTRACT
Objective: To know indications and incidence of adverse events during
intrahospital transport of high risk ICU patients. Material & Method: A
prospective audit was done between 01, September 2012 to 30, November 2012
in 12 bedded ICU of department of critical care medicine from a university
hospital. Transport of high risk patient (requiring ventilator support) was
done on manual ventilation with Bain's circuit by trained registrar and
accompanied by nurse. Vitals were monitored. Proforma include: demographic
profile, vitals, IV infusions, ABG (same settings on ventilator before and
after transport), indication and duration of transport and adverse events
(high risk or serious adverse event). Results: There were 32 intrahospital
transports (21 patients); 12 (60%) requiring vasopressors. Mean SOFA score
was 8.87. Indications: mainly diagnostic 29 (90%), [18 CT scan, 5 MRI, 3 USG
or Doppler, 2 NCV study], followed by 5 (15%) for intervention [4 NJ tube
placement, 1 CT guided intervention]. Median duration of transport was 60
min (30 - 180 min). Seven patients needed increment of sedation, while one
muscle relaxant. After transport, mean heart rate and mean vasopressor
requirement were increased significantly (p=0.026 and p=0.04 respectively);
while systolic BP, PaO2/FiO2 ratio, PCO2 did not differ significantly. Total
adverse events were in 18 (56%) transport which were high risk [13 (39%)
patient related and 6 (18%) equipment related]. Amongst patient related
events 9 (28%) had CVS followed by respiratory in 5 (15.6%). Seven (21.8%)
had hypotension, followed by 4 (12.5%) tachypnea, 3 (9%) tachycardia 2 (6%)
hypertension, 1 (3%) bradycardia and 1 (3%) increased airway pressure. Among
equipments: 4 (12.5%) monitor related, followed by 1 (3%) infusion pump, 1
(3%) elevator malfunction. Conclusion: Intrahospital transports of
ventilated patient are at high risk for adverse events including significant
increment of vasopressor; while there is no significant impact on blood
gases.
EMTREE DRUG INDEX TERMS
hypertensive factor
muscle relaxant agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
clinical audit
human
manual ventilation
patient
risk
university hospital
EMTREE MEDICAL INDEX TERMS
airway pressure
blood gas
bradycardia
building
computer assisted tomography
diagnosis
heart rate
high risk patient
hypertension
hypotension
infusion pump
intensive care
intravenous drug administration
nuclear magnetic resonance imaging
nurse
sedation
Sequential Organ Failure Assessment Score
tachycardia
tachypnea
tube
ventilated patient
ventilator
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71239382
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 409
TITLE
Close monitoring of temperature and timing of sample transport in a large
hospital in summer time
AUTHOR NAMES
Rapi S.
Salti S.
Ognibene A.
Brogi M.
Melli F.
Simonetti S.
Abbruscato R.
Veroni F.
AUTHOR ADDRESSES
(Rapi S.; Salti S.; Ognibene A.; Brogi M.; Melli F.; Simonetti S.;
Abbruscato R.; Veroni F.) Central Laboratory, Laboratory Department, AOU
Careggi, Florence, Italy.
CORRESPONDENCE ADDRESS
S. Rapi, Central Laboratory, Laboratory Department, AOU Careggi, Florence,
Italy.
SOURCE
Biochimica Clinica (2013) 37 SUPPL. 1 (S353). Date of Publication: 2013
CONFERENCE NAME
20th IFCC-EFLM European Congress of Clinical Chemistry and Laboratory
Medicine, EuroMedLab, 45th Congress of the Italian Society of Clinical
Biochemistry and Clinical Molecular Biology, SIBioC 2013
CONFERENCE LOCATION
Milan, Italy
CONFERENCE DATE
2013-05-19 to 2013-05-23
ISSN
0393-0564
BOOK PUBLISHER
Biomedia Srl
ABSTRACT
Background: Handling and intra-hospital transfer of biological samples can
affect analytical results, given the temperature variation and the time
delay itself. Standardization of transport methods and temperature
monitoring need to be pursued, particularly in centralized laboratory, where
long distance may need to be covered. We decided to investigate timing delay
and temperature variation occurring from blood draw moment and sample
centrifugation; we conduct a survey in summer and we valuated the possible
advantages of a new transport box that allows time and temperature
monitoring. Methods: Careggi hospital is located in several buildings with
an area of over 2 square Kms. Internal biological transport is assured by
cars on request for emergency and scheduled for routine samples. The survey
was performed monitoring time and temperature of routine delivery from 4
different units care in august 2012. Three clinical wards were located in
the same building nearby the laboratory (200 m) and the forth in a structure
more distant (1 Km). The latter and two of the previous three used specific
transport box (H-BIN Biotransport, Becton Dickinson UK) and the samples were
tracked by a monitoring system (BD T&T, Becton Dickinson UK). The forth unit
carried on with the standard transport system becoming the naÏve condition
reference. A total amounts of 219 shipments were monitored, 169 employing
specific transport box and 50 using traditional bag provided by a
thermometer for temperature registrations. Results: Overall median transfer
time was 51 min (range 30-123 min); noticeably no difference was found
between buildings location. Mean shipments temperatures resulted 26.0 °C and
27.3 °C with and without transport box respectively (P <0.01). Discussion:
The close monitoring of sample shipments allows to verify the quality of
pre-analytical phase and to underline possible drawbacks in samples
transfer. The use of specifically designed transport boxes resulted in a
closer temperature control even if the transport temperature does not appear
to be a major problem. Ninetieth percentile of transport time is a criticism
in our pre analytical phase; a fixed limit of shipment time can be used to
avoid the analysis of sensible tests with significant pre analytical
improvements.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
clinical chemistry
hospital
laboratory
molecular biology
monitoring
society
summer
temperature
EMTREE MEDICAL INDEX TERMS
blood
car
centrifugation
emergency
registration
standardization
temperature measurement
thermometer
transport at the cellular level
United Kingdom
ward
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71436320
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 410
TITLE
Factors contributing to adverse events after ICU discharge: A survey of
liaison nurses
AUTHOR NAMES
Elliott M.
Worrall-Carter L.
Page K.
AUTHOR ADDRESSES
(Elliott M., S00072102@myacu.edu.au) St Vincent's Centre for Nursing
Research, Melbourne, Australia.
(Elliott M., S00072102@myacu.edu.au) Holmesglen Institute, Melbourne,
Australia.
(Elliott M., S00072102@myacu.edu.au) Locked Bag 4115, Fitzroy MDC, Victoria
3065, Australia.
(Worrall-Carter L.) St Vincent's Centre for Nursing Research, Australian
Catholic University, Melbourne, Australia.
(Page K.) Clinical Care Engagement, Heart Foundation, Melbourne, Australia.
CORRESPONDENCE ADDRESS
M. Elliott, Locked Bag 4115, Fitzroy MDC, Victoria 3065, Australia. Email:
S00072102@myacu.edu.au
SOURCE
Australian Critical Care (2013) 26:2 (76-80). Date of Publication: May 2013
ISSN
1036-7314
BOOK PUBLISHER
Elsevier Ireland Ltd, P.O. Box 85, Limerick, Ireland.
ABSTRACT
Background: A significant number of patients experience an adverse event
when discharged from intensive care to a ward. More than half of these
events may be preventable with better standards of care. Aim: To explore the
opinions of an expert group of clinicians around factors contributing to
adverse events in patients discharged from ICU. Method: Online survey of
Australian ICU Liaison Nurses (n= 39) using a validated questionnaire of 25
items. Results: The response rate was 92.8%. Key contributing factors
included a lack of experienced ward staff, patient co-morbidities and the
clinically challenging nature of many patients. Conclusion: Modifying
processes of care may decrease the risk or impact of adverse events in this
high risk patient population. © 2012 Australian College of Critical Care
Nurses Ltd.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
patient transport
treatment outcome
EMTREE MEDICAL INDEX TERMS
article
clinical handover
comorbidity
critical illness
health care quality
health care survey
hospital discharge
human
mortality
qualitative research
standard
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
22948080 (http://www.ncbi.nlm.nih.gov/pubmed/22948080)
PUI
L52188838
DOI
10.1016/j.aucc.2012.07.005
FULL TEXT LINK
http://dx.doi.org/10.1016/j.aucc.2012.07.005
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 411
TITLE
VRE transmission via the reusable breathing circuit of a transport
ventilator: Outbreak analysis and experimental study of surface disinfection
AUTHOR NAMES
Schulz-Stübner S.
Schmidt-Warnecke A.
Hwang J.-H.
AUTHOR ADDRESSES
(Schulz-Stübner S., schust@t-online.de) Deutsches Beratungszentrum für
Hygiene, Schnewlinstr. 10, 79098 Freiburg im Breisgau, Germany.
(Schmidt-Warnecke A.) Synlab Hygieneinstitut Berlin-Brandenburg
(Zweigniederlassung der Synlab Umweltinstitut GmbH), Turmstr. 21 Haus M
Eingang O, 10559 Berlin, Germany.
(Hwang J.-H.) Klinik für Anästhesiologie und Operative Intensivmedizin, Sana
Krankenhaus Gerresheim, Gräulinger Str. 120, 40625 Düsseldorf, Germany.
CORRESPONDENCE ADDRESS
S. Schulz-Stübner, Deutsches Beratungszentrum für Hygiene, Schnewlinstr. 10,
79098 Freiburg im Breisgau, Germany. Email: schust@t-online.de
SOURCE
Intensive Care Medicine (2013) 39:5 (975-976). Date of Publication: May 2013
ISSN
0342-4642
1432-1238 (electronic)
BOOK PUBLISHER
Springer Verlag, Tiergartenstrasse 17, Heidelberg, Germany.
EMTREE DRUG INDEX TERMS
disinfectant agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
bacterial transmission
breathing circuit
disinfection
epidemic
mechanical ventilator
vancomycin resistant Enterococcus
EMTREE MEDICAL INDEX TERMS
bacterial colonization
bacterium contamination
breathing circuit bacterial filter
clinical article
colony forming unit
critically ill patient
enterococcal infection
Enterococcus faecium
human
intensive care
intensive care unit
letter
nonhuman
DEVICE TRADE NAMES
Drager Oxylog 2000 transport ventilator , GermanyDrager
Schulke mikrozid AF , GermanySchuelke and Mayr
DEVICE MANUFACTURERS
(Germany)Drager
(Germany)Schuelke and Mayr
EMBASE CLASSIFICATIONS
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
Anesthesiology (24)
Biophysics, Bioengineering and Medical Instrumentation (27)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2013623879
MEDLINE PMID
23404473 (http://www.ncbi.nlm.nih.gov/pubmed/23404473)
PUI
L52441274
DOI
10.1007/s00134-013-2842-y
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-013-2842-y
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 412
TITLE
Mannitol dosing error during intra-facility transfer for intracranial
emergencies
AUTHOR NAMES
Elliott C.A.
MacKenzie M.
O'Kelly C.
AUTHOR ADDRESSES
(Elliott C.A.; MacKenzie M.; O'Kelly C.) Edmonton, Canada.
CORRESPONDENCE ADDRESS
C.A. Elliott, Edmonton, Canada.
SOURCE
Canadian Journal of Neurological Sciences (2013) 40:3 SUPPL. 1 (S16-S17)
CONFERENCE NAME
48th Annual Congress of the Canadian Neurological Sciences Federation
CONFERENCE LOCATION
Montreal, QC, Canada
CONFERENCE DATE
2013-06-12 to 2013-06-14
ISSN
0317-1671
BOOK PUBLISHER
Canadian Journal of Neurological Sciences
ABSTRACT
Background: Mannitol is commonly used to treat elevated intracranial
pressure. We analyzed mannitol dosing errors at peripheral hospitals prior
to transport to tertiary care facilities for intracranial emergencies.
Methods: We conducted a retrospective review of the Shock Trauma Air Rescue
Society (STARS) electronic patient database of helicopter medical
evacuations in Alberta, Canada between 2004-2012 limited to patients
receiving mannitol before transfer. We extracted data on mannitol
administration; patient characteristics including diagnosis, mechanism, GCS,
weight, age and pupils. Results: 120 patients received a mannitol infusion
initiated at a peripheral hospital for intracranial emergency (median gcs 6;
range 3 - 13). There was a 23% error rate, including an underdosing rate
(<0.25 g/kg) of 8.3% (10/120), an overdosing rate (>1.5g/kg) of 7.5%
(9/120), and a non-bolus administration rate (> 1 hour) of 6.7% (8/120). A
process analysis was used to identify potential factors leading to these
errors and will be presented. Conclusions: Mannitol administration at
peripheral hospitals is prone to dosing error. Our analysis suggests
potential strategies, such as a pre transport checklist, to mitigate this
risk.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
mannitol
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency
EMTREE MEDICAL INDEX TERMS
Canada
checklist
data base
diagnosis
helicopter
hospital
human
infusion
injury
intracranial pressure
patient
risk
society
tertiary health care
weight
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71096039
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 413
TITLE
Pssst... AINS secrets! Today from the area of critical care transfer
ORIGINAL (NON-ENGLISH) TITLE
Pssst⋯ AINS-secrets! Heute aus dem bereich intensivverlegung
AUTHOR NAMES
Gill-Schuster D.
Ockelmann P.
Bergold M.
Zacharowski K.
AUTHOR ADDRESSES
(Zacharowski K., Kai.Zacharowski@kgu.de) FRCA Direktor der Klinik für
Anästhesiologie, Intensivmedizin und Schmerztherapie, Universitätsklinikum
Frankfurt Am Main, Theodor-Stern-Kai 7, 60 590 Frankfurt am Main, Germany.
(Gill-Schuster D.; Ockelmann P.; Bergold M.)
CORRESPONDENCE ADDRESS
K. Zacharowski, FRCA Direktor der Klinik für Anästhesiologie,
Intensivmedizin und Schmerztherapie, Universitätsklinikum Frankfurt Am Main,
Theodor-Stern-Kai 7, 60 590 Frankfurt am Main, Germany. Email:
Kai.Zacharowski@kgu.de
SOURCE
Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie (2013) 48:2
(102-105). Date of Publication: 2013
ISSN
0939-2661
1439-1074 (electronic)
BOOK PUBLISHER
Georg Thieme Verlag, Rudigerstrasse 14, Stuttgart, Germany.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
EMTREE MEDICAL INDEX TERMS
article
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
German
EMBASE ACCESSION NUMBER
2013174639
MEDLINE PMID
23504465 (http://www.ncbi.nlm.nih.gov/pubmed/23504465)
PUI
L52491192
DOI
10.1055/s-0032-1333090
FULL TEXT LINK
http://dx.doi.org/10.1055/s-0032-1333090
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 414
TITLE
Patient-driven resource planning of a health care facility evacuation
AUTHOR NAMES
Petinaux B.
Yadav K.
AUTHOR ADDRESSES
(Petinaux B., bpetinaux@mfa.gwu.edu; Yadav K.) Department of Emergency
Medicine, George Washington University, 2150 Pennsylvania Avenue NW,
Washington, DC 20037, United States.
CORRESPONDENCE ADDRESS
B. Petinaux, Department of Emergency Medicine, George Washington University,
2150 Pennsylvania Avenue NW, Washington, DC 20037, United States. Email:
bpetinaux@mfa.gwu.edu
SOURCE
Prehospital and Disaster Medicine (2013) 28:2 (120-126). Date of
Publication: April 2013
ISSN
1049-023X
1945-1938 (electronic)
BOOK PUBLISHER
Cambridge University Press, Shaftesbury Road, Cambridge, United Kingdom.
ABSTRACT
Introduction The evacuation of a health care facility is a complex
undertaking, especially if done in an immediate fashion, ie, within minutes.
Patient factors, such as continuous medical care needs, mobility, and
comprehension, will affect the efficiency of the evacuation and translate
into evacuation resource needs. Prior evacuation resource estimates are 30
years old. Methods Utilizing a cross-sectional survey of charge nurses of
the clinical units in an urban, academic, adult trauma health care facility
(HCF), the evacuation needs of hospitalized patients were assessed
periodically over a two-year period. Results Survey data were collected on
2,050 patients. Units with patients having low continuous medical care needs
during an emergency evacuation were the postpartum, psychiatry,
rehabilitation medicine, surgical, and preoperative anesthesia care units,
the Emergency Department, and Labor and Delivery Department (with the
exception of patients in Stage II labor). Units with patients having high
continuous medical care needs during an evacuation included the neonatal and
adult intensive care units, special procedures unit, and operating and
post-anesthesia care units. With the exception of the neonate group, 908
(47%) of the patients would be able to walk out of the facility, 492 (25.5%)
would require a wheelchair, and 530 (27.5%) would require a stretcher to
exit the HCF. A total of 1,639 patients (84.9%) were deemed able to
comprehend the need to evacuate and to follow directions; the remainder were
sedated, blind, or deaf. The charge nurses also determined that 17 (6.9%) of
the 248 adult intensive care unit patients were too ill to survive an
evacuation, and that in 10 (16.4%) of the 61 ongoing surgery cases, stopping
the case was not considered to be safe. Conclusion Heath care facilities can
utilize the results of this study to model their anticipated resource
requirements for an emergency evacuation. This will permit the Incident
Management Team to mobilize the necessary resources both within the facility
and the community to provide for the safest evacuation of patients.
Copyright © World Association for Disaster and Emergency Medicine 2012.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
disaster planning
hospital
patient care
patient transport
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
article
child
cross-sectional study
female
health personnel attitude
human
infant
intensive care unit
male
middle aged
newborn
operating room
preschool child
United States
walking difficulty
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
23257081 (http://www.ncbi.nlm.nih.gov/pubmed/23257081)
PUI
L368683279
DOI
10.1017/S1049023X12001793
FULL TEXT LINK
http://dx.doi.org/10.1017/S1049023X12001793
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 415
TITLE
Early identification of children at risk for critical care: Standardizing
communication for inter-emergency department transfers
AUTHOR NAMES
Sahyoun C.
Fleegler E.
Kleinman M.
Monuteaux M.C.
Bachur R.
AUTHOR ADDRESSES
(Sahyoun C., cs2476@columbia.edu; Fleegler E.; Monuteaux M.C.; Bachur R.)
Divisions of Emergency Medicine, Department of Anesthesia, Boston Children's
Hospital, Boston, MA, United States.
(Kleinman M.) Critical Care Medicine, Department of Anesthesia, Boston
Children's Hospital, Boston, MA, United States.
(Sahyoun C., cs2476@columbia.edu) Columbia University, Morgan Stanley
Children's Hospital of New York, Division of Pediatric Emergency Medicine,
622 West 168th St, PH 137, New York, NY 10032, United States.
CORRESPONDENCE ADDRESS
C. Sahyoun, Columbia University, Morgan Stanley Children's Hospital of New
York, Division of Pediatric Emergency Medicine, 622 West 168th St, PH 137,
New York, NY 10032, United States. Email: cs2476@columbia.edu
SOURCE
Pediatric Emergency Care (2013) 29:4 (419-424). Date of Publication: April
2013
ISSN
0749-5161
1535-1815 (electronic)
BOOK PUBLISHER
Lippincott Williams and Wilkins, 530 Walnut Street,P O Box 327,
Philadelphia, United States.
ABSTRACT
BACKGROUND: Interfacility transfers occur frequently and often involve
critically ill patients. Clear communication at the time of patient referral
is essential for patient safety. OBJECTIVES: The objective of this work was
to study whether a standardized inter-emergency department (ED) transfer
communication template for pediatric patients with respiratory complaints
identifies patients that require intensive care unit (ICU) admission.
METHODS: We created a template to structure the communication between
referring and receiving providers involved in inter-ED transfers of children
with respiratory complaints. The template was designed for use by
nonphysicians to prompt specific questions that would trigger notification
of the ED attending based on signs of critical illness. The template was
retrospectively applied to determine whether it would have properly
triggered attending physician notification of a child ultimately requiring
ICU admission. RESULTS: Of 285 transferred children, 61 (21%) were admitted
to an ICU from the receiving ED. The sensitivity of the communication
template in predicting the need for ICU admission was 84% (95% confidence
interval [CI], 72%-92%), negative predictive value of 95% (95% CI, 90%-97%),
specificity of 77% (95% CI, 71%-82%), positive predictive value of 50% (95%
CI, 40%-60%). Of the 10 patients admitted to an ICU who were not identified
by the tool, none were critically ill upon arrival. Of the individual
communication elements, the sensitivity and negative predictive value ranged
from 3% to 38% and from 79% to 86%, respectively. CONCLUSIONS: A
standardized communication template for inter-ED transfers can identify
children with respiratory complaints who require ICU admission. Next steps
include real-time application to judge screening performance compared with
current nonstandardized intake protocols.© Copyright 2013 by Lippincott
Williams & Wilkins.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
interpersonal communication
patient referral
patient safety
EMTREE MEDICAL INDEX TERMS
article
asthma
bronchiolitis
child
child safety
cohort analysis
controlled study
critical illness
croup
Delphi study
emergency ward
human
infant
major clinical study
pneumonia
predictive value
preschool child
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2013250406
MEDLINE PMID
23528500 (http://www.ncbi.nlm.nih.gov/pubmed/23528500)
PUI
L52509560
DOI
10.1097/PEC.0b013e318289d7c1
FULL TEXT LINK
http://dx.doi.org/10.1097/PEC.0b013e318289d7c1
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 416
TITLE
Interhospital transport with extracorporeal life support: Results and
perspectives after 5 years experience
ORIGINAL (NON-ENGLISH) TITLE
Transport interhospitalier sous extracorporeal life support : Résultats et
perspectives après cinq ans d'expérience
AUTHOR NAMES
Desebbe O.
Rosamel P.
Henaine R.
Vergnat M.
Farhat F.
Dubien P.Y.
Bastien O.
AUTHOR ADDRESSES
(Desebbe O.; Rosamel P., prosamel@aol.com; Bastien O.) Service
d'anesthésie-réanimation, Hôpital cardiovasculaire et pneumologique
Louis-Pradel, Hospices civils de Lyon, 28, avenue du Doyen-Lépine, 69677
Bron cedex, France.
(Desebbe O.; Bastien O.) Laboratoire EA4169, Université Claude-Bernard Lyon
1, 69003 Lyon, France.
(Henaine R.; Vergnat M.; Farhat F.) Service de chirurgie cardiaque, Hôpital
cardiovasculaire et pneumologique Louis-Pradel, Hospices civils de Lyon, 28,
avenue du Doyen-Lépine, 69677 Bron cedex, France.
(Dubien P.Y.) Samu de Lyon, Hôpital édouard-Herriot, 5, place d'Arsonval,
69437 Lyon cedex 03, France.
CORRESPONDENCE ADDRESS
P. Rosamel, Service d'anesthésie-réanimation, Hôpital cardiovasculaire et
pneumologique Louis-Pradel, Hospices civils de Lyon, 28, avenue du
Doyen-Lépine, 69677 Bron cedex, France. Email: prosamel@aol.com
SOURCE
Annales Francaises d'Anesthesie et de Reanimation (2013) 32:4 (225-230).
Date of Publication: April 2013
ISSN
0750-7658
1769-6623 (electronic)
BOOK PUBLISHER
Elsevier Masson SAS, 62 rue Camille Desmoulins, Issy les Moulineaux Cedex,
France.
ABSTRACT
Objective: Describing the experience of a referral center for interhospital
patients transport treated with extracorporeal circulatory or respiratory
support (ECLS), the difficulties encountered and the results obtained. Study
design: Retrospective and observational study. Patients and methods: All
patients with respiratory or circulatory failure accepted for extracorporeal
assistance for which routine medical transport was life threatening.
Statistical analysis: A descriptive analysis was performed (median and
interquartile deviation). Comparison of biological data was performed using
a non-parametric Wilcoxon test and 5 years overall survival was determined
by a Kaplan-Meier analysis. Results: Over a 55-month period, 29 patients
were selected for transportation under ECMO or ECLS. Indication was
respiratory failure in 38 % of cases, hemodynamic instability in 52 % of
cases and combined symptoms in 10 % of cases. Average duration of
transportation was 40. km (9-64. km). No complication related to transport
was observed. Incidence of intrahospital death was 57 %. There was no
correlation between death and indication of ECLS. Five-year survival was 55
% and 39 % for venovenous and arteriovenous ECLS, respectively. Conclusion:
In our experience, interhospital transport of patients under ECMO is
feasible in satisfactory conditions of safety with trained team and standard
procedures. © 2013 Société française d'anesthésie et de réanimation (Sfar).
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
extracorporeal circulation
extracorporeal life support
patient transport
EMTREE MEDICAL INDEX TERMS
article
death
extracorporeal oxygenation
health care quality
hemodynamics
human
ischemia (therapy)
observational study
overall survival
patient safety
respiratory failure (therapy)
retrospective study
survival time
treatment indication
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
French
LANGUAGE OF SUMMARY
French, English
EMBASE ACCESSION NUMBER
2013252956
MEDLINE PMID
23499393 (http://www.ncbi.nlm.nih.gov/pubmed/23499393)
PUI
L52489090
DOI
10.1016/j.annfar.2013.02.006
FULL TEXT LINK
http://dx.doi.org/10.1016/j.annfar.2013.02.006
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 417
TITLE
Safety standards for intrahospital transfer of critical care patients
AUTHOR NAMES
Ashton-Cleary D.
AUTHOR ADDRESSES
(Ashton-Cleary D.) Royal Cornwall Hospital, Truro, United Kingdom.
CORRESPONDENCE ADDRESS
D. Ashton-Cleary, Royal Cornwall Hospital, Truro, United Kingdom.
SOURCE
Critical Care (2013) 17 SUPPL. 2 (S108). Date of Publication: 19 Mar 2013
CONFERENCE NAME
33rd International Symposium on Intensive Care and Emergency Medicine
CONFERENCE LOCATION
Brussels, Belgium
CONFERENCE DATE
2013-03-19 to 2013-03-22
ISSN
1364-8535
BOOK PUBLISHER
BioMed Central Ltd.
ABSTRACT
Introduction The aim was to assess care of patients during intrahospital
transfer. The UK Royal College of Anaesthetists has defined auditable
standards for the care of patients and the training of escorting medical and
nursing staf in this context [1]. Methods Patients in a 27-bed combined
general and neurosurgical critical care unit were studied in January 2011
and May 2012. Patients undergoing radiology department imaging or
intervention were identif ed from the electronic imaging library. Records of
these transfers were sought in the critical care electronic notes and the
standards of documentation graded on a f ve-point scale (very good, good,
average, minimal, absent). Documentation of the grade and training of
escorting staf was also sought. Between the two study periods, a transfer
safety checklist was introduced. Results A total of 20.9% of 143 patients
underwent one or more transfers in January 2011 (40 transfers). In May 2012,
26.4% of 151 patients underwent 57 transfers. In the first period,
documentation was graded as minimal (limited to a statement that the patient
had left the critical care unit) or absent in 77.5% of transfers. In the
62.5% of patients transferred whilst on invasive ventilation, 88.0% had no
documentation by the doctor and in 84.0% it was not known which doctor had
escorted the patient. There was only slight improvement in the second period
(71.9% minimal or absent documentation, 80.0% no documentation by the
doctor, 72.0% not known which doctor escorted). In the documentation
available, six severe complications were noted during the second period
(including episodes of severe bradycardia, hypotension and pupil
dilatation). Conclusion On average our unit conducts nearly two critical
care transfers each day. Severe complications seem to complicate at least
10% of these, stressing the risk, need for good care and ongoing training.
The intervention made in this audit had little impact on the standard of
documentation. However, it has raised the issue within the consciousness of
the staf . It is important to identify interventions that have failed to
reach a gold standard to provide the impetus to seek other solutions. As a
result of this study, the author has devised new hospital protocols and
specif c training courses to improve standards of transfer medicine locally.
The study also identif ed our portable head CT scanner to have the potential
to reduce transfers by 52% and so this has been strongly promoted.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency medicine
human
intensive care
patient
patient transport
safety
EMTREE MEDICAL INDEX TERMS
air conditioning
anesthesist
bradycardia
checklist
clinical audit
college
computed tomography scanner
consciousness
documentation
gold standard
hospital
hypotension
imaging
library
mydriasis
nursing
physician
radiology department
risk
training
United Kingdom
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71030581
DOI
10.1186/cc12222
FULL TEXT LINK
http://dx.doi.org/10.1186/cc12222
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 418
TITLE
Activity and case-mix changes in a medical ICU after the geographical
transfer of a third-level university hospital
AUTHOR NAMES
Cebrián J.C.
Monsalve F.M.
Bonastre J.B.
AUTHOR ADDRESSES
(Cebrián J.C.; Monsalve F.M.; Bonastre J.B.) Hospital Universitario,
Politecnico la Fe, Valencia, Spain.
CORRESPONDENCE ADDRESS
J.C. Cebrián, Hospital Universitario, Politecnico la Fe, Valencia, Spain.
SOURCE
Critical Care (2013) 17 SUPPL. 2 (S186-S187). Date of Publication: 19 Mar
2013
CONFERENCE NAME
33rd International Symposium on Intensive Care and Emergency Medicine
CONFERENCE LOCATION
Brussels, Belgium
CONFERENCE DATE
2013-03-19 to 2013-03-22
ISSN
1364-8535
BOOK PUBLISHER
BioMed Central Ltd.
ABSTRACT
Introduction Information about big hospital geographical transfer is scarce
in the medical literature. On 20 February 2011 our hospital (in fact, a big
university complex) was transferred from their previous location in the
north-center of our city towards a new southern peripheral, geographical
location. This transfer has been done without any changes in assisted
population or nursing/medical staf . The only change was a slight increase
in bed number (21 to 24). Our aim is to analyze changes in activity indexes
(length of stay, occupancy rate, and so forth) and case mix (origin,
previous quality of life and NYHA score, main diagnostic groups, severity
scores, in-ICU and in-hospital mortality). Methods To compare our number of
admissions, related activity and case-mix indicators 1 year before and after
the geographical change was done. We analyzed our whole number of patients
admitted to the ICU. We used the chi-square test for categorical variables
and one-way analysis of variance for quantitative data. Minitab and Statbas
statistical programs were used. We plotted activity data using the
Barber-Johnson 1 diagram. Results A total of 2,774 cases (63% males; mean
age 61 years) were admitted to our ICU during the period (1 year before and
after the transfer). No differences between both groups were founded in
demographic data, Knaus score and NYHA status. Regarding their origin, we
found more patients admitted from other hospital centers (20 vs. 29%; P
<0.001). APACHE II score increased from 17.24 to 19.08% (P <0.001) and a
slight increase change in SAPS 3 score was also found (52.29 to 53.75; P
<0.01). Our in-ICU mortality remains lower (15.5 to 15.6%) whereas observed
mortality decreased (22.37 to 19.88%; P <0.001). An increase in our
neurologic patients has been the most consistent change regarding diagnostic
groups. The activity indexes show a slightly decrease in occupancy rate
(79.2 vs. 76.8). Conclusion According to the previous data our ICU seems to
perform better in the new location with a decrease in the standardized
mortality rate. On the other hand, we are admitting more patients
transferred from other hospitals. A better occupancy rate was found.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
case mix
emergency medicine
intensive care
university hospital
EMTREE MEDICAL INDEX TERMS
analysis of variance
APACHE
chi square test
city
diagnosis related group
hairdresser
hospital
human
length of stay
male
medical literature
mortality
New York Heart Association class
patient
population
quality of life
Simplified Acute Physiology Score
university
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71030798
DOI
10.1186/cc12443
FULL TEXT LINK
http://dx.doi.org/10.1186/cc12443
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 419
TITLE
Improving maintenance of critical care land and aeromedical transfer
equipment
AUTHOR NAMES
Ashton-Cleary D.
Boyd N.
AUTHOR ADDRESSES
(Ashton-Cleary D.; Boyd N.) Royal Cornwall Hospital, Truro, United Kingdom.
CORRESPONDENCE ADDRESS
D. Ashton-Cleary, Royal Cornwall Hospital, Truro, United Kingdom.
SOURCE
Critical Care (2013) 17 SUPPL. 2 (S107-S108). Date of Publication: 19 Mar
2013
CONFERENCE NAME
33rd International Symposium on Intensive Care and Emergency Medicine
CONFERENCE LOCATION
Brussels, Belgium
CONFERENCE DATE
2013-03-19 to 2013-03-22
ISSN
1364-8535
BOOK PUBLISHER
BioMed Central Ltd.
ABSTRACT
Introduction The aim was to assess the content and state of repair of
equipment carried for transfer of critical care patients to other hospitals.
By chance, several items of date-expired stock were identif ed in the Data
presented as n (%). transfer kit whilst moving a patient to a tertiary
centre. This raised the possibility of a more extensive problem with the
equipment bags. Due to the geographical location of our district general
hospital we undertake around 70 transfers of critical care patients to other
hospitals per year (16% by air) and it is clearly important that our
equipment is well maintained for these journeys. Methods We maintain two
identical sets of equipment (syringes, fluid, airway management items, and
so forth) and drug bags to take on transfers; one equipment and one drug bag
taken on each trip. The contents of all four bags were checked and itemised.
By careful consideration of the aims of the bags (to provide emergency
equipment and drugs for managing one patient during an en-route emergency) a
new inventory was devised. Excess items were removed to lighten the bags and
improve accessibility to the essential items. Expired stock was removed. A
daily checking procedure and tamper-proof seals on the bags were instigated
and the bags were reassessed 12 months later. Results A total of 13.9% of
drug items and 29.2% of equipment items had expired or would do so within 30
days of the initial assessment. The combined weight of one equipment and one
drug bag was reduced from 14 to 9 kg (36% reduction) by introducing the new
inventory. At reassessment in November 2012, only 10 items of equipment
(3.2%) were expired or near to expiry and there were no expired drug items
(4.1% near to expiry). In total, 0.3 kg (26 small items) of extraneous
equipment had been added through over-restocking and was removed. Conclusion
These bags are designed for a clinician to manage a patient when an
emergency arises during transfer of a critical care patient. By the
introduction of simple measures, the risks posed by expired items or
cluttered equipment bags have almost been eradicated. Signif cant weight
savings have been made; this of ers improved ergonomics for staf and is also
an important consideration for aeromedical operations. Our department was
surprised to discover the extent of decline of our equipment and it may be
that other departments would f nd themselves in a similar position. The
anaesthetic registrars who routinely escort the transfer patients have a
vested interest to maintain this equipment and this has secured their buy-in
to the new checking procedure with clear results.
EMTREE DRUG INDEX TERMS
anesthetic agent
prednicarbate
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency medicine
intensive care
EMTREE MEDICAL INDEX TERMS
emergency
ergonomics
general hospital
hospital
human
liquid
patient
procedures
respiration control
risk
syringe
weight
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71030580
DOI
10.1186/cc12221
FULL TEXT LINK
http://dx.doi.org/10.1186/cc12221
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 420
TITLE
The Impact of postintubation chest radiograph during pediatric and neonatal
critical care transport
AUTHOR NAMES
Sanchez-Pinto N.
Giuliano J.S.
Schwartz H.P.
Garrett L.
Gothard M.D.
Kantak A.
Bigham M.T.
AUTHOR ADDRESSES
(Sanchez-Pinto N.; Giuliano J.S.; Schwartz H.P.; Garrett L.; Gothard M.D.;
Kantak A.; Bigham M.T.)
CORRESPONDENCE ADDRESS
N. Sanchez-Pinto,
SOURCE
Pediatric Critical Care Medicine (2013). Date of Publication: 2013
ISSN
1529-7535
BOOK PUBLISHER
The Society of Critical Care Medicine and the World Federation of Pediatric
Intensive and Critical Care Societies
ABSTRACT
OBJECTIVES: Tracheal intubation is necessary in the setting of
pediatric/neonatal critical care transport but information regarding
usefulness and efficiency of a confirmatory postintubation chest radiograph
is limited. We hypothesize that routine postintubation chest radiograph to
confirm tracheal tube position is not informative and can be eliminated to
improve efficiency without compromising safety in transport. DESIGN: This
was a prospective observational study. The primary study outcome was the
rate of tracheal tube repositioning after postintubation chest radiograph
and the secondary outcome was the on-scene time. Additional data obtained
included the initial accuracy of tracheal tube depth based on Pediatric
Advanced Life Support and Neonatal Resuscitation Program guidelines.
SETTING: A children's hospital-based pediatric/neonatal critical care
transport team in northeastern Ohio. PATIENTS: All pediatric/neonatal
patients intubated by the transport team during the 18-month study period
(January 2009-July 2010). MEASUREMENTS AND MAIN RESULTS: There were 77
patients enrolled (43 pediatric, 34 neonatal). A postintubation chest
radiograph was obtained 85.7% of the time and showed tracheal tube
malposition in 47% of cases. No difference was seen in the rate of
malpositioned tracheal tubes in the neonatal group compared with pediatric
group (51.7% vs. 43.2%, p = 0.54). The calculated tracheal tube depth based
on the Neonatal Resuscitation Program and Pediatric Advanced Life Support
guidelines was correct in 50% of the neonates and 41.9% of the pediatric
patients. In patients with appropriate initial tracheal tube depth by
calculations, the tracheal tube was repositioned at similar rates after
postintubation chest radiograph in both neonatal and pediatric patients (50%
vs. 41.9%, p = 0.48). When comparing mean onscene times for patients
with/without a postintubation chest radiograph, the neonatal patients saved
33 mins on average when no chest radiograph was obtained (mean ± SD: 60.6 ±
35.8 min vs. 93.8 ± 23.8 min, p = 0.01). There was no statistical difference
in on-scene time for pediatric patients whether they did or did not receive
a postintubation chest radiograph. CONCLUSIONS: Although postintubation
chest radiographs may extend the overall on-scene transport times in select
patients, our data show that the postintubation chest radiographs remain
informative in pediatric/neonatal critical care specialty transport and
should be obtained when feasible.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
thorax radiography
EMTREE MEDICAL INDEX TERMS
endotracheal intubation
endotracheal tube
human
newborn
observational study
patient
pediatric advanced life support
pediatric hospital
resuscitation
safety
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
23439465 (http://www.ncbi.nlm.nih.gov/pubmed/23439465)
PUI
L52459431
DOI
10.1097/PCC.0b013e3182772e13
FULL TEXT LINK
http://dx.doi.org/10.1097/PCC.0b013e3182772e13
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 421
TITLE
A delicate handoff: Improving transfer of care from the neurologic intensive
care unit (ICU) to non-ICU neurologic hospital services
AUTHOR NAMES
Morparia N.
Coon E.
Fabris R.
Klaas J.
Burkholder D.
Broomall E.
Graff-Radford J.
Moore S.
Morita H.
Rubin M.
Britton J.
AUTHOR ADDRESSES
(Morparia N.; Coon E.; Fabris R.; Klaas J.; Burkholder D.; Broomall E.;
Graff-Radford J.; Moore S.; Morita H.; Rubin M.; Britton J.) Mayo Clinic
Rochester, Rochester, United States.
CORRESPONDENCE ADDRESS
N. Morparia, Mayo Clinic Rochester, Rochester, United States.
SOURCE
Neurology (2013) 80:1 MeetingAbstracts. Date of Publication: 12 Feb 2013
CONFERENCE NAME
65th American Academy of Neurology Annual Meeting
CONFERENCE LOCATION
San Diego, CA, United States
CONFERENCE DATE
2013-03-16 to 2013-03-23
ISSN
0028-3878
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
OBJECTIVE: To implement a standardized documentation template for physician
use during transfer from the neurosciences intensive care unit (ICU) to
non-ICU neurology hospital services. BACKGROUND: Transfer of neurologic
patients from an ICU to hospital services is a complex process leading to
discontinuity in care with potential for errors. DESIGN/METHODS: A survey
methodology was used to identify problem areas in the Neurosciences ICU to
non-ICU transfer process. A standardized documentation template was
developed with sections addressing medication reconciliation, urinary
catheter use, vital sign parameters, rehabilitation consultation and
outstanding test results. Physicians during the three-month intervention
period were trained to incorporate elements of the template into the
transfer note. Physician satisfaction regarding the transfer process was
assessed before and after intervention. RESULTS: The survey response rate
was 37.5% pre-intervention and 19% post-intervention. The compliance rate of
the standardized transfer template was 93%. Overall, satisfaction with the
transfer process by accepting physicians was unchanged in the
post-intervention period (p=0.34). There was a significant decline in the
average number of patient transfers with urinary catheter (1.74 to 0.79;
p=0.04), but not in the number of times that medications had not been
reconciled (1.84 to 1.26; p=0.20). The majority of accepting physicians felt
that the transfer template made documentation easier to complete (74%) and
saved time for the physician in the transfer process (95%). Of accepting
physicians, 84% felt that the template should continue, with the most useful
aspects being medication reconciliation and reducing urinary catheter use.
Of transferring physicians, 88% felt that the template reminded them to
address an issue prior to patient transfer. CONCLUSIONS: The implementation
of standardized documentation for the transfer of neurologic patients from
the ICU to the non-ICU hospital services was beneficial to both transferring
and accepting physicians, and decreased the number of patients transferred
with urinary catheters, potentially preventing infections.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital service
intensive care unit
neurology
EMTREE MEDICAL INDEX TERMS
compliance (physical)
consultation
documentation
drug therapy
human
infection
medication therapy management
methodology
parameters
patient
patient transport
physician
rehabilitation
satisfaction
urinary catheter
vital sign
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71130920
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 422
TITLE
Safety of patients transferred from the operating room to the intensive care
unit
AUTHOR NAMES
Kaplow R.
AUTHOR ADDRESSES
(Kaplow R., roberta.kaplow@emoryhealthcare.org) Emory University Hospital,
Atlanta, GA, United States.
CORRESPONDENCE ADDRESS
R. Kaplow, Emory University Hospital, Atlanta, GA, United States. Email:
roberta.kaplow@emoryhealthcare.org
SOURCE
Critical Care Nurse (2013) 33:1 (68-70). Date of Publication: February 2013
ISSN
0279-5442
1940-8250 (electronic)
BOOK PUBLISHER
American Association of Critical Care Nurses, 101 Columbia, Suite 100, Aliso
Viejo, United States.
ABSTRACT
On the basis of the physician's preference or the intraoperative course,
patients may be admitted directly from the operating room to the intensive
care unit (ICU). Therefore, ICU nurses must be familiar with standards of
care for patients in the immediate postoperative period, anesthetic agents,
and management of potential complications. By focusing on the following
aspects of postanesthesia care, patient safety and optimal outcomes can be
achieved. © 2013 American Association of Critical-Care Nurses.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
operating room
patient transport
EMTREE MEDICAL INDEX TERMS
article
methodology
safety
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
23377159 (http://www.ncbi.nlm.nih.gov/pubmed/23377159)
PUI
L368290405
DOI
10.4037/ccn2013866
FULL TEXT LINK
http://dx.doi.org/10.4037/ccn2013866
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 423
TITLE
Patient transfer check off decreases fall rate on stroke unit
AUTHOR NAMES
Ashcraft S.
Coon L.
Bussey C.
Cargal J.
Allred A.
AUTHOR ADDRESSES
(Ashcraft S.; Coon L.; Bussey C.; Cargal J.; Allred A.) Cone Health,
Greensboro, United States.
CORRESPONDENCE ADDRESS
S. Ashcraft, Cone Health, Greensboro, United States.
SOURCE
Stroke (2013) 44:2 MeetingAbstract. Date of Publication: February 2013
CONFERENCE NAME
2013 International Stroke Conference and Nursing Symposium of the American
Heart Association/American Stroke Association
CONFERENCE LOCATION
Honolulu, HI, United States
CONFERENCE DATE
2013-02-06 to 2013-02-08
ISSN
0039-2499
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Background and Issues: Protecting stroke patients from falls and injury is
fundamental to providing exceptional care. An increased risk for falls has
been recognized among persons with diagnoses of stroke and other
neurological disorders. Our Stroke Unit's comprehensive fall prevention
program, while helpful, did not adequately identify stroke patients who
would fall. While instituting video monitoring of patients at high risk for
falls provided a 20% reduction in fall rate, stroke patients evaluated at
low and moderate risk continued to fall. Purpose: The purpose of our
practice change was to determine if implementing high risk measures on all
patients admitted to a stroke unit until demonstration of five safe
transfers would decrease the number of patient falls. Methods: Utilizing a
shared responsibility model, our Stroke Unit engaged all staff members in
the falls prevention program. Each patient was evaluated using the current
falls risk assessment tool. If the patient was scored high risk, full falls
prevention measures were maintained. For patients scoring low to moderate
risk, a safe patient transfer check off procedure was implemented. Each
patient was monitored five times to ensure independent demonstration of all
aspects of transfer without support. Upon five safe transfers, the patient's
bed alarm could be shut off and general fall preventative measures
maintained. Unit secretaries checked the bed alarm system twice a day to
monitor proper activation of alarms. A report was created representing the
retrieved information for the charge nurse. The charge nurse followed up
with nurses whose patient alarms were not on and ensured proper activation.
Results: Since implementation of the safe patient transfer check off, we
have seen an additional 33% reduction in fall rate compared to our
post-implementation of video monitoring rate (3.48/1000 patient days
compared to 5.20/1000 patient days). There were zero falls for patients who
were successfully checked off on safe transfers. Conclusion: Implementing a
safe transfer check off for mild to moderate fall risk patients on a Stroke
Unit may be a successful strategy to prevent falls and fall related
injuries. Engaging all staff members in the program increased awareness of
the importance of falls prevention.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cerebrovascular accident
heart
human
nursing
patient transport
stroke unit
EMTREE MEDICAL INDEX TERMS
charge nurse
diagnosis
fall risk
injury
model
monitoring
neurologic disease
nurse
patient
prevention
procedures
responsibility
risk
risk assessment
stroke patient
videorecording
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71144160
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 424
TITLE
Management of criticallyill cirrhotic patients: Transfer in intensive care
unit or stop of care?
ORIGINAL (NON-ENGLISH) TITLE
Prise en charge du patient cirrhotique grave : Transfert en réanimation ou
limitation des soins ?
AUTHOR NAMES
Colin M.
Langlois J.
Kipnis E.
Lebuffe G.
Mathurin P.
Dharancy S.
AUTHOR ADDRESSES
(Colin M., marie.colin@chru-lille.fr; Mathurin P.; Dharancy S.) CHRU Lille,
Ȟopital Claude Huriez, Maladies de l'appareil digestif et de la nutrition,
59037 Lille Cedex, France.
(Langlois J.; Kipnis E.; Lebuffe G.) CHRU Lille, Ȟopital Claude Huriez,
P̌ole médico-chirurgical Huriez, Lille, France.
CORRESPONDENCE ADDRESS
M. Colin, CHRU Lille, Ȟopital Claude Huriez, Maladies de l'appareil digestif
et de la nutrition, 59037 Lille Cedex, France. Email:
marie.colin@chru-lille.fr
SOURCE
Hepato-Gastro (2013) 20:2 (133-140). Date of Publication: February 2013
ISSN
1253-7020
1952-4048 (electronic)
BOOK PUBLISHER
John Libbey Eurotext, 127, avenue de la Republique, Montrouge, France.
ABSTRACT
Cirrhosis is an independent prognostic factor formortality in Intensive Care
Unit (ICU). The improvedmanagement of acute complications of cirrhosis and a
'fast tracking' access to liver transplantation are the keystones of
reflection in the setting of invasive acute care. ICU admission is
amultiparametric decision taking into account patient related factors, type
of complications, intensive care scores and the existence of a therapeutical
project. The decision between active resuscitation or withholding and
withdrawal of life-sustaining treatment in critically-ill cirrhotic patient
is difficult to make. In fact, the occurrence of a complication in these
patients is often a turning point in the natural history and often leads to
multi-organ failure. These procedures of withholding and withdrawal of
life-sustaining treatment regulated by law have been developed to address
these difficult ethical questions. The hepato-gastroenterologist plays a
central role in this multidisciplinary reflection.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
liver cirrhosis
patient care
EMTREE MEDICAL INDEX TERMS
critically ill patient
decision making
human
liver transplantation
multiple organ failure
resuscitation
review
treatment withdrawal
EMBASE CLASSIFICATIONS
Gastroenterology (48)
LANGUAGE OF ARTICLE
French
LANGUAGE OF SUMMARY
English, French
EMBASE ACCESSION NUMBER
2013239502
PUI
L368729619
DOI
10.1684/hpg.2013.0839
FULL TEXT LINK
http://dx.doi.org/10.1684/hpg.2013.0839
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 425
TITLE
Management of Critically-Ill cirrhotic patients: Transfer in intensive care
unit or stop of care?
ORIGINAL (NON-ENGLISH) TITLE
Prise en charge du patient cirrhotique grave: Transfert en réanimation ou
limitation des soins?
AUTHOR NAMES
Colin M.
Langlois J.
Kipnis E.
Lebuffe G.
Mathurin P.
Dharancy S.
AUTHOR ADDRESSES
(Colin M., marie.colin@chru-lille.fr; Mathurin P.; Dharancy S.) CHRU Lille,
Hopital Claude Huriez, Maladies de l'Appareil Digestif et de La Nutrition,
Lille Cedex, France.
(Langlois J.; Kipnis E.; Lebuffe G.) CHRU Lille, Hôpital Claude Huriez, Pôle
Médico-Chirurgical Huriez, Service de Réanimation Chirurgicale, Lille,
France.
(Lebuffe G.) CHRU Lille, Hopital Claude Huriez, Pôle Médico-Chirurgical
Huriez, Service d'Anesthésie et Transplantation Hépatique, Lille, France.
SOURCE
Hepato-Gastro et Oncologie Digestive (2013) 20:2 (133-140). Date of
Publication: 1 Feb 2013
ISSN
2115-5631 (electronic)
2115-3310
BOOK PUBLISHER
John Libbey Eurotext, 127, avenue de la Republique, Montrouge, France.
contact@jle.com
ABSTRACT
Cirrhosis is an independent prognostic factor for mortality in Intensive
Care Unit (ICU). The improved management of acute complications of cirrhosis
and a "fast tracking" access to liver transplantation are the keystones of
reflection in the setting of invasive acute care. ICU admission is a
multiparametric decision taking into account patient related factors, type
of complications, intensive care scores and the existence of a therapeutical
project. The decision between active resuscitation or withholding and
withdrawal of life-sustaining treatment in critically-ill cirrhotic patient
is difficult to make. In fact, the occurrence of a complication in these
patients is often a turning point in the natural history and often leads to
multi-organ failure. These procedures of withholding and withdrawal of
life-sustaining treatment regulated by law have been developed to address
these difficult ethical questions. The hepato-gastroenterologist plays a
central role in this multidisciplinary reflection.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
intensive care unit
liver cirrhosis
treatment withdrawal
EMTREE MEDICAL INDEX TERMS
human
life sustaining treatment
liver transplantation
multiple organ failure
resuscitation
review
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Gastroenterology (48)
LANGUAGE OF ARTICLE
French
LANGUAGE OF SUMMARY
English, French
EMBASE ACCESSION NUMBER
20160901331
PUI
L613607900
DOI
10.1684/hpg.2013.0839
FULL TEXT LINK
http://dx.doi.org/10.1684/hpg.2013.0839
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 426
TITLE
Protracted outbreak of multidrug-resistant acinetobacter baumannii after
intercontinental transfer of colonized patients
AUTHOR NAMES
Landelle C.
Legrand P.
Lesprit P.
Cizeau F.
Ducellier D.
Gouot C.
Bréhaut P.
Soing-Altrach S.
Girou E.
Brun-Buisson C.
AUTHOR ADDRESSES
(Landelle C., caroline.landelle@gmail.com; Lesprit P.; Cizeau F.; Ducellier
D.; Gouot C.; Bréhaut P.; Soing-Altrach S.; Girou E.; Brun-Buisson C.) Unité
de Contrôle, Epidémiologie et Prévention de l'Infection, Centre Hospitalier
Universitaire Albert Chenevier-Henri Mondor, Assistance Publique-Hopitaux de
Paris, Université Paris 12, Créteil, France.
(Legrand P.) Service de Bactériologie-Virologie-Hygiène, Centre Hôspitalier
Universitaire Albert Chenevier-Henri Mondor, Assistance Publique-Hôpitaux de
Paris, Université Paris 12, Créteil, France.
(Brun-Buisson C.) Service de Réanimation Médicale, Centre Hôspitalier
Universitaire Albert Chenevier-Henri Mondor, Assistance Publique-Hopitaux de
Paris, Universite Paris 12, Créteil, France.
CORRESPONDENCE ADDRESS
C. Landelle, Unité de Contrôle, Epidémiologie et Prévention de l'Infection,
Centre Hospitalier Universitaire Albert Chenevier-Henri Mondor, Assistance
Publique-Hopitaux de Paris, Université Paris 12, Créteil, France. Email:
caroline.landelle@gmail.com
SOURCE
Infection Control and Hospital Epidemiology (2013) 34:2 (119-124). Date of
Publication: February 2013
ISSN
0899-823X
BOOK PUBLISHER
University of Chicago Press, 1427 E. 60th Street, Chicago, United States.
ABSTRACT
objective. To describe the course and management of a protracted outbreak
after intercontinental transfer of 2 patients colonized with
multidrug-resistant Acinetobacter baumannii (MDRAB). design. An 18-month
outbreak investigation. setting. An 860-bed university hospital in France.
patients. Case patients (ie, carriers) were those colonized or infected with
an MDRAB isolate. methods. During the epidemic period, all intensive care
unit (ICU) patients and contacts of carriers who were transferred to wards
were screened for MDRAB carriage. Contact precautions, environmental
screening, and auditing of healthcare worker (HCW) practices were
implemented; rooms were cleaned with hydrogen peroxide mist disinfection.
One ICU, in which most of the cases occurred, was closed on 4 occasions for
thorough cleaning and disinfection. results. The 2 index case patients were
identified as 2 patients who carried the same MDRAB strain and who were
admitted to the hospital after repatriation from Tahiti 5 months apart.
During an 18-month period, a total of 84 secondary cases occurred.
Reintroduction of MDRAB into the ICUs occurred from patients previously
colonized or from healthcare personnel. Termination of the outbreak was only
achieved when all carriers from wards or the ICU were cohorted to an
isolation unit with dedicated healthcare personnel. conclusions.
Intercontinental transfer of carriers of MDRAB can result in extensive
outbreaks and serious disruption of the hospital's organization.
Transmission from carriers most likely occurred via the hands of HCWs, poor
cleaning protocols, airborne spread, and contaminated water from sink traps.
This protracted outbreak was controlled only after implementation of an
extensive control program and eventual cohorting of all carriers in an
isolation unit with dedicated healthcare personnel. © 2012 by The Society
for Healthcare Epidemiology of America. All rights reserved.
EMTREE DRUG INDEX TERMS
aminoglycoside
cephalosporin
ciprofloxacin
colistin
hydrogen peroxide
imipenem
penicillin derivative
rifampicin
sultamicillin
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Acinetobacter infection (epidemiology)
multidrug resistance
patient transport
EMTREE MEDICAL INDEX TERMS
article
cleaning
disease surveillance
disinfection
health care personnel
health program
human
infection control
intensive care unit
major clinical study
mass screening
CAS REGISTRY NUMBERS
cephalosporin (11111-12-9)
ciprofloxacin (85721-33-1)
colistin (1066-17-7, 1264-72-8)
hydrogen peroxide (7722-84-1)
imipenem (64221-86-9)
rifampicin (13292-46-1)
sultamicillin (76497-13-7)
EMBASE CLASSIFICATIONS
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
Public Health, Social Medicine and Epidemiology (17)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2013030384
MEDLINE PMID
23295556 (http://www.ncbi.nlm.nih.gov/pubmed/23295556)
PUI
L368093571
DOI
10.1086/669093
FULL TEXT LINK
http://dx.doi.org/10.1086/669093
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 427
TITLE
Reasons for repeat imaging in the pediatric emergency department (ED) and
the impact of a state wide trauma image repository system
AUTHOR NAMES
Thompson T.M.
Lovvorn J.
Lynch A.
Hunter E.
AUTHOR ADDRESSES
(Thompson T.M.; Lovvorn J.; Lynch A.) Univ of Arkansas for Medical Sciences,
Little Rock, United States.
(Hunter E.) Children's Mercy, Kansas City, United States.
CORRESPONDENCE ADDRESS
T.M. Thompson, Univ of Arkansas for Medical Sciences, Little Rock, United
States.
SOURCE
Journal of Investigative Medicine (2013) 61:2 (454). Date of Publication:
February 2013
CONFERENCE NAME
American Federation for Medical Research Southern Regional Meeting, AFMR
2013
CONFERENCE LOCATION
New Orleans, LA, United States
CONFERENCE DATE
2013-02-21 to 2013-02-23
ISSN
1081-5589
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Purpose of Study: Many patients transferred from outside facilities have the
same radiographic studies repeated in the ED for a variety of reasons. This
practice exposes patients to addition radiation which can have harmful
effects on and increase costs to the patient. Previously we determined the
reasons for repeat radiographic imaging in our ED.With the advent of a state
wide Trauma Image Repository (TIR) in 2012, which can send high quality
images ahead of the patient to the receiving hospital, we are evaluating
whether the types and reasons for repeat imaging in our ED has changed.
Methods Used: A prospective study was designed to identify patients who
require repeat radiographic imaging upon arrival to the ED of a tertiary
pediatric hospital, commencing in January 2011 and currently ongoing. Upon
arrival, an evaluation sheet was filled out by ED staff to identify the type
of study and the reason it was obtained. The results were analyzed using
SSPS and reported in aggregate. Summary of Results: To date, 139 subjects
were identified in the pre TIR study period; approximately 45% were
identified as trauma patients. 70.3% of these patients had repeat plain
films, 16.7% had a repeated CT scan, and 7.2% had both a repeated CT scan
and plain films. The most common reasons cited for repeat imaging were poor
quality film/inadequate views (43%), no films sent with patient at time of
transfer (20%), and inability to open the film disk that was sent (12%).
Only 18% of repeat images were clinically indicated due to a patient status
change that warranted further evaluation. Data collection in the post TIR
period is currently ongoing but preliminary data analysis indicates an
approximate 8% decrease in repeat trauma imaging studies. Conclusions:
Repeat imaging for intra-hospital transfer to a tertiary facility is
sometimes unavoidable. However, in our institution, clinical indication was
not the primary reason for repeat studies. This practice incurs both a
monitory cost and additional radiation exposure to the patient. The use of a
state wide TIR, which can send images to the receiving facility may be one
way to decrease radiation exposure and costs to the patient.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency ward
imaging
injury
medical research
EMTREE MEDICAL INDEX TERMS
computer assisted tomography
data analysis
hospital
human
information processing
patient
pediatric hospital
prospective study
radiation
radiation exposure
Tertiary (period)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70993220
DOI
10.231/JIM.0b013e3182820c55
FULL TEXT LINK
http://dx.doi.org/10.231/JIM.0b013e3182820c55
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 428
TITLE
Transfer out of intensive care: an evidence-based literature review.
AUTHOR NAMES
Cypress B.S.
AUTHOR ADDRESSES
(Cypress B.S., brigitte.cypress@lehman.cuny.edu) Lehman College and The
Graduate Center, City University of New York, NY, USA.
CORRESPONDENCE ADDRESS
B.S. Cypress, Email: brigitte.cypress@lehman.cuny.edu
SOURCE
Dimensions of critical care nursing : DCCN (2013) 32:5 (244-261). Date of
Publication: 2013 Sep-Oct
ISSN
1538-8646 (electronic)
ABSTRACT
Critical care beds are a finite resource. Transfer or discharge of patients
from the intensive care unit affects the flow of patients in critical care.
Effective whole hospital bed management is key to the successful management
of the critical care service. However, admission to the critical care unit
alone can be extremely frightening, distressing, and traumatic not only for
the patients but their families as well. Although transfer to the medical
floors is a positive step toward physical recovery, it can be equally
traumatic, and many patients and their families exhibit stress, fear, and
anxiety. The purpose of this article was to systematically review the
effects of intensive care unit transfer or discharge to medical-surgical
floors on adult critically ill patients, their family members and nurses.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
hospital discharge
intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
anxiety (etiology)
evidence based nursing
family
human
mental stress (etiology)
psychological aspect
review
LANGUAGE OF ARTICLE
English
MEDLINE PMID
23933644 (http://www.ncbi.nlm.nih.gov/pubmed/23933644)
PUI
L563078956
COPYRIGHT
Copyright 2015 Medline is the source for the citation and abstract of this
record.
RECORD 429
TITLE
A blueprint for critical care transport research
AUTHOR NAMES
Jaynes C.L.
Werman H.A.
White L.J.
AUTHOR ADDRESSES
(Jaynes C.L., cathy.jaynes@tcmtr.org; Werman H.A.) Center for Medical
Transport Research, 2827 W. Dublin-Granville Road, Columbus, OH 43235-2712,
United States.
(Werman H.A.; White L.J.) Ohio State University, Columbus, OH, United
States.
CORRESPONDENCE ADDRESS
C.L. Jaynes, Center for Medical Transport Research, 2827 W. Dublin-Granville
Road, Columbus, OH 43235-2712, United States. Email: cathy.jaynes@tcmtr.org
SOURCE
Air Medical Journal (2013) 32:1 (30-35). Date of Publication:
January-February 2013
ISSN
1067-991X
1532-6497 (electronic)
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
ABSTRACT
Introduction: An estimated 500,000 critical care patient transports occur
annually in the United States. Little research exists to inform optimal
practices, promote safety, or encourage responsible, cost-effective use of
this resource. Previous efforts to develop a research agenda have not
yielded significant progress in producing much-needed scientific study.
Purpose: Identify and characterize areas of research needed to direct the
development of evidence-based guidelines Methods: The study used a modified
Delphi technique to develop a concept map of the research domains in
critical care transport. Proprietary, internet-based software was used for
both data collection and analysis. The study was conducted in 3 phases:
brainstorming, categorizing, and prioritizing, using experts from all
aspects of critical care transport. Results: A total of 101 research
questions were developed and ranked by 27 participants representing the
transport community and stakeholders. An 8-cluster solution was developed
with multidimensional scaling and hierarchical cluster analysis to identify
the following research areas: clinical care, education/training, finance,
human factors, patient outcomes, safety, team configuration, and
utilization. A plot characterized each domain by urgency and feasibility.
Conclusion: The content and concepts represented by the cluster map can help
direct research planning in the critical care transport industry and
prioritize funding decisions. © 2013 Air Medical Journal Associates.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
evidence based medicine
health care utilization
human
outcome assessment
patient safety
practice guideline
priority journal
research priority
software
EMBASE CLASSIFICATIONS
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2013001041
MEDLINE PMID
23273307 (http://www.ncbi.nlm.nih.gov/pubmed/23273307)
PUI
L368005500
DOI
10.1016/j.amj.2012.11.001
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2012.11.001
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 430
TITLE
Pediatric and neonatal interfacility transport: Results from a national
consensus conference
AUTHOR NAMES
Stroud M.H.
Trautman M.S.
Meyer K.
Moss M.M.
Schwartz H.P.
Bigham M.T.
Tsarouhas N.
Douglas W.P.
Romito J.
Hauft S.
Meyer M.T.
Insoft R.
AUTHOR ADDRESSES
(Stroud M.H., stroudmichaelh@uams.edu; Moss M.M.) Department of Pediatrics,
Section of Critical Care Medicine, University of Arkansas for Medical
Sciences, United States.
(Trautman M.S.) Department of Pediatrics, Section of Neonatal-Perinatal
Medicine, Indian University School of Medicine, United States.
(Trautman M.S.; Meyer K.; Moss M.M.; Schwartz H.P.; Bigham M.T.; Tsarouhas
N.; Douglas W.P.; Romito J.; Hauft S.; Meyer M.T.; Insoft R.) American
Academy of Pediatrics, Section on Transport Medicine, United States.
(Meyer K.) Department of Pediatrics, Miami Children's Hospital, United
States.
(Schwartz H.P.) Division of Emergency Medicine, Cincinnati Children's
Hospital Medical Center, Cincinnati, OH, United States.
(Bigham M.T.) Department of Pediatrics, Section of Critical Care Medicine,
Akron Children's Hospital, Akron, OH, United States.
(Tsarouhas N.) Department of Pediatrics, Perelman School of Medicine,
University of Pennsylvania, Philadelphia, PA, United States.
(Douglas W.P.) Maryland Regional Neonatal Transport Program, Baltimore, MD,
United States.
(Hauft S.) Department of Pediatrics, Washington University, School of
Medicine, United States.
(Meyer M.T.) Department of Pediatrics, Section of Critical Care Medicine,
Medical College of Wisconsin, United States.
(Insoft R.) Department of Newborn Medicine, Brigham and Women's Hospital,
Harvard Medical School, United States.
(Stroud M.H., stroudmichaelh@uams.edu) 1 Children's Way, Little Rock, AR
72202, United States.
CORRESPONDENCE ADDRESS
M.H. Stroud, 1 Children's Way, Little Rock, AR 72202, United States. Email:
stroudmichaelh@uams.edu
SOURCE
Pediatrics (2013) 132:2 (359-366). Date of Publication: August 2013
ISSN
1098-4275 (electronic)
0031-4005
BOOK PUBLISHER
American Academy of Pediatrics, 141 Northwest Point Blvd, P.O. Box 927, Elk
Grove Village, United States.
ABSTRACT
The practice of pediatric/neonatal interfacility transport continues to
expand. Transport teams have evolved into mobile ICUs capable of delivering
state-of-the-art critical care during pediatric and neonatal transport. The
most recent document regarding the practice of pediatric/neonatal transport
is more than a decade old. The following article details changes in the
practice of interfacility transport over the past decade and expresses the
consensus views of leaders in the field of transport medicine, including the
American Academy of Pediatrics' Section on Transport Medicine. Pediatrics
2013;132:359-366 Copyright © 2013 by the American Academy of Pediatrics.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
newborn care
patient transport
EMTREE MEDICAL INDEX TERMS
accreditation
administrative personnel
air medical transport
article
clinical research
consensus
disaster medicine
health care quality
health economics
helicopter
human
intensive care unit
law
medical education
medical society
patient safety
priority journal
quality control
simulation
teamwork
working time
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2013518765
MEDLINE PMID
23821698 (http://www.ncbi.nlm.nih.gov/pubmed/23821698)
PUI
L369593966
DOI
10.1542/peds.2013-0529
FULL TEXT LINK
http://dx.doi.org/10.1542/peds.2013-0529
COPYRIGHT
Copyright 2018 Elsevier B.V., All rights reserved.
RECORD 431
TITLE
Vertical hospital evacuations: a new method.
AUTHOR NAMES
Iserson K.V.
AUTHOR ADDRESSES
(Iserson K.V.) University of Arizona and the AZ-1 Disaster Medical
Assistance Team, Tucson, AZ, USA.
CORRESPONDENCE ADDRESS
K.V. Iserson, University of Arizona and the AZ-1 Disaster Medical Assistance
Team, Tucson, AZ, USA. Email: kvi@u.arizona.edu
SOURCE
Southern medical journal (2013) 106:1 (37-42). Date of Publication: Jan 2013
ISSN
1541-8243 (electronic)
ABSTRACT
Rarely are hospitals forced to evacuate their nonambulatory patients;
however, when a disaster occurs, evacuating nonambulatory patients,
particularly from multilevel facilities, represents a major logistical
hurdle. Hospital disaster plans often rely on outside agencies and limited
equipment to perform vertical evacuations. This article describes a novel
method using readily available materials (patient mattresses and bedsheets)
to effect a rapid, safe vertical evacuation. This method also can be used in
nonhealthcare facilities for less-than-fully ambulatory individuals.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
bed
disaster planning
patient lifting
patient transport
EMTREE MEDICAL INDEX TERMS
article
hospital
human
intensive care unit
methodology
organization and management
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
23263312 (http://www.ncbi.nlm.nih.gov/pubmed/23263312)
PUI
L366384991
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 432
TITLE
Making good better: Implementing a standardized handoff in pediatric
transport
AUTHOR NAMES
Weingart C.
Herstich T.
Baker P.
Garrett M.L.
Bird M.
Billock J.
Schwartz H.P.
Bigham M.T.
AUTHOR ADDRESSES
(Weingart C.; Herstich T.; Bigham M.T., mbigham@chmca.org) Department of
Pediatrics, Division of Critical Care Medicine, Akron Children's Hospital, 1
Perkins Square, Akron, OH 44308, United States.
(Baker P.; Garrett M.L.; Billock J.) Department of Nursing, Akron Children's
Hospital, Akron, OH, United States.
(Garrett M.L.) Transport Services, Akron Children's Hospital, Akron, OH,
United States.
(Bird M.) Medical Services, Akron Children's Hospital, Akron, OH, United
States.
(Schwartz H.P.) Department of Pediatrics, Children's Hospital, Medical
Center of Cincinnati, Cincinnati, OH, United States.
CORRESPONDENCE ADDRESS
M.T. Bigham, Department of Pediatrics, Division of Critical Care Medicine,
Akron Children's Hospital, 1 Perkins Square, Akron, OH 44308, United States.
Email: mbigham@chmca.org
SOURCE
Air Medical Journal (2013) 32:1 (40-46). Date of Publication:
January-February 2013
ISSN
1067-991X
1532-6497 (electronic)
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
ABSTRACT
Background: Failures in communication lead to adverse events in healthcare.
Handoffs, defined as the transfer of information, responsibility, and
authority from one provider to another, have been identified as a cause of
communication failure compromising patient safety. Locally, there was
dissatisfaction among caregivers working on the general care and intensive
care units regarding the quality of information received from the pediatric
transport team for transferred patients. Methods: Using the Model for
Improvement, a quality improvement team was engaged to lead this improvement
effort. The team developed a standardized and scripted transport handoff
process that incorporated parental input. The primary measure was provider
satisfaction (reported as overall handoff score, OHS). Secondary outcomes
included the use of components outlined by the Joint Commission's guidelines
for safe handoff. Data were collected using a Likert-style survey and
collated using Microsoft Excel. Results: Baseline measures of OHS were 81.5
± 19.4 (mean±SD) with an interval analysis showing no improvement
(81.6±17.4, P=0.99). Further modifications were made to both education and
process with an improved OHS (88.8±11.1, P<0.05). Certain specific handoff
components showed the greatest improvement according to caregivers.
Conclusion: This practical, low-cost quality-improvement project may help
others improve handoff communication and provide safe, high-quality care. ©
2013 Air Medical Journal Associates.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient transport
practice guideline
EMTREE MEDICAL INDEX TERMS
article
caregiver
health care quality
health survey
human
intensive care unit
interpersonal communication
outcome assessment
priority journal
standardization
total quality management
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2013001034
MEDLINE PMID
23273309 (http://www.ncbi.nlm.nih.gov/pubmed/23273309)
PUI
L368005493
DOI
10.1016/j.amj.2012.06.005
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2012.06.005
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 433
TITLE
21st critical care transport medicine conference: We're going to austin-live
music capital of the world!
AUTHOR NAMES
Newman M.
Petersen P.
Wojdyla K.
AUTHOR ADDRESSES
(Newman M.) International Association of Flight and Critical Care
Paramedics, United States.
(Petersen P.) Air Medical Physician Association, United States.
(Wojdyla K.) Air and Surface Transport Nurses Association, Austin Convention
and Visitors Bureau, United States.
CORRESPONDENCE ADDRESS
M. Newman, International Association of Flight and Critical Care Paramedics,
United States.
SOURCE
Air Medical Journal (2013) 32:1 (28-29). Date of Publication:
January-February 2013
ISSN
1067-991X
1532-6497 (electronic)
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
consensus development
EMTREE MEDICAL INDEX TERMS
certification
conference paper
emergency medicine
human
intensive care
patient care
patient transport
practice guideline
priority journal
professionalism
United States
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2013001039
MEDLINE PMID
23273306 (http://www.ncbi.nlm.nih.gov/pubmed/23273306)
PUI
L368005498
DOI
10.1016/j.amj.2012.10.007
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2012.10.007
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 434
TITLE
Pharmacy resident takes care to new height
AUTHOR NAMES
Traynor K.
AUTHOR ADDRESSES
(Traynor K.)
CORRESPONDENCE ADDRESS
K. Traynor,
SOURCE
American Journal of Health-System Pharmacy (2013) 70:19 (1648). Date of
Publication: 1 Oct 2013
ISSN
1535-2900 (electronic)
1079-2082
BOOK PUBLISHER
American Society of Health-Systems Pharmacy
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient transport
pharmacy
EMTREE MEDICAL INDEX TERMS
airplane crew
critically ill patient
emergency medicine
emergency ward
health care system
helicopter
human
intensive care unit
note
physician
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2014800444
MEDLINE PMID
24048595 (http://www.ncbi.nlm.nih.gov/pubmed/24048595)
PUI
L600050632
DOI
10.2146/news130069
FULL TEXT LINK
http://dx.doi.org/10.2146/news130069
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 435
TITLE
The generation, transfer, and implementation of evidence in health care is
critical for consistent improvement in health outcomes.
AUTHOR NAMES
Lisy K.
AUTHOR ADDRESSES
(Lisy K.)
CORRESPONDENCE ADDRESS
K. Lisy,
SOURCE
Journal of nursing measurement (2013) 21:3 (347-348). Date of Publication:
2013
ISSN
1061-3749
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
evidence based nursing
health care delivery
health care quality
total quality management
EMTREE MEDICAL INDEX TERMS
editorial
human
methodology
organization and management
treatment outcome
LANGUAGE OF ARTICLE
English
MEDLINE PMID
24620509 (http://www.ncbi.nlm.nih.gov/pubmed/24620509)
PUI
L372795719
DOI
10.1891/1061-3749.21.3.347
FULL TEXT LINK
http://dx.doi.org/10.1891/1061-3749.21.3.347
COPYRIGHT
Copyright 2014 Medline is the source for the citation and abstract of this
record.
RECORD 436
TITLE
Improving situation awareness to reduce unrecognized clinical deterioration
and serious safety events
AUTHOR NAMES
Brady P.W.
Muething S.
Kotagal U.
Ashby M.
Gallagher R.
Hall D.
Goodfriend M.
White C.
Bracke T.M.
DeCastro V.
Geiser M.
Simon J.
Tucker K.M.
Olivea J.
Conway P.H.
Wheeler D.S.
AUTHOR ADDRESSES
(Brady P.W., patrick.brady@cchmc.org; Muething S.; White C.; Conway P.H.)
Divisions of Hospital Medicine, 3333 Burnet Ave, Cincinnati, OH 45229,
United States.
(Brady P.W., patrick.brady@cchmc.org; Muething S.; Kotagal U.; Ashby M.;
Bracke T.M.; Olivea J.; Wheeler D.S.) James M. Anderson Center for Health
Systems Excellence, Cincinnati, OH, United States.
(Wheeler D.S.) Critical Care Medicine, Department of Pediatrics, Cincinnati,
OH, United States.
(Goodfriend M.) Family Relations, Cincinnati, OH, United States.
(Gallagher R.; Hall D.; Goodfriend M.; DeCastro V.; Tucker K.M.) Department
of Patient Services, Cincinnati Children's Hospital Medical Center,
Cincinnati, OH, United States.
(Geiser M.; Simon J.) Division of Quality Services, Akron Children's
Hospital, Akron, OH, United States.
(Conway P.H.) Centers for Medicare and Medicaid Services, Office of Clinical
Standards and Quality, Baltimore, MD, United States.
CORRESPONDENCE ADDRESS
P.W. Brady, Divisions of Hospital Medicine, 3333 Burnet Ave, Cincinnati, OH
45229, United States. Email: patrick.brady@cchmc.org
SOURCE
Pediatrics (2013) 131:1 (e298-e308). Date of Publication: January 2013
ISSN
0031-4005
1098-4275 (electronic)
BOOK PUBLISHER
American Academy of Pediatrics, 141 Northwest Point Blvd, P.O. Box 927, Elk
Grove Village, United States.
ABSTRACT
BACKGROUND AND OBJECTIVE: Failure to recognize and treat clinical
deterioration remains a source of serious preventable harm for hospitalized
patients. We designed a system to identify, mitigate, and escalate patient
risk by using principles of high-reliability organizations. We hypothesized
that our novel care system would decrease transfers determined to be
unrecognized situation awareness failures events (UNSAFE). These were
defined as any transfer from an acute care floor to an ICU where the patient
received intubation, inotropes, or s3 fluid boluses in first hour after
arrival or before transfer. METHODS: The setting for our observational time
series study was a quaternary care children's hospital. Before initiating
tests of change, 2 investigators reviewed recent serious safety events
(SSEs) and floor-to-ICU transfers. Collectively, 5 risk factors were
associated with each event: family concerns, high-risk therapies, presence
of an elevated early warning score, watcher/clinician gut feeling, and
communication concerns. Using the model for improvement, an intervention was
developed and tested to reliably and proactively identify patient risk and
mitigate that risk through unit-based huddles. A 3-times daily inpatient
huddle was added to ensure risks were escalated and addressed. Later, a
'robust' and explicit plan for at-risk patients was developed and spread.
RESULTS: The rate of UNSAFE transfers per 10 000 non-ICU inpatient days was
significantly reduced from 4.4 to 2.4 over the study period. The days
between inpatient SSEs also increased significantly. CONCLUSIONS: A reliable
system to identify, mitigate, and escalate risk was associated with a near
50% reduction in UNSAFE transfers and SSEs. Copyright © 2013 by the American
Academy of Pediatrics.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health service
intensive care unit
patient transport
unrecognized situation awareness failures events
EMTREE MEDICAL INDEX TERMS
article
child health care
emergency care
family counseling
high risk patient
hospital patient
human
interpersonal communication
observational study
pediatric hospital
physician attitude
priority journal
risk assessment
risk reduction
scoring system
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2013062452
MEDLINE PMID
23230078 (http://www.ncbi.nlm.nih.gov/pubmed/23230078)
PUI
L368184715
DOI
10.1542/peds.2012-1364
FULL TEXT LINK
http://dx.doi.org/10.1542/peds.2012-1364
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 437
TITLE
Improving patient safety in the ICU by prospective identification of missing
safety barriers using the bow-tie prospective risk analysis model.
AUTHOR NAMES
Kerckhoffs M.C.
van der Sluijs A.F.
Binnekade J.M.
Dongelmans D.A.
AUTHOR ADDRESSES
(Kerckhoffs M.C., M.Kerckhoffs@gmail.com) Department of Intensive Care
Medicine, Academic Medical Centre, Amsterdam, TheNetherlands.
(van der Sluijs A.F.; Binnekade J.M.; Dongelmans D.A.)
CORRESPONDENCE ADDRESS
M.C. Kerckhoffs, Email: M.Kerckhoffs@gmail.com
SOURCE
Journal of patient safety (2013) 9:3 (154-159). Date of Publication: Sep
2013
ISSN
1549-8425 (electronic)
ABSTRACT
To improve patient safety, potential critical events should be analyzed for
the existence of preventive barriers. The aim of this study was to
prospectively identify existing and missing barriers using the Bow-Tie
model. We expected that the analysis of these barriers would lead to
feasible recommendations to improve safety in daily patient care.
Multidisciplinary teams of doctors and nurses on a 28 bed ICU conducted the
study. The Bow-Tie analysis was performed on intrahospital transportation,
unplanned extubation, and communication, which led to 9 critical events. For
each event, potential threats and consequences were defined and placed in a
Bow-Tie diagram. Then, barriers were determined, ways to prevent the threat
or limit the consequences. The barriers were defined as existing or missing
and analyzed for feasibility. Intrahospital transportation: this hazard led
to 7 critical events, the Bow-Tie analysis to 52 missing but implementable
barriers and 8 practical recommendations. For example, a pretransportation
checklist.Unplanned extubation: this Bow-Tie analysis revealed 15
implementable missing barriers (of a total of 32) and led to 22
recommendations. One of them was optimizing treatment of
delirium.Communication: this analysis showed 21 barriers, of which, 12 were
missing but feasible to implement. These barriers led to 7 recommendations
such as the need to cosign after the handover of a patient. Prospective risk
analysis using the Bow-Tie model proved usable to identify existing and
missing barriers for potential critical events. Many missing barriers seemed
feasible to implement and led to practical recommendations and improvements
in patient safety.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
patient safety
risk assessment
EMTREE MEDICAL INDEX TERMS
article
human
methodology
Netherlands
patient transport
prospective study
standard
statistics
tertiary care center
LANGUAGE OF ARTICLE
English
MEDLINE PMID
23965838 (http://www.ncbi.nlm.nih.gov/pubmed/23965838)
PUI
L563067139
COPYRIGHT
Copyright 2015 Medline is the source for the citation and abstract of this
record.
RECORD 438
TITLE
Safe transport of intra-aortic balloon pump-dependent patients by skilled
air and land critical care Crews
AUTHOR NAMES
Allendes F.
MacDonald R.D.
AUTHOR ADDRESSES
(Allendes F.) McMacster University, Canada.
(MacDonald R.D.) Ornge, University of Toronto, Canada.
CORRESPONDENCE ADDRESS
F. Allendes, McMacster University, Canada.
SOURCE
Air Medical Journal (2013) 32:5 (251-252). Date of Publication:
September-October 2013
CONFERENCE NAME
2013 Air Medical Transport Conference, AMTC 2013
CONFERENCE LOCATION
Virginia Beach, VA, United States
CONFERENCE DATE
2013-10-21 to 2013-10-21
ISSN
1067-991X
BOOK PUBLISHER
Mosby Inc.
ABSTRACT
Introduction: Transfer of intra-aortic balloon pump (IABP)- dependent
patients between health care facilities is increasingly common. The
transfers are typically time-sensitive and require specialized staff or
other personnel familiar with operation of the IABP and management of a
potentially unstable patient to ensure patient safety. There are few reports
of interfacility transfer of IABP-dependent patients by paramedics alone.
This study examined such transfers carried out by specially trained critical
care flight paramedics in a large air medical and land critical care
transport service. Methods: This retrospective, descriptive review of
prospectively collected data for IABP-dependent patient transfers in
Ontario, Canada from September 2003 to January 2013. Call records and
patient care reports were reviewed to capture demographic, patient care,
adverse events, and transferrelated data. Adverse events, including
resuscitation medication, procedure, and patient instability, were
independently reviewed by 2 investigators. Results: There were 140
IABP-dependent patients transported during the study period. Fifty-five were
carried out by land critical care transfer vehicle, 60 by helicopter, and 25
by fixed wing aircraft. The mean patient age was 62.7 ± 13.9 years, and the
majority (72.1%) was male. Fifty-two patients (37.1%) were inotrope- or
vasopressor-dependent, and 38 (27.1%) were intubated and mechanically
ventilated. The most common indications for IABP insertion were acute
myocardial infarction requiring prompt surgical intervention (n±59),
cardiogenic shock (n±30), and bridge to definitive care (n±23). The mean
transport time was 89 ± 80 minutes. There were 47 complications in 35
patients, most commonly hypotension (SBP±90 mm Hg; n±18) or tachyarrhythmia
requiring therapy (n±14). There were 3 IABP malfunctions and 2 cases where
the transport vehicle was inoperable resulting in a transport delay. One
patient with cardiogenic shock died just prior to departing the referral
hospital. Paramedics managed all complications without assistance from other
health care personnel. Conclusion: This study demonstrates that specially
trained critical care flight paramedics can safely transfer potentially
unstable intra-aortic balloon pump-dependent patients to definitive cardiac
surgical care.
EMTREE DRUG INDEX TERMS
hypertensive factor
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
human
intensive care
intraaortic balloon pump
patient
EMTREE MEDICAL INDEX TERMS
acute heart infarction
aircraft
Canada
cardiogenic shock
drug therapy
flight
forelimb
health care facility
health care personnel
helicopter
hospital
hypotension
male
patient care
patient safety
patient transport
personnel
procedures
resuscitation
surgery
tachycardia
therapy
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71267251
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 439
TITLE
Critical care transportation by paramedics: A cross-sectional survey
AUTHOR NAMES
Raynovich W.
Hums J.
Stuhlmiller D.F.
Bramble J.D.
Kasha T.
Galt K.
AUTHOR ADDRESSES
(Raynovich W., billr@creighton.edu) Emergency Medical Services Medical
Education Program, Creighton University, 2514 Cuming Street, Omaha NE 68131,
United States.
(Hums J.; Stuhlmiller D.F.) International Association of Flight and Critical
Care Paramedics, Snellville, GA, United States.
(Stuhlmiller D.F.) LifeNet of NewYork/Guthrie Air, Albany, NY, United
States.
(Bramble J.D.; Kasha T.; Galt K.) Center for Health Services Research and
Patient Safety, School of Pharmacy and Health Professions, Creighton
University, Omaha, NE, United States.
CORRESPONDENCE ADDRESS
W. Raynovich, Emergency Medical Services Medical Education Program,
Creighton University, 2514 Cuming Street, Omaha NE 68131, United States.
Email: billr@creighton.edu
SOURCE
Air Medical Journal (2013) 32:5 (280-288). Date of Publication: 2013
ISSN
1532-6497 (electronic)
1067-991X
BOOK PUBLISHER
Mosby Inc., customerservice@mosby.com
ABSTRACT
Objective The purpose of this study was to gather data from paramedics
practicing in the critical care transport setting to guide development of
the education, training, and clinical practices for certification as a
critical care paramedic. Methods A paper survey of 1991 randomly selected
nationally registered (NREMT) paramedics was conducted. Nine paramedics with
residences in small US Pacific Island territories were not included in the
survey. Results We received 610 responses (30.6%). Respondents that stated
that they provided critical care transport services reported using pediatric
skills and equipment the most and intracranial pressure monitoring the
least. Paramedics served as the primary provider for pediatric patients
(72.5%), 12-lead electrocardiogram (66.3%), intravenous infusion pump
(76.7%), mechanical ventilator (66.9%), central line management (63.1%), and
chest tube management (63.3%). Paramedics served in a team member capacity
most often with neonatal isolette (71.8%), intra-aortic balloon pump
(79.2%), and ICP monitoring (64.9%). The majority provided ground critical
care transport (249) compared to 44 rotor-wing and 6 fixed-wing. Sixteen
respondents reported serving as primary providers on combinations of ground,
rotor-, and fixed-wing services. Conclusions Paramedics reported being the
primary provider on the critical care transport team and performing skills
while using equipment and administering medications that exceeded their
education and training as paramedic and, at times, without the benefit of
any additional education or training. National appreciation of this reality
should spur development of standardized education, licensing or
certification, and continuing education to prepare paramedics for their role
as critical care medical providers. © 2013 Air Medical Journal Associates.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
intensive care
paramedical profession
EMTREE MEDICAL INDEX TERMS
article
central venous catheterization
cross-sectional study
electrocardiogram
human
intraaortic balloon pump
intracranial pressure monitoring
intravenous drug administration
mechanical ventilator
Pacific islands
paramedical education
paramedical personnel
priority journal
pump
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2013568477
MEDLINE PMID
24001916 (http://www.ncbi.nlm.nih.gov/pubmed/24001916)
PUI
L369787761
DOI
10.1016/j.amj.2013.05.008
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2013.05.008
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 440
TITLE
Occurrence of secondary insults of traumatic brain injury in patients
transported by critical care air transport teams from Iraq/Afghanistan:
2003-2006.
AUTHOR NAMES
Dukes S.F.
Bridges E.
Johantgen M.
AUTHOR ADDRESSES
(Dukes S.F.) United States Air Force School of Aerospace Medicine, 2510 5th
Street, Wright-Patterson AFB, OH 45433, USA.
(Bridges E.; Johantgen M.)
CORRESPONDENCE ADDRESS
S.F. Dukes, United States Air Force School of Aerospace Medicine, 2510 5th
Street, Wright-Patterson AFB, OH 45433, USA.
SOURCE
Military medicine (2013) 178:1 (11-17). Date of Publication: Jan 2013
ISSN
0026-4075
ABSTRACT
Traumatic brain injury patients are susceptible to secondary insults to the
injured brain. A retrospective cohort study was conducted to describe the
occurrence of secondary insults in 63 combat casualties with severe isolated
traumatic brain injury who were transported by the U.S. Air Force Critical
Care Air Transport Teams (CCATT) from 2003 through 2006. Data were obtained
from the Wartime Critical Care Air Transport Database, which describes the
patient's physiological state and care as they are transported across the
continuum of care from the area of responsibility (Iraq/Afghanistan) to
Germany and the United States. Fifty-three percent of the patients had at
least one documented episode of a secondary insult. Hyperthermia was the
most common secondary insult and was associated with severity of injury. The
hyperthermia rate increased across the continuum, which has implications for
en route targeted temperature management. Hypoxia occurred most frequently
within the area of responsibility, but was rare during CCATT flights,
suggesting that concerns for altitude-induced hypoxia may not be a major
factor in the decision when to move a patient. Similar research is needed
for polytrauma casualties and analysis of the association between
physiological status and care across the continuum and long-term outcomes.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
brain injury (epidemiology)
soldier
EMTREE MEDICAL INDEX TERMS
adolescent
adult
anoxia (epidemiology)
article
cohort analysis
female
fever (epidemiology)
human
hypertension (epidemiology)
hypotension (epidemiology)
injury scale
intensive care
male
middle aged
retrospective study
statistics
United States
war
LANGUAGE OF ARTICLE
English
MEDLINE PMID
23356112 (http://www.ncbi.nlm.nih.gov/pubmed/23356112)
PUI
L368519110
DOI
10.7205/MILMED-D-12-00177
FULL TEXT LINK
http://dx.doi.org/10.7205/MILMED-D-12-00177
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 441
TITLE
[The transition process from the intensive care unit to the ward: a review
of the literature]
ORIGINAL (NON-ENGLISH) TITLE
El proceso de transición de la unidad de cuidados intensivos al área de
hospitalización: una revisión bibliográfica
AUTHOR NAMES
Vázquez Calatayud M.
Portillo M.C.
AUTHOR ADDRESSES
(Vázquez Calatayud M.; Portillo M.C.) Área de Investigación, Formación y
Desarrollo Profesional en Enfermería, Clínica Universidad de Navarra,
Pamplona, España. mvazca@unav.es
SOURCE
Enfermería intensiva / Sociedad Española de Enfermería Intensiva y Unidades
Coronarias (2013) 24:2 (72-88). Date of Publication: 2013 Apr-Jun
ISSN
1578-1291 (electronic)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health care facility
intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
human
patient satisfaction
LANGUAGE OF ARTICLE
Spanish
LANGUAGE OF SUMMARY
Spanish
MEDLINE PMID
23375829 (http://www.ncbi.nlm.nih.gov/pubmed/23375829)
PUI
L603062458
DOI
10.1016/j.enfi.2012.12.002
FULL TEXT LINK
http://dx.doi.org/10.1016/j.enfi.2012.12.002
COPYRIGHT
Copyright 2015 Medline is the source for the citation and abstract of this
record.
RECORD 442
TITLE
[Modes of mechanical ventilation during transferring the patient to
spontaneous breathing].
AUTHOR NAMES
Chemykh A.S.
AUTHOR ADDRESSES
(Chemykh A.S.)
CORRESPONDENCE ADDRESS
A.S. Chemykh,
SOURCE
Anesteziologiia i reanimatologiia (2013) :1 (74-76). Date of Publication:
2013 Jan-Feb
ISSN
0201-7563
ABSTRACT
Mechanical ventilation (MV) has become a general treatment in the intensive
care unit in recent years. Mechanical ventilation is a resuscitation
treatment; however MV causes many implications therefore it is to be
finished as soon as the patient's condition begins improve. Modern
transferring the patient to spontaneous breathing decreases implications
number. Significant part of mechanical ventilation time (40%) is a time of
weaning from mechanical ventilation. Weaning from MV is an economical,
clinical and ethical problem. Many ventilation modes have introduced in
clinical practice through the microprocessor technologies development.
Supporting ventilation modes help to avoid some adverse effects of
mechanical ventilation. The article deals with historical approaches
development their advantages and limitations.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
artificial ventilation (adverse drug reaction)
intensive care unit
EMTREE MEDICAL INDEX TERMS
article
human
lung function test
methodology
resuscitation
time
LANGUAGE OF ARTICLE
Russian
MEDLINE PMID
23808263 (http://www.ncbi.nlm.nih.gov/pubmed/23808263)
PUI
L369361818
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 443
TITLE
Analysis of the interface and data transfer from ICU to normal wards in a
German University Hospital
AUTHOR NAMES
Vollmer A.-M.
Skonetzki-Cheng S.
Prokosch H.-U.
AUTHOR ADDRESSES
(Vollmer A.-M.; Skonetzki-Cheng S.; Prokosch H.-U.) Departmant of Medical
Informatics, Friedrich-Alexander University, Erlangen, Germany
SOURCE
Studies in health technology and informatics (2013) 192 (1104). Date of
Publication: 2013
ISSN
0926-9630
ABSTRACT
Typically general wards and intensive care units (ICU) have very different
labor organizations, structures and IT-systems in Germany. There is a need
for coordination, because of the different working arrangements. Our team
investigated the interface between ICU and general ward and especially the
respective information transfer in the University hospital in Erlangen
(Bavaria, Germany). The research team used a combination of interviews,
observations and the analysis of transfer records and forms as part of a
methodical triangulation. We identified 41 topics, which are discussed or
presented in writing during the handover. In a second step, we investigate
the requirements of data transmission in expert interviews. A data transfer
concept from the perspective of the nurses and physicians was developed and
we formulated recommendations for improvements of process and communication
for this interface. Finally the data transfer concept was evaluated by the
respondents.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
organization and management
procedures
EMTREE MEDICAL INDEX TERMS
clinical handover
computer interface
electronic medical record
Germany
health care facility
hospital management
information retrieval
intensive care unit
medical record
patient transport
university hospital
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
23920878 (http://www.ncbi.nlm.nih.gov/pubmed/23920878)
PUI
L603662121
COPYRIGHT
Copyright 2015 Medline is the source for the citation and abstract of this
record.
RECORD 444
TITLE
The incidence of fever in US critical care air transport team combat trauma
patients evacuated from the theater between March 2009 and March 2010
AUTHOR NAMES
Minnick J.M.
Bebarta V.S.
Stanton M.
Lairet J.R.
King J.
Torres P.
Aden J.
Ramirez R.
AUTHOR ADDRESSES
(Minnick J.M., jodymm13@yahoo.com; Torres P.) Air Force Enroute Care
Research Center, US Army Institute of Surgical Research, San Antonio,
Military Medical Center, Ft. Sam Houston, TX, United States.
(Bebarta V.S.) Enroute Care Research Center, USAF, and Chair, Medical
Toxicology, Department of Emergency Medicine, San Antonio Military Medical
Center, Ft. Sam Houston, TX, United States.
(Stanton M.) Capstone College of Nursing, The University of Alabama,
Tuscaloosa, AL, United States.
(Lairet J.R.) Department of Emergency Medicine, Emory University, Atlanta,
GA, United States.
(King J.) Department of Emergency Medicine, Air Force Enroute Care Research
Center, US Army Institute of Surgical Research, San Antonio, Military
Medical Center, Ft. Sam Houston, TX, United States.
(Aden J.) US Army Institute of Surgical Research, Ft. Sam Houston, TX,
United States.
(Ramirez R.) Wilford Hall Ambulatory Surgical Center, Lackland AFB, TX,
United States.
CORRESPONDENCE ADDRESS
J.M. Minnick, Email: jodymm13@yahoo.com
SOURCE
Journal of Emergency Nursing (2013) 39:6 (e101-e106). Date of Publication:
November 2013
ISSN
1527-2966 (electronic)
0099-1767
ABSTRACT
Introduction: Most critically ill injured patients are transported out of
the theater by Critical Care Air Transport Teams (CCATTs). Fever after
trauma is correlated with surgical complications and infection. The purposes
of this study are to identify the incidence of elevated temperature in
patients managed in the CCATT environment and to describe the complications
reported and the treatments used in these patients. Methods: We performed a
retrospective review of available records of trauma patients from the combat
theater between March 1, 2009, and March 31, 2010, who were transported by
the US Air Force CCATT and had an incidence of hyperthermia. We then divided
the cohort into 2 groups, patients transported with an elevation in
temperature greater than 100.4°F and patients with no documented elevation
in temperature. We used a standardized, secure electronic data collection
form to abstract the outcomes. Descriptive data collected included injury
type, temperature, use of a mechanical ventilator, cooling treatment
modalities, antipyretics, intravenous fluid administration, and use of blood
products. We also evaluated the incidence of complications during the
transport in patients who had a recorded elevation in temperature greater
than 100.4°F. Results: A total of 248 trauma patients met the inclusion
criteria, and 101 trauma patients (40%) had fever. The mean age was 28
years, and 98% of patients were men. The mechanism of injury was an
explosion in 156 patients (63%), blunt injury in 11 (4%), and penetrating
injury in 45 (18%), whereas other trauma-related injuries accounted for 36
patients (15%). Of the patients, 209 (84%) had battle-related injuries and
39 (16%) had non-battle-related injuries. Traumatic brain injury was found
in 24 patients (24%) with an incidence of elevated temperature. The mean
temperature was 101.6°F (range, 100.5°F-103.9°F). After evaluation of
therapies and treatments, 80 trauma patients (51%) were intubated on a
mechanical ventilator (P < .001). Of the trauma patients with documented
fever, 22 (22%) received administration of blood products. Nineteen patients
received antipyretics during their flight (19%), 9 received intravenous
fluids (9%), and 2 received nonpharmacologic cooling interventions, such as
cooling blankets or icepacks. We identified 1 trauma patient with neurologic
changes (1%), 6 with hypotension (6%), 48 with tachycardia (48%), 33 with
decreased urinary output (33%), and 1 with an episode of shivering or
sweating (1%). We did not detect any transfusion reactions or deaths during
flight. Conclusion: Fever occurred in 41% of critically ill combat-injured
patients evacuated out of the combat theater in Iraq and Afghanistan. Fewer
than 20% of patients with a documented elevated temperature received
treatments to reduce the temperature. Intubation of patients with
ventilators in use during the transport was the only factor significantly
associated with fever. Serious complications were rare, and there were no
deaths during these transports. © 2013 Emergency Nurses Association.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
fever (epidemiology)
injury (epidemiology)
intensive care
patient care
soldier
EMTREE MEDICAL INDEX TERMS
adolescent
adult
article
battle
blunt trauma (epidemiology)
brain injury (epidemiology)
comorbidity
Critical care transport
female
Flight medicine
human
incidence
intensive care nursing
Iraq
male
methodology
middle aged
military medicine
nursing
penetrating trauma (epidemiology)
retrospective study
statistics
war
young adult
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
23684131 (http://www.ncbi.nlm.nih.gov/pubmed/23684131)
PUI
L1052586049
DOI
10.1016/j.jen.2013.02.001
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jen.2013.02.001
COPYRIGHT
Copyright 2014 Medline is the source for the citation and abstract of this
record.
RECORD 445
TITLE
Number of women requiring care at a tertiary hospital equipped with a
neonatal intensive care unit at night in an area with a population of 2
million
AUTHOR NAMES
Yamada T.
Cho K.
Morikawa M.
Yamada T.
Akaishi R.
Ishikawa S.
Minakami H.
AUTHOR ADDRESSES
(Yamada T., taka0197@med.hokudai.ac.jp; Cho K.; Morikawa M.; Yamada T.;
Akaishi R.; Ishikawa S.; Minakami H.) Department of Obstetrics, Hokkaido
University, Graduate School of Medicine, N15W7, Sapporo 060-8638, Japan.
CORRESPONDENCE ADDRESS
T. Yamada, Department of Obstetrics, Hokkaido University, Graduate School of
Medicine, N15W7, Sapporo 060-8638, Japan. Email: taka0197@med.hokudai.ac.jp
SOURCE
Journal of Obstetrics and Gynaecology Research (2013) 39:12 (1592-1595).
Date of Publication: December 2013
ISSN
1447-0756 (electronic)
1341-8076
BOOK PUBLISHER
Blackwell Publishing Asia, 5F 3-11-14 Iidabashi, Chiyoda-ku, Tokyo, Japan.
ABSTRACT
Aim: Women with imminent premature labor (IPL) are transported to a tertiary
hospital equipped with neonatal intensive care unit (NICU) even during the
night. However, there have been no extensive studies of the occurrence rate
of night IPL. The aim of this study was to determine the occurrence rate of
night IPL in an area with a population of 2 million. Materials and Methods:
A retrospective analysis was conducted using data collected by the Sapporo
Obstetric System for Emergency Patients launched in October 2008, in which
women, physicians, and ambulance staff who sought appropriate
obstetric/gynecological facilities available in the night (19.00-06.00
hours) were informed of candidate hospitals by coordinators through
telephone consultation. This system covered the Sapporo area, which has a
population of 2 000 000 and 17 000 births annually. Approximately 14% and
86% of women received antenatal care at six and 35 obstetric facilities with
and without NICU, respectively, in this area. Night IPL was defined as a
threatened premature labor and transport to one of six tertiary hospitals
with NICU between 19.00 and 06.00 hours the next morning. Results: During a
4-year period from 1 October 2008 to 30 September 2012, the Sapporo
Obstetric System for Emergency Patients received 158 ± 23 (mean ± standard
deviation) monthly telephone consultations (range 114-218 per month). The
monthly number of patients with night IPL was 3.0 ± 2.2 (range 0-9 per
month). Conclusions: The monthly number of cases of night IPL was around
three among women who received antenatal care at obstetrics facilities
without NICU in an area with a population of 2 000 000. © 2013 The Authors.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
newborn intensive care
patient transport
premature labor
tertiary care center
EMTREE MEDICAL INDEX TERMS
article
female
human
maternity ward
prenatal care
prevalence
teleconsultation
EMBASE CLASSIFICATIONS
Obstetrics and Gynecology (10)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2014214220
PUI
L372697743
DOI
10.1111/jog.12113
FULL TEXT LINK
http://dx.doi.org/10.1111/jog.12113
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 446
TITLE
Design of a medical record review study on the incidence and preventability
of adverse events requiring a higher level of care in Belgian hospitals.
AUTHOR NAMES
Vlayen A.
Marquet K.
Schrooten W.
Vleugels A.
Hellings J.
De Troy E.
Weekers F.
Claes N.
AUTHOR ADDRESSES
(Vlayen A.) Hasselt University, Faculty of Medicine, Patient Safety Group,
Agoralaan Building D, Room D58, Diepenbeek 3590, Belgium.
(Marquet K.; Schrooten W.; Vleugels A.; Hellings J.; De Troy E.; Weekers F.;
Claes N.)
CORRESPONDENCE ADDRESS
A. Vlayen, Hasselt University, Faculty of Medicine, Patient Safety Group,
Agoralaan Building D, Room D58, Diepenbeek 3590, Belgium. Email:
annemie.vlayen@uhasselt.be
SOURCE
BMC research notes (2012) 5 (468). Date of Publication: 2012
ISSN
1756-0500 (electronic)
ABSTRACT
Adverse events are unintended patient injuries that arise from healthcare
management resulting in disability, prolonged hospital stay or death.
Adverse events that require intensive care admission imply a considerable
financial burden to the healthcare system. The epidemiology of adverse
events in Belgian hospitals has never been assessed systematically. A
multistage retrospective review study of patients requiring a transfer to a
higher level of care will be conducted in six hospitals in the province of
Limburg. Patient records are reviewed starting from January 2012 by a
clinical team consisting of a research nurse, a physician and a clinical
pharmacist. Besides the incidence and the level of causation and
preventability, also the type of adverse events and their consequences
(patient harm, mortality and length of stay) will be assessed. Moreover, the
adequacy of the patient records and quality/usefulness of the method of
medical record review will be evaluated. This paper describes the rationale
for a retrospective review study of adverse events that necessitate a higher
level of care. More specifically, we are particularly interested in
increasing our understanding in the preventability and root causes of these
events in order to implement improvement strategies. Attention is paid to
the strengths and limitations of the study design.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
iatrogenic disease (epidemiology, prevention)
medical error (prevention)
methodology
patient transport
treatment outcome
EMTREE MEDICAL INDEX TERMS
article
Belgium (epidemiology)
clinical audit
cluster analysis
disability
hospital
hospital admission
human
incidence
intensive care unit
length of stay
medical record
mortality
multicenter study
patient safety
retrospective study
risk factor
time
LANGUAGE OF ARTICLE
English
MEDLINE PMID
22931859 (http://www.ncbi.nlm.nih.gov/pubmed/22931859)
PUI
L369014138
DOI
10.1186/1756-0500-5-468
FULL TEXT LINK
http://dx.doi.org/10.1186/1756-0500-5-468
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 447
TITLE
Proactive vs. reactive rapid response systems: Decreasing unplanned ICU
transfers
AUTHOR NAMES
Danesh V.
Guerrier L.
Health O.
Jimenez E.
AUTHOR ADDRESSES
(Danesh V.; Guerrier L.; Health O.; Jimenez E.) Orlando Regional Medical
Center, United States.
CORRESPONDENCE ADDRESS
V. Danesh, Orlando Regional Medical Center, United States.
SOURCE
Critical Care Medicine (2012) 40:12 SUPPL. 1 (1). Date of Publication:
December 2012
CONFERENCE NAME
42nd Critical Care Congress of the Society of Critical Care Medicine, SCCM
2013
CONFERENCE LOCATION
San Juan, Puerto Rico
CONFERENCE DATE
2013-01-19 to 2013-01-23
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: Rapid Response Teams (RRT) traditionally respond to patient
deteriorations identified by nurses outside of the ICU. ICU admissions from
inpatient areas are indicators of physiological decline and are associated
with increased mortality. Next steps for RRT are to proactively identify
patients at-risk, and to act as a resource to increase anticipatory nursing
care while promoting expertise-sharing among nurses. Hypothesis: Increased
presence of a Rapid Response Team RN (RRT RN) guided by warning score
algorithms to proactively round on patients at risk for deterioration can
decrease the number of unplanned ICU transfers. Methods: Proactive rounds by
an RRT RN in all inpatient areas of a 270-bed community hospital were guided
by algorithms (Rothman Severity of Illness Index) within the EMR to identify
patients at risk for deterioration. The RRT RN inspected graphics (vital
signs, laboratory values, nursing assessments and an indexed value) and
proactively rounded on 8+ patients per day while delegating additional
patients to charge RNs for follow-up. Reasons and interventions for each
visit were recorded prospectively (October 2011-March 2012). Data was
collected retrospectively for the prior 12-month period for comparison using
Wilcoxon rank sum tests. A reactive RRT remained active during both periods.
Results: Proactive visits were conducted on 1,444 occasions. Nursing-driven
interventions were implemented 533 times (37%). When interventions resulted
from proactive rounds, they were most often related to anticipatory nursing
care such as coaching on vital signs (48%), calls to providers (36%), or
diagnostics (36%). ICU transfers from wards were not significant, but
transfers from Intermediate Critical Care Units (ICCU) decreased
significantly (3.16/1,000 patient days vs 1.91/1,000 patient days, p=.028).
Conclusions: Differences in the frequency of assessments between the wards
and ICCUs may contribute to changes in detection of patient instability. The
interventions and coaching on anticipatory nursing care to staff RNs during
proactive rounds may be associated with a dramatic increase in the
stabilization of patients in ICCUs and corresponding decreases in unplanned
ICU transfers.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
rapid response team
society
EMTREE MEDICAL INDEX TERMS
algorithm
community hospital
deterioration
diagnosis
follow up
hospital patient
human
hypothesis
laboratory
mortality
nurse
nursing
nursing assessment
nursing care
patient
rank sum test
risk
severity of illness index
vital sign
ward
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71065183
DOI
10.1097/01.ccm.0000425605.04623.4b
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000425605.04623.4b
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 448
TITLE
Improving patient care during transitions from the ICU to the general care
floor via staff and family collaboration and a novel patient/familycentered
transfer brochure
AUTHOR NAMES
Meaburn A.
Boylan A.
Ford D.
Nivea K.
Byrne J.
AUTHOR ADDRESSES
(Meaburn A.; Boylan A.; Ford D.; Nivea K.; Byrne J.) Medical University of
South Carolina, United States.
CORRESPONDENCE ADDRESS
A. Meaburn, Medical University of South Carolina, United States.
SOURCE
Critical Care Medicine (2012) 40:12 SUPPL. 1 (225). Date of Publication:
December 2012
CONFERENCE NAME
42nd Critical Care Congress of the Society of Critical Care Medicine, SCCM
2013
CONFERENCE LOCATION
San Juan, Puerto Rico
CONFERENCE DATE
2013-01-19 to 2013-01-23
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: The transition from the ICU to the general floor can cause
“relocation stress” and contribute to slower recovery and reduce
patient/family satisfaction. To improve patient/family centered care, our
Medical Intensive Care Unit (MICU) developed and implemented a transfer
rounding team and tool. Hypothesis: Our hypothesis was transfer rounding
data would provide valuable patient and family input to make meaningful
patient and family-centered changes in the MICU transfer process. Methods:
Our study population was a convenience sample of all MICU patients between
October 2010- March 2012 within 24-48 hours after transfer. Our transfer
rounding team included staff nurses, patient care technicians, and a patient
liaison. The transfer survey consisted of five validated patient
satisfaction questions scored on a 1-5 Likert scale. Additionally, patients
and family responded to questions about opportunities for improvement,
educational needs, recognition of staff, comfort of our waiting room and
noise levels/sleep quality. The patient and family survey data was used to
develop performance reports. Transfer rounding satisfaction data was
reviewed monthly at MICU leadership and quality meetings and the quarterly
hospital in-patient satisfaction meeting. Results: In 2011, n=233 transfer
surveys were completed with an average score of 4.64 on questions related to
pain management, physician attention, care of personal belongings, nursing
staff responsiveness, and interdisciplinary teamwork. The rounding data was
utilized to update our patient educational materials, implement a sleep
protocol, enhance our staff recognition program, secure funding for an
afterhours concierge, provide real-time service recovery, and develop a
novel transfer brochure. The transfer brochure was developed using a patient
and family interviews to incorporate their recommendations. Conclusions: The
survey tool is simple to use and easily integrated into daily practice.
Other intensive care units at our institution have adopted our transfer
rounding survey process and transfer brochure.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
human
intensive care
patient care
society
EMTREE MEDICAL INDEX TERMS
analgesia
comfort
convenience sample
funding
hospital
hospital patient
hypothesis
intensive care unit
interview
leadership
Likert scale
noise
nursing staff
patient
patient satisfaction
physician
population
satisfaction
sleep
staff nurse
teamwork
waiting room
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71066032
DOI
10.1097/01.ccm.0000425605.04623.4b
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000425605.04623.4b
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 449
TITLE
Clonal spread and patient risk factors for acquisition of extensively
drug-resistant Acinetobacter baumannii in a neonatal intensive care unit in
Italy
AUTHOR NAMES
Zarrilli R.
Di Popolo A.
Bagattini M.
Giannouli M.
Martino D.
Barchitta M.
Quattrocchi A.
Iula V.D.
de Luca C.
Scarcella A.
Triassi M.
Agodi A.
AUTHOR ADDRESSES
(Zarrilli R., rafzarri@unina.it; Di Popolo A.; Bagattini M.; Giannouli M.;
Martino D.; Triassi M.) Department of Preventive Medical Sciences, Hygiene
Section, University 'Federico II', Naples, Italy.
(Zarrilli R., rafzarri@unina.it) CEINGE Advanced Biotechnologies, Naples,
Italy.
(Barchitta M.; Quattrocchi A.; Agodi A.) Department GF Ingrassia, University
of Catania, Catania, Italy.
(Iula V.D.; de Luca C.) Department of Molecular and Cellular Biology and
Pathology 'L. Califano', University 'Federico II', Naples, Italy.
(Scarcella A.) Department of Paediatrics, University 'Federico II', Naples,
Italy.
CORRESPONDENCE ADDRESS
R. Zarrilli, Department of Preventive Medical Sciences, University of Naples
'Federico II', Via Pansini 5, 80131 Napoli, Italy. Email: rafzarri@unina.it
SOURCE
Journal of Hospital Infection (2012) 82:4 (260-265). Date of Publication:
December 2012
ISSN
0195-6701
1532-2939 (electronic)
BOOK PUBLISHER
W.B. Saunders Ltd, 32 Jamestown Road, London, United Kingdom.
ABSTRACT
Aim: To report an outbreak of extensively drug-resistant (XDR) Acinetobacter
baumannii in the neonatal intensive care unit (NICU) of an Italian
university hospital. Patient risk profiles for acquisition of A. baumannii
and measures used to control the outbreak are described. Methods: Antibiotic
susceptibility of strains was evaluated by microdilution. Genotyping was
performed by pulsed-field gel electrophoresis (PFGE) and multi-locus
sequence typing. Carbapenemase genes were analysed by polymerase chain
reaction and DNA sequencing. A case-control study was designed to identify
risk factors for acquisition of A. baumannii. Findings: A. baumannii was
isolated from 22 neonates, six of whom were infected. One major PFGE type
was identified, assigned to sequence type (ST) 2, corresponding to
International Clone II; this was indistinguishable from isolates from the
adult ICU in the same hospital. A. baumannii isolates were resistant to
aminoglycosides, quinolones and classes of β-lactam antibiotics, but were
susceptible to tigecycline and colistin. Carbapenem resistance was
associated with the presence of transposon Tn2006 carrying the bla(OxA-23)
gene. Length of NICU stay, length of exposure to A. baumannii, gestational
age, use of invasive devices and length of exposure to invasive devices were
significantly associated with acquisition of A. baumannii on univariate
analysis, while length of exposure to central venous catheters and assisted
ventilation were the only independent risk factors after multi-variate
analysis. Conclusions: This XDR A. baumannii outbreak in an NICU was
probably caused by intrahospital transfer of bacteria via a colonized
neonate whose mother was admitted to the adult ICU. Strengthened infection
control measures were necessary to control the outbreak. © 2012 The
Healthcare Infection Society.
EMTREE DRUG INDEX TERMS
aminoglycoside antibiotic agent
beta lactam antibiotic
carbapenemase
cephalosporin derivative
colistin (drug therapy, intravenous drug administration)
cotrimoxazole
penicillin G
quinoline derived antiinfective agent
sultamicillin
tigecycline
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Acinetobacter baumannii
Acinetobacter infection (drug therapy, drug resistance, drug therapy,
epidemiology)
newborn intensive care
EMTREE MEDICAL INDEX TERMS
antibiotic sensitivity
article
bacterium isolate
controlled study
DNA sequence
epidemic
female
genotype
gestational age
human
infection control
Italy
length of stay
major clinical study
male
newborn
risk factor
transposon
CAS REGISTRY NUMBERS
colistin (1066-17-7, 1264-72-8)
cotrimoxazole (8064-90-2)
penicillin G (1406-05-9, 61-33-6)
sultamicillin (76497-13-7)
tigecycline (220620-09-7)
EMBASE CLASSIFICATIONS
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2012675639
MEDLINE PMID
23102814 (http://www.ncbi.nlm.nih.gov/pubmed/23102814)
PUI
L52272041
DOI
10.1016/j.jhin.2012.08.018
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jhin.2012.08.018
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 450
TITLE
Endotracheal tube exchange in pediatric patients after transfer from
non-pediatric facilities
AUTHOR NAMES
Frugoni B.
Khanna S.
Bush R.
Peterson B.
Shellington D.
AUTHOR ADDRESSES
(Frugoni B.; Khanna S.; Bush R.; Peterson B.; Shellington D.) Rady
Children's Hospital, San Diego, United States.
CORRESPONDENCE ADDRESS
B. Frugoni, Rady Children's Hospital, San Diego, United States.
SOURCE
Critical Care Medicine (2012) 40:12 SUPPL. 1 (108-109). Date of Publication:
December 2012
CONFERENCE NAME
42nd Critical Care Congress of the Society of Critical Care Medicine, SCCM
2013
CONFERENCE LOCATION
San Juan, Puerto Rico
CONFERENCE DATE
2013-01-19 to 2013-01-23
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: We describe the incidence of and indication for endotracheal
tube exchange in intubated pediatric patients transferred to a pediatric
intensive care unit. Hypothesis: We hypothesize that pediatric patients who
are intubated at non-pediatric facilities require endotracheal tube exchange
more frequently than a previously reported rate of 4%. Methods: We performed
a retrospective chart review of pediatric patients age 0-18 years admitted
to our pediatric ICU from outside facilities over a 4 year period. Data
collected included age, PRISM scores, indication for intubation,
endotracheal tube size, presence of cuff, air leak, necessity of tube
exchange, and the timing of that exchange. Data was analyzed via contingency
tables using Fisher Exact Test and Pearson Chi-Square where appropriate.
Results: Over the study period, 260 patients met inclusion criteria. Of
these patients, 58 (22.3%) required endotracheal tube exchange in the first
5 days of care. A majority of tube exchanges (81%) were required for
excessive air leak around the endotracheal tube causing loss of tidal volume
and inadequate ventilation. Patients 0-1 years old and 1-7 years old
required endotracheal tube change more frequently than patients > 7 years
old (26.9% vs 28% vs 9%, p = 0.004). Cuffed endotracheal tubes were used in
significantly fewer patients 0-1 years and 1-7 years compared to > 7 years
(15.8% vs 19.2% vs 92.2%, p < 0.001). Patients requiring endotracheal tube
exchange had higher PRISM scores (9.2 vs 13.5, p = 0.003). Those intubated
for respiratory or cardiac disease had a higher likelihood of requiring
exchange (38.2% vs 31.2% vs 10%, p < 0.001). Conclusions: In this cohort of
transported, intubated pediatric patients, we found a higher incidence of
subsequent endotracheal tube exchange than previously reported. Endotracheal
tube exchange occurred more frequently in younger, sicker patients. Future
studies should evaluate whether placement of cuffed endotracheal tubes by
non-pediatric providers in young patients would reduce the need for
subsequent tube exchange without increased risk of other complications.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
endotracheal tube
human
intensive care
patient
society
EMTREE MEDICAL INDEX TERMS
air conditioning
contingency table
cuff
Fisher exact test
heart disease
hypothesis
intensive care unit
intubation
medical record review
risk
tidal volume
tube
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71065587
DOI
10.1097/01.ccm.0000425605.04623.4b
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000425605.04623.4b
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 451
TITLE
Look what the ccatt brought in: Epidemiology of usaf critical care air
transport team operations in contemporary warfare
AUTHOR NAMES
Galvagno S.
DuBose J.
Fang R.
Grissom T.
Smith R.
Scalea T.
AUTHOR ADDRESSES
(Galvagno S.; DuBose J.; Fang R.; Grissom T.; Scalea T.) University of
Maryland, Medical Center R Adams Cowley Shock Trauma Center, United States.
(Smith R.) United States Air Force, United States.
CORRESPONDENCE ADDRESS
S. Galvagno, University of Maryland, Medical Center R Adams Cowley Shock
Trauma Center, United States.
SOURCE
Critical Care Medicine (2012) 40:12 SUPPL. 1 (10). Date of Publication:
December 2012
CONFERENCE NAME
42nd Critical Care Congress of the Society of Critical Care Medicine, SCCM
2013
CONFERENCE LOCATION
San Juan, Puerto Rico
CONFERENCE DATE
2013-01-19 to 2013-01-23
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: US Air Force Critical Care Air Transport Teams (CCATTs) are a
unique component of the military medical evacuation system. An understanding
of the epidemiology of contemporary warfare is essential for pre-deployment
training and optimal outcomes for critically injured warriors. We performed
an epidemiological analysis of military patients transported by CCATTs
during a discrete period of time. Hypothesis: The epidemiology of
contemporary wartime casualties requiring critical care air transport
contrasts with the characteristcs of patients seen in previous conventional
conflicts. Methods: The primary source of data was the US Transportation
Command (TRANSCOM) Regulating and Command and Control (C2) Evacuation System
(TRAC2ES). Secondary sources were reviewed and abstracted to compare injury
patterns. Descriptive statistics were used to describe the cohort. Results:
Final analysis of 2011 TRAC2ES data included 396 CCATT patient transports,
representing 290 patients after duplicate transports were removed. The
median age was 25 years (IQR, 22 to 33). The majority of transports were
male (97.6 %). The most common ICD-9-CM diagnosis was bilateral lower
extremity amputation (40%). Nineteen cases of acute coronary syndromes were
reported (6.6%). Nine patients with stroke were transported (3.1%).
Forty-six cases of traumatic brain injury were reported (15.9%), although
reporting for this injury was inconsistent. Only two patients (0.7%) had a
primary diagnosis of burns. 125 subjects were injured as the result of an
improvised explosive device (IED) explosion (43%), of which 87 (66%)
occurred while patients were dismounted from vehicles. In 2011, more
non-battle related injuries and illnesses were reported, as compared to
historic data from 2001-06. Conclusions: The epidemiology of patients
transported by CCATT has changed with contemporary warfare. Amputations and
IED injuries were more prevalent in 2011. A higher prevalence of non-battle
related injuries and explosion-related injuries may be expected in similar
future conflicts. Studies of CCATT epidemiology will help focus training
programs and direct evidence-based practices aimed at improving both
survival and morbidity for the most severely injured casualties.
EMTREE DRUG INDEX TERMS
explosive
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
epidemiology
intensive care
society
war
EMTREE MEDICAL INDEX TERMS
accident
acute coronary syndrome
air force
amputation
army
cerebrovascular accident
devices
diagnosis
diseases
evidence based practice
human
hypothesis
ICD-9
injury
leg amputation
male
morbidity
patient
patient transport
prevalence
statistics
survival
traffic and transport
training
traumatic brain injury
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71065215
DOI
10.1097/01.ccm.0000425605.04623.4b
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000425605.04623.4b
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 452
TITLE
Impact of a transfer center to manage transfer of pediatric patients from
the emergency department to the intensive care unit in an academicbased
setting and a community-based setting
AUTHOR NAMES
Vats A.
Hatfield M.
Cocks A.
Warnick R.
Hirsh D.
AUTHOR ADDRESSES
(Vats A.) Emory University, School of Medicine, Children's Healthcare of
Atlanta, United States.
(Hatfield M.; Cocks A.; Warnick R.; Hirsh D.) Children's Healthcare of
Atlanta, United States.
CORRESPONDENCE ADDRESS
A. Vats, Emory University, School of Medicine, Children's Healthcare of
Atlanta, United States.
SOURCE
Critical Care Medicine (2012) 40:12 SUPPL. 1 (27). Date of Publication:
December 2012
CONFERENCE NAME
42nd Critical Care Congress of the Society of Critical Care Medicine, SCCM
2013
CONFERENCE LOCATION
San Juan, Puerto Rico
CONFERENCE DATE
2013-01-19 to 2013-01-23
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: Transfer of care (TOC) of patients from the Emergency
Department (ED) to the Intensive Care Unit (ICU) can be problematic with
several aspects of TOC operating independently (e.g. physician
transfer/handoff, nurse-to-nurse transfer, and bed placement/coordination)
that can lead to delayed transfer time, delays in treatment, misinformation,
and errors. Transfer centers (TC) have been utilized at many institutions to
improve quality of care and efficiency for acceptance of patients from
outside institutions. Use of a TC to manage ED-to-ICU transfer suggests a
decrease in disposition-to-exit time (DTE) in a pilot study (Hatfield, et
al, CCM 2011:39(S12)p27). Hypothesis: Use of a TC to coordinate all
ED-to-ICU patient transfers at a pediatric healthcare system will lead to
decreased ED length of stay (LOS), decreased DTE, and decreased errors.
Methods: Children's Healthcare of Atlanta (Children's) established a TC in
2009 for referrals from outside centers. The study was performed on two
campuses: an Academic Children's Hospital (ACH) affiliated with a
University, and a Community Based Hospital (CBH) within Children's.
Children's has an occurrence notification system (ONS) used to report and
monitor patient care related occurrences/errors. The TC was implemented for
all ED-to-ICU transfers on May 16, 2011. DTE and ED LOS for 6 month periods
prior to (PRE = 12/15/10-5/15/11) and after implementation
(POST=12/15/11-5/15/12) were compared (reported as mean+SD). ONS rates
related to ED TOC were monitored. Results: ACH had 426 patients PRE and 433
POST. For ACH, DTE decreased from 87.2+65.8 to 69.4+48.0 minutes (p<0.005),
and ED LOS was unchanged from 246+116 to 236+109 minutes (p=0.133). ACH had
an ONS rate of 3.5/month PRE and 0.5/month POST. CBH had 362 patients PRE
and 359 POST. For CBH, DTE was unchanged from 69.0+48.7 to 65.0+35.9 minutes
(p=0.204), and ED LOS unchanged from 216+96 to 229+107 minutes (p=0.096).
CBH had zero ONS PRE and POST. Conclusions: Utilization of a TC to manage
ED-to-ICU patient TOC had a positive impact on DTE and errors (based on ONS
rates) for the ACH, but no significant impact on the CBH. ED LOS was not
significantly changed on either campus.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
community
emergency ward
human
intensive care
intensive care unit
patient
society
EMTREE MEDICAL INDEX TERMS
child
health care
health care system
hospital
hypothesis
length of stay
nurse
patient care
patient transport
pediatric hospital
physician
pilot study
university
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71065278
DOI
10.1097/01.ccm.0000425605.04623.4b
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000425605.04623.4b
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 453
TITLE
Institution of a multi-specialty transfer process improves the admission of
patients directly from the or to ICU
AUTHOR NAMES
Roth M.
Dobrzynski J.
Fenimore P.
Fillo M.
Oberhansli T.
Peters C.
Propper K.
Wanner K.
Fulda G.
AUTHOR ADDRESSES
(Roth M.; Dobrzynski J.; Fenimore P.; Fillo M.; Oberhansli T.; Peters C.;
Propper K.; Wanner K.; Fulda G.) Christiana Care Health System, United
States.
CORRESPONDENCE ADDRESS
M. Roth, Christiana Care Health System, United States.
SOURCE
Critical Care Medicine (2012) 40:12 SUPPL. 1 (29). Date of Publication:
December 2012
CONFERENCE NAME
42nd Critical Care Congress of the Society of Critical Care Medicine, SCCM
2013
CONFERENCE LOCATION
San Juan, Puerto Rico
CONFERENCE DATE
2013-01-19 to 2013-01-23
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: Every time a patient changes their level of care, the health
care team must handoff essential information. Failure to adequately complete
this process can lead to patient harm. While current research has focused on
resident handoffs the critical care team is multi-professional (MP). There
is less research on the multi-professional handoff. We developed a MP
committee to assess our current hand off system for patients admitted
directly from the OR to the SICU. Hypothesis: The goal of this study was to
determine if a MP handoff would improve staff perception of handoff quality
and Pt care. Methods: In 2012 we empowered a MP team of attendings in
anesthesiology and critical care, nurse anesthetist, ICU nurses and fellows,
and respiratory therapist to evaluate our current handoff process on direct
admits from the OR to the ICU. A new process was developed to make the
handoff MP. This includes a standardized report process and written
communication checklist. A 10 item handoff survey on a 4 point Likert scale
was developed. Of the 10 items, four had objective measures, three evaluated
process, and 2 communications, the 10th item was an overall rating.
Compliance and perceptions of the handoff process before and after
establishing the MP handoff was compared. Responses before and after were
tested using Mann Whitney U with significance set at 0.05. Results: There
were 124 presurvey and 93 post-survey responses. The average increase was
0.31 (range 0.01- 0.51). There was an overall improvement and in 3 objective
(30 & 5 min notice, resident presence on arrival), 2 process (Clear role
defined & tine for questions), and 2 communication (adequate phone &
in-person report given) measures (p < 0.05). Increased, improvements in pt
stability and having a clear transition were NS. CRNAs and RN were more
likely to report improvements then MDs or RTs. All team members thought the
care was improved with a MP handoff. Conclusions: A structured MP handoff
improves information exchange and process of care on direct admits from the
OR to ICU. The checklist improves the ability to monitor the performance of
the MP team and subjectively improved patient care. A future prospective
evaluation of patient outcomes is warranted.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
human
intensive care
patient
society
EMTREE MEDICAL INDEX TERMS
anesthesiology
checklist
health care
hypothesis
interpersonal communication
Likert scale
nurse
nurse anesthetist
patient care
respiratory therapist
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71065286
DOI
10.1097/01.ccm.0000425605.04623.4b
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000425605.04623.4b
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 454
TITLE
Mortality among unplanned intensive care unit transfer cases
AUTHOR NAMES
Mochizuki T.
AUTHOR ADDRESSES
(Mochizuki T.) St. Luke's International Hospital, United States.
CORRESPONDENCE ADDRESS
T. Mochizuki, St. Luke's International Hospital, United States.
SOURCE
Critical Care Medicine (2012) 40:12 SUPPL. 1 (193). Date of Publication:
December 2012
CONFERENCE NAME
42nd Critical Care Congress of the Society of Critical Care Medicine, SCCM
2013
CONFERENCE LOCATION
San Juan, Puerto Rico
CONFERENCE DATE
2013-01-19 to 2013-01-23
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: Rapid response systems (RRS) are very important for
hospitalized patients whose conditions deteriorate acutely. However, a
unified RRS protocol is not practicable because facilities vary across
hospitals. Hypothesis: We aimed to find the associations between causes and
mortality in unplanned intensive care unit (ICU) transfer cases. Methods:
Our prospective observational study included unplanned ICU transfer cases to
42 ICU beds in an urban teaching hospital from December 1, 2010 to November
30, 2011. We measured mortality as well as causes (6 types) and objectives
(4 types) of ICU transfer. We analyzed the associations between mortality
and these causes/objectives. Results: The 205 unplanned ICU transfer cases
observed constituted 1.3% of all hospitalized patients. The mortality in
these cases constituted 27.3% of overall hospital mortality. The causes of
ICU transfer were failure of initial management (3%), failure to predict
sudden patient deterioration (24%), failure to prevent sudden deterioration
(1%), complications of the procedure (19%), early transfer after predicting
sudden deterioration (28%), and difficulty in predicting sudden
deterioration (25%). The objectives of ICU transfer were respiratory
management (46%), circulatory management (28%), neurological management
(19%), and monitoring (31%). The cause with the highest mortality was
failure to predict sudden patient deterioration (48%). The objective with
the highest mortality was respiratory management (43.2%). Conclusions: Our
results indicate the characteristics of unplanned ICU transfer cases in our
hospital and that the prognosis of patients undergoing unplanned ICU
transfer with sudden, severe deterioration is poor, and that their prognosis
is good if ICU transfers for monitoring occurs at an early stage. Thus, it
is important to understand the trends in each hospital to develop an
effective RRS.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
intensive care unit
mortality
society
EMTREE MEDICAL INDEX TERMS
deterioration
hospital
hospital patient
human
hypothesis
monitoring
observational study
patient
procedures
prognosis
rapid response team
teaching hospital
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71065911
DOI
10.1097/01.ccm.0000425605.04623.4b
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000425605.04623.4b
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 455
TITLE
Improving emgergency department to intensive care unit transfer time does
not effect morbidity or mortality
AUTHOR NAMES
Frost J.
Syed M.
Mazer J.
Reinert S.
Carino G.
AUTHOR ADDRESSES
(Frost J.; Syed M.; Carino G.) Miriam Hospital, United States.
(Mazer J.) Miriam Hospital, Rhode Island Hospital, United States.
(Reinert S.) Brown University, United States.
CORRESPONDENCE ADDRESS
J. Frost, Miriam Hospital, United States.
SOURCE
Critical Care Medicine (2012) 40:12 SUPPL. 1 (197-198). Date of Publication:
December 2012
CONFERENCE NAME
42nd Critical Care Congress of the Society of Critical Care Medicine, SCCM
2013
CONFERENCE LOCATION
San Juan, Puerto Rico
CONFERENCE DATE
2013-01-19 to 2013-01-23
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: Emergency Department (ED) patient flow and prolonged waits for
inpatient beds are constant problems for many institutions. Current data is
inconclusive on outcomes of critically ill patients with extended stays in
the ED. Since October 2009, as part of a collaborative quality improvement
(QI) project between the ICU and ED, we have worked to reduce the amount of
time critically ill patients spend in the ED. Hypothesis: The objective of
this study was to determine if this reduction in time was associated with
higher mortality. Methods: As part of the QI project, all patients admitted
to the ICU through the ED between October 2009 and August 2011 were
collected. Time of admission decision in the ED and time of arrival in the
ICU were recorded. We compared hospital mortality, ICU and hospital length
of stay for patients above and below a 90 minute threshold. We also compared
mortality in the subgroups of respiratory failure, shock and stroke.
Results: There was an observed decline in the mean duration of stay in the
ED post decision to admit from October 2009 (130+/-72 minutes, n=49) to
August 2011 (69+/-30 minutes, n= 53), p <.01. During the study period, 317
patients were admitted <=90 minutes and 209 were >90 minutes. The survival
rate for those admitted <=90 minutes was 86.7% and 90.3% for those >90
minutes (p=0.234). There was also no difference in mean ICU or hospital
length of stay. For the subgroups of respiratory failure, shock and stroke,
we also found no differences in hospital mortality. Conclusions: As part of
a collaborative initiative to improve ED to ICU flow, we were able to
decrease the duration of stay post ICU admission decision in the ED.
Importantly, we did not find a difference in hospital mortality.
Furthermore, we did not see any difference in ICU or hospital length of stay
between the groups. These results were consistent in easily defined
subgroups of patients including those with respiratory failure, shock and
stroke. These data suggest that improvements in patient flow of
critically-ill patients may be accomplished without adversely affecting
mortality.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
intensive care unit
morbidity
mortality
society
EMTREE MEDICAL INDEX TERMS
cerebrovascular accident
critically ill patient
emergency ward
hospital
hospital patient
human
hypothesis
length of stay
patient
respiratory failure
survival rate
total quality management
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71065928
DOI
10.1097/01.ccm.0000425605.04623.4b
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000425605.04623.4b
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 456
TITLE
Elective bedside tracheostomy at the intensive care unit: A safe option
compared to the operating room?
AUTHOR NAMES
Do Ceará V.D.A.
Fernandes I.
Queiroz-Asfor
Pontes-Arruda A.
Martins L.F.
Távora H.F.
Dos Santos M.C.F.C.
Furtado-Lima B.
De Castro L.G.
Neto H.M.-C.
AUTHOR ADDRESSES
(Do Ceará V.D.A.; Furtado-Lima B.; De Castro L.G.; Neto H.M.-C.) Faculdade
de Medicina Christus, Brazil.
(Fernandes I.; Queiroz-Asfor; Martins L.F.; Távora H.F.; Dos Santos
M.C.F.C.) Hospital Fernandes Távora, Brazil.
(Pontes-Arruda A.) Hospital Fernandes Távora, Faculdade de Medicina
Christus, Brazil.
CORRESPONDENCE ADDRESS
V.D.A. Do Ceará, Faculdade de Medicina Christus, Brazil.
SOURCE
Critical Care Medicine (2012) 40:12 SUPPL. 1 (199). Date of Publication:
December 2012
CONFERENCE NAME
42nd Critical Care Congress of the Society of Critical Care Medicine, SCCM
2013
CONFERENCE LOCATION
San Juan, Puerto Rico
CONFERENCE DATE
2013-01-19 to 2013-01-23
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: To evaluate the incidence of minor and major complications
associated with open surgical tracheostomy performed at the bedside.
Hypothesis: Tracheostomy is a frequently performed procedure, and
historically has had a high reported complication rate. This has led some
authors to suggest that a tracheostomy should be done only in the operating
room (OR). Concerns regarding the hazards of transporting critically ill
patients to the OR may inhibit the use of tracheostomy. Bedside tracheostomy
in the Intensive Care Unit (ICU) has been shown to be safe, but this concept
has not been widely accepted. Methods: This was a prospetive and cohort
study evaluating all elective and open surgical tracheostomies performed at
the beside in the intensive care department of a tertiary hospital during
one year(July/2008 to June/2009). Data regarding the demographic
charateristicas of the patients (such as age, gender, APACHE II score) as
well and the incidence of minor and major complications was collected.
Results: A total of 46 elective procedures were evaluated. The mean age was
70.7±14.9 years, APACHE II 25.5±7.0, and 58.7% of the included patients were
males. It was observed an incidence of 6.52% of major complications (one
infection and two major bleeding episodes associated with the procedure), no
minor complications were observed. Conclusions: The incidence of
complications associated with open surgical tracheostomy performed at the
ICU bedside in the population evaluated in this work was considered similar
to what has been previously described in the literature (Petrotos et al.Crit
Care Med 27,1999) and, therefore, was considered safe and without the
inconvenience and inherent risks of intra-hospital transport of critically
ill and potentially unstable patients.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
intensive care unit
operating room
society
tracheostomy
EMTREE MEDICAL INDEX TERMS
APACHE
bleeding
cohort analysis
critically ill patient
gender
hazard
hospital
human
hypothesis
infection
male
patient
population
procedures
risk
tertiary health care
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71065935
DOI
10.1097/01.ccm.0000425605.04623.4b
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000425605.04623.4b
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 457
TITLE
Evaluation of post-pyloric feeding tube placement using electromagnetic
placement device in the PICU
AUTHOR NAMES
Brown A.-M.
Handwork C.
Perebzak C.
Nagy K.
Gothard M.
AUTHOR ADDRESSES
(Brown A.-M.; Handwork C.; Perebzak C.; Nagy K.) Akron Children's Hospital,
United States.
(Gothard M.) BIOSTATS, United States.
CORRESPONDENCE ADDRESS
A.-M. Brown, Akron Children's Hospital, United States.
SOURCE
Critical Care Medicine (2012) 40:12 SUPPL. 1 (79). Date of Publication:
December 2012
CONFERENCE NAME
42nd Critical Care Congress of the Society of Critical Care Medicine, SCCM
2013
CONFERENCE LOCATION
San Juan, Puerto Rico
CONFERENCE DATE
2013-01-19 to 2013-01-23
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: When gastric feeding is not tolerated in the Pediatric ICU
(PICU), a post-pyloric feeding tube (PPFT) may be placed, both requiring
radiologic confirmation. Conventional bedside PPFT placement (CBP) may
require multiple attempts/tubes, radiation exposures (RE), intra-hospital
transports (IHT) and staff time. PPFT placement using an electromagnetic
(EM) tipped stylet that emits a signal detected by the Cortrak© device
(Corpak MedSystems) allows the user to track the progress across the
pylorus. Few PICU studies have been done with this device. Our hospital
purchased the device and we launched an efficacy study as part of the
implementation process. Hypothesis: There is no difference in the number of
RE, IHT, insertion costs (IC), or # attempts to achieve PPFT between CBP and
the Cortrak© device. Methods: Quasi-experimental design comparing data from
a historical control group (Jan-Jun 2011), to a prospective intervention
group (Jan-Jun 2012). Sample/Setting: PICU patients < 18years of age and?
3kg requiring PPFT in a 23 bed freestanding pediatric teaching hospital.
PICU nurse practitioners were trained in device use Sept 2011, followed by a
“washout” period Oct-Dec 2011. Primary outcome was number of RE.
Demographic/outcomes data obtained from Virtual PICU Performance System
(VPS, LLC). Results: Total subjects N=77 (pre-32, post-45). There were no
differences between groups in gender, age, PICU length of stay, diagnostic
groups, or severity of illness scores (p >0.05). There were differences
between control vs intervention groups in mean number of RE (1.6 vs 1.2,
p=.024), successful insertion attempts [29/68 (42.6%) vs 54/84 (64.3%)
p=.008, OR 3.72 (95% C.I., 1.35 - 10.26)], IHT (0.3 vs 0.1, p=.013), number
of tubes charged (1.3 vs 1.0 p=.004) and costs per episode ($488.64 vs
$356.59, p=.008). Conclusions: Our results indicate strong evidence for use
of the Cortrak or similar device as an adjunct for PPFT placement in
pediatrics, positively impacting safety, efficacy, and efficiency and
timeliness. Limitations include diverse group RN inserters in control vs
small NP intervention group. Historical controls may introduce bias but no
differences were detected.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
devices
feeding apparatus
intensive care
society
EMTREE MEDICAL INDEX TERMS
control group
diagnosis related group
diseases
experimental design
feeding
gender
hospital
human
hypothesis
length of stay
nurse practitioner
patient
pediatrics
pylorus
radiation exposure
safety
teaching hospital
tube
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71065474
DOI
10.1097/01.ccm.0000425605.04623.4b
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000425605.04623.4b
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 458
TITLE
[Pages of the past: hospitalization and regime for patients with myocardial
infarction].
AUTHOR NAMES
Syrkin A.L.
Sazonova I.S.
AUTHOR ADDRESSES
(Syrkin A.L.; Sazonova I.S.)
CORRESPONDENCE ADDRESS
A.L. Syrkin,
SOURCE
Klinicheskaia meditsina (2012) 90:9 (79-80). Date of Publication: 2012
ISSN
0023-2149
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
coronary care unit
heart infarction (therapy)
patient transport
EMTREE MEDICAL INDEX TERMS
article
disease management
emergency health service
history
hospitalization
human
methodology
LANGUAGE OF ARTICLE
Russian
MEDLINE PMID
23214022 (http://www.ncbi.nlm.nih.gov/pubmed/23214022)
PUI
L366369266
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 459
TITLE
Interfacility transportation of the critical care patient and its medical
direction. Policy statement.
AUTHOR NAMES
American College of Emergency Physicians
AUTHOR ADDRESSES
(American College of Emergency Physicians)
SOURCE
Annals of emergency medicine (2012) 60:5 (677). Date of Publication: Nov
2012
ISSN
1097-6760 (electronic)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
physician
EMTREE MEDICAL INDEX TERMS
article
emergency medicine
human
manpower
standard
LANGUAGE OF ARTICLE
English
MEDLINE PMID
23089103 (http://www.ncbi.nlm.nih.gov/pubmed/23089103)
PUI
L366362900
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 460
TITLE
Interfacility transfers of noncritically ill children to academic pediatric
emergency departments
AUTHOR NAMES
Bosch D.
Li J.
Monuteaux M.
Bachur R.
AUTHOR ADDRESSES
(Li J.; Monuteaux M.; Bachur R.)
(Bosch D.) Denver Health Medical Center, Denver, United States.
CORRESPONDENCE ADDRESS
D. Bosch, Denver Health Medical Center, Denver, United States.
SOURCE
Journal of Emergency Medicine (2012) 43:5 (e382-e383). Date of Publication:
November 2012
CONFERENCE NAME
1st Pan-Pacific Emergency Medicine Congress
CONFERENCE LOCATION
Seoul, South Korea
CONFERENCE DATE
2012-10-23 to 2012-10-26
ISSN
0736-4679
BOOK PUBLISHER
Elsevier USA
ABSTRACT
There are over 27 million pediatric Emergency Department (ED) visits
annually in the United States. Of these, 89% occur in general EDs, many of
which operate without dedicated pediatric staff. Previous studies have
raised growing concerns regarding children receiving suboptimal care in
rural, non-academic centers, and other recent studies have shown that
critically ill pediatric patients have improved outcomes when cared for in a
Pediatric Intensive Care Unit. However, whether these outcomes translate to
non-critically ill patients has not been well studied. The current study was
a cross-sectional analysis to evaluate pediatric inter-facility transfers
with regards to ED management and disposition at the receiving facility.
Included in the 1-year study period were patients younger than 18 years of
age with an inter-facility transport to one of 29 tertiary care pediatric
hospitals in the United States. The primary study measures were diagnoses
and ED management. These measures were compared in patients categorized into
three groups based upon disposition: 1) those directly discharged from the
ED, 2) those admitted for < 24 h, and 3) those admitted for more than 24 h.
During the study period, 22,891 inter-facility transfers were included in
the data analysis. Overall, 24.7% of patients were discharged directly from
the ED, 17% were admitted for < 24 h, and 58.4% required more than 24 h of
hospitalization. Orthopedic injuries were the most common diagnoses for
which patients were transferred, of which 48.5% of patients were discharged
directly from the ED, 27.1% were admitted for < 24 h, and 25.4% required
more than 24 h of hospitalization. Regardless of diagnosis, approximately
21% of patients who were directly discharged from the ED received no
medications, testing, or procedures. In addition, 33% received nothing more
than acetaminophen, ibuprofen, ondansetron, or a plain radiograph. The most
common diagnoses in these patients were orthopedic/ hand injuries (16%),
non-surgical abdominal pain (6.2%), and gastroenteritis/dehydration (5.5%).
Of patients transferred for orthopedic conditions, 48.5% were discharged
from the ED. This was true for 72.5% of non-surgical abdominal pain patients
and 40.4% of those with viral gastroenteritis/dehydration. The authors
concluded that it is not ideal to transfer all children to academic
pediatric hospitals considering that 41.7% of such patients had a < 24-h
hospital stay, suggesting low acuity. They encourage ongoing physician and
nurse education in pediatrics, with a focus on abdominal pain,
gastroenteritis, orthopedics, asthma, and seizures. Reducing unnecessary
inter-facility transports in low-acuity patients could potentially decrease
duplication in testing and treatment, which wastes resources and leads to
decreased patient satisfaction.
EMTREE DRUG INDEX TERMS
ibuprofen
ondansetron
paracetamol
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child
emergency medicine
emergency ward
human
EMTREE MEDICAL INDEX TERMS
abdominal pain
asthma
critically ill patient
data analysis
diagnosis
drug therapy
gastroenteritis
hand injury
hospital
hospitalization
injury
intensive care unit
nursing education
orthopedics
patient
patient satisfaction
pediatrics
physician
procedures
seizure
tertiary health care
United States
waste
X ray film
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70931271
DOI
10.1016/j.jemermed.2012.09.012
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jemermed.2012.09.012
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 461
TITLE
Face-to-face handoff: Improving transfer to the pediatric intensive care
unit after cardiac surgery
AUTHOR NAMES
Vergales J.E.
Addison N.G.
Nicholson E.A.
Carver D.J.
Baum V.C.
Gangemi J.J.
AUTHOR ADDRESSES
(Nicholson E.A.)
(Vergales J.E.; Addison N.G.; Carver D.J.) Pediatrics, University of
Virginia, Charlottesville, United States.
(Baum V.C.) Anesthesiology, University of Virginia, Charlottesville, United
States.
(Gangemi J.J.) Thoracic and Cardiovascular Surgery, University of Virginia,
Charlottesville, United States.
CORRESPONDENCE ADDRESS
J.E. Vergales, Pediatrics, University of Virginia, Charlottesville, United
States.
SOURCE
Pediatric Critical Care Medicine (2012) 13:6 (709). Date of Publication:
November 2012
CONFERENCE NAME
American Academy of Pediatrics Section on Critical Care National Conference
and Exhibition, AAP 2012
CONFERENCE LOCATION
New Orleans, LA, United States
CONFERENCE DATE
2012-10-21 to 2012-10-21
ISSN
1529-7535
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Purpose: The transfer of children after cardiac surgery to the intensive
care unit (ICU) is a critical step in ensuring smooth post-operative
management. This requires excellent communication and coordination among a
variety of providers to make certain details are not overlooked and the
handoff process is accurate, complete and efficient. Methods: We sought to
develop a comprehensive, primarily face-to-face, handoff process that begins
initially in the operating room and concludes at the bedside in the ICU. The
system involves formalized process steps, utilizing a variety of essential
providers across multiple disciplines, with the goal of improving overall
accuracy and efficiency. After an initial trial period to accommodate
unforeseen problems, the final process was evaluated by the use of observer
checklists to evaluate quality metrics and timing in all subsequent patients
admitted to the ICU following cardiac surgery. Results: Prior to initiation
of the new system, only 73% of providers at our institution believed that
information transfer was smooth from one unit to another. Similarly, only
41% believed the process to be standard among all providers, and just 58%
believed there was good interdisciplinary communication and efficiency at
the time of transfer. 30 cases were observed after the new system was
finalized. The admitting nurse travelled to the operating room near the
completion of the case to receive face-to-face handoff prior to assisting in
the transport to the ICU. The total time to stabilize, secure and transport
the patient was not prolonged (mean of 26.0 minutes ± 8.5) and was not
statistically significant when stratified across RACHS-1 categories
(p=0.82), meaning that even the most complex patients were able to be
transported efficiently. Similarly, the time from patient arrival in the ICU
to completion of handoff was rapid (mean of 7.8 minutes ± 4.2) and also did
not differ when stratified to complexity of the surgery (p=0.30). This step
included the stabilization of lines, drains and airways, drawing necessary
labs, reporting of an initial arterial blood gas, obtaining a chest
radiograph and initiation of face-to-face handoff among all providers caring
for the child. Accuracy of information was assured by the use of a
standardized electronic post-operative note completed during the case by the
anesthesiologist, with 100% compliance, and available prior to the patient's
arrival in the ICU. Further, all subspecialties and ancillary services
involved were able to be present 90% of the time for the final steps of the
handoff. Conclusion: A standardized process-driven system, that emphasizes
face-to-face communication, can be implemented for transferring patients to
the ICU after cardiac surgery. It can improve efficiency and accuracy of the
information in addition to improving overall communication between the many
providers caring for these critical patients.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
heart surgery
intensive care
intensive care unit
pediatrics
EMTREE MEDICAL INDEX TERMS
airway
anesthesist
arterial gas
checklist
child
human
interdisciplinary communication
interpersonal communication
nurse
operating room
patient
surgery
thorax radiography
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70931471
DOI
10.1097/PCC.0b013e31826df088
FULL TEXT LINK
http://dx.doi.org/10.1097/PCC.0b013e31826df088
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 462
TITLE
2012 critical care transport workplace and salary survey
AUTHOR NAMES
Greene M.J.
AUTHOR ADDRESSES
(Greene M.J., mgreene@fitchassoc.com) Fitch and Associates, LLC, Platte
City, MO, United States.
CORRESPONDENCE ADDRESS
M.J. Greene, Fitch and Associates, LLC, Platte City, MO, United States.
Email: mgreene@fitchassoc.com
SOURCE
Air Medical Journal (2012) 31:6 (276-280). Date of Publication:
November-December 2012
ISSN
1067-991X
1532-6497 (electronic)
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
ABSTRACT
Critical care transport (CCT) is provided in a unique and challenging
out-of-hospital environment. The workplace and salaries for CCT staff are
similarly unique and distinct within the health care industry. An
industry-specific workplace and salary survey was conducted under Federal
Safe Harbor guidelines to update information for 2012. As safety is a key
concern for CCT workers and organizations, the survey elicited industry best
practices under safety management system (SMS) categories. © 2012 Air
Medical Journal Associates.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
intensive care
occupational safety
EMTREE MEDICAL INDEX TERMS
health care industry
human
medical practice
medical staff
practice guideline
priority journal
review
risk assessment
salary
workplace
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
Occupational Health and Industrial Medicine (35)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2012636533
MEDLINE PMID
23116868 (http://www.ncbi.nlm.nih.gov/pubmed/23116868)
PUI
L365948353
DOI
10.1016/j.amj.2012.09.004
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2012.09.004
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 463
TITLE
Reducing cost at the end of life by initiating transfer to inpatient hospice
in the emergency department
AUTHOR NAMES
DeVader T.E.
DeVader S.R.
Jeanmonod R.
AUTHOR ADDRESSES
(DeVader T.E.; DeVader S.R.; Jeanmonod R.) Kaweah Delta Med. Ctr., Visalia,
CA, USA; Arcadia Univ., Glenside, PA, USA; St. Luke's Hosp. and Hlth. Care
Netwk., Bethlehem, PA, USA
CORRESPONDENCE ADDRESS
T.E. DeVader,
SOURCE
Annals of Emergency Medicine (2012) 60:4 SUPPL. 1 (S73). Date of
Publication: October 2012
CONFERENCE NAME
American College of Emergency Physicians, ACEP Research Forum 2012
CONFERENCE LOCATION
Denver, CO, United States
CONFERENCE DATE
2012-10-08 to 2012-10-09
ISSN
0196-0644
BOOK PUBLISHER
Mosby Inc.
ABSTRACT
Study Objectives: The objective of this study was to determine the cost
savings associated with transferring patients directly from the emergency
department (ED) to an inpatient hospice unit. Methods: This is a
retrospective cohort of patients who died at an inpatient hospice unit from
July 1, 2008, to June 30, 2010. The study site was an academic tertiary
Level-1 trauma center with approximately 75,000 ED visits annually. Using
inpatient hospice unit admission records and the hospital's electronic
medical record, the place of transfer initiation to the inpatient hospice
unit was determined. The places of transfer initiation included the ED,
Intensive Care Unit (ICU), and the general medical floor. All patients
admitted to the inpatient hospice unit during the specified time frame were
eligible for inclusion in the study. Exclusion criteria included patients
transferred to the inpatient hospice unit who were not admitted to the
hospital from the ED, patients who were trauma alerts, patients who were
enrolled in Hospice but transfer to the inpatient hospice unit was not
completed, and patients who were admitted to the inpatient hospice unit from
other hospitals. Cost and charges pertaining to the hospitalization were
determined from financial records, with admission to ED to time of death
comprising the time period assessed. All dollars were adjusted for inflation
to 2010 dollars. Since data was not normally distributed, nonparametric
statistical tests were utilized for median dollar comparisons. The study was
deemed exempt by the institutional review board. Results: A total of 372
patients met study criteria. Forty three patients were transferred directly
from the ED to the inpatient hospice unit, 31 patients were transferred from
the ICU to the inpatient hospice unit, 226 patients were transferred from
the medical floor to the inpatient hospice unit and 72 patients had combined
ICU and floor stays prior to transfer. Hospital charges were reduced in
patients transferred from the ED ($3,652) versus those transferred from all
inpatient services ($65,156, p < 0.0001). Although part of this can be
attributed to room and board charges (median ED room and board charges $0,
median inpatient room and board charges $26,591.13, p < 0.0001), there were
also differences in charges for laboratory studies ($783.54 versus
$3,440.13, p < 0.0001) and radiology studies ($446.90 versus $3,992.63, p <
0.0001). When the ED portions of the patients' stays were viewed
independently of other hospital charges, the ED charges generated by
patients transferred directly to an inpatient hospice unit were less than
those who were admitted to the hospital prior to transfer ($1,321.00 versus
$1,641.00, p < 0.0001). Total cost for the patient's hospital and inpatient
hospice unit stay was also reduced for patients who were transferred to an
inpatient hospice unit directly from the ED as opposed to those who were
admitted to the hospital prior to transfer ($3,347.35 versus $11,119.90, p <
0.0001). All charge and cost differentials were accentuated when comparing
patients with ICU stays to patients transferred directly from the ED (Table
1). (Table Presented) Conclusion: Initiating transfers to an inpatient
hospice unit from the ED significantly reduces hospital charges (ED, room
and board, laboratory, and radiology) and hospital costs with the most
significant savings in those patients who spend any time in the ICU during
their hospitalization.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
college
emergency physician
emergency ward
hospice
hospital patient
human
EMTREE MEDICAL INDEX TERMS
cost control
electronic medical record
emergency health service
hospital
hospital charge
hospital cost
hospitalization
injury
institutional review
intensive care unit
laboratory
patient
radiology
Tertiary (period)
time of death
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70897289
DOI
10.1016/j.annemergmed.2012.06.180
FULL TEXT LINK
http://dx.doi.org/10.1016/j.annemergmed.2012.06.180
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 464
TITLE
'Tubes' and catheter positions in neonates transferred to a tertiary
neonatal intensive care unit over a 2 year period
AUTHOR NAMES
Nepali G.
Tasbihi M.
Egyepong J.
AUTHOR ADDRESSES
(Nepali G.; Egyepong J.) Neonatal Intensive Care Unit, Luton and Dunstable
Hospital NHS Trust, Luton, United Kingdom.
(Tasbihi M.) Department of Paediatric, Luton and Dunstable University
Hospital NHS Trust, Luton, United Kingdom.
CORRESPONDENCE ADDRESS
G. Nepali, Neonatal Intensive Care Unit, Luton and Dunstable Hospital NHS
Trust, Luton, United Kingdom.
SOURCE
Archives of Disease in Childhood (2012) 97 SUPPL. 2 (A373-A374). Date of
Publication: October 2012
CONFERENCE NAME
4th Congress of the European Academy of Paediatric Societies
CONFERENCE LOCATION
Istanbul, Turkey
CONFERENCE DATE
2012-10-05 to 2012-10-09
ISSN
0003-9888
BOOK PUBLISHER
BMJ Publishing Group
ABSTRACT
Introduction • Endotracheal tubes (ETT), Chest tubes (CT), Nasogastric tubes
(NGT), umbilical artery and venous catheters (UAC, UVC), Long lines (LL) are
crucial in the management of babies transferred and admitted to neonatal
intensive care units (NICU). Optimal positions must be ascertained before
transfer and on admission to avoid complications. • To the best of our
knowledge, there has not been any published data looking at admission
positions of all these tubes and catheters. Aim To determine: • positions of
these tubes and lines on admission of babies transferred for intensive care
to a tertiary NICU. • any radiological and other complications that may have
been associated with sub-optimally placement on admission. Methods
Retrospective study • All babies transferred in • Inclusion criteria:
Admission X-ray done within 12 hrs Results • 148 babies were admitted for
tertiary neonatal care of which 127 met inclusion criteria. Patients were
stratified as < 1 kg, 1-2 kg and >2 kg. Correctly positioned tubes were as
follows: • < 1 kg: 33% ETT, 81%NGT, 48% UAC • 1-2 kg: 31% ETT, 100% NGT,
33%UAC • >2kg: 54% ETT, 100% NGT, 31%UAC Conclusion • Infants less than 1 kg
were at higher risk of suboptimally positioned tubes and lines. • Position
prior to transfer and on admission must be ascertained to minimise
complications. (Table presented).
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
catheter
intensive care unit
newborn
newborn intensive care
organization
Tertiary (period)
tube
EMTREE MEDICAL INDEX TERMS
baby
chest tube
endotracheal tube
human
infant
intensive care
intravenous catheter
nasogastric tube
newborn care
patient
retrospective study
risk
umbilical artery
X ray
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71063240
DOI
10.1136/archdischild-2012-302724.1311
FULL TEXT LINK
http://dx.doi.org/10.1136/archdischild-2012-302724.1311
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 465
TITLE
Is delayed ICU referral associated with adverse maternal outcome? A study at
tertiary level hospital in India
AUTHOR NAMES
Khan M.S.
Sultana T.
AUTHOR ADDRESSES
(Khan M.S.) Dept of Anesthesiology, Lady Hardinge Medical College, New
Delhi, India.
(Sultana T.) Dept of Obstetrics and Gynecology, Lady Hardinge Medical
College, New Delhi, India.
CORRESPONDENCE ADDRESS
M.S. Khan, Dept of Anesthesiology, Lady Hardinge Medical College, New Delhi,
India.
SOURCE
International Journal of Gynecology and Obstetrics (2012) 119 SUPPL. 3
(S389). Date of Publication: October 2012
CONFERENCE NAME
20th FIGO World Congress of Gynecology and Obstetrics
CONFERENCE LOCATION
Rome, Italy
CONFERENCE DATE
2012-10-07 to 2012-10-12
ISSN
0020-7292
BOOK PUBLISHER
Elsevier Ireland Ltd
ABSTRACT
Objectives: Delay in ICU referral is a common phenomenon in the government
hospitals of developing nations. This kind of delay has been associated with
adverse outcomes in various ICU populations. Present study was designed to
find out association between delayed ICU referral and 28-day mortality in
obstetric critically ill patients. Materials: A retrospective cohort study
was performed on obstetric patients referred to the surgical-medical ICU of
LHMC and SSK Hospital, New Delhi, India from January 2010 to December 2011.
All critically ill women admitted to ICU during pregnancy or within 6 weeks
of delivery and ICU length of stay (ICU LOS) greater than 24 hours of
admission were included in the study. Methods: ICU referral was classified
as either delayed referral (DR) or immediate referral (IR). We defined the
delayed ICU referral as “ICU referral after 6 hours of admission to
gynecology casualty”. Times of admission to gynecology casualty, first ICU
referral and ICU admission, indication of ICU referral, ICU diagnosis,
interventions required, course during ICU stay and maternal outcome were
recorded for each patient on a pre-structured data sheet. The primary
outcomes analyzed were the 28-day maternal mortality, SAPS (Simplified Acute
Physiological score) II and ICU LOS. Results: One hundred and twenty six
obstetric patients were included in study. Delayed referral was recorded in
about 47% of patients. Mean delay in ICU referral was 7.96±9.47 hours which
was significantly higher among DR group as compared to IR group (1.31±1.20
vs 14.61±9.45; p < 0.001). The overall 28-day mortality was 27.8% percent
which was significantly higher in DR group as compared to IR group (38.9% vs
17.9%; p < 0.001). ICU LOS was also longer in DR group. Patients in DR group
had significantly higher SAPS II scores as compared to those in IR group
(43.19±9.52 vs 29.66±5.42; p < 0.0001). There were no significant
differences in the two groups with respect to age, gestational age, parity,
number of antenatal visits and co-morbidities. Conclusions: This study
outlines the impact of delayed ICU referral on maternal mortality in
developing nations. This delay is potentially preventable. Hospital
administration should take solid steps to minimize delays in decision
making, pre-ICU care and intra-hospital transfer of critically ill patients.
Specific institutional triage algorithm should be developed at obstetric
emergency room for timely referral of high priority obstetric patients to
the ICU.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
gynecology
hospital
India
obstetrics
EMTREE MEDICAL INDEX TERMS
accident
adverse outcome
algorithm
cohort analysis
critically ill patient
decision making
diagnosis
emergency health service
emergency ward
female
gestational age
government
hospital management
human
length of stay
maternal mortality
morbidity
mortality
obstetric emergency
obstetric patient
parity
patient
population
pregnancy
solid
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70905696
DOI
10.1016/S0020-7292(12)60793-0
FULL TEXT LINK
http://dx.doi.org/10.1016/S0020-7292(12)60793-0
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 466
TITLE
Reduction in late-onset sepsis on relocating a neonatal intensive care
nursery
AUTHOR NAMES
Jones A.R.
Kuschel C.
Jacobs S.
Doyle L.W.
AUTHOR ADDRESSES
(Jones A.R.; Kuschel C.; Jacobs S.; Doyle L.W., lwd@unimelb.edu.au)
Department of Obstetrics and Gynaecology, Royal Women's Hospital, University
of Melbourne, 20 Flemington Road, Parkville, VIC 3052, Australia.
(Doyle L.W., lwd@unimelb.edu.au) Critical Care and Neurosciences Theme,
Murdoch Childrens Research Institute, Parkville, Australia.
(Jones A.R.; Kuschel C.; Jacobs S.; Doyle L.W., lwd@unimelb.edu.au) Neonatal
Services, Royal Women's Hospital, Melbourne, VIC, Australia.
CORRESPONDENCE ADDRESS
L.W. Doyle, Department of Obstetrics and Gynaecology, Royal Women's
Hospital, University of Melbourne, 20 Flemington Road, Parkville, VIC 3052,
Australia. Email: lwd@unimelb.edu.au
SOURCE
Journal of Paediatrics and Child Health (2012) 48:10 (891-895). Date of
Publication: October 2012
ISSN
1034-4810
1440-1754 (electronic)
BOOK PUBLISHER
Blackwell Publishing, 550 Swanston Street, Carlton South, Australia.
ABSTRACT
Aims: The aims of this study were to compare rates of late-onset sepsis
(LOS) in very preterm or very low birthweight infants before and after
relocation to a new nursery and to determine risk factors for LOS. Methods:
The study was undertaken at The Royal Women's Hospital, Melbourne, which
relocated to a new site in June 2008. Infants with birthweight <1500 g or
<32 weeks' gestation, born between July and December 2007 (n= 149) and July
and December 2008 (n= 152) were included. Each septic episode was identified
from blood cultures taken from patients >48 h after birth and was
categorised as definite, probable, uncertain or no sepsis. Results: Overall,
117 infants had 218 septic episodes. The proportion of infants with clinical
LOS decreased from 29.5% in 2007 to 22.4% in 2008 after the relocation,
although this was not statistically significant. There was a significant (P
< 0.05) reduction in the severity (definite LOS = most severe) of sepsis in
2008 compared with 2007, and in rates of coagulase-negative staphylococcal
LOS. Significant risk factors for LOS were: lower birthweight (g; mean -351,
95% confidence interval (CI) -446, -256); lower gestational age (weeks; mean
-2.3, 95% CI -2.8, -1.7) and presence of a percutaneous inserted central
catheter (odds ratio (OR) 2.56, 95% CI 1.03, 6.67). Conclusions: There was a
significant reduction in the severity of LOS in very preterm and/or very low
birthweight infants that correlated with the relocation from the old to new
nursery. Smaller and more immature infants with percutaneous central
catheters were more at risk. © 2012 Paediatrics and Child Health Division
(Royal Australasian College of Physicians).
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
late onset sepsis
newborn care
newborn sepsis
sepsis
EMTREE MEDICAL INDEX TERMS
antibiotic therapy
artery catheter
article
birth weight
blood culture
central venous catheterization
coagulase negative Staphylococcus
disease association
disease severity
endotracheal tube
Escherichia coli
gestational age
hospital hygiene
human
immaturity
infant
infection risk
intravenous catheter
Klebsiella pneumoniae
length of stay
major clinical study
newborn
newborn intensive care
patient transport
positive end expiratory pressure
prematurity
priority journal
Pseudomonas aeruginosa
risk factor
Streptococcus agalactiae
treatment duration
very low birth weight
EMBASE CLASSIFICATIONS
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2012625494
MEDLINE PMID
22897216 (http://www.ncbi.nlm.nih.gov/pubmed/22897216)
PUI
L52172744
DOI
10.1111/j.1440-1754.2012.02524.x
FULL TEXT LINK
http://dx.doi.org/10.1111/j.1440-1754.2012.02524.x
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 467
TITLE
Do we need to reconcile medicines when patients are transferred between
wards and critical care?
AUTHOR NAMES
Hebron B.
Graham-Clarke E.
Shafia A.
Sohal K.
AUTHOR ADDRESSES
(Hebron B.; Shafia A.; Sohal K.) Aston University, Birmingham, United
Kingdom.
(Hebron B.; Graham-Clarke E.) Sandwell and West Birmingham NHS Trust,
Birmingham, United Kingdom.
CORRESPONDENCE ADDRESS
B. Hebron, Aston University, Birmingham, United Kingdom.
SOURCE
International Journal of Pharmacy Practice (2012) 20 SUPPL. 2 (81). Date of
Publication: October 2012
CONFERENCE NAME
Royal Pharmaceutical Society, RPS Annual Conference 2012
CONFERENCE LOCATION
Birmingham, United Kingdom
CONFERENCE DATE
2012-09-09 to 2012-09-10
ISSN
0961-7671
BOOK PUBLISHER
Pharmaceutical Press
ABSTRACT
Introduction: In December 2007, the National Institute for Clinical
Excellence and the National Patient Safety Agency developed patient safety
guidance to improve the accuracy of recording medication history through
reconciliation. Subsequent audits have confirmed that appropriate
continuation of maintenance medication improves the care of patients in
hospital( 1). Our previous work indicated that transfer of care during
critical care units might raise similar issues. The aim of the present study
was to compare medicine reconciliation during the transfer from primary care
to the hospital setting with that during the transfer into and out of
critical care. Method: Five retrospective audits were performed between
January 2009 and October 2011 to examine changes in maintenance medication
recorded from admission to discharge. The study was conducted on the medical
admission units [MAU] and critical care services [CCS] on the 2 hospital of
the Trust. The audits examined changes during admission to hospital from
primary care and from a hospital ward to CCS, from CCS to a ward and
subsequent discharge from hospital. Only those patients, who were
hospitalised, or only those remaining on critical care, for more than 24
hours were included. Patients who were transferred, died, readmitted to CCS
or whose notes were not available were excluded. Within each patient's
medical records, the initial assessment record, the ward discharge summary,
the critical care service admission and discharge forms and medication
records were scrutinised to identify any changes in maintenance medication
during the admission. The data was gathered by pharmaceutical staff and
final year undergraduate students, and reviewed by a consultant or senior
pharmacist with expertise in the area. Approval by the Clinical
Effectiveness Committee of the Trust was given for this analysis. Results:
During the course of the study 576 patients who were admitted to MAU met the
entry criteria, of whom the notes of 196 were available for analysis and 195
patients admitted to CCS who met the entry criteria, of whom the notes of 63
were available. A total of 2345 medicines were examined, of which 390
[16.6%] required amendment of the prescription. Most discrepancies [365 of
the 390 - 93%] were for omission of medicines of which the most common were
cardiovascular medicines [11%] followed by those with an action on the
central nervous system [9%]. Errors were greater on admission to hospital
affecting 196 patients [19.6%] and on discharge from CCS, affecting 126
patients [66%], than on transfer from MAU to a ward [8% of patients] or from
a ward to CCS [6.5% of patients]. Discussion: This study has found that on
admission to hospital, most discrepancies in medication history are
omissions of maintenance medication. This supports other reports in the
literature where reconciliation on admission to hospital has been
described(1). Maintenance medicines are often stopped on CCS as patients are
unable to take oral medicines and rapid intravenous treatment is available
to treat acute conditions. We have found that this is often not communicated
on discharge from CCS to other wards. During the course of this work similar
results have been reported from Canada(2). We believe that CCS should be
regarded as a transition of care requiring a further reconciliation of
medication from that on admission to hospital.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health care organization
human
intensive care
patient
ward
EMTREE MEDICAL INDEX TERMS
acute disease
Canada
central nervous system
clinical audit
clinical effectiveness
consultation
drug therapy
hospital
medical record
patient safety
pharmacist
prescription
primary medical care
recording
stomatology
undergraduate student
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70879083
DOI
10.1111/j.2042-7174.2012.00235.x
FULL TEXT LINK
http://dx.doi.org/10.1111/j.2042-7174.2012.00235.x
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 468
TITLE
Hemodynamic and oxygen transport during aortocoronary shunting on the
working heart
AUTHOR NAMES
Ibadov R.A.
Mansurov A.A.
Arifjanov A.S.
Mansurov Z.N.
Strijkov N.A.
AUTHOR ADDRESSES
(Ibadov R.A.; Mansurov A.A.; Arifjanov A.S.; Mansurov Z.N.; Strijkov N.A.)
Republican Specialized Center of Surgery named after acad. V. Vakhidov,
Tashkent, Uzbekistan.
CORRESPONDENCE ADDRESS
R.A. Ibadov, Republican Specialized Center of Surgery named after acad. V.
Vakhidov, Tashkent, Uzbekistan.
SOURCE
Intensive Care Medicine (2012) 38 SUPPL. 1 (S160). Date of Publication:
October 2012
CONFERENCE NAME
25th Annual Congress of the European Society of Intensive Care Medicine,
ESICM 2012
CONFERENCE LOCATION
Lisbon, Portugal
CONFERENCE DATE
2012-10-13 to 2012-10-17
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag
ABSTRACT
OBJECTIVE. To evaluate the impact of the algorithm based on a combination of
transpulmonary dilution and continuous venous blood oxygen saturation
monitoring on preoperative infusion therapy and hemodynamic correction and
on the length of postoperative stay in an intensive care unit and at
hospital after aortocoronary bypass surgery without extracorporeal
circulation. SUBJECTS AND METHODS. The patients were randomized to two
hemodynamic monitoring groups: 1. routine monitoring (RM) (n = 20) and 2.
complex monitoring (CM) (n = 20). In the RM group, therapy was based on the
values of central venous pressure, mean blood pressure (BP mean), and heart
rate (HR). In the CM group, it was founded on the values of intrathoracic
blood volume index, BP mean, HR, central venous saturation (ScvO(2)), and
cardiac index (CI). Measurements were made before, during, and 2, 4 and 6 h
after surgery. RESULTS. In the CM group, colloidal solutions and dobutamine
were significantly more frequently used, which was followed by increases in
ScvO(2) and CI as compared with the baseline values. The frequency of use of
ephedrine was significantly higher in the RM group. The algorithm based on
complex monitoring reduced the time of achieving the criteria for
transferring from the intensive care unit and the length of postoperative
hospital stay by 15 and 25 %, respectively. CONCLUSION. Thus, the
goal-oriented algorithm based on the complex monitoring of hemodynamic and
oxygen transport makes it possible to reveal hemodynamic disturbances and
correct them early, which can improve an early postoperative period during
aortocoronary bypass surgery on the working heart.
EMTREE DRUG INDEX TERMS
dobutamine
ephedrine
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
heart
intensive care
oxygen transport
shunting
society
EMTREE MEDICAL INDEX TERMS
algorithm
blood oxygen tension
blood volume
cardiac index
central venous pressure
colloid
coronary artery bypass surgery
dilution
extracorporeal circulation
group therapy
heart rate
hemodynamic monitoring
hemodynamics
hospital
hospitalization
human
infusion
intensive care unit
mean arterial pressure
monitoring
patient
postoperative period
surgery
venous blood
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71013795
DOI
10.1007/s00134-012-2683-0
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-012-2683-0
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 469
TITLE
Regional paediatric intensive care (PIC) transport services: Benefits of 2
becoming 1!
AUTHOR NAMES
Lakin B.
Parkins K.
Walker C.
Barber R.
Santo S.
Claydon-Smith K.
AUTHOR ADDRESSES
(Lakin B.; Parkins K.; Walker C.; Barber R.; Santo S.; Claydon-Smith K.)
North West and North UK Paediatric Transport Service, Warrington, United
Kingdom.
CORRESPONDENCE ADDRESS
B. Lakin, North West and North UK Paediatric Transport Service, Warrington,
United Kingdom.
SOURCE
Archives of Disease in Childhood (2012) 97 SUPPL. 2 (A278). Date of
Publication: October 2012
CONFERENCE NAME
4th Congress of the European Academy of Paediatric Societies
CONFERENCE LOCATION
Istanbul, Turkey
CONFERENCE DATE
2012-10-05 to 2012-10-09
ISSN
0003-9888
BOOK PUBLISHER
BMJ Publishing Group
ABSTRACT
Background Approximately 1.7 million children North West and North Wales
(UK) and 600-700 are transferred annually from 31 hospitals into 2 regional
PICUs. Prior to 2010 specialist PIC transport teams were unit based but
review (2007) revealed problems: • Minimum 30% PIC transfers by
non-specialised teams (associated with adverse incidents) • Poor access to
clinical advice • Delays finding PIC bed • Delays mobilising specialist PIC
transport team • Adverse incidents associated with inexperienced medical
personnel (specialist teams) Regional Paediatric Transport Service (NWTS)
started 2010 with a single point of contact providing advice, organisation
transfer and PIC bed. Methods Several database audits (first 12 months) to
assess quality of retrievals compared to previous data. Results 91.6% PIC
transfers done by NWTS in first year (target > 85%). Retrieval times
(median) Mobilisation 29.5mins (pre NWTS 80mins); stabilisation 102 mins
(pre NWTS 110mins); total retrieval time 201mins (pre NWTS 310mins) Winter
data consultant present 50% (n=40) retrievals - supporting inexperienced
staff. Snapshot (6 weeks) audit showed patient management advice was
substantial and potentially avert admission. For example, 13 children were
initially referred, but with advice over 3 (median) phone calls (range 2-8)
remained in the local centre. Better utilisation PIC beds refusal rate 5.8%
versus 37% pre-NWTS. Satisfaction survey (referring hospitals) demonstrated
overall satisfaction excellent or good in domains including comparison with
previous arrangements and clinical care. Conclusions Our data suggest that
improvement in quality has occurred since the launch of NWTS, including
improved utilisation of regional PICU beds.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
organization
EMTREE MEDICAL INDEX TERMS
child
clinical audit
consultation
data base
hospital
human
medical personnel
medical specialist
patient care
satisfaction
United Kingdom
winter
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71062902
DOI
10.1136/archdischild-2012-302724.0973
FULL TEXT LINK
http://dx.doi.org/10.1136/archdischild-2012-302724.0973
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 470
TITLE
Identifying pre-analytic variables that contribute to hemolysis in neonatal
blood specimens: Sample collection site, transportation method and lipid
emulsion infusion status
AUTHOR NAMES
Tolan N.V.
Kaleta E.J.
Karon B.S.
Baumann N.A.
AUTHOR ADDRESSES
(Tolan N.V.; Kaleta E.J.; Karon B.S.; Baumann N.A.) Mayo Clinic, Rochester,
United States.
CORRESPONDENCE ADDRESS
N.V. Tolan, Mayo Clinic, Rochester, United States.
SOURCE
Clinical Chemistry (2012) 58:10 SUPPL. 1 (A148). Date of Publication:
October 2012
CONFERENCE NAME
64th Annual Scientific Meeting of the American Association for Clinical
Chemistry, AACC 2012
CONFERENCE LOCATION
Los Angeles, CA, United States
CONFERENCE DATE
2012-07-17 to 2012-07-19
ISSN
0009-9147
BOOK PUBLISHER
American Association for Clinical Chemistry Inc.
ABSTRACT
Objective: A quality improvement project was initiated to identify major
pre-analytic variables associated with specimen hemolysis in the Neonatal
Intensive Care Unit (NICU) with the goal of reducing the rate of hemolysis
in neonatal specimens. In this study, the effects of sample collection site,
specimen transportation method and lipid emulsion infusion status were
systematically investigated. Methodology: Over a period of two months,
specimen collection site information and lipid emulsion infusion status were
recorded for patients in the NICU at Saint Marys Hospital (Rochester, MN)
who had orders for routine chemistry tests (direct and total bilirubin, CRP,
Mg, Phosphorus) performed in the Central Clinical Laboratory (CCL), located
1.5 miles from the NICU. All samples were collected in microtainer serum
separator tubes. Chemistry analytes and H-index, to quantitate hemolysis,
were measured on Roche Modular analytics (Roche Diagnostics, Indianopolis,
IN). In addition, specimen transport from NICU to CCL was alternated between
being hand-carried or transported by the pneumatic tube system. The data
were analyzed as a binary function of hemolyzed or non-hemolyzed using the
most stringent H index cut-off for the tests included (direct bilirubin).
Results: Thirty-nine unique patients (20 males and 19 females) ranging in
age from 28 to 68 days old (median = 46 days) were included in the study. A
total of 137 samples were collected through either arterial/venous line
(66%) or venipuncture (34%). The percentage of hemolyzed specimens for each
collection site was 41% (21/51), 15% (7/46) and 13% (5/40) for arterial
line, venipuncture and venous line, respectively. In this study 67% of
patients were prescribed lipid emulsion infusion. Rates of hemolysis were
38% (8/21) for infants receiving lipid infusion at the time of sample
collection, 24% (13/54) for infants prescribed lipid emulsion but for whom
the infusion was paused at the time of sample collection, and 24% (11/45)
for infants without a prescription for lipid emulsion therapy. Specimens
that were hand-carried to the laboratory had a hemolysis rate of 9% (3/32)
compared to 20% (11/54) for samples sent through the pneumatic tube. Among
samples sent through the pneumatic tube, the percentage of hemolyzed samples
was greatest when the patient was receiving lipids at the time of
phlebotomy, 50% (6/12); compared to when the lipids were paused, 30% (10/33)
and when no lipids were prescribed, 33% (8/24). Conclusions: In our study,
the largest contributor to serum sample hemolysis in NICU patients was the
method of sample acquisition (arterial line collection), followed by lipid
infusion status at time of collection and the transport method. The data
also suggest that there is an additive effect of lipid infusion at the time
of sample acquisition and transport through the pneumatic tube system. The
trends identified provide a starting point for practice improvements that
may reduce hemolysis rates in the NICU patient population including reducing
arterial line collections when possible and changes in lipid emulsion
infusion protocols.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
lipid emulsion
EMTREE DRUG INDEX TERMS
bilirubin
bilirubin glucuronide
lipid
phosphorus
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
American
blood
clinical chemistry
hemolysis
infusion
traffic and transport
EMTREE MEDICAL INDEX TERMS
arterial line
Christian
clinical laboratory
diagnosis
female
hospital
human
infant
intensive care unit
intravenous catheter
laboratory
male
methodology
newborn intensive care
patient
phlebotomy
population
prescription
serum
therapy
total quality management
tube
vein puncture
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L72249848
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 471
TITLE
Saving more than money: Comparison of emergency department versus
hospital-initiated transfers to hospice
AUTHOR NAMES
DeVader T.E.
DeVader S.R.
Jeanmonod R.
AUTHOR ADDRESSES
(DeVader T.E.; DeVader S.R.; Jeanmonod R.) Kaweah Delta Med. Ctr., Visalia,
CA, USA; Arcadia Univ., Glenside, PA, USA; St. Luke's Hosp. and Hlthcare.
Netwk., Bethlehem, PA, USA
CORRESPONDENCE ADDRESS
T.E. DeVader,
SOURCE
Annals of Emergency Medicine (2012) 60:4 SUPPL. 1 (S108-S109). Date of
Publication: October 2012
CONFERENCE NAME
American College of Emergency Physicians, ACEP Research Forum 2012
CONFERENCE LOCATION
Denver, CO, United States
CONFERENCE DATE
2012-10-08 to 2012-10-09
ISSN
0196-0644
BOOK PUBLISHER
Mosby Inc.
ABSTRACT
Study Objectives: For patients seeking care in the emergency department (ED)
in whom hospice was ultimately consulted, we sought to determine differences
in time to consultation and time to death as a function of whether the
patient was receiving care in the ED, the intensive care unit, or the
inpatient ward. Methods: This is a retrospective cohort study of patients
who were seen in the ED at evaluation and were ultimately transferred to an
inpatient hospice unit from a single tertiary care 500-bed hospital with an
ED census of 75,000 patients annually Patients were identified using
inpatient hospice unit records of all admitted patients who died during the
2-year study period (July 1, 2008 to June 30, 2010), with subsequent
identification of site of transfer initiation using the electronic medical
record. Site of transfer initiation was categorized as »ED,« »ICU,«
»Inpatient,« or »Combined« (for those patients who spent time on the
inpatient ward as well as in the intensive care unit). Inpatient hospice
unit patients were excluded if they were transferred to the inpatient
hospice unit from a site other than the study institution, if they were
transferred from an inpatient service without having been initially
evaluated in the ED, or if their admission was the result of a trauma alert.
Data regarding time in days (d) to hospice consultation and time in days (d)
to death once admitted to the inpatient hospice unit were recorded in a
standardized Excel spreadsheet. Since data was not normally distributed,
nonparametric statistical tests were utilized for median time comparisons.
The study was reviewed by the institutional review board and found to be
exempt. Results: A total of 372 patients were enrolled. Of these, 43
patients were transferred to the inpatient hospice unit directly from the
ED, 226 patients were transferred from the inpatient service, 31 patients
were transferred from the intensive care unit, and 72 patients had both
inpatient and intensive care unit stays prior to transfer. By definition,
patients transferred to the inpatient hospice unit from the ED had 0 days to
hospice consultation and 0 days to hospice transfer. For patients who were
admitted to the intensive care unit from the ED and then transferred, the
median time to hospice consultation was 2d, with a median time to transfer
of 3d (p < 0.0001, Mann-Whitney). For patients admitted to the inpatient
service and then transferred to the inpatient hospice unit, the median time
to hospice consultation was 4d with a median time to transfer of 5d (p <
0.0001, Mann-Whitney). For patients with combined inpatient and intensive
care unit stays after admission from the ED, median time to hospice
consultation was 8.5d, with a median time to hospice transfer of 11d (p <
0.0001). The median time to hospice consultation for all inpatient hospice
unit patients who were hospitalized prior to transfer was 4d, with a median
time to transfer of 6d. The median time spent in hospice prior to death for
patients transferred directly to the inpatient hospice unit from the ED was
2d. The median time spent on hospice prior to death for ED patients who were
hospitalized prior to transfer was 3d (p = 0.2). Conclusion: Admission to
the hospital can delay appropriate consultation of hospice and timely
transfer to an inpatient hospice unit. Patients transferred to an inpatient
hospice unit from the ED spend a similar amount of time on hospice compared
to those transferred from other sites.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
college
emergency physician
emergency ward
hospice
hospital
human
money
EMTREE MEDICAL INDEX TERMS
cohort analysis
consultation
death
electronic medical record
hospital patient
injury
institutional review
intensive care unit
patient
population research
tertiary health care
ward
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70897388
DOI
10.1016/j.annemergmed.2012.06.282
FULL TEXT LINK
http://dx.doi.org/10.1016/j.annemergmed.2012.06.282
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 472
TITLE
Assessment of need for training of junior doctors in intra hospital transfer
of acutely ILL patients
AUTHOR NAMES
Prasad C.N.
Hayes R.
Ranganathan M.
AUTHOR ADDRESSES
(Prasad C.N.; Hayes R.; Ranganathan M.) George Eliot Hospital,
Anaesthetics/ITU, Nuneaton, United Kingdom.
CORRESPONDENCE ADDRESS
C.N. Prasad, George Eliot Hospital, Anaesthetics/ITU, Nuneaton, United
Kingdom.
SOURCE
Intensive Care Medicine (2012) 38 SUPPL. 1 (S62). Date of Publication:
October 2012
CONFERENCE NAME
25th Annual Congress of the European Society of Intensive Care Medicine,
ESICM 2012
CONFERENCE LOCATION
Lisbon, Portugal
CONFERENCE DATE
2012-10-13 to 2012-10-17
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag
ABSTRACT
INTRODUCTION. Junior doctors are key providers of care to sick patient. Most
acutely ill and critically ill patients are transferred within hospital-for
investigations or treatment or from ED to the wards. Transfers involve risk
of morbidity and mortality. Managing these risks specifically is not always
a part of junior doctor training. OBJECTIVES. To explore the need for formal
training of Junior doctors for Intra hospital transfer of acutely ill
patients. METHODS. Questionnaire circulated amongst Foundation Year 1/2,
Core Anaesthetic Trainees. Questions related to: Training in
anaesthesia/ITU, life support training. Training in patient transfers.
Experience in patient transfers. Confidence in patient transfers. Need for
training in patient transfers. RESULTS. No doctors in their foundation years
had any form of training in transfer of patients within hospitals. Of the
doctors in specialist training only 2 had received training in patient
transfers, only one of which had been assessed. No doctors had attended a
formal transfer course. 100 % of FY&CT doctors that responded felt they
required formal training in patient transfers.
EMTREE DRUG INDEX TERMS
anesthetic agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital
human
intensive care
patient
physician
society
EMTREE MEDICAL INDEX TERMS
critically ill patient
hospital patient
medical specialist
morbidity
mortality
non profit organization
patient transport
questionnaire
risk
student
ward
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71013433
DOI
10.1007/s00134-012-2683-0
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-012-2683-0
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 473
TITLE
“Case mix” changes in a medical intensive care unit after a geographical
transfer of a third level, university hospital
AUTHOR NAMES
Cebrián Domènech J.
Monsalve Vila F.
Bonastre Mora J.
Vacacela Córdova K.
AUTHOR ADDRESSES
(Cebrián Domènech J.; Monsalve Vila F.; Bonastre Mora J.; Vacacela Córdova
K.) Hospital Universitario y Politécnico La Fe, ICU, Valencia, Spain.
CORRESPONDENCE ADDRESS
J. Cebrián Domènech, Hospital Universitario y Politécnico La Fe, ICU,
Valencia, Spain.
SOURCE
Intensive Care Medicine (2012) 38 SUPPL. 1 (S106). Date of Publication:
October 2012
CONFERENCE NAME
25th Annual Congress of the European Society of Intensive Care Medicine,
ESICM 2012
CONFERENCE LOCATION
Lisbon, Portugal
CONFERENCE DATE
2012-10-13 to 2012-10-17
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag
ABSTRACT
INTRODUCTION. Information about big hospital geographical transfer is scarce
in the medical literature. On February 20th of 2011 our Hospital (in fact, a
big university complex) was transferred from their previous location in the
North-Center of our city towards a new Southern peripheral, geographical
location. This transfer has been done without any changes in assisted
population nor nursing or medical staff. OBJECTIVES. Our aim is to analyze
possible changes in the main characteristics of our “Case Mix” (Origin,
previous quality of life and NYHA score, main diagnostic groups, severity
scores, and in ICU, in hospital mortality). METHODS. A number of 2,774 cases
(63 % males; mean age 61 years) were admitted in our medical ICU during the
study period (1 year before and after the transfer).We have compared both
groups (previous and before) by using simple statistical contrasts (Chi
square and Oneway analysis of variance). Bonferroni0s correction, if
appropriate, was done to overcome the problem of multiple contrasts. Minitab
and Statbas statistical packets were used. RESULTS. No differences between
both groups were founded in demographic data, Knaus score and NYHA status.
Regarding their origin, we have founded more patients admitted from other
hospital centers (20 vs. 29 %; p<0.001). Apache II score increase from 17.24
to 19.08 (p<0.001) and a slight increase change in Saps 3 score was founded
too (52.29 to 53.75; p<0.01). In spite of these increases in severity
indexes and their associated mortality, our in ICU mortality remains lower
(15.5-15.6 %) whereas observed in hospital mortality decreased (22.37-19.88;
p<0.001). An increase in our neurologic patients has been the most
consistent change regarding diagnostic groups. (Figure presented)
CONCLUSIONS. According to the previous data our ICU seems to perform better
in the new location with a decrease in Standardized Mortality Rate. On the
other hand we are admitting more patients transferred from other hospitals.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
case mix
intensive care
intensive care unit
society
university hospital
EMTREE MEDICAL INDEX TERMS
analysis of variance
city
diagnosis related group
hospital
human
male
medical literature
medical staff
mortality
New York Heart Association class
nursing
patient
population
quality of life
Simplified Acute Physiology Score
university
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71013602
DOI
10.1007/s00134-012-2683-0
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-012-2683-0
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 474
TITLE
In-house preparation of hydrogels for batch affinity purification of
glutathione S-transferase tagged recombinant proteins
AUTHOR NAMES
Buhrman J.S.
Rayahin J.E.
Köllmer M.
Gemeinhart R.A.
AUTHOR ADDRESSES
(Buhrman J.S., jbuhrm2@uic.edu; Rayahin J.E., jrayah2@uic.edu; Köllmer M.,
mkollmer@uic.edu; Gemeinhart R.A., rag@uic.edu) Department of
Biopharmaceutical Sciences, University of Illinois, Chicago, IL, 60612-7231,
United States.
(Gemeinhart R.A., rag@uic.edu) Department of Bioengineering, University of
Illinois, Chicago, IL, 60607-7052, United States.
(Gemeinhart R.A., rag@uic.edu) Department of Ophthalmology and Visual
Science, University of Illinois, Chicago, IL, 60612-4319, United States.
CORRESPONDENCE ADDRESS
R.A. Gemeinhart, Department of Biopharmaceutical Sciences, University of
Illinois, Chicago, IL, 60612-7231, United States. Email: rag@uic.edu
SOURCE
BMC Biotechnology (2012) 12 Article Number: 63. Date of Publication: 18 Sep
2012
ISSN
1472-6750 (electronic)
BOOK PUBLISHER
BioMed Central Ltd., Floor 6, 236 Gray's Inn Road, London, United Kingdom.
ABSTRACT
Background: Many branches of biomedical research find use for pure
recombinant proteins for direct application or to study other molecules and
pathways. Glutathione affinity purification is commonly used to isolate and
purify glutathione S-transferase (GST)-tagged fusion proteins from total
cellular proteins in lysates. Although GST affinity materials are
commercially available as glutathione immobilized on beaded agarose resins,
few simple options for in-house production of those systems exist. Herein,
we describe a novel method for the purification of GST-tagged recombinant
proteins.Results: Glutathione was conjugated to low molecular weight
poly(ethylene glycol) diacrylate (PEGDA) via thiol-ene " click" chemistry.
With our in-house prepared PEGDA:glutathione (PEGDA:GSH) homogenates, we
were able to purify a glutathione S-transferase (GST) green fluorescent
protein (GFP) fusion protein (GST-GFP) from the soluble fraction of E. coli
lysate. Further, microspheres were formed from the PEGDA:GSH hydrogels and
improved protein binding to a level comparable to purchased GSH-agarose
beads.Conclusions: GSH containing polymers might find use as in-house
methods of protein purification. They exhibited similar ability to purify
GST tagged proteins as purchased GSH agarose beads. © 2012 Buhrman et al.;
licensee BioMed Central Ltd.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
glutathione transferase
glutathione transferase green fluorescent protein fusion protein
hybrid protein
recombinant protein
EMTREE DRUG INDEX TERMS
cell protein
microsphere
poly(ethylene glycol)diacrylate
polymer
resin
unclassified drug
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
enzyme purification
EMTREE MEDICAL INDEX TERMS
article
click chemistry
Escherichia coli
hydrogel
protein analysis
protein expression
CAS REGISTRY NUMBERS
glutathione transferase (50812-37-8)
EMBASE CLASSIFICATIONS
Clinical and Experimental Biochemistry (29)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2012579941
MEDLINE PMID
22989306 (http://www.ncbi.nlm.nih.gov/pubmed/22989306)
PUI
L52220306
DOI
10.1186/1472-6750-12-63
FULL TEXT LINK
http://dx.doi.org/10.1186/1472-6750-12-63
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 475
TITLE
The use of a modified pediatric early warning score to assess stability of
pediatric patients during transport
AUTHOR NAMES
Petrillo-Albarano T.
Stockwell J.
Leong T.
Hebbar K.
AUTHOR ADDRESSES
(Petrillo-Albarano T., toni.petrillo@choa.org; Stockwell J.; Hebbar K.)
Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA,
United States.
(Petrillo-Albarano T., toni.petrillo@choa.org; Stockwell J.; Hebbar K.)
Children's Healthcare of Atlanta at Egleston, Rollins School of Public
Health, Emory University, Atlanta, GA, United States.
(Leong T.) Department of Biostatistics and Bioinformatics, Rollins School of
Public Health, Emory University, Atlanta, GA, United States.
CORRESPONDENCE ADDRESS
T. Petrillo-Albarano, Critical Care Medicine Division, Children's Healthcare
of Atlanta at Egleston, 1405 Clifton Rd NE, Atlanta, GA 30322, United
States. Email: toni.petrillo@choa.org
SOURCE
Pediatric Emergency Care (2012) 28:9 (878-882). Date of Publication:
September 2012
ISSN
0749-5161
1535-1815 (electronic)
BOOK PUBLISHER
Lippincott Williams and Wilkins, 530 Walnut Street,P O Box 327,
Philadelphia, United States.
ABSTRACT
OBJECTIVE: Pediatric early warning scores (PEWSs) have been used effectively
in limited patient care areas. Children's Transport, at Children's
Healthcare of Atlanta, transports approximately 5000 children annually. In
an effort to consistently assess patient acuity and the impact of our team's
interventions, we instituted a modified "transport PEWS" (TPEWS). METHODS:
The existing PEWS was modified to reflect the transport environment. A
retrospective chart review was conducted of 100 consecutive children
transported by Children's Transport in March 2009. Transport PEWS given
during triage by the dispatch center (TPEWStri), TPEWS calculated at
referring facility by the team (TPEWSref), and final TPEWS at the accepting
institution (TPEWSacc) were compared. RESULTS: Eighty-six patients were
transported by ground. The median age was 50.4 months. Sixty patients (60%)
received some intervention from the transport team. Median TPEWSref was 3
(0-9) upon initial assessment, and TPEWSacc was 2 (0-9) on arrival at the
accepting facility (P = 0.0001). Seventy-three percent (73/100) of patients
were transported to the emergency room; 15 (15%) of 100 to the general
inpatient area, and 12 (12%) of 100 to the intensive care unit. In addition,
a triage TPEWS (TPEWStri) was calculated from information given from the
referring facility in 59 of the 100 patients. A significant difference in
TPEWStri and TPEWSref was noted (P = 0.0001). CONCLUSIONS: In this cohort of
pediatric transport patients, TPEWS appears to be a helpful additional
assessment tool. Transport PEWS may function as a tool for assessing
severity of illness, hence optimizing transport dispatch and patient
disposition. © 2012 by Lippincott Williams & Wilkins.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient transport
scoring system
transport pediatric early warning score
EMTREE MEDICAL INDEX TERMS
adolescent
adult
child
clinical assessment
emergency health service
emergency ward
human
infant
intensive care unit
major clinical study
preschool child
retrospective study
review
school child
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2012526041
MEDLINE PMID
22929132 (http://www.ncbi.nlm.nih.gov/pubmed/22929132)
PUI
L52185773
DOI
10.1097/PEC.0b013e31826763a3
FULL TEXT LINK
http://dx.doi.org/10.1097/PEC.0b013e31826763a3
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 476
TITLE
A novel approach to safety: The neurocritical care transport and resource
nurse
AUTHOR NAMES
Olson D.M.
Conrad C.L.
Sullivan S.L.
AUTHOR ADDRESSES
(Olson D.M.; Conrad C.L.; Sullivan S.L.) Duke University Medical Center,
Dep. Medicine/Neurology, Durham, United States.
CORRESPONDENCE ADDRESS
D.M. Olson, Duke University Medical Center, Dep. Medicine/Neurology, Durham,
United States.
SOURCE
Neurocritical Care (2012) 17 SUPPL. 2 (S265). Date of Publication: September
2012
CONFERENCE NAME
10th Annual Meeting of the Neurocritical Care Society
CONFERENCE LOCATION
Denver, CO, United States
CONFERENCE DATE
2012-10-04 to 2012-10-07
ISSN
1541-6933
BOOK PUBLISHER
Humana Press
ABSTRACT
Introduction: Intrahospital transport of neurocritical care unit (NCCU)
patients is associated with accidental line removal, unplanned extubation,
and hemodynamic instability. Further, because patients must be accompanied
by a nurse during intrahospital transport, there is an inherent reduction in
home unit staffing which reduces direct patient care and monitoring for
other NCCU patients. The purpose of this project was to assess the impact of
a Neurocritical Care Transport Nurse (NTRN) on patient safety, improved
direct patient care time and improved staff satisfaction. Methods: The
3-month NTRN pilot program was initiated in our 16 bed NCCU. For three
months, the NTRN worked five 8-hour shifts per week. The NTRN accompanied
patients during intrahospital transports, assisted with admissions,
functioned as resource nurse in the NCCU, and relieved nurses for meal
breaks. Data was collected in real time and included time-inmotion data,
adverse event records, and a pre-post work-flow surveys. Results: The NTRN
completed 103 intrahospital transports with were zero safety events. The
mean length of time for intrahospital transport prior to the pilot was
significantly greater than transport by the NTRN (87 vs. 28 minutes;
p<.001). The mean time it took nurses to stabilize a new admission/post-op
patients was reduced from 85 minutes to 28 minutes. Staff surveys were
overwhelmingly positive with 89% of nurses reporting the NTRN saved them
time; 24% reported increased opportunity for meal breaks, and 71% attributed
reduced overtime due to the NTRN program. Individual nurses reported that
the NTRN program saved them an average of 47.5 minutes each shift (8.7 hours
per shift). Conclusions: The NTRN pilot program was associated with fewer
safety events, increased staff satisfaction, more rapid attention to patient
needs and reduced overtime. The program should be implemented full time and
evaluated for potential costsavings.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
human
nurse
safety
society
EMTREE MEDICAL INDEX TERMS
extubation
monitoring
patient
patient care
patient safety
satisfaction
workflow
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70930202
DOI
10.1007/s12028-012-9775-0
FULL TEXT LINK
http://dx.doi.org/10.1007/s12028-012-9775-0
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 477
TITLE
Survey of head-injured patients transferred to St George's neuro intensive
care unit
AUTHOR NAMES
Boss J.
AUTHOR ADDRESSES
(Boss J.) St George Hospital, Australia.
CORRESPONDENCE ADDRESS
J. Boss, St George Hospital, Australia.
SOURCE
Anaesthesia and Intensive Care (2012) 40:5 (876). Date of Publication:
September 2012
CONFERENCE NAME
Australian and New Zealand College of Anaesthetists Annual Scientific
Meeting, ANZCA 2012
CONFERENCE LOCATION
Perth, WA, Australia
CONFERENCE DATE
2012-05-12 to 2012-05-16
ISSN
0310-057X
BOOK PUBLISHER
Australian Society of Anaesthetists
ABSTRACT
Introduction: Outcome after primary brain injury is improved by minimising
secondary brain injury. Prevention of secondary brain injury starts during
resuscitation and continues through transfer to the definitive care unit.
The Association of Anaesthetists of Great Britain and Ireland published
clinical guidelines “Transfer of the brain injured patient” 20061. We aimed
to investigate the south-west Thames region's compliance with these
guidelines, and identify and address areas for improvement. Methods: We
prospectively analysed all head injured patients admitted to St George's
hospital neuro intensive care unit during September 2010 using a proforma
designed in accordance with the Association of Anaesthetists of Great
Britain and Ireland guidelines. We then locally advertised our results and
educated the region's hospitals. We repeated our survey for all patients
admitted during April 2011. Results: We analysed a total of 71 patients
referred from 15 hospitals within the region over the two time periods.
Physiological parameter control, including PaO2 >10 KPa, PaCO2 <5 KPa and
MAP >80 mmHg, remained high between the two investigation periods and
problems with intravenous access remained stable (Figure 1). However, the
treatment of neurological deterioration, such as drop in GCS and pupillary
changes, improved following the education. The grade of doctor transferring
the patient increased, as did completeness of the documentation accompanying
the patient. Conclusions: Although both sets of data demonstrated that
hospitals have a high compliance with recognised guidelines, there was room
for improvement. Using the Internet to distribute survey data and
educational material seems to confer an increased adherence to national
clinical guidelines and improvement in the care of the head injured patient.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
anesthesist
college
human
intensive care unit
New Zealand
patient
EMTREE MEDICAL INDEX TERMS
brain
brain injury
deterioration
documentation
education
hospital
Internet
Ireland
physician
prevention
resuscitation
United Kingdom
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71053232
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 478
TITLE
The critically-ill pediatric hemato-oncology patient: Epidemiology,
management, and strategy of transfer to the pediatric intensive care unit
AUTHOR NAMES
Demaret P.
Pettersen G.
Hubert P.
Teira P.
Emeriaud G.
AUTHOR ADDRESSES
(Demaret P., demaret.pierre@gmail.com; Pettersen G.,
geraldine.pettersen.hsj@ssss.gouv.qc.ca; Emeriaud G.,
guillaume.emeriaud@umontreal.ca) Division of pediatric critical care
medicine, Department of Pediatrics, Sainte-Justine Hospital, Chemin de la
Côte-Sainte-Catherine, Montreal, H2J3V6, Canada.
(Hubert P., philippe.hubert@nck.aphp.fr) Division of pediatric critical care
medicine, Hôpital Necker-Enfants Malades, Rue de Sèvres, 75007 Paris,
France.
(Teira P., pierre.teira.hsj@ssss.gouv.qc.ca) Division of pediatric
hemato-oncology, Department of Pediatrics, Sainte-Justine Hospital, Chemin
de la Côte-Sainte-Catherine, Montreal, H2J3V6, Canada.
CORRESPONDENCE ADDRESS
P. Demaret, Division of pediatric critical care medicine, Department of
Pediatrics, Sainte-Justine Hospital, Chemin de la Côte-Sainte-Catherine,
Montreal, H2J3V6, Canada. Email: demaret.pierre@gmail.com
SOURCE
Annals of Intensive Care (2012) 2:1 (1-20). Date of Publication: 2012
ISSN
2110-5820 (electronic)
BOOK PUBLISHER
Springer Verlag, Tiergartenstrasse 17, Heidelberg, Germany.
ABSTRACT
Cancer is a leading cause of death in children. In the past decades, there
has been a marked increase in overall survival of children with cancer.
However, children whose treatment includes hematopoietic stem cell
transplantation still represent a subpopulation with a higher risk of
mortality. These improvements in mortality are accompanied by an increase in
complications, such as respiratory and cardiovascular insufficiencies as
well as neurological problems that may require an admission to the pediatric
intensive care unit where most supportive therapies can be provided. It has
been shown that ventilatory and cardiovascular support along with renal
replacement therapy can benefit pediatric hemato-oncology patients if
promptly established. Even if admissions of these patients are not
considered futile anymore, they still raise sensitive questions, including
ethical issues. To support the discussion and potentially facilitate the
decision-making process, we propose an algorithm that takes into account the
reason for admission (surgical versus medical) and the hematooncological
prognosis. The algorithm then leads to different types of admission:
full-support admission, "pediatric intensive care unit trial" admission,
intensive care with adapted level of support, and palliative intensive care.
Throughout the process, maintaining a dialogue between the treating
physicians, the paramedical staff, the child, and his parents is of
paramount importance to optimize the care of these children with complex
disease and evolving medical status. © 2012 Demaret et al.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cancer patient
childhood cancer (epidemiology, therapy)
critically ill patient
hematologic malignancy (epidemiology, therapy)
EMTREE MEDICAL INDEX TERMS
algorithm
bone marrow transplantation
cancer epidemiology
cancer mortality
cancer prognosis
disease association
extracorporeal circulation
extracorporeal oxygenation
graft versus host reaction (complication)
hematopoietic stem cell transplantation
human
intensive care unit
kidney dysfunction
leukemia (therapy)
lung disease
patient care
pediatrics
postoperative care
priority journal
renal replacement therapy
respiratory failure
review
sepsis (complication)
septic shock
tumor lysis syndrome
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Cancer (16)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2012439062
PUI
L365316793
DOI
10.1186/2110-5820-2-14
FULL TEXT LINK
http://dx.doi.org/10.1186/2110-5820-2-14
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 479
TITLE
End of life in intensive care: Is transfer home an alternative?
AUTHOR NAMES
Tellett L.
Pyle L.
Coombs M.
AUTHOR ADDRESSES
(Tellett L., Lynda.Tellett@suht.swest.nhs.uk; Pyle L.) E Level Cardiac Unit,
Southampton General Hospital, Southampton SO16 6YD, United Kingdom.
(Coombs M., mc9@soton.ac.uk) Cardiac Intensive Care Unit, Southampton
General Hospital, Southampton SO16 6YD, United Kingdom.
CORRESPONDENCE ADDRESS
L. Tellett, E Level Cardiac Unit, Southampton General Hospital, Southampton
SO16 6YD, United Kingdom. Email: Lynda.Tellett@suht.swest.nhs.uk
SOURCE
Intensive and Critical Care Nursing (2012) 28:4 (234-241). Date of
Publication: August 2012
ISSN
0964-3397
BOOK PUBLISHER
Churchill Livingstone, 1-3 Baxter's Place, Leith Walk, Edinburgh, United
Kingdom.
ABSTRACT
The past decade has witnessed an increased focus on improving the quality of
end of life care internationally. This has resulted in the development of
specific health policy work streams to support patient choice and improve
standards of care and patient experience. One concept well explored in areas
outside of critical care is that of home care at the end of life. This paper
seeks to challenge assumptions and practices about the options for
transferring the critically ill patient home at end of life.As a piece of
collaborative writing from a bereaved family member and critical care
nursing team, this paper explores care given to one gentleman at the end of
his life. In this, his journey is detailed, the decisions made are outlined
and the experience for him and his family are examined with a retrospective
narrative account from his wife that is woven throughout the paper.In this
paper, we are not asserting that transfer home at end of life is desirable
or feasible for all critically ill patients. We are challenging
practitioners to consider when and how the initiative of transferring
critically ill patients home at end of life, may occur. © 2012 Elsevier Ltd.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
home care
intensive care unit
patient preference
patient transport
terminal care
EMTREE MEDICAL INDEX TERMS
article
congenital heart malformation
human
human relation
male
patient care planning
United Kingdom
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
22406252 (http://www.ncbi.nlm.nih.gov/pubmed/22406252)
PUI
L51899198
DOI
10.1016/j.iccn.2012.01.006
FULL TEXT LINK
http://dx.doi.org/10.1016/j.iccn.2012.01.006
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 480
TITLE
Efficacy of information interventions in reducing transfer anxiety from a
critical care setting to a general ward: A systematic review and
meta-analysis
AUTHOR NAMES
Brooke J.
Hasan N.
Slark J.
Sharma P.
AUTHOR ADDRESSES
(Brooke J., j.m.brooke@greenwich.ac.uk) University of Greenwich, G308,
Southwood Site, Avery Hill Road, Eltham, London SE9 2UG, United Kingdom.
(Hasan N.; Slark J.; Sharma P.) Imperial College Cerebrovascular Research
Unit (ICCRU), Imperial College, London W6 8RF, United Kingdom.
CORRESPONDENCE ADDRESS
J. Brooke, University of Greenwich, G308, Southwood Site, Avery Hill Road,
Eltham, London SE9 2UG, United Kingdom. Email: j.m.brooke@greenwich.ac.uk
SOURCE
Journal of Critical Care (2012) 27:4 (425.e9-425.e15). Date of Publication:
August 2012
ISSN
0883-9441
1557-8615 (electronic)
BOOK PUBLISHER
W.B. Saunders, Independence Square West, Philadelphia, United States.
ABSTRACT
Purpose: Our aim was to undertake a comprehensive systematic review on the
efficacy of information interventions on reducing anxiety in patients and
family members on transfer from a critical care setting to a general ward.
Materials and methods: MEDLINE, EMBASE, CINAHL, Cochrane Database of
Systematic Reviews, and Google Scholar databases from 1990 to January 1,
2011, were searched. Bibliographies of identified articles were reviewed.
Only high-quality randomized controlled trials comparing an intervention to
reduce transfer anxiety with standard care, where transfer anxiety is
measured by the validated State Trait Anxiety Inventory, were included. Data
were extracted to estimate standard mean differences (SMDs), pooled odds
ratios (ORs), and 95% confidence intervals (CIs) using both fixed and random
effects model. Results: Of 266 studies identified in the primary search, 5
studies enrolling 629 participants met the inclusion criteria, family
members' transfer anxiety was significantly reduced in the intervention arm
of information provision (OR, 1.70; 95% CI, 1.15-2.52; P = .01) compared
with those who received standard care (OR, 0.42; 95% CI; 0.276-0.625; P <
.001), and patients' transfer anxiety was significantly reduced in one
study. Conclusions: Providing information to understand a future ward
environment can significantly reduce patients' and family members' transfer
anxiety from the critical care setting when compared with standard care. ©
2012 Elsevier Inc.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
anxiety
patient transport
transfer anxiety
EMTREE MEDICAL INDEX TERMS
clinical effectiveness
coronary care unit
family attitude
family counseling
human
intensive care unit
intermethod comparison
length of stay
nursing care
outcome assessment
patient attitude
patient care planning
patient education
personalized medicine
review
State Trait Anxiety Inventory
systematic review
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2012432412
MEDLINE PMID
22824085 (http://www.ncbi.nlm.nih.gov/pubmed/22824085)
PUI
L365298268
DOI
10.1016/j.jcrc.2012.01.009
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jcrc.2012.01.009
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 481
TITLE
Low adverse event incidence during intra-hospital transportation of
critically ill mechanically ventilated patients with a multidisciplinary
team
AUTHOR NAMES
Bocchile R.L.R.
Timenetsky K.T.
Machado M.M.
Fuhrmann K.F.
Giovanetti E.A.
Eid R.A.C.
AUTHOR ADDRESSES
(Bocchile R.L.R., raquel_case@einstein.br; Timenetsky K.T.; Machado M.M.;
Fuhrmann K.F.; Giovanetti E.A.) Hospital Albert Einstein, Sao Paulo, Brazil.
(Eid R.A.C.) Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
CORRESPONDENCE ADDRESS
R.L.R. Bocchile, Hospital Albert Einstein, Sao Paulo, Brazil. Email:
raquel_case@einstein.br
SOURCE
American Journal of Respiratory and Critical Care Medicine (2012) 185
MeetingAbstracts. Date of Publication: 2012
CONFERENCE NAME
American Thoracic Society International Conference, ATS 2012
CONFERENCE LOCATION
San Francisco, CA, United States
CONFERENCE DATE
2012-05-18 to 2012-05-23
ISSN
1073-449X
BOOK PUBLISHER
American Thoracic Society
ABSTRACT
Rationale: Intra-hospital transport is a very common procedure in critically
ill patients submitted to invasive and noninvasive mechanical ventilation,
mainly due to transfer the patients to the operate room or to the tomography
or magnetic resonance room to perform exams. However, adverse events are
described in the literature to occur around 60% during transportation. These
transports usually require a specialized multidisciplinary team. In our
hospital we have a specialized multidisciplinary team for the transportation
of mechanically ventilated patients and we wanted to know our adverse event
incidence. Objective: To evaluate the incidence of adverse events during
intra-hospital transportation of mechanically ventilated critically ill
patients with a multidisciplinary team. Method: We prospectively evaluated
the incidence of adverse events of critically ill patients submitted to
invasive and noninvasive mechanical ventilation during intra-hospital
transportation with a specialized multidisciplinary team during a 3 month
period. All patients were monitored with a transport monitor (Datascope®)
that display ECG, noninvasive arterial pressure, and oxygen saturation.
Results: The specialized multidisciplinary team performed 44 intra-hospital
transportations, of these 50% were transported with invasive mechanical
ventilation and 50% with noninvasive ventilation. Of the 22 patients
transported with invasive mechanical ventilation, 60% were orothraqueal
intubated and 40% were tracheostomized. The median age was 79 years (range
of 27-101), and 50% were male. The most frequent hospital admission
diagnosis was due to cancer (22.7%), followed by stroke (18.2%), pneumonia
(13.6%) and sepsis (11.3%). The most common reason for intra-hospital
transportation was acute respiratory failure (45.4%) followed by unit change
(31.8%) and exams (16%). The median time of transportation was 30 minutes
(range of 10-180 minutes). There was only 1 (2.3%) adverse event related to
mechanical ventilator battery failure. Conclusions: Intra-hospital
transportation of mechanically ventilated patients performed by a
specialized multidisciplinary team showed a low adverse event incidence.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
American
critically ill patient
hospital
human
society
traffic and transport
ventilated patient
EMTREE MEDICAL INDEX TERMS
acute respiratory failure
arterial pressure
artificial ventilation
cerebrovascular accident
diagnosis
electrocardiogram
hospital admission
male
mechanical ventilator
neoplasm
noninvasive ventilation
nuclear magnetic resonance
oxygen saturation
patient
pneumonia
procedures
sepsis
tomography
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71986162
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 482
TITLE
Discrepancies in arterial PO2 (Pao2) measurements between a point of care
testing (POCT) analyzer and standard laboratory analysis of samples
transported via pneumatic tube system (PTS)
AUTHOR NAMES
Borders M.K.
Sofronescu A.-G.
Huckabee D.D.
Boylan A.M.
Byrne J.
Ford D.W.
Strange C.
Epps J.A.
Schmidt C.A.
Washington K.Q.
Warren M.
Zhu Y.
AUTHOR ADDRESSES
(Borders M.K.; Sofronescu A.-G.; Huckabee D.D.; Boylan A.M.,
boylana@musc.edu; Byrne J.; Ford D.W.; Strange C.; Epps J.A.; Schmidt C.A.;
Washington K.Q.; Warren M.; Zhu Y.) Medical University of South Carolina,
Charleston, United States.
CORRESPONDENCE ADDRESS
A.M. Boylan, Medical University of South Carolina, Charleston, United
States. Email: boylana@musc.edu
SOURCE
American Journal of Respiratory and Critical Care Medicine (2012) 185
MeetingAbstracts. Date of Publication: 2012
CONFERENCE NAME
American Thoracic Society International Conference, ATS 2012
CONFERENCE LOCATION
San Francisco, CA, United States
CONFERENCE DATE
2012-05-18 to 2012-05-23
ISSN
1073-449X
BOOK PUBLISHER
American Thoracic Society
ABSTRACT
Rationale: POCT assessment of arterial blood gases is an increasingly common
method of measurement for guiding ventilator management in intensive care
units. We observed discrepancies in Pao2values between our POCT analyzer and
specimens transported to our laboratory via PTS. The purpose of this quality
improvement (QI) study was to determine accuracy of Pao values obtained via
POCT 2 analyzer, PTS transport, and hand delivery to the laboratory.
Methods: The QI project took place in our medical intensive care unit and
consisted of two stages. First, we analyzed 24 arterial blood gas samples
from 12 patients via POCT and laboratory analyzers. Samples were sent to the
laboratory via PTS at ambient temperature. Subsequently, we obtained
arterial blood from 18 different patients (three 0.5 cc samples per
patient), and each patient's blood was tested using three techniques: 1) the
POCT analyzer, 2) sent via PTS (laboratory analyzer), and 3) walked to the
laboratory (laboratory analyzer) in a timely fashion by staff. We compared
Pao 2 results via a two-sided, dependent paired t-test. Results: With the
initial evaluation, eight of the twelve specimens had a Pao 2 difference
greater than 10 mmHg, which was considered clinically significant. This
prompted the subsequent phase of the study in which we compared Pao 2 values
obtained via the three different techniques. The largest variation in Pao 2
results was found between samples sent via PTS versus POCT or walked to the
laboratory. Specifically, the mean difference between POCT analysis and
samples sent via PTS was 18.4 mmHg (95% CI 9.4-27.4 mmHg) and the mean
difference between walked samples and PTS samples was 9.7mmHg (95% CI
5.9-13.5 mmHg). Additionally, we found lower paO2's for each sample analyzed
via POCT as compared to laboratory analysis regardless of delivery technique
(PTS versus walked). Conclusion: Arterial blood gas samples sent via PTS
have more Pao 2 variability than samples tested using POCT or walked to the
laboratory. The discrepancies may be due to air bubbles which are mixed in
the sample when transported via PTS. This theory is also supported by the
observation of consistently lower Pao 2 values obtained via POCT which might
avoid the introduction microscopic air resulting from transport.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
American
analyzer
arterial oxygen tension
laboratory
oxygen tension
point of care testing
society
tube
EMTREE MEDICAL INDEX TERMS
arterial blood
arterial gas
blood
environmental temperature
human
intensive care unit
patient
Student t test
total quality management
ventilator
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71993151
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 483
TITLE
Outcomes of direct emergency room to ICU admission vs. Later ICU transfer
for patients with severe sepsis
AUTHOR NAMES
Leung S.
Rakowski E.
Gong M.N.
AUTHOR ADDRESSES
(Leung S., sleung@montefiore.org) Albert Einstein College of Medicine,
Bronx, United States.
(Rakowski E.; Gong M.N.) Montefiore Medical Center, Bronx, United States.
CORRESPONDENCE ADDRESS
S. Leung, Albert Einstein College of Medicine, Bronx, United States. Email:
sleung@montefiore.org
SOURCE
American Journal of Respiratory and Critical Care Medicine (2012) 185
MeetingAbstracts. Date of Publication: 2012
CONFERENCE NAME
American Thoracic Society International Conference, ATS 2012
CONFERENCE LOCATION
San Francisco, CA, United States
CONFERENCE DATE
2012-05-18 to 2012-05-23
ISSN
1073-449X
BOOK PUBLISHER
American Thoracic Society
ABSTRACT
Rationale: Approximately half of the patients admitted to an ICU with severe
sepsis were transferred from a non-ICU floor rather than admitted directly
from the Emergency Department (ED). The purpose of this study is to evaluate
the 1-year survival difference who were directly admitted to the ICU from ED
compared with those who were transferred from the wards. To date, survival
analysis in this area is lacking. Methods: This was a nested case control
study from a retrospective cohort analysis of hospitalized patients admitted
for severe sepsis over a four-month period at two tertiary hospitals of the
Montefiore Medical Center (MMC), Bronx, New York. The inclusion criterion
was patients admitted with severe sepsis based on the ICD-9 codes indicative
of infection concurrent with new onset organ dysfunction who were admitted
to an ICU within 7 days of hospital admission. Cases were defined as direct
ICU admissions from the ED (Direct Admissions) and controls were defined as
patients who transferred from the wards to the ICU (ICU Transfers). Because
the groups compared were not randomly assigned, we reduced bias with
propensity score weighting of the group comparisons. All statistical
analyses were performed using STATA version 11.2. Results: Between December
1, 2009 and March 31, 2010, there were 163 Direct Admissions and 110 ICU
Transfers. The median (IQR) time in the transfer group from admission to ICU
transfer was 1.8 (1.1, 3.4) days. Compared to Direct Admissions, ICU
Transfers had more history of moderate to severe liver disease (p<0.01). The
mean (SD) APACHE II score upon ICU admission for the Direct Admission and
ICU Transfers was 23.5 (5.8) and 22.3 (5.6) respectively (p=0.07). The
median (IQR) ICU lengths of stay (LOS) for the Direct Admissions and ICU
Transfers were 4.0 (2.0, 7.0) and 3.1 (1.7, 6.3) days respectively (p=0.10).
The median (IQR) hospital LOS for the Direct Admissions and ICU Transfers
were 11.8 (7.2, 23.2) and 14.9 (8.1, 24.0) days respectively (p=0.09). The
crude 1-year mortality rate was 49.7% for Direct Admissions and 58.2% for
ICU Transfers (p=0.18). In propensity-weighted analyses, the 1-year
mortality was associated with age ≥65 (HR 1.83 [95%C.I. 1.07-3.11]), APACHE
II score ≥23 (HR 2.28 [95%C.I. 1.30-4.01]), lactate ≥4 mmol, but not Direct
Admissions (HR 0.85 [95%C.I. 0.52-1.38]). Conclusion: For patients admitted
with severe sepsis, after adjusting for the propensity of direct ICU
admission, early ICU admission did not show 1-year survival benefits.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
American
emergency ward
human
patient
sepsis
society
EMTREE MEDICAL INDEX TERMS
APACHE
case control study
cohort analysis
hospital
hospital admission
hospital patient
ICD-9
infection
liver disease
mortality
propensity score
statistical analysis
survival
tertiary care center
United States
ward
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71993152
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 484
TITLE
How can nurses facilitate patient's transitions from intensive care?. A
grounded theory of nursing.
AUTHOR NAMES
Häggström M.
Asplund K.
Kristiansen L.
AUTHOR ADDRESSES
(Häggström M., marie.haggstrom@miun.se) Department of Health Sciences, Mid
Sweden University, SE-85170 Sundsvall, Sweden.
(Asplund K.; Kristiansen L.) Mid Sweden University, Sweden.
CORRESPONDENCE ADDRESS
M. Häggström, Department of Health Sciences, Mid Sweden University, SE-85170
Sundsvall, Sweden. Email: marie.haggstrom@miun.se
SOURCE
Intensive and Critical Care Nursing (2012) 28:4 (224-233). Date of
Publication: August 2012
ISSN
0964-3397
BOOK PUBLISHER
Churchill Livingstone, 1-3 Baxter's Place, Leith Walk, Edinburgh, United
Kingdom.
ABSTRACT
Objectives: Intensive care patients often experience feelings of
powerlessness and vulnerability when being transferred from an intensive
care unit to a general ward. The aim of this study was to develop a grounded
theory of nurses care for patients in the ICU transitional care process.
Methods: Group interviews, individual interviews and participant
observations were conducted with nurses in two hospitals in Sweden and were
analysed using grounded theory. Result: The substantive theory shows the
process of nursing care activities - from the contexts of the ICU and the
general ward. The main concern was to achieve a coordinated, strengthening,
person-centered standard of care to facilitate patient transitions. The core
category " being perceptive and adjustable" was a strategy to individualise,
that was related to the other categories; " preparing for a change" and "
promoting the recovery" . However, the nurses were forced to " balance
between patient needs and the caregivers' resources" and consequently were
compromising their care. Conclusions: To facilitate an ICU-patient's
transition, individual care planning is needed. It is also essential that
the patients are adequately prepared for the change to facilitate the
transitional care. Knowledge about transitional needs, empowerment and
patient-education seems to be important issues for facilitating transitions.
© 2012 Elsevier Ltd.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital discharge
nurse attitude
patient care
patient care planning
patient transport
EMTREE MEDICAL INDEX TERMS
aftercare
article
clinical trial
human
intensive care unit
multicenter study
nurse patient relationship
observation
social support
Sweden
verbal communication
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
22386583 (http://www.ncbi.nlm.nih.gov/pubmed/22386583)
PUI
L51887147
DOI
10.1016/j.iccn.2012.01.002
FULL TEXT LINK
http://dx.doi.org/10.1016/j.iccn.2012.01.002
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 485
TITLE
Transport of pediatric patients with the assistance of a physical therapy
team
AUTHOR NAMES
Valério N.
Remondini R.
Giovanetti E.A.
Do Prado C.
Troster E.J.
AUTHOR ADDRESSES
(Valério N.; Remondini R., rremondini@yahoo.com.br; Giovanetti E.A.; Do
Prado C.; Troster E.J.) Hospital Israelita Albert Einstein, São Paulo,
Brazil.
CORRESPONDENCE ADDRESS
R. Remondini, Hospital Israelita Albert Einstein, São Paulo, Brazil. Email:
rremondini@yahoo.com.br
SOURCE
American Journal of Respiratory and Critical Care Medicine (2012) 185
MeetingAbstracts. Date of Publication: 2012
CONFERENCE NAME
American Thoracic Society International Conference, ATS 2012
CONFERENCE LOCATION
San Francisco, CA, United States
CONFERENCE DATE
2012-05-18 to 2012-05-23
ISSN
1073-449X
BOOK PUBLISHER
American Thoracic Society
ABSTRACT
Rationale: Transport of critically ill pediatric patients by untrained
professionals tends to be associated with a higher incidence of
complications than transport led by specialized pediatric critical care
teams. Transport teams should be capable of ensuring a high degree of
patient stability, as well as have access to the equipment and supplies
required for Advanced Life Support and emergency treatment en route. The
level of care and monitoring provided during transport of these patients
should approach that provided in a pediatric intensive care unit (PICU)
setting. Inadequate ventilator support, airway loss or obstruction of the
airway device, lack of monitoring, equipment failure, and lack of or errors
in drug use and administration are the most common untoward events occurring
during pediatric transport. The involvement of physical therapists in
pediatric transport teams optimizes patient care, particularly of
mechanically ventilated children, and reduces the risk of clinical
complications during transport. Methods: Retrospective study of information
added to a database of all events of physical therapist-assisted ground
transport of mechanically ventilated pediatric patients between 24 August
2010 and 24 September 2011. During the referred period, 25 children between
the ages of 4 months and 14 years were transported. These patients were
transported under the care of the emergency department transport team, which
comprised a physician, a nurse, and a nursing technician, with the
assistance of the duty PICU physical therapist. Management of mechanical
ventilation is the core objective of the physical therapist in this setting.
The therapist's roles include choosing the most adequate ventilator to the
patient's respiratory condition, monitoring, and adjusting ventilator
settings, as well as care of the chosen airway device. After each transport,
the physical therapist who was involved in the case added information on the
transport event and patient characteristics to the database. All
participating physical therapists were trained by the local transport team,
which comprised seven physical therapists in charge of training and
validating all providers involved in ground and air medical transport of
adult and pediatric patients. Results: No untoward events occurred during
physical therapist-assisted transport of pediatric patients. Vital signs and
ventilator parameters remained stable and airways were maintained
satisfactorily in all cases. Conclusion: The involvement of physical
therapists in the transportation of pediatric patients adds a specificity
component to pediatric transport and retrieval teams and minimizes clinical
complications, particularly those associated with mechanical ventilation,
which is considered a risk factor for mortality during pediatric transport.
(Table Presented).
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
American
human
patient
physiotherapy
society
EMTREE MEDICAL INDEX TERMS
adult
air medical transport
airway
artificial ventilation
child
critically ill patient
data base
device failure
devices
drug use
emergency treatment
emergency ward
intensive care
intensive care unit
monitoring
mortality
nurse
nursing
obstruction
parameters
patient care
physician
physiotherapist
retrospective study
risk
risk factor
traffic and transport
ventilator
vital sign
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71986362
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 486
TITLE
The impact of the new Turkish regulation, imposing single embryo transfer
after assisted reproduction technology, on neonatal intensive care unit
utilization: A single center experience
AUTHOR NAMES
Guzoglu N.
Kanmaz H.G.
Dilli D.
Uras N.
Erdeve O.
Dilmen U.
AUTHOR ADDRESSES
(Guzoglu N., nguzoglu@gmail.com; Kanmaz H.G.; Uras N.; Erdeve O.; Dilmen U.)
Department of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital,
Talatpasa Bulvari, Samanpazari, 06230 Ankara, Turkey.
(Dilli D.) Department of Neonatology, Sami Ulus Children's Hospital, Ankara,
Turkey.
(Dilmen U.) Department of Pediatry, Yildirim Beyazit University, Ankara,
Turkey.
CORRESPONDENCE ADDRESS
N. Guzoglu, Department of Neonatology, Zekai Tahir Burak Maternity Teaching
Hospital, Talatpasa Bulvari, Samanpazari, 06230 Ankara, Turkey. Email:
nguzoglu@gmail.com
SOURCE
Human Reproduction (2012) 27:8 (2384-2388). Date of Publication: August 2012
ISSN
0268-1161
1460-2350 (electronic)
BOOK PUBLISHER
Oxford University Press, Great Clarendon Street, Oxford, United Kingdom.
ABSTRACT
Objectives and aim: IVF has become an efficient and widely used treatment
for infertile couples, however, it is responsible for an increasing number
of multifetal pregnancies and adverse neonatal outcomes. This study aimed to
assess a health service utilization in one neonatal intensive care unit
(NICU), as a response to the 2010 Turkish reproductive regulation requiring
single embryo transfer (SET). methods: All assisted reproductive technology
(ART) pregnancies delivered at Zekai Tahir Burak Maternity Teaching Hospital
between February 2010 and October 2011 were included in this study. Subjects
were divided into two groups: Group 1 consisted of infants conceived before
the ART regulation, and born between February 2010 and October 2010, and
Group 2 consisted of infants conceived after the ART regulation, and born
between November 2010 and October 2011. results: Upon comparing the study
groups, we observed a significant decrease in the incidence of multiple
births in Group 2. The mean gestational age and mean birthweight were
significantly higher in Group 2. The rates of prematurity and low
birthweight, very low birthweight and extremely low birthweight infants were
significantly lower in Group 2. Similarly, the rates of NICU admission,
respiratory distress syndrome, necrotizing enterocolitis anemia and
pneumonia/sepsis, and the need for respiratory support (mechanical
ventilation and nasal continuous positive airway pressure) were
significantly lower in Group 2. conclusions: According to our data, NICU
utilization was reduced and the early post-natal outcomes of the babies were
improved after the new Turkish regulation on ART imposing SET. However,
multicenter studies are needed to generalize our results to the whole
country. © The Author 2012.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
embryo transfer
health care utilization
infertility therapy
EMTREE MEDICAL INDEX TERMS
adult
anemia (epidemiology)
article
artificial ventilation
birth weight
female
gestational age
human
infant
low birth weight (epidemiology)
major clinical study
male
morbidity
multiple pregnancy
necrotizing enterocolitis (epidemiology)
newborn
newborn intensive care
pneumonia (epidemiology)
positive end expiratory pressure
pregnancy outcome
prematurity (epidemiology)
respiratory distress (epidemiology)
sepsis (epidemiology)
Turkey (republic)
very low birth weight (epidemiology)
EMBASE CLASSIFICATIONS
Obstetrics and Gynecology (10)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2012693233
MEDLINE PMID
22617124 (http://www.ncbi.nlm.nih.gov/pubmed/22617124)
PUI
L366131032
DOI
10.1093/humrep/des171
FULL TEXT LINK
http://dx.doi.org/10.1093/humrep/des171
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 487
TITLE
Is physiology just physiology? Ward vital sign comparisons before cardiac
arrest, ICU transfer, and death
AUTHOR NAMES
Churpek M.M.
Yuen T.C.
Edelson D.P.
AUTHOR ADDRESSES
(Churpek M.M.; Yuen T.C.; Edelson D.P.) University of Chicago, Chicago,
United States.
CORRESPONDENCE ADDRESS
M.M. Churpek, University of Chicago, Chicago, United States.
SOURCE
American Journal of Respiratory and Critical Care Medicine (2012) 185
MeetingAbstracts. Date of Publication: 2012
CONFERENCE NAME
American Thoracic Society International Conference, ATS 2012
CONFERENCE LOCATION
San Francisco, CA, United States
CONFERENCE DATE
2012-05-18 to 2012-05-23
ISSN
1073-449X
BOOK PUBLISHER
American Thoracic Society
ABSTRACT
RATIONALE: Clinical deterioration of ward patients can be signaled by
transfer to an ICU, cardiac arrest, or death. While all three of these
outcomes have been utilized in the literature to test various risk
prediction algorithms and rapid response team calling criteria, there is no
consensus, making comparison across studies challenging. It is unknown how
patients who experience these outcomes compare to one another in terms of
vital signs or how models derived to predict each of these outcomes would
predict the other two. METHODS: We performed a retrospective cohort study at
an academic hospital that included all patients hospitalized on the general
wards between November 8 and January . We calculated mean ward vital signs
in the 4 hours prior to ward CA, ICU transfer, or death. Three logistic
regression models were calculated for each of the outcomes within 4 hours of
each simultaneous vital sign set in the entire hospitalized cohort. Last
value carried forward imputation was used for incomplete vital sign sets.
Areas under the receiver operating characteristic curves (AUCs) were
calculated for each of the three models in predicting the outcome for which
it was derived, as well as for the other two outcomes. RESULTS: A total of
,74,88 vital sign sets were obtained from 4738 patients, of which 88
experienced a CA, 77 died, 99 were transferred to the ICU, and 458
experienced none of the those outcomes. Differences in mean vital signs in
the 4 hours prior to each event are shown below (Table 1). (Table presented)
Logistic regression coefficients for each derived model is shown in Table 2
below. (Table presented) The Figure below illustrates the AUCs of each
derived model in of the three outcomes. Each model performed better in the
model it was derived in than the other two derived model (P<.5 for each) and
the AUCs for predicting mortality were highest for each of the three models.
(Figure presented) CONCLUSIONS: Models derived to predict cardiac arrest,
mortality and ICU transfer have some notable differences in the weighting
and direction of some of the included vital sign covariates. However,
despite these differences, the different models perform similarly for each
of the three outcomes, with mortality being the easiest to predict and ICU
transfer the most difficult. Model performance is strongly associated with
the chosen outcome, and studies should be interpreted with these differences
in mind.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
American
death
heart arrest
physiology
society
vital sign
ward
EMTREE MEDICAL INDEX TERMS
algorithm
cohort analysis
consensus
deterioration
hospital
human
logistic regression analysis
model
mortality
patient
prediction
rapid response team
receiver operating characteristic
risk
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71986003
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 488
TITLE
Effect of contactless continuous patient monitoring in a medical-surgical
unit on intensive care unit transfers: A controlled clinical trial
AUTHOR NAMES
Zimlichman E.
Terrence J.
Argaman D.
Shinar Z.
Brown H.
AUTHOR ADDRESSES
(Zimlichman E., EZIMLICHMAN@PARTNERS.ORG) Brigham and Women's Hospital,
Boston, United States.
(Terrence J.; Brown H.) California Hospital Medical Center, Los Angeles,
United States.
(Argaman D.; Shinar Z.) Earlysense LTD, Ramat Gan, Israel.
CORRESPONDENCE ADDRESS
E. Zimlichman, Brigham and Women's Hospital, Boston, United States. Email:
EZIMLICHMAN@PARTNERS.ORG
SOURCE
American Journal of Respiratory and Critical Care Medicine (2012) 185
MeetingAbstracts. Date of Publication: 2012
CONFERENCE NAME
American Thoracic Society International Conference, ATS 2012
CONFERENCE LOCATION
San Francisco, CA, United States
CONFERENCE DATE
2012-05-18 to 2012-05-23
ISSN
1073-449X
BOOK PUBLISHER
American Thoracic Society
ABSTRACT
Rationale: Most patients in acute care hospitals are considered at low or
average risk for life threatening events, and thus are hospitalized in
non-intensive care units (ICUs). However, these patients might deteriorate
clinically and require emergency care. For patients with unexpected clinical
deterioration delayed or suboptimal intervention is associated with
increased morbidity and mortality. Technology applications that allow for
continuous vital sign monitoring designed for non-ICU settings may help
hospitals achieve meaningful results when implementing as part of a rapid
response system. The EarlySense system is a piezo-electric sensor based
contact-less continuous measurement monitoring system for heart rate,
respiration rate and bed motion. Objective: To determine the effects of
continuous patient monitoring using the Earlysense monitor in a
medical-surgical unit on ICU transfers and ICU length of stay for patients
initially admitted to non-ICU units. Methods: The study was conducted in a
316 bed acute care hospital as a pre-post evaluation study. Earlysense
monitors were implemented in a 36-bed medical-surgical unit including bed
side monitors, central nursing station display and nurse pagers. We have
used two control groups a historic control for the same unit
pre-implementation and a oesister unit that did not go through the
implementation. We have reviewed charts for co-morbidity, acuity level and
study outcomes for patients in each study group. Results: We have reviewed a
total of 4000 patient charts a 1000 patients in the intervention arm and
3000 for the three control arms. Patient's demographics data is presented on
table 1. For the evaluation unit we have measured a 39.5% decrease in ICU
transfers with a 36.4% decrease in total ICU days comparing pre to post
intervention periods (borderline significance, p=0.07) (Table 2). Comparing
the intervention to the control unit we did not find a statistical
significant difference in transfers (26 vs. 20 respectively, p=0.3) but did
find a statistically borderline decrease in total ICU days (p=0.07). Total
hospital length of stay has decreased significantly in the evaluation unit
following the intervention. Conclusions: Continuous monitoring of patients
in a medical-surgical unit using the Earlysense contact less vital signs
monitor has resulted in a statistically borderline reduction in number of
patients transferred to the ICU and total number of ICU days with a
reduction in average hospital length of stay. We believe, giving these clear
trends, that a larger scale study will show significant effects and would
also be able to assess effect on mortality.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
American
controlled clinical trial
human
intensive care unit
patient monitoring
society
EMTREE MEDICAL INDEX TERMS
arm
breathing rate
control group
deterioration
emergency care
evaluation study
heart rate
hospital
length of stay
monitor
monitoring
morbidity
mortality
nurse
nursing station
patient
rapid response team
risk
sensor
technology
vital sign
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71988366
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 489
TITLE
Comment on "Under-triage as a Significant Factor Affecting Transfer Time
between the Emergency Department and the Intensive Care Unit"
AUTHOR NAMES
Bergs J.
Gillet J.-B.
AUTHOR ADDRESSES
(Bergs J., jochen.bergs@uzleuven.be) Emergency Department, and Jonas Tundo,
MSc, Department of Management, Information and Reporting, University
Hospital Leuven, Leuven, Belgium.
(Gillet J.-B.) University of Massachusetts, Amherst, MA, United States.
CORRESPONDENCE ADDRESS
J. Bergs, Emergency Department, and Jonas Tundo, MSc, Department of
Management, Information and Reporting, University Hospital Leuven, Leuven,
Belgium. Email: jochen.bergs@uzleuven.be
SOURCE
Journal of Emergency Nursing (2012) 38:4 (320-321). Date of Publication:
July 2012
ISSN
0099-1767
1527-2966 (electronic)
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
intensive care unit
patient transport
sepsis (therapy)
EMTREE MEDICAL INDEX TERMS
female
human
letter
male
utilization review
LANGUAGE OF ARTICLE
English
MEDLINE PMID
22677097 (http://www.ncbi.nlm.nih.gov/pubmed/22677097)
PUI
L52045762
DOI
10.1016/j.jen.2011.09.022
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jen.2011.09.022
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 490
TITLE
Acute care nurse practitioner led critical care transport team leads to
improved door to imaging time in acute ischemic stroke patients
AUTHOR NAMES
Steiner S.
Winfield M.
Manacci C.
Kralovic D.
Hussain M.
AUTHOR ADDRESSES
(Steiner S.; Winfield M.; Manacci C.; Kralovic D.; Hussain M.) Critical Care
Transport Services, Cleveland Clinic, United States.
CORRESPONDENCE ADDRESS
S. Steiner, Critical Care Transport Services, Cleveland Clinic, United
States.
SOURCE
Air Medical Journal (2012) 31:4 (168-169). Date of Publication: July-August
2012
CONFERENCE NAME
2012 Critical Care Transport Medicine Conference
CONFERENCE LOCATION
Nashville, TN, United States
CONFERENCE DATE
2012-04-02 to 2012-04-04
ISSN
1067-991X
BOOK PUBLISHER
Mosby Inc.
ABSTRACT
Background: In evaluating the acute ischemic stroke patient, targeting time
intervals for imaging and treatment times are paramount in optimizing
outcomes. This can be augmented by a collaborative approach with a
hospitalbased critical care transport team that can extend primary stroke
program care to a referring facility's bedside. The suspicion of a vessel
occlusion causing an acute ischemic stroke in patients at an outside
hospital triggers an “Auto Launch” process, which bypasses the usual
hospital transfer process to expedite care transitions for patients with
time-sensitive emergencies. Referring facilities directly contact a critical
care transport coordinator, who launches the transport team. The team
includes an acute care nurse practitioner (ACNP), who evaluates the stroke
patient on arrival to the outside facility, including a National Institutes
of Health Stroke Scale, and transitions the patient directly to the computed
tomography (CT) scanner/magnetic resonance imaging (MRI) on return to the
receiving facility. The stroke neurologist and team meet the patient
directly in the CT scanner for definitive determinations for further care. A
Critical Care Transport Team with an ACNP on board can augment not only door
to CT and MRI times, but also time to evaluation by a stroke neurologist and
time to intervention, often by bypassing the Emergency Department on their
arrival and proceeding directly to studies or time-sensitive intervention as
appropriate. Objective: To describe a stroke program with a coordinated
approach with a critical care transport (CCT) team to facilitate rapid care
transitions as well as decreased time to imaging in patients with acute
ischemic stroke by having an ACNP on board during transport and throughout
the continuum of care. Methods: A retrospective audit of a database of
patients undergoing hyperacute evaluation of acute ischemic stroke symptoms
from April 30, 2010 to July 31, 2011 was performed. Demographic information,
types of imaging performed, hyperacute therapies administered, and the time
to imaging modalities and treatment were collected and analyzed. Results: A
total of 107 patients, 28 males, and 36 females, with a mean age of 70, were
included in the analysis. Sixty-four (60%) of the patients were transferred
via the CCT team over 26.42 average nautical miles. The mean time of call to
arrival was 1 hour 19 minutes. The CCT Team continued tissue plasminogen
activator (tPA) infusion in 27 patients and initiated tPA infusion in two
patients. Sixty-four patients had CT imaging performed, and 64 had MRI
performed after the CT. [The average door to CT completed time was 22
minutes, and the average door to MRI completed time was 1 hour 29 minutes,
compared with 1 hour 8 minutes and 2 hours 36 minutes in patients not
arriving by CCT Team], P < .05. Conclusion: Collaboration between the stroke
team and critical care transport team has allowed acute ischemic stroke
patients to be taken directly to the CT/MRI scanner, allowing for rapid
evaluation, definitive treatment decisions, and the potential for improved
patient outcomes by decreasing the door to imaging time.
EMTREE DRUG INDEX TERMS
tissue plasminogen activator
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
acute care nurse practitioner
brain ischemia
human
imaging
intensive care
stroke patient
EMTREE MEDICAL INDEX TERMS
cerebrovascular accident
clinical audit
computed tomography scanner
computer assisted tomography
data base
emergency
emergency ward
female
hospital
infusion
male
National Institutes of Health Stroke Scale
neurologist
nuclear magnetic resonance imaging
occlusion
patient
therapy
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70816230
DOI
10.1016/j.amj.2012.04.009
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2012.04.009
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 491
TITLE
An analysis of lack of available literature for pain management in air
medical and critical care transport: A research opportunity
AUTHOR NAMES
Brozen R.
AUTHOR ADDRESSES
(Brozen R.) Dartmouth-Hitchcock Advanced Response Team, Dartmouth Medical
School, Section of Emergency Medicine, Lebanon, United States.
CORRESPONDENCE ADDRESS
R. Brozen, Dartmouth-Hitchcock Advanced Response Team, Dartmouth Medical
School, Section of Emergency Medicine, Lebanon, United States.
SOURCE
Air Medical Journal (2012) 31:4 (169). Date of Publication: July-August 2012
CONFERENCE NAME
2012 Critical Care Transport Medicine Conference
CONFERENCE LOCATION
Nashville, TN, United States
CONFERENCE DATE
2012-04-02 to 2012-04-04
ISSN
1067-991X
BOOK PUBLISHER
Mosby Inc.
ABSTRACT
Objective: Air Medical and Critical Care Transport (AMT/CCT) traditionally
only use opiate pain medications to manage patients' pain during
interfacility and scene transports. Many other methods of pain management
are available to medical providers. We attempted to analyze the amount and
quality of literature devoted specifically to pain management during AMT and
CCT. Methods: A literature search was performed using combinations of
traditional transport terms and pain management terms in MeSH Medline
terminology on PubMed and Ovid. Results: When pain management is entered in
PubMed, 19 subcategories, such as postoperative, acute, chronic, cancer, and
so on, are suggested by the search engine. For pain management alone, there
are 99,113 biomedical literature citations and abstracts. With limits set to
include human and randomized controlled trial, there are 11,719. The 19
subcategories have a range of citations from 398 to 40,443 (average, 9,572).
With limits set, the range is 20 to 7,554 (average, 1,420). Pairing the
terms prehospital, EMS, HEMS, helicopter, air medical transport, and
aeromedical, the range is 4 to 192 (average, 54), and with limits the range
is 0 to 11 (average, 2). Pairing the terms alternative, nontraditional, and
acupuncture, the average is 2,686, and 443 with limits. Conclusion: A dearth
of published research exists on pain management in either AMT or CCT when
compared with other areas of pain management. Helicopter, HEMS, aeromedical,
and air medical transport pain management literature contains a single
published human randomized controlled trial cited in Medline. Opportunity
exists for further research and improvement in patient care.
EMTREE DRUG INDEX TERMS
opiate
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
analgesia
intensive care
EMTREE MEDICAL INDEX TERMS
acupuncture
air medical transport
drug therapy
helicopter
hospital patient
human
Medline
neoplasm
pain
patient
patient care
randomized controlled trial
search engine
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70816231
DOI
10.1016/j.amj.2012.04.009
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2012.04.009
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 492
TITLE
Prehospital use of hydroxocobalamin for cyanide toxicity in a rotarywing
primary aeromedical evacuation and critical care transport program
AUTHOR NAMES
Vu E.N.
Peet H.E.
Bernklau R.P.
Wand R.T.
Wheeler S.J.
Tallon J.M.
AUTHOR ADDRESSES
(Vu E.N.; Peet H.E.; Bernklau R.P.; Wand R.T.; Wheeler S.J.; Tallon J.M.)
British Columbia Ambulance Service, Provincial Air Evac and Critical Care
Transport Programs, Vancouver, Canada.
CORRESPONDENCE ADDRESS
E.N. Vu, British Columbia Ambulance Service, Provincial Air Evac and
Critical Care Transport Programs, Vancouver, Canada.
SOURCE
Air Medical Journal (2012) 31:4 (171). Date of Publication: July-August 2012
CONFERENCE NAME
2012 Critical Care Transport Medicine Conference
CONFERENCE LOCATION
Nashville, TN, United States
CONFERENCE DATE
2012-04-02 to 2012-04-04
ISSN
1067-991X
BOOK PUBLISHER
Mosby Inc.
ABSTRACT
Introduction: Cyanide (CN) toxicity is an underreported and underrecognized
cause of morbidity and mortality associated with closed-space severe burns
and inhalation injury. The risk of CN toxicity from acts of terrorism or
industrial accidents remains high. With the recent release of
hydroxocobalamin (OHCo) in North America, the ability of EMS personnel to
mitigate the morbidity and mortality associated with suspected or confirmed
CN toxicity has improved substantially. Methods: OHCo was introduced into
our prehospital CBRNE hazardous substance response program in June 2011.
This program has 24-hour CBRNE paramedic advisors screening such calls, and
24-hour on-line medical oversight. Our CCP flight paramedics are equipped
for the prehospital use of OHCo for confirmed or suspected CN toxicity. Our
teams have monitoring and point-of-care field testing allowing for on-scene
assessment of arterial blood gases, lactate, and carboxyhemoglobin, thereby
facilitating prehospital triage and decision-making processes to expedite
administration of the antidote in the field. Indications for the
administration of OHCo include: CN level > 39 ?mol/L, or high clinical index
of exposure (e.g., smoke inhalation, known CN exposure/ingestion) and
altered LOC (Glasgow Coma Scale [GCS] < 13), shock (SBP < 90 mmHg), or
lactate greater tan 8 mmol/L. Results: Over a 4-month period, OHCo has been
used 3 times. All 3 patients were involved in separate trailer/ vehicle
fires, with severe burns (30%, 45%, 90% TBSA full-thickness burns). Two had
a pH of 7.20, one had a lactate of 4 mmol/L, and one had a COHgb level of
21%. All were obtunded with GCS 3, 6, and 7 before intubation. No
complications were reported with the administration of OHCo in any patient.
All were successfully transported to definitive care. Conclusion: We report
the successful implementation of a prehospital OHCo program for confirmed or
suspected CN toxicity. Further studies are required to assess the effect of
the antidote in this patient population.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
cyanide
hydroxocobalamin
EMTREE DRUG INDEX TERMS
antidote
carboxyhemoglobin
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
toxicity
EMTREE MEDICAL INDEX TERMS
arterial gas
dangerous goods
decision making
emergency health service
exposure
fire
flight
Glasgow coma scale
human
inhalation
injury
intubation
monitoring
morbidity
mortality
North America
occupational accident
patient
personnel
pH
population
risk
screening
smoke
terrorism
thickness
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70816235
DOI
10.1016/j.amj.2012.04.009
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2012.04.009
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 493
TITLE
Improving the transfer of traumatic brain-injured patients
AUTHOR NAMES
Batuwitage B.T.
Brennan K.
Jankowski S.
AUTHOR ADDRESSES
(Batuwitage B.T.; Brennan K.; Jankowski S.) Department of Anaesthetics,
Royal Hallamshire Hospital, Sheffield, United Kingdom.
CORRESPONDENCE ADDRESS
B.T. Batuwitage, Department of Anaesthetics, Royal Hallamshire Hospital,
Sheffield, United Kingdom.
SOURCE
Journal of Neurosurgical Anesthesiology (2012) 24:3 (253). Date of
Publication: July 2012
CONFERENCE NAME
Annual Scientific Meeting of the Neuroanaesthesia Society of Great Britain
and Ireland 2012
CONFERENCE LOCATION
Belfast, Northern Ireland, United Kingdom
CONFERENCE DATE
2012-05-10 to 2012-05-11
ISSN
0898-4921
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: High-quality transfer of patients with brain injury improves
outcome.1 A prospective audit of the transfer of severe traumatic
brain-injured (TBI) patients to our neurosurgical center using a data
collection form designed to provide guidance and improve transfer quality
was undertaken. The aim was to identify delays in transfer and their causes
and assess quality of transfer. Methods: Intubated TBI patients urgently
transferred to the neurosurgical intensive care unit (NICU) or to
neurosurgical theatres over a 10-month period were included. Forms were
placed in critical care and emergency (Table presented) departments (ED) of
referring hospitals and were completed during or after transfer. Data on the
quality of the transfer were collected at the neurosurgical center; any
missing data were collected retrospectively. Results: Thirty-one TBI
patients were transferred over the study period. Complete data on transfer
time were available for 27. Average time from admission to ED of referring
hospital to admission to the neurosurgical center was 7 hours and 3 minutes,
this varied widely among referring hospitals. Twenty of 27 (74%) of
transfers were delayed. Two of 20 (10%) of delays were unavoidable. Eighteen
of 20 (90%) were deemed avoidable. (Table 1) illustrates causes for
avoidable delays. Eleven of 31 (35%) of transfers were undertaken by junior
trainees. Pretransfer arterial blood gas results were documented in 18/31
(58%). A contemporaneous record was kept in 22/31 (71%). In 11 patients,
data were collected on admission to the neurosurgical center. In 2/11 this
decreased below the targets set for a high-quality transfer. Conclusions:
There were many areas where transfer of TBI patients could be improved. We
plan to discuss our findings with neurosurgeons, medical staff in referring
hospitals and continue to use our transfer forms with an aim to improve the
standards of transfer in our region.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
brain
human
Ireland
patient
society
United Kingdom
EMTREE MEDICAL INDEX TERMS
arterial gas
brain injury
clinical audit
emergency
hospital
information processing
intensive care
intensive care unit
medical staff
neurosurgeon
student
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70819359
DOI
10.1097/ANA.0b013e318258b649
FULL TEXT LINK
http://dx.doi.org/10.1097/ANA.0b013e318258b649
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 494
TITLE
How to transport the critically ill children?
AUTHOR NAMES
Dzulfikar D.L.H.
AUTHOR ADDRESSES
(Dzulfikar D.L.H.) Department of Child Health, Padjadjaran University, Dr.
Hasan Sadikin Hospital Bandung, Indonesia.
CORRESPONDENCE ADDRESS
D.L.H. Dzulfikar, Department of Child Health, Padjadjaran University, Dr.
Hasan Sadikin Hospital Bandung, Indonesia.
SOURCE
Critical Care and Shock (2012) 15:3 (66-67). Date of Publication: 2012
CONFERENCE NAME
19th International Symposium on Critical Care and Emergency Medicine 2012
CONFERENCE LOCATION
Kuta, Bali, Indonesia
CONFERENCE DATE
2012-07-12 to 2012-07-14
ISSN
1410-7767
BOOK PUBLISHER
Indonesian Society of Critical Care Medicine
ABSTRACT
Safe transport of the critically ill children remains a global important
issues. The importance is because of high risk mortality and morbidity that
exists during the transport process. The goal is to stabilize the patient
condition and to refer the patient to a better facility and more specialized
personnel to prevent further deterioration. Thus, extremely ill patients can
be transferred with minimal risk with this approach. In critically ill
children, the indications for emergency transport are most likely due to
respiratory problems (32%), trauma (22%), neurologic (15%), neonatal (15%),
and several other emergencies (9%). Transfers can be primary or secondary.
Primary transport occurs from the scene of acute illness or injury to
hospital and secondary transport is transfer of patient between a referring
and receiving hospital. The intra-hospital and inter-hospital transfer of
critically ill patients is an inevitable part of emergency department
practice. Transportation of patients within a hospital for the purpose of
undergoing diagnostic, procedures, therapeutic, or transfer to a specialized
unit are called intra-hospital transport and transportation between
hospitals by several transfer mode are called inter-hospital transport.
Transfer can be safely accomplished even in extremely ill patients. Those
involved in transfers have the responsibility for ensuring that everything
necessary in pre-transport, during transport, and after-transport/arrival is
well prepared. In pre-transport, good coordination and communication between
personnel, trained personnel, adequate equipment and medication, mode of
transport, and monitoring during transport are required. During transport,
an algorithm is provided for the inter- and intrahospital transport of
critically ill patient for assuring patient condition. After transport, the
receiving teams reevaluate patient condition with SOAP approach and should
make the retrieval process uneventful. Although, transport of critically ill
patient carries inherent morbidity and mortality risk, with safe transport
of critically ill children, patient safety is enhanced and this will give
better outcome in those who received the measures. Establishing an organized
and efficient safe transport process supported by adequate personnel and
equipment resources is mandatory.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child
critically ill patient
emergency medicine
human
intensive care
EMTREE MEDICAL INDEX TERMS
acute disease
algorithm
deterioration
diagnostic procedure
drug therapy
emergency
emergency ward
hospital
injury
interpersonal communication
monitoring
morbidity
mortality
patient
patient safety
patient transport
personnel
responsibility
risk
traffic and transport
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71527474
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 495
TITLE
Design and evaluation of a multi-disciplinary web-based handoff tool
AUTHOR NAMES
Schnipper J.L.
Karson A.S.
Morash S.K.
Glotzbecker B.
Milone M.J.
Yolin Raley D.S.
Nolido N.V.
Horsky J.
Leinen L.
Bhan I.
Dankers C.
Church K.L.
Minahan J.A.
Yoon C.
AUTHOR ADDRESSES
(Schnipper J.L.; Glotzbecker B.; Milone M.J.; Yolin Raley D.S.; Nolido N.V.;
Horsky J.; Church K.L.; Minahan J.A.; Yoon C.) Brigham and Women's Hospital,
Boston, United States.
(Schnipper J.L.; Karson A.S.; Glotzbecker B.; Bhan I.; Dankers C.) Harvard
Medical School, Boston, United States.
(Karson A.S.; Morash S.K.; Bhan I.; Dankers C.) Massachusetts General
Hospital, Boston, United States.
(Horsky J.; Leinen L.) Partners Healthcare, Boston, United States.
CORRESPONDENCE ADDRESS
J.L. Schnipper, Brigham and Women's Hospital, Boston, United States.
SOURCE
Journal of General Internal Medicine (2012) 27 SUPPL. 2 (S156-S157). Date of
Publication: July 2012
CONFERENCE NAME
35th Annual Meeting of the Society of General Internal Medicine, SGIM 2012
CONFERENCE LOCATION
Orlando, FL, United States
CONFERENCE DATE
2012-05-09 to 2012-05-12
ISSN
0884-8734
BOOK PUBLISHER
Springer New York
ABSTRACT
BACKGROUND: Failures in communication among healthcare personnel during
intra-hospital handoffs in care are known threats to patient safety. In
August, 2009, our healthcare system held a multi-stakeholder summit on
handoffs, developed consensus around the need for a system-wide electronic
handoff tool, and recommended a pilot study to develop and evaluate this
technology. METHODS: We adapted a web-based, multi-disciplinary handoff tool
used by a single residency program. Enhancements to the existing tool
included: 1) implementation at a second hospital in our system; 2) support
for simultaneous handoffs by nurses, residents/PAs, and attendings with
shared information among the different roles; 3) custom structured templates
for each user group; and 4) the ability to create progress notes and
multiple sign-out forms from the same core data. The tool was refined and
tested on a generalmedicine teaching service at one hospital and a
hematologic malignancy PA service at the other. For 3 months
pre-intervention and 4 months post-implementation, we surveyed receivers of
handoffs regarding continuity of care and evaluated signout content using
explicit criteria. We also conducted formal usability testing using
simulated cases.We conducted principal components analysis to derive
categories from the survey questions and create composite scores for each
category. RESULTS: We received survey responses from 315 clinicians (66%
response rate). In a pre-post analysis, 2 of 5 composite scores improved:
perceived negative impact of handoff on clinical information and
decision-making (composite score 14.7 pre, 10.2 post, p=0.01), and negative
subjective rating of handoff quality and accuracy (28.4 vs. 25.8, p=0.01).
Among survey questions to nurses, 10 improved, including an increase in how
well handoffs prepared them for things that might go wrong (47.3 vs. 65.2,
p=0.01). In the explicit review of written sign-outs, inclusion of 5 data
elements (e.g., % tasks with if/then statements) increased, but decreases
were noted in other data elements. Usability testing revealed a tension
between desire for a clinical narrative and the use of structured template
fields. CONCLUSIONS: A multi-disciplinary, web-based sign-out tool was able
to increase subjective measures of sign-out quality and impact on clinical
decision-making, particularly among nurses. Much of the improvement may have
come from the ability to produce both a progress note and sign-out with one
tool, which led to more frequent updating of sign-outs and greater faith in
their accuracy. The use of customized “templated” fields was inconsistent
and suggests that these should be minimized to those most necessary for
continuity of care. Greater improvements in care may require further
enhancements in usability of the tool, training in use of the tool, and
education in best practices in handoffs in care.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
internal medicine
society
EMTREE MEDICAL INDEX TERMS
clinical decision making
consensus
decision making
education
health care personnel
health care system
hematologic malignancy
hospital
human
interpersonal communication
narrative
nurse
patient care
patient safety
pilot study
principal component analysis
teaching
technology
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71296576
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 496
TITLE
Development of a potassium repletion protocol to decrease interruptions
during ICU transfer of care
AUTHOR NAMES
Shvets L.
Khan W.
Ali M.
Carson M.P.
AUTHOR ADDRESSES
(Shvets L.; Khan W.; Ali M.; Carson M.P.) Jersey Shore University Medical
Center, Neptune, United States.
CORRESPONDENCE ADDRESS
L. Shvets, Jersey Shore University Medical Center, Neptune, United States.
SOURCE
Journal of General Internal Medicine (2012) 27 SUPPL. 2 (S160-S161). Date of
Publication: July 2012
CONFERENCE NAME
35th Annual Meeting of the Society of General Internal Medicine, SGIM 2012
CONFERENCE LOCATION
Orlando, FL, United States
CONFERENCE DATE
2012-05-09 to 2012-05-12
ISSN
0884-8734
BOOK PUBLISHER
Springer New York
ABSTRACT
BACKGROUND: Resident work hour limitations have highlighted the importance
of avoiding interruptions during transitions of care, especially in the
intensive care unit (ICU). Calls regarding abnormal potassium (K+) results
are a common cause of such interruptions in our ICU. We implemented an
automated K+repletion protocol for ICU patients with mild hyperkalemia and
collected data to a) determine if it could decrease the number of phone
calls made by nurses and received by residents, b) monitor and assess the
response to the repletion dictated by the protocol, and c) determine whether
protocol use changed the average time to first K+dose. METHODS: ICU nurses
and residents completed surveys regarding the current potassium replacement
system, and for a week tracked the relative number of calls/pages made
regarding K+repletion. A written order set was developed, approved by the
ICU committee and piloted for a month. The nurses used the automated
protocol to direct K+ repletion only for patients whose eGFR was>=50 cc/min
AND initial morning K+was between 3.3 and 3.9 meq/L (Protocol Used Group).
For those with an eGFR<50 OR an initial K+<=3.2, the nurses called/paged the
residents as usual (Standard Care). The protocol was only used once per day.
The following were recorded each day: initial K+levels, creatinine, eGFR,
K+supplement dose, time to administration, repeat K+values, and medications.
K+repletion was separately tracked for those with eGFR<50 cc/min. RESULTS:
Prior to the pilot program, residents received an average of 7 pages/day
from nurses during morning sign-out rounds regarding potassium repletion
orders. The median time to the first K+dose was longer for the Standard Care
patients, and was over 9 hours for 4 (Table), but the difference between the
mean time to repletion was not significantly different (Wilcoxn-Rank Sum
p=0.13). 14 additional patients with an eGFR <50 (range 12-44) treated by
Standard Care were tracked: the average morning K+was 3.5 meq/L, the average
repletion dose was 43 meq of KCl, and the average next morning K+value was
3.7 meq/L, similar to the patients with an eGFR>=50. The nurses and
residents thought the protocol was an effective tool. CONCLUSIONS: The pilot
protocol was well received by the staff, did not cause hyperkalemia,
prevented long delays in repletion, and prevented 2-3 interruptions/day
during the morning transition of care when the pilot was implemented. Those
with an eGFR<50 received similar repletion doses without developing
hyperkalemia. Patients on the protocol received less total repletion because
it was only implemented for those with a K+>=3.3 meq/L. The protocol is now
in place as part of our standard, computerized, ICU order set and except for
those with critically low K+, it is being used to address the first daily K+
regardless of eGFR. As 88% of patients had a K+>=3.3 meq/L, it has the
potential to prevent at least 5-6 interruptions per day. (Table Presented).
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
potassium
EMTREE DRUG INDEX TERMS
creatinine
potassium chloride
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
internal medicine
society
EMTREE MEDICAL INDEX TERMS
drug therapy
human
hyperkalemia
intensive care unit
nurse
patient
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71296585
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 497
TITLE
Improved neonatal outcomes after the new Turkish regulation on assisted
reproduction technology imposing single embryo transfer
AUTHOR NAMES
Guzoglu N.
Kanmaz H.G.
Uras N.
Erdeve O.
Dilli D.
Dilmen U.
AUTHOR ADDRESSES
(Guzoglu N.; Kanmaz H.G.; Uras N.; Erdeve O.; Dilmen U.) Zekai Tahir Burak
Maternity Teaching Hospital, Neonatology, Ankara, Turkey.
(Dilli D.) Sami Ulus Children Hospital, Neonatology, Ankara, Turkey.
CORRESPONDENCE ADDRESS
N. Guzoglu, Zekai Tahir Burak Maternity Teaching Hospital, Neonatology,
Ankara, Turkey.
SOURCE
Human Reproduction (2012) 27 SUPPL. 2. Date of Publication: 2012
CONFERENCE NAME
28th Annual Meeting of the European Society of Human Reproduction and
Embryology, ESHRE 2012
CONFERENCE LOCATION
Istanbul, Turkey
CONFERENCE DATE
2012-07-01 to 2012-07-04
ISSN
0268-1161
BOOK PUBLISHER
Oxford University Press
ABSTRACT
Objectives and Aim: In vitro fertilization (IVF) has become an efficient and
widely used treatment for infertile couples however it is responsible for
the increasing number of multifetal pregnancies and adverse neonatal
outcomes. The aim of this study was to assess efficacy of the 2010 Turkish
reproductive regulation obligating single embryo transfer (SET) to decrease
incidence of multiple pregnancies and impact of a mandatory policy of SET
embryo transfer on neonatal intensive care unit (NICU) admissions in
addition to morbidity and mortality rates for our hospital. Material and
Methods: Between February 2010 and October 2011 all assisted reproductive
technology (ART) pregnancies delivered at Zekai Tahir Burak Maternity
Teaching Hospital were subjected to this study. Subjects were divided into
two groups; Group 1 consisted of infants delivered before ART regulation
between February 2010 and October 2010 and Group 2 consisted of infants
delivered after the ART regulation between November 2010 and October 2011.
Results: Comparing the study groups, we observed a significant decrease in
the incidence of multiple births in Group 2. Mean gestational age was
significantly lower and significantly higher rates of <28 w and <37 w were
found in Group 1. Mean birth weight was significantly lower and the
incidence of low birth weight, very low birth weight and extremely low birth
weight were significantly higher in Group 1. NICU admission rates and the
incidence of respiratory distress syndrome, patent ductus arteriosus,
necrotizing enterocolitis, pneumonia and sepsis, anemia, bronchopulmonary
dysplasia and mortality rates were significantly higher in Group 1.
Conclusion: Implementation of new Turkish ART regulation which obligates SET
successfully decreased the rates of multiple births and resulted in better
neonatal outcomes and may also have a beneficial effect on long term
results.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
embryo transfer
embryology
human
infertility therapy
reproduction
society
EMTREE MEDICAL INDEX TERMS
anemia
birth weight
extremely low birth weight
gestational age
hospital
in vitro fertilization
infant
intensive care unit
low birth weight
lung dysplasia
morbidity
mortality
multiple pregnancy
necrotizing enterocolitis
newborn intensive care
patent ductus arteriosus
pneumonia
policy
pregnancy
respiratory distress syndrome
sepsis
teaching hospital
technology
very low birth weight
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71113503
DOI
10.1093/humrep/27.s2.79
FULL TEXT LINK
http://dx.doi.org/10.1093/humrep/27.s2.79
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 498
TITLE
Time from CT to groin puncture lower in patients transferred from outside
hospitals compared to the local emergency room
AUTHOR NAMES
Nogueira R.
Glenn B.
Belagaje S.
Anderson A.
Frankel M.
Nahab F.
Gupta R.
AUTHOR ADDRESSES
(Nogueira R.; Glenn B.; Belagaje S.; Anderson A.; Frankel M.; Nahab F.;
Gupta R.) Department of Neurology, Emory University, School of Medicine,
Atlanta, United States.
CORRESPONDENCE ADDRESS
R. Nogueira, Department of Neurology, Emory University, School of Medicine,
Atlanta, United States.
SOURCE
Journal of NeuroInterventional Surgery (2012) 4 SUPPL. 1 (A70). Date of
Publication: July 2012
CONFERENCE NAME
9th Annual Meeting of the Society of NeuroInterventional Surgery, SNIS 2012
CONFERENCE LOCATION
San Diego, CA, United States
CONFERENCE DATE
2012-07-23 to 2012-07-26
ISSN
1759-8478
BOOK PUBLISHER
BMJ Publishing Group
ABSTRACT
Introduction Patients being transferred from outside facilities are often
excluded from intra-arterial therapy due to delays in transfer, evaluation
and imaging. The Marcus Stroke and Neuroscience Center at Grady Memorial
Hospital is a unique prototype for stroke reperfusion therapies in the
future. The CT scanner and biplane angiography suite are housed in the
intensive care unit. Patients being transferred from outside facilities are
brought directly to the intensive care unit where imaging and reperfusion
therapies can be performed rapidly. We sought to determine if there were
time differences in patients evaluated in our emergency room compared to
transfers from outside facilities. Materials and Methods A prospective
database of consecutive intra-arterial therapy at the Marcus Stroke Center
was reviewed. Patients treated from October 2010eJanuary 2012 were reviewed.
We assessed demographic, radiographic and clinical variables in addition to
if patients were transferred from outside facilities. We assessed times from
CT to groin puncture for patients evaluated in our emergency room and
compared them to patients transferred from outside hospitals. Patients with
anterior circulation strokes <8 h from symptom onset were assessed. Patients
with posterior circulation strokes were excluded. We performed Fisher's
exact testing for categorical variables and student's t-test for continuous
variables. Results A total of 165 patients with a mean age of 66613 years
with a mean NIHSS of 1965. A total of 109 (65%) patients were transferred
from outside hospitals. Patients from outside facilities were significantly
less likely to have hypertension (61% vs 81%, p<0.01) but there were no
baseline differences in age, NIHSS, clot location and time from symptom
onset. Patients transferred from outside facilities had significantly lower
times from CTat our institution to groin puncture compared to patients from
our emergency room (42620 min vs 74±30 min, p<0.0001). Conclusions The
presence of a biplane angiography suite in the neurological intensive care
unit may help to reduce times to reperfusion in patients being transferred
from an outside facility. Developing systems of care to reduce times to
reperfusion will require assessment of systems of care that focus on
available resources. Efficient systems to treat patients from outside
hospitals may help to improve the ability to offer treatments to more
patients.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency ward
hospital
human
inguinal region
patient
puncture
society
surgery
EMTREE MEDICAL INDEX TERMS
aircraft
angiography
cerebrovascular accident
computed tomography scanner
data base
hypertension
imaging
intensive care unit
intraarterial drug administration
National Institutes of Health Stroke Scale
reperfusion
Student t test
therapy
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70899062
DOI
10.1136/neurintsurg-2012-010455c.56
FULL TEXT LINK
http://dx.doi.org/10.1136/neurintsurg-2012-010455c.56
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 499
TITLE
Emergent interfacility evacuation of critical care patients in combat
AUTHOR NAMES
Franco Y.E.
Lorenzo R.A.D.
Salyer S.W.
AUTHOR ADDRESSES
(Franco Y.E.) C.R. Darnall Army Medical Center, Fort Hood, TX, United
States.
(Lorenzo R.A.D., Robert.DeLorenzo@amedd.army.mil; Salyer S.W.) Department of
Clinical Investigation, Brooke Army Medical Center, 3851 Roger Brooke Dr.,
Fort Sam Houston, TX 78234-6200, United States.
CORRESPONDENCE ADDRESS
R.A.D. Lorenzo, Department of Clinical Investigation, Brooke Army Medical
Center, 3851 Roger Brooke Dr., Fort Sam Houston, TX 78234-6200, United
States. Email: Robert.DeLorenzo@amedd.army.mil
SOURCE
Air Medical Journal (2012) 31:4 (185-188). Date of Publication: July-August
2012
ISSN
1067-991X
1532-6497 (electronic)
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
ABSTRACT
During the Second Iraq War (Operation Iraqi Freedom), high-intensity,
low-utilization medical and surgical services, such as neurosurgical care,
were consolidated into a centralized location within the combat zone. This
arrangement necessitated intra-theater air medical evacuation of critically
ill or injured patients from outlying combat support hospitals (CSH) to
another combat zone facility having the needed services. A case series is
presented of intratheater transfer of neurosurgical patients in Iraq during
2005-06. Ninety-eight patients are included in the series, with typical
transfer distances of 40 miles (approximately 20-25 minutes of flight time).
All patients were transported with a CSH nurse in addition to the standard
Army EMT-B flight medic. Seventy-six percent of cases were battle injury, 17
were non-battle injuries, and the balance were classified as non-injury
mechanisms. Seventy-six percent of cases were head injuries, with the
balance involving burns, stroke, and other injuries. At 30 days, 12 of the
patients had died, and 9 remained hospitalized in a critical care setting.
None of the patients died during evacuation. Intratheater and interfacility
transfer of critical care patients in the combat theater often involves
severely head-injured and other neurosurgical cases. Current Army staffing
for helicopter transport in these case requires a nurse or other advanced
personnel to supplement the standard EMT-B flight medic. © 2012 Air Medical
Journal Associates.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
patient transport
war
EMTREE MEDICAL INDEX TERMS
air medical transport
army
article
battle injury
burn patient
cerebrovascular accident
combat support hospital
head injury
health care facility
health service
helicopter
hospital
human
Iraq
major clinical study
mortality
neurosurgery
nurse
paramedical personnel
priority journal
surgical patient
EMBASE CLASSIFICATIONS
Internal Medicine (6)
Neurology and Neurosurgery (8)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2012380722
MEDLINE PMID
22748416 (http://www.ncbi.nlm.nih.gov/pubmed/22748416)
PUI
L365149015
DOI
10.1016/j.amj.2011.09.004
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2011.09.004
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 500
TITLE
The development of a portable life support device for transporting
pre-hospital critically ill patients
AUTHOR NAMES
Song Z.-X.
Wu T.-H.
Meng X.-J.
Lu H.-Z.
Zheng J.-W.
Wang H.-T.
AUTHOR ADDRESSES
(Song Z.-X., song9705@163.com; Wu T.-H.; Meng X.-J.; Lu H.-Z.; Zheng J.-W.;
Wang H.-T.) Institute of Medical Equipment, Academy of Military Medical
Science, Tianjin 300161, China.
CORRESPONDENCE ADDRESS
Z.-X. Song, Institute of Medical Equipment, Academy of Military Medical
Science, Tianjin 300161, China. Email: song9705@163.com
SOURCE
Chinese Critical Care Medicine (2012) 24:6 (323-326). Date of Publication:
10 Jun 2012
ISSN
1003-0603
BOOK PUBLISHER
Heilongjiang Institute of Science and Technology Information, 74 Yinhnag St,
Nangang-qu, Harbin, China.
ABSTRACT
Objective: To describe a portable life support device for transportation of
pre-hospital patients with critical illness. Methods: The characteristics
and requirements for urgent management during transportation of critically
ill patients to a hospital were analyzed. With adoption of the original
equipment, with the aid of stale of the art soft ware, the overall
structure, its installation, fixation, freedom from interference,
operational function were studied, and the whole system of life support and
resuscitation was designed. Results: The system was composed by different
modules, including mechanical ventilation, transfusion, aspiration, critical
care, oxygen supply and power supply parts. The system could be fastened
quickly to a stretcher to form portable intensive care unit (ICU), and it
could be carried by different size vehicles to provide nonstop treatment by
using power supply of the vehicle, thus raising the efficiency of urgent
care. Conclusion: With characteristics of its small size, lightweight and
portable, the device is particularly suitable for narrow space and extreme
environment.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
life support device
medical device
patient transport
portable equipment
EMTREE MEDICAL INDEX TERMS
article
artificial ventilation
aspiration
emergency care
human
intensive care
intensive care unit
oxygen supply
power supply
resuscitation
software
transfusion
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Biophysics, Bioengineering and Medical Instrumentation (27)
LANGUAGE OF ARTICLE
Chinese
LANGUAGE OF SUMMARY
English, Chinese
EMBASE ACCESSION NUMBER
2012422993
MEDLINE PMID
22681658 (http://www.ncbi.nlm.nih.gov/pubmed/22681658)
PUI
L365272881
DOI
10.3760/cma.j.issn.1003-0603.2012.06.002
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.issn.1003-0603.2012.06.002
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 501
TITLE
A 5-year review of transfers of suspected single ventricle cardiac lesions
through west of Scotland neonatal transport service
AUTHOR NAMES
Daspal S.
Jackson L.
AUTHOR ADDRESSES
(Daspal S.; Jackson L.) West Of Scotland Neonatal Transport, United Kingdom.
CORRESPONDENCE ADDRESS
S. Daspal, West Of Scotland Neonatal Transport, United Kingdom.
SOURCE
Journal of Maternal-Fetal and Neonatal Medicine (2012) 25 SUPPL. 2 (25).
Date of Publication: June 2012
CONFERENCE NAME
23rd European Congress of Perinatal Medicine
CONFERENCE LOCATION
Paris, France
CONFERENCE DATE
2012-06-13 to 2012-06-16
ISSN
1476-7058
BOOK PUBLISHER
Informa Healthcare
ABSTRACT
Introduction: Single ventricle cardiac lesions are best managed in dedicated
tertiary cardiac service centre involving a multidisciplinary team. The West
of Scotland Neonatal Transport Service has always adopted a role in bridging
between multidisciplinary team management by providing safe and stable
transfer. Our aim was to review the demographic & clinical details of the
infants transferred with single ventricle cardiac lesions by a national
neonatal transport team. Methods: A retrospective review of
suspected/confirmed single ventricle cardiac lesion transfers to and from a
national cardiology service between August 2006 and July 2011. Information
was collated from transport logs, referral letters and cardiology database
for each case. Data was analysed by using descriptive statistics. Results: A
total of 57 infants were transferred with wide variation of age between 1
and 23 days (Mean 3.2 days). A total 38 infants (67%) stayed in the West of
Scotland with neonatal intensive care unit being the highest receiver (51%).
A variety of defects were transferred during this study period with
hypoplastic left heart being the commonest (46%) followed by pulmonary
atresia (26%). Prostin therapy was used in 54 cases (95%) with half of them
required low dose (<10 ng/kg/min). Interestingly there was a correlation
between increased number of antenatal diagnosis and use of low dose of
prostin (<10 ng/kg/min) with correlation coefficient of 0.94. A total of 18
infants (31%) were ventilated. Only one infant on low dose of prostin
required ventilatory support whereas all the seven infants of higher dose of
prostin (>20 ng/kg/min) required ventilatory support prior to transfer. All
infants remained stable with mean oxygen saturation of 85% (StdV 12.13) and
mean blood pressure of 49 mmHg (StdV 8.2). End tidal carbon dioxide (EtCO2)
was recorded in all ventilated infants (Mean 5.6 KpA, StdV 1.6) with similar
blood gas carbon dioxide measurement (Mean 5.9 KpA, StdV 1.4). Adequate
systemic oxygen delivery was noted with a mean pH of 7.34 (StdV 0.09) and
mean lactate of 3 mmol (StdV 2.6). In nine transfers (16%), inotropic
supports were used (Dobutamine in 6 transfers and Dopamine in 3 transfers).
Discussion: The relationship between dose of prostin infusion and antenatal
diagnosis was likely due to smaller requirement of prostin to maintain
ductal patency. Although there was increasing trend of ventilatory
requirement in higher dose of prostin infusion, this could be due to
infant's general condition rather than prostin effect. Conclusion: Our data
showed a recognised association between antenatal diagnosis of cardiac
defects and a low dose prostin requirement as well as less ventilatory
requirement which would have favourable effect on the cardiac physiology.
Carbon dioxide monitoring should be standard practice when transferring
ventilated cardiac infants. We appreciate that the results from this study
would provide useful information for future research & audit.
EMTREE DRUG INDEX TERMS
carbon dioxide
dobutamine
dopamine
oxygen
prostaglandin E2
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
heart injury
heart single ventricle
perinatal care
United Kingdom
EMTREE MEDICAL INDEX TERMS
blood gas
capnometry
cardiology
clinical audit
correlation coefficient
data base
end tidal carbon dioxide tension
general condition
heart
human
infant
infusion
inotropism
intensive care unit
low drug dose
mean arterial pressure
monitoring
newborn intensive care
oxygen saturation
pH
physiology
prenatal diagnosis
pulmonary valve atresia
statistics
Tertiary (period)
therapy
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70781395
DOI
10.3109/14767058.2012.679162
FULL TEXT LINK
http://dx.doi.org/10.3109/14767058.2012.679162
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 502
TITLE
Can cardiac surgery patients transfer from ICU the same day as surgery?
AUTHOR NAMES
Manji R.A.
Arora R.C.
Bell D.D.
Menkis A.
Jacobsohn E.
AUTHOR ADDRESSES
(Manji R.A.; Arora R.C.; Menkis A.) Surgery, University of Manitoba,
Winnipeg, Canada.
(Bell D.D.; Jacobsohn E.) Anesthesia, University of Manitoba, Winnipeg,
Canada.
CORRESPONDENCE ADDRESS
R.A. Manji, Surgery, University of Manitoba, Winnipeg, Canada.
SOURCE
Canadian Journal of Anesthesia (2012) 59 SUPPL. 1. Date of Publication: June
2012
CONFERENCE NAME
2012 Annual Meeting of the Canadian Anesthesiologists' Society, CAS
CONFERENCE LOCATION
Quebec City, QC, Canada
CONFERENCE DATE
2012-06-15 to 2012-06-18
ISSN
0832-610X
BOOK PUBLISHER
Springer New York LLC
ABSTRACT
Introduction: Ability to transfer a patient out of the cardiac surgery ICU
(CSICU) same day as surgery would assist with improving flow of cardiac
surgery patients through the system as it would allow two patients to
“occupy” the same bed in a 24 hour period. Objective: To characterize
patients that are ward transfer ready ≤ 4 hours or >4 hours post arrival in
CSICU. Methods: Local HREB approval was granted. From Mar 2008 to Mar 2009,
all cardiac surgery patients admitted to CSICU were specifically evaluated
for earliest transfer time possible using specified criteria relating to
bleeding, urine output, hemodynamic/respiratory status, neurological status
and cardiac rhythm status. They were divided into two groups: early transfer
group (ETG) were patients ready for transfer ≤ 4 hours from arrival in ICU
who actually were transferred to ward in stable condition within 24 hours
and late transfer group (LTG) which were all other patients. Multivariable
logistic regression identified patients requiring longer ICU stay. Results:
There were 1010 patients enrolled in the study of which 274 (27.1%) were in
the ETG having a transfer ready time of 2.1 ± 1.1 hours (mean ± SD). There
were no readmissions to ICU and no in-hospital mortality in the ETG group.
Logistic regression revealed emergency operation (OR 17.6; 95% CI 2.4 -
129.9; p=0.01), congestive heart failure (OR 2.9; 95% CI 1.5 - 5.7; p<0.01),
cerebrovascular disease (OR 2.2; 95% CI 1.2 - 3.9; p<0.01), procedure
involving aortic valve (OR 2.2; 95% CI 1.2 - 3.9; p<0.01); and procedure
involving thoracic aorta (OR 5.0; 95% CI 1.5 - 17.3; p<0.01) to be
associated with longer stay with peripheral vascular disease (p=0.06) and
chronic renal failure (p=0.08) trending to be significantly associated with
longer stay. Variables not significant in the model, suggesting they would
be suitable for early transfer (assuming they did not also have one of the
longer stay factors), were: isolated CABG, open chamber procedure, redo
cardiac surgery, stable angina, and pre-operative arrhythmias. ICU length of
stay in the two groups was - median (interquartile range): ETG 20.5 (18.0 -
22.3) versus LTG 40.8 (22.5 - 68.4) hours - p<0.01. Discussion: Our data
suggest that there are predictable factors that could be used to decide
which patients may be transferable to the ward same day as surgery.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
anesthesist
Canadian
heart surgery
human
society
surgery
surgical patient
EMTREE MEDICAL INDEX TERMS
aortic valve
astronomy
bleeding
cerebrovascular disease
chronic kidney failure
congestive heart failure
emergency surgery
heart arrhythmia
heart rhythm
hospital readmission
length of stay
logistic regression analysis
model
mortality
patient
peripheral vascular disease
procedures
stable angina pectoris
thoracic aorta
urine volume
ward
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71888702
DOI
10.1007/s12630-012-9785-6
FULL TEXT LINK
http://dx.doi.org/10.1007/s12630-012-9785-6
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 503
TITLE
Intrahospital transport: Safe passage or potential for disaster?
AUTHOR NAMES
Winemiller M.
Stermer C.
AUTHOR ADDRESSES
(Winemiller M.; Stermer C.) Clin III, York Hospitals, York, United States.
CORRESPONDENCE ADDRESS
M. Winemiller, Clin III, York Hospitals, York, United States.
SOURCE
Journal of Radiology Nursing (2012) 31:2 (74). Date of Publication: June
2012
CONFERENCE NAME
2012 Annual Convention of the Association for Radiologic and Imaging
Nursing, ARIN 2012
CONFERENCE LOCATION
San Francisco, CA, United States
CONFERENCE DATE
2012-03-24 to 2012-03-28
ISSN
1546-0843
BOOK PUBLISHER
Elsevier Inc.
ABSTRACT
Transport of acutely ill patients throughout the hospital can be potentially
unsafe and place the patient at an increased risk for complications,
morbidity, and mortality. Acutely ill patients are defined as any
nonintensive care unit patient on continuous monitoring being transported to
treatments, diagnostic procedures, or a higher level of care within the
hospital setting. Limited resources such as expertise of transport staff and
equipment also add to the potential for complications during transport. A
wide variation in practice exists because there are currently no best
practices for transport of the non-intensive care unit patient. Some
patients may be transported with portable monitors with qualified staff in
attendance and others may be transported by non-licensed personnel only.
Radiology and imaging nurses as well as other procedural area staff share
concerns about patient safety, notably, that monitoring may be interrupted
during procedures and transport. An interdisciplinary evidence-based
practice project was conducted to address these concerns. Recommendations
from the project support the continuation of the same physiologic monitoring
during procedures and transport that the patient receives on a nursing unit.
Based on the evidence, changes were made to policies that specified
personnel, equipment, monitoring, and communication throughout the transport
and procedure. Other practice changes included the development of a
checklist to ensure appropriate resources are provided. Implementation of
these practice changes has resulted in an established standard of care for
these patients and improved patient safety during transport. Objective 1: To
describe the necessary components of safe intrahospital patient transport.
Content for Objective 1: Components include: 1. Detailed policies and
protocols, 2. Pre-transport coordination, 3. Qualifications of transport
personnel, 4. Type and availability of transport equipment, 5. Monitoring
parameters during transport, and 6. Communication and documentation.
Objective 2: To explore the benefits of using a checklist or scorecard for
patient transport. Content for Objective 2: Checklist or scorecard
establishes: 1. The decision to transport, 2. Patient acuity assessment, 3.
Identification of proper equipment, 4. Transport team, 5. Handoff
communication, 6. Consistent practice, and 7. Improved patient safety.
Objective 3: To describe the necessary components of safe intrahospital
patient transport. Content for Objective 3: Components include: 1. Detailed
policies and protocols, 2. Pre-transport coordination, 3. Qualifications of
transport personnel, 4. Type and availability of transport equipment, 5.
Monitoring parameters during transport, and 6. Communication and
documentation. Objective 4: To explore the benefits of using a checklist or
scorecard for patient transport. Content for Objective 4: Checklist or
scorecard establishes: 1. The decision to transport, 2. Patient acuity
assessment, 3. Identification of proper equipment, 4. Transport team, 5.
Handoff communication, 6. Consistent practice, and 7. Improved patient
safety.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
imaging
nursing
EMTREE MEDICAL INDEX TERMS
checklist
diagnostic procedure
documentation
evidence based practice
health care quality
hospital
human
intensive care unit
interpersonal communication
monitoring
morbidity
mortality
nurse
nursing unit
parameters
patient
patient safety
patient transport
personnel
policy
procedures
radiology
risk
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70817119
DOI
10.1016/j.jradnu.2012.03.019
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jradnu.2012.03.019
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 504
TITLE
2012 ARIN Convention and Poster Abstracts
AUTHOR ADDRESSES
SOURCE
Journal of Radiology Nursing (2012) 31:2. Date of Publication: June 2012
CONFERENCE NAME
2012 Annual Convention of the Association for Radiologic and Imaging
Nursing, ARIN 2012
CONFERENCE LOCATION
San Francisco, CA, United States
CONFERENCE DATE
2012-03-24 to 2012-03-28
ISSN
1546-0843
BOOK PUBLISHER
Elsevier Inc.
ABSTRACT
The proceedings contain 17 papers. The topics discussed include: nurses in
leadership and decision-making roles: new I.R. model; warning: triaging for
improved patient outcomes; comparison of skin antisepsis agents; improvement
of nursing skill and competence using interdisciplinary simulation training;
our journey on the path to magnet status; synergistic nursing professionals
in radiology to enhance patient care; initial assessment of outpatients
previously scheduled for ultrasound-guided invasive procedures;
double-checking of the medical request before ultrasound examinations: a way
to ensure a safe examination; intrahospital transport: safe passage or
potential for disaster?; the planning & implementation of multidisciplinary
peer review; and PET/CT with retrograde bladder filling: to cath or not to
cath?.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
imaging
nursing
EMTREE MEDICAL INDEX TERMS
antisepsis
bladder filling
competence
decision making
examination
human
invasive procedure
leadership
magnet
model
nurse
nursing competence
outpatient
patient
patient care
peer review
planning
radiology
simulation
skin
ultrasound
LANGUAGE OF ARTICLE
English
PUI
L70817122
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 505
TITLE
Transfer patterns of guillain-barŕe syndrome patients in the Netherlands
AUTHOR NAMES
Van Leeuwen N.
Lingsma H.F.
Vanrolleghem A.M.
Van Doorn P.A.
Sturkenboom M.
Steyerberg E.W.
Jacobs B.C.
AUTHOR ADDRESSES
(Van Leeuwen N.; Lingsma H.F.; Steyerberg E.W.) Centre for Medical Decision
Making, Department of Public Health, Rotterdam, Netherlands.
(Vanrolleghem A.M.; Sturkenboom M.) Department of Medical Informatics,
Rotterdam, Netherlands.
(Van Doorn P.A.; Jacobs B.C.) Department of Neurology, Rotterdam,
Netherlands.
(Jacobs B.C.) Department of Immunology, Erasmus Medical Center, Rotterdam,
Netherlands.
CORRESPONDENCE ADDRESS
N. Van Leeuwen, Centre for Medical Decision Making, Department of Public
Health, Rotterdam, Netherlands.
SOURCE
Journal of the Peripheral Nervous System (2012) 17:2 (276-277). Date of
Publication: June 2012
CONFERENCE NAME
2012 Peripheral Nerve Society/Inflammatory Neuropathy Consortium Meeting,
PNS/INC
CONFERENCE LOCATION
Rotterdam, Netherlands
CONFERENCE DATE
2012-06-24 to 2012-06-27
ISSN
1085-9489
BOOK PUBLISHER
Blackwell Publishing Inc.
ABSTRACT
Guillain-Barré syndrome (GBS) patients have a highly heterogeneous disease
course with often a long duration of admission, which results in frequent
transfers within and between hospitals, especially between medium and
intensive care units (ICU). Little is known about these transfers, despite
the fact that transfers have a major impact on patient and public health
care. Therefore we aimed to describe frequency, timing, and circumstances of
transfers within and between hospitals in an unselected cohort of Dutch GBS
patients. All 123 Dutch hospitals were requested to report patients
diagnosed with GBS between 2009 and 2010. Information regarding clinical
course and transfers was obtained via neurologists, general practitioners
and discharge letters from hospital. We included 87 GBS patients from 33
hospitals with a representative combination ofmild and severe cases, as
reflected by the range in maximal GBS disability scores: 1 or 2 (28%), 3 or
4 (53%), 5 (19%), and 6 (1%). Four (5%) patients had a mild GBS and were not
admitted to hospital. 71 (82%) were originally admitted at a neurology
department in an academic or non-academic hospital. The other 11 patients
(13%) were admitted at the ICU, internal medicine, or pediatrics department.
The median hospital stay was 42 days (IQR 20-64 days). Of the 83 admitted
patients, 40% had at least one (single) transfer to another department or
hospital, in which more than 50% within 2 days after admission. 25 (30%)
patients were transferred 2 times or more during their hospital stay, 2 (2%)
patients were transferred 4 times, 30 (36%) patients stayed in an ICU
anytime during their hospital stay. Eight (13%) of 60 patients originally
admitted to a non-academic hospital were transferred to an academic center.
Eventually, 41 (49%) patients went home after discharge, while the others
were referred to a rehabilitation center (46%) or nursing home (5%). This
study shows the high frequency of transfers of GBS patients and that
transfer patterns are very heterogeneous. In the future we aim to identify
which subgroups of patients are at risk for transfer, and to develop the
most patient friendly and cost-effective strategy to guide these transfers.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
human
Netherlands
neuropathy
patient
peripheral nerve
EMTREE MEDICAL INDEX TERMS
disability
disease course
general practitioner
hospital
hospitalization
intensive care unit
internal medicine
neurologist
neurology
nursing home
pediatrics
public health service
rehabilitation center
risk
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71387849
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 506
TITLE
An audit on intrahospital transfers of critically ill patients
AUTHOR NAMES
Trapani Galea Feriol P.
Buttigieg M.
Sciberras S.
AUTHOR ADDRESSES
(Trapani Galea Feriol P.; Buttigieg M.; Sciberras S.) Mater Dei Hospital,
Department of Anaesthesiology and Intensive Care, Msida, Malta.
CORRESPONDENCE ADDRESS
P. Trapani Galea Feriol, Mater Dei Hospital, Department of Anaesthesiology
and Intensive Care, Msida, Malta.
SOURCE
European Journal of Anaesthesiology (2012) 29 SUPPL. 50 (217). Date of
Publication: June 2012
CONFERENCE NAME
European Anaesthesiology Congress, EUROANAESTHESIA 2012
CONFERENCE LOCATION
Paris, France
CONFERENCE DATE
2012-06-09 to 2012-06-12
ISSN
0265-0215
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Background and Goal of Study: Patient safety during intrahospital transfers
has not received as much attention in the literature as interhospital
transfers. Indeed our institution does not have a specific guideline for
transfer of critically ill patients.The purpose of this audit was to assess
the logistics, quality and safety of intrahospital transfers requiring input
from on-call anaesthetists within a 800-bed hospital. Material and Methods:
A prospective audit of 100 intrahospital transfers was carried out within
Mater Dei Hospital, between 13-07-11 and 20-09-11. Coordination and
collection of data was carried out by one of the authors (P.Trapani Galea
Feriol) who interviewed the on call anaesthetists after a 24 hour shift
using the data collection form. Statistical analysis (chi squared test when
appropriate) was carried out to demonstrate a statistically significant
relationship between clinical incidents and the following variables:
different time of day, referring clinical area and number of staff
accompanying the anaesthetist. Results and Discussion: Of the 100 patient
transfers requiring anaesthetic cover studied, the commonest reason for
requesting an anaesthetist was to accompany a ventilated patient (43%). Most
transfers occurred between 14.00 and 20.00 hours and 70% of transfers lasted
less than 30 minutes. Analysis of data regarding accompanying personnel
revealed that 45% were not accompanied by a porter. In 24% of transfers the
anaesthetist was only supported by one paramedic member of staff with a
median of 2 paramedic personnel accompanying a transfer (range 1-3).Clinical
incidents (defined according to the 2011 Clinical Incident Management Policy
DoH Western Australia) occurred in 10% of transfers. Statistical analysis
did not reveal any statistically significant relationship between clinical
incident frequency and number of people accompanying a transfer (p=0.50) or
time of day(p=0.41). Conclusion: This study confirmed that intrahospital
transfers may be associated with a clinically significant clinical incident
rate, although we did not demonstrate a statistically significant
association with any variable studied. This has stimulated interest to draw
up a local transfer checklist and improve education and training to optimise
safety for intrahospital transfers.
EMTREE DRUG INDEX TERMS
anesthetic agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
anesthesiology
clinical audit
critically ill patient
human
patient transport
EMTREE MEDICAL INDEX TERMS
anesthesist
Australia
checklist
education
hospital
information processing
patient safety
personnel
policy
safety
statistical analysis
ventilated patient
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71084709
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 507
TITLE
Review on the need of telemetry monitoring in general ward after
transferring out from coronary care unit in STEMI patients who remained in
Killip 1 after undergoing successful primary percutaneous intervention
AUTHOR NAMES
Tan V.H.
Tong K.L.
Ng F.C.
Loh D.
Yap Q.Y.
Goh P.P.
AUTHOR ADDRESSES
(Tan V.H.; Tong K.L.; Goh P.P.) Cardiology Department, Changi General
Hospital, Singapore, Singapore.
(Ng F.C.; Loh D.; Yap Q.Y.) Coronary Care Unit, Changi General Hospital,
Singapore, Singapore.
CORRESPONDENCE ADDRESS
F.C. Ng, Coronary Care Unit, Changi General Hospital, Singapore, Singapore.
SOURCE
Circulation (2012) 125:19 (e793). Date of Publication: 15 May 2012
CONFERENCE NAME
World Congress of Cardiology Scientific Sessions 2012, WCC 2012
CONFERENCE LOCATION
Dubai, United Arab Emirates
CONFERENCE DATE
2012-04-18 to 2012-04-21
ISSN
0009-7322
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: With the increasing number of patients with heart diseases
requiring telemetry monitoring in general ward after transferred out from
Coronary Care Unit (CCU), there is an urgent need to ensure appropriate
telemetry allocation in view of limited numbers of telemetry available.
Objectives: We assess the need of telemetry monitoring in general wards
after transferred out from CCU in patients with ST elevation myocardial
infarction (STEMI) who remained in Killip Class 1 after undergoing
successful primary percutaneous coronary intervention (PPCI). Methods: This
was a retrospective study over 12-month period. Inclusion criteria including
patients presented with STEMI who remained in Killip 1 after undergoing
successful PPCI. Study end point was in-hospital occurrence of sustained
ventricular tachycardia (>30 seconds) or ventricular fibrillation (VF) post
PPCI. Exclusion criteria include patients on intra-aortic balloon
counterpulsation (IABP), temporary pacemaker, urgent CABG or unsuccessful
PPCI. Results: A total of 271 patients had STEMI and underwent PPCI in year
2010. 197 patients (72.7%) patients remained in Killip 1 after PPCI. In the
Killip 1 group, mean age was 53.6 ± 11.3 years. Majorities were male
(89.8%), smoker (52.3%) and have dyslipidaemia (82.7%). None of the patients
developed sustained ventricular tachycardia or VF. 9 patients (4.6%)
developed reperfusion arrhythmia (accelerated idioventricular rhythm) post
PPCI which were transient in nature and no treatment required. Conclusion:
STEMI patients who remained in Killip 1 after successful PPCI were not at
risk of developing sustained ventricular tachycardia or ventricular
fibrillation. They may not require telemetry monitoring in general wards and
this may improve utilisation of limited numbers of telemetry.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cardiology
coronary care unit
human
monitoring
patient
ST segment elevation myocardial infarction
telemetry
ward
EMTREE MEDICAL INDEX TERMS
aortic balloon
counterpulsation
heart arrhythmia
heart disease
heart ventricle fibrillation
heart ventricle tachycardia
hospital
male
pacemaker
percutaneous coronary intervention
reperfusion
retrospective study
risk
smoking
supraventricular tachycardia
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71051588
DOI
10.1161/CIR.0b013e31824fcdb3
FULL TEXT LINK
http://dx.doi.org/10.1161/CIR.0b013e31824fcdb3
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 508
TITLE
Rapid response team-triggered procalcitonin measurement predicts infectious
intensive care unit transfers
AUTHOR NAMES
Wunderink R.G.
Diederich E.R.
Caramez M.P.
Donnelly H.K.
Norwood S.D.
Kho A.
Reed K.D.
AUTHOR ADDRESSES
(Wunderink R.G.; Diederich E.R.; Caramez M.P.; Donnelly H.K.; Norwood S.D.;
Kho A.; Reed K.D.)
CORRESPONDENCE ADDRESS
R. G. Wunderink,
SOURCE
Critical Care Medicine (2012). Date of Publication: 4 May 2012
ISSN
0090-3493
1530-0293 (electronic)
BOOK PUBLISHER
Society of Critical Care Medicine and Lippincott Williams & Wilkins
ABSTRACT
OBJECTIVE:: Determine if procalcitonin at the time of initial rapid response
team activation identifies patients who are likely to need subsequent
intensive care unit transfer. DESIGN:: Prospective observational cohort
study. SETTING:: Urban, tertiary care hospital with rapid response team
activation through an electronic modified early warning score. PATIENTS::
One hundred nineteen oncology and 100 consecutive non-oncology patients
after initial rapid response team visit precipitated by an elevated
electronic modified early warning score were recruited. Rapid response team
activations by request of nursing or for other reasons were not studied.
Five oncology patients seen by a rapid response team for complications of
interleukin-2 therapeutic infusions were subsequently excluded.
INTERVENTIONS:: Residual serum from the next ordered clinical test (within
12 hrs) was retrieved, frozen, and stored for procalcitonin determination. A
second sample 12-24 hrs after the initial specimen was also retrieved if
available and if the patient had not yet been transferred to the intensive
care unit. MEASUREMENTS AND MAIN RESULTS:: Seventy-three patients (33%) were
transferred to the intensive care unit. Rapid response team activations that
did not result in intensive care unit transfer had significantly lower
procalcitonin levels (median 0.28 ng/mL [interquartile range 0.09-1.24])
than those that resulted in intensive care unit transfer (median 0.51 ng/mL
[interquartile range 0.11-1.97], p = .0001) but the area under the receiver
operating curve was only 0.656. The change in procalcitonin level in
patients with intensive care unit transfers was very heterogeneous but was
significantly increased compared to the change in patients not transferred
to the intensive care unit. Procalcitonin levels for intensive care unit
transfers for probable or definite infection were 2.28 ng/mL [interquartile
range 0.68-8.05], and were significantly greater than rapid response team
visits that did not result in transfer (p = .0001). The difference between
infectious and noninfectious intensive care unit transfers (0.95 ng/mL
[interquartile range 0.26-1.89]) was also significant (p = .03). The
procalcitonin levels of patients with noninfectious intensive care unit
transfers were also different than the levels of patients who never
transferred (p = .04). CONCLUSIONS:: Preliminary results suggest
procalcitonin levels in patients at the time of initial visit by a rapid
response team correlate with the need for subsequent intensive care unit
transfer, particularly for infectious reasons.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
procalcitonin
EMTREE DRUG INDEX TERMS
interleukin 2
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
rapid response team
EMTREE MEDICAL INDEX TERMS
cohort analysis
hospital
human
infection
infusion
nursing
oncology
patient
serum
tertiary health care
PUI
L51988658
DOI
10.1097/CCM.0b013e31824fc027
FULL TEXT LINK
http://dx.doi.org/10.1097/CCM.0b013e31824fc027
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 509
TITLE
Factors affecting the success of prehospital intubation in an air and land
critical care transport service: Results of a multivariate analysis
AUTHOR NAMES
MacDonald A.M.
MacDonald R.D.
Lee J.S.
AUTHOR ADDRESSES
(MacDonald A.M., anna.macdonald@utoronto.ca; MacDonald R.D.; Lee J.S.)
Division of Emergency Medicine, University of Toronto, Canada.
CORRESPONDENCE ADDRESS
A.M. MacDonald, Division of Emergency Medicine, University of Toronto,
Canada. Email: anna.macdonald@utoronto.ca
SOURCE
Canadian Journal of Emergency Medicine (2012) 14 SUPPL. 1 (S24). Date of
Publication: May 2012
CONFERENCE NAME
2012 CAEP/ACMU Scientific Abstracts
CONFERENCE LOCATION
Niagara Falls, ON, Canada
CONFERENCE DATE
2012-06-02 to 2012-06-06
ISSN
1481-8035
BOOK PUBLISHER
Decker Publishing
ABSTRACT
Introduction: Paramedics perform tracheal intubation in the prehospital
environment, and the morbidity associated with failed attempts causes some
to question the appropriateness of intubation in this setting. To inform
this discussion, we should understand the factors that predict the success
of prehospital intubation. This study aims to determine the factors that
affect success on first attempt of paramedic intubations in a rapid sequence
intubation (RSI)-capable critical care transport service. Methods: We
conducted a multivariate logistic analysis on a prospectively collected
database from a critical care transport service that provides scene
responses and interfacility transport in Ontario. The study population
includes all intubations by flight paramedics from January 2006 to July
2009. The primary outcome is success on first attempt. A list of potential
factors predicting success was obtained from a review of the literature and
includes age, sex, Glasgow Coma Scale, location of intubation attempt,
paralytics and sedation given, a difficult airway prediction score, and type
of call (trauma, medical or cardiac arrest). Results: Data from 549
intubations were analyzed. The success rate on first attempt at intubation
was 57.7%, and the overall success rate was 87.4%. A total of 498 had
complete data for all predictive variables and were included in the
multivariate analysis. The factors found to be statistically significant
were age per decade (OR 1.1, CI 1.04-1.2), female gender (OR 1.5, CI
1.03-2.32), paralytics given (OR 2.7, CI 1.5-4.7), and sedation given (OR
0.6, CI 0.41-0.91). This model demonstrated a good fit (Hosmer-Lemeshow =
8.906), with an AUC of 0.632. Conclusions: Use of a paralytic agent, age,
and gender were associated with increased success of intubation. The
association of sedative use alone with decreased success was unexpected and
may be due to confounding related to the indications for sedation, such as
patient agitation. Our findings may have implications for RSI-capable
paramedics and require further study.
EMTREE DRUG INDEX TERMS
sedative agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
airway
emergency health service
emergency medicine
intensive care
intubation
multivariate analysis
EMTREE MEDICAL INDEX TERMS
agitation
Canada
data base
endotracheal intubation
environment
female
flight
gender
Glasgow coma scale
heart arrest
human
injury
model
morbidity
patient
population
prediction
sedation
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70843530
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 510
TITLE
Transporting the adult critically ill patient
AUTHOR NAMES
Martin T.
AUTHOR ADDRESSES
(Martin T.) Royal Hampshire County Hospital, Winchester, United Kingdom.
CORRESPONDENCE ADDRESS
T. Martin, Royal Hampshire County Hospital, Winchester, United Kingdom.
SOURCE
Surgery (2012) 30:5 (219-224). Date of Publication: May 2012
ISSN
0263-9319
1878-1764 (electronic)
BOOK PUBLISHER
Elsevier Ltd, Langford Lane, Kidlington, Oxford, United Kingdom.
ABSTRACT
More than 10,000 intensive care patients are transferred each year in the
UK, of whom the vast majority are accompanied by staff from the referring
hospital. The high frequency of transfer of critically ill patients is
primarily due to the escalating complexity of healthcare, the concentration
of skills into specialized regional centres, and the relative lack of
availability of intensive care unit (ICU) beds. The care practised during
the constraints of patient transfer (whether within or between hospitals)
should attempt to mirror the detailed attention provided in the hospital
ICU, and it is the responsibility of the transport team to ensure the
efficacy of the process and safety of the patient. This is achieved through
careful preparation and planning and preparation starts with adequate and
appropriate training of transfer personnel as well as selection of equipment
which is fit for purpose. Success is based on anticipation and prevention of
potential complications and hazards to the patient and transfer team. This
article gives an overview of the hazards, organization, and planning of
patient transfers, and highlights the importance of interdisciplinary
teamwork, good communications, and appropriate decision-making. It also
discusses special situations encountered in the transfer or retrieval of
patients with complex needs, such as those requiring intra-aortic balloon
counterpulsation or extracorporeal membrane oxygenation. © 2012 Elsevier
Ltd. All rights reserved.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
patient transport
EMTREE MEDICAL INDEX TERMS
allied health education
article
counterpulsation
devices
extracorporeal oxygenation
hazard
health care personnel
human
intensive care
intensive care unit
interdisciplinary communication
patient safety
planning
priority journal
teamwork
United Kingdom
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2012264795
PUI
L364768920
DOI
10.1016/j.mpsur.2012.02.004
FULL TEXT LINK
http://dx.doi.org/10.1016/j.mpsur.2012.02.004
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 511
TITLE
Heliox in children with croup: A strategy to hasten improvement
AUTHOR NAMES
Kline-Krammes S.
Reed C.
Giuliano Jr. J.S.
Schwartz H.P.
Forbes M.
Pope J.
Besunder J.
Gothard M.D.
Russell K.
Bigham M.T.
AUTHOR ADDRESSES
(Kline-Krammes S.) Department of Pediatrics, Division of Emergency Medicine,
Akron Children's Hospital, Akron, OH, United States.
(Reed C.; Russell K.) Department of Respiratory Care, Akron Children's
Hospital, Akron, OH, United States.
(Giuliano Jr. J.S.) Department of Pediatrics, Division of Critical Care
Medicine, Yale Children's Hospital, New Haven, CT, United States.
(Schwartz H.P.) Department of Pediatrics, Division of Emergency Medicine,
Cincinnati Children's Hospital, Cincinnati, OH, United States.
(Forbes M.; Pope J.; Besunder J.; Bigham M.T., mbigham@chmca.org) Department
of Pediatrics, Division of Critical Care Medicine, Akron Children's
Hospital, Akron, OH 44308-1066, United States.
(Gothard M.D.) Rebecca D. Considine Clinical Research Institute, Akron
Children's Hospital, Akron, OH, United States.
CORRESPONDENCE ADDRESS
M.T. Bigham, Department of Pediatrics, Division of Critical Care Medicine,
Akron Children's Hospital, Akron, OH 44308-1066, United States. Email:
mbigham@chmca.org
SOURCE
Air Medical Journal (2012) 31:3 (131-137). Date of Publication: May-June
2012
ISSN
1067-991X
1532-6497 (electronic)
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
ABSTRACT
Objective: Upper airway obstruction is responsive to the reduction in
airflow turbulence provided by helium/oxygen (heliox) admixture. Our
pediatric critical care transport team (PCCTT) has used heliox for children
with upper airway obstruction from croup. We sought to describe our
experience with heliox on transport and hypothesized that heliox-treated
children with croup would show a more rapid clinical improvement. Methods:
Children with croup transported by our PCCTT and admitted to the PICU were
evaluated. We analyzed pretransport care, transport interventions, and
outcomes. Croup scores (Modified Taussig) were assigned retrospectively
according to respiratory therapy charting. Data were analyzed using
appropriate statistical tests, including Pearson's chi-square test, Fisher's
exact test, Mann-Whitney U rank comparison, and two-sample t-test. Results:
Thirty-five children met inclusion criteria. Demographics were similar
between groups. The pretransport medical care was similar between groups.
Children receiving heliox had a higher baseline croup score [mean (SD) =
5.7(2.3) vs no heliox 2.9 (2.0), P < 0.001]. The improvement in croup scores
over the first 60 minutes of transport was more rapid in the heliox-treated
children (P < 0.001). There was no difference in the number of children
requiring additional nebulized racemic epinephrine during transport. The
PICU length of stay (P = 0.59) and hospital length of stay (P = 0.64) were
similar between groups. Conclusion: Heliox added to standard transport
treatment for critically ill children with croup provides a more rapid
improvement in croup scores. Heliox for croup during transport does not
prolong intensive care unit stay. A prospective clinical trial is warranted
to evaluate heliox in pediatric transport. © 2012 Air Medical Journal
Associates.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
heliox
EMTREE DRUG INDEX TERMS
epinephrine
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
childhood disease
croup (therapy)
patient transport
EMTREE MEDICAL INDEX TERMS
body temperature
body weight
breathing rate
child
clinical article
consciousness
controlled study
critically ill patient
cyanosis
disease severity
emergency care
female
heart rate
human
infant
intensive care unit
length of stay
lung clearance
male
medical history
nebulization
oxygen saturation
preschool child
priority journal
retrospective study
review
skin color
stridor
treatment duration
CAS REGISTRY NUMBERS
adrenalin (51-43-4, 55-31-2, 6912-68-1)
heliox (58933-55-4)
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2012244969
MEDLINE PMID
22541348 (http://www.ncbi.nlm.nih.gov/pubmed/22541348)
PUI
L364707582
DOI
10.1016/j.amj.2011.08.004
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2011.08.004
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 512
TITLE
Intrahospital transport of critically ill patients (excluding newborns)
recommendations of the Société de Réanimation de Langue Française (SRLF),
the Société Française d'Anesthésie et de Réanimation (SFAR), and the Société
Française de Médecine d'Urgence (SFMU)
AUTHOR NAMES
Quenot J.-P.
Milési C.
Cravoisy A.
Capellier G.
Mimoz O.
Fourcade O.
Gueugniaud P.-Y.
AUTHOR ADDRESSES
(Quenot J.-P., quenot@chu-dijon.fr) Service de Réanimation Médicale, CHU
Bocage Central Gabriel, 14 rue Paul Gaffarel, 21 079 Dijon, France.
(Milési C.) Service de Réanimation Pédiatrique, CHU Lapeyronie, 371 avenue
du doyen Gaston Giraud, 34 295 Montpelier, France.
(Cravoisy A.) Service de Réanimation Médicale, CHU Hôpital Central, 29,
avenue du Maréchal de Lattre de Tassigny, 54 035 Nancy, France.
(Capellier G.) Service de Réanimation Médicale, CHU Hôpital Jean Minjoz, 3,
Boulevard Fleming, 25 000 Besançon, France.
(Mimoz O.) Service d'Anesthésie Réanimation, CHU de la Milétrie, 2 rue de la
Milétrie, 86 021 Poitiers, France.
(Fourcade O.) Pôle Anesthesie Réanimation, CHU pavillon urgences et
réanimation, Hôpital Purpan, place du Docteur Baylac, 31 059 Toulouse,
France.
(Gueugniaud P.-Y.) Service Aide Médicale Urgente, CHU hospices civils, 162,
avenue Lacassagne, 69 003 Lyon, France.
CORRESPONDENCE ADDRESS
J.-P. Quenot, Service de Réanimation Médicale, CHU Bocage Central Gabriel,
14 rue Paul Gaffarel, 21 079 Dijon, France. Email: quenot@chu-dijon.fr
SOURCE
Annals of Intensive Care (2012) 2:1 (1-6). Date of Publication: 2012
ISSN
2110-5820 (electronic)
BOOK PUBLISHER
Springer Verlag, Tiergartenstrasse 17, Heidelberg, Germany.
ABSTRACT
Critically ill adult patients often require multiple examinations in the
hospital and need transport from one department to another, or even between
hospitals. However, to date, no guidelines exist regarding optimum practices
for transport of these fragile patients. We present recommendations for
intrahospital transport of critically ill patients, excluding newborns,
developed by an expert group of the French-Language Society of Intensive
Care (Société de Réanimation de Langue Française (SRLF), the Société
Française d'Anesthésie et de Réanimation (SFAR), and the Société Française
de Médecine d'Urgence (SFMU). The recommendations cover five fields of
application: epidemiology of adverse events; equipment, monitoring, and
maintenance; preparation of patient before transport; human resources and
training for caregivers involved in transport processes; and guidelines for
planning, structure, and traceability of transport processes. © 2012 Quenot
et al.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
patient transport
EMTREE MEDICAL INDEX TERMS
caregiver
human
intensive care unit
patient monitoring
practice guideline
priority journal
review
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2012220900
PUI
L364638386
DOI
10.1186/2110-5820-2-1
FULL TEXT LINK
http://dx.doi.org/10.1186/2110-5820-2-1
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 513
TITLE
Neuroradiological pattern of peripartum cerebro vascular disease medicating
transfer to determine care unit
ORIGINAL (NON-ENGLISH) TITLE
Aspects neuroradiologiques de la pathologie vasculaire cérébrale du
peripartum nécessitant un transfert en milieu de reanimation
AUTHOR NAMES
Lakhdar R.
Baffoun N.
Hammami N.
Nagi S.
Baccar K.
Drissi S.
Kaddour C.
AUTHOR ADDRESSES
(Lakhdar R.) Service de cardiologie, CHU La Rabta, Tunisia.
(Baffoun N.; Baccar K.; Kaddour C.) Service d'anesthésie et de réanimation,
Institut national de neurologie de Tunis, Tunisia.
(Hammami N.; Nagi S.; Drissi S.) Service de radiologie, Institut national de
neurologie de Tunis Faculté de médecine de Tunis, Université de Tunis El
Manar, Tunisia.
CORRESPONDENCE ADDRESS
R. Lakhdar, Service de cardiologie, CHU La Rabta, Tunisia.
SOURCE
Tunisie Medicale (2012) 90:3 (223-232). Date of Publication: 2012
ISSN
0041-4131
BOOK PUBLISHER
Maison du Medicine, 16 rue de Touraine, Tunis Belvedere, Tunisia.
ABSTRACT
Background: Pregnancy and puerperium are considered a period of a high risk
of stroke responsible in a part of the morbidity and mortality in women.
Imaging is the pivotal tool to diagnostics and care. Aim: To investigate the
clinical and imaging features cerebrovascular complications during pregnancy
and in post partum period. Methods: We report a retrospective analysis of
forty four patients (November 2002 - October 2010) admitted in the intensive
car department of the national institute of neurology for cerebro-vascular
complications during pregnancy and in post partum period. Results:
Cerebro-vascular imaging modalities included cerebral computed tomography
(CCT) with and without contrast in 94% of cases, magnetic resonance imaging
(MRI) in 30.6% of cases completed by venous angiography MRI in 27.2% of
cases and angiography MRI of Willis polygon in 11.3% of cases and by
cerebral angiography in 13.6% of cases. Posterior reversible encephalopathy
syndrome (PRES) is diagnosed in 61.4% of cases followed by meningo-cerebral
haemorrhage (MCH) in 29.5% and finally cerebral venous thrombosis (CVT) and
arterial ischemia in 4.5% of cases each one. The cerebro-vascular
complications are revelled in 86.3% of the cases during the postpartum and
were associated with the eclampsia or preeclampsia in 90.9% of the cases
(n=40). CCT showed typical lesions of PRES in 23 patients. It confirms the
presence of hematoma in the 13 patients with MCH and find hypodense lesion
in one case with ischemic stroke. CCT show direct (delta sign) and indirect
signs of CVT. MRI confirms the diagnostic of PRES, when done (11 of 12
cases) and show cortical sub cortical hyper signal on T2 and FLAIR and hypo
signal on T1 sequences. MRI was normal in one case. It shows hemorrhagic
lesion in the 2 cases of MCH, thrombosis in the cases of CVT and ischemic
lesion in the cases of ischemic stroke. CCT and MRI done within 48 hours
from admission were decisive for early diagnostic and for fast and adequate
care. Conclusion: Early recognition of stroke in peri partum by cerebral
imaging is of paramount importance for prompt diagnosis and treatment to
improve maternal morbidity and mortality.
EMTREE DRUG INDEX TERMS
contrast medium
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cerebrovascular disease (diagnosis)
EMTREE MEDICAL INDEX TERMS
article
brain angiography
brain hemorrhage (diagnosis)
brain ischemia (diagnosis)
cerebral computed tomography
cerebral sinus thrombosis (diagnosis)
clinical article
computer assisted tomography
disease association
eclampsia
female
human
intensive care unit
meningo cerebral hemorrhage (diagnosis)
nuclear magnetic resonance imaging
perinatal period
phlebography
posterior reversible encephalopathy syndrome
preeclampsia
EMBASE CLASSIFICATIONS
Neurology and Neurosurgery (8)
Radiology (14)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English, French
LANGUAGE OF SUMMARY
English, French
EMBASE ACCESSION NUMBER
2012205595
MEDLINE PMID
22481194 (http://www.ncbi.nlm.nih.gov/pubmed/22481194)
PUI
L364596309
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 514
TITLE
Handover patterns: an observational study of critical care physicians.
AUTHOR NAMES
Ilan R.
LeBaron C.D.
Christianson M.K.
Heyland D.K.
Day A.
Cohen M.D.
AUTHOR ADDRESSES
(Ilan R.) Department of Medicine and Critical Care Program, Queen's
University, Kingston General Hospital, Etherington Hall, Kingston, ON,
Canada, K7L 3N6.
(LeBaron C.D.; Christianson M.K.; Heyland D.K.; Day A.; Cohen M.D.)
CORRESPONDENCE ADDRESS
R. Ilan, Department of Medicine and Critical Care Program, Queen's
University, Kingston General Hospital, Etherington Hall, Kingston, ON,
Canada, K7L 3N6. Email: ilanr@kgh.kari.net
SOURCE
BMC health services research (2012) 12 (11). Date of Publication: 2012
ISSN
1472-6963 (electronic)
ABSTRACT
Handover (or 'handoff') is the exchange of information between health
professionals that accompanies the transfer of patient care. This process
can result in adverse events. Handover 'best practices', with emphasis on
standardization, have been widely promoted. However, these recommendations
are based mostly on expert opinion and research on medical trainees. By
examining handover communication of experienced physicians, we aim to inform
future research, education and quality improvement. Thus, our objective is
to describe handover communication patterns used by attending critical care
physicians in an academic centre and to compare them with currently popular,
standardized schemes for handover communication. Prospective, observational
study using video recording in an academic intensive care unit in Ontario,
Canada. Forty individual patient handovers were randomly selected out of 10
end-of-week handover sessions of attending physicians. Two coders
independently reviewed handover transcripts documenting elements of three
communication schemes: SBAR (Situation, Background, Assessment,
Recommendations); SOAP (Subjective, Objective, Assessment, Plan); and a
standard medical admission note. Frequency and extent of questions asked by
incoming physicians were measured as well. Analysis consisted of descriptive
statistics. Mean (± standard deviation) duration of patient-specific
handovers was 2 min 58 sec (± 57 sec). The majority of handovers' content
consisted of recent and current patient status. The remainder included
physicians' interpretations and advice. Questions posed by the incoming
physicians accounted for 5.8% (± 3.9%) of the handovers' content. Elements
of all three standardized communication schemes appeared repeatedly
throughout the handover dialogs with no consistent pattern. For example,
blocks of SOAP's Assessment appeared 5.2 (± 3.0) times in patient handovers;
they followed Objective blocks in only 45.9% of the opportunities and
preceded Plan in just 21.8%. Certain communication elements were
occasionally absent. For example, SBAR's Recommendation and admission note
information about the patient's Past Medical History were absent from 22
(55.0%) and 20 (50.0%), respectively, of patient handovers. Clinical
handover practice of faculty-level critical care physicians did not conform
to any of the three predefined structuring schemes. Further research is
needed to examine whether alternative approaches to handover communication
can be identified and to identify features of high-quality handover
communication.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
clinical practice
intensive care
interpersonal communication
patient care
patient transport
EMTREE MEDICAL INDEX TERMS
article
Canada
comparative study
health services research
human
intensive care unit
prospective study
standard
time
university hospital
videorecording
LANGUAGE OF ARTICLE
English
MEDLINE PMID
22233877 (http://www.ncbi.nlm.nih.gov/pubmed/22233877)
PUI
L364592201
DOI
10.1186/1472-6963-12-11
FULL TEXT LINK
http://dx.doi.org/10.1186/1472-6963-12-11
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 515
TITLE
Medical transport of children with complex chronic conditions
AUTHOR NAMES
Lerner C.F.
Kelly R.B.
Hamilton L.J.
Klitzner T.S.
AUTHOR ADDRESSES
(Lerner C.F., clerner@mednet.ucla.edu; Kelly R.B., rkelly@mednet.ucla.edu;
Hamilton L.J., lhamilton@mednet.ucla.edu; Klitzner T.S.,
tklitzner@mednet.ucla.edu) Department of Pediatrics, Mattel Children's
Hospital UCLA, David Geffen School of Medicine at UCLA, Los Angeles, CA
90095, United States.
CORRESPONDENCE ADDRESS
C.F. Lerner, Department of Pediatrics, Mattel Children's Hospital UCLA,
David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, United
States. Email: clerner@mednet.ucla.edu
SOURCE
Emergency Medicine International (2012) 2012 Article Number: 837020. Date of
Publication: 2012
ISSN
2090-2840
2090-2859 (electronic)
BOOK PUBLISHER
Hindawi Publishing Corporation, 410 Park Avenue, 15th Floor, 287 pmb, New
York, United States.
ABSTRACT
One of the most notable trends in child health has been the increase in the
number of children with special health care needs, including those with
complex chronic conditions. Care of these children accounts for a growing
fraction of health care resources. We examine recent developments in health
care, especially with regard to medical transport and prehospital care, that
have emerged to adapt to this remarkable demographic trend. One such
development is the focus on care coordination, including the dissemination
of the patient-centered medical home concept. In the prehospital setting,
the need for greater coordination has catalyzed the development of the
emergency information form. Training programs for prehospital providers now
incorporate specific modules for children with complex conditions. Another
notable trend is the shift to a family-centered model of care. We explore
efforts toward regionalization of care, including the development of
specialized pediatric transport teams, and conclude with recommendations for
a research agenda. © 2012 Carlos F. Lerner et al.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
childhood disease
chronic disease
patient transport
EMTREE MEDICAL INDEX TERMS
artificial heart pacemaker
cardiopulmonary arrest
central venous catheter
cerebrospinal fluid shunting
child
child health care
congenital heart disease
education program
emergency care
emergency health service
family centered care
feeding apparatus
genetic disorder
health care need
health care system
hospital admission
human
hypotension
intensive care unit
length of stay
long term care
medical education
medical technology
occupational therapist
pediatric advanced life support
pharmacist
physical medicine
physician
physiotherapist
primary medical care
priority journal
pulse oximeter
rescue personnel
residency education
resource management
respiratory therapist
review
stomach tube
tracheostomy
United States
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2012186910
PUI
L364535512
DOI
10.1155/2012/837020
FULL TEXT LINK
http://dx.doi.org/10.1155/2012/837020
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 516
TITLE
Air Transported Pediatric Rescue Extracorporeal Membrane Oxygenation: A
Single Institutional Review
AUTHOR NAMES
Horne D.
Lee J.J.
Maas M.
Divekar A.
Kesselman M.
Drews T.
Veroukis S.
Hancock B.J.
Hiebert B.
Cronin G.
Soni R.
AUTHOR ADDRESSES
(Horne D., drhorne@shaw.ca; Lee J.J.; Maas M.) Department of Surgery,
Cardiac Surgery, University of Manitoba, Paediatrics and Child Health,
Winnipeg, MB, Canada.
(Divekar A.; Soni R.) Department of Surgery, Cardiology, University of
Manitoba, Paediatrics and Child Health, Winnipeg, MB, Canada.
(Kesselman M.; Drews T.; Veroukis S.) Department of Surgery, Intensive Care,
University of Manitoba, Paediatrics and Child Health, Winnipeg, MB, Canada.
(Hancock B.J.; Hiebert B.) Department of Surgery, Paediatric Surgery,
University of Manitoba, Paediatrics and Child Health, Winnipeg, MB, Canada.
(Cronin G.) Department of Surgery, Quality and Decision Support, University
of Manitoba, Paediatrics and Child Health, Winnipeg, MB, Canada.
CORRESPONDENCE ADDRESS
D. Horne, Cardiac Surgery program, St. Boniface General Hospital, 3500-9,
409 Tache Ave., Winnipeg, MB R2H 2A6, Canada. Email: drhorne@shaw.ca
SOURCE
World Journal for Pediatric and Congenital Hearth Surgery (2012) 3:2
(236-240). Date of Publication: April 2012
ISSN
2150-1351
2150-136X (electronic)
BOOK PUBLISHER
SAGE Publications Inc., 2455 Teller Road, Thousand Oaks, United States.
ABSTRACT
Background: Pediatric extracorporeal membrane oxygenation (ECMO) programs
are sophisticated endeavors usually found only in high-volume cardiac
surgical programs. Worldwide, many cardiology programs do not have on-site
pediatric cardiac surgery expertise. Our single-center experience shows that
an organized multidisciplinary rescue-ECMO program, in collaboration with an
accepting facility, can achieve survival rates comparable to modern era
on-site ECMO. Methods: A retrospective review was conducted of all patients
initiated on rescue-ECMO from 2004 to 2009 in a single academic pediatric
hospital without a pediatric cardiac surgery program. All aspects of ECMO
were formalized using Failure Mode Effects Analysis. Results: Eight patients
were initially cannulated for ECMO at our institution. Six were subsequently
transported by air to the receiving facility 1,305 km away. Extracorporeal
membrane oxygenation was initiated in 0.2% of our Pediatric Intensive Care
Unit admissions and in 0.52% of all our pediatric cardiac patients. Mean age
was 4.0 years (7 weeks to 15 years). Indications for ECMO initiations were
cardiogenic shock (n = 5) and acute respiratory distress syndrome (n = 3).
Six had veno-arterial- and two had veno-veno ECMO. Two patients were not
transported (one death and one weaned locally). Six patients were
successfully transported within 2 to 24 hours, with a survival to hospital
discharge rate of 67% (four of six). Median total time on ECMO was 5.5 days.
Complication rate was 50% (4/8). Conclusions: Our rescue-ECMO survival
results were comparable to that of current published results from
established pediatric ECMO programs. Air transport of ECMO patients can be
performed safely using an organized multidisciplinary team approach. © World
Society for Pediatric and Congential Heart Surgery 2012.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
extracorporeal oxygenation
patient transport
rescue personnel
EMTREE MEDICAL INDEX TERMS
adolescent
adult respiratory distress syndrome (therapy)
application site bleeding (complication)
application site infection (complication)
article
brain hemorrhage (complication)
cannulation
cardiac patient
cardiogenic shock (therapy)
child
clinical article
controlled study
health program
hospital discharge
human
infant
intensive care unit
patient safety
pediatric hospital
portal vein thrombosis (complication)
preschool child
priority journal
retrospective study
school child
survival rate
treatment duration
treatment indication
treatment outcome
veno arterial extracorporeal oxygenation
veno veno extracorporeal oxygenation
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Cardiovascular Diseases and Cardiovascular Surgery (18)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2012469568
PUI
L365403081
DOI
10.1177/2150135111428627
FULL TEXT LINK
http://dx.doi.org/10.1177/2150135111428627
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 517
TITLE
Evaluation of the bedside pediatric early warning system score for pediatric
placement after inter-facility transports
AUTHOR NAMES
Keyes J.
Yen K.
Meyer M.
Gorelick M.
AUTHOR ADDRESSES
(Keyes J.; Meyer M.; Gorelick M.) Medical College of Wisconsin, Milwaukee,
United States.
(Yen K.) UT Southwestern Medical Center, Dallas, United States.
CORRESPONDENCE ADDRESS
J. Keyes, Medical College of Wisconsin, Milwaukee, United States.
SOURCE
Academic Emergency Medicine (2012) 19 SUPPL. 1 (S349). Date of Publication:
April 2012
CONFERENCE NAME
2012 Annual Meeting of the Society for Academic Emergency Medicine, SAEM
2012
CONFERENCE LOCATION
Chicago, IL, United States
CONFERENCE DATE
2012-05-09 to 2012-05-12
ISSN
1069-6563
BOOK PUBLISHER
Blackwell Publishing Ltd
ABSTRACT
Background: The Bedside Pediatric Early Warning System (BPEWS) score is a
pediatric assessment tool that combines seven clinical measurements for the
assessment of severity of illness. This tool has been shown to be effective
in identifying sick children in the hospital setting. The effectiveness of
this tool in identifying pediatric patients undergoing inter-facility
transport that require critical care placement has not been evaluated.
Objectives: We hypothesize that children with higher BPEWS scores are more
likely to be admitted to the pediatric intensive care unit (PICU) or
emergency department (ED) than the general pediatric unit. Methods: A random
sample of pediatric patients transported by the Children's Hospital of
Wisconsin (CHW) Transport Team during a one-year period were assessed. All
patient transports to the neonatal intensive care unit and all patients with
tracheostomies who were admitted to the PICU according to placement
protocols were excluded. Data were collected utilizing a retrospective chart
review and included the components of the BPEWS score (heart rate,
respiratory rate, systolic blood pressure, oxygen saturation, oxygen
therapy, respiratory effort, and capillary refill time) at two different
time points during the transport: when the transport team arrived at the
outside facility, and again when the transport team arrived at CHW.
Mann-Whitney test was used to compare the BPEWS scores at each time point
with patient placement to PICU, ED, or general inpatient unit. Results: Data
have been collected for 144 patients. Overall, 36% were admitted to the
PICU, 32% to the ED, and 32% to the floor. Forty percent are female.
Significant differences were found in BPEWS scores based on site of
admission. For the initial time point (team arrival at outside facility),
scores for PICU, ED, and general inpatient unit were 7.63, 3.26, and 4.59,
respectively (p < 0.001). The final time point (team arrival at CHW) BPEWS
scores were 6.94, 2.65, and 3.65, respectively (p < 0.001). Conclusion: The
BPEWS score, measured at two time points in the transport process, is
associated with site of admission. The highest scores are seen for patients
admitted to the PICU and the lowest for those admitted to the ED. Logistic
regression with ROC curves is planned to determine the optimal BPEWS score
to discriminate placement in the PICU compared to the general inpatient
unit.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency medicine
society
EMTREE MEDICAL INDEX TERMS
breathing rate
capillary
child
diseases
emergency ward
female
heart rate
hospital
hospital patient
human
intensive care
intensive care unit
logistic regression analysis
medical record review
newborn intensive care
oxygen saturation
oxygen therapy
patient
patient transport
pediatric hospital
pediatric ward
random sample
rank sum test
receiver operating characteristic
systolic blood pressure
tracheostomy
United States
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70745826
DOI
10.1111/j.1553-2712.2012.01332.x
FULL TEXT LINK
http://dx.doi.org/10.1111/j.1553-2712.2012.01332.x
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 518
TITLE
Comparison of door to balloon times in patients presenting directly or
transferred to a regional heart center with STEMI
AUTHOR NAMES
Ehlers J.
Wurstle A.V.
Gruberg L.
Singer A.J.
AUTHOR ADDRESSES
(Ehlers J.; Wurstle A.V.; Gruberg L.; Singer A.J.) Stony Brook University,
Stony Brook, United States.
CORRESPONDENCE ADDRESS
J. Ehlers, Stony Brook University, Stony Brook, United States.
SOURCE
Academic Emergency Medicine (2012) 19 SUPPL. 1 (S104-S105). Date of
Publication: April 2012
CONFERENCE NAME
2012 Annual Meeting of the Society for Academic Emergency Medicine, SAEM
2012
CONFERENCE LOCATION
Chicago, IL, United States
CONFERENCE DATE
2012-05-09 to 2012-05-12
ISSN
1069-6563
BOOK PUBLISHER
Blackwell Publishing Ltd
ABSTRACT
Background: Based on the evidence, a door-to-balloon- TIME (DTBT) of less
than 90 minutes is recommended by the AHA/ACC for patients with STEMI. In
many regions, patients with STEMI are transferred to a regional heart center
for percutaneous coronary intervention (PCI). Objectives: We compared DTBT
for patients presenting directly to a regional heart center with those for
patients transferred from other regional hospitals. We hypothesized that
DTBT would be significantly longer for transferred patients. Methods: Study
Design-Retrospective medical record review. Setting-Academic ED at a
regional heart center with an annual census of 80,000 that includes a
catchment area of 12 hospitals up to 50 miles away. Patients-Patients with
acute STEMI identified on ED 12-lead ECG. Measures-Demographic and clinical
data including time from triage to ECG, from ECG to activation of regional
catheterization lab, and from initial triage to PCI (DTBT). Outcomes-Median
DTBT and percentage of patients with a DTBT under 90 minutes. Data Analysis-
Median DTBT compared with Mann Whitney U tests and proportions compared with
chi-square tests. Results: In 2010 there were 379 catheterization lab
activations for STEMI: 183 were in patients presenting directly, and 196 in
transferred patients. Thrombolytics were administered in 19 (9.7%)
transfers. Compared with patients presenting directly to the heart center,
transferred patients had longer median [IQR] DTBT (127 [105-151] vs. 64
[49-80]; P < 0.001). Transferred patients also had longer door to ECG (9
[5-18] vs. 5 [2-8]; P < 0.001) and ECG to catheterization lab activation
times (18 [12-38] vs. 8 [4-17]; P < 0.001). The percentages of patients with
a DTBT within 90 minutes in direct and transfer patients were 83% vs. 17%; P
< 0.001. Conclusion: Most patients transferred to a regional heart center do
not meet national DTBT guidelines. Consideration should be given to
administering thrombolytics in transfer patients, especially if the
transport time is prolonged.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
coronary care unit
emergency medicine
human
patient
society
ST segment elevation myocardial infarction
EMTREE MEDICAL INDEX TERMS
catchment
catheterization
chi square test
clinical study
data analysis
electrocardiogram
emergency health service
hospital
medical record review
percutaneous coronary intervention
population research
rank sum test
study design
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70745357
DOI
10.1111/j.1553-2712.2012.01332.x
FULL TEXT LINK
http://dx.doi.org/10.1111/j.1553-2712.2012.01332.x
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 519
TITLE
Identifying the patient at risk-when to rapidly transfer to the intensive
care unit?
AUTHOR NAMES
Mégarbane B.
AUTHOR ADDRESSES
(Mégarbane B.) Department of Medical and Toxicological Critical Care, INSERM
U705, Paris-Diderot University, Paris, France.
CORRESPONDENCE ADDRESS
B. Mégarbane, Department of Medical and Toxicological Critical Care, INSERM
U705, Paris-Diderot University, Paris, France.
SOURCE
Clinical Toxicology (2012) 50:4 (274-275). Date of Publication: April 2012
CONFERENCE NAME
2012 International Congress of the European Association of Poisons Centres
and Clinical Toxicologists, EAPCCT 2012
CONFERENCE LOCATION
London, United Kingdom
CONFERENCE DATE
2012-05-25 to 2012-06-01
ISSN
1556-3650
BOOK PUBLISHER
Informa Healthcare
ABSTRACT
Background: Poisonings represent one of the first causes of admission to the
emergency room. Due to the significant morbidities and mortality that may
result from overdoses, transfer to the intensive care unit (ICU) should
sometimes be mandatory. Our objective was to identify clinical criteria
indicating ICU transfer. Methods: Review of published data on severity
criteria of poisoning and analysis of their pertinence in helping physicians
in the emergency room (ER) to identify patients at risk requiring ICU
transfer. Results: Poisoning should be considered as severe and transferred
to the ICU if: (i) close monitoring is required in relation to a significant
drug exposure; (ii) life-threatening symptoms occur including loss of
consciousness, respiratory, and circulatory failure; (iii) the patient
appears more vulnerable to the drug e.g. if presenting specific morbidities
or chronic organ insufficiencies.(1) Poisoning features could result either
from the direct effects of the drug or from non-specific complications (like
aspiration pneumonia with a psychotropic drug or anoxic encephalopathy with
cardiotoxicant-induced severe collapse). Absence of severe symptoms on
hospital admission does not necessarily mean no severe poisoning. Thus,
assessing poisoning severity should not only rely on the routine criteria of
severity and organ failure used in critical medicine but also include
prognosticators, mainly in the case of exposure to substances resulting in
organ injuries. Risk evaluation should take into account the dose, the
formulation (sustained release), the different co-ingestions (additive or
synergic effects), the delay in management since exposure, patient's medical
conditions, the possible active metabolites from the ingested toxicant, and
the possible occurrence of delayed symptoms. General scores (either
physiological scores like APACHE-I or II, SAPS-II or III, and SOFA scores as
well as specific poisoning scores like Poisoning Severity Score or Toxscore)
are interesting for retrospectively stratifying poisoned patients amongst a
study population but are quite limited for deciding at the individual level
for patient referral to the ICU. Regarding psychotropic drugs, there is no
clear relationship between the patient's Glasgow coma scale (GCS) score on
admission and his final prognosis. Decreased GCS score does not mandate
tracheal intubation in the emergency department.(2) The
alert/verbal/painful/unresponsive (AVPU) responsiveness scale provides a
rapid simple method of assessing consciousness level in most poisoned
patients except those intoxicated with alcohol.(3) In cardiotoxicant
overdose, occurrence of hypotension does not necessarily mean the presence
of circulatory failure and does not necessarily require catecholamine
administration. In contrast, in poisoned patients with a past history of
significant hypertension or advanced cardiac disease, apparently normal
values of blood pressure may be associated with progressive deterioration of
microcirculation that would either not be indentified, or recognized too
late in the emergency department. Thus, abnormal signs of microcirculation
resulting from hypotension should be assessed by regular monitoring in the
ICU, including low urine output, increased concentrations of plasma lactate,
serum creatinine and transaminases. We believe that any symptomatic patient
in relation to cardiotoxicant ingestion should therefore be transferred to
the ICU.(1) Prognosticators, including clinical, biological, ECG, and
analytical parameters are drug-specific. They are generally more often
identified based on retrospective approaches then prospectively assessed,
ideally using multicentre studies, if their specificity, sensitivity, and
predictive values appear interesting. Several prognosticators have been
determined regarding antidepressants, acetaminophen, aspirin, chloroquine,
colchicine, paraquat, corrosives and organophosphates. They may be helpful
in indicating ICU transfer. Some of them are immediately available as soon
as the patient is admitted to the ER. Others, based on specific assays (like
verapamil concentrations in verapamil poisonings(4)) or complicated
calculations (measurement of the terminal 40-millisecond frontal plane axis
in tricyclic antidepressant poisoning(5)), appear less useful as they are
not available in the majority of hospitals. Recently, in a case-control
study, Manini and colleagues reported the utility of serum lactate
concentration in the emergency room for predicting drug overdose fatalities,
identifying the optimal cutoff point to be 3.0 mmol/L with 84% sensitivity
and 75% specificity.(6) However, we assessed that the usefulness of serum
lactate in predicting beta-blocker-overdose fatality appears limited, due to
mild elevations despite extreme severity(7), highlighting the impossibility
of evaluating poisoning prognosis based on a unique measurement in the
emergency room. On the other hand, excessive admission in the ICU may also
result in non-useful expenses and limited bed availability. The patient's
low risk was assessed when none of the following criteria was present in the
emergency room(8) : need for intubation, seizures, unresponsiveness to
verbal stimuli, PaO(2) ≥ 45 mmHg, any rhythm except sinus, second- or
third-degree atrioventricular block, QRS ≥ 0.12 s or systolic pressure < 100
mmHg. In this study, of 151 low-risk patients, none developed a high-risk
condition after admission, and none required an intensive care intervention.
The use of these predictive criteria eliminated over half the intensive care
days without compromising quality of care. Conclusion: ICU transfer may be
mandatory if poisoned patients present with organ failure in order to set up
adequate monitoring and invasive symptomatic treatments if necessary.
Routinely available emergent prognosticators are required: they are
drug-dependent. In contrast, general scores have limited interests at the
individual level.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
poison
EMTREE DRUG INDEX TERMS
acetylsalicylic acid
alcohol
aminotransferase
antidepressant agent
beta adrenergic receptor blocking agent
catecholamine
chloroquine
colchicine
organophosphate
paracetamol
paraquat
psychotropic agent
tricyclic antidepressant agent
verapamil
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
human
intensive care unit
patient
risk
EMTREE MEDICAL INDEX TERMS
analytical parameters
APACHE
aspiration pneumonia
assay
blood pressure
brain disease
case control study
complete heart block
concentration (parameters)
consciousness
consciousness level
creatinine blood level
deterioration
drug exposure
drug overdose
electrocardiogram
emergency
emergency ward
endotracheal intubation
exposure
fatality
Glasgow coma scale
heart disease
hospital
hospital admission
hypertension
hypotension
ingestion
intensive care
intoxication
intubation
ischemia
lactate blood level
metabolite
microcirculation
monitoring
morbidity
mortality
multicenter study
normal value
organ injury
palliative therapy
patient referral
physician
population
predictive value
prognosis
rhythm
seizure
Sequential Organ Failure Assessment Score
Simplified Acute Physiology Score
sustained drug release
systolic blood pressure
urine volume
verbalization
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71197319
DOI
10.3109/15563650.2012.669957
FULL TEXT LINK
http://dx.doi.org/10.3109/15563650.2012.669957
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 520
TITLE
How many poisoned patients transported by emergency medical services
actually require hospital treatment?
AUTHOR NAMES
Amlin T.C.
Coffman S.A.
Morgan D.L.
Blair H.W.
AUTHOR ADDRESSES
(Amlin T.C.; Morgan D.L.) Emergency Department, Scott and White Memorial
Hospital, Temple, United States.
(Coffman S.A.) Texas A and M Health Science Center, Temple, United States.
(Morgan D.L.; Blair H.W.) Central Texas Poison Center, Temple, United
States.
CORRESPONDENCE ADDRESS
T.C. Amlin, Emergency Department, Scott and White Memorial Hospital, Temple,
United States.
SOURCE
Clinical Toxicology (2012) 50:4 (333-334). Date of Publication: April 2012
CONFERENCE NAME
2012 International Congress of the European Association of Poisons Centres
and Clinical Toxicologists, EAPCCT 2012
CONFERENCE LOCATION
London, United Kingdom
CONFERENCE DATE
2012-05-25 to 2012-06-01
ISSN
1556-3650
BOOK PUBLISHER
Informa Healthcare
ABSTRACT
Objective: Every year in the USA, emergency medical services (EMS) providers
respond to thousands of calls for toxic exposures. However, these emergency
providers have limited training in toxicology. Previous studies have
demonstrated that EMS providers may effectively use poison centers (PCs) to
determine those patients who do not require transportation to a hospital
emergency department (ED). Our goal was to retrospectively determine the
number of transported poisoned patients who did and who did not require
treatment at one hospital. Methods: This was a retrospective review of PC
charts of calls from Jan 2010 to Dec 2010. Inclusion criteria were (1) toxic
exposure, (2) patient transported by EMS to one large teaching hospital, and
(3) there was a call to a PC from a staff member at that hospital after the
patient arrived. A patient was determined to have required treatment if any
medical treatment (including activated charcoal) was administered in the ED
or the patient was admitted to the hospital for medical or psychiatric
treatment. Results: There were 193 PC charts that met the inclusion
criteria. The patients' ages ranged from 1 month to 69 years old. There were
over 50 different substance exposures, and 53% were intentional. Over half
(50.8%) were admitted, 41.5% were discharged home from the ED, and 7.8% left
against medical advice or disposition was unknown. Of those admitted to the
hospital, 39.8% were admitted to psychiatry, 36.7% went to the intensive
care unit (ICU), and 23.5% went to internal medicine. There was one death.
Of the 80 discharged home, 14 received some ED treatment. Therefore, 66
(34.1%) did not appear to require transportation to the hospital.
Conclusion: This is the first study of the disposition of poisoned patients
transported to an ED by EMS providers. This small study reveals that over
half are admitted to the hospital (many to the ICU). However, about
one-third of all transported poisoned patients may not require
transportation if a PC had been utilized at the scene. If some of these
patients could remain at the scene with PC follow-up, this could decrease
both pre-hospital and hospital resources.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
poison
EMTREE DRUG INDEX TERMS
activated carbon
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
hospital
human
patient
EMTREE MEDICAL INDEX TERMS
death
emergency
emergency ward
exposure
follow up
intensive care unit
internal medicine
poison center
psychiatric treatment
psychiatry
teaching hospital
therapy
toxicology
traffic and transport
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71197540
DOI
10.3109/15563650.2012.669957
FULL TEXT LINK
http://dx.doi.org/10.3109/15563650.2012.669957
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 521
TITLE
Factors affecting success of prehospital intubation in an air and land
critical care transport service: Results of a multivariate analysis
AUTHOR NAMES
MacDonald A.
MacDonald R.D.
Lee J.S.
AUTHOR ADDRESSES
(MacDonald A.) University of Toronto, Toronto, Canada.
(MacDonald R.D.) Ornge Transport Medicine, Mississauga, Canada.
(Lee J.S.) Sunnybrook Health Sciences Centre, Toronto, Canada.
CORRESPONDENCE ADDRESS
A. MacDonald, University of Toronto, Toronto, Canada.
SOURCE
Academic Emergency Medicine (2012) 19 SUPPL. 1 (S141-S142). Date of
Publication: April 2012
CONFERENCE NAME
2012 Annual Meeting of the Society for Academic Emergency Medicine, SAEM
2012
CONFERENCE LOCATION
Chicago, IL, United States
CONFERENCE DATE
2012-05-09 to 2012-05-12
ISSN
1069-6563
BOOK PUBLISHER
Blackwell Publishing Ltd
ABSTRACT
Background: Prehospital providers perform tracheal intubation in the
prehospital environment, and failed attempts are of concern due to the
danger of hypoxia and hypotension. Some question the appropriateness of
intubation in this setting due to the morbidity risk associated with
intubation in the field. Thus it is important to gain an understanding of
the factors that predict the success of prehospital intubation attempts to
inform this discussion. Objectives: To determine the factors that affect
success rates on first attempt of paramedic intubations in a rapid sequence
intubation (RSI) capable critical care transport service. Methods: We
conducted a multivariate logistic analysis on a prospectively collected
database of airway management from an air and land critical care transport
service that provides scene responses and interfacility transport in the
Province of Ontario. The study population includes all intubations performed
by flight paramedics from January 2006 to July 2009. The primary outcome is
success on first attempt. A list of potential factors predicting success was
obtained from a review of the literature and included age, sex, Glasgow Coma
Scale, location of intubation attempt, paralytics and sedation given, a
difficult airway prediction score, and type of call (trauma, medical, or
cardiac arrest). Results: Data from 549 intubations were analysed. The
success rate on first attempt at intubation was 317/549 (57.7%) and the
overall success rate was 87.4%. The mean age was 43.5 years and 69.4% were
male and 56.4% were trauma patients. Of these, 498 had complete data for all
predictive variables and were included in the multivariate analysis. The
factors that were found to be statistically significant were age per decade
(OR 1.12, CI 1.04-1.2), female sex (OR 1.5, CI 1.03-2.32), paralytics given
(OR 2.66, CI 1.5-4.7), and sedation given (OR 0.61, CI 0.41-0.91). This
model demonstrated a good fit (Hosmer Lemeshow = 8.906) with an AUC of
0.632. Conclusion: Use of a paralytic agent, age, and sex were associated
with increased success of intubation. The association of sedative use only
with decreased success of intubation was unexpected and may be due to
confounding related to the indications for sedation, such as patient
agitation. Our findings may have implications for RSI-capable paramedics and
require further study.
EMTREE DRUG INDEX TERMS
sedative agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency medicine
intensive care
intubation
multivariate analysis
society
EMTREE MEDICAL INDEX TERMS
agitation
airway
Canada
data base
endotracheal intubation
environment
female
flight
Glasgow coma scale
heart arrest
human
hypotension
hypoxia
injury
male
model
morbidity
patient
population
prediction
respiration control
sedation
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70745424
DOI
10.1111/j.1553-2712.2012.01332.x
FULL TEXT LINK
http://dx.doi.org/10.1111/j.1553-2712.2012.01332.x
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 522
TITLE
Risk factors for unplanned transfer to intensive care within 24 hours of
admission from the emergency department in an integrated health care system
AUTHOR NAMES
Delgado M.K.
Liu V.
Pines J.M.
Kipnis P.
Escobar G.J.
AUTHOR ADDRESSES
(Delgado M.K.) Stanford University, School of Medicine, Stanford, United
States.
(Liu V.; Kipnis P.; Escobar G.J.) Kaiser Permanente, Division of Research,
Oakland, United States.
(Pines J.M.) George Washington University, Washington, United States.
CORRESPONDENCE ADDRESS
M.K. Delgado, Stanford University, School of Medicine, Stanford, United
States.
SOURCE
Academic Emergency Medicine (2012) 19 SUPPL. 1 (S162). Date of Publication:
April 2012
CONFERENCE NAME
2012 Annual Meeting of the Society for Academic Emergency Medicine, SAEM
2012
CONFERENCE LOCATION
Chicago, IL, United States
CONFERENCE DATE
2012-05-09 to 2012-05-12
ISSN
1069-6563
BOOK PUBLISHER
Blackwell Publishing Ltd
ABSTRACT
Background: ED patients admitted to hospital wards who are subsequently
transferred to the intensive care unit (ICU) within 24 hours have higher
mortality than direct ICU admissions. Objectives: Describe risk factors for
unplanned transfer to the ICU within 24 hours of ward arrival from the ED.
Methods: Retrospective cohort analysis of all ED non- ICU admissions (N =
178,315) to 14 U.S. community hospitals from 2007-09. We tabulated patient
demographics, clinical characteristics, and hospital volume by the outcome
of unplanned ICU transfer. We present factors that were independently
associated with unplanned ICU transfer within 24 hours after adjusting for
patient and hospital differences in a multilevel mixed-effects logistic
regression model. Results: Of all ED non-ICU admissions, 4,252 (2.4%) were
transferred to the ICU within 24 hours. After adjusting for patient and
hospital differences, the top five admitting diagnoses associated with
unplanned transfer were: sepsis (odds ratio [OR] 2.6; 95% CI 2.1- 3.1),
catastrophic conditions (OR 2.3; 95% 1.9-2.8), pneumonia/acute respiratory
infections (OR 1.6; 95% CI 1.4-1.8), acute myocardial infarction (AMI) (OR
1.6; 95% CI 1.3-1.8), and chronic obstructive pulmonary disease (COPD) (OR
1.5; 95% CI 1.3-1.7). Other factors associated with unplanned transfer
included: male sex, Comorbidity Points Score (COPS) >145, Laboratory Acute
Physiology Score (LAPS) >7, and arriving on the ward between 11 PM-7 AM.
Decreased risk of unplanned transfer was found with admission to monitored
transitional care units vs. non-monitored wards (OR 0.86; 95% CI 0.80-0.96)
and admission to a high-volume vs. low-volume hospital (OR 0.73; 95% CI
0.59-0.89). Conclusion: ED patients admitted with respiratory conditions,
sepsis, AMI, multiple comorbidities, and abnormal lab results are at higher
risk for unplanned ICU transfer and may benefit from better inpatient triage
from the ED, earlier intervention to prevent acute decompensation, or closer
monitoring. More research is needed to determine how intermediate care
units, hospital volume, time of day, and sex affect risk of unplanned ICU
transfer.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency medicine
emergency ward
integrated health care system
intensive care
risk factor
society
EMTREE MEDICAL INDEX TERMS
acute heart infarction
chronic obstructive lung disease
cohort analysis
community hospital
comorbidity
diagnosis
emergency health service
hospital
hospital patient
human
intensive care unit
laboratory
logistic regression analysis
male
model
monitoring
mortality
patient
physiology
respiratory tract infection
risk
sepsis
United States
ward
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70745461
DOI
10.1111/j.1553-2712.2012.01332.x
FULL TEXT LINK
http://dx.doi.org/10.1111/j.1553-2712.2012.01332.x
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 523
TITLE
Evidence-based inpatient handovers: A literature review and research agenda
AUTHOR NAMES
Scott P.
Ross P.
Prytherch D.
AUTHOR ADDRESSES
(Scott P., Philip.scott@port.ac.uk; Ross P.; Prytherch D.) Centre for
Healthcare Modelling and Informatics, University of Portsmouth, Portsmouth,
United Kingdom.
CORRESPONDENCE ADDRESS
P. Scott, Centre for Healthcare Modelling and Informatics, University of
Portsmouth, Portsmouth, United Kingdom. Email: Philip.scott@port.ac.uk
SOURCE
Clinical Governance (2012) 17:1 (14-27). Date of Publication: 2012
ISSN
1477-7274
1758-6038 (electronic)
BOOK PUBLISHER
Emerald Group Publishing Ltd., Howard House, Wagon Lane, Bingley, United
Kingdom.
ABSTRACT
Purpose - The objective of this review is to address two research questions:
What is evidence-based best practice for intra-hospital inpatient handovers?
What areas need further research? The paper aims to take a particular
interest in the interpersonal skills involved in successful handover,
theoretically-based approaches to implementing improvements in handovers,
and whether there is sufficient data to construct an evaluation methodology.
Design/methodology/approach - The paper takes the form of a narrative
synthesis based on search of PubMed, CINAHL and the Cochrane Library.
Findings - A total of 82 papers, comprising 29 implementation studies, 13
conceptual models or improvement methods, five subject reviews and 35
background papers were identified. None of the studies met the normal
parameters of evidence-based medicine, but this is unsurprising for a
complex healthcare service intervention. Research limitations/implications -
Those papers published in English between 2000 and July 2010 that were
indexed in CINAHL, Medline or the Cochrane Library or found
opportunistically were the only ones to be reviewed. The authors did not
search any grey literature or hand-search any journals. Practical
implications - The evidence is sufficient to justify widespread adoption of
the guiding principles for inpatient handover best practice, provided that
concurrent evaluation is also undertaken. Originality/value - This is the
first comprehensive review published in the peer-reviewed literature that
examines the evidence base for the practice of inpatient handovers across
healthcare professions and specialties. © Emerald Group Publishing Limited.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
evidence based inpatient handovers
evidence based practice
good clinical practice
EMTREE MEDICAL INDEX TERMS
Cinahl
Cochrane Library
communication skill
health care access
health care delivery
health care quality
health service
human
information dissemination
medical information
medical research
medical specialist
Medline
paramedical personnel
patient care
patient education
patient information
patient referral
patient safety
patient transport
peer review
practice guideline
primary medical care
priority journal
responsibility
review
social support
teamwork
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2012090311
PUI
L364249453
DOI
10.1108/14777271211200710
FULL TEXT LINK
http://dx.doi.org/10.1108/14777271211200710
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 524
TITLE
Evolution of an incompatibility group IncA/C plasmid harboring bla (CMY-16)
and qnrA6 genes and its transfer through three clones of Providencia
stuartii during a two-year outbreak in a Tunisian burn unit
AUTHOR NAMES
Arpin C.
Thabet L.
Yassine H.
Messadi A.A.
Boukadida J.
Dubois V.
Coulange-Mayonnove L.
Andre C.
Quentina C.
AUTHOR ADDRESSES
(Arpin C., corinne.arpin@bacterio.u-bordeaux2.fr; Yassine H.; Dubois V.;
Coulange-Mayonnove L.; Andre C.; Quentina C.) Univ. Bordeaux, Microbiologie
Fondamentale et Pathogénicité, UMR 5234, Bordeaux, France.
(Thabet L.; Messadi A.A.) Hôpital Aziza Othmana, Tunis, Tunisia.
(Boukadida J.) Hôpital Universitaire Farhat Hached, Sousse, Tunisia.
CORRESPONDENCE ADDRESS
C. Arpin, Univ. Bordeaux, Microbiologie Fondamentale et Pathogénicité, UMR
5234, Bordeaux, France. Email: corinne.arpin@bacterio.u-bordeaux2.fr
SOURCE
Antimicrobial Agents and Chemotherapy (2012) 56:3 (1342-1349). Date of
Publication: March 2012
ISSN
0066-4804
1098-6596 (electronic)
BOOK PUBLISHER
American Society for Microbiology, 1752 N Street N.W., Washington, United
States.
ABSTRACT
During a 2-year period in 2005 and 2006, 64 multidrug-resistant Providencia
stuartii isolates, including 58 strains from 58 patients and 6 strains
obtained from the same tracheal aspirator, were collected in a burn unit of
a Tunisian hospital. They divided into four antibiotypes (ATB1 to ATB4) and
three SmaI pulsotypes (PsA to PsC), including 49 strains belonging to clone
PsA (48 of ATB1 and 1 of ATB4), 11 strains to clone PsB (7 of ATB2 and 4 of
ATB3), and 4 strains to clone PsC (ATB3). All strains, except for the
PsA/ATB4 isolate, were highly resistant to broad-spectrum cephalosporins due
to the production of the plasmidmediated CMY-16 β-lactamase. In addition,
the 15 strains of ATB2 and ATB3 exhibited decreased quinolone susceptibility
associated with QnrA6. Most strains (ATB1 and ATB3) were gentamicin
resistant, related to an AAC(6′)-Ib′ enzyme. All these genes were located on
a conjugative plasmid belonging to the incompatibility group IncA/C(2) of
195, 175, or 100 kb. Despite differences in size and in number of resistance
determinants, they derived from the same plasmid, as demonstrated by similar
profiles in plasmid restriction analysis and strictly homologous sequences
of repAIncA/C(2), unusual antibiotic resistance genes (e.g., aphA- 6), and
their genetic environments. Further investigation suggested that deletions,
acquisition of the ISCR1 insertion sequence, and integron cassette mobility
accounted for these variations. Thus, this outbreak was due to both the
spread of three clonal strains and the dissemination of a single IncA/C(2)
plasmid which underwent a remarkable evolution during the epidemic period.
Copyright © 2012, American Society for Microbiology. All Rights Reserved.
EMTREE DRUG INDEX TERMS
amikacin
cefepime
cefotaxime
cefoxitin
ceftazidime
cephalosporin
chloramphenicol
ciprofloxacin
clavulanic acid
cloxacillin
florfenicol
gentamicin
isepamicin
neomycin
netilmicin
norfloxacin
ofloxacin
spectinomycin
streptomycin
sulfonamide
tetracycline
ticarcillin
trimethoprim
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
nucleotide sequence
Providencia stuartii
EMTREE MEDICAL INDEX TERMS
antibiotic resistance
antibiotic sensitivity
article
bacterial gene
bacterial strain
burn unit
clone
epidemic
gene cassette
gene deletion
gene insertion sequence
gene transfer
genetic variability
human
integron
major clinical study
minimum inhibitory concentration
plasmid
priority journal
restriction mapping
CAS REGISTRY NUMBERS
amikacin (37517-28-5, 39831-55-5)
cefepime (88040-23-7)
cefotaxime (63527-52-6, 64485-93-4)
cefoxitin (33564-30-6, 35607-66-0)
ceftazidime (72558-82-8)
cephalosporin (11111-12-9)
chloramphenicol (134-90-7, 2787-09-9, 56-75-7)
ciprofloxacin (85721-33-1)
clavulanic acid (58001-44-8)
cloxacillin (61-72-3, 642-78-4)
florfenicol (73231-34-2)
gentamicin (1392-48-9, 1403-66-3, 1405-41-0)
isepamicin (58152-03-7)
neomycin (11004-65-2, 1404-04-2, 1405-10-3, 8026-22-0)
netilmicin (56391-56-1, 56391-57-2)
norfloxacin (70458-96-7)
ofloxacin (82419-36-1)
spectinomycin (1695-77-8, 21736-83-4, 23312-56-3)
streptomycin (57-92-1)
tetracycline (23843-90-5, 60-54-8, 64-75-5, 8021-86-1)
ticarcillin (29457-07-6, 34787-01-4, 4697-14-7)
trimethoprim (738-70-5)
MOLECULAR SEQUENCE NUMBERS
GENBANK (FJ855437, JN193566, JN193567, JN193568)
EMBASE CLASSIFICATIONS
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2012103086
MEDLINE PMID
22155825 (http://www.ncbi.nlm.nih.gov/pubmed/22155825)
PUI
L364279870
DOI
10.1128/AAC.05267-11
FULL TEXT LINK
http://dx.doi.org/10.1128/AAC.05267-11
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 525
TITLE
Design and evaluation of a multidisciplinary web-based handoff tool
AUTHOR NAMES
Schnipper J.
Karson A.
Morash S.
Glotzbecker B.
Milone M.
Raley D.Y.
Nolido N.
Horsky J.
Leinen L.
Bhan I.
Dankers C.
Church K.
Minahan J.
Yoon C.
AUTHOR ADDRESSES
(Schnipper J.; Glotzbecker B.; Milone M.; Raley D.Y.; Nolido N.; Horsky J.;
Church K.; Minahan J.; Yoon C.) Brigham and Women's Hospital, Boston, United
States.
(Karson A.; Morash S.; Bhan I.; Dankers C.) Massachusetts General Hospital,
Boston, United States.
(Leinen L.) Partners Health Care, Boston, United States.
CORRESPONDENCE ADDRESS
J. Schnipper, Brigham and Women's Hospital, Boston, United States.
SOURCE
Journal of Hospital Medicine (2012) 7 SUPPL. 2 (S11-S12). Date of
Publication: March 2012
CONFERENCE NAME
2012 Annual Meeting of the Society of Hospital Medicine, SHM 2012
CONFERENCE LOCATION
San Diego, CA, United States
CONFERENCE DATE
2012-04-01 to 2012-04-04
ISSN
1553-5592
BOOK PUBLISHER
Wiley Blackwell
ABSTRACT
Background: Failures in communication among healthcare personnel during
intrahospital handoffs in care are known threats to patient safety. In
August, 2009, our healthcare system held a multistakeholder summit on
handoffs, developed consensus around the need for a system-wide electronic
handoff tool, and recommended a pilot study to develop and evaluate this
technology. Methods: We adapted a web-based handoff tool used by a single
residency program. Enhancements to the existing tool included: (1) ability
to implement the tool at a second hospital in our system; (2) support for
simultaneous handoffs by nurses, residents/PAs, and attendings with shared
information among the different roles; (3) custom structured templates for
each user group; and (4) the ability to create progress notes and multiple
sign-out forms from the same core data. The tool was refined and tested on a
general medicine teaching service at one hospital and a hematologic
malignancy PA service at the other. For 3 months preintervention and 4
months postimplementation, we surveyed receivers of handoffs regarding
continuity of care and evaluated signout content using explicit criteria. We
also conducted formal usability testing using simulated cases. We conducted
principal components analysis to derive categories from the survey questions
and create composite scores for each category. Results: We received survey
responses from 315 clinicians (66% response rate). In a pre-post analysis,
two of five composite scores improved: perceived negative impact of handoff
on clinical information and decision-making (composite score 14.7 pre, 10.2
post, p = 0.01), and negative subjective rating of handoff quality and
accuracy (28.4 vs 25.8, p = 0.01). Among survey questions to nurses, 10
improved, including an increase in how well handoffs prepared them for
things that might go wrong (47.3 vs 65.2, p = 0.01). In the explicit review
of written sign-outs, inclusion of five data elements (e.g., % tasks with
if/then statements) increased, but decreases were noted in other data
elements. Usability testing revealed a tension between desire for a clinical
narrative and the use of structured template fields. Conclusions: A
multidisciplinary, webbased sign-out tool was able to increase subjective
measures of sign-out quality and impact on clinical decision-making,
particularly among nurses. Much of the improvement may have come from the
ability to produce both a progress note and sign-out with one tool, which
led to more frequent updating of sign-outs and greater faith in their
accuracy. The use of customized “templated” fields was inconsistent and
suggests that these should be minimized to those most necessary for
continuity of care. Greater improvements in care may require further
enhancements in usability of the tool, training in use of the tool, and
education in best practices in handoffs in care.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital
society
EMTREE MEDICAL INDEX TERMS
clinical decision making
consensus
decision making
education
general practice
health care personnel
health care system
hematologic malignancy
human
interpersonal communication
narrative
nurse
patient care
patient safety
pilot study
principal component analysis
teaching
technology
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70698008
DOI
10.1002/jhm.1927
FULL TEXT LINK
http://dx.doi.org/10.1002/jhm.1927
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 526
TITLE
Recognition of infantile botulism: A case illustrating the importance of
rapid reassessment after hospital transfers
AUTHOR NAMES
Trost M.
AUTHOR ADDRESSES
(Trost M.) Children's Hospital Los Angeles, Los Angeles, United States.
CORRESPONDENCE ADDRESS
M. Trost, Children's Hospital Los Angeles, Los Angeles, United States.
SOURCE
Journal of Hospital Medicine (2012) 7 SUPPL. 2 (S269-S270). Date of
Publication: March 2012
CONFERENCE NAME
2012 Annual Meeting of the Society of Hospital Medicine, SHM 2012
CONFERENCE LOCATION
San Diego, CA, United States
CONFERENCE DATE
2012-04-01 to 2012-04-04
ISSN
1553-5592
BOOK PUBLISHER
Wiley Blackwell
ABSTRACT
Case Presentation: A 7-month-old Caucasian male was admitted to a hospital
in central California due to complaints of poor feeding. There was remote
history of choking on a plastic bead which was removed by mother. Five days
prior to admission he was noted to have difficulty biopsy showing malignant
cells. breastfeeding and decreased activity. Family denied fever and
endorsed constipation. They had recently moved to a new house in a rural
area near a large corn field. The patient and siblings were unimmunized.
Initially there was concern for retained foreign body or retropharyngeal
abscess. He received neck radiographs and CT scan which were normal. Lab
work showed a mild leukocytosis and elevated platelet count. He was started
on broad spectrum antibiotics but developed new respiratory distress. At
this point there was also concern for atypical infection such as
epiglottitis or diphtheria given his unimmunized status. He was transferred
to our tertiary care facility for further evaluation. His initial exam was
significant for ptosis, hypotonia, and difficulty handling secretions.
Shortly after arrival the patient had an episode of apnea and bradycardia
that required chest compressions, intubation, and transfer to the intensive
care unit. Due to history and physical exam, we suspected botulism. He
received one dose of baby botulism immune globulin (baby BIG) and stool was
positive for botulism toxin type A. The patient improved, was extubated
after 8 days, and was feeding well with good muscle strength at the time of
discharge. Discussion: Infantile botulism occurs when an infant ingests
Clostridium botulinum spores which germinate in the intestinal tract and
release neurotoxins that block acetylcholine release. It is a rare disorder
with an average of 71 cases per year in the United States, of which half
occur in California. Recognized risk factors are exposure to honey or soil.
Clinical diagnosis is based on classic findings of constipation, hypotonia,
and a weak cry. Definitive diagnosis requires indirect detection of toxin in
stool, which is done only by state health departments or the CDC and can
take several days. Electromyogram studies also support the diagnosis, but
can be normal in early disease. Treatment is therefore often initiated based
on clinical suspicion alone. Baby BIG should be given as soon as possible to
inactivate unbound toxin. Most patients have prolonged hospital stays
requiring intubation and intensive supportive care. Infant botulism has also
been implicated in cases of Sudden Infant Death Syndrome. Prognosis is
generally good if the disease is recognized. Conclusions: This case
illustrates how infantile botulism is often confused with other diagnoses.
When accepting transferred patients, hospitalists must reassess patients and
reconsider the differential diagnosis. An up to date literature review is
presented to improve recognition and patient outcomes.
EMTREE DRUG INDEX TERMS
antibiotic agent
botulinum antiserum
botulinum toxin
neurotoxin
plastic
toxin
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
botulism
hospital
society
EMTREE MEDICAL INDEX TERMS
acetylcholine release
apnea
baby
bacterial spore
biopsy
bodily secretions
bradycardia
cancer cell
Caucasian
Clostridium botulinum
compression
computer assisted tomography
constipation
diagnosis
differential diagnosis
diphtheria
diseases
electromyogram
epiglottitis
exposure
feeding
female
fever
foreign body
honey
hospitalization
human
infant
infection
intensive care unit
intestine
intubation
leukocytosis
male
medical staff
mother
muscle hypotonia
muscle strength
neck
patient
platelet count
prognosis
ptosis
public health service
respiratory distress
retropharyngeal abscess
risk factor
rural area
sibling
soil
sudden infant death syndrome
tertiary health care
thorax
United States
X ray film
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70698428
DOI
10.1002/jhm.1927
FULL TEXT LINK
http://dx.doi.org/10.1002/jhm.1927
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 527
TITLE
Pilot implementation of a perioperative protocol to guide operating
room-to-intensive care unit patient handoffs
AUTHOR NAMES
Petrovic M.A.
Aboumatar H.
Baumgartner W.A.
Ulatowski J.A.
Moyer J.
Chang T.Y.
Camp M.S.
Kowalski J.
Senger C.M.
Martinez E.A.
AUTHOR ADDRESSES
(Petrovic M.A., rpetrov@jhmi.edu; Aboumatar H.; Baumgartner W.A.; Ulatowski
J.A.; Chang T.Y.; Camp M.S.; Kowalski J.; Senger C.M.; Martinez E.A.) Johns
Hopkins University, School of Medicine, Tower 711, 600 North Wolfe Street,
Baltimore, MD 21287, United States.
(Moyer J.) Johns Hopkins Hospital, Baltimore, MD, United States.
(Martinez E.A.) Department of Anesthesia, Critical Care and Pain Medicine,
Massachusetts General Hospital, Harvard Medical School, Boston, MA, United
States.
CORRESPONDENCE ADDRESS
M.A. Petrovic, Johns Hopkins University, School of Medicine, Tower 711, 600
North Wolfe Street, Baltimore, MD 21287, United States. Email:
rpetrov@jhmi.edu
SOURCE
Journal of Cardiothoracic and Vascular Anesthesia (2012) 26:1 (11-16). Date
of Publication: February 2012
ISSN
1053-0770
1532-8422 (electronic)
BOOK PUBLISHER
W.B. Saunders, Independence Square West, Philadelphia, United States.
ABSTRACT
Objectives: Perioperative handoffs are a particularly high-risk period given
patients' postprocedural physiology, their physical transport through the
hospital, and the triad transfer of personnel, information, and technology.
The authors piloted a new perioperative handoff process to guide patient
transfers from the cardiac operating room (OR) to the cardiac surgical
intensive care unit (CSICU). The aim of the study was to evaluate the impact
of a standardized handoff process on patient care and provider satisfaction.
Design: A prospective, unblinded intervention study. Setting: A CSICU in a
teaching hospital. Participants: Two hundred thirty-eight health care
practitioners during the transfer of care of 60 patients. Interventions: The
implementation of a standardized handoff protocol and checklist.
Measurements and Main Results: After the protocol's implementation, the
presence of all handoff core team members at the bedside increased from 0%
at baseline to 68% after intervention. The percentage of missed information
in the surgery report decreased from 26% to 16% (p = 0.03), but the
percentage of missed information in the anesthesia report showed no
significant change (19% to 17%, p > 0.05). Handoff satisfaction scores among
intensive care unit (ICU) nurses increased from 61% to 81%. On average, the
duration of handoff increased by 1 minute. Conclusions: A standardized
handoff protocol that guides the transfer of care from the OR team to the
CSICU team can reduce the risk of missed information and improve
satisfaction among perioperative providers. © 2012 Elsevier Inc. All rights
reserved.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health personnel attitude
patient care
patient transport
EMTREE MEDICAL INDEX TERMS
anesthesia
article
health care personnel
human
intensive care unit
major clinical study
operating room
patient information
perioperative period
priority journal
prospective study
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2012011544
MEDLINE PMID
21889365 (http://www.ncbi.nlm.nih.gov/pubmed/21889365)
PUI
L51601582
DOI
10.1053/j.jvca.2011.07.009
FULL TEXT LINK
http://dx.doi.org/10.1053/j.jvca.2011.07.009
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 528
TITLE
Quality improvement of microsurgery through telecommunication-the
postoperative care after microvascular transfer of intestine
AUTHOR NAMES
Chen H.-C.
Kuo H.-C.
Chung K.-P.
Chen S.-H.
Tang Y.-B.
Su S.
AUTHOR ADDRESSES
(Chen H.-C.) Plastic Surgery, China Medical Hospital, China Medical
University, Taiwan.
(Kuo H.-C., simon@isu.edu.tw) Health Management, I-Shou University,
Kaohsiung County, Taiwan.
(Chung K.-P.; Su S.) Health Policy and Management, National Taiwan
University, Taiwan.
(Chen S.-H.; Tang Y.-B.) Plastic Surgery, National Taiwan University
Hospital, Taiwan.
CORRESPONDENCE ADDRESS
H.-C. Kuo, I-Shou University, Kaohsiung County, Taiwan. Email:
simon@isu.edu.tw
SOURCE
Microsurgery (2012) 32:2 (96-102). Date of Publication: February 2012
ISSN
0738-1085
1098-2752 (electronic)
BOOK PUBLISHER
Wiley-Liss Inc., 111 River Street, Hoboken, United States.
ABSTRACT
The purpose of this report is to describe the use of telecommunication to
improve the quality of postoperative care following microsurgery, especially
following microvascular transfer of intestinal transfer for which shortening
of ischemia time is of utmost importance to achieve high success rate. From
2003 to 2009 microvascular transfer of intestinal flaps had been performed
in 112 patients. After surgery the patients were put in intensive care unit
and the flaps were checked every 1 hour. The image for circulatory status of
the flaps was sent directly to the attending surgeon for judgment. The
information was sent through intranet and the surgeon can get access to the
intranet through internet if necessary. Among the 112 cases, there were 9
cases of reexploration. The average duration between the time of problem
detection and the time of starting reexploration was 54 min in 7 cases, and
other 2 cases were delayed to enter the operating room which had been
occupied by other cases of major trauma. Only two flaps were lost
completely, two patients developed narrowing at the junction of cervical
esophagus and thoracic esophagus. The rate of salvage for intestinal flap is
apparently higher than those reported in the literature. In the
postoperative management of microsurgery in ICU, telecommunication can help
to reduce the ischemia time after vascular compromise in the transfer of
free intestinal flap. Telecommunication is really an easy and effective tool
in improving the outcome of reconstructive surgery. © 2012 Wiley
Periodicals, Inc. Microsurgery, 2012. Copyright © 2012 Wiley Periodicals,
Inc.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
microsurgery
microvascular surgery
telecommunication
EMTREE MEDICAL INDEX TERMS
article
catheter infection (complication)
cervical esophagus
esophagus
health care quality
human
intensive care unit
intestine
intestine necrosis (complication)
ischemia
major clinical study
operating room
pneumonia (complication)
postoperative care
priority journal
reoperation
thoracic esophagus
thrombosis (complication)
treatment failure
wound dehiscence (complication)
EMBASE CLASSIFICATIONS
Surgery (9)
Gastroenterology (48)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2012063702
MEDLINE PMID
22267277 (http://www.ncbi.nlm.nih.gov/pubmed/22267277)
PUI
L51827509
DOI
10.1002/micr.20965
FULL TEXT LINK
http://dx.doi.org/10.1002/micr.20965
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 529
TITLE
Operation mountain rescue
AUTHOR NAMES
Bowen L.
Dykes L.
AUTHOR ADDRESSES
(Bowen L., Lowribowen@gmail.com) University Hospital, Cardiff, United
Kingdom.
(Dykes L.) Ysbyty Gwynedd, Bangor, United Kingdom.
CORRESPONDENCE ADDRESS
L. Bowen, University Hospital, Cardiff, United Kingdom. Email:
Lowribowen@gmail.com
SOURCE
Anaesthesia (2012) 67 SUPPL. 1 (29). Date of Publication: February 2012
CONFERENCE NAME
Winter Scientific Meeting of the Association of Anaesthetists of Great
Britain and Ireland, AAGBI 2012
CONFERENCE LOCATION
London, United Kingdom
CONFERENCE DATE
2012-01-18 to 2012-01-20
ISSN
0003-2409
BOOK PUBLISHER
Blackwell Publishing Ltd
ABSTRACT
The RCoA 2010 CCT curriculum has created training units focusing on Trauma,
Resuscitation, Stabilization and Transfer Medicine [1]. Ysbyty Gwynedd
receives around 100 casualties a year brought in by Mountain Rescue/RAF
teams from the mountains of Snowdonia. Injuries arise from hill walking,
scrambling, ice/rock climbing or paragliding and often require operative
fixation; some need intensive care therapy or transfer to tertiary referral
centres Methods To identify the anaesthetic challenges and workload posed by
mountain casualties brought to a district general hospital by RAF/Mountain
Rescue, the database of mountain casualties, case notes, theatre ledgers and
ICU admissions records were examined for the time period March 2004-August
2010 Results Over a six and a half year period, 144 operations (mainly
orthopaedic trauma) were carried out on 122 casualties. NCEPOD criteria were
followed, with only four operations after midnight: 63% of the operations
took place on designated day trauma lists. There were seven interhospital
transfers: four neurosurgical, one cardiothoracic, one orthopaedic and one
maxillofacial. Only 12 intrahospital transfers to radiology or ICU were
documented. There were 26 critical care admissions: 21 multiple traumas, two
hypothermia, two psychiatric and a post-cardiac arrest. Two patients died in
the emergency department despite the cardiac arrest team's best efforts.
Discussion The workload is mainly orthopaedic lower limb fractures who are
generally assisted off the mountains (upper limb injuries mostly
selfevacuate). The database only reflects casualties requiring assistance
from SAR services, thus underestimates the true treated numbers. Two-thirds
of operations take place on a dedicated trauma list conferring valuable
learning experience for trainees. Few tertiary centre transfers occur as
massive injuries do not generally survive to admission. Improvement is
needed on poor documentation of trauma call attendance or intrahospital
transfers. Most critical care admissions are polytrauma which involve
resuscitation, theatre trips and transfers. These skills are not specific to
mountain trauma, but added to other more conventionally sustained trauma
fulfils all training needs of any grade of anaesthetist for several
essential units in the 2010 Curriculum [1].
EMTREE DRUG INDEX TERMS
anesthetic agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
anesthesist
human
Ireland
United Kingdom
winter
EMTREE MEDICAL INDEX TERMS
accident
arm
climbing
curriculum
data base
documentation
emergency ward
general hospital
heart arrest
hypothermia
injury
intensive care
learning
leg
limb fracture
limb injury
multiple trauma
patient
patient transport
radiology
resuscitation
skill
student
Tertiary (period)
therapy
walking
workload
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71056048
DOI
10.1111/j.1365-2044.2011.07058.x
FULL TEXT LINK
http://dx.doi.org/10.1111/j.1365-2044.2011.07058.x
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 530
TITLE
Does hospital transfer predict mortality in very low birth weight infants
requiring surgery for necrotizing enterocolitis?
AUTHOR NAMES
Kelley-Quon L.I.
Tseng C.
Scott A.
Jen H.C.
Calkins K.L.
Shew S.B.
AUTHOR ADDRESSES
(Kelley-Quon L.I.; Tseng C.; Scott A.; Jen H.C.; Calkins K.L.; Shew S.B.)
UCLA, Los Angeles, United States.
(Kelley-Quon L.I.) Robert Wood Johnson Foundation Clinical Scholars Program,
Los Angeles, United States.
CORRESPONDENCE ADDRESS
L.I. Kelley-Quon, UCLA, Los Angeles, United States.
SOURCE
Journal of Surgical Research (2012) 172:2 (213). Date of Publication:
February 2012
CONFERENCE NAME
7th Annual Academic Surgical Congress of the Association for Academic
Surgery, AAS and the Society of University Surgeons, SUS
CONFERENCE LOCATION
Las Vegas, NV, United States
CONFERENCE DATE
2012-02-14 to 2012-02-16
ISSN
0022-4804
BOOK PUBLISHER
Academic Press Inc.
ABSTRACT
Introduction: Necrotizing enterocolitis (NEC) is one of the leading causes
of infant mortality and the most common reason for emergent surgery in very
low birth weight (VLBW, <1500g) infants. However, surgical capabilities are
not available in all neonatal intensive care units (NICUs). the goal of this
study was to investigate whether transfer for higher level of surgical care
affects mortality for VLBW infants with surgical NEC. Methods: VLBWinfants
who underwent NEC surgery from 1999-2007 were retrospectively reviewed from
the California Patient Discharge Linked Birth Cohort Database. Hospital
admissions/transfers from birth to first discharge home were identified.
Hospitals were stratified by NICU levels 2A- 3C. NEC diagnosis and surgeries
were identified by ICD9 codes. Transfer for emergent NEC surgery was defined
as surgery ≥2d after transfer. Infants were categorized as either
transferred for surgery or received surgery at their primary NICU. Mortality
was analyzed with multivariate logistic regression using a fixed effects
model at the individual hospital level. Covariates included transferring
NICU level, peritoneal drainage, surgery <7d after birth (as a proxy for
spontaneous intestinal perforation), birth weight (BW), maternal age,
prenatal care, insurance, gender and major medical comorbidities. Results:
Overall, 1,272 VLBW infants (BW: 8606260g) with surgical NEC were identified
from 70 hospitals with a 39% mortality. the majority of the cohort underwent
surgery at a 3C level NICU (63%). Overall, 406 (32%) infants were
transferred for surgical care leaving 866 (68%) who had surgery at their
primary NICU. Surgery <7d after birth occurred in 213 (17%) infants, most
(73%) with a BW<1000g. Unadjusted mortality was not increased for infants
transferred for surgery versus those not transferred for surgery, 37% vs.
40% (p=0. 25). on multivariate analysis, adjusted mortality for infants
transferred for surgery did not differ from those who received surgery at
their primary NICU (OR 0. 46, 95% CI 0. 12-1. 72). Lower BW, peritoneal
drainage as sole surgical intervention, grade IV intraventricular
hemorrhage, pulmonary interstitial emphysema, and pulmonary hemorrhage were
associated with increased odds of mortality (p<0. 05). Surgery <7d after
birth was associated with decreased odds of mortality (OR 0. 11, 95% CI 0.
04-0. 27). Exclusion of this subset on subsequent analysis did not impact
the effect of transfer on mortality. Conclusions: VLBW infants with surgical
NEC do not demonstrate increased risk of mortality when transferred
emergently for higher level of surgical care. It is otherwise uncertain
whether lack of surgically capable NICU's contributes to mortality prior to
transfer or whether morbidity is affected for infants who survive transport.
Future efforts must engage health professionals at all levels caring for
this vulnerable population in order to truly maximize resource allocation
and safety.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital
human
mortality
necrotizing enterocolitis
society
surgeon
surgery
university
very low birth weight
EMTREE MEDICAL INDEX TERMS
abdominal drainage
birth weight
brain hemorrhage
custodial care
data base
diagnosis
emphysema
gender
health practitioner
hospital discharge
infant
infant mortality
insurance
intensive care unit
intestine perforation
logistic regression analysis
lung hemorrhage
maternal age
model
morbidity
multivariate analysis
newborn intensive care
prenatal care
resource allocation
risk
safety
United States
vulnerable population
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70651245
DOI
10.1016/j.jss.2011.11.305
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jss.2011.11.305
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 531
TITLE
Acute care nurse practicioner led critical care transport team leads to
improved door to imaging time in acute ischemic stroke patients
AUTHOR NAMES
Winfield M.M.
McNeil J.A.
Steiner S.L.
Manacci C.F.
Kralovic D.
Hussain M.S.
AUTHOR ADDRESSES
(Winfield M.M.; McNeil J.A.; Steiner S.L.; Manacci C.F.; Kralovic D.;
Hussain M.S.) Cleveland Clinic, Cleveland, United States.
CORRESPONDENCE ADDRESS
M.M. Winfield, Cleveland Clinic, Cleveland, United States.
SOURCE
Stroke (2012) 43:2 Meeting Abstracts. Date of Publication: February, 2012
CONFERENCE NAME
2012 International Stroke Conference and Nursing Symposium
CONFERENCE LOCATION
New Orleans, LA, United States
CONFERENCE DATE
2012-02-01 to 2012-02-03
ISSN
0039-2499
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Background: In evaluating the acute ischemic stroke (AIS) patient, targeting
time intervals for imaging and treatment times are paramount in optimizing
outcomes. Initial evaluation by skilled providers who can facilitate the
extension of a tertiary care facility can positively influence patient
outcomes. A collaborative approach with a hospital based Critical Care
Transport (CCT) Team can extend primary stroke program care out to a
referring facility's bedside. In the Cleveland Clinic Health System, the
suspicion of a large vessel occlusion causing AIS in patients at an outside
hospital triggers an “Auto Launch” process, bypassing typical transfer
processes to expedite care transitions for patients with time sensitive
emergencies. Referring facilities contact a CCT Coordinator, with immediate
launching of the transport team that consists of an Acute Care Nurse
Practitioner (ACNP) who evaluates the patient at outside facility, performs
NIHSS and transitions the patient directly to CT/MRI upon return to
Cleveland Clinic facility. Patient is met by the Stroke Neurology Team at CT
scanner for definitive care. A CCT Team with an ACNP on board can augment
not only door to CT and MRI times, but also time to evaluation by a stroke
neurologist and time to intervention, bypassing the Emergency Department
upon their arrival and proceeding directly to studies and/or time sensitive
intervention as appropriate. Objective: To describe a stroke program with a
coordinated approach with a CCT Team to facilitate rapid care transitions as
well as decreased time to imaging in patients with AIS by having an ACNP on
board during transport and throughout the continuum of care. Methods: A
retrospective audit of a database of patients undergoing hyperacute
evaluation of acute ischemic stroke symptoms from April 30, 2010 to July 31,
2011 was performed. Demographic information, types of imaging performed,
hyperacute therapies administered and time intervals to imaging modalities
and treatment were collected and analyzed. Results: 107 patients total, 28
males, and 36 females with a mean age of 70 were included in the analysis.
60% [64] of patients transferred via the CCT Team over 26.42 average
nautical miles. The mean time of call to arrival was 1 hr and 19 min. The
CCT Team monitored tPA infusion in 27 patients and initiated tPA infusion in
2 patients. 64 patients had CT imaging performed and 64 had MRI performed
following the CT. [The average door to CT completion was 22 min, the average
door to MRI completion was 1 hr and 29 min, compared to 1 hr and 8 min and 2
hr and 36 min, respectively, in patients not arriving by CCT Team], p<0.05.
Conclusion: Collaboration between the Stroke Neurology Team and CCT Team has
allowed acute ischemic stroke patients to be taken directly to CT/MRI
scanner, allowing for rapid evaluation, definitive treatment decisions, and
the potential for improved patient outcomes by decreasing the door to
imaging time.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
brain ischemia
cerebrovascular accident
emergency care
human
imaging
intensive care
nurse
nursing
stroke patient
EMTREE MEDICAL INDEX TERMS
acute care nurse practitioner
clinical audit
computed tomography scanner
data base
emergency
emergency ward
female
health care
hospital
infusion
male
National Institutes of Health Stroke Scale
neurologist
neurology
nuclear magnetic resonance imaging
occlusion
patient
tertiary health care
therapy
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70925715
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 532
TITLE
Using Six Sigma methodology to reduce patient transfer times from floor to
critical-care beds.
AUTHOR NAMES
Silich S.J.
Wetz R.V.
Riebling N.
Coleman C.
Khoueiry G.
Abi Rafeh N.
Bagon E.
Szerszen A.
AUTHOR ADDRESSES
(Silich S.J.) Six Sigma Certified Blackbelt for Staten Island University
Hospital in Staten Island, New York, USA.
(Wetz R.V.; Riebling N.; Coleman C.; Khoueiry G.; Abi Rafeh N.; Bagon E.;
Szerszen A.)
CORRESPONDENCE ADDRESS
S.J. Silich, Six Sigma Certified Blackbelt for Staten Island University
Hospital in Staten Island, New York, USA. Email: ssilich@siuh.edu
SOURCE
Journal for healthcare quality : official publication of the National
Association for Healthcare Quality (2012) 34:1 (44-54). Date of Publication:
2012 Jan-Feb
ISSN
1945-1474 (electronic)
ABSTRACT
In response to concerns regarding delays in transferring critically ill
patients to intensive care units (ICU), a quality improvement project, using
the Six Sigma process, was undertaken to correct issues leading to transfer
delay. To test the efficacy of a Six Sigma intervention to reduce transfer
time and establish a patient transfer process that would effectively enhance
communication between hospital caregivers and improve the continuum of care
for patients. The project was conducted at a 714-bed tertiary care hospital
in Staten Island, New York. A Six Sigma multidisciplinary team was assembled
to assess areas that needed improvement, manage the intervention, and
analyze the results. Results: The Six Sigma process identified eight key
steps in the transfer of patients from general medical floors to critical
care areas. Preintervention data and a root-cause analysis helped to
establish the goal transfer-time limits of 3 h for any individual transfer
and 90 min for the average of all transfers. The Six Sigma approach is a
problem-solving methodology that resulted in almost a 60% reduction in
patient transfer time from a general medical floor to a critical care area.
The Six Sigma process is a feasible method for implementing healthcare
related quality of care projects, especially those that are complex. © 2011
National Association for Healthcare Quality.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
patient transport
total quality management
EMTREE MEDICAL INDEX TERMS
article
critical illness (therapy)
health care quality
health services research
human
interdisciplinary communication
length of stay
mortality
organization and management
standard
statistics
teaching hospital
time
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
23552174 (http://www.ncbi.nlm.nih.gov/pubmed/23552174)
PUI
L369194710
DOI
10.1111/j.1945-1474.2011.00184.x
FULL TEXT LINK
http://dx.doi.org/10.1111/j.1945-1474.2011.00184.x
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 533
TITLE
Waiting time for transfer of patients with prostaglandin dependant
congenital heart defects to tertiary cardiac centers
AUTHOR NAMES
Al Mesned A.R.
Al Akhfash A.A.
Sayed M.
AUTHOR ADDRESSES
(Al Mesned A.R., almesnid@yahoo.com; Al Akhfash A.A.; Sayed M.) Paediatric
Cardiology, Prince Sultan Cardiac Center, Al-Qassim, Saudi Arabia.
CORRESPONDENCE ADDRESS
A.R. Al Mesned, Paediatric Cardiology, Prince Sultan Cardiac Canter, PO Box
896, Al-Qassim 51421, Saudi Arabia. Email: almesnid@yahoo.com
SOURCE
Journal of the Saudi Heart Association (2012) 24:2 (79-83). Date of
Publication: April 2012
ISSN
2212-5043 (electronic)
1016-7315
BOOK PUBLISHER
Elsevier
ABSTRACT
Worldwide congenital heart defects (CHD) are the leading cause of infant
deaths owing to congenital anomalies. Delay in diagnosing and operating in
neonates with prostaglandin dependant CHD may lead to significant morbidity
and mortality.Objectives: To assess the time interval needed for acceptance
and transfer of patients with critical CHD to a tertiary cardiac center and
the impact on the patient's survival.Study design: Retrospective database
reviews of all cases diagnosed to have prostaglandin dependant (PG) CHD at
Prince Sultan Cardiac Center-Qassim during a 43. months period (from May
2007 to December 2010).Results: During the study period 104 patients were
diagnosed to have PG dependant CHD. Patients with PG dependant systemic
circulation constitute 60% of patients. Patients with ventricular septal
defect (VSD) associated with coarctation of the aorta constituted 16% of
patients. The mean waiting time for transfer to a tertiary cardiac center
was 10. ±. 10. days. Twenty-two (21%) patients died while waiting for
acceptance and transfer. Eleven patients were diagnosed with hypoplastic
left heart syndrome (HLHS). There was no significant difference in the
waiting time for those with or without HLHS, with a mean of 9. days for
both. Six of our patients had infections with positive blood cultures. The
mean waiting period for those with proved infection was 25. days compared
with 8. days for those with no proved infection (. p value. <.
0.005).Conclusion: There are a significant number of patients with severe
CHD who die while waiting for acceptance and transfer to a tertiary cardiac
center. The causes for delay could be the presence of infection, prematurity
and low birth weight. The limited numbers of tertiary cardiac centers in
Saudi Arabia as well as cardiac ICU beds are among the factors delaying the
acceptance of patients requiring cardiac surgery. © 2011 .
EMTREE DRUG INDEX TERMS
prostaglandin
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
congenital heart malformation
patient transport
tertiary health care
watchful waiting
EMTREE MEDICAL INDEX TERMS
adolescent
aortic arch interruption
aortic coarctation
aortic stenosis
article
blood culture
child
clinical article
coronary care unit
great vessels transposition
heart right ventricle double outlet
heart ventricle septum defect
human
hypoplastic left heart syndrome
infant
newborn
preschool child
priority journal
pulmonary valve atresia
school child
survival
systemic circulation
EMBASE CLASSIFICATIONS
Cardiovascular Diseases and Cardiovascular Surgery (18)
Drug Literature Index (37)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2012222435
PUI
L51712675
DOI
10.1016/j.jsha.2011.10.004
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jsha.2011.10.004
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 534
TITLE
Sim-man vs powerpoint for teaching critical care transport medicine airway
management decision- Making
AUTHOR NAMES
Holmes J.
Carleton S.
Hart K.
Leblanc D.
Lindsell C.
AUTHOR ADDRESSES
(Holmes J.) Maine Medical Center, United States.
(Carleton S.; Hart K.; Leblanc D.; Lindsell C.) University of Cincinnati,
United States.
CORRESPONDENCE ADDRESS
J. Holmes, Maine Medical Center, United States.
SOURCE
Air Medical Journal (2012) 31:6 (257). Date of Publication:
November-December 2012
CONFERENCE NAME
2012 Air Medical Transport Conference, AMTC 2012
CONFERENCE LOCATION
Seattle, WA, United States
CONFERENCE DATE
2012-10-22 to 2012-10-22
ISSN
1067-991X
BOOK PUBLISHER
Mosby Inc.
ABSTRACT
Introduction: Airway management decision-making is a fundamental skill in
critical care transport medicine (CCTM). The complexity and acuity of CCTM
patients render the educational model of see one, do one, teach one
incompatible with patient safety. Highfidelity simulation has been shown to
be effective for teaching airway management, but whether it is superior to
didactic training remains unclear. We hypothesized that simulation training
would be more effective than didactic training for teaching CCTM provider
orientees airway management decision-making. Methods: Twelve PGY-1 emergency
medicine residents, orienting to become flight physicians, participated in
this IRB-approved, randomized crossover study. Two three-hour educational
sessions with specific, identical objectives regarding CCTM airway
management decision-making were delivered. One session used traditional
didactic classroom teaching; the other used six airway scenarios
pre-programmed on a Laerdal high-fidelity Sim-Man with debriefing after each
scenario. Participants completed both sessions in one day, with six
completing didactic education followed by simulation education and six
completing simulation education followed by didactic education. Before
either session, participants completed a baseline knowledge assessment. They
also completed a post-test knowledge assessment after each session. Each
test asked slightly different questions but tested the same content. Paired
samples t-tests were used to compare pre- and post-test scores. Independent
samples t-tests were used to compare scores between groups. Results: All 12
participants completed the training. Overall, the mean pre-test score was
41% and the mean score for post-test 1 was 47%. Post-test 1 scores did not
differ between participants completing didactic education first and
participants completing simulation education first (48% vs 46%, p=0.610).
Overall, the mean post-test 2 score was 60%, which was significantly higher
than baseline (p Conclusion: Contrary to our hypothesis, simulation training
was not superior to didactic training in facilitating immediate recall of
the educational content. Our study is limited by a small sample size, and by
the didactic and simulation sessions having been taught by different
instructors. The data suggest that tandem training using both methods, in
either order, did result in statistically significant improvement in
immediate recall of CCTM airway management decision-making principles.
Further study is indicated to clarify the optimal distribution, timing, and
ordering of didactic and simulation education.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
decision making
human
intensive care
male
respiration control
teaching
EMTREE MEDICAL INDEX TERMS
airway
crossover procedure
education
educational model
emergency medicine
flight
hypothesis
patient
patient safety
physician
recall
sample size
simulation
skill
Student t test
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71267276
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 535
TITLE
Implementing a critical care transport provider risk assessment tool:
Translating subjective factors into objective measurable data
AUTHOR NAMES
Singleton J.
Carr B.
Hodgson N.
Wicinski S.
Kunkel S.
AUTHOR ADDRESSES
(Singleton J.; Carr B.; Hodgson N.; Wicinski S.) Metro Life Flight, United
States.
(Kunkel S.) Champion EMS, Flight for Life, United States.
CORRESPONDENCE ADDRESS
J. Singleton, Metro Life Flight, United States.
SOURCE
Air Medical Journal (2012) 31:6 (260). Date of Publication:
November-December 2012
CONFERENCE NAME
2012 Air Medical Transport Conference, AMTC 2012
CONFERENCE LOCATION
Seattle, WA, United States
CONFERENCE DATE
2012-10-22 to 2012-10-22
ISSN
1067-991X
BOOK PUBLISHER
Mosby Inc.
ABSTRACT
Introduction: Metro Life Flight is a critical care transport program that
has provided both air and ground services for 30 years. Life Flight crews
work in a challenging, fast paced and demanding environment. At times the
ability to recognize circumstances that may inhibit safe and effective care
can be clouded by the desire to help. Providing invaluable service to
Northeast Ohio and beyond, these medical providers work either a 12 hour or
a 24 hour shift. Until the implementation of the crew fatigue risk tool,
there was only subjective interpretation of a crew members fatigue. This
tool has helped to standardize and define fatigue criteria as well as allow
for risk mitigation and remediation. Further development of the process
created a method for crew members to report, aggregate and communicate risk
levels in real-time. Methods: Self reporting of fatigue factors through an
automated tool completed by medical crew at the start of each shift and upon
return to base after completion of missions. Results: During the 1st quarter
of 2012 a total of 1157 records were reviewed for compliance and risk
status. 1106 (94%) resulted as green or low risk, 51 (6%) were yellow or
medium risk and there were no reported incidences of service interruption
for staff going into the red or high risk category. We focused our review on
the issues that surround the yellow category to assess the factors that
drove this risk elevation. The following categories were examined and
resulted: Overall risk assessment ratings Medium status related to years of
experience Medium status by time of day Medium status by rest hours Medium
status related to shift length Medium status by personnel The average green
or low score was 11/17 with a high of 17 and a low score of 5. The average
yellow or medium score was 19/29 with a high of 25 and a low score of 18.
Conclusion: This process provides an improved, safe and universal way of
reporting fatigue and identifying those that could be at risk to suffer high
levels of fatigue. Providers that have a high level of fatigue are at risk
to make errors that could impact the safety of patients as well as other
crew members. This tool provides a nonpunitive reporting method for staff.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
intensive care
risk assessment
EMTREE MEDICAL INDEX TERMS
airplane crew
crew member
environment
fatigue
flight
human
patient
personnel
risk
safety
United States
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71267283
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 536
TITLE
Minor changes monumental impact: Improving critical care transport services
AUTHOR NAMES
McCool S.
Loehr A.
Hunt C.
AUTHOR ADDRESSES
(McCool S.; Loehr A.; Hunt C.) Children's Mercy Hospital, United States.
CORRESPONDENCE ADDRESS
S. McCool, Children's Mercy Hospital, United States.
SOURCE
Air Medical Journal (2012) 31:6 (260). Date of Publication:
November-December 2012
CONFERENCE NAME
2012 Air Medical Transport Conference, AMTC 2012
CONFERENCE LOCATION
Seattle, WA, United States
CONFERENCE DATE
2012-10-22 to 2012-10-22
ISSN
1067-991X
BOOK PUBLISHER
Mosby Inc.
ABSTRACT
Introduction: In trauma or illness, quick access to specialized critical
care resources can mean the difference between life or death. To better
serve the areas pediatric patients and improve outcomes, one Pediatric
Critical Care Transport Team (CCTT) evaluated the efficiency of current
staff scheduling processes to reduce missed transports. Methods: The CCTT
Operations Committee (OC) was developed to evaluate the departments staffing
and scheduling plan efficiency and effectiveness in relation to transport
activity, specifically completed and missed transports. When the project
began, the CCTTs daily staffing plan provided the following coverage:
0700-1930 2 Transport Teams 1000-2230 1 Transport Team 1700-0530 1 Transport
Team 1900-0730 2 Transport Team The OC utilize transport data, such as total
missed transports, missed/delayed transports due to team availability, time
requests were received, frequency of open shifts, and transport activity to
evaluate scheduling practices and their impact on operations, patient and
staff safety, and costs. This data supported replacing the 1700 shift with a
1500 shift. The 1700 shift was viewed as undesirable by staff. Data also
revealed that the transport request volumes increased nominally between 1200
and 0230. The 1500 shift provides more appropriate coverage for this surge.
The new staffing model would also allow the 24 hr shift CCTT members
adequate time to sleep during the early morning hours when there were fewer
transport requests. Results: Drastic improvements were seen in the
efficiencies of transport operations. Within the first year of
implementation, missed transports due to no teams available decreased by
36.6% during the hours of the new 1500 shift. In addition, when comparing
data from 11/2008-02/2009 and 11/2010-02/2011, typically the busiest
transport months, the number of total missed transports decreased by half.
In 11/2008-02/2009, 8.6% overall transport requests received by the
department resulting in a missed transport, constituted a total of 146
missed transports. In 11/2010-02/2011, only 4.5% of all transport requests
resulted in a missed transport, reducing the total number of missed
transports to 76. Conclusion: Significant improvements can be attributed to
the implementation of the OCs recommendations. By engaging direct care staff
in evaluating the effectiveness and efficiency of the departments staffing
plan, the CCTT has been able to enhance availability.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
intensive care
EMTREE MEDICAL INDEX TERMS
death
diseases
human
injury
model
patient
safety
sleep
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71267284
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 537
TITLE
Missed opportunities during pediatric residency training: Report of a
10-year follow-up survey in critical care transport medicine
AUTHOR NAMES
Kline-Krammes S.
Wheeler D.S.
Schwartz H.P.
Forbes M.
Bigham M.T.
AUTHOR ADDRESSES
(Kline-Krammes S.; Forbes M.; Bigham M.T., mbigham@chmca.org) Division of
Pediatric Critical Care, Akron Children's Hospital Medical Center, One
Perkins Square, Akron, OH 44308, United States.
(Wheeler D.S.) Division of Critical Care Medicine, Cincinnati Children's
Hospital Medical Center, Cincinnati, OH, United States.
(Schwartz H.P.) Division of Emergency Medicine, Cincinnati Children's
Hospital Medical Center, Cincinnati, OH, United States.
CORRESPONDENCE ADDRESS
M.T. Bigham, Division of Pediatric Critical Care, Akron Children's Hospital
Medical Center, One Perkins Square, Akron, OH 44308, United States. Email:
mbigham@chmca.org
SOURCE
Pediatric Emergency Care (2012) 28:1 (1-5). Date of Publication: January
2012
ISSN
0749-5161
1535-1815 (electronic)
BOOK PUBLISHER
Lippincott Williams and Wilkins, 530 Walnut Street,P O Box 327,
Philadelphia, United States.
ABSTRACT
OBJECTIVES: The Accreditation Council for Graduate Medical Education
requires pediatric residency training programs to provide exposure to the
prehospital management and transport of patients. The authors hypothesized
that compared with a similar study a decade prior, current pediatric
residency training programs have reduced requirements for participation in
transport medicine, thus reducing further the opportunities for residents to
learn the management of critically ill infants and children. METHODS: In
2009, a questionnaire was distributed to 182 pediatric residency program
directors. The authors obtained information regarding the neonatal and
pediatric transport teams, the training program size, and the pediatric
residents' role in the transport team. RESULTS: Sixty-eight (37%) of the 182
surveyed institutions responded. Residents were involved in neonatal and
pediatric transports in 42.8% and 55.0% of programs, respectively. When
involved in transports, residents were the neonatal and pediatric team
leaders 44.4% and 42.4% of the time, respectively. Evaluation of resident
transport performance occurred consistently in only 23.3% (neonatal) and 21%
(pediatric) of programs. Most programs (90.3%) endorsed the concept of a
curriculum that would uniquely provide an integrated experience in critical
care transport to increase resident exposure, competence, and confidence.
CONCLUSIONS: Pediatric residency participation in neonatal and pediatric
critical care transport continued to decline among training programs.
Residents participating in transports were less likely to function as team
leaders and frequently did not receive performance evaluations. Most
respondents welcomed a curriculum that would increase residents' exposure to
the critically ill infants and children transported by neonatal and
pediatric teams. Copyright © 2012 by Lippincott Williams & Wilkins.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
residency education
transport medicine
EMTREE MEDICAL INDEX TERMS
article
education program
follow up
health care facility
health survey
human
medical education
questionnaire
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2012016927
MEDLINE PMID
22193690 (http://www.ncbi.nlm.nih.gov/pubmed/22193690)
PUI
L51781832
DOI
10.1097/PEC.0b013e31823ed4ab
FULL TEXT LINK
http://dx.doi.org/10.1097/PEC.0b013e31823ed4ab
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 538
TITLE
Sim-Man vs powerpoint for teaching critical care transport Medicine airway
management decision-making
AUTHOR NAMES
Holmes J.
Carleton S.
Hart K.
LeBlanc D.
Lindsell C.
AUTHOR ADDRESSES
(Holmes J.) Maine Medical Center, United States.
(Carleton S.; Hart K.; LeBlanc D.; Lindsell C.) University of Cincinnati,
United States.
CORRESPONDENCE ADDRESS
J. Holmes, Maine Medical Center, United States.
SOURCE
Air Medical Journal (2012) 31:5 (226). Date of Publication:
September-October 2012
CONFERENCE NAME
2012 Air Medical Transport Conference, AMTC 2012
CONFERENCE LOCATION
Seattle, WA, United States
CONFERENCE DATE
2012-10-22 to 2012-10-24
ISSN
1067-991X
BOOK PUBLISHER
Mosby Inc.
ABSTRACT
Introduction: Airway management decision-making is a fundamental skill in
critical care transport medicine (CCTM). The complexity and acuity of CCTM
patients render the educational model of see one, do one, teach one
incompatible with patient safety. Highfidelity simulation has been shown to
be effective for teaching airway management, but whether it is superior to
didactic training remains unclear. We hypothesized that simulation training
would be more effective than didactic training for teaching CCTM provider
orientees airway management decision-making. Methods: Twelve PGY-1 emergency
medicine residents, orienting to become flight physicians, participated in
this IRB-approved, randomized crossover study. Two three-hour educational
sessions with specific, identical objectives regarding CCTM airway
management decision-making were delivered. One session used traditional
didactic classroom teaching; the other used six airway scenarios
pre-programmed on a Laerdal high-fidelity Sim-Man with debriefing after each
scenario. Participants completed both sessions in one day, with six
completing didactic education followed by simulation education and six
completing simulation education followed by didactic education. Before
either session, participants completed a baseline knowledge assessment. They
also completed a post-test knowledge assessment after each session. Each
test asked slightly different questions but tested the same content. Paired
samples t-tests were used to compare pre- and post-test scores. Independent
samples t-tests were used to compare scores between groups. Results: All 12
participants completed the training. Overall, the mean pre-test score was
41% and the mean score for post-test 1 was 47%. Post-test 1 scores did not
differ between participants completing didactic education first and
participants completing simulation education first (48% vs 46%, p=0.610).
Overall, the mean post-test 2 score was 60%, which was significantly higher
than baseline (p Conclusion: Contrary to our hypothesis, simulation training
was not superior to didactic training in facilitating immediate recall of
the educational content. Our study is limited by a small sample size, and by
the didactic and simulation sessions having been taught by different
instructors. The data suggest that tandem training using both methods, in
either order, did result in statistically significant improvement in
immediate recall of CCTM airway management decision-making principles.
Further study is indicated to clarify the optimal distribution, timing, and
ordering of didactic and simulation education.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
decision making
human
intensive care
male
respiration control
teaching
EMTREE MEDICAL INDEX TERMS
airway
crossover procedure
education
educational model
emergency medicine
flight
hypothesis
patient
patient safety
physician
recall
sample size
simulation
skill
Student t test
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70875443
DOI
10.1016/j.amj.2012.07.007
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2012.07.007
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 539
TITLE
Implementing a critical care transport provider risk assessment tool:
Translating subjective factors into objective measurable data
AUTHOR NAMES
Singleton J.
Carr B.
Hodgson N.
Wicinski S.
Kunkel S.
AUTHOR ADDRESSES
(Singleton J.; Carr B.; Hodgson N.; Wicinski S.; Kunkel S.) Metro Life
Flight Champion EMS, Flight for Life, United States.
CORRESPONDENCE ADDRESS
J. Singleton, Metro Life Flight Champion EMS, Flight for Life, United
States.
SOURCE
Air Medical Journal (2012) 31:5 (229). Date of Publication:
September-October 2012
CONFERENCE NAME
2012 Air Medical Transport Conference, AMTC 2012
CONFERENCE LOCATION
Seattle, WA, United States
CONFERENCE DATE
2012-10-22 to 2012-10-24
ISSN
1067-991X
BOOK PUBLISHER
Mosby Inc.
ABSTRACT
Introduction: Metro Life Flight is a critical care transport program that
has provided both air and ground services for 30 years. Life Flight crews
work in a challenging, fast paced and demanding environment. At times the
ability to recognize circumstances that may inhibit safe and effective care
can be clouded by the desire to help. Providing invaluable service to
Northeast Ohio and beyond, these medical providers work either a 12 hour or
a 24 hour shift. Until the implementation of the crew fatigue risk tool,
there was only subjective interpretation of a crew members fatigue. This
tool has helped to standardize and define fatigue criteria as well as allow
for risk mitigation and remediation. Further development of the process
created a method for crew members to report, aggregate and communicate risk
levels in real-time. Methods: Self reporting of fatigue factors through an
automated tool completed by medical crew at the start of each shift and upon
return to base after completion of missions. Results: During the 1st quarter
of 2012 a total of 1157 records were reviewed for compliance and risk
status. 1106 (94%) resulted as green or low risk, 51 (6%) were yellow or
medium risk and there were no reported incidences of service interruption
for staff going into the red or high risk category. We focused our review on
the issues that surround the yellow category to assess the factors that
drove this risk elevation. The following categories were examined and
resulted: Overall risk assessment ratings Medium status related to years of
experience Medium status by time of day Medium status by rest hours Medium
status related to shift length Medium status by personnel The average green
or low score was 11/17 with a high of 17 and a low score of 5. The average
yellow or medium score was 19/29 with a high of 25 and a low score of 18.
Conclusion: This process provides an improved, safe and universal way of
reporting fatigue and identifying those that could be at risk to suffer high
levels of fatigue. Providers that have a high level of fatigue are at risk
to make errors that could impact the safety of patients as well as other
crew members. This tool provides a nonpunitive reporting method for staff.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
intensive care
risk assessment
EMTREE MEDICAL INDEX TERMS
airplane crew
crew member
environment
fatigue
flight
human
patient
personnel
risk
safety
United States
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70875450
DOI
10.1016/j.amj.2012.07.007
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2012.07.007
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 540
TITLE
Minor changes monumental impact: Improving critical care transport services
AUTHOR NAMES
McCool S.
Loehr A.
Hunt C.
AUTHOR ADDRESSES
(McCool S.; Loehr A.; Hunt C.) Children's Mercy Hospital, United States.
CORRESPONDENCE ADDRESS
S. McCool, Children's Mercy Hospital, United States.
SOURCE
Air Medical Journal (2012) 31:5 (229). Date of Publication:
September-October 2012
CONFERENCE NAME
2012 Air Medical Transport Conference, AMTC 2012
CONFERENCE LOCATION
Seattle, WA, United States
CONFERENCE DATE
2012-10-22 to 2012-10-24
ISSN
1067-991X
BOOK PUBLISHER
Mosby Inc.
ABSTRACT
Introduction: In trauma or illness, quick access to specialized critical
care resources can mean the difference between life or death. To better
serve the areas pediatric patients and improve outcomes, one Pediatric
Critical Care Transport Team (CCTT) evaluated the efficiency of current
staff scheduling processes to reduce missed transports. Methods: The CCTT
Operations Committee (OC) was developed to evaluate the departments staffing
and scheduling plan efficiency and effectiveness in relation to transport
activity, specifically completed and missed transports. When the project
began, the CCTTs daily staffing plan provided the following coverage:
0700-1930 2 Transport Teams 1000-2230 1 Transport Team 1700-0530 1 Transport
Team 1900-0730 2 Transport Team The OC utilize transport data, such as total
missed transports, missed/delayed transports due to team availability, time
requests were received, frequency of open shifts, and transport activity to
evaluate scheduling practices and their impact on operations, patient and
staff safety, and costs. This data supported replacing the 1700 shift with a
1500 shift. The 1700 shift was viewed as undesirable by staff. Data also
revealed that the transport request volumes increased nominally between 1200
and 0230. The 1500 shift provides more appropriate coverage for this surge.
The new staffing model would also allow the 24 hr shift CCTT members
adequate time to sleep during the early morning hours when there were fewer
transport requests. Results: Drastic improvements were seen in the
efficiencies of transport operations. Within the first year of
implementation, missed transports due to no teams available decreased by
36.6% during the hours of the new 1500 shift. In addition, when comparing
data from 11/2008-02/2009 and 11/2010-02/2011, typically the busiest
transport months, the number of total missed transports decreased by half.
In 11/2008-02/2009, 8.6% overall transport requests received by the
department resulting in a missed transport, constituted a total of 146
missed transports. In 11/2010-02/2011, only 4.5% of all transport requests
resulted in a missed transport, reducing the total number of missed
transports to 76. Conclusion: Significant improvements can be attributed to
the implementation of the OCs recommendations. By engaging direct care staff
in evaluating the effectiveness and efficiency of the departments staffing
plan, the CCTT has been able to enhance availability.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
intensive care
EMTREE MEDICAL INDEX TERMS
death
diseases
human
injury
model
patient
safety
sleep
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70875451
DOI
10.1016/j.amj.2012.07.007
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2012.07.007
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 541
TITLE
An evaluation of repeat imaging in the pediatric emergency department: Is it
clinically indicated, safe, or cost effective?
AUTHOR NAMES
Hunter E.
Lovvorn J.
Lynch A.
Thompson T.
AUTHOR ADDRESSES
(Lovvorn J.; Lynch A.; Thompson T.) Arkansas Children's Hospital, Little
Rock, United States.
(Hunter E.) Children's Mercy Hospital, Kansas City, United States.
CORRESPONDENCE ADDRESS
E. Hunter, Children's Mercy Hospital, Kansas City, United States.
SOURCE
Journal of Investigative Medicine (2012) 60:1 (397). Date of Publication:
January 2012
CONFERENCE NAME
American Federation for Medical Research Southern Regional Meeting, AFMR
2012
CONFERENCE LOCATION
New Orleans, LA, United States
CONFERENCE DATE
2012-02-09 to 2012-02-11
ISSN
1081-5589
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Purpose of Study: Many patients transported from outside facilities have the
same radiographic studies repeated in the ED for a multitude of reasons.
This practice exposes patients to addition radiation and incurs a monetary
cost billed to the patient. We sought to determine the reasons for repeat
radiographic imaging in the ED and to assess both the monetary and radiation
cost to the patient. Methods Used: A prospective study was designed to
identify patients who required repeat radiographic imaging upon arrival to
the ED of a tertiary pediatric hospital between January 2011- October 2011.
Upon arrival, a score sheet was filled out by ED staff to identify the type
of study and the reason it was obtained. The results were analyzed using
SPSS and reported in aggregate. Summary of Results: 139 subjects were
identified in the study period. The most common reasons cited for repeat
imaging was poor quality film/inadequate views (43%), no films sent with
patient at time of transfer (21%) and requested by the service (9%). Only 16
% of patients had repeat imaging because it was clinically indicated; e.g. a
change in clinical status. Types of repeated studies include 70% plain
films, 18% CTs and 9 % Ultrasound or MRI, with ∼3% representing other
studies. Eight percent of subjects received multiple repeat imaging
modalities during this study. The average cost of a chest x-ray billed to
the patient from our hospital is $140 and incurs 0.1 milliSeverts (mSv) of
radiation. This is equal to 10 days of background radiation exposure the
average person in the US receives. The cost of a Head CT billed to a patient
is $1,870 and incurs on average 2mSv which is equivalent to 4 months of
background radiation exposure. Radiation doses incurred from outside
referral facilities are typically higher and this does not include radiology
technician or radiologist cost. Conclusions: Repeat imaging for
intra-hospital transfer to a tertiary facility is common. However, in our
institution, clinical indication was not the primary reason. This practice
incurs both a monitory cost and additional radiation exposure to the
patient. This preliminary study will allow us to identify potential targets
for quality improvement and improve patient safety.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency ward
imaging
medical research
EMTREE MEDICAL INDEX TERMS
hospital
human
ionizing radiation
nuclear magnetic resonance imaging
patient
patient safety
pediatric hospital
prospective study
radiation
radiation dose
radiation exposure
radiologist
radiology
Tertiary (period)
thorax radiography
total quality management
ultrasound
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70982247
DOI
10.231/JIM.0b013e3182820c55
FULL TEXT LINK
http://dx.doi.org/10.231/JIM.0b013e3182820c55
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 542
TITLE
The effect of repeated audit on the quality of transfer of brain-injured
patients into a regional neurosciences centre
AUTHOR NAMES
Messer P.B.
Sweenie A.C.
Whittle R.J.
Mceleavy I.M.
AUTHOR ADDRESSES
(Messer P.B., benmesser@doctors.net.uk; Sweenie A.C.; Whittle R.J.; Mceleavy
I.M.) Royal Victoria Infirmary, Newcastle-upon-Tyne, United Kingdom.
CORRESPONDENCE ADDRESS
P. B. Messer, Royal Victoria Infirmary, Newcastle-upon-Tyne, United Kingdom.
Email: benmesser@doctors.net.uk
SOURCE
Journal of the Intensive Care Society (2012) 13:1 (39-42). Date of
Publication: January 2012
ISSN
1751-1437
BOOK PUBLISHER
Stansted News Ltd, 134 South Street, Bishop's Stortford, Hertfordshire,
Essex, United Kingdom.
ABSTRACT
Brain injury is common and transfer of such patients to a neuroscience
centre is a frequently occurring event. Transfer is a time of potential
instability and can contribute to physiological changes that could cause
secondary brain injury. UK data suggest that there has been a gradual
improvement in quality and outcome of transfers of brain-injured patients
during the last three decades. The Association of Anaesthetists of Great
Britain and Ireland (AAGBI) have published guidelines to improve the safety
and quality of transfers. Over a seven-year period, we audited transfers
four times and implemented three successive interventions aimed at improving
the quality of transfers of brain-injured patients into the regional
neurosciences centre. We observed a significant improvement in the transfer
of patients according to AAGBI guidelines across most domains of patient
care. The use of repeated cycles of audit and intervention significantly
improved the quality of transfer of brain-injured patients, which could
improve patient safety and outcome. © The Intensive Care Society 2012.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
brain injury
clinical audit
patient transport
EMTREE MEDICAL INDEX TERMS
arterial pressure
article
end tidal carbon dioxide tension
human
intensive care unit
patient care
patient safety
total quality management
EMBASE CLASSIFICATIONS
Neurology and Neurosurgery (8)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2012110538
PUI
L364307683
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 543
TITLE
Quality improvement and patient care checklists in intrahospital transfers
involving pediatric surgery patients
AUTHOR NAMES
Nakayama D.K.
Lester S.S.
Rich D.R.
Weidner B.C.
Glenn J.B.
Shaker I.J.
AUTHOR ADDRESSES
(Nakayama D.K., Nakayama.Don@mccg.org; Lester S.S.; Rich D.R.; Weidner B.C.;
Glenn J.B.; Shaker I.J.) Department of Surgery, Mercer University School of
Medicine, Medical Center of Central Georgia, Macon, GA 31201, United States.
CORRESPONDENCE ADDRESS
D.K. Nakayama, Department of Surgery, Mercer University School of Medicine,
Medical Center of Central Georgia, Macon, GA 31201, United States. Email:
Nakayama.Don@mccg.org
SOURCE
Journal of Pediatric Surgery (2012) 47:1 (112-118). Date of Publication:
January 2012
ISSN
0022-3468
1531-5037 (electronic)
BOOK PUBLISHER
W.B. Saunders, Independence Square West, Philadelphia, United States.
ABSTRACT
Background: Intrahospital transfers are necessary but hazardous aspects of
pediatric surgical care. Plan-Do-Study-Act processes identify risks during
hospitalization and improve care systems and patient safety. Methods: A
multidisciplinary team developed a checklist that documented patient data
and handoffs for all intrahospital transfers involving pediatric surgical
inpatients. The checklist summarized major clinical events and provided
concurrent summaries by 3-month quarters (Q) over 1 year. Results: There
were 903 intrahospital transfers involving 583 inpatients undergoing
surgery. Total handoffs were documented in 436 (75% of 583), with greater
than 1 handoff in 202 (46% of 436). Documented problems occurred in 31
transfers (3.4%), the most during Q1 (19/191; 9.9%). Incidence fell to 3.5%
(9/260) in Q2, 0.4% (1/243) in Q3, and 1.0% (2/209) in Q4 (P <.001). Patient
care issues (14/31; 45%) were most common, followed by documentation (10,
32%) and process problems (7, 23%). The quality improvement team was able to
resolve patient instability during transport (5 in Q1, none in Q3, Q4) and
poor pain control (3 in Q2, 1 in Q3, Q4). Of the patients, 3.2% had
identified problems with patient care during intrahospital transfer.
Conclusions: Plan-Do-Study-Act review emphasizes ongoing process analysis by
multidisciplinary teams. Checklists reinforce communication and provide
feedback on whether system goals are being achieved. © 2012 Elsevier Inc.
All rights reserved.
EMTREE DRUG INDEX TERMS
analgesic agent (drug therapy)
antibiotic agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient safety
patient transport
pediatric surgery
EMTREE MEDICAL INDEX TERMS
article
checklist
feedback system
hospital patient
human
incidence
major clinical study
medical documentation
medical information
patient care
patient coding
postoperative pain (complication, drug therapy)
priority journal
total quality management
treatment planning
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2012032317
MEDLINE PMID
22244402 (http://www.ncbi.nlm.nih.gov/pubmed/22244402)
PUI
L364091762
DOI
10.1016/j.jpedsurg.2011.10.030
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jpedsurg.2011.10.030
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 544
TITLE
Neonatal land transport
ORIGINAL (NON-ENGLISH) TITLE
Kopneni prijevoz novorocrossed d signenčadi
AUTHOR NAMES
Bregun-Doronjski A.
AUTHOR ADDRESSES
(Bregun-Doronjski A., adoronjski@yahoo.co.uk) Institut za Zdravstvenu
Zaštitu Djece I Omladine Vojvodine, Vojvodanskih brigada 12, 21000 Novi Sad,
Serbia.
CORRESPONDENCE ADDRESS
A. Bregun-Doronjski, Institut za Zdravstvenu Zaštitu Djece I Omladine
Vojvodine, Vojvodanskih brigada 12, 21000 Novi Sad, Serbia. Email:
adoronjski@yahoo.co.uk
SOURCE
Paediatria Croatica, Supplement (2011) 55:SUPPL. 1 (151-161). Date of
Publication: 2011
ISSN
1330-724X
BOOK PUBLISHER
Children's Hospital Zagreb, Klaiceva 16, Zagreb, Croatia.
ABSTRACT
Improved perinatal care over the past decades (prenatal diagnosis and good
timing of the prenatal transport) has resulted in the fact that seriously
ill newborns are born in larger perinatal centers (with level III of
perinatal care). In these centers newborns are provided with high level of
care and treatment. When this is not the case, the newborn prognosis is
largely affected by the level of perinatal care. Due to the lack of needed
treatment, they have to be transferred to the higher level of perinatal
care. The sooner the problem is identified, the better is the neonatal
outcome. However, the postnatal transport is tied with the higher morbidity
and mortality than the prenatal transport (transport in utero), particularly
with the extremely immature and very immature neonates. In order to achieve
proper medical transport for these high-risk and vulnerable neonates, there
is a need for highly skilled staff and sophisticated medical equipment. In
an ideal world neonatal transport team is one of the important factors in
neonatal care. This procedure is followed by treatment in the neonatal
intensive care unit (NICU) where the personnel and the equipment are
dedicated to these babies. By the type of transport (land, air, water), and
organization (one way, two way) and a different personnel in the transport
team, neonatal transport is organized differently in various countries. It
is extremely important to have highly educated, knowledgeable and well
equipped transport service providers. The need for stabilizing the patient
prior the transport is essential. Moreover, all the necessary medical and
technical procedures are to be performed before and during transport
(regardless of the participants in the transport team). Special procedures
(surfactant replacement therapy, "cooling", prostaglandin treatment etc.)
should be applied by an experienced team that has the knowledge and skills
in these techniques, as well as in monitoring of the patient and possible
complications. There are some special procedures in the neonatal transport
of surgical patients like stomach emptying before the transport,
ventilation, prone or supine positioning etc.
EMTREE DRUG INDEX TERMS
prostaglandin
surfactant
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
newborn period
patient transport
EMTREE MEDICAL INDEX TERMS
health care personnel
high risk patient
human
induced hypothermia
intensive care unit
knowledge
medical device
morbidity
mortality
newborn care
patient monitoring
perinatal care
prognosis
review
skill
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
unknown
LANGUAGE OF SUMMARY
English, unknown
EMBASE ACCESSION NUMBER
2011655568
PUI
L363010363
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 545
TITLE
Intra-hospital transport: From aeronautic to medicine
ORIGINAL (NON-ENGLISH) TITLE
Transports intrahospitaliers: De l'aéronautique à la médecine
AUTHOR NAMES
Rayeh-Pelardy F.
Mimoz O.
AUTHOR ADDRESSES
(Rayeh-Pelardy F.) Service des urgences-Samu-Smur, CHU de Poitiers, 86021
Poitiers, France.
(Mimoz O., o.mimoz@chu-poitiers.fr) Service d'anesthésie réanimation, Inserm
ERI 23, université de Poitiers, CHU de Poitiers, 86021 Poitiers, France.
(Mimoz O., o.mimoz@chu-poitiers.fr) Pôle
anesthésie-réanimations-urgences-Samu-Smur-médecine légale, Inserm ERI 23,
CHU de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France.
CORRESPONDENCE ADDRESS
O. Mimoz, Service d'anesthésie réanimation, Inserm ERI 23, université de
Poitiers, CHU de Poitiers, 86021 Poitiers, France. Email:
o.mimoz@chu-poitiers.fr
SOURCE
Annales Francaises d'Anesthesie et de Reanimation (2011) 30:12 (875-876).
Date of Publication: December 2011
ISSN
0750-7658
1769-6623 (electronic)
BOOK PUBLISHER
Elsevier Masson SAS, 62 rue Camille Desmoulins, Issy les Moulineaux Cedex,
France.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital care
intra hospital transport
EMTREE MEDICAL INDEX TERMS
anesthesia
checklist
editorial
resuscitation
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
French
EMBASE ACCESSION NUMBER
2011682462
MEDLINE PMID
22100623 (http://www.ncbi.nlm.nih.gov/pubmed/22100623)
PUI
L51720238
DOI
10.1016/j.annfar.2011.10.015
FULL TEXT LINK
http://dx.doi.org/10.1016/j.annfar.2011.10.015
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 546
TITLE
Can the use of apache II score in hypotensive patients in the general ward
predict intensive care unit transfer?
AUTHOR NAMES
Khalid I.
Almasari A.
Alkhammash S.
Qabajah M.
Khalid T.
Al-Zyoud A.
AUTHOR ADDRESSES
(Khalid I.; Almasari A.; Alkhammash S.; Qabajah M.; Khalid T.; Al-Zyoud A.)
King Faisal Specialist Hospital, Research Center, Jeddah, Saudi Arabia.
CORRESPONDENCE ADDRESS
I. Khalid, King Faisal Specialist Hospital, Research Center, Jeddah, Saudi
Arabia.
SOURCE
Critical Care Medicine (2011) 39 SUPPL. 12 (140). Date of Publication:
December 2011
CONFERENCE NAME
Critical Care Congress 2012
CONFERENCE LOCATION
Houston, TX, United States
CONFERENCE DATE
2012-02-04 to 2012-02-08
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: Severity scores are used in patients admitted to the Intensive
Care Unit (ICU). However, usefulness of a severity score for triaging at the
time of initial evaluation in hypotensive patients in the general ward is
not clear. Hypothesis: We hypothesized that calculating APACHE II score at
the time of new onset hypotension in the ward would help prognosticate
transfer of patients to the ICU. Methods: Rapid response team (RRT) is
activated for any hypotensive patient with SBP<90 mm of Hg in our tertiary
care hospital. We retrospectively looked at all those encounters from Jan
2009 till Oct 2010. Patients were divided into two groups; those who did not
require an ICU transfer after RRT evaluation, and the other who were
transferred to the ICU within 48 hours. APACHE II scores were calculated
from the data available at the time of RRT call. We also looked at the 28
day mortality as a secondary outcome. Data was analyzed using student t-test
and Pearson chi-square test, as appropriate. Results: A total of 281
hypotensive patients were identified. 126 patients were treated and
stabilized in the ward while 155 were transferred to the ICU. 44/155 of the
later were deemed stable initially but later deteriorated and admitted to
the ICU within 48 hours. The mean APACHE II score for patients who remained
in the ward was 16.5 + 6.9 and for those transferred to the ICU was 20 + 5.4
(p<0.0001). Using Receiver Operating Characteristic analysis, an APACHE II
score of 20 as a cutoff to predict ICU transfer had an area under the curve
of 0.67, and sensitivity, specificity and positive predictive value of 61%,
74% and 74% respectively. 28 day mortality in patients who remained in the
ward was 4.7% (6/126) and in those transferred to ICU was 31% (48/155),
p<0.0001. An alarming 44% (21/48) of patients (mean APACHE II 21.7) who died
in ICU were deemed stable at the initial RRT evaluation, but had to be
transferred later. Conclusions: An APACHE II score of 20 or more is
associated with an ICU transfer in hypotensive patients in the general ward.
As an adjunctive tool it may help identify borderline patients, which in our
study had the highest mortality. These results should be validated
prospectively in a multicenter study.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
antihypertensive agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
human
intensive care
intensive care unit
patient
ward
EMTREE MEDICAL INDEX TERMS
APACHE
area under the curve
chi square test
hospital
hypotension
hypothesis
mortality
multicenter study
predictive value
rapid response team
receiver operating characteristic
Student t test
tertiary health care
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71058818
DOI
10.1097/01.ccm.0000408627.24229.88
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000408627.24229.88
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 547
TITLE
Intrahospital transport of critically ill patients (excluding newborns).
AUTHOR NAMES
Quenot J.P.
Milési C.
Cravoisy A.
Capellier G.
Mimoz O.
Fourcade O.
Gueugniaud P.Y.
Soc. de Reanimation de Langue Francaise
Societe Francaise d'anesthesie et de reanimation
Société française de médecine d'urgence
AUTHOR ADDRESSES
(Quenot J.P.) Service de réanimation médicale, CHU Bocage-Central-Gabriel,
14, rue Paul-Gaffarel, 21079 Dijon, France.
(Milési C.; Cravoisy A.; Capellier G.; Mimoz O.; Fourcade O.; Gueugniaud
P.Y.; Soc. de Reanimation de Langue Francaise; Societe Francaise
d'anesthesie et de reanimation; Société française de médecine d'urgence)
CORRESPONDENCE ADDRESS
J.P. Quenot, Service de réanimation médicale, CHU Bocage-Central-Gabriel,
14, rue Paul-Gaffarel, 21079 Dijon, France. Email:
jean-pierre.quenot@chu-dijon.fr
SOURCE
Annales françaises d'anesthèsie et de rèanimation (2011) 30:12 (e83-87,
952-956). Date of Publication: Dec 2011
ISSN
1769-6623 (electronic)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
patient transport
EMTREE MEDICAL INDEX TERMS
article
human
monitoring
practice guideline
standard
LANGUAGE OF ARTICLE
English, French
MEDLINE PMID
22100622 (http://www.ncbi.nlm.nih.gov/pubmed/22100622)
PUI
L560066388
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 548
TITLE
Are subinhibitory concentrations of antibiotics the only culprit of
antibiotic resistance?
AUTHOR NAMES
Krcmery V.
AUTHOR ADDRESSES
(Krcmery V., vladimir.krcmery@szu.sk) St. Elizabeth University, College of
Health and Social Sciences, Namestie 1. maja No 1, 811 01 Bratislava,
Slovakia.
CORRESPONDENCE ADDRESS
V. Krcmery, St. Elizabeth University, College of Health and Social Sciences,
Namestie 1. maja No 1, 811 01 Bratislava, Slovakia. Email:
vladimir.krcmery@szu.sk
SOURCE
Future Microbiology (2011) 6:12 (1391-1394). Date of Publication: December
2011
ISSN
1746-0913
1746-0921 (electronic)
BOOK PUBLISHER
Future Medicine Ltd., 2nd Albert Place, Finchley Central, London, United
Kingdom.
ABSTRACT
Evaluation of: Gullberg E, Cao S, Berg OG et al. Selection of resistant
bacteria at very low antibiotic concentrations. PLoS Pathog. 7(7), e1002158
(2011). Subinhibitory concentrations of antibiotics and antifungals promote
resistance. Antibiotic consumption including hospital use, and country use,
including patients self-medications is one of the major drivers of
antibiotic or antifungal resistance. However, consumption of antibiotics
should be distinguished between the hospital and community. Hospital
consumption, poor hospital hygiene and intrahospital transfer have been
determined as major risk factors for development of resistance. The
correlation between resistance and consumption in the community is not so
clear. Therefore consumption of antibiotics and antifungals alone cannot
explain the selection of resistant bacterial and fungal mutants and other
factors have to be investigated. © 2011 Future Medicine Ltd.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
antibiotic agent
EMTREE DRUG INDEX TERMS
amphotericin B
cotrimoxazole
echinocandin
fluconazole
macrolide
nystatin
penicillin G
quinolone derivative
tetracycline derivative
voriconazole
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
antibiotic resistance
EMTREE MEDICAL INDEX TERMS
acute leukemia
antifungal resistance
article
bone marrow transplantation
Candida dubliniensis
Candida glabrata
Candida parapsilosis
Candida rugosa
Candida tropicalis
Clavispora lusitaniae
Enterobacter cloacae
Escherichia coli
hospital hygiene
human
intensive care unit
methicillin resistant Staphylococcus aureus
Meyerozyma guilliermondii
neutropenia
nonhuman
Pichia kudriavzevii
priority journal
risk factor
Yarrowia lipolytica
CAS REGISTRY NUMBERS
amphotericin B (1397-89-3, 30652-87-0)
cotrimoxazole (8064-90-2)
echinocandin (80619-41-6)
fluconazole (86386-73-4)
nystatin (1400-61-9, 34786-70-4, 62997-67-5)
penicillin G (1406-05-9, 61-33-6)
voriconazole (137234-62-9)
EMBASE CLASSIFICATIONS
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2011656282
PUI
L363012383
DOI
10.2217/fmb.11.129
FULL TEXT LINK
http://dx.doi.org/10.2217/fmb.11.129
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 549
TITLE
Predictive score for clinical complications during intra-hospital transports
of infants treated in a neonatal unit
AUTHOR NAMES
Vieira A.L.P.
dos Santos A.M.N.
Okuyama M.K.
Miyoshi M.H.
de Almeida M.F.B.
Guinsburg R.
AUTHOR ADDRESSES
(Vieira A.L.P.; dos Santos A.M.N., ameliamiyashiro@yahoo.com.br; Okuyama
M.K.; Miyoshi M.H.; de Almeida M.F.B.; Guinsburg R.) Department of
Pediatrics, Neonatal Division of Medicine, Federal University of São Paulo,
São Paulo/SP, Brazil.
CORRESPONDENCE ADDRESS
A. M. N. dos Santos, Department of Pediatrics, Neonatal Division of
Medicine, Federal University of São Paulo, São Paulo/SP, Brazil. Email:
ameliamiyashiro@yahoo.com.br
SOURCE
Clinics (2011) 66:4 (573-577). Date of Publication: 2011
ISSN
1807-5932
BOOK PUBLISHER
Universidade de Sao Paulo, Av.Dr.Arnaldo 455-Cerqueira Cesar, Sao Paulo,
Brazil.
ABSTRACT
OBJECTIVE: To develop and validate a predictive score for clinical
complications during intra-hospital transport of infants treated in neonatal
units. METHODS: This was a cross-sectional study nested in a prospective
cohort of infants transported within a public university hospital from
January 2001 to December 2008. Transports during even (n = 301) and odd (n =
394) years were compared to develop and validate a predictive score. The
points attributed to each score variable were derived from multiple logistic
regression analysis. The predictive performance and the score calibration
were analyzed by a receiver operating characteristic (ROC) curve and
Hosmer-Lemeshow test, respectively. RESULTS: Infants with a mean gestational
age of 35±4 weeks and a birth weight of 2457±841 g were studied. In the
derivation cohort, clinical complications occurred in 74 (24.6%) transports.
Logistic regression analysis identified five variables associated with these
complications and assigned corresponding point values: gestatin at birth
[,28 weeks (6 pts); 28-34 weeks (3 pts); >34 weeks (2 pts)]; pre-transport
temperature [<36.3°C or >37°C (3 pts); 36.3-37.0°C (2 pts)]; underlying
pathological condition [CNS malformation (4 pts); other (2 pts)]; transport
destination [surgery (5 pts); magnetic resonance or computed tomography
imaging (3 pts); other (2 pts)]; and pre-transport respiratory support
[mechanical ventilation (8 pts); supplemental oxygen (7 pts); no oxygen (2
pts)]. For the derivation and validation cohorts, the areas under the ROC
curve were 0.770 and 0.712, respectively. Expected and observed frequencies
of complications were similar between the two cohorts. CONCLUSION: The
predictive score developed and validated in this study presented adequate
discriminative power and calibration. This score can help identify infants
at risk of clinical complications during intra-hospital transports. © 2011
CLINICS.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
nervous system malformation (complication)
newborn intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
epidemiology
female
human
infant
male
methodology
risk assessment
standard
statistics
validation study
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
21655749 (http://www.ncbi.nlm.nih.gov/pubmed/21655749)
PUI
L361932403
DOI
10.1590/S1807-59322011000400009
FULL TEXT LINK
http://dx.doi.org/10.1590/S1807-59322011000400009
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 550
TITLE
The use of pews to predict provider intervention and adverse events during
air transport of critically ill children with congenital heart disease
AUTHOR NAMES
Wolf M.
Hoar E.
Patel M.
Petrillo-Albarano T.
Simsic J.
AUTHOR ADDRESSES
(Wolf M.; Hoar E.; Patel M.; Petrillo-Albarano T.) Children's Healthcare of
Atlanta, United States.
(Simsic J.) Emory University, Children's Healthcare of Atlanta, Egleston,
United States.
CORRESPONDENCE ADDRESS
M. Wolf, Children's Healthcare of Atlanta, United States.
SOURCE
Critical Care Medicine (2011) 39 SUPPL. 12 (62). Date of Publication:
December 2011
CONFERENCE NAME
Critical Care Congress 2012
CONFERENCE LOCATION
Houston, TX, United States
CONFERENCE DATE
2012-02-04 to 2012-02-08
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: Children with congenital heart disease (CHD) are often
transferred from referring hospitals to tertiary care centers via air
transport for management. Hypothesis: The purpose of this study was to
examine (1) medical interventions or adverse events during air transports
and (2) utility of PEWS in predicting need for intervention or adverse
events during air transport. Methods: Retrospective review from January
2006-August 2008 of all children with CHD air transported to the cardiac
intensive care unit. N = 79. Transport assessment and events during
transport were reviewed. Medical interventions were defined as intubation,
volume administration, acidosis management, sedation, and need for IV
access. Adverse events were intubation/extubation, addition of inotrope, and
CPR. Results: Mean age at transport 12 ± 36 months; median 7.5 days (0
days-16 yrs). 54 (68%) were <1 mos. Most common diagnoses were transposition
of great arteries (19%); coarctation of aorta (14%); hypoplastic left heart
syndrome (7%). Mean initial PEWS score 4.9 - 2.7; median 5 (0-9). 36 (46%)
PEWS <4 and 43 (54%) PEWS 5. Medical interventions occurred in 62% of
transports. Adverse events occurred in 3 (3.8%). Medical interventions were
more frequent in patients with PEWS 5 vs PEWS <4 (88(90%) vs 10(10%); p =
0.001); and in intubated vs non-intubated patients (89(91%) vs 8(8%); p =
0.001). Of 36 patients on PGE, 24 (67%) were intubated. Medical
interventions were more frequent in neonates on PGE vs not on PGE (59 (60%)
vs 20 (20%); p = 0.06). Conclusions: Adverse events were uncommon during the
air transport of children with CHD. PEWS 5, intubation, and PGE were
predictive of medical interventions by the transport team. PGE infusion does
not appear to be a risk for intubation prior to or during transport.
Frequent need for medical interventions, especially with PEWS 5 supports the
importance of a pediatric transport team, and the use of PEWS as a triage
tool in patients with CHD transported by air.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child
congenital heart disease
critically ill patient
human
intensive care
EMTREE MEDICAL INDEX TERMS
acidosis
aorta
artery
diagnosis
emergency health service
hospital
hypoplastic left heart syndrome
hypothesis
infusion
intensive care unit
intubation
newborn
patient
risk
sedation
tertiary health care
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71058556
DOI
10.1097/01.ccm.0000408627.24229.88
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000408627.24229.88
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 551
TITLE
Invasive circulation assist devices for intrahospital and interhospital
transport
ORIGINAL (NON-ENGLISH) TITLE
Invasive kreislaufunterstützungssysteme bei intra-und interhospitalen
transporten
AUTHOR NAMES
Fürnau G.
Thiele H.
AUTHOR ADDRESSES
(Fürnau G., fuerg@med.uni-leipzig.de; Thiele H.,
thielh@medizin.uni-leipzig.de) Klinik für Innere Medizin/Kardiologie,
Universität Leipzig, Herzzentrum Strümpellstraße 39, 04289 Leipzig, Germany.
CORRESPONDENCE ADDRESS
G. Fürnau, Klinik für Innere Medizin/Kardiologie, Universität Leipzig,
Herzzentrum Strümpellstraße 39, 04289 Leipzig, Germany. Email:
fuerg@med.uni-leipzig.de
SOURCE
Notfall und Rettungsmedizin (2011) 14:8 (630-634). Date of Publication:
December 2011
ISSN
1434-6222
1436-0578 (electronic)
BOOK PUBLISHER
Springer Verlag, Tiergartenstrasse 17, Heidelberg, Germany.
ABSTRACT
The use of left ventricular assist devices is becoming increasingly more
common. Current developments allow percutaneous canulation without the
setting of a cardiac surgery department or a perfusionist. This brings
assist device treatment also to smaller facilities and makes the transfer of
unstable patients from the primary clinic to specialized centers for
extended treatment possible. This review describes the different systems and
current experience in patient transfer. © Springer-Verlag 2011.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
heart assist device
patient transport
EMTREE MEDICAL INDEX TERMS
article
experience
human
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Cardiovascular Diseases and Cardiovascular Surgery (18)
Biophysics, Bioengineering and Medical Instrumentation (27)
LANGUAGE OF ARTICLE
German
LANGUAGE OF SUMMARY
English, German
EMBASE ACCESSION NUMBER
2012047168
PUI
L51739376
DOI
10.1007/s10049-011-1417-0
FULL TEXT LINK
http://dx.doi.org/10.1007/s10049-011-1417-0
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 552
TITLE
Adverse events leading to ICU transfer from inpatient units: Investigating
trends and prevent-ability
AUTHOR NAMES
Miles A.
Spaeder M.
Stockwell D.
AUTHOR ADDRESSES
(Miles A.; Spaeder M.; Stockwell D.) Children's National Medical Center,
United States.
CORRESPONDENCE ADDRESS
A. Miles, Children's National Medical Center, United States.
SOURCE
Critical Care Medicine (2011) 39 SUPPL. 12 (175). Date of Publication:
December 2011
CONFERENCE NAME
Critical Care Congress 2012
CONFERENCE LOCATION
Houston, TX, United States
CONFERENCE DATE
2012-02-04 to 2012-02-08
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: A portion of unplanned transfers to an ICU from inpatient
units results from adverse events (AEs). We examined trends in AE-related
ICU transfer to identify at-risk populations. Hypothesis: AEs (and their
preventability) may be more common in some populations depending on
diagnosis, time of day, and weekday vs. weekend. Methods: A retrospective
observational study of ICU transfers from inpatient units during a 1-year
period in a tertiary care children's hospital. Transfers were identified via
electronic health record and investigated to establish if an AE had
occurred. Predefined AEs included ICU transfers in < 12 hours of admission
to acute care, re-admissions to an ICU in <24 hours of ICU discharge, and
cardiopulmonary arrests on an acute care unit. We determined the
preventability of the AEs and categorized them by type, diagnosis, time of
day, and weekday vs. weekend to examine trends. Results: 533 ICU transfers
occurred with 114 (21.4%) AEs; 27 (23.7%) were preventable. The majority
were transfers in <12 hours of admission (60.5%; 15.9% of these were
preventable), cardiopulmonary arrests (16.7%; 15.8% preventable) and ICU
re-admissions in <24 hours (15.8%; 61.1% preventable). Reasons for transfer
included respiratory distress (48.2%), sepsis (13.2%), and need for
increased monitoring (9.6%). Among the 55 AEs related to respiratory
distress, associated diagnoses were pneumonia (29.1%), status asthmaticus
(21.8%), bronchiolitis (16.4%) and upper airway disease (12.7%). Night
events accounted for 57% (65) of AE-related transfers with 25% deemed
preventable. All 3 preventable cardiopulmonary arrests and all 5 preventable
sepsis-related AEs occurred at night as did 73.3% of total sepsis-related
AEs. The incidence of preventable AEs on weekends (29.4%) was higher than
the overall incidence of preventable events. Conclusions: Understanding
reasons for ICU transfers is crucial in order to recognize areas for
improvement in care. Status asthmaticus, pneumonia, and bronchiolitis were
the most common diagnoses involved in AE-related ICU transfer and may
suggest areas for future research to improve assessment of likely clinical
course. Nights and weekends were not significantly associated with an
increase in AEs.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital patient
human
intensive care
EMTREE MEDICAL INDEX TERMS
asthmatic state
bronchiolitis
cardiopulmonary arrest
diagnosis
disease course
electronic medical record
emergency care
hypothesis
monitoring
night
observational study
pediatric hospital
pneumonia
population
respiratory distress
respiratory tract disease
risk
sepsis
tertiary health care
upper respiratory tract
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71058945
DOI
10.1097/01.ccm.0000408627.24229.88
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000408627.24229.88
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 553
TITLE
Transport time-out: Improving safety in critically ill patient transport
AUTHOR NAMES
Fairfax L.
Kaylor C.
Huynh T.
AUTHOR ADDRESSES
(Fairfax L.; Kaylor C.; Huynh T.) Carolinas Medical Center, United States.
CORRESPONDENCE ADDRESS
L. Fairfax, Carolinas Medical Center, United States.
SOURCE
Critical Care Medicine (2011) 39 SUPPL. 12 (178). Date of Publication:
December 2011
CONFERENCE NAME
Critical Care Congress 2012
CONFERENCE LOCATION
Houston, TX, United States
CONFERENCE DATE
2012-02-04 to 2012-02-08
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: Intrafacility transport of critically ill patients is
associated with adverse events. Key components to promote safety include
assurance of transport necessity and provision of adequate personnel,
resources and equipment. This requires a formalized process with consistent
structure and interdisciplinary communication. Hypothesis: We hypothesized
that implementation of a safety verification process (SVP) will reduce the
incidence of adverse events associated with intrafacility transport of
critically ill patients. Methods: A multi-professional team developed and
implemented a SVP in our 29-bed ICU over an 11-week period. The SVP
consisted of nursing and respiratory staff assessing transport necessity,
patient condition, required personnel and equipment. Transports were
categorized as green, yellow or red based on increasing order of concern. A
minimum of two staff members and emergency medications were required for
each transport. Ventilated patients had in-line CO2 detection and portable
suction. Documents and data included category of transports, compliance and
number of transports aborted. Results: Sixty-eight SVP forms were completed
prior to transport with 39 green, 18 yellow and 11 red. Transport concerns
were present in 29% of cases; all were communicated to physician resulting
in 3 procedures changed to bedside and 1 aborted. Adequate staffing was
present in 91%, with more staff than required accompanying 19% of
transports. A physician or advanced practitioner accompanied 72% of red
transports. No adverse events were reported. Conclusions: Our
multi-professional initiative for intrafacility transport led to more
effective staff communication, improved triage and sufficient resources to
ensure transport safety. Multi-professional collaboration was paramount in
achieving a culture of safety in our ICU.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
human
intensive care
patient transport
safety
EMTREE MEDICAL INDEX TERMS
drug therapy
emergency
emergency health service
hypothesis
interdisciplinary communication
interpersonal communication
nursing
patient
personnel
physician
procedures
suction
ventilated patient
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71058953
DOI
10.1097/01.ccm.0000408627.24229.88
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000408627.24229.88
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 554
TITLE
Use of a transfer center to manage the transfer of pediatric patients from
the emergency department to the intensive care unit: A pilot study
AUTHOR NAMES
Hatfield M.
Cocks A.
Warnick R.
Hirsh D.
Vats A.
AUTHOR ADDRESSES
(Hatfield M.; Cocks A.; Warnick R.; Hirsh D.; Vats A.) Children's Healthcare
of Atlanta, United States.
(Vats A.) Emory University School of Medicine, United States.
CORRESPONDENCE ADDRESS
M. Hatfield, Children's Healthcare of Atlanta, United States.
SOURCE
Critical Care Medicine (2011) 39 SUPPL. 12 (27). Date of Publication:
December 2011
CONFERENCE NAME
Critical Care Congress 2012
CONFERENCE LOCATION
Houston, TX, United States
CONFERENCE DATE
2012-02-04 to 2012-02-08
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: Transfer of care of patients is recognized as problematic. The
transfer of care of patients from the Emergency Department (ED) to the
Intensive Care Unit (ICU) has several aspects of transfer that operate
independently (ED-to-ICU physician transfer/handoff, nurse-to-nurse
transfer, and bed placement) that can lead to delays in transfer to a higher
level of care, delays in treatment, delays in care for other waiting ED
patients, misinformation, and errors. Transfer centers (TC) have been
utilized at many institutions to improve quality of care and efficiency for
acceptance of patients from outside institutions. Hypothesis: Use of a TC to
coordinate all ED to ICU patient transfers at an academic pediatric hospital
will lead to decreased ED length of stay (LOS), decreased disposition to
exit time (DTE), and decreased errors. Methods: Children's Healthcare of
Atlanta has a TC that was established in 2009 for referrals from outside
centers. The study was performed on the Egleston campus which is affiliated
with Emory University. The institution has an occurence notification system
(ONS) utilized for reporting and monitoring patient care related occurrences
and errors. The TC was implemented as a trial for all ED to ICU transfers
from May 16-July 11, 2011. DTE and ED LOS for the trial period were compared
to same time period one year earlier (YE) and the same time period
immediately prior (IP). ONS rates related to ED transfer of care were
monitored. Results: 118 patients were transferred from the ED to ICU during
the study period compared to 129 YE and 154 IP. Average DTE decreased to
69.9+47.5 minutes (78.3+48.7 YE, p = 0.17. 80.2+51.6 IP, p = 0.09) and ED
LOS decreased to 215 + 99 minutes (229+ 110 YE, p = 0.281. 241 +114 IP, p =
0.04). The campus ONS rate was 3.5/month in 2009-2011. There were zero ONS
reports during the study period. Conclusions: In this pilot trial of
utilizing a TC to manage transfer of patients from the ED to ICU, there was
a decrease DT and ED LOS in the time period immediately after initiation of
the process change. The trial has also been associated with a decreased ONS
rate. Further study is warranted to see if the results of this trial period
are sustained.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency ward
human
intensive care
intensive care unit
patient
pilot study
EMTREE MEDICAL INDEX TERMS
child
health care
hypothesis
length of stay
monitoring
nurse
patient care
patient transport
pediatric hospital
physician
therapy delay
university
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71058449
DOI
10.1097/01.ccm.0000408627.24229.88
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000408627.24229.88
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 555
TITLE
Falling through the cracks: information breakdowns in critical care handoff
communication.
AUTHOR NAMES
Abraham J.
Nguyen V.
Almoosa K.F.
Patel B.
Patel V.L.
AUTHOR ADDRESSES
(Abraham J.) Center for Cognitive Informatics and Decision Making, School of
Biomedical Informatics, UTHealth, Houston, TX, USA.
(Nguyen V.; Almoosa K.F.; Patel B.; Patel V.L.)
CORRESPONDENCE ADDRESS
J. Abraham, Center for Cognitive Informatics and Decision Making, School of
Biomedical Informatics, UTHealth, Houston, TX, USA.
SOURCE
AMIA ... Annual Symposium proceedings / AMIA Symposium. AMIA Symposium
(2011) 2011 (28-37). Date of Publication: 2011
ISSN
1942-597X (electronic)
ABSTRACT
Handoffs have been recognized as a major healthcare challenge primarily due
to the breakdowns in communication that occur during transitions in care.
Consequently, they are characterized as being "remarkably haphazard". To
investigate the information breakdowns in group handoff communication, we
conducted a study at a large academic hospital in Texas. We used
multifaceted qualitative methods such as observations, shadowing of care
providers and their work activities, audio-recording of handoffs, and care
provider interviews to examine the handoff communication workflow, with
particular emphasis on investigating the sources of information breakdowns.
Using a mixed inductive-deductive analysis approach, we identified two
critical sources for information breakdowns - lack of standardization in
handoff communication events and unsuccessful completion of pre-turnover
coordination activities. We propose strategic solutions that can effectively
help mitigate the handoff communication breakdowns.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
interpersonal communication
patient care
patient transport
EMTREE MEDICAL INDEX TERMS
article
human
medical error (prevention)
nonbiological model
organization and management
statistics
United States
university hospital
workflow
LANGUAGE OF ARTICLE
English
MEDLINE PMID
22195052 (http://www.ncbi.nlm.nih.gov/pubmed/22195052)
PUI
L560078251
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 556
TITLE
Intrahospital transport increases the risk of VAP in critically ill surgical
patients
AUTHOR NAMES
Kelliher K.
Nailor M.
Staff I.
Brautigam R.
Butler K.
AUTHOR ADDRESSES
(Kelliher K.; Nailor M.; Staff I.; Brautigam R.; Butler K.) Hartford
Hospital, United States.
CORRESPONDENCE ADDRESS
K. Kelliher, Hartford Hospital, United States.
SOURCE
Critical Care Medicine (2011) 39 SUPPL. 12 (102). Date of Publication:
December 2011
CONFERENCE NAME
Critical Care Congress 2012
CONFERENCE LOCATION
Houston, TX, United States
CONFERENCE DATE
2012-02-04 to 2012-02-08
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: The purpose of this study was to determine whether
intrahospital transport (IHT) is a risk factor for ventilator associated
pneumonia (VAP). Hypothesis: We hypothesized that IHT of critically ill
surgical patients was an independent risk factor for VAP. Methods: A
retrospective review of consecutive admissions to the neurotrauma/general
surgery intensive care unit (SICU) from January thru September 2010 was
performed. Patients were included if they were intubated within 24 hours of
admission and required mechanical ventilation for >48 hours. Clinical
suspicion of VAP was based on ATS/IDSA criteria and confirmed by sampling
lower respiratory secretions (BAL>104 cfu/ml). Age, gender, ethnicity, BMI,
APACHE II, length of stay, mortality and discharge disposition were
collected. Data are expressed as mean±SD. Results: A total of 1300 patients
were admitted to the SICU, 413 patients required mechanical ventilation, 128
(31%) met inclusion criteria. The mean age was 54±21 years, 67% were male,
APACHE II 19±6, mean BMI 29±8 and mean SICU LOS 16±13 days. VAP was
identified in 51 (40%) patients and occurred more frequently (85%) in
patients >50 years compared to younger patients (P = 0.015). There were no
differences in ethnicity, APACHE II, or BMI in the VAP( +) or VAP(-) groups.
ICU LOS (21 ± 13 days vs. 13 - 11 days, ( +)vs.(-), P<0.01) and hospital LOS
(31±19 days vs. 22±19 days, (+)vs.(-), P = 0.01) were significantly longer
for VAP (+) patients. The mean number of IHT's for all patients was 3 - 2
(range 0-9) with 75% of patients transported more than once. The most common
destination was radiology for CT imaging (75% of all patients and 93% of
those with multiple transports). On multivariate analysis patients
transported out of the ICU 2 times had a significantly greater rate of VAP
independent of demographic and illness severity measures (OR = 2.8, CI =
1.02-7.6, P<0.045). Sixty-four percent of patients survived to hospital
discharge; home (18%), rehab (29%) or skilled nursing facility (17%).
Conclusions: Intrahospital transport is an important risk factor for VAP in
the SICU patient. Quality improvement initiatives aimed at reducing the rate
of VAP must address risks inside and outside of the intensive care unit.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
human
intensive care
risk
surgical patient
EMTREE MEDICAL INDEX TERMS
APACHE
artificial ventilation
bodily secretions
disease severity
ethnicity
gender
hospital
hospital discharge
hypothesis
imaging
intensive care unit
length of stay
male
mortality
multivariate analysis
nursing home
patient
radiology
risk factor
sampling
surgery
total quality management
ventilator associated pneumonia
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71058690
DOI
10.1097/01.ccm.0000408627.24229.88
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000408627.24229.88
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 557
TITLE
Three percent saline administration during pediatric critical care transport
AUTHOR NAMES
Luu J.L.
Wendtland C.L.
Gross M.F.
Mirza F.
Zouros A.
Zimmerman G.J.
Barcega B.
Abd-Allah S.A.
AUTHOR ADDRESSES
(Luu J.L.; Wendtland C.L.; Gross M.F.; Mirza F.; Zouros A.; Zimmerman G.J.;
Barcega B.; Abd-Allah S.A.)
CORRESPONDENCE ADDRESS
J. L. Luu,
SOURCE
Pediatric Emergency Care (2011). Date of Publication: 30 Nov 2011
ISSN
0749-5161
BOOK PUBLISHER
Lippincott Williams & Wilkins, Inc.
ABSTRACT
OBJECTIVES: The purpose of this study was to describe the administration of
3% saline (3%S) during pediatric critical care transport. METHODS: A
retrospective study was performed on pediatric patients who underwent
critical transport to Loma Linda University Children's Hospital from January
1, 2003, to June 30, 2007, and were given 3%S. Patients' demographics,
admission diagnosis, route and amount of 3%S administration, serum
electrolytes, vital signs, radiographic data, and Glasgow Coma Scale scores
were collected and analyzed. RESULTS: A total of 101 children who received
3%S infusions during pediatric critical care transport were identified. Mean
patient age was 5.9 years, and mean patient weight was 27.6 kg. The main
indications for infusing 3%S were suspected cerebral edema (41%),
intracranial bleed with edema (51%), and symptomatic hyponatremia (6%). The
amount of 3%S bolus ranged from 1.2 to 24 mL/kg, with a mean of 5.4 mL/kg.
Serum electrolytes before and after 3%S infusion demonstrated significant
increases in sodium, chloride, and bicarbonate levels (P < 0.05). A
significant reduction was also seen in serum urea nitrogen levels and anion
gap. Radiographic imaging performed before 3%S infusion demonstrated
findings consistent with concerns of increased intracranial pressure such as
intracranial bleed and cerebral edema. The route of initial 3%S infusions
was mainly through peripheral intravenous lines (96%). No complications
related to the 3%S delivery such as local reactions, renal abnormalities, or
central pontine myelinolysis were observed. CONCLUSIONS: It seems 3%S may be
administered safely during pediatric critical transport and administration
routes can include peripheral lines. With the importance of initiating
therapy early to improve patient outcomes, the use of 3%S may benefit
transported children with brain injury and suspected intracranial
hypertension.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
sodium chloride
EMTREE DRUG INDEX TERMS
bicarbonate
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
EMTREE MEDICAL INDEX TERMS
anion gap
brain edema
brain injury
central pontine myelinolysis
child
diagnosis
drug administration route
edema
electrolyte blood level
Glasgow coma scale
human
hyponatremia
imaging
infusion
intracranial hypertension
Loma
patient
pediatric hospital
retrospective study
therapy
university
urea nitrogen blood level
vital sign
weight
PUI
L51747822
DOI
10.1097/PEC.0b013e31823aff59
FULL TEXT LINK
http://dx.doi.org/10.1097/PEC.0b013e31823aff59
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 558
TITLE
A clinical nurse specialist intervention to facilitate safe transfer from
ICU.
AUTHOR NAMES
St-Louis L.
Brault D.
AUTHOR ADDRESSES
(St-Louis L.) Critical Care and Cardiac Surgery, Jewish General Hospital,
Intensive Care Unit, 3755 Chemin de la Côte Ste-Catherine, Montréal, Quebec,
Canada.
(Brault D.)
CORRESPONDENCE ADDRESS
L. St-Louis, Critical Care and Cardiac Surgery, Jewish General Hospital,
Intensive Care Unit, 3755 Chemin de la Côte Ste-Catherine, Montréal, Quebec,
Canada. Email: lstlouis@nurs.jgh.mcgill.ca
SOURCE
Clinical nurse specialist CNS (2011) 25:6 (321-326). Date of Publication:
2011 Nov-Dec
ISSN
1538-9782 (electronic)
ABSTRACT
The purpose of this article was to describe an innovative quality initiative
implemented by the clinical nurses specialist in medicine to facilitate the
transition process between the intensive care unit and the medical wards.
Safely transferring patients with complex health conditions from an area of
high technology and increased monitoring, like the intensive care unit, to
an area with lower nurse-to-patient ratio is an intricate process. The care
of these patients, once transferred, also requires varying levels of
expertise. As indicated in the nursing literature, this type of transition
is often associated with high stress levels for the patient and family, as
well as for the healthcare providers. To maximize patient safety and ensure
optimal care for this patient population, well-defined mechanisms must be
put in place. DESCRIPTION OF THE PROJECT/INNOVATION: The introduction of a
formal assessment, consultation, and follow-up process conducted by a
clinical nurse specialist (CNS). On average, 150 patients are assessed each
year by the CNS. Among these patients, 15% are considered at high risk for
complications upon transfer to the unit.
INTERPRETATION/CONCLUSION/IMPLICATIONS: A systematic evaluation of patients
by the CNS, before their transfer from the ICU to a medical unit, has been
proven beneficial in ensuring a comprehensive patient care plan. Patients
and families have verbalized that this intervention is helpful. Staff
members have indicated that this safety initiative is useful in planning
patient transfers. The next step would be to formally measure patient,
family, and staff satisfaction with this initiative.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
nurse
patient safety
patient transport
EMTREE MEDICAL INDEX TERMS
article
health care quality
human
nursing methodology research
organization
organization and management
LANGUAGE OF ARTICLE
English
MEDLINE PMID
22016020 (http://www.ncbi.nlm.nih.gov/pubmed/22016020)
PUI
L560044082
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 559
TITLE
2011 critical care transport workplace and salary survey
AUTHOR NAMES
Greene M.J.
AUTHOR ADDRESSES
(Greene M.J., mgreene@fitchassoc.com) LLC, Platte City, MO, United States.
CORRESPONDENCE ADDRESS
M.J. Greene, LLC, Platte City, MO, United States. Email:
mgreene@fitchassoc.com
SOURCE
Air Medical Journal (2011) 30:6 (306-312). Date of Publication:
November-December 2011
ISSN
1067-991X
1532-6497 (electronic)
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
ABSTRACT
Critical care transport (CCT) leaders from 260 organizations were invited to
participate in an online, hosted survey of industry compensation and
workplace practices. Approximately 150 questions were presented to
participants, soliciting a broad base of information on CCT organizations,
personnel, compensation, and workplace practices, notably alertness and
fatigue management. CCT organizational salaries are represented by common
job class and reported by summary with minimum, middle, and maximum hourly
rates in a national aggregate and by Association of Air Medical Services
region. © 2011 Air Medical Journal Associates.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
occupational health
salary and fringe benefit
work environment
EMTREE MEDICAL INDEX TERMS
alertness
compensation
demography
emergency health service
fatigue
health care organization
health care survey
medical staff
occupational safety
practice guideline
priority journal
review
EMBASE CLASSIFICATIONS
Occupational Health and Industrial Medicine (35)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2011609193
MEDLINE PMID
22055178 (http://www.ncbi.nlm.nih.gov/pubmed/22055178)
PUI
L362871772
DOI
10.1016/j.amj.2011.10.001
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2011.10.001
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 560
TITLE
Does a team base knowledge transfer intervention to manage fever,
hyperglycaemia and swallowing dysfunction, improve 90-day outcomes following
stroke?
AUTHOR NAMES
Middleton S.
Ward J.
Grimshaw J.
Griffiths R.
D'Este C.
Dale S.
Drury P.
Cheung N.
Quinn C.
Evans M.
Cadhilac D.
McElduff P.
Levi C.
AUTHOR ADDRESSES
(Middleton S.) Nursing Research Institute, St Vincent's and Mater Health
Sydney, Australian Catholic University, Darlinghurst, Australia.
(Ward J.) Department of Epidemiology, Community Medicine, University of
Ottawa, Canada.
(Middleton S.; Dale S.; Drury P.) National Centre for Clinical Outcomes
Research (NaCCOR), Australian Catholic University, North Sydney, Australia.
(Grimshaw J.) Clinical Epidemiology Program, Ottawa Health Research
Institute, Ottawa, Canada.
(Griffiths R.) School of Nursing and Midwifery, University of Western
Sydney, Penrith, Australia.
(D'Este C.) Centre for Clinical Epidemiology, Biostatistics, Faculty of
Health, The University of Newcastle, Callaghan, Australia.
(Dale S.; Drury P.) Nursing Research Institute, St Vincents and Mater Health
Sydney, School of Nursing (NSW and ACT), Australian Catholic University,
Darlinghurst, Australia.
(Cheung N.) Department of Diabetes and Endocrinology, Westmead Hospital,
University of Sydney, Westmead, Australia.
(Quinn C.) Speech Pathology Department, Prince of Wales Hospital, Randwick,
Australia.
(Evans M.; Levi C.) Priority Centre for Brain and Mental Health Research,
University of Newcastle, Callaghan, Australia.
(Cadhilac D.) Public Health Division, National Stroke Research Institute,
Heidelberg Repatriation Hospital, Heidelberg, Australia.
(Cadhilac D.) University of Melbourne, Melbourne, Australia.
(McElduff P.; Levi C.) Hunter Medical Research Institute, University of
Newcastle, Callaghan, Australia.
CORRESPONDENCE ADDRESS
S. Middleton, Nursing Research Institute, St Vincent's and Mater Health
Sydney, Australian Catholic University, Darlinghurst, Australia.
SOURCE
Stroke (2011) 42:11 (e587-e588). Date of Publication: November 2011
CONFERENCE NAME
2nd Canadian Stroke Congress, 2011
CONFERENCE LOCATION
Ottawa, ON, Canada
CONFERENCE DATE
2011-10-02 to 2011-10-04
ISSN
0039-2499
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Background: We conducted a single blind cluster randomized controlled trial
of a multidisciplinary implementation intervention targeting clinicians'
evidence-based management of fever, hyperglycaemia and swallowing
dysfunction following acute stroke. Methods: 19 Australian acute stroke
units were recruited and randomised to intervention (n=10) or control (n=9)
group. The intervention consisted of evidence-based treatment protocols to
manage fever, hyperglycaemia and swallowing dysfunction, multidisciplinary
team building workshops, staff education programs and local stroke unit
coordinator engagement. The control group ASUs received an abridged copy of
the Australian acute stroke guidelines relevant to the management of fever,
hyperglycaemia and swallowing. We recruited baseline and post-intervention
patient cohorts, comparing 90 day death or dependency (modified Rankin scale
>2); functional dependency (Barthel Index); and physical and mental health
scores (SF-36) for patients blind to stroke unit allocation and collected
processes of care data. Intention to treat analyses were undertaken
adjusting for baseline data and clustering. Results: A total of 1699
patients participated (690 pre-intervention; 1009 post-intervention).
Irrespective of stroke severity, patients from intervention ASU's were
significantly less likely to be dead or dependent at 90-days (42% vs 58%)
(p=0.002) than patients from control stroke units (number needed to treat
6.4) with improved SF-36 mean physical health scores (45.6 vs 42.5,
p=0.002). Patients from intervention stroke units demonstrated significant
reductions in: mean temperature reading (p=0.001); number of febrile
(=>37.5°C) patients (p<0.001); mean blood glucose (p=0.02); and improved
swallowing screening within 24 hours of admission (p<0.001). Conclusion:
Patients who received care in stroke units delivering the multidisciplinary
intervention demonstrated an absolute reduction for 90-day death or
dependency of 16%. This landmark study provides compelling evidence that a
team base knowledge transfer intervention to manage fever, hyperglycaemia
and swallowing dysfunction can decrease death and disability and improve
health status.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cerebrovascular accident
fever
hyperglycemia
swallowing
EMTREE MEDICAL INDEX TERMS
Barthel index
control group
death
disability
education program
evidence based practice
glucose blood level
health
health status
human
intention to treat analysis
mental health
patient
randomized controlled trial
randomized controlled trial (topic)
Rankin scale
reading
screening
staff training
stroke unit
team building
temperature
workshop
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70918201
DOI
10.1161/STR.0b013e3182301bf4
FULL TEXT LINK
http://dx.doi.org/10.1161/STR.0b013e3182301bf4
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 561
TITLE
Transport time out for cardiovascular intensive care unit patients traveling
off of the unit
AUTHOR NAMES
Boord J.B.
Symlar R.
Cunningham B.L.
McPherson J.
Burns K.
Byrd J.
AUTHOR ADDRESSES
(Boord J.B.; Symlar R.; Cunningham B.L.; McPherson J.; Burns K.; Byrd J.)
Vanderbilt Univ, Nashville, United States.
CORRESPONDENCE ADDRESS
J.B. Boord, Vanderbilt Univ, Nashville, United States.
SOURCE
Circulation: Cardiovascular Quality and Outcomes (2011) 4:6
MeetingAbstracts2010. Date of Publication: November 2011
CONFERENCE NAME
Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke
2010 Scientific Sessions, QCOR 2010
CONFERENCE LOCATION
Washington, DC, United States
CONFERENCE DATE
2010-05-19 to 2010-05-21
ISSN
1941-7705
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Background: Transportation of critically ill patients to other areas for
diagnostic testing or procedures can present risks to patient safety. It is
necessary to ensure that the same level of care and support be provided for
critically ill patients when they are removed from the ICU environment.
There were no established processes available in the literature to address
this safety issue. Aim: To establish a “transport time out” checklist
process for transport of critically ill patients outside of the ICU
environment. This process ensures that patient care and monitoring continues
at the level deemed necessary by patient condition without interruption.
Methods: A multidisciplinary team of nurses, physicians, and respiratory
therapists created an algorithm to ensure that crucial care elements were
considered prior to leaving the ICU environment with a critically ill
patient. Elements were categorized in the “Airway, Breathing, Circulation,
Drugs (ABCD)” format. Tools developed included a flowchart and transport
time out check list (Figure). Results: The checklist outlines essential
equipment and supplies for respiratory care, intravenous infusions, and
clinical monitoring. The process has been in use for over 9 months
encompassing approximately 330 patient transports. The process was rapidly
and widely accepted by nursing staff. No adverse events during transport
have occurred since implementation of the transport time out process.
Conclusion: Use of a “transport time out” checklist process potentially can
decrease the likelihood of adverse events during transport of a critically
ill patient from the ICU. The process was simple and easy to implement.
(Table Presented).
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cardiovascular disease
cerebrovascular accident
human
intensive care unit
outcomes research
patient
patient care
total quality management
travel
EMTREE MEDICAL INDEX TERMS
airway
algorithm
breathing
checklist
critically ill patient
devices
diagnosis
environment
intravenous drug administration
monitoring
nurse
nursing staff
patient safety
patient transport
physician
procedures
respiratory care
respiratory therapist
risk
safety
traffic and transport
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71256882
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 562
TITLE
Factors that influence neonatal transport in Attica, Greece
AUTHOR NAMES
Mouskou S.
Varakis C.
Vassilaki N.
Krikri A.
Pyrros D.
AUTHOR ADDRESSES
(Mouskou S.; Vassilaki N.; Krikri A.; Pyrros D.) National Centre of
Emergency Care (EKAB) Headquaters, Athens, Greece.
(Varakis C.) Economist, Dr. University of Athens, Athens, Greece.
CORRESPONDENCE ADDRESS
S. Mouskou, National Centre of Emergency Care (EKAB) Headquaters, Athens,
Greece.
SOURCE
Intensive Care Medicine (2011) 37 SUPPL. 2 (S404). Date of Publication:
November 2011
CONFERENCE NAME
22nd Annual Congress of the European Society of Paediatric and Neonatal
Intensive Care, ESPNIC 2011
CONFERENCE LOCATION
Hannover, Germany
CONFERENCE DATE
2011-11-02 to 2011-11-05
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag
ABSTRACT
Introduction: Since premature and seriously ill neonates continue to be born
in hospitals without an appropriate infrastructure, there is a continuous
need for postnatal transfer to neonatal intensive care units (NICY).
Purpose: To list the frequency, the main causes of neonatal transport in
Attica and to examine a connection between the type of transport and the
existence or not of NICY at the hospital of uptake. Materials and methods:
All neonates that had to be transferred to NICY in Attica during 2009. For
statistical analysis we used the Chisquare test, from SPSS-15. Statistical
significance was set at P<0.05. Results: 1580 neonateswere in need to be
transported: 633 fromAttica's hospitals, 200 by airtransport, 226 from
peripheral hospitals and 507 neonates remained on the waiting list. The
greatest percentage of neonates that is being transported derives from
Attica's NICU's (62.2%). Most of neonates are transported on the first day
of life (51.7%). Respiratory distress (55.6%), prematurity (47.6%) and
congenital heart disease (12.6%) are the main causes of transport.
Additional 17.8% of neonatal transport takes place because of exceeded
hospitalization capacity of the NICU's. Neonates with congenital heart
disease are transported mainly from NICU's of peripheral hospitals
(P<0.001), whereas neonates transported due to prematurity derive mainly
from hospitals in Attica (P<0.001). Neonates that are being transported for
intermediate care derive from peripheral hospitals without a NICU (P<0.001).
Conclusion: There is an increased need for neonatal transport in Attica.
Increasing the number of intermediate care units in peripheral hospitals and
the hospitalization capacity of Attica's NICU's one would reduce the number
of neonatal emergency transport.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Greece
newborn intensive care
society
EMTREE MEDICAL INDEX TERMS
congenital heart disease
emergency
hospital
hospital admission
hospitalization
intensive care unit
newborn
prematurity
respiratory distress
statistical analysis
statistical significance
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70638693
DOI
10.1007/s00134-011-2387-x
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-011-2387-x
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 563
TITLE
Can we easily anticipate on admission pediatric patient transfers from
intermediate to intensive care?
AUTHOR NAMES
Hamze-Sinno R.
Abdoul H.
Neve M.
Jones P.
Tsapis M.
Dauger S.
AUTHOR ADDRESSES
(Hamze-Sinno R.; Neve M.; Jones P.; Tsapis M.; Dauger S.,
stephane.dauger@rdb.aphp.fr) Pediatric Intensive Care Unit, Department of
Pediatrics and Internal Medicine, Robert-Debré Hospital, AP-HP Diderot-Paris
VII University, Paris, France.
(Abdoul H.) Unit of Epidemiology, Robert-Debré Hospital, AP-HP, INSERM CIE
5, Diderot-Paris VII University, Paris, France.
CORRESPONDENCE ADDRESS
S. Dauger, Pediatric Intensive Care Unit, Robert-Debré Hospital, 48
Boulevard Sérurier, 75019 Paris, France. Email: stephane.dauger@rdb.aphp.fr
SOURCE
Minerva Anestesiologica (2011) 77:10 (1022-1023). Date of Publication:
October 2011
ISSN
0375-9393
BOOK PUBLISHER
Edizioni Minerva Medica S.p.A., Corso Bramante 83-85, Torino, Italy.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital admission
patient transport
EMTREE MEDICAL INDEX TERMS
breathing rate
cardiovascular disease
heart rate
hematologic disease
hospital discharge
human
intensive care unit
length of stay
letter
medical record review
mortality
neurologic disease
outcome assessment
patient identification
patient monitoring
pediatric ward
respiratory failure
risk factor
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2011547803
MEDLINE PMID
21952602 (http://www.ncbi.nlm.nih.gov/pubmed/21952602)
PUI
L362681070
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 564
TITLE
Impact of hospital transfers on mortality in an intensive care unit of
central kentucky
AUTHOR NAMES
Diaz-Guzman E.
Ihle R.
Davenport D.
Mitrache I.
Mannino D.
AUTHOR ADDRESSES
(Diaz-Guzman E.; Ihle R.; Davenport D.; Mitrache I.; Mannino D.) University
of Kentucky, Lexington, United States.
CORRESPONDENCE ADDRESS
E. Diaz-Guzman, University of Kentucky, Lexington, United States.
SOURCE
Chest (2011) 140:4 MEETING ABSTRACT. Date of Publication: October 2011
CONFERENCE NAME
CHEST 2011
CONFERENCE LOCATION
Honolulu, HI, United States
CONFERENCE DATE
2011-10-22 to 2011-10-26
ISSN
0012-3692
BOOK PUBLISHER
American College of Chest Physicians
ABSTRACT
PURPOSE: Studies have reported that patients transferred to higher levels of
care following admission have excess mortality and length of stay (LOS).
Additionally, it has been suggested that patients transferred to a tertiary
care ICU are more severely ill and consume more resources. METHODS: We
performed a retrospective chart review of all patients admitted to the
medical ICU at University of Kentucky (UKMC) between 2007 and 2009. Data was
collected from hospital admissions data, US Census Bureau, and Social
Security Death Index. Zip code was used for US Census data analysis of
percentage of residents at the poverty level (PL) and percentage at two
times the poverty level (PL2). RESULTS: There were 2003 admissions to the
ICU. Ten admissions were excluded due to lack of data. Mean age was
55.6±16.0 years; 88% were Caucasian decent and 54% were male. APACHE IV
score ranged from 5 to 213 (median 69). The mean PL of the cohort was
20.6%±10.5% while the mean PL2 was 43.6%±14.7%. This compares to Kentucky
rates of 15.8% and 35.9%, respectively. Multivariable regression analysis
showed that age (OR 1.011; 95% CI 1.001-1.021) and APACHE IV score (OR
1.039; CI 1.035-1.044) were predictors of higher mortality. Race, gender, PL
and PL2, insurance status, distance to UKMC, admitting source (ward vs.
emergency department), use of dialysis, and day of admission were not
associated with ICU mortality. ICU admissions from outside hospital
transfers were associated with shorter LOS and lower mortality when compared
to other admission sources (OR 0.610; CI 0.442-0.842). Similarly, total
charges (142x103 vs. 197x103, p=0.0001) were different between outside
hospital transfers and intra-hospital transfers. CONCLUSIONS: Age and APACHE
IV score are good predictors of mortality in our ICU. Compared to
intra-hospital transfers, admissions from referral institutions are
associated with shorter LOS, lower mortality and cost. CLINICAL
IMPLICATIONS: Inter-hospital transfer to an ICU is associated with lower
mortality, cost and LOS. This may reflect referral bias. Further studies are
needed to confirm these findings.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital
intensive care unit
mortality
United States
EMTREE MEDICAL INDEX TERMS
APACHE
Caucasian
data analysis
death
dialysis
emergency ward
gender
hospital admission
human
insurance
length of stay
male
medical record review
patient
population research
poverty
regression analysis
social security
tertiary health care
university
ward
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70634685
DOI
10.1378/chest.1113925
FULL TEXT LINK
http://dx.doi.org/10.1378/chest.1113925
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 565
TITLE
Critical care transfers: Using audit to make a difference
AUTHOR NAMES
Shonfeld A.
Riyat A.
Kotecha A.
Sacks M.
AUTHOR ADDRESSES
(Shonfeld A., adamshonfeld@gmail.com; Riyat A.; Kotecha A.; Sacks M.) St
Mary's Hospital, London, United Kingdom.
CORRESPONDENCE ADDRESS
A. Shonfeld, St Mary's Hospital, London, United Kingdom. Email:
adamshonfeld@gmail.com
SOURCE
Anaesthesia (2011) 66:10 (946-947). Date of Publication: October 2011
ISSN
0003-2409
1365-2044 (electronic)
BOOK PUBLISHER
Blackwell Publishing Ltd, 9600 Garsington Road, Oxford, United Kingdom.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
anesthetic equipment
capnometry
clinical audit
critically ill patient
emergency ward
human
letter
medical device
patient safety
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Biophysics, Bioengineering and Medical Instrumentation (27)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2011518298
MEDLINE PMID
21916863 (http://www.ncbi.nlm.nih.gov/pubmed/21916863)
PUI
L362564278
DOI
10.1111/j.1365-2044.2011.06879.x
FULL TEXT LINK
http://dx.doi.org/10.1111/j.1365-2044.2011.06879.x
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 566
TITLE
Factors associated with clinical complications during intra-hospital
transports in a neonatal unit in Brazil
AUTHOR NAMES
Vieira A.L.P.
Dos santos A.M.N.
Okuyama M.K.
Miyoshi M.H.
Almeida M.F.B.D.
Guinsburg R.
AUTHOR ADDRESSES
(Vieira A.L.P., ameliamiyashiro@yahoo.com.br; Dos santos A.M.N.; Okuyama
M.K.; Miyoshi M.H.; Almeida M.F.B.D.; Guinsburg R.) Disciplina de Pediatria
Neonatal, Departamento de Pediatria, Universidade Federal de São Paulo, São
Paulo, SP, Brazil.
CORRESPONDENCE ADDRESS
A.L.P. Vieira, Disciplina de Pediatria Neonatal, Departamento de Pediatria,
Universidade Federal de São Paulo, São Paulo, SP, Brazil. Email:
ameliamiyashiro@yahoo.com.br
SOURCE
Journal of Tropical Pediatrics (2011) 57:5 (368-374) Article Number: fmq111.
Date of Publication: October 2011
ISSN
0142-6338
1465-3664 (electronic)
BOOK PUBLISHER
Oxford University Press, Great Clarendon Street, Oxford, United Kingdom.
ABSTRACT
Objective: Analyze factors associated with clinical complications during
intra-hospital transport of neonatal intensive care unit (NICU)
patients.Methods: Prospective study of 641 infants submitted to 1197
intra-hospital transports at a public university NICU. Factors associated
with clinical complications during intra-hospital transports were studied by
multiple logistic regression analysis.Results: Included infants had a mean
gestational age of 35.1 ± 3.8 weeks and a birth weight of 2328 ± 906 g.
Underline diseases were: malformations (71.9%), infections (7.6%),
respiratory distress (4.1%) and others (16.4%). Patients were transported
for surgical procedures (22.6%), magnetic resonance (10.6%), tomography
imaging (20.9%), contrasted exams (18.2%), ultrasound (10.4%) and others
(17.3%). Clinical complications occurred in 327 (27.3%) transports and were
associated (odds ratio; 95% CI) with: central nervous system malformations
(1.6; 95% CI 1.0-2.0); use of supplemental oxygen (4.0; 95% CI 2.8-5.6);
mechanical ventilation (5.0; 95% CI 3.5-7.5); transport for surgeries (4.0;
95% CI 1.1-14.0) and duration of the transport longer than 120 min (1.6; 95%
CI 1.1-2.4).Conclusions: Intra-hospital transports are associated with
increased risk of clinical complications. © The Author [2010]. Published by
Oxford University Press. All rights reserved.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
newborn intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
artificial ventilation
birth weight
Brazil
central nervous system malformation
computer assisted tomography
congenital malformation
contrast radiography
echography
female
gestational age
human
hypothermia
infant
infection
major clinical study
male
multivariate logistic regression analysis
newborn
nuclear magnetic resonance imaging
oxygen therapy
prospective study
respiratory distress
risk factor
surgical patient
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2012008664
MEDLINE PMID
21123316 (http://www.ncbi.nlm.nih.gov/pubmed/21123316)
PUI
L364021149
DOI
10.1093/tropej/fmq111
FULL TEXT LINK
http://dx.doi.org/10.1093/tropej/fmq111
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 567
TITLE
Improving adverse drug event detection in critically ill patients through
intensive care unit transfer summary screening
AUTHOR NAMES
Anthes A.
Harinstein L.M.
Smithburger P.L.
Seybert A.L.
Kane-Gill S.L.
AUTHOR ADDRESSES
(Anthes A.) University of Pittsburgh Medical Center, Pittsburgh, United
States.
(Harinstein L.M.) Cleveland Clinic, Cleveland, United States.
(Smithburger P.L.; Seybert A.L.; Kane-Gill S.L.) University of Pittsburgh,
School of Pharmacy, Pittsburgh, United States.
CORRESPONDENCE ADDRESS
A. Anthes, University of Pittsburgh Medical Center, Pittsburgh, United
States.
SOURCE
Pharmacotherapy (2011) 31:10 (313e). Date of Publication: October 2011
CONFERENCE NAME
2011 Annual Meeting of the American College of Clinical Pharmacy
CONFERENCE LOCATION
Pittsburgh, PA, United States
CONFERENCE DATE
2011-10-16 to 2011-10-19
ISSN
0277-0008
BOOK PUBLISHER
Pharmacotherapy Publications Inc.
ABSTRACT
PURPOSE: Hospital discharge notes have been studied as a form of
surveillance; however, ICU transfer summaries have not been studied for this
purpose. Improving ADE prevention strategies relies upon improving
detection. METHODS: A retrospective electronic medical record review was
conducted among medical ICU patients. Inclusion criteria included patients
≥18 years of age admitted between January through April 2009 with an ICU
length of stay ≥24 hours. Two scales were utilized to assess chart
documentation for ADEs: 1) Harvard Medical Practice Scale (MPS) and 2)
Leonard Evidence Assessment Scale. The Harvard MPS was used to rank the
strength of the wording in the medical record with a score of 4 (more than
50-50) up through 6 (virtually certain) indicating the presence of an ADE.
The Leonard criteria were used to score causality with 1 out of 4 criteria
indicating unlikely presence of an ADE and 4 out of 4 indicating a definite
ADE occurrence. RESULTS: Demographic information indicates 50% of the
patients were male with a mean age of 60.3 years (+/- 16). 258 unique
patients had ICU transfer summaries screened and evaluated for ADEs. 105
patients had at least 1 ADE with a total of 139 ADEs. The Harvard MPS scores
collected were 4 (39.6%), 5 (51.8%) and 6 (7.9%). The Leonard scores were 2
of 4 (17.3%), 3 of 4 (54.7%) and 4 of 4 (28.1%). Most common medications
associated with an ADE were furosemide, ciprofloxacin, warfarin and heparin.
Most common ADEs were Clostridium difficile, hypotension, acute kidney
injury and hyperglycemia. CONCLUSION: 41% of ICU transfer summaries
contained a description of an ADE; therefore, reviewing ICU transfer
summaries is a useful method of detecting ICU-specific ADEs and should be
considered as part of an ADE surveillance system. Understanding contributing
medications and resulting reactions of ADEs will aid in future prevention
strategies.
EMTREE DRUG INDEX TERMS
ciprofloxacin
furosemide
heparin
warfarin
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
adverse drug reaction
clinical pharmacy
college
critically ill patient
intensive care unit
screening
EMTREE MEDICAL INDEX TERMS
acute kidney failure
documentation
drug therapy
electronic medical record
epidemiology
hospital discharge
human
hyperglycemia
hypotension
length of stay
male
medical practice
medical record
medical record review
patient
Peptoclostridium difficile
prevention
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70647885
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 568
TITLE
Critical care air transport team (CCATT) short term outcomes of casualties
with spinal fractures moved with the vacuum spine board between 2009 and
2010
AUTHOR NAMES
Lairet J.R.
McCafferty R.
Lairet K.
Muck A.
Balls A.
Minnick J.
Torres P.
King J.
AUTHOR ADDRESSES
(Lairet J.R.; McCafferty R.; Lairet K.; Muck A.; Balls A.; Minnick J.;
Torres P.; King J.) Wilford Hall Medical Center, Lackland AFB, United
States.
(Lairet J.R.; McCafferty R.; Lairet K.; Muck A.; Balls A.; Minnick J.;
Torres P.; King J.) US Army Institute of Surgical Research, Ft Sam Houston,
United States.
CORRESPONDENCE ADDRESS
J.R. Lairet, Wilford Hall Medical Center, Lackland AFB, United States.
SOURCE
Annals of Emergency Medicine (2011) 58:4 SUPPL. 1 (S241). Date of
Publication: October 2011
CONFERENCE NAME
American College of Emergency Physicians, ACEP 2011 Research Forum
CONFERENCE LOCATION
San Francisco, CA, United States
CONFERENCE DATE
2011-10-15 to 2011-10-16
ISSN
0196-0644
BOOK PUBLISHER
Mosby Inc.
ABSTRACT
Study Objectives: The purpose of this studyis to describe the outcome of
patients managed by USAF CCATT with the Vacuum Spine Board (VSB) to
stabilize unstable thoracic and lumbar spine fractures deployed in support
of Operation Iraqi Freedom and Operation Enduring Freedom between July2009
and June 2010. Methods: We performed a retrospective chart review of
available records of patients who were transported by USAF CCATT on the VSB
between July1, 2009 and June 30, 2010. A standardized abstraction form was
used. We included the following demographic data: age, and sex of the
patient. We recorded descriptive data to include: mechanism of injury (MOI),
if the patient was transported on mechanical ventilator, administration of
vasoactive medications, and administration of blood products during
transport. Short term events/outcomes were documented to include: death,
skin breakdown resulting from the use of the VSB, decline in neurological
status related to the spinal injury, desaturation of the patient below 90%,
hypotension belowa systolic BP of90 mmHg, loss of airway and/or chest tubes
during transport. A search of the Joint Theater Trauma Registry (JTTR) was
also carried out for reported complications and the Injury Severity Score
(ISS) of the included patients. All data was reported in a descriptive
manner. Results: A total of 73 patients met the inclusion criteria,
resulting in a total of 107 patient moves on the VSB. Seven patients (9.6%)
had a cervical injury, 59 (80.8%) had a thoracic/lumbar injury and 7 (9.6%)
suffered both a cervical and a thoracic/lumbar injury. The mean age was 28.9
years (SD 8.3) and 95.9% were male. The MOI was explosion in 48 (65.8%),
blunt in 22 (30.1%) and penetrating in 3 (4.1%). The mean ISS was 23.5 (SD
13.4). When evaluating the treatment received during transport, 102 of the
patient moves were on oxygen therapy (95.3%), 64 were mechanically
ventilated (59.8%), 10 received vasoactive medications (9.4%) and 13
received blood products during the flight (12.2%). When we evaluated the
cohort for events or complications occurring during transport, we
encountered a total of 10 skin breakdown events related to the VSB (9.3%).
The study cohort revealed 2 cases of neurological deterioration during
transport which was attributed to progression of the original neurological
insult (1.9%). We also noted 3 episodes of transient desaturation (2.8%) and
13 episodes of transient hypotension (12.2%). We did not encounter any
deaths, loss of airway or chest tubes during transport. The primary
limitation is the retrospective nature of this study. Other limitations
include the descriptive nature of the study as well as the small number of
casualties studied. Conclusion: The VSB was successfully used to stabilize
spine injuries during transport. We did note a skin breakdown rate of 9.3%.
A risk/benefit assessment must be performed before deciding to use the VSB
to transport casualties with spinal injuries.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
accident
college
emergency physician
human
intensive care
spine
spine fracture
vacuum
EMTREE MEDICAL INDEX TERMS
airway
blood
death
deterioration
drug therapy
fatty acid desaturation
flight
hypotension
injury
injury scale
lumbar spine
male
medical record review
oxygen therapy
patient
register
skin
spine injury
tube
ventilator
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70551449
DOI
10.1016/j.annemergmed.2011.06.218
FULL TEXT LINK
http://dx.doi.org/10.1016/j.annemergmed.2011.06.218
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 569
TITLE
Transport as a system: Reorganization of perinatal assistance in northern
Lombardy
AUTHOR NAMES
Martinelli S.
Vergani P.
Zanini R.
Bellù R.
Farina C.
Tagliabue P.
AUTHOR ADDRESSES
(Martinelli S., stefano.martinelli@ospedaleniguarda.it) Neonatology and
Neonatal Intensive Care Unit, Niguarda “Ca’ Granda” Hospital, Milan, Italy.
(Vergani P.) Obstetrics and Gynaecology Unit, Milano Bicocca University,
MBBM Foundation, Monza, Italy.
(Zanini R.) Departments of Obstetrics and Pediatrics, Hospitals of Lecco
Province, Italy.
(Bellù R.) Neonatology and Neonatal Intensive Care Unit, Manzoni Hospital,
Lecco, Italy.
(Farina C.; Tagliabue P.) Neonatology and Neonatal Intensive Care Unit, MBBM
Foundation, Monza, Italy.
CORRESPONDENCE ADDRESS
S. Martinelli, Neonatology and Neonatal Intensive Care Unit, Niguarda “Ca’
Granda” Hospital, Milan, Italy. Email:
stefano.martinelli@ospedaleniguarda.it
SOURCE
Journal of Maternal-Fetal and Neonatal Medicine (2011) 24 Supplement 1
(122-125). Date of Publication: 23 Sep 2011
ISSN
1476-4954 (electronic)
1476-7058
BOOK PUBLISHER
Taylor and Francis Ltd, healthcare.enquiries@informa.com
ABSTRACT
The organization of perinatal care has been a pivotal mean for improvement
in neonatal survivals. Despite the excellent standard of assistance in
Lombardy, Obstetrics and Neonatal Units of MBBM Foundation-Monza, Manzoni
Hospital-Lecco and Niguarda Hospital-Milan put forward a pilot project
proposing reorganization of perinatal care in the northern part of Lombardy.
The main goals of the project are implementation of maternal transport
system and use of neonatal back transport as a system to increase the
availability of intensive care beds. The project’s fundamental steps and
critical points will be discussed.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient transport
perinatal care
EMTREE MEDICAL INDEX TERMS
article
automation
health care availability
hospital bed
human
information system
intensive care unit
Italy
priority journal
EMBASE CLASSIFICATIONS
Obstetrics and Gynecology (10)
Public Health, Social Medicine and Epidemiology (17)
Biophysics, Bioengineering and Medical Instrumentation (27)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
20160698000
PUI
L612378877
DOI
10.3109/14767058.2011.607670
FULL TEXT LINK
http://dx.doi.org/10.3109/14767058.2011.607670
COPYRIGHT
Copyright 2016 Elsevier B.V., All rights reserved.
RECORD 570
TITLE
Under-triage as a significant factor affecting transfer time between the
emergency department and the intensive care unit
AUTHOR NAMES
Yurkova I.
Wolf L.
AUTHOR ADDRESSES
(Yurkova I.) Elaine Rehabilitation Center, Hadley, MA, United States.
(Wolf L., Noblewolf3@aol.com) University of Massachusetts, Amherst, MA,
United States.
CORRESPONDENCE ADDRESS
L. Wolf, 110 Middle St., Hadley, MA 01035, United States. Email:
Noblewolf3@aol.com
SOURCE
Journal of Emergency Nursing (2011) 37:5 (491-496). Date of Publication:
September 2011
ISSN
0099-1767
1527-2966 (electronic)
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
ABSTRACT
Introduction: The purpose of the study was to identify factors that affect
transfer times between the emergency department and the intensive care unit
(ICU) in a community hospital. Patients who are transferred from the
emergency department to the ICU are usually in critical condition and in
need of prompt treatment by qualified personnel. As a result of delayed
transfers, a patient may experience complications, such as increased
mortality rates and longer hospital stays. Methods: A quantitative
descriptive correlational design was used in this study. Data were collected
from the charts of 75 patients who were transferred from the emergency
department to the ICU of a 142-bed community hospital in the eastern United
States. "Delayed patients" were identified as those who were transferred
after more than 4 hours. Results: Forty-four patients (58.7%) spent more
than 4 hours in the emergency department. Nineteen out of 25 patients (76%)
with an Emergency Severity Index designation of 3 were identified as
delayed. Delayed status and an Emergency Severity Index designation of 3
showed a significant correlation (r = -339, P = .004). Eleven patients
(64.7%) diagnosed with sepsis were delayed, compared with 6 who were not
delayed. A total of 70.4% of female patients were delayed, compared with
52.1% of male patients. Discussion: This study provides a more comprehensive
view of the factors involved in delayed patient transfer and provides data
needed for effective interventions to be developed. The results suggest
significant problems with the under-triage of critically ill patients,
specifically patients with sepsis. Future research should include a larger
group of subjects and a multifactorial analysis. © 2011 Emergency Nurses
Association.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
intensive care unit
patient transport
sepsis (diagnosis, therapy)
EMTREE MEDICAL INDEX TERMS
age
article
community hospital
comparative study
critical illness (therapy)
emergency treatment
evaluation study
female
human
male
mortality
needs assessment
risk factor
sex difference
standard
time
treatment outcome
United States
utilization review
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
21549418 (http://www.ncbi.nlm.nih.gov/pubmed/21549418)
PUI
L51408682
DOI
10.1016/j.jen.2011.01.016
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jen.2011.01.016
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 571
TITLE
Intrahospital transfer of intensive care patients: Prospective evaluation in
a tertiary hospital
AUTHOR NAMES
Quesada Suescun A.
Muñoz C.
Cordero M.
Gómez Marco V.
Iglesias-Posadilla D.
García Miguelez A.
Suarez V.J.
López Sánchez M.
Burón F.J.
Ballesteros M.A.
AUTHOR ADDRESSES
(Quesada Suescun A.; Muñoz C.; Cordero M.; Gómez Marco V.;
Iglesias-Posadilla D.; García Miguelez A.; Suarez V.J.; López Sánchez M.;
Burón F.J.; Ballesteros M.A.) Marqués de Valdecilla Universitary Hospital,
Critical Care Department, Santander, Spain.
(Quesada Suescun A.) Marques de Valdecilla Institute for Formation and
Research (IFIMAV), Santander, Spain.
CORRESPONDENCE ADDRESS
A. Quesada Suescun, Marqués de Valdecilla Universitary Hospital, Critical
Care Department, Santander, Spain.
SOURCE
Intensive Care Medicine (2011) 37 SUPPL. 1 (S224). Date of Publication:
September 2011
CONFERENCE NAME
24th Annual Congress of the European Society of Intensive Care Medicine,
ESICM LIVES 2011
CONFERENCE LOCATION
Berlin, Germany
CONFERENCE DATE
2011-10-01 to 2011-10-05
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag
ABSTRACT
INTRODUCTION. Intrahospital transfer of patients from intensive care units
leads toimportant risks and the probability of side effects. The development
of standardization transferprotocols can be a strategy to improve clinical
safety and assistance quality. Following severalnotifications recorded at
the website of our service about adverse events potentially avoidable,we
proposed this study.OBJECTIVES. To record and describe the incidents during
Intrahospital transport of patientsfrom intensive care units (ICU) in our
hospital.METHODS. A descriptive prospective study of intra-hospital transfer
from ICU patients atthe “Marqués de Valdecilla” University Hospital, during
November 2010 to March 2011. Thedata are shown in absolute value and/or
percentage.RESULTS. There were 145 intrahospital transports in 98 patients.
69% of these transfers weremade from the neurocritical ICU, and 31% from the
polyvalent ICU. Most of them were madeto the radiology department (57.2% CT,
3.4% MRI, 6.2% interventional radiology), followedby the transfers to the
operating room (29.7%). Monitoring progress (24.5%) and diagnosis(36%) were
the main reasons, leading to a change in the management in 50% of the
cases.Patients and/or their relatives were informed before the transfer in
66.2% of the cases. In almostall transfers, previous appropriate measures
were taken: bag transfer verification (92.4%);availability of oxygen
cylinders for 30 min (97.3%); equipment battery life (99.3%); checkingalarms
(96.5%); isolated venous access (100%); nasogastric tube bag drainage
(81.1%); urinarycatheter clamped (91.7%); and aspiration of respiratory
secretions (87.1%). Transferswere made by nurses (100%), orderly (100%) and
doctors (25.9% staff, 81% residents).Coordination with reception service was
marked by poor communication in 5% of casesinvolving delays, which did not
exceed 5 min at admission to the surgical ward or at receptionin the
radiology department. There was no sentinel case in the study
group.CONCLUSIONS.Measures of patient preparation and verification of
equipment were carriedout correctly. Coordination with reception service
must be a strategy for improvement in ourenvironment. We believe that
systematic use of a “check list” can improve safety in thetransfer of
critical patients.
EMTREE DRUG INDEX TERMS
oxygen
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
human
intensive care
patient
patient transport
society
tertiary health care
EMTREE MEDICAL INDEX TERMS
aspiration
bodily secretions
checklist
diagnosis
hospital
intensive care unit
interpersonal communication
interventional radiology
monitoring
nasogastric tube
nuclear magnetic resonance imaging
nurse
nursing assistant
operating room
physician
prospective study
radiology department
risk
safety
side effect
standardization
surgical ward
university hospital
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70639685
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 572
TITLE
Improving communication during patient transfers between the operating room
and neuroscience intensive care unit
AUTHOR NAMES
Olm-Shipman C.
Yagoda D.
Tehan T.
Guanci M.
Nozari A.
Nahed B.
Farren S.
O'Malley T.
Scheer K.
Rosand J.
Cobb J.P.
Kimberly W.T.
AUTHOR ADDRESSES
(Olm-Shipman C.; Yagoda D.; Tehan T.; Guanci M.; Nozari A.; Nahed B.; Farren
S.; O'Malley T.; Scheer K.; Rosand J.; Cobb J.P.; Kimberly W.T.)
Massachusetts General Hospital, Boston, United States.
CORRESPONDENCE ADDRESS
C. Olm-Shipman, Massachusetts General Hospital, Boston, United States.
SOURCE
Neurocritical Care (2011) 15:1 SUPPL. 1 (S196). Date of Publication:
September 2011
CONFERENCE NAME
9th Annual Meeting of the Neurocritical Care Society
CONFERENCE LOCATION
Montreal, QC, Canada
CONFERENCE DATE
2011-09-21 to 2011-09-24
ISSN
1541-6933
BOOK PUBLISHER
Humana Press
ABSTRACT
Introduction The transfer of patient information and responsibility of care
between services is a process prone to variation and one which may
contribute to errors in care and higher health care costs. We designed and
implemented a quality improvement initiative to reduce variability and
improve communication during the handoff process between the operating room
and Neuroscience ICU. Methods We convened a multidisciplinary team that
included representation from Neurosurgery, Neuroanesthesia, Neurocritical
Care, Nursing, and Administration. We defined key elements of an ideal
handoff and compared this list to the results of 17 observed ICU handoffs.
We constructed a process map highlighting fail points, and applied root
cause analysis to uncover their underlying sources. We designed process
interventions to correct the fail points, including a bedside transfer aid
that defined team member roles, structured the handoff sequence, and
highlighted key information to be communicated. We also improved
communication mechanisms between the OR and ICU to assist with preparation
of patient arrival. Following the implementation of these interventions, we
performed 17 observations to assess efficacy. Results We observed a two- to
ten-fold improvement in the handoff process metrics, including the provision
of a one-hour warning notification, a group neurological exam to define the
patient's baseline function, and the presence of all team members during the
handoff (all P<0.001).Moreover, a Likert scale rating of clinician
satisfaction in the ICU increased from a median of 3 (IQR 2, 3) to 4 (IQR 3,
4) (P<0.0001). Conclusions Brevity, organization, and efficiency contributed
to the successful implementation of this handoff improvement initiative. A
multidisciplinary team representing each stakeholder was critical, as
process solutions often required incremental changes in practice across
specialties. The interventions improved both the handoff process and
clinician satisfaction.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
human
intensive care unit
interpersonal communication
operating room
patient transport
society
EMTREE MEDICAL INDEX TERMS
anesthesia
health care cost
Likert scale
neurosurgery
nursing
patient
patient information
responsibility
root cause analysis
satisfaction
total quality management
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71193791
DOI
10.1007/s12028-011-9625-5
FULL TEXT LINK
http://dx.doi.org/10.1007/s12028-011-9625-5
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 573
TITLE
Impact of intra-hospital transport in ventilated critically ill patients
AUTHOR NAMES
Schwebel C.
Clec'h C.
Magne S.
Minet C.
Garrouste-Orgeas M.
Bonadona A.
Soufir L.
Darmon M.
Azoulay E.
Souweine B.
Timsit J.-F.
AUTHOR ADDRESSES
(Schwebel C.; Minet C.; Bonadona A.; Timsit J.-F.) Centre Hospitalier
Universitaire, Grenoble, France.
(Clec'h C.) Centre Hospitalier, Avicenne, France.
(Magne S.) Institut Albert Bonniot, Grenoble, France.
(Garrouste-Orgeas M.; Soufir L.) Hopital Saint Joseph, Paris, France.
(Darmon M.) Centre Hospitalier Universitaire, Saint-Etienne, France.
(Azoulay E.) Hopital Saint-Louis, Paris, France.
(Souweine B.) Centre Hospitalier Universitaire, Clermont-Ferrand, France.
CORRESPONDENCE ADDRESS
C. Schwebel, Centre Hospitalier Universitaire, Grenoble, France.
SOURCE
Intensive Care Medicine (2011) 37 SUPPL. 1 (S9). Date of Publication:
September 2011
CONFERENCE NAME
24th Annual Congress of the European Society of Intensive Care Medicine,
ESICM LIVES 2011
CONFERENCE LOCATION
Berlin, Germany
CONFERENCE DATE
2011-10-01 to 2011-10-05
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag
ABSTRACT
Intra-hospital transport (IHT) of critically ill patients is routinely
required for diagnostic or therapeutic procedures in daily practice.
Complications in IHT may be life threatening [1]. OBJECTIVES. To describe
IHT related adverse events (AE) in ventilated critically ill patients: (1)
incidence ofAErelated to the first IHT (2) description of targeted AE,
evolution of SAPS II post-IHT, outcome in ICU. METHODS. 6252 ventilated
patients (invasive mechanical ventilation) from a multicentric (12 ICU)
database were prospectively considered. Statistical analysis included: (1)
description of demographic and clinical characteristics of the cohort, (2)
identification of risk factors for IHT and construction of a propensity
score to be transported, (3) matched exposed/non exposed study to compare
IHT related AE (IHT to operating room excluded). Matching criteria:
propensity score, length of stay (LOS) and confounding factors on day before
IHT. A written procedure but no check-list was available for IHT at each ICU
location. RESULTS.IHT was required for 28.7% patients. 3,006 IHT were
performed for 1,782 patients (1-17 IHT/patient). Transported patients had
higher SAPS II (52 ± 19.2 vs. 49.4) at admission, higher ICU LOS (12 days
[6; 23] vs. 5 [3; 11] and higher ICU mortality (31.4% vs. 28.7%), p<10(-4)).
37.4% patients exhibited complications post-TIH. Risk factors associated
with IHT included in the propensity score were: origin (transfert) and type
of patients, diagnosis at admission and SAPS II. 1,782 transported patients
were matched with 4,460 non transported patients. After adjustment
transported patients were at higher risk of AE (OR 2,1, IC 95% [1.7-2.3],
p<0.0001), i.e. pneumothorax (OR 3.2, IC95% [1.7-6.4], p = 0.0005,
atelectasis (OR 3,4, IC95% [1.6-7; 2], p = 0.001), ventilator associated
pneumonia (OR 1,5 IC95% [1.1-2.0] p = 0.001), hypo (OR 2 IC95% [1.3-2.9], p
= 0.0008) and hyperglycemia (OR 2,5 IC95% [2.1-3], p<10(-4)). Transported
patients had a significant longer post-IHT ICU LOS with non significant
mortality rate (OR = 0.9, IC 95% [0.7-0.9], p = 0.9). DISCUSSION. Conditions
(planned vs. emergency IHT), medical supervision (senior vs. junior),
context (off-hours, workload, ICU occupancy) and effective impact of IHT in
patient's management are limiting factors for direct IHT imputability in
targeted AE occurrence. However, these data highlight the potential
consequences of IHT rising the need for a benefit/ risk evaluation and
preventive measures (check-list). CONCLUSION. IHT is a procedure at risk for
AEin ventilated critically ill patients justifying a dedicated policy in a
continuous quality improvement program.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
hospital
intensive care
society
EMTREE MEDICAL INDEX TERMS
artificial ventilation
atelectasis
checklist
data base
diagnosis
emergency
hospital patient
human
hyperglycemia
length of stay
mortality
operating room
patient
patient care
pneumothorax
policy
procedures
propensity score
risk
risk factor
statistical analysis
total quality management
ventilated patient
ventilator associated pneumonia
workload
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70638825
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 574
TITLE
Intrahospital critical care transfers: Are we taking them seriously enough?
AUTHOR NAMES
Scanlan M.S.
Chakrabarti K.
Browett K.
Scott C.
AUTHOR ADDRESSES
(Scanlan M.S.; Chakrabarti K.; Browett K.; Scott C.) Sheffield Teaching
Hospitals NHS Foundation Trust, Critical Care Department, Sheffield, United
Kingdom.
CORRESPONDENCE ADDRESS
M.S. Scanlan, Sheffield Teaching Hospitals NHS Foundation Trust, Critical
Care Department, Sheffield, United Kingdom.
SOURCE
Intensive Care Medicine (2011) 37 SUPPL. 1 (S10). Date of Publication:
September 2011
CONFERENCE NAME
24th Annual Congress of the European Society of Intensive Care Medicine,
ESICM LIVES 2011
CONFERENCE LOCATION
Berlin, Germany
CONFERENCE DATE
2011-10-01 to 2011-10-05
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag
ABSTRACT
INTRODUCTION. Despite evidence showing a high incidence of complications
during intrahospital critical care transfer [1], UK national guidelines have
yet to be published. We report current practice and adverse event rates in a
tertiary referral centre in the UK. OBJECTIVES. (1) To determine current
practice in critical care intrahospital transfer. (2) To reveal the
incidence of complications. METHODS. A proforma was designed with reference
to ANZCA [2] standards. The monitoring period was from 17/11/2010 to
28/1/2011. The proforma was divided into two parts. The critical care
technician accompanying the transfer completed the first part prospectively.
The second part was collected retrospectively by analysing data from the
computer record. RESULTS. There were 30 intrahospital transfers. The minimal
grade of doctor was Specialty Registrar year 3 (ST3). Mean transfer time was
41 min. All transfers recorded were between 0800 and 2000 hours to ensure
technician presence. (Figure presented) The results demonstrate there is
poor clinical assessment of the patient and ventilator/alarm settings
pre-transfer, and poor documentation of the transfer. There is a varied
practice in choosing pre-transfer equipment. Only a small number of
transfers (13%) were performed on unstable patients. There was a 10%adverse
event rate, which is lower than published data [1, 2]. CONCLUSIONS. Despite
relatively experienced doctors with experienced staff accompanying, there
still remains a measurable adverse event rate in critical care patients. A
clear policy and formal staff training is needed to optimise safety and
minimize the attendant risks associated with intrahospital transfer.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
society
EMTREE MEDICAL INDEX TERMS
clinical assessment
computer
documentation
human
monitoring
patient
patient transport
physician
policy
risk
safety
staff training
Tertiary (period)
United Kingdom
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70638829
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 575
TITLE
Ortho-geriatric patient transfer between departments and hospitals prolongs
hospital stay and effects survival
AUTHOR NAMES
Barat I.
AUTHOR ADDRESSES
(Barat I.) Region Hospital Horsens, Hojbjerg, Denmark.
CORRESPONDENCE ADDRESS
I. Barat, Region Hospital Horsens, Hojbjerg, Denmark.
SOURCE
European Geriatric Medicine (2011) 2 SUPPL. 1 (S87). Date of Publication:
September 2011
CONFERENCE NAME
7th Congress of the EUGMS
CONFERENCE LOCATION
Malaga, Spain
CONFERENCE DATE
2011-09-28 to 2011-09-30
ISSN
1878-7649
BOOK PUBLISHER
Elsevier
ABSTRACT
Objective.- To assess the impact of transferring orthogeriatric patients
between departments and hospitals on the length of hospitalization and the
death rate. An observational correlation study. Background.- Transfer of the
orthogeriatric patientswas a routine in the Region hospital of Horsens,
Denmark until 01-01-2009. Postoperative patients with hip fracture were
transferred to two nearby hospitals for geriatric medical care and
rehabilitation purposes. Due to structural changes in the hospital this
praxis was terminated in 2009. The patients were then operated and
rehabilitated in the orthopedic department with daily geriatric care and
supervision. Methods.- All patients with hip fracture admitted to the
hospital during the period of 01-01-2007 and 12-31-2010 were included. The
total length of stay from admission to discharge was calculated by adding
all intrahospital and interhospital transfers. The differences between the
periods of 2007-2008 (period.1) and 2009-2010 (period.2) were compared by
t-test statistic. Dates of death were collected from the national population
register and data were assessed in a similar manner. Results.- During a 4
years period 833 patients (mean age 79.8, female 69.2%) were admitted with
hip fracture to the orthopedic department. While in period.1 38% of the
patients were transferred, only 5% were transferred in period.2 (mostly due
to complications). The mean total length of hospital stay in period.1 was
18.1 days while in period.2 10.5 days (P < 0.001, mean diff. 7.7, 95CI
5.94-9.40). The mean 30 days death rate in period.1 was 6.1% and in period.2
2.9% (P = 0.026 mean diff. 3.2, 95CI 0.39-6.00). The mean 3 months death
rate in period.1 was 11.1% and in period.2 6.9% (P = 0.033 mean diff. 4.2,
95CI 0.34-8.13). Conclusion.- The study shows a correlation between the
transfer of orthogeriatric patients, the prolongation of hospitalization and
the increase of death rates. Although no causal conclusion can be made, the
differences in death rates is unmistakable. Three to four percent of the
patients survived longer in period 2. Also the economical issue is
remarkable. By avoiding transfer the hospitalstay was reduced by 7.7 days
for each patient and saved the hospital about 1600 bed-days a year.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
geriatric patient
hospital
hospitalization
human
patient transport
survival
EMTREE MEDICAL INDEX TERMS
correlational study
death
Denmark
female
geriatric care
hip fracture
length of stay
medical care
mortality
patient
population
register
rehabilitation
Student t test
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70705525
DOI
10.1016/j.eurger.2011.06.002
FULL TEXT LINK
http://dx.doi.org/10.1016/j.eurger.2011.06.002
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 576
TITLE
Perceived patient safety of health care providers in a critical care
transport program
AUTHOR NAMES
Erler C.
Pesut D.
Jingwei W.
Richey S.
Edwards N.
Sands L.
AUTHOR ADDRESSES
(Erler C.; Pesut D.; Jingwei W.) Indiana University, Indianapolis, United
States.
(Richey S.) IU Health LifeLine, Indianapolis, United States.
(Edwards N.; Sands L.) Purdue University, West Lafayette, United States.
CORRESPONDENCE ADDRESS
C. Erler, Indiana University, Indianapolis, United States.
SOURCE
Air Medical Journal (2011) 30:5 (256). Date of Publication:
September-October 2011
CONFERENCE NAME
2011 Air Medical Transport Conference, AMTC
CONFERENCE LOCATION
St. Louis, MO, United States
CONFERENCE DATE
2011-10-17 to 2011-10-19
ISSN
1067-991X
BOOK PUBLISHER
Mosby Inc.
ABSTRACT
Introduction: Safety culture among health care providers has been studied in
various contexts however; there are limited investigations of safety culture
variables in critical care transport (CCT) programs. This study examined the
association between safety dimensions and safety outcome measures of
healthcare providers in a CCT program. Methods: A descriptive
cross-sectional correlational design, was conducted using a convenience
sample (-Acny<76) of CCT personnel in a large CCT program. The Hospital
Survey on Patient Safety Culture included the following safety culture
factors: communication openness, teamwork, and managerial expectations and
actions to promote safety. Safety outcomes included overall safety
perception, error reporting frequency and patient safety grade. Results:
Findings revealed a significant association between teamwork within the
program and error reporting frequency (r < .428, p <0.001) and significant
association between teamwork and safety outcomes of overall perception of
safety (r < .745, p < 0.001) and perceived patient safety grade (r < -0.681,
p <0.001). There was a significant association between perception of manager
and actions promoting safety and the outcome variables of frequency of error
reporting (r < .521, p <0.001); overall perception of safety (r < .779, p
<0.001) and perceived patient safety grade (r < -.756, p <0.001). There was
a significant association between communication openness and safety outcomes
of frequency of error reporting (r < .575, p <0.001), overall perception of
safety (r < 0.588, p <0.000) and perceived patient safety grade (r < -0.627,
p <0.001). Cronbach's alpha was consistent with that reported by the Agency
for Healthcare Research Quality (AHRQ) for each of the safety culture
dimensions and safety outcomes. Conclusions: The study assessed health care
provider perceptions of patient safety in a CCT program. Data supports a
relationship between safety culture dimensions and safety outcomes. Although
findings are limited to one CCT program, this study adds to the literature
and evidence regarding patient safety culture in CCT programs and
adaptations of the AHRQ Safety Culture survey for CCT context.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
health care personnel
intensive care
patient safety
EMTREE MEDICAL INDEX TERMS
adaptation
convenience sample
Cronbach alpha coefficient
health care
hospital
human
interpersonal communication
manager
outcome variable
personnel
safety
teamwork
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70545236
DOI
10.1016/j.amj.2011.07.013
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2011.07.013
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 577
TITLE
Which cardiac surgery patients may be suitable for transfer from ICU the
same day as surgery?
AUTHOR NAMES
Manji R.A.
Chartrand S.
Arora R.C.
Rivet M.
Jacobsohn E.
Bell D.D.
Menkis A.H.
AUTHOR ADDRESSES
(Manji R.A.; Chartrand S.; Arora R.C.; Rivet M.; Jacobsohn E.; Bell D.D.;
Menkis A.H.) Winnipeg, Canada.
CORRESPONDENCE ADDRESS
R.A. Manji, Winnipeg, Canada.
SOURCE
Canadian Journal of Cardiology (2011) 27:5 SUPPL. 1 (S197-S198). Date of
Publication: September-October 2011
CONFERENCE NAME
64th Annual Meeting of the Canadian Cardiovascular Society, CCS 2011
CONFERENCE LOCATION
Vancouver, BC, Canada
CONFERENCE DATE
2011-10-22 to 2011-10-26
ISSN
0828-282X
BOOK PUBLISHER
Pulsus Group Inc.
ABSTRACT
INTRODUCTION: Ability to transfer a patient out of the cardiac surgery ICU
(CSICU) same day as surgery would assist with improving flow of cardiac
surgery patients through the system as it would allow two patients to
“occupy” the same bed in a 24 hour period. OBJECTIVE: Tocharacterize
patients that are ward transfer ready- 4 hours or >4 hours post arrival in
CSICU. METHODS: From Mar 2008 to Mar 2009, all cardiac surgery patients
admitted to CSICU were specifically evaluated for earliest transfer time
possible using specified criteria relating to bleeding, urine output,
hemodynamic/respiratory status, neurological status and cardiac rhythm
status. They were divided into two groups: early transfer group (ETG) were
patients ready for transfer ≤ 4 hours from arrival in ICU who actually were
transferred to ward in stable condition within 24 hours and late transfer
group (LTG) which were all other patients. Multivariable logistic regression
identified patients requiring longer ICU stay. RESULTS: There were 1010
patients enrolled in the study of which 274 (27.1%) were in the ETG having a
transfer ready time of 2.1 ± 1.1 hours (mean ± SD). There were no
readmissions to ICU and no in-hospital mortality in the ETG group. The table
below lists clinically relevant variables between the groups. Logistic
regression revealed emergency operation (OR 17.6; 95% CI 2.4-129.9; P =
0.01), congestive heart failure (OR 2.9; 95% CI 1.5-5.7; P = 0.01),
cerebrovascular disease (OR 2.2; 95% CI 1.2-3.9; P < 0.01), procedure
involving aortic valve (OR 2.2; 95% CI 1.2-3.9; P < 0.01); and procedure
involving thoracic aorta (OR 5.0; 95% CI 1.5-17.3; P < 0.01) to be
associated with longer stay with peripheral vascular disease (P = 0.06) and
chronic renal failure (P = 0.08) trending to be significantly associated
with longer stay. Variables not significant in the model, suggesting they
would be suitable for early transfer (assuming they did not also have one of
the longer stay factors), were: isolated CABG, open chamber procedure, redo
cardiac surgery, stable angina, and pre-operative arrhythmias. ICU length of
stay in the two groups was - median (interquartile range): ETG 20.5
(18.0-22.3) versus LTG 40.8 (22.5-68.4) hours - P < 0.01. CONCLUSION: Our
data suggest that there are predictable factors that could be used to decide
which patients may be transferable to the ward same day as surgery. (Table
presented).
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
heart surgery
human
society
surgery
surgical patient
EMTREE MEDICAL INDEX TERMS
aortic valve
astronomy
bleeding
cerebrovascular disease
chronic kidney failure
congestive heart failure
emergency surgery
heart arrhythmia
heart rhythm
length of stay
logistic regression analysis
model
mortality
patient
peripheral vascular disease
stable angina pectoris
thoracic aorta
urine volume
ward
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70608336
DOI
10.1016/j.cjca.2011.07.318
FULL TEXT LINK
http://dx.doi.org/10.1016/j.cjca.2011.07.318
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 578
TITLE
Relationship between delayed admission to critical care, delayed transfers
of care and waste of critical care resources in a 15 bedded district general
hospital critical care unit
AUTHOR NAMES
Muthuswamy M.B.
Beuschel S.
Parry-Jones J.
Jayne J.
AUTHOR ADDRESSES
(Muthuswamy M.B.; Beuschel S.; Parry-Jones J.) Royal Gwent Hospital,
Department of Anaesthesia, Intensive Care Medicine, Newport, United Kingdom.
(Jayne J.) South East Wales Critical Care Network, Pontypool, United
Kingdom.
CORRESPONDENCE ADDRESS
M.B. Muthuswamy, Royal Gwent Hospital, Department of Anaesthesia, Intensive
Care Medicine, Newport, United Kingdom.
SOURCE
Intensive Care Medicine (2011) 37 SUPPL. 1 (S34). Date of Publication:
September 2011
CONFERENCE NAME
24th Annual Congress of the European Society of Intensive Care Medicine,
ESICM LIVES 2011
CONFERENCE LOCATION
Berlin, Germany
CONFERENCE DATE
2011-10-01 to 2011-10-05
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag
ABSTRACT
INTRODUCTION. Delayed transfers of care (DTOCs) are wasteful of critical
care resources, potentially harmful to patients waiting to be discharged,
and potentially harmful to patients with a delayed admission to critical
care (DACC). Patients deserve care from appropriately trained staff in the
correct environment in the correct timeframe. For the critically ill this
means prompt admission to critical care, and for those recovering from
critical illness prompt discharge for rehabilitation. DACC increases the
risk of morbidity and mortality. DTOCs impact negatively on patient recovery
by increasing the risk of infection, and reducing ability to provide
appropriate facilities and rehabilitation. OBJECTIVE. We aimed to identify
the proportion of patients where appropriate care has been delayed either
due to DACC or DTOC. The economic cost of this was calculated. METHODS. Data
was collected prospectively in October 2010 for all critical care referrals.
A DACC was defined as a delay of more than 60 min from the point of
acceptance and following completion of any intervention. DTOC was a delay of
more than 4 h after a consultant decision that the patient was fit for ward
discharge. The data was collated and submitted to the Critical Care Network
for analysis. RESULTS. 71/101 referrals were accepted for critical care
admission. 31% were DACC. All DACC were directly related temporarily with at
least one DTOC. 70% of DACC were also associated with time required to clean
the bed space followingDTOCdischarge to allow a patients' admission, and20%
to nursing capacity due to care provided forDTOCand transfer to a ward bed.
Over the study period critical care hours lost due to DTOCs was 1,352 h
(56.3 days). This equates, (at a level 2 bed day cost of £900) to £50, 708
and £608,499.00/year (E 760624.00). DTOCs had a negative impact on
rehabilitation of patients prior to critical care discharge affecting their
sleep, and participation with physiotherapy. (Table presented) CONCLUSIONS.
Despite attempts to reduce DTOC they clearly continue to present a
considerable economic burden by the inefficient use of scarce critical care
resources. This study also demonstrates DTOCs effects on the timely
admission of the critically ill to critical care, where they should be cared
for, and the negative effect on rehabilitation for patients awaiting
discharge from critical care. DTOC need to be viewed as an inefficient use
of resources and an adverse health event, rather than a necessary
inconvenience of inadequate in-patient hospital beds.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
general hospital
intensive care
society
waste
EMTREE MEDICAL INDEX TERMS
consultation
critical illness
critically ill patient
environment
health
hospital bed
hospital patient
human
infection
morbidity
mortality
nursing
patient
physiotherapy
rehabilitation
risk
sleep
ward
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70638923
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 579
TITLE
Improved patient safety during critical care transfers resulting from a
sustained network approach
AUTHOR NAMES
Handy J.
Walsh A.
Suntharalingam G.
AUTHOR ADDRESSES
(Handy J.; Walsh A.; Suntharalingam G.) North West London Critical Care
Network, London, United Kingdom.
(Handy J.) Chelsea and Westminster Hospital, London, United Kingdom.
(Handy J.) Imperial College London, London, United Kingdom.
(Suntharalingam G.) North West London Hospitals Trust, London, United
Kingdom.
CORRESPONDENCE ADDRESS
J. Handy, North West London Critical Care Network, London, United Kingdom.
SOURCE
Intensive Care Medicine (2011) 37 SUPPL. 1 (S223). Date of Publication:
September 2011
CONFERENCE NAME
24th Annual Congress of the European Society of Intensive Care Medicine,
ESICM LIVES 2011
CONFERENCE LOCATION
Berlin, Germany
CONFERENCE DATE
2011-10-01 to 2011-10-05
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag
ABSTRACT
INTRODUCTION. Critical care transfers are recognised as being an
intervention duringwhichpatientsmay be exposed to increased critical events.
Severalmodels for improving the quality ofcritical care transfers have been
proposed, all largely focusing on single interventions.OBJECTIVES.We
analysed the 5 year impact of implementing amultifaceted Network
strategyaimed specifically at monitoring and improving patient safety during
critical care transfers.METHODS. The North West London Critical Care Network
representsmember hospitals withcritical care requirements but varying
capacity.The number ofmember hospitalswas 17 in 2005,increasing to 19 in
2008. Following the implementation of a Network transfer form, analysis
ofearly data revealed: a high number of transfers thatwere taking place due
to lack of capacity (nonclinicaltransfers); themajority of escorting
personnel had not received specific training in criticalcare transfers; and
a large number of critical incidents were occurring, particularly due
toequipment problems. In response to these findings a strategic response was
developed whichincluded: the development and implementation of transfer
training aimed at addressing thespecific issues highlighted within the
Network sector; the collation of hospital-specific datawhich was reported
quarterly and annually at all clinical and management levels;
widespreadpresentation of data and strategy within a variety of clinical and
managerial groups (includingnursing, medical, physiotherapy and local
critical care delivery groups); the review and renewal(where indicated) of
equipment used during transfers at local sites across the sector.RESULTS. In
response to the Network strategy, and despite the increased number of
memberhospitals in 2008, our transfer data revealed: a sustained
year-on-year reduction in level 3transfers; a sustained improvement
(reversal) in the ratio of non-clinical to clinical transfers; areduction in
critical incidents, in particular those due to equipment & battery problems.
(Table presented) Our data also showed that neurosurgical emergencies were
consistently the most commonindication for clinical transfer.CONCLUSIONS.
Our strategy demonstrates that the safety of critical care transfers can
besignificantly improved at local and regional levels through the adoption
of a multifacetedapproach targeting: continued transfer data collection and
analysis; improved clinician,managerial and commissioner awareness of
transfer issues; education of escorting staff;review of recurring critical
incidents with targeted strategies to reduce them.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient safety
society
EMTREE MEDICAL INDEX TERMS
education
hospital
human
information processing
monitoring
neurosurgery
personnel
physiotherapy
safety
United Kingdom
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70639681
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 580
TITLE
Lower limb salvage in a 7-month-old infant using free tissue transfer
AUTHOR NAMES
Wechselberger G.
Radauer W.
Schimpl G.
Kholosy H.
Ensat F.
Edelbauer M.
Hladik M.
AUTHOR ADDRESSES
(Wechselberger G.; Kholosy H.; Ensat F.; Hladik M.,
michaela.hladik@bbsalz.at) Department of Plastic and Reconstructive Surgery,
Hospital of the Barmherzigen Brüder, Medical University Salzburg,
Kajetanerplatz 1, 5020 Salzburg, Austria.
(Radauer W.) Department of Pediatrics and Adolescent Medicine, Medical
University Salzburg, Müllner-Hauptstraße 48, 5020 Salzburg, Austria.
(Schimpl G.) Department of Pediatrics and Adolescent Surgery, Medical
University Salzburg, Müllner-Hauptstraße 48, 5020 Salzburg, Austria.
(Edelbauer M.) Department of Pediatrics and Adolescent Medicine, Medical
University Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria.
CORRESPONDENCE ADDRESS
M. Hladik, Department of Plastic and Reconstructive Surgery, Hospital of the
Barmherzigen Brüder, Medical University Salzburg, Kajetanerplatz 1, 5020
Salzburg, Austria. Email: michaela.hladik@bbsalz.at
SOURCE
Journal of Pediatric Surgery (2011) 46:9 (1852-1854). Date of Publication:
September 2011
ISSN
0022-3468
1531-5037 (electronic)
BOOK PUBLISHER
W.B. Saunders, Independence Square West, Philadelphia, United States.
ABSTRACT
Free flap reconstruction in infants is extremely rare. A
seven-and-a-half-month-old male infant sustained an extensive soft tissue
defect on his left knee caused by extravasation of an intraosseous arterenol
infusion. A free latissimus dorsi flap was successfully performed for soft
tissue reconstruction. Indications, advantages, and outcome of the procedure
are discussed. © 2011 Elsevier Inc.
EMTREE DRUG INDEX TERMS
low molecular weight heparin
noradrenalin (adverse drug reaction, drug therapy, intraosseous drug
administration)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
free tissue graft
latissimus dorsi flap
limb salvage
soft tissue defect (side effect, complication, etiology, side effect,
surgery, therapy)
EMTREE MEDICAL INDEX TERMS
article
case report
cast application
cast removal
end to end anastomosis
epiphysis
extravasation (side effect)
gastrocnemius muscle
human
immobilization
infant
intensive care unit
ischemia (drug therapy)
joint function
knee
male
meningococcemia
microsurgery
muscle
necrosectomy
Neisseria meningitidis
outcome assessment
physiotherapy
plastic surgery
popliteus muscle
postoperative period
priority journal
septic shock
split thickness skin graft
suture
tibial artery
tissue necrosis (side effect)
wound dehiscence (complication)
CAS REGISTRY NUMBERS
noradrenalin (1407-84-7, 51-41-2)
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Surgery (9)
General Pathology and Pathological Anatomy (5)
Drug Literature Index (37)
Adverse Reactions Titles (38)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2011526968
MEDLINE PMID
21930003 (http://www.ncbi.nlm.nih.gov/pubmed/21930003)
PUI
L362594856
DOI
10.1016/j.jpedsurg.2011.06.037
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jpedsurg.2011.06.037
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 581
TITLE
Dogs leaving the ICU carry a very large multi-drug resistant enterococcal
population with capacity for biofilm formation and horizontal gene transfer
AUTHOR NAMES
Ghosh A.
Dowd S.E.
Zurek L.
AUTHOR ADDRESSES
(Ghosh A.; Zurek L., lzurek@vet.k-state.edu) Department of Diagnostic
Medicine and Pathobiology, College of Veterinary Medicine, Kansas State
University, Manhattan, KS, United States.
(Dowd S.E.) Medical Biofilm Research Institute, Lubbock, TX, United States.
(Zurek L., lzurek@vet.k-state.edu) Department of Entomology, Kansas State
University, Manhattan, KS, United States.
CORRESPONDENCE ADDRESS
L. Zurek, Department of Diagnostic Medicine and Pathobiology, College of
Veterinary Medicine, Kansas State University, Manhattan, KS, United States.
Email: lzurek@vet.k-state.edu
SOURCE
PLoS ONE (2011) 6:7 Article Number: e22451. Date of Publication: 2011
ISSN
1932-6203 (electronic)
BOOK PUBLISHER
Public Library of Science, 185 Berry Street, Suite 1300, San Francisco,
United States.
ABSTRACT
The enterococcal community from feces of seven dogs treated with antibiotics
for 2-9 days in the veterinary intensive care unit (ICU) was characterized.
Both, culture-based approach and culture-independent 16S rDNA amplicon 454
pyrosequencing, revealed an abnormally large enterococcal community:
1.4±0.8×10(8) CFU gram(-1) of feces and 48.9±11.5% of the total 16,228
sequences, respectively. The diversity of the overall microbial community
was very low which likely reflects a high selective antibiotic pressure. The
enterococcal diversity based on 210 isolates was also low as represented by
Enterococcus faecium (54.6%) and Enterococcus faecalis (45.4%). E. faecium
was frequently resistant to enrofloxacin (97.3%), ampicillin (96.5%),
tetracycline (84.1%), doxycycline (60.2%), erythromycin (53.1%), gentamicin
(48.7%), streptomycin (42.5%), and nitrofurantoin (26.5%). In E. faecalis,
resistance was common to tetracycline (59.6%), erythromycin (56.4%),
doxycycline (53.2%), and enrofloxacin (31.9%). No resistance was detected to
vancomycin, tigecycline, linezolid, and quinupristin/dalfopristin in either
species. Many isolates carried virulence traits including gelatinase,
aggregation substance, cytolysin, and enterococcal surface protein. All E.
faecalis strains were biofilm formers in vitro and this phenotype correlated
with the presence of gelE and/or esp. In vitro intra-species conjugation
assays demonstrated that E. faecium were capable of transferring
tetracycline, doxycycline, streptomycin, gentamicin, and erythromycin
resistance traits to human clinical strains. Multi-locus variable number
tandem repeat analysis (MLVA) and pulsed-field gel electrophoresis (PFGE) of
E. faecium strains showed very low genotypic diversity. Interestingly, three
E. faecium clones were shared among four dogs suggesting their nosocomial
origin. Furthermore, multi-locus sequence typing (MLST) of nine
representative MLVA types revealed that six sequence types (STs) originating
from five dogs were identical or closely related to STs of human clinical
isolates and isolates from hospital outbreaks. It is recommended to restrict
close physical contact between pets released from the ICU and their owners
to avoid potential health risks. © 2011 Ghosh et al.
EMTREE DRUG INDEX TERMS
ampicillin
antibiotic agent
cell surface protein
cytolysin
dalfopristin plus quinupristin
DNA 16S
doxycycline
enrofloxacin
erythromycin
gelatinase
genomic DNA (endogenous compound)
gentamicin
linezolid
nitrofurantoin
streptomycin
tetracycline
tigecycline
vancomycin
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
bacterial load
biofilm
horizontal gene transfer
intensive care unit
multidrug resistance
EMTREE MEDICAL INDEX TERMS
amplicon
antibiotic resistance
antibiotic sensitivity
antibiotic therapy
article
bacterial strain
bacterial transmission
bacterial virulence
bacterium conjugation
bacterium isolate
cell clone
colony forming unit
controlled study
dog
Enterococcus faecalis
Enterococcus faecium
feces microflora
genetic variability
health hazard
hospital infection
in vitro study
microbial community
microbial diversity
minimum inhibitory concentration
multilocus sequence typing
nonhuman
phenotype
pulsed field gel electrophoresis
pyrosequencing
treatment duration
variable number of tandem repeat
veterinary medicine
CAS REGISTRY NUMBERS
ampicillin (69-52-3, 69-53-4, 7177-48-2, 74083-13-9, 94586-58-0)
dalfopristin plus quinupristin (126602-89-9)
doxycycline (10592-13-9, 17086-28-1, 564-25-0)
enrofloxacin (93106-60-6)
erythromycin (114-07-8, 70536-18-4)
gelatinase (9040-48-6)
gentamicin (1392-48-9, 1403-66-3, 1405-41-0)
linezolid (165800-03-3)
nitrofurantoin (54-87-5, 67-20-9)
streptomycin (57-92-1)
tetracycline (23843-90-5, 60-54-8, 64-75-5, 8021-86-1)
tigecycline (220620-09-7)
vancomycin (1404-90-6, 1404-93-9)
EMBASE CLASSIFICATIONS
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2011395437
MEDLINE PMID
21811613 (http://www.ncbi.nlm.nih.gov/pubmed/21811613)
PUI
L362161268
DOI
10.1371/journal.pone.0022451
FULL TEXT LINK
http://dx.doi.org/10.1371/journal.pone.0022451
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 582
TITLE
[Acute coronary syndrome: the system of organization of treatment].
AUTHOR NAMES
Ruda M.I.
AUTHOR ADDRESSES
(Ruda M.I.)
CORRESPONDENCE ADDRESS
M.I. Ruda,
SOURCE
Kardiologiia (2011) 51:3 (4-9). Date of Publication: 2011
ISSN
0022-9040
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
acute coronary syndrome (complication, diagnosis, therapy)
coronary care unit
emergency health service
heart ventricle fibrillation (diagnosis, etiology, therapy)
patient transport
EMTREE MEDICAL INDEX TERMS
angioplasty
article
cardioversion
clinical competence
clinical pathway
defibrillator
devices
drug eluting stent
electrocardiography
fibrinolytic therapy
health service
human
methodology
mortality
organization and management
standard
time
LANGUAGE OF ARTICLE
Russian
MEDLINE PMID
21627606 (http://www.ncbi.nlm.nih.gov/pubmed/21627606)
PUI
L362241877
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 583
TITLE
Prognosis of patients transferred from intensive care units to departments
of chest diseases and the factors affecting their prognosis
ORIGINAL (NON-ENGLISH) TITLE
yoǧun baki{dotless}mlardan göǧüs hastali{dotless}klari{dotless} kliniǧine
devir ali{dotless}nan olgulari{dotless}n prognozu ve prognozu etkileyen
faktörler
AUTHOR NAMES
Kalemci S.
Sevinç C.
Ellidokuz H.
AUTHOR ADDRESSES
(Kalemci S., skalemci79@mynet.com) Şanliurfa Suruç Devlet Hastanesi, Göǧüs
Hastaliklari Bölümü, Şanliurfa, Turkey.
(Sevinç C.) Dokuz Eylül Üniversitesi Tip Fakültesi, Göǧüs Hastaliklari
Anabilim Dali, Izmir, Turkey.
(Ellidokuz H.) Dokuz Eylül Üzniversitesi Tip Fakültesi, Halk Saǧliǧi
Anabilim Dali, Halk Saǧliǧi, Izmir, Turkey.
CORRESPONDENCE ADDRESS
S. Kalemci, Şanliurfa Suruç Devlet Hastanesi, Göǧüs Hastaliklari Bölümü,
Şanliurfa, Turkey. Email: skalemci79@mynet.com
SOURCE
Journal of Medical and Surgical Intensive Care Medicine (2011) 2:2 (29-33).
Date of Publication: August 2011
ISSN
1309-1689
1309-6222 (electronic)
BOOK PUBLISHER
Turkish Society of Medical and Surgical Intensive Care Medic, Ankara,
Turkey.
ABSTRACT
Aim: One-third of deaths due to a critical disease occur after patients are
transferred from intensive care units to hospital departments. Some of the
deaths occur in patients who are considered not to need further intensive
care treatment or that they are adequately stabilized or recovered according
to their clinical and physiological findings. Deaths in patients transferred
from intensive care units to departments might result from the incomplete
recovery of the primary disease or from development of new complications.
The aim of this study is to monitor the prognosis of cases who have been
intubated and supported with mechanical ventilation in the intensive care
unit and then transferred from this unit to the chest diseases department
after having been taken off mechanical ventilation, and to determine the
factors affecting their prognosis. Material and Methods: Medical records of
the patients who were first intubated and monitored in different intensive
care units of internal diseases, anesthesia, coronary, cardio-vascular
surgery and emergency departments in Dokuz Eylül University Hospital and
then transferred to the Department of Chest Diseases of the same hospital
between 2006 and 2008 were retrospectively investigated. Results:
Seventy-eight patients were included in the study. Fifty-three patients
(67.9%) from intensive care units in the internal diseases department
(internal medicine, chest diseases, coronary, and the resuscitation unit of
the emergency room) and 25 patients (32.1%), from surgical intensive care
units (anesthesia, cardiovascular surgery) were transferred to the
Department of Chest Diseases. Forty-eight patients (61.5%) were discharged
from the department. Thirteen cases (16.7%) were sent back to the intensive
care unit because of their deteriorating conditions. Twenty-four patients
[seventeen (21.8%) in our clinic and seven in the intensive care unit where
they had been sent back] lost their lives. The following were determined to
play an important role in total mortality: the presence of atrial
fibrillation and malignancy during the patients' stay in the intensive care
unit and in the Department of Chest Diseases, high D-dimer levels in the
department, the presence of atelectasis on chest radiograph, acute
physiological and chronic health evaluation system scores (APACHE II)
obtained in the intensive care unit, and APACHE II scores and Sequential
Organ Failure Assessment (SOFA) scores. Conclusion: APACHE II scores
obtained in the intensive care unit and APACHE II scores and SOFA scores
obtained when the patients were transferred to the department were the most
important mortality estimation parameters after patients were discharged
from the intensive care units. It was also found that the presence of atrial
fibrillation and/ or malignancy, high D-dimer levels and atelectasis on
chest radiograph of patients who were transferred from the intensive care
unit to the department led to an increase in mortality. Therefore, the
decision to transfer these patients should be made more judiciously and they
should be followed more carefully.
EMTREE DRUG INDEX TERMS
D dimer (endogenous compound)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital department
intensive care unit
patient transport
prognosis
thorax disease
EMTREE MEDICAL INDEX TERMS
APACHE
article
artificial ventilation
atelectasis (diagnosis)
atrial fibrillation
coronary care unit
emergency ward
human
internal medicine
major clinical study
malignant neoplasm
medical record
mortality
respiratory tract intubation
retrospective study
risk factor
thorax radiography
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English, Turkish
LANGUAGE OF SUMMARY
English, Turkish
EMBASE ACCESSION NUMBER
2011457701
PUI
L362360058
DOI
10.5152/dcbybd.2011.07
FULL TEXT LINK
http://dx.doi.org/10.5152/dcbybd.2011.07
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 584
TITLE
Acute medical complications in patients admitted to a stroke unit and safe
transfer to rehabilitation
AUTHOR NAMES
Bonaiuti D.
Sioli P.
Fumagalli L.
Beghi E.
Agostoni E.
AUTHOR ADDRESSES
(Bonaiuti D.; Sioli P.) Physical Medicine and Rehabilitation Department, S.
Gerardo Hospital, Monza, Italy.
(Fumagalli L.) Department of Neurosciences, San Gerardo Hospital, Monza,
Italy.
(Beghi E., beghi@marionegri.it) Istituto di Ricerche Farmacologiche ''Mario
Negri'', Via G. la Masa 19, 20156 Milan, Italy.
(Agostoni E.) Department of Neurosciences, Manzoni Hospital, Lecco, Italy.
CORRESPONDENCE ADDRESS
E. Beghi, Istituto di Ricerche Farmacologiche ''Mario Negri'', Via G. la
Masa 19, 20156 Milan, Italy. Email: beghi@marionegri.it
SOURCE
Neurological Sciences (2011) 32:4 (619-623). Date of Publication: August
2011
ISSN
1590-1874
1590-3478 (electronic)
BOOK PUBLISHER
Springer Milan, Via Podgora 4, Milan, Italy.
ABSTRACT
Acute medical complications often prevent patients with stroke from being
transferred from stroke units to rehabilitation units, prolonging the
occupation of hospital beds and delaying the start of intensive
rehabilitation. This study defined incidence, timing, duration and risk
factors of these complications during the acute phase of stroke. A
retrospective case note review was made of hospital admissions of patients
with stroke not associated with other disabling conditions, admitted to a
stroke unit over 12 months and requiring rehabilitation for gait impairment.
In this cohort, a search was made of hypertension, oxygen de-saturation,
fever, and cardiac and pulmonary symptoms requiring medical intervention.
Included were 135 patients. Hypertension was the most common complication
(16.3%), followed by heart disease (14.8%), oxygen de-saturation (7.4%),
fever (6.7%) and pulmonary disease (5.2%). Heart disease was the earliest
and shortest complication. Most complications occurred during the first
week. Except for hypertension, all complications resolved within 2 weeks. ©
2011 Springer-Verlag.
EMTREE DRUG INDEX TERMS
penicillin G
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
acute disease
cerebrovascular accident
patient transport
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
brain hemorrhage (complication)
brain ischemia (complication)
controlled study
disease duration
disease severity
female
fever (complication)
gait disorder
heart disease (complication)
human
hypertension (complication)
length of stay
lung embolism (complication)
major clinical study
male
oxygen saturation
patient safety
pneumonia (complication)
Rankin scale
rehabilitation center
review
risk factor
stroke unit
CAS REGISTRY NUMBERS
penicillin G (1406-05-9, 61-33-6)
EMBASE CLASSIFICATIONS
Neurology and Neurosurgery (8)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2011563230
MEDLINE PMID
21533563 (http://www.ncbi.nlm.nih.gov/pubmed/21533563)
PUI
L51400664
DOI
10.1007/s10072-011-0588-2
FULL TEXT LINK
http://dx.doi.org/10.1007/s10072-011-0588-2
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 585
TITLE
Transportable enhanced simulation technologies for pre-implementation
limited operations testing: neonatal intensive care unit.
AUTHOR NAMES
Bender J.
Shields R.
Kennally K.
AUTHOR ADDRESSES
(Bender J.) Department of Pediatrics, Women & Infants' Hospital, Providence,
RI 02905, USA.
(Shields R.; Kennally K.)
CORRESPONDENCE ADDRESS
J. Bender, Department of Pediatrics, Women & Infants' Hospital, Providence,
RI 02905, USA. Email: gbender@wihri.org
SOURCE
Simulation in healthcare : journal of the Society for Simulation in
Healthcare (2011) 6:4 (204-212). Date of Publication: Aug 2011
ISSN
1559-713X (electronic)
ABSTRACT
Transition of a Neonatal Intensive Care Unit (NICU) to a new physical plant
incurs many challenges. These are amplified when the culture of care is
changing from traditional cohort-based care to the single-family room model.
Altered healthcare delivery systems can be tested in situ with TESTPILOT:
Transportable Enhanced Simulation Technologies for Pre-Implementation
Limited Operations Testing. The aims of the study included promoting
translation of existing processes and identifying staff orientation
material. We hypothesized that (1) numerous process gaps would be discovered
and resolved, and (2) participants would feel better prepared. A functional
neonatal intensive care unit was modeled before its opening. Scenarios were
developed, volunteers recruited, and rooms supplied with equipment.
Participants performed usual duties in two 30-minute in situ simulations
followed by facilitated debriefings. As latent safety hazards were
identified, they were corrected and retested in subsequent simulations.
Staff was surveyed for perceived preparedness. Ninety-six multidisciplinary
participants identified 164 latent safety hazards in verbal and written
communication, facilities, supplies, staffing, and training, 93% of which
were resolved at transition. Staff preparedness varied but showed improving
communication, workflow patterns, and awareness of equipment and supply
locations. The majority stated that this simulation experience changed their
practice. Simulation is very effective for identifying process gaps before
major institutional change. TESTPILOT generated iterative workflow
enhancements and staff orientation toward improving patient care at
transition and beyond. The extensive coordination required to implement such
large-scale simulations is well worth the benefit for systems refinement and
patient safety.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health care quality
interdisciplinary communication
newborn intensive care
EMTREE MEDICAL INDEX TERMS
adult
article
education
female
health care survey
human
male
methodology
middle aged
newborn
safety
standard
LANGUAGE OF ARTICLE
English
MEDLINE PMID
21546863 (http://www.ncbi.nlm.nih.gov/pubmed/21546863)
PUI
L560007203
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 586
TITLE
Transfer of take-home messages in graduate ICU education
AUTHOR NAMES
Lautrette A.
Schwebel C.
Gruson D.
Talbot R.W.
Timsit J.-F.
Souweine B.
AUTHOR ADDRESSES
(Lautrette A., alautrette@chu-clermontferrand.fr; Talbot R.W.; Souweine B.)
Medical ICU, Pôle REUNNIRH, CHU Gabriel Montpied Teaching Hospital of
Clermont-Ferrand, Université d'Auvergne-Clermont Ferrand 1, 58 Rue
Montalembert, Clermont-Ferrand 63003, France.
(Schwebel C.) Medical ICU, Michallon Teaching Hospital, Grenoble Cedex 9
38043, France.
(Gruson D.) Medical ICU, PellegrinTeaching Hospital, Bordeaux Cedex 33000,
France.
(Timsit J.-F.) UFR Santé, University Joseph Fourrier and U823 Research
Center, INSERM/University Joseph Fourrier, Grenoble Cedex 9 38043, France.
CORRESPONDENCE ADDRESS
A. Lautrette, Medical ICU, Pôle REUNNIRH, CHU Gabriel Montpied Teaching
Hospital of Clermont-Ferrand, Université d'Auvergne-Clermont Ferrand 1, 58
Rue Montalembert, Clermont-Ferrand 63003, France. Email:
alautrette@chu-clermontferrand.fr
SOURCE
Intensive Care Medicine (2011) 37:8 (1323-1330). Date of Publication: August
2011
ISSN
0342-4642
1432-1238 (electronic)
BOOK PUBLISHER
Springer Verlag, Tiergartenstrasse 17, Heidelberg, Germany.
ABSTRACT
Purpose: Teaching by lecture (lecture format) is widely used at congresses
and in medical educational programmes. The process involves the transfer of
take-home messages. The aim of this study was to assess the number of
take-home messages identified by postgraduate critical care junior doctors
(juniors) during lectures. Methods: This was a prospective observational
study of 13 lectures. Lecturers were not informed in advance of the study.
At the end of the lecture (30 or 50 min), the lecturer (senior doctor) and
juniors listed the three main take-home messages on a form. Subjective
elements of the juniors' appraisal (quality of the presentation, explanation
of the topic's relevance, enthusiasm of the lecturer, background,
case-based, delivery and personality, comprehensibility, practical
applicability of information given, prioritization, presence of raw data,
references, overall satisfaction) and objective elements (length of lecture,
number of take-home messages written on the slides) of the lectures were
recorded. Successful knowledge transfer was assessed by matching lecturers'
and juniors' take-home messages. Results: In total, 367 forms completed by
367 juniors were analysed. A match equal to 3 (highest match), 2, 1 or 0 was
observed in 3.8, 26.7, 48.2 and 21.2% of the forms, respectively. No single
subjective or objective element of the lecture was associated with the
number of identified take-home messages. Conclusions: Two-thirds of critical
care junior doctors identified at best only one of the three main take-home
messages of a lecture, suggesting that knowledge transfer is poor during
passive format learning. These results suggest that there is a need to
develop strategies to improve the performance of lecture-based learning. ©
2011 Copyright jointly held by Springer and ESICM.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
medical education
EMTREE MEDICAL INDEX TERMS
article
health program
human
observational study
postgraduate education
problem based learning
prospective study
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2011425983
MEDLINE PMID
21660536 (http://www.ncbi.nlm.nih.gov/pubmed/21660536)
PUI
L51469149
DOI
10.1007/s00134-011-2256-7
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-011-2256-7
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 587
TITLE
Intrahospital transport of critically ill patients (excluding newborns).
Expert guidelines from the Société de réanimation de langue française
(SRLF), Société française d'anesthésie et de réanimation (SFAR) and the
Socié té française de médecine d'urgence (SFMU)
ORIGINAL (NON-ENGLISH) TITLE
Transport intrahospitalier des patients à risque vital (nouveau-né exclu).
Recommandations formalisées d'experts sous l'égide de la Société de
réanimation de langue française (SRLF), de la Société française d'anesthésie
et de réanimation (SFAR) et de la Societe francaise de medecine d'urgence
(SFMU)
AUTHOR NAMES
Quenot J.-P.
Milési C.
Cravoisy A.
Capellier G.
Mimoz O.
Fourcade O.
Gueugniaud P.-Y.
AUTHOR ADDRESSES
(Quenot J.-P., jean-pierre.quenot@chu-dijon.fr) Service de réanimation
médicale, CHU Bocage-Central-Gabriel, 14, rue Paul-Gaffarel, F-21079 Dijon,
France.
(Milési C.) Service de réanimation pédiatrique, CHU Lapeyronie, 371, avenue
du Doyen-Gaston-Giraud, F-34295 Montpelier, France.
(Cravoisy A.) Service de réanimation médicale, CHU-Hôpital Central, 29,
avenue du Maréchal-de-Lattre-de-Tassigny, F-54035 Nancy, France.
(Capellier G.) Service de réanimation médicale, CHU-hôpital Jean-Minjoz, 3,
boulevard Fleming, F-25000 Besandşon, France.
(Mimoz O.) Service d'anesthésie-réanimation, CHU de la Milétrie, 2, rue de
la Milétrie, F-86021 Poitiers, France.
(Fourcade O.) Pôle anesthésie-réanimation, CHU, pavillon urgences et
réanimation, HôPital Purpan, place du Docteur-Baylac, F-31059 Toulouse,
France.
(Gueugniaud P.-Y.) Service aide médicale urgente, CHU-hospices civils, 162,
avenue Lacassagne, F-69003 Lyon, France.
CORRESPONDENCE ADDRESS
J.-P. Quenot, Service de réanimation médicale, CHU Bocage-Central-Gabriel,
14, rue Paul-Gaffarel, F-21079 Dijon, France. Email:
jean-pierre.quenot@chu-dijon.fr
SOURCE
Reanimation (2011) 20:4 (361-366). Date of Publication: July 2011
ISSN
1624-0693
1951-6959 (electronic)
BOOK PUBLISHER
Springer Paris, 1 rue Paul Cezanne, Paris, France.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
patient transport
EMTREE MEDICAL INDEX TERMS
article
human
practice guideline
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
French
EMBASE ACCESSION NUMBER
2012060606
PUI
L364157198
DOI
10.1007/s13546-011-0271-x
FULL TEXT LINK
http://dx.doi.org/10.1007/s13546-011-0271-x
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 588
TITLE
Country-to-country transfer of patients and the risk of multi-resistant
bacterial infection
AUTHOR NAMES
Rogers B.A.
Aminzadeh Z.
Hayashi Y.
Paterson D.L.
AUTHOR ADDRESSES
(Rogers B.A., benrogers@uq.edu.au; Aminzadeh Z.; Hayashi Y.; Paterson D.L.)
University of Queensland Centre for Clinical Research, University of
Queensland, 918 Royal Brisbane Hospital, Level 8, Herston, Brisbane 4006,
Australia.
(Aminzadeh Z.) Infectious Diseases Research Centre, Shaheed Beheshti
University M. C., Tehran, Iran.
(Hayashi Y.) Department of Intensive Care Medicine, Royal Brisbane and
Women's Hospital, Brisbane, Australia.
CORRESPONDENCE ADDRESS
B. A. Rogers, University of Queensland Centre for Clinical Research,
University of Queensland, 918 Royal Brisbane Hospital, Level 8, Herston,
Brisbane 4006, Australia. Email: benrogers@uq.edu.au
SOURCE
Clinical Infectious Diseases (2011) 53:1 (49-56). Date of Publication: 1 Jul
2011
ISSN
1058-4838
1537-6591 (electronic)
BOOK PUBLISHER
Oxford University Press, 2001 Evans Road, Cary, United States.
ABSTRACT
Management of patients with a history of healthcare contact in multiple
countries is now a reality for many clinicians. Leisure tourism, the
burgeoning industry of medical tourism, military conflict, natural
disasters, and changing patterns of human migration may all contribute to
this emerging epidemiological trend. Such individuals may be both vectors
and victims of healthcare-associated infection with multiresistant bacteria.
Current literature describes intercountry transfer of multiresistant
Acinetobacter spp and Klebsiella pneumoniae (including Klebsiella pneumoniae
carbapenemase- and New Delhi metallo-β-lactamase-producing strains),
methicillin-resistant Staphylococcus aureus, vancomycin-resistant
enterococci, and hypervirulent Clostridium difficile. Introduction of such
organisms to new locations has led to their dissemination within hospitals.
Healthcare institutions should have sound infection prevention strategies to
mitigate the risk of dissemination of multiresistant organisms from patients
who have been admitted to hospitals in other countries. Clinicians may also
need to individualize empiric prescribing patterns to reflect the risk of
multiresistant organisms in these patients. © 2011 The Author.
EMTREE DRUG INDEX TERMS
antibiotic agent
bacterial enzyme (endogenous compound)
carbapenem
carbapenemase (endogenous compound)
extended spectrum beta lactamase (endogenous compound)
metallo beta lactamase (endogenous compound)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
bacterial infection (drug resistance, etiology)
multidrug resistance
patient transport
EMTREE MEDICAL INDEX TERMS
Acinetobacter
Acinetobacter infection (drug resistance, etiology)
aerospace medicine
antibiotic resistance
bacterial gene
bacterial strain
bacterial virulence
Belgium
Citrobacter freundii
Clostridium difficile infection (etiology)
disease transmission
empiricism
Escherichia coli
Escherichia coli infection
France
Gram negative bacterium
health care organization
hospital admission
hospital infection
hospital patient
human
infection prevention
infection risk
intensive care unit
Ireland
Klebsiella pneumoniae
Klebsiella pneumoniae infection (drug resistance, etiology)
medical tourism
methicillin resistant Staphylococcus aureus
nonhuman
Peptoclostridium difficile
population distribution
population risk
priority journal
review
soldier
traumatic brain injury
vancomycin resistant Enterococcus
CAS REGISTRY NUMBERS
carbapenem (83200-96-8)
EMBASE CLASSIFICATIONS
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
Internal Medicine (6)
General Pathology and Pathological Anatomy (5)
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2011327518
MEDLINE PMID
21653302 (http://www.ncbi.nlm.nih.gov/pubmed/21653302)
PUI
L361949268
DOI
10.1093/cid/cir273
FULL TEXT LINK
http://dx.doi.org/10.1093/cid/cir273
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 589
TITLE
Travel time from home to hospital and adverse perinatal outcomes in women at
term in the Netherlands
AUTHOR NAMES
Ravelli A.C.J.
Jager K.J.
De Groot M.H.
Erwich J.J.H.M.
Rijninks-Van Driel G.C.
Tromp M.
Eskes M.
Abu-Hanna A.
Mol B.W.J.
AUTHOR ADDRESSES
(Ravelli A.C.J.; Jager K.J.; De Groot M.H.; Erwich J.J.H.M.; Rijninks-Van
Driel G.C.; Tromp M.; Eskes M.; Abu-Hanna A.; Mol B.W.J.) Department of
Medical Informatics, Academic Medical Centre, Amsterdam, Netherlands.
(Ravelli A.C.J.; Jager K.J.; De Groot M.H.; Erwich J.J.H.M.; Rijninks-Van
Driel G.C.; Tromp M.; Eskes M.; Abu-Hanna A.; Mol B.W.J.) Department of
Obstetrics and Gynaecology, University Medical Centre Groningen, Groningen,
Netherlands.
(Ravelli A.C.J.; Jager K.J.; De Groot M.H.; Erwich J.J.H.M.; Rijninks-Van
Driel G.C.; Tromp M.; Eskes M.; Abu-Hanna A.; Mol B.W.J.) Department of
Obstetrics and Gynaecology, Medical Centre, Amsterdam, Netherlands.
CORRESPONDENCE ADDRESS
A.C.J. Ravelli, Department of Medical Informatics, Academic Medical Centre,
Amsterdam, Netherlands.
SOURCE
Obstetrical and Gynecological Survey (2011) 66:7 (396-398). Date of
Publication: July 2011
ISSN
0029-7828
1533-9866 (electronic)
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
home
hospital
newborn mortality
patient transport
perinatal period
pregnancy outcome
travel
EMTREE MEDICAL INDEX TERMS
Apgar score
car
cohort analysis
economic aspect
ethnicity
gestational age
hospital admission
human
intensive care unit
intrapartum care
maternal age
maternity ward
Netherlands
note
obstetric delivery
parity
population
primary medical care
register
risk factor
social aspect
stillbirth
urbanization
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Obstetrics and Gynecology (10)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2011541955
PUI
L362659479
DOI
10.1097/OGX.0b013e3182338407
FULL TEXT LINK
http://dx.doi.org/10.1097/OGX.0b013e3182338407
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 590
TITLE
Intra-hospital transport of critically ill patients (excluding newborns)
ORIGINAL (NON-ENGLISH) TITLE
Transport intrahospitalier des patients à risque vital (nouveau-né exclu):
Recommandations formalisées d'experts sous l'égide de la Société de
réanimation de langue française (SRLF), de la Société française d'anesthésie
et de réanimation (Sfar) et de la Sociéte francaise de medecine d'urgence
(SFMU)
AUTHOR NAMES
Quenot J.-P.
Milési C.
Cravoisy A.
Capellier G.
Mimoz O.
Fourcade O.
Gueugniaud P.Y.
AUTHOR ADDRESSES
(Quenot J.-P., jean-pierre.quenot@chu-dijon.fr) Service de réanimation
médicale, CHU Bocage-Central-Gabriel, 14, rue Paul-Gaffarel, F-21079 Dijon,
France.
(Milési C.) CHU Lapeyronie, F-34295 Montpellier, France.
(Cravoisy A.) Hôpital central, CHU de Nancy, F-54035 Nancy, France.
(Capellier G.) Hôpital Jean-Minjoz, CHU de Besançon, F-25000 Besançon,
France.
(Mimoz O.) CHU de la Milétrie, F-86021 Poitiers, France.
(Fourcade O.) Pavillon urgences et réanimation, Hôpital Purpan, CHU de
Toulouse, F-31059 Toulouse, France.
(Gueugniaud P.Y.) CHU hospices civils de Lyon, F-69003 Lyon, France.
CORRESPONDENCE ADDRESS
J.-P. Quenot, Service de réanimation médicale, CHU Bocage-Central-Gabriel,
14, rue Paul-Gaffarel, F-21079 Dijon, France. Email:
jean-pierre.quenot@chu-dijon.fr
SOURCE
Annales Francaises de Medecine d'Urgence (2011) 1:4 (278-283). Date of
Publication: July 2011
ISSN
2108-6524
2108-6591 (electronic)
BOOK PUBLISHER
Springer Paris, 1 rue Paul Cezanne, Paris, France.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
patient transport
EMTREE MEDICAL INDEX TERMS
article
human
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
French, English
EMBASE ACCESSION NUMBER
2012374233
PUI
L365121491
DOI
10.1007/s13341-011-0080-x
FULL TEXT LINK
http://dx.doi.org/10.1007/s13341-011-0080-x
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 591
TITLE
The PICU perspective on monitoring hemodynamics and oxygen transport.
AUTHOR NAMES
Wong H.R.
Dalton H.J.
AUTHOR ADDRESSES
(Wong H.R.; Dalton H.J.)
CORRESPONDENCE ADDRESS
H.R. Wong,
SOURCE
Pediatric critical care medicine : a journal of the Society of Critical Care
Medicine and the World Federation of Pediatric Intensive and Critical Care
Societies (2011) 12:4 Suppl (S66-68). Date of Publication: Jul 2011
ISSN
1529-7535
ABSTRACT
Alterations of hemodynamics and oxygen transport balance are very common
scenarios in the pediatric intensive care unit (PICU), and these alterations
are as heterogeneous and diverse in nature as are the patient populations
that typically exist in the PICU. Accordingly, the PICU perspective on
monitoring of hemodynamics and oxygen transport balance in critically ill
children must be understood in this context of heterogeneity and diversity.
We provide an interpretation of the evidence supporting various monitoring
strategies as presented in the The Pediatric Cardiac Intensive Care Society
Evidence Based Review and Consensus Statement on Monitoring of Hemodynamics
and Oxygen Transport Balance from a Pediatric Intensive Care perspective.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
oxygen (pharmacokinetics)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hemodynamics
intensive care unit
monitoring
EMTREE MEDICAL INDEX TERMS
editorial
human
infant
methodology
oxygen consumption
pathophysiology
physiology
preschool child
shock
transport at the cellular level
CAS REGISTRY NUMBERS
oxygen (7782-44-7)
LANGUAGE OF ARTICLE
English
MEDLINE PMID
21857798 (http://www.ncbi.nlm.nih.gov/pubmed/21857798)
PUI
L560061769
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 592
TITLE
The Pediatric Cardiac Intensive Care Society evidence-based review and
consensus statement on monitoring of hemodynamics and oxygen transport
balance
AUTHOR NAMES
Checchia P.A.
Bronicki R.A.
AUTHOR ADDRESSES
(Checchia P.A.) St. Louis Children's Hospital, Washington University School
of Medicine, St. Louis, MO, United States.
(Bronicki R.A.) Children's Hospital of Orange County, University of
California, Orange, CA, United States.
(Bronicki R.A.) David Geffen School of Medicine, University of California,
Los Angeles, CA, United States.
CORRESPONDENCE ADDRESS
P. A. Checchia, St. Louis Children's Hospital, Washington University School
of Medicine, St. Louis, MO, United States.
SOURCE
Pediatric Critical Care Medicine (2011) 12:4 SUPPL. (S1). Date of
Publication: July 2011
ISSN
1529-7535
1947-3893 (electronic)
BOOK PUBLISHER
Lippincott Williams and Wilkins, 530 Walnut Street,P O Box 327,
Philadelphia, United States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
coronary care unit
hemodynamic monitoring
medical society
oxygen transport
pediatrics
EMTREE MEDICAL INDEX TERMS
blood pressure
cardiovascular function
central venous pressure
consensus
critically ill patient
editorial
evidence based medicine
heart rate
human
myocarditis (diagnosis)
neonatology
patient monitoring
pediatric intensive care nursing
physical examination
priority journal
pulmonary artery catheter
pulmonary hypertension
tissue oxygenation
United States
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
Cardiovascular Diseases and Cardiovascular Surgery (18)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2011369440
MEDLINE PMID
22129543 (http://www.ncbi.nlm.nih.gov/pubmed/22129543)
PUI
L362077274
DOI
10.1097/PCC.0b013e318220e64f
FULL TEXT LINK
http://dx.doi.org/10.1097/PCC.0b013e318220e64f
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 593
TITLE
The pediatric intensive care unit perspective on monitoring hemodynamics and
oxygen transport
AUTHOR NAMES
Wong H.R.
Dalton H.J.
AUTHOR ADDRESSES
(Wong H.R., hector.wong@cchmc.org) Department of Pediatrics, Cincinnati
Children's Hospital Medical Center, University of Cincinnati College of
Medicine, Cincinnati, OH, United States.
(Dalton H.J.) Division of Critical Care Medicine, Phoenix Children's
Hospital, Phoenix, AZ, United States.
CORRESPONDENCE ADDRESS
H. R. Wong, Department of Pediatrics, Cincinnati Children's Hospital Medical
Center, University of Cincinnati College of Medicine, Cincinnati, OH, United
States. Email: hector.wong@cchmc.org
SOURCE
Pediatric Critical Care Medicine (2011) 12:4 SUPPL. (S66-S68). Date of
Publication: July 2011
ISSN
1529-7535
1947-3893 (electronic)
BOOK PUBLISHER
Lippincott Williams and Wilkins, 530 Walnut Street,P O Box 327,
Philadelphia, United States.
ABSTRACT
Alterations of hemodynamics and oxygen transport balance are very common
scenarios in the pediatric intensive care unit (PICU), and these alterations
are as heterogeneous and diverse in nature as are the patient populations
that typically exist in the PICU. Accordingly, the PICU perspective on
monitoring of hemodynamics and oxygen transport balance in critically ill
children must be understood in this context of heterogeneity and diversity.
We provide an interpretation of the evidence supporting various monitoring
strategies as presented in the Pediatric Cardiac Intensive Care Society
Evidence-Based Review and Consensus Statement on Monitoring of Hemodynamics
and Oxygen Transport Balance from a Pediatric Intensive Care perspective.
Copyright © 2011 by the Society of Critical Care Medicine and the World
Federation of Pediatric Intensive and Critical Care Societies.
EMTREE DRUG INDEX TERMS
beta adrenergic receptor stimulating agent (drug therapy)
brain natriuretic peptide (endogenous compound)
lactic acid (endogenous compound)
troponin (endogenous compound)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hemodynamic monitoring
intensive care unit
oxygen transport
pediatrics
EMTREE MEDICAL INDEX TERMS
asthmatic state (drug therapy)
cardiogenic shock
cardiovascular equipment
conference paper
consensus
critically ill patient
echocardiography
electrocardiography
evidence based medicine
femoral pulse waveform device
fulminating purpura
gold standard
heart function
heart muscle ischemia
hemodynamics
human
hypovolemic shock
hypoxia
lactate blood level
muscular dystrophy
near infrared spectroscopy
obstructive shock
oxygen saturation
physical examination
priority journal
pulmonary artery catheter
resuscitation
septic shock (therapy)
superior cava vein
systemic vascular resistance
thermodilution
CAS REGISTRY NUMBERS
brain natriuretic peptide (114471-18-0)
lactic acid (113-21-3, 50-21-5)
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Radiology (14)
Cardiovascular Diseases and Cardiovascular Surgery (18)
Biophysics, Bioengineering and Medical Instrumentation (27)
Drug Literature Index (37)
CLINICAL TRIAL NUMBERS
ClinicalTrials.gov (NCT00510835)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2011369450
PUI
L362077284
DOI
10.1097/PCC.0b013e3182211c60
FULL TEXT LINK
http://dx.doi.org/10.1097/PCC.0b013e3182211c60
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 594
TITLE
The cardiac intensive care unit perspective on hemodynamic monitoring of
oxygen transport balance
AUTHOR NAMES
Checchia P.A.
Laussen P.C.
AUTHOR ADDRESSES
(Checchia P.A., pchecchia@wustl.edu) Department of Pediatrics (PAC), St
Louis Children's Hospital, Washington University School of Medicine, St
Louis, MO, United States.
(Laussen P.C.) Department of Cardiology (PCL), Children's Hospital Boston,
Boston, MA, United States.
(Laussen P.C.) Department of Pediatrics (PCL), Harvard Medical School,
Boston, MA, United States.
CORRESPONDENCE ADDRESS
P. A. Checchia, Department of Pediatrics (PAC), St Louis Children's
Hospital, Washington University School of Medicine, St Louis, MO, United
States. Email: pchecchia@wustl.edu
SOURCE
Pediatric Critical Care Medicine (2011) 12:4 SUPPL. (S69-S71). Date of
Publication: July 2011
ISSN
1529-7535
1947-3893 (electronic)
BOOK PUBLISHER
Lippincott Williams and Wilkins, 530 Walnut Street,P O Box 327,
Philadelphia, United States.
ABSTRACT
The purpose of this consensus statement is to present the available evidence
supporting the use of a variety of hemodynamic monitors in a pediatric
population. Each article within this supplement and the presentations at the
Eighth International Conference of the Pediatric Cardiac Intensive Care
Society provide the evidence to support recommendations for the use of each
monitoring modality. The purpose of this editorial is to interpret the
evidence provided elsewhere in this supplement from the perspective of
cardiac critical care. Copyright © 2011 by the Society of Critical Care
Medicine and the World Federation of Pediatric Intensive and Critical Care
Societies.
EMTREE DRUG INDEX TERMS
nitric oxide
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
coronary care unit
hemodynamic monitoring
intensive care unit
oxygen transport
EMTREE MEDICAL INDEX TERMS
caregiver
central venous pressure
conference paper
consensus
critically ill patient
echocardiography
end tidal carbon dioxide tension
heart function
heart output measurement
heart right atrium pressure
heart surgery
hemodynamic parameters
human
lung artery pressure
lung vascular resistance
medical society
near infrared spectroscopy
nuclear magnetic resonance imaging
oximetry
oxygen consumption
oxygen saturation
oxygen therapy
patient monitoring
pediatrics
postoperative complication (complication)
priority journal
pulmonary artery catheter
pulmonary artery occlusion pressure
quality of life
resuscitation
thermodilution
CAS REGISTRY NUMBERS
nitric oxide (10102-43-9)
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Radiology (14)
Cardiovascular Diseases and Cardiovascular Surgery (18)
Anesthesiology (24)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2011369451
MEDLINE PMID
22129553 (http://www.ncbi.nlm.nih.gov/pubmed/22129553)
PUI
L362077285
DOI
10.1097/PCC.0b013e3182211d3d
FULL TEXT LINK
http://dx.doi.org/10.1097/PCC.0b013e3182211d3d
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 595
TITLE
The nursing perspective on monitoring hemodynamics and oxygen transport
AUTHOR NAMES
Tucker D.
Hazinski M.F.
AUTHOR ADDRESSES
(Tucker D., dawnatucker@gmail.com) Children's Mercy Hospital, Kansas City,
MO, United States.
(Hazinski M.F.) Vanderbilt University School of Nursing, School of Medicine,
Nashville, TN, United States.
CORRESPONDENCE ADDRESS
D. Tucker, Children's Mercy Hospital, Kansas City, MO, United States. Email:
dawnatucker@gmail.com
SOURCE
Pediatric Critical Care Medicine (2011) 12:4 SUPPL. (S72-S75). Date of
Publication: July 2011
ISSN
1529-7535
1947-3893 (electronic)
BOOK PUBLISHER
Lippincott Williams and Wilkins, 530 Walnut Street,P O Box 327,
Philadelphia, United States.
ABSTRACT
Maintenance of adequate systemic oxygen delivery requires careful clinical
assessment integrated with hemodynamic measurements and calculations to
detect and treat conditions that may compromise oxygen delivery and lead to
life-threatening shock, respiratory failure, or cardiac arrest. The bedside
nurse constantly performs such assessments and measurements to detect subtle
changes and trends in patient condition. The purpose of this editorial is to
highlight nursing perspectives about the hemodynamic and oxygen transport
monitoring systems summarized in the Pediatric Cardiac Intensive Care
Society Evidence- Based Review and Consensus Statement on Monitoring of
Hemodynamics and Oxygen Transport Balance. There is no substitute for the
observations of a knowledgeable and experienced clinician who understands
the patient's condition and potential causes of deterioration and is able to
evaluate response to therapy. Copyright © 2011 by the Society of Critical
Care Medicine and the World Federation of Pediatric Intensive and Critical
Care Societies.
EMTREE DRUG INDEX TERMS
biochemical marker (endogenous compound)
carbon dioxide
lactic acid (endogenous compound)
oxyhemoglobin (endogenous compound)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hemodynamic monitoring
oxygen transport
pediatric intensive care nursing
EMTREE MEDICAL INDEX TERMS
arterial pH
arterial pressure
blood oxygen tension
blood pressure monitoring
capnometry
capnometry
central venous pressure
conference paper
consensus
coronary care unit
echocardiography
electrocardiogram
electrocardiography
end tidal carbon dioxide tension
exhalation
expired air
heart arrest
heart output measurement
heart rate variability
hemodynamic parameters
hemodynamics
hemoglobin blood level
Holter monitoring
human
near infrared spectroscopy
nursing knowledge
oximetry
oxygen consumption
patient assessment
priority journal
pulmonary artery catheter
pulmonary hypertension
pulse oximetry
respiratory failure
shock
transducer
treatment response
venous oximetry
CAS REGISTRY NUMBERS
carbon dioxide (124-38-9, 58561-67-4)
lactic acid (113-21-3, 50-21-5)
oxyhemoglobin (9061-63-6)
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
Cardiovascular Diseases and Cardiovascular Surgery (18)
Biophysics, Bioengineering and Medical Instrumentation (27)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2011369452
MEDLINE PMID
22129554 (http://www.ncbi.nlm.nih.gov/pubmed/22129554)
PUI
L362077286
DOI
10.1097/PCC.0b013e3182211d5b
FULL TEXT LINK
http://dx.doi.org/10.1097/PCC.0b013e3182211d5b
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 596
TITLE
2011 Critical Care Transport Medicine Conference Abstracts
AUTHOR ADDRESSES
SOURCE
Air Medical Journal (2011) 30:4. Date of Publication: July-August 2011
CONFERENCE NAME
2011 Critical Care Transport Medicine Conference
CONFERENCE LOCATION
Nashville, TN, United States
CONFERENCE DATE
2011-04-04 to 2011-04-06
ISSN
1067-991X
BOOK PUBLISHER
Mosby Inc.
ABSTRACT
The proceedings contain 3 papers. The topics discussed include: confirmation
of out-of-hospital endotracheal tube placement: factors associated with
non-usage of objective methods; hems management of arterial hypertension in
patients with intracranial hemorrhage; and characteristics of the helicopter
emergency medical services endotracheal intubation attempt: a descriptive
analysis.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
EMTREE MEDICAL INDEX TERMS
brain hemorrhage
emergency health service
endotracheal intubation
endotracheal tube
helicopter
hospital
human
hypertension
patient
LANGUAGE OF ARTICLE
English
PUI
L70492671
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 597
TITLE
Transportation conditions of newborns admitted to the neonatal intensive
care unit
ORIGINAL (NON-ENGLISH) TITLE
Yenidoǧan yoǧun bakim ünitesine kabul edilen yenidoǧanlarda transport
koşullari
AUTHOR NAMES
Yilmaz Ö.
Çalkavur Ş.
Olukman Ö.
Yilmaz N.
Atlihan F.
AUTHOR ADDRESSES
(Yilmaz Ö.; Olukman Ö., egefarma@yahoo.com; Yilmaz N.; Atlihan F.) Dr.
Behcet Uz Cocuk Hastaliklari ve Cerrahisi Egitim ve Arastirma Hastanesi,
Çocuk Saǧliǧi ve Hastaliklari Kliniǧi, Izmir, Turkey.
(Çalkavur Ş.) Neonatoloji Kliniǧi, Dr. Behcet Uz Cocuk Hastaliklari ve
Cerrahisi Egitim ve Arastirma Hastanesi, Izmir, Turkey.
CORRESPONDENCE ADDRESS
Ö. Olukman, Dr. Behcet Uz Cocuk Hastaliklari ve Cerrahisi Egitim ve
Arastirma Hastanesi, Çocuk Saǧliǧi ve Hastaliklari Kliniǧi, Izmir, Turkey.
Email: egefarma@yahoo.com
SOURCE
Turkiye Klinikleri Pediatri (2011) 20:1 (29-37). Date of Publication: 2011
ISSN
1300-0381
BOOK PUBLISHER
Turkiye Klinikleri, Turkocagi Caddesi No. 30, Balgat, Turkey.
ABSTRACT
Objective: To evaluate the transportation conditions and affecting factors
on the transportatiton of new borns postnatally referred to the newborn
intensive care unit (NICU) at our hospital. Material and Methods: During the
9-months period between September 2007 and June 2008, we evaluated the
transportation conditions of 83 newborns who were postnatally referred to
our NICU. Referring hospitals were divided into three groups: Group A,
peripheral hospital without a NICU; group B, central hospitals without NICU;
group C, central hospitals, training hospital or university hospital
containing NICU. Necessary criteria that should be provided for transported
babies were grouped in 7 subtitles. Type of transportation,status of
transportation (informed or not), age at the time of transportation,
presence of air-way and resuscitation, evaluation of respiration,
circulation and clinic. Total score was calculated by giving 1-2 points for
correct applications and 0 point for false applications. The transport score
was established from a total of 28 points. Results: The majority of the
transports were from group A hospitals. In group C hospitals, the transport
score and ratio of neonatal resuscitation before transportation was
significantly higher than the scores of group A and B hospitals. The ratio
of resuscitation after transportation and mortality rates were minimum in
group C and maximum in group B. The total mortality rate was calculated as
38.6%. The mortality rate was minimum for babies transported from group C
hospitals but maximum for babies transported from group B hospitals. This
difference was statistically significant. Conclusion: The high transport
scores and low mortality rates of group C hospitals reflect the suitability
of transportation conditions. In other words better conditions of
transportation from group C hospitals are strongly associated with better
outcomes. Therefore the improvement of transportation will supply the high
ratio of survivals. Copyright © 2011 by Türkiye Klinikleri.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
newborn intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
breathing
circulation
health care facility
hospitalization
human
newborn
resuscitation
university hospital
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
Turkish
LANGUAGE OF SUMMARY
English, Turkish
EMBASE ACCESSION NUMBER
2011284685
PUI
L361804840
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 598
TITLE
Adverse drug events in intra-hospital transfers to intensive care unit
AUTHOR NAMES
Besson M.
Gasche Y.
Dayer P.
Desmeules J.
AUTHOR ADDRESSES
(Besson M.; Gasche Y.; Dayer P.; Desmeules J.) Geneva University Hospitals,
University of Geneva, Switzerland.
CORRESPONDENCE ADDRESS
M. Besson, Geneva University Hospitals, University of Geneva, Switzerland.
SOURCE
Basic and Clinical Pharmacology and Toxicology (2011) 109 SUPPL. 1 (78).
Date of Publication: June 2011
CONFERENCE NAME
10th Congress of the European Association for Clinical Pharmacology and
Therapeutics
CONFERENCE LOCATION
Budapest, Hungary
CONFERENCE DATE
2011-06-26 to 2011-06-29
ISSN
1742-7835
BOOK PUBLISHER
Blackwell Publishing Ltd
ABSTRACT
Introduction: Adverse drug events (ADE) represent more than 6% of
hospitalisations and can be life threatening. In a pilot study, we
previously showed that ADE were implicated in 20% of intensive care unit
(ICU) admissions. As 1/3 came from the hospital wards, we focused on
assessing the contribution of ADE in intra-hospital transfers to ICU and to
determine their preventability. Method: Prospective observational study.
Admissions to the ICU of the Geneva University Hospitals (36 beds) for 6
months were systematically analysed from January to July 2009. Demographic
and medical data, drug history, clinical evolution and outcome were
systematically collected. Clinical pharmacologists and ICU specialists
decided independently on drug imputability, according to WHO criteria and
preventability. Results: From January to July 2009, 1310 ICU admissions were
recorded, 323 of which were from the hospital wards. Most of the ADE were
respiratory (30%), haemorrhagic (28%) or cardiovascular (20%) events.
Accordingly drugs were mainly opioïds, benzodiazepines or both,
anticoagulants and beta-blockers. Clinical pharmacologists implied twice as
much an ADE in ICU admission than the ICU specialist. More than one third of
the AE were considered probably related with ICU transfer and 18% were
considered preventable by both specialists. Conclusion: These results
confirm that ADE are frequently involved in ICU inward transfer and that one
fifth are considered preventable. Our results stress the important
contribution of the clinical pharmacologist for improving intra hospital
serious adverse event detection and underscore the need of developing
strategies to try to prevent these ADE related transfers.
EMTREE DRUG INDEX TERMS
anticoagulant agent
benzodiazepine derivative
beta adrenergic receptor blocking agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
adverse drug reaction
clinical pharmacology
hospital
intensive care unit
therapy
EMTREE MEDICAL INDEX TERMS
human
medical specialist
observational study
pilot study
university hospital
ward
world health organization
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70623095
DOI
10.1111/j.1742-7843.2011.00722.x
FULL TEXT LINK
http://dx.doi.org/10.1111/j.1742-7843.2011.00722.x
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 599
TITLE
Intrahospital transport to the radiology department: Risk for adverse
events, nursing surveillance, utilization of a MET, and practice
implications
AUTHOR NAMES
Ott L.K.
Hoffman L.A.
Hravnak M.
AUTHOR ADDRESSES
(Ott L.K., ottl@pitt.edu; Hoffman L.A.; Hravnak M.) Department of Acute and
Tertiary Care, School of Nursing, University of Pittsburgh, 3500 Victoria
St., Pittsburgh, PA 15261, United States.
CORRESPONDENCE ADDRESS
L. K. Ott, Department of Acute and Tertiary Care, School of Nursing,
University of Pittsburgh, 3500 Victoria St., Pittsburgh, PA 15261, United
States. Email: ottl@pitt.edu
SOURCE
Journal of Radiology Nursing (2011) 30:2 (49-54). Date of Publication: June
2011
ISSN
1546-0843
1555-9912 (electronic)
BOOK PUBLISHER
Elsevier Inc., 360 Park Avenue South, New York, United States.
ABSTRACT
Nurses providing care in the radiology department (RD) are challenged by the
broad scope of conditions and varied acuity of patients served by this unit.
Nurses must facilitate the required diagnostic testing and simultaneously
provide the surveillance necessary to detect physiologic changes signaling
the need for rescue interventions. When instability occurs, one method of
rescue involves activation of a medical emergency team (MET) to bring an
experienced cadre of critical care providers to the unstable patient.
Despite recognition that the RD can be a high-risk area, there is little in
the literature specific to the surveillance of RD patients, risk for and
prevention of adverse events, MET activation or the management of patient
instability specific to the RD. The purpose of this article is to examine
what is known regarding risk for adverse events during intrahospital
transport, utilization of a MET as a rescue intervention, and practice
implications. Copyright © 2011 by the Association for Radiologic & Imaging
Nursing.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient transport
radiology nursing
rapid response team
EMTREE MEDICAL INDEX TERMS
article
health care utilization
human
intensive care nursing
nurse
nursing care
nursing practice
patient safety
practice guideline
priority journal
radiology department
risk assessment
EMBASE CLASSIFICATIONS
Radiology (14)
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2011308523
PUI
L361891095
DOI
10.1016/j.jradnu.2011.02.001
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jradnu.2011.02.001
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 600
TITLE
Transport of cardiac surgical patients from operation room to ICU
AUTHOR NAMES
Basagan-Mogol E.
Girgin N.K.
Kaya F.N.
Goren S.
Yeniaydogmus T.
AUTHOR ADDRESSES
(Basagan-Mogol E.; Girgin N.K.; Kaya F.N.; Goren S.; Yeniaydogmus T.) Uludag
University, School of Medicine, Department of Anaesthe-siology and
Reanimation, Bursa, Turkey.
CORRESPONDENCE ADDRESS
E. Basagan-Mogol, Uludag University, School of Medicine, Department of
Anaesthe-siology and Reanimation, Bursa, Turkey.
SOURCE
Journal of Cardiothoracic and Vascular Anesthesia (2011) 25:3 SUPPL. 1
(S35-S36). Date of Publication: June 2011
CONFERENCE NAME
26th Annual Meeting of the European Association of Cardiothoracic
Anaesthesiologists, EACTA 2011
CONFERENCE LOCATION
Vienna, Austria
CONFERENCE DATE
2011-06-01 to 2011-06-04
ISSN
1053-0770
BOOK PUBLISHER
W.B. Saunders
ABSTRACT
Introduction. Transport of cardiac surgical patients from the operation room
to ICU is a very important procedure. The aim of this study was to evaluate
the factors affecting this procedure, to display and compare the
haemodynamic parameters and arterial blood gases with values taken prior to
surgery in patients undergoing cardiac surgery. Method. After obtaining
ethical committee approval, 100 patients scheduled for cardiac surgery, ASA
grade II-IV, aged 20-72 were included. Ventilation during the transport of
the patients to the ICU was performed manually. Haemodynamic parameters (HR,
SAP, DAP, MAP, CVP, PAP, PCWP, CO), arterial blood gases (pH, PCO(2),PO(2),
BE) and SpO(2) values were recorded in 9 measurement times: before surgery
(T1), 30 and 15 min before transport (T2 and T3), at the end of surgery
(T4), at transport bed (T5), at elevator (T6), in ICU (T7), at 30th and 60th
min in ICU (T8 and T9). At transport bed and elevator SAP, DAP, HR, SpO(2)
values were recorded. Stroke volume index (SVI) systemic and pulmonary
vascular resistance indices (SVRI, PVRI) were calculated. The drugs and
their dosages used during surgery and complications were recorded.
Wilcoxon's signed ranks test was used for statistics. Results. Patients
received 10.6±8.5 mg midazolam, 1120.4± 389.9 μg fentanyl, 153.6±52.3 mg
rocuronium during surgery lasting 4.3±1.2 hr. 3 personnel (anaesthetist,
surgeon, nurse) were present during transport. 22 patients needed medication
during transport. Hypotension, hypertension orarrhythmias were detected in
10, 7 and 5 patients respectively. Discussion. The results highlight the
interventions, ventilation strategies, haemodynamic monitoring and the
presence of qualified staff during the transport process of cardiac surgical
patients from operation room to ICU.
EMTREE DRUG INDEX TERMS
fentanyl
midazolam
rocuronium
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
operating room
surgical patient
EMTREE MEDICAL INDEX TERMS
air conditioning
arterial gas
building
drug therapy
heart stroke volume
heart surgery
hypertension
hypotension
lung vascular resistance
monitoring
nurse
patient
personnel
pH
pulmonary artery occlusion pressure
statistics
surgeon
surgery
Wilcoxon signed ranks test
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70428820
DOI
10.1053/j.jvca.2011.03.096
FULL TEXT LINK
http://dx.doi.org/10.1053/j.jvca.2011.03.096
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 601
TITLE
An exploration of patients' and relatives' experiences of transfer from
intensive care
AUTHOR NAMES
Lindsay S.
Bulley C.
AUTHOR ADDRESSES
(Lindsay S.) Raigmore Hospital, Physiotherapy Department, Inverness, United
Kingdom.
(Bulley C.) Queen Margaret University Edinburgh, Physiotherapy, Musselburgh,
United Kingdom.
CORRESPONDENCE ADDRESS
S. Lindsay, Raigmore Hospital, Physiotherapy Department, Inverness, United
Kingdom.
SOURCE
Physiotherapy (United Kingdom) (2011) 97 SUPPL. 1 (eS699). Date of
Publication: June 2011
CONFERENCE NAME
World Physical Therapy 2011
CONFERENCE LOCATION
Amsterdam, Netherlands
CONFERENCE DATE
2011-06-20 to 2011-06-23
ISSN
0031-9406
BOOK PUBLISHER
Elsevier Ltd
ABSTRACT
Purpose: The evolution of intensive care medicine has considerably enhanced
the survival of critically ill patients. Although for many transfer from
intensive care is uncomplicated, for others, transfer marks the beginning of
an uncertain road to recovery. This qualitative study aimed to analyse the
perspectives of patients, and of their relatives, in an ICU unit in the
United Kingdom (U.K.). Reactions to a written information booklet were also
explored. Relevance: Improved understanding of the impacts of an ICU stay
will enable health professionals to take actions that may develop critical
care services; this will optimise the care and treatment of those
transferring from the ICU. Participants: Individuals who had experienced an
ICU stay of 48 hours or more, and their relatives, were invited to
participate in a single interview within a week of transition from ICU.
Purposive sampling ensured a variety of experiences. Fourwomen and
fourmen(age range 40-70) completed interviews. All were white Caucasians
living in the Highlands of Scotland, U.K. Methods: The study was carried out
within the framework of Interpretative Phenomenological Analysis (IPA).
Semistructured interviews (11-19 minutes) were carried out in participants'
wards. A topic guide was developed to focus on experiences of an ICU stay
and views regarding written information packs. Ethical approval was granted
by Queen Margaret University, Edinburgh and the North of Scotland Research
Ethics Committee. Analysis: Transcribed interviews were thematically
analysed utilising the IPA framework. Two researchers were involved in the
development of themes, iteratively developing a classification or typology
of participants' views and experiences, progressing to the development of
relationships between themes. Three overarching themes emerged. Results:
Themes are labelled to reflect views described by interviewees. The first,
'The importance of receiving timely information' described relatives' desire
for knowledge of the patient's condition and what might happen in the
future. Patients also described a desire for timely information and
knowledge of their condition. Some individuals described doubt when there
was insufficient information. The second theme is called: 'Evaluating the
ICU journey'. The impact of an ICU stay resulted in differing experiences
and encompassed positive and negative emotions. Negative emotions related to
uncertainty about the future; whilst positive emotions related to
experiences of progression along the continuum of recovery. The last theme
was labelled: 'Attributing value to a written information booklet'. This
reflects individuals' appreciation of the information provided in a written
information booklet. Conclusions: In this study, participants demonstrated a
strong need for both timely verbal information and written information
booklets. Implications: It is important that staff communicate with patients
and relatives in easy to understand terms. Timely verbal communication,
coupled with written information booklets, is likely to enable adjustment to
unknown realities and unfamiliar environments, leading to certainty and
clarity over what to expect.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
human
intensive care
patient
physiotherapy
EMTREE MEDICAL INDEX TERMS
classification
critically ill patient
emotion
environment
health practitioner
interview
professional standard
qualitative research
research ethics
sampling
scientist
semi structured interview
survival
United Kingdom
university
verbal communication
ward
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71883126
DOI
10.1016/j.physio.2011.04.002
FULL TEXT LINK
http://dx.doi.org/10.1016/j.physio.2011.04.002
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 602
TITLE
A systematic review of failures in handoff communication during
intrahospital transfers.
AUTHOR NAMES
Ong M.S.
Coiera E.
AUTHOR ADDRESSES
(Ong M.S.) Centre for Health Informatics, University of New South Wales,
Sydney, Australia.
(Coiera E.)
CORRESPONDENCE ADDRESS
M.S. Ong, Centre for Health Informatics, University of New South Wales,
Sydney, Australia. Email: m.ong@unsw.edu.au
SOURCE
Joint Commission journal on quality and patient safety / Joint Commission
Resources (2011) 37:6 (274-284). Date of Publication: Jun 2011
ISSN
1553-7250
ABSTRACT
Handoffs serve a critical function in ensuring patient care continuity
during transitions of care. Studies to date have predominantly focused on
intershift handoffs, with relatively little attention given to intrahospital
transfers. A systematic literature review was conducted to characterize the
nature of handoff failures during intrahospital transfers and to examine
factors affecting handoff communication and the effectiveness of current
interventions. Primary studies investigating handoff communication between
care providers during intrahospital transfers were sought in the
English-language literature between 1980 and February 2011. Data for study
design, population characteristics, sample size, setting, intervention
specifics, and relevant outcome measures were extracted. Study results were
summarized by the impact of communication breakdown during intrahospital
transfer of patients, and the current deficiencies in the process. Results
of interventions were summarized by their effect on the quality of handoff
communication and patient safety. The initial search identified 516
individual articles, 24 of which satisfied the inclusion criteria. Some 19
were primary studies on handoff practices and deficiencies, and the
remaining 5 were interventional studies. The studies were categorized
according to the clinical settings involved in the intrahospital patient
transfers. There is consistent evidence on the perceived impact of
communication breakdown on patient safety during intrahospital transfers.
Exposure of handoffs at patient transfers presents challenges that are not
experienced in intershift handoffs. The distinct needs of the specific
clinical settings involved in the intrahospital patient transfer must be
considered when deciding on suitable interventions.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
interdisciplinary communication
patient care
patient transport
EMTREE MEDICAL INDEX TERMS
human
information dissemination
organization and management
review
standard
LANGUAGE OF ARTICLE
English
MEDLINE PMID
21706987 (http://www.ncbi.nlm.nih.gov/pubmed/21706987)
PUI
L362248189
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 603
TITLE
Intra-hospital transport: University of Michigan SWAT Team takes the ICU to
the patient.
AUTHOR NAMES
Stonebraker K.
AUTHOR ADDRESSES
(Stonebraker K.)
CORRESPONDENCE ADDRESS
K. Stonebraker,
SOURCE
The Michigan nurse (2011) 84:3 (10-12). Date of Publication: 2011 May-Jun
ISSN
0026-2366
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
patient care
patient transport
EMTREE MEDICAL INDEX TERMS
article
human
organization and management
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
21744722 (http://www.ncbi.nlm.nih.gov/pubmed/21744722)
PUI
L362278540
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 604
TITLE
Effect of team composition on the quality and efficiency of a paediatric
intensive care transport team
AUTHOR NAMES
Clement M.
Ramnarayan P.
AUTHOR ADDRESSES
(Clement M.; Ramnarayan P.) Children's Acute Transfer Service, London,
United Kingdom.
CORRESPONDENCE ADDRESS
M. Clement, Children's Acute Transfer Service, London, United Kingdom.
SOURCE
Pediatric Critical Care Medicine (2011) 12:3 SUPPL. 1 (A70). Date of
Publication: May 2011
CONFERENCE NAME
6th World Congress on Pediatric Critical Care: One World Sharing Knowledge
CONFERENCE LOCATION
Sydney, NSW, Australia
CONFERENCE DATE
2011-03-13 to 2011-03-17
ISSN
1529-7535
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Objectives: To examine the effect of three different team compositions
(Consultant-led, Advanced Nurse Practitioner (ANP)-led and Fellow-led), on
the quality and efficiency of a regional paediatric intensive care (PICU)
transport team Methods: We conducted a retrospective analysis of prospective
data from emergency transfers of critically ill children (April 2009 -
August 2010). Details on patient demographics and composition of team, as
well as key indicators of quality (physiological adverse events on retrieval
and mortality within 24 hours of PICU admission) and efficiency
(mobilization time, stabilization time and number of major interventions
performed on retrieval) were collected. Analyses were adjusted for relevant
confounding variables using appropriate regression models. Results: 1396
retrievals were analysed (133 consultant-led; 97 ANP-led; and 1166 fellow-
led). There were no significant differences between the groups in terms of
age or sex, but mean PIM-2 score and need for inotropic agents on retrieval
were significantly greater for consultant-led retrievals (p<0.05). Rates of
24 hr PICU mortality and adverse events on retrieval were similar
irrespective of team composition. However, stabilisation time was
significantly lower among ANP-led retrievals even after adjustment for age,
major interventions on retrieval and PIM-2 score (p= 0.01). Conclusions: We
found no significant difference in quality in PICU retrievals performed by 3
different team compositions. ANP-led teams spent a shorter duration
stabilising the patient, but performed similar numbers of major
interventions. Our findings might be explained by standardization of the
retrieval process as well as by the unique ability of ANP's to function both
in a medical and nursing role during retrieval.
EMTREE DRUG INDEX TERMS
inotropic agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
EMTREE MEDICAL INDEX TERMS
child
confounding variable
consultation
critically ill patient
emergency
mobilization
model
mortality
nurse practitioner
nursing role
patient
standardization
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70418700
DOI
10.1097/PCC.0b013e3182112e80
FULL TEXT LINK
http://dx.doi.org/10.1097/PCC.0b013e3182112e80
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 605
TITLE
Delirium and coma in the ICU are associated with drug metabolism and
transporter activity
AUTHOR NAMES
Skrobik Y.
Michaud V.
Leger C.
Kubes P.
Turgeon J.
AUTHOR ADDRESSES
(Skrobik Y., skrobik@sympatico.ca; Michaud V.; Turgeon J.) Universite De
Montreal, Montreal, Canada.
(Leger C.; Kubes P.) University of Calgary, Calgary, Canada.
CORRESPONDENCE ADDRESS
Y. Skrobik, Universite De Montreal, Montreal, Canada. Email:
skrobik@sympatico.ca
SOURCE
American Journal of Respiratory and Critical Care Medicine (2011) 183:1
MeetingAbstracts. Date of Publication: 1 May 2011
CONFERENCE NAME
American Thoracic Society International Conference, ATS 2011
CONFERENCE LOCATION
Denver, CO, United States
CONFERENCE DATE
2011-05-13 to 2011-05-18
ISSN
1073-449X
BOOK PUBLISHER
American Thoracic Society
ABSTRACT
Delirium and drug-induced coma are common in the critical care setting, and
worsen morbidity, mortality, health care costs, and patient and caregiver
distress. Adjusting opiates and benzodiazepines to patient symptoms is
associated with only partial reduction in iatrogenic coma rates and no
change in the incidence of delirium. Mechanisms attributable to
pharmacokinetic or pharmacogenetic variables may contribute to these
clinical pathologies. Coma and/or delirium may be associated with the amount
of administered drug, serum drug levels, sedative drug metabolism, and/or
transport across the blood brain barrier, all attributable to
pharmacokinetic or pharmacogenetic variables. Specifically, midazolam and
fentanyl compete with other drugs for the same systemic pathway.
P-glycoprotein (MDR1) pathways affect blood brain barrier transport of
opiates and benzodiazepines. Methods: in 86 consenting patients receiving
intravenous fentanyl (F), midazolam (MDZ) or both, we evaluated administered
drug dose, covariates likely to influence drug effect (age, BMI, renal and
hepatic dysfunction, and delirium risk factors), concomitant administration
of CYP3A4/5 and P-glycoprotein (MDR1) pathway-mediated drugs, MDR1 and
CYP450 3A4/5 genetic polymorphisms, and drug levels for F and MDZ. Clinical
outcomes (delirium and coma) were evaluated daily. Results: Days in
iatrogenic coma were associated with administered F and MDZ doses (p= 0.0006
and p=0.117, respectively), with the co-administration of CYP3A4/5
inhibitors (p=0.0036), and with interleukin 1 and interleukin 6 levels. Days
of delirium were not associated with either F or MDZ doses, and only
associated with co-administration of MDR1 inhibitors (p=0.036). Conclusion:
Iatrogenic coma and delirium do not appear to be mechanistically linked. In
addition to drug exposure, coma appears to be associated with systemic drug
metabolism and possibly with inflammatory status. Delirium, on the other
hand, may be associated with blood brain transport mechanisms rather than
systemic exposure.
EMTREE DRUG INDEX TERMS
ABC transporter subfamily B
benzodiazepine derivative
fentanyl
interleukin 1
interleukin 6
midazolam
opiate
sedative agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
coma
delirium
drug metabolism
society
EMTREE MEDICAL INDEX TERMS
blood
blood brain barrier
brain
caregiver
drug blood level
drug dose
drug effect
drug exposure
exposure
genetic polymorphism
health care cost
human
intensive care
liver dysfunction
morbidity
mortality
pathology
patient
pharmacokinetics
risk factor
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70847000
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 606
TITLE
Accumulation of carbapenemase-producing Gram-negative bacteria in a single
patient linked to the acquisition of multiple carbapenemase-producing
strains and to the in vivo transfer of a plasmid encoding VIM-1
AUTHOR NAMES
Drieux L.
Bourgeois-Nicolaos N.
Cremniter J.
Lawrence C.
Macheras E.
Jarlier V.
Doucet-Populaire F.
Sougakoff W.
AUTHOR ADDRESSES
(Drieux L.; Bourgeois-Nicolaos N.; Cremniter J.; Lawrence C.; Macheras E.;
Jarlier V.; Doucet-Populaire F.; Sougakoff W.) Paris, Boulogne-Billancourt,
Garches, France.
CORRESPONDENCE ADDRESS
L. Drieux, Paris, Boulogne-Billancourt, Garches, France.
SOURCE
Clinical Microbiology and Infection (2011) 17 SUPPL. 4 (S124). Date of
Publication: May 2011
CONFERENCE NAME
21st ECCMID/27th ICC
CONFERENCE LOCATION
Milan, Italy
CONFERENCE DATE
2011-05-07 to 2011-05-10
ISSN
1198-743X
BOOK PUBLISHER
Blackwell Publishing Ltd
ABSTRACT
Objectives: Six imipenem-resistant strains were successively isolated from a
single patient transferred from Greece to France in an Intensive Care Unit
(ICU). A few days after his admission, 2 MDR Gram negative bacteria were
isolated from rectal swab, Klebsiella pneumoniae (Kp1) and Providencia
stuartii (Ps), and an imipenemresistant Pseudomonas aeruginosa (Pa) was
cultured from tibial wound specimen. Two months later, a K. pneumoniae
strain (Kp2), distinct from Kp1, was isolated from wound drain fluid. Two
additional months later, 2 MDR Enterobacteriaceae, Proteus mirabilis (Pm)
and Escherichia coli (Ec),were isolated from rectal swabs. The molecular
bases of resistance to b-lactam antibiotics in these strains were
investigated. Methods and Results: The Kp1 strain showed a synergy between
imipenem and clavulanate, suggesting the production of a class A
carbapenemase identified by PCR and DNA sequencing as KPC-2. Kp1 also
harboured two bla genes encoding TEM-1 and the extendedspectrum β-lactamase
(ESBL) SHV-12. The Ps, Pm and Ec strains were found to produce the
metallo-β-lactamase (MBL) VIM-1 with an additional ESBL, SHV-5, while both
Pa and Kp2 strains had blaVIM-1 alone. Genes encoding VIM-1 and SHV-5 were
co-transferred to E. coli J53 by in vitro conjugation from Ps, Pm and Ec.
Only blaVIM-1 was transferred from Kp2. The fingerprints obtained from
plasmid DNA digestions of the transconjugants TCPs, TCPm and TCEc were
highly similar, while the pattern obtained from TCKp2 was different. In all
the MBL producers, the blaVIM-1 gene was integrated in a class I integron.
PCR mapping of the variable region of the integron revealed three distinct
types of cassette arrays, of which one corresponded to a truncated class-I
integron shared by TCPs, TCPm and TCEc. In vivo conjugation in a gnotobiotic
mouse model permitted the transfer of the integron carrying blaVIM-1 from
the Ps strain to the recipient strain E. coli J53. Conclusions: The time
sequence of β-lactamase producers detection, the molecular analysis of the
genetic support of blaVIM-1 and the conjugation results obtained in vivo in
the gnotobiotic mouse model strongly suggest the in-patient transfer between
Ps, Pm and Ec of a plasmid carrying a truncated class-I integron harbouring
blaVIM-1. This inter-species transfer, together with a probable acquisition
of multiple multidrug-resistant bacteria, led to a worrying accumulation of
carbapenemase-producing strains in a single patient.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
carbapenemase
EMTREE DRUG INDEX TERMS
beta lactam antibiotic
clavulanic acid
DNA
extended spectrum beta lactamase
imipenem
penicillinase
plasmid DNA
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Gram negative bacterium
human
patient
plasmid
EMTREE MEDICAL INDEX TERMS
bacterium
conjugation
digestion
DNA sequence
Enterobacteriaceae
Escherichia coli
finger dermatoglyphics
France
gene
gnotobiotics
Greece
hospital patient
in vitro study
integron
intensive care unit
Klebsiella pneumoniae
liquid
model
patient transport
Proteus mirabilis
Providencia stuartii
Pseudomonas aeruginosa
recipient
species
wound
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70599277
DOI
10.1111/j.1469-0691.2011.03558.x
FULL TEXT LINK
http://dx.doi.org/10.1111/j.1469-0691.2011.03558.x
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 607
TITLE
Advanced en-route critical care during combat operations.
AUTHOR NAMES
Cannon J.W.
Zonies D.H.
Benfield R.J.
Elster E.A.
Wanek S.M.
AUTHOR ADDRESSES
(Cannon J.W.) Uniformed Services University of the Health Sciences,
Bethesda, MD, USA.
(Zonies D.H.; Benfield R.J.; Elster E.A.; Wanek S.M.)
CORRESPONDENCE ADDRESS
J.W. Cannon, Uniformed Services University of the Health Sciences, Bethesda,
MD, USA.
SOURCE
Bulletin of the American College of Surgeons (2011) 96:5 (21-29). Date of
Publication: May 2011
ISSN
0002-8045
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
general surgery
patient transport
war
EMTREE MEDICAL INDEX TERMS
article
human
military medicine
LANGUAGE OF ARTICLE
English
MEDLINE PMID
22312820 (http://www.ncbi.nlm.nih.gov/pubmed/22312820)
PUI
L364448010
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 608
TITLE
Standardized multidisciplinary protocol improves handover of cardiac surgery
patients to the intensive care unit
AUTHOR NAMES
Joy B.F.
Elliott E.
Hardy C.
Sullivan C.
Backer C.L.
Kane J.M.
AUTHOR ADDRESSES
(Joy B.F., bjoy@childrensmemorial.org; Kane J.M.) Division of Pediatric
Critical Care, United States.
(Elliott E.; Backer C.L.) Pediatric Cardiothoracic Surgery, United States.
(Hardy C.) Pediatric Anesthesia, Northwestern University, Feinberg School of
Medicine, Chicago, IL, United States.
(Sullivan C.) Children's Memorial Hospital, Children's Memorial Research
Center, Chicago, IL, United States.
CORRESPONDENCE ADDRESS
B. F. Joy, Division of Pediatric Critical Care, United States. Email:
bjoy@childrensmemorial.org
SOURCE
Pediatric Critical Care Medicine (2011) 12:3 (304-308). Date of Publication:
May 2011
ISSN
1529-7535
BOOK PUBLISHER
Lippincott Williams and Wilkins, 530 Walnut Street,P O Box 327,
Philadelphia, United States.
ABSTRACT
OBJECTIVES:: To determine whether the implementation of a standardized
handover protocol could reduce the number of errors occurring during patient
transitions from the operating room to the intensive care unit. DESIGN::
Prospective, interventional study. SETTING:: Pediatric cardiac intensive
care unit. SUBJECTS:: Seventy-nine patient handovers in patients
transitioning from the operating room to the cardiac intensive care unit
after congenital cardiac surgery. INTERVENTIONS:: A preintervention
assessment of patient handovers was obtained by direct observation using a
standardized checklist. A teamwork-driven handover process and protocol was
developed using traditional and novel quality-improvement techniques. The
postimplementation observational assessment of handovers was performed using
the same preintervention assessment tool. Preintervention and
postintervention data metrics were analyzed and compared. MEASUREMENTS AND
MAIN RESULTS:: Forty-one and 38 observations were performed in the
preintervention and postintervention periods, respectively. Protocol
implementation improved key areas of the handover process. Technical errors
per handover were reduced from 6.24 to 1.52 (p < .0001), and critical verbal
handoff information omissions were reduced from 6.33 to 2.38 (p < .0001) per
handover. There was no change in duration of either the verbal handoff
briefing or the overall handover process. Caregivers noted improvement in
teamwork and handoff content received after the intervention. CONCLUSIONS::
A formal, structured handover process for pediatric patients transitioning
to the intensive care unit after cardiac surgery can reduce medical errors
that occur during the admission process and improve teamwork among
caregivers. Copyright © 2011 by the Society of Critical Care Medicine and
the World Federation of Pediatric Intensive and Critical Care Societies.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
clinical protocol
heart surgery
patient transport
EMTREE MEDICAL INDEX TERMS
article
cardiac patient
controlled study
human
intensive care unit
intervention study
major clinical study
medical error
observational method
operating room
patient safety
pediatric surgery
priority journal
prospective study
standardization
surgical patient
teamwork
verbal communication
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
Cardiovascular Diseases and Cardiovascular Surgery (18)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2011262291
MEDLINE PMID
21057370 (http://www.ncbi.nlm.nih.gov/pubmed/21057370)
PUI
L51141435
DOI
10.1097/PCC.0b013e3181fe25a1
FULL TEXT LINK
http://dx.doi.org/10.1097/PCC.0b013e3181fe25a1
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 609
TITLE
The introduction of a nurse-led blind bedside jejunal tube insertion
guideline in paediatric intensive care
AUTHOR NAMES
Macleod I.
Greenock S.
Davidson M.
Spenceley N.
Bird J.
Gentles E.
Ellis D.
AUTHOR ADDRESSES
(Macleod I.; Gentles E.) Women and Children's Directorate, RHSC, NHS Greater
Glasgow and Clyde, United Kingdom.
(Greenock S.; Davidson M.; Spenceley N.; Bird J.; Ellis D.) Paediatric
Intensive Care Unit, RHSC, NHS Greater Glasgow and Clyde, United Kingdom.
(Davidson M.; Spenceley N.) College of Medicine, Veterinary and Life
Science, University of Glasgow, United Kingdom.
(Bird J.) Department of Dietetics and Nutrition, RHSC, NHS Greater Glasgow
and Clyde, United Kingdom.
CORRESPONDENCE ADDRESS
I. Macleod, Women and Children's Directorate, RHSC, NHS Greater Glasgow and
Clyde, United Kingdom.
SOURCE
Pediatric Critical Care Medicine (2011) 12:3 SUPPL. 1 (A115). Date of
Publication: May 2011
CONFERENCE NAME
6th World Congress on Pediatric Critical Care: One World Sharing Knowledge
CONFERENCE LOCATION
Sydney, NSW, Australia
CONFERENCE DATE
2011-03-13 to 2011-03-17
ISSN
1529-7535
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Objectives: To evaluate the success of jejunal tube placement in a
paediatric intensive care unit (PICU) following the introduction of a
nurse-led blind bedside jejunal tube insertion guideline. Methods: A
prospective observational audit over a six month period. Data was entered
into an electronic database and analysed using descriptive statistics. The
audit was completed under clinical governance structures and registered with
the local clinical effectiveness of fice, as per local guidelines. Results:
28 jejunal tube insertion attempts in 18 patients resulted in an overall
success rate of 71.4%. 86% of placement attempts (n=24) were by nurses
(n=8), of which 79.1% were successfully placed. On admission to PICU the
study population had a median age of 43weeks (IQR 22-101, range 1-691) and
median weight of 9.7kg (IQR 6-12.8, range 2.1 - 26.7). 78.6% of attempts
were performed in patients who were invasively ventilated (n= 22), of which
2 were paralysed. Of the 6 attempts made in 5 non-ventilated patients, 2
attempts in the same patient were unsuccessful. Diagnostic categories
included; cardiac surgery (33%), sepsis/meningococcal (22%), respiratory
(11%) and burns (11%). The majority of attempts (79%) were initiated due to
the unit's enteral feeding guideline, which was simultaneously introduced in
January 2010. Conclusion: The use of this bedside technique of fers a
reliable alternative to radiologically or endoscopically sited jejunal
feeding tubes which would involve the intra-hospital transfer of a child
requiring intensive care. The impact of introducing enteral feeding
guidelines and nurse-led jejunal tube placement on enhancing nutritional
care delivery warrants further investigation.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
nurse
tube
EMTREE MEDICAL INDEX TERMS
child
clinical audit
clinical effectiveness
data base
diagnosis
enteric feeding
feeding apparatus
health care quality
heart surgery
hospital
intensive care unit
patient
population
statistics
ventilated patient
weight
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70418939
DOI
10.1097/PCC.0b013e3182112e80
FULL TEXT LINK
http://dx.doi.org/10.1097/PCC.0b013e3182112e80
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 610
TITLE
Does the use of low dose dopamine in the medical ward help prevent intensive
care unit transfer?
AUTHOR NAMES
Khalid I.
Soliman I.R.
Qabajah M.R.
Al-Zyoud A.A.
Nisar A.
DiGiovine B.
AUTHOR ADDRESSES
(Khalid I., doc_ik@yahoo.com; Soliman I.R.; Qabajah M.R.; Al-Zyoud A.A.)
King Faisal Specialist Hospital, Research Center, Jeddah, Saudi Arabia.
(Nisar A.) Oakwood Hospital, Medical Center, Dearborn, United States.
(DiGiovine B.) Wayne State University, School of Medicine, Detroit, United
States.
CORRESPONDENCE ADDRESS
I. Khalid, King Faisal Specialist Hospital, Research Center, Jeddah, Saudi
Arabia. Email: doc_ik@yahoo.com
SOURCE
American Journal of Respiratory and Critical Care Medicine (2011) 183:1
MeetingAbstracts. Date of Publication: 1 May 2011
CONFERENCE NAME
American Thoracic Society International Conference, ATS 2011
CONFERENCE LOCATION
Denver, CO, United States
CONFERENCE DATE
2011-05-13 to 2011-05-18
ISSN
1073-449X
BOOK PUBLISHER
American Thoracic Society
ABSTRACT
Rationale: In most hospitals, patients who develop hypotension and require a
vasopressor agent in addition to intravenous fluids are transferred to the
intensive care unit (ICU). In our institution, however, use of up to 5
mcg/kg/min of dopamine is allowed on the medical ward to deal with the
shortage of ICU beds. The impact of this policy on patient outcome is not
known. Purpose: The purpose of this study is to evaluate whether using low
dose dopamine in hypotensive patients in medical ward would prevent their
transfer to ICU or impact their mortality. Methods: Rapid response team
(RRT) is activated for any hypotensive patient with SBP <90 mm of Hg in our
tertiary care hospital. We retrospectively looked at all those encounters
from January 2009 till September 2010. Patients who were immediately
transferred to the ICU were excluded. The patients who remained on the ward
were divided into two groups; one requiring dopamine and the other without
dopamine. Both groups received intravenous fluids for their hypotension. The
primary outcome was transfer to the ICU within 48 hours from the RRT call
and the secondary outcomes were ICU death and 28 day mortality. Data was
analyzed using student's t test or Pearson's chi-square test, where
appropriate. Results: A total of 346 RRT calls were activated for
hypotension. 133 patients were immediately transferred to the ICU and were
excluded. Out of the remaining 213 patients who stayed on the ward, 128 were
treated with intravenous fluids only (F Group) and 85 required the
additional use of dopamine up to 5 mcg/kg/min (D+F Group). Both groups
received the same amount of fluids (F 634 ml;D+F 732 ml;p=0.37). There was
no difference in the primary outcome measure of ICU transfer within 48 hours
between the groups {F 22.7% (29/128 patients);D+F 28.2% (24/85
patients);p=0.35}. The ICU mortality {F10.2% (13/128);D+F10.6%
(9/85);p=0.91} and the 28 day mortality was also not different {F 17.2%
(22/128);D+F 12.9%(11/85);p=0.4}. The lack of difference in outcome was seen
despite the fact that 72% (61/85) of the patients treated with dopamine did
not require an ICU admission. Conclusion: Our experience would suggest that
low dose dopamine up to 5 mcg/kg/min on the medical ward can be used safely
to avoid ICU transfer in selected hypotensive patients. Identification of
such patients and findings of this study need to be evaluated in a
prospective trial.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
dopamine
EMTREE DRUG INDEX TERMS
antihypertensive agent
hypertensive agent
infusion fluid
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
low drug dose
society
ward
EMTREE MEDICAL INDEX TERMS
chi square test
death
hospital
human
hypotension
liquid
mortality
patient
policy
rapid response team
Student t test
tertiary health care
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70846068
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 611
TITLE
The transfer of parents from picu to the ward
AUTHOR NAMES
Boyles C.
Langley R.
AUTHOR ADDRESSES
(Boyles C.; Langley R.) Southampton University, Hospitals NHS Trust, United
Kingdom.
CORRESPONDENCE ADDRESS
C. Boyles, Southampton University, Hospitals NHS Trust, United Kingdom.
SOURCE
Pediatric Critical Care Medicine (2011) 12:3 SUPPL. 1 (A64-A65). Date of
Publication: May 2011
CONFERENCE NAME
6th World Congress on Pediatric Critical Care: One World Sharing Knowledge
CONFERENCE LOCATION
Sydney, NSW, Australia
CONFERENCE DATE
2011-03-13 to 2011-03-17
ISSN
1529-7535
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Background: Discharge from PICU to a general ward area can provoke stress
and anxiety. Interventions to help the family cope with this have financial
implications that compete with other areas of healthcare. Aim: The aim of
the service evaluation was to identify parental needs at the time of
discharge from PICU. An additional aim was to assess ifthe needs of parents
whose child stayed longer than 7 days (Group 1) have different needs to
parents whose child was discharged within 48 hours (Group 2) Results: Data
was collected using a locally developed questionnaire guided by literature
and interview of 3 sets of parents. The results show that there were
differences in the needs of the 2 groups, although many common needs were
identified. Timely communication of discharge plan, prompt assessment by
ward medical staff, and follow-up by PICU staff were identified as areas for
improvement. Implications: Parents of children discharged from PICU have
many common needs. These can be addressed by implementing simple changes in
practice such as timely communication and a discharge plan. Parents whose
children stay longer than 7 days may need an individual assessment. These
interventions may not only improve satisfaction of the service, but also
have the potential to save costs subsequently by reducing stress and
anxiety.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
parent
ward
EMTREE MEDICAL INDEX TERMS
anxiety
child
follow up
health care
interpersonal communication
interview
medical staff
questionnaire
satisfaction
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70418670
DOI
10.1097/PCC.0b013e3182112e80
FULL TEXT LINK
http://dx.doi.org/10.1097/PCC.0b013e3182112e80
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 612
TITLE
Leadership strategies in transport team recruitment and retention
AUTHOR NAMES
Caron S.
AUTHOR ADDRESSES
(Caron S.) Royal Roads University, Victoria, Canada.
CORRESPONDENCE ADDRESS
S. Caron, Royal Roads University, Victoria, Canada.
SOURCE
Pediatric Critical Care Medicine (2011) 12:3 SUPPL. 1 (A67). Date of
Publication: May 2011
CONFERENCE NAME
6th World Congress on Pediatric Critical Care: One World Sharing Knowledge
CONFERENCE LOCATION
Sydney, NSW, Australia
CONFERENCE DATE
2011-03-13 to 2011-03-17
ISSN
1529-7535
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Objectives: This qualitative action research project was created to explore
the positive potential of recruitment and retention solutions for our
pediatric critical care transport team and arrive at insights,
recommendations, and strategies to move forward on this innovative
two-person transport team. Methods: The study involved 15 people in 2 phases
of research and was conducted in Calgary, Canada. Participants included
multidisciplinary stakeholders from the aero- medical transport community,
neonatal intensive care unit, and pediatric intensive care unit including
nurses, paramedics, respiratory therapists, and managers. Results: The main
themes of education, leadership, and teamwork will be explored in this
section. Education was a strong recruitment and retention strategy that was
recorded in both phases of the research. The data from phase one suggested a
leader that displays such leadership behaviors as inclusiveness and
collaboration with team members, and has a sense of purpose. From a teamwork
perspective, differences in perception may exist between the two phases of
this research that influences team interaction in establishing trust in
teams. Conclusion: This study expanded upon three recommendations to improve
recruitment and retention. Establishing a healthy culture is the first
recommendation for the RN-RRT Transport team and a crucial component of
enhancing recruitment and retention practices in the transport team. The
second recommendation would be to enhance communication skills to support
and develop the leadership skills of RN-RRT Transport team members. The
third recommendation would be to reframe the notion of the transport team to
be inclusive of entire PICU staff.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
leadership
EMTREE MEDICAL INDEX TERMS
action research
Canada
communication skill
community
education
intensive care unit
manager
newborn intensive care
nurse
respiratory therapist
skill
teamwork
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70418682
DOI
10.1097/PCC.0b013e3182112e80
FULL TEXT LINK
http://dx.doi.org/10.1097/PCC.0b013e3182112e80
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 613
TITLE
Outcomes following a rapid response and the impact on transfer to the
Intensive Care Unit
AUTHOR NAMES
Panico M.
Pisani M.
Jenq G.
Araujo K.
Honiden S.
AUTHOR ADDRESSES
(Panico M., megan.panico@yale.edu; Pisani M.; Jenq G.; Araujo K.; Honiden
S.) Yale University, New Haven, United States.
CORRESPONDENCE ADDRESS
M. Panico, Yale University, New Haven, United States. Email:
megan.panico@yale.edu
SOURCE
American Journal of Respiratory and Critical Care Medicine (2011) 183:1
MeetingAbstracts. Date of Publication: 1 May 2011
CONFERENCE NAME
American Thoracic Society International Conference, ATS 2011
CONFERENCE LOCATION
Denver, CO, United States
CONFERENCE DATE
2011-05-13 to 2011-05-18
ISSN
1073-449X
BOOK PUBLISHER
American Thoracic Society
ABSTRACT
RATIONALE: There is conflicting data on the impact of Rapid Response Teams
(RRT) on outcomes. There is no data on process of care after patients
undergo an RRT. Examining outcomes from RRT's are crucial to optimizing
valuable resources in the hospital. Understanding process of care and
outcomes related to RRTs will help physicians to better triage patients
during an RRT as well as improve discussions with patients on code status
and what it means to transfer to an ICU level of care. We sought to examine
the demographics of patients who underwent an RRT at our institution and
evaluate outcomes. METHODS: Retrospective Descriptive Study of 260 RRT calls
over three and half months in 2009. Reason for RRT call, clinical
characteristics, and changes in status were collected. We examined which
patients were being transferred to the ICU based on age, acuity (APACHE II)
and reason for RRT. We examined changes in code status, hospital mortality
and discharge location. RESULTS: of the 260 patient's evaluated (Table 1),
131 remained on the floor, 16 were transferred to step down and 113 were
transferred to the ICU. The average APACHE II score for patients who
remained on the floor versus those transferred to the ICU was 14.7 versus
20.9 (p<0.0001). RRT's called for hypoxia and“staff worried” were
significantly more likely to be transferred to a higher level of care.
Patients with dementia were less likely to be transferred to the ICU (8% to
ICU vs. 21% remained on floor). of patients remaining on the floor 27% were
DNR/DNI, while 9% of ICU transfers were DNR/DNI. of patients transferred to
the ICU 25% had code status changes to less aggressive. Forty percent of the
patient's transferred to the ICU died and, 28% of patients remaining on the
floor died. Among patients admitted from home who were transferred to the
ICU 35% returned home, 21% were admitted to a facility and 42% died. Among
patients who were admitted from home and remained on the floor 52% returned
home, 22% were admitted to a facility and 22% died. (Table presented)
CONCLUSION: RRT's identify sicker patients who may benefit from ICU care.
Patients with dementia and DNR/DNI orders were less likely to be transferred
to the ICU after an RRT. Interestingly 25% of ICU transfers had their code
status changed to DNR/DNI after RRT. Further research is needed regarding
which patients receive benefit from ICU transfer after RRT's.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
society
EMTREE MEDICAL INDEX TERMS
APACHE
dementia
emergency health service
hospital
human
hypoxia
mortality
patient
physician
rapid response team
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70849032
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 614
TITLE
Immediate postoperative extubation in patients undergoing free tissue
transfer
AUTHOR NAMES
Allak A.
Nguyen T.N.
Shonka Jr. D.C.
Reibel J.F.
Levine P.A.
Jameson M.J.
AUTHOR ADDRESSES
(Allak A.; Nguyen T.N.; Shonka Jr. D.C.; Reibel J.F.; Levine P.A.; Jameson
M.J., mjj4e@virginia.edu) Department of Otolaryngology-Head and Neck
Surgery, University of Virginia, PO Box 800713, Charlottesville, VA,
22908-0713, United States.
CORRESPONDENCE ADDRESS
A. Allak, Department of Otolaryngology-Head and Neck Surgery, University of
Virginia, PO Box 800713, Charlottesville, VA, 22908-0713, United States.
SOURCE
Laryngoscope (2011) 121:4 (763-768). Date of Publication: April 2011
ISSN
0023-852X
BOOK PUBLISHER
John Wiley and Sons Inc., P.O.Box 18667, Newark, United States.
ABSTRACT
Objectives/Hypothesis: Extubation (cessation of ventilatory support) is
often delayed in free flap patients to protect the microvascular
anastomosis, presumably by reducing emergence-related agitation. We sought
to determine if immediate extubation in the operating room (OR) would
improve the postoperative course compared to delayed extubation in the
intensive care unit (ICU). Study Design: Retrospective chart review.
Methods: Medical records of all patients undergoing free tissue transfer for
head and neck reconstruction between January 2009 and July 2010 were
reviewed (n = 52). Patients extubated immediately postoperatively in the OR
(immediate group, n = 26) were compared to patients extubated in the ICU
(delayed group, n = 26). Results: Tobacco use, alcohol use, pulmonary
history, case length, and free flap type were not significantly different
between the two groups. Although the average ICU stay for the immediate
group was significantly shorter than the delayed group (2.0 days vs. 3.4
days; P =.008), the reduction in overall hospital stay for the immediate
group did not achieve statistical significance (8.2 days vs. 9.5 days; P
=.21). Use of treatment for agitation (27% vs. 65%) and physical restraints
(8% vs. 69%) were significantly lower in the immediate versus delayed group
(P =.01 and P <.001, respectively). Although flap-related, surgical, and
medical complication rates were not significantly different between the two
groups, the delayed extubation group had a significantly higher incidence of
pneumonia (15% vs. 0%; P =.05). Conclusions: Immediate postoperative
extubation in the OR following head and neck microvascular free tissue
transfer reduces ICU stay, anxiolytic use, restraint use, and incidence of
pneumonia without an increase in flap- or wound-related complications. ©
2011 The American Laryngological, Rhinological, and Otological Society, Inc.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
extubation
free tissue graft
EMTREE MEDICAL INDEX TERMS
agitation
alcohol consumption
anamnesis
article
cigarette smoking
controlled study
head and neck surgery
hospitalization
human
incidence
intensive care unit
major clinical study
medical record
operating room
pneumonia
postoperative complication
postoperative period
priority journal
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2011170651
MEDLINE PMID
21433018 (http://www.ncbi.nlm.nih.gov/pubmed/21433018)
PUI
L361507720
DOI
10.1002/lary.21397
FULL TEXT LINK
http://dx.doi.org/10.1002/lary.21397
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 615
TITLE
What do relatives experience when patients are transferred from intensive
care units to general wards
AUTHOR NAMES
Lauberg A.
Jacobsen C.J.
AUTHOR ADDRESSES
(Lauberg A.; Jacobsen C.J.) Aalborg Hospital of the Aarhus University
Hospital, Aalborg, Denmark.
CORRESPONDENCE ADDRESS
A. Lauberg, Aalborg Hospital of the Aarhus University Hospital, Aalborg,
Denmark.
SOURCE
European Journal of Cardiovascular Nursing (2011) 10 SUPPL. 1 (S25). Date of
Publication: April 2011
CONFERENCE NAME
11th Annual Spring Meeting on Cardiovascular Nursing
CONFERENCE LOCATION
Brussels, Belgium
CONFERENCE DATE
2011-04-01 to 2011-04-02
ISSN
1474-5151
BOOK PUBLISHER
Elsevier
ABSTRACT
Background: In international studies the dilemma that relatives face when a
patient is transferred from intensive care unit to a general ward is
illustrated. The dilemma stands between a concern that the close observation
in the intensive care unit is completed and transfer to a general ward is an
indication that the patient is recovering. This can cause anxiety and
depression in relatives. Several studies have shown that there is a
correlation between relatives coping ability and patient progress in the
aftermath. And it appears that support of relatives optimizes the effect of
the care and rehabilitation the patient receives. Purpose: The purpose in
this study is to investigate relatives' experiences from the transfer of
patients from the intensive care unit to the ward with the aim of developing
nursing practice. Method: A hermeneutic-phenomenological study was designed
intending to gain insight in relatives' experiences and perception of the
transfer. Six family members were interviewed after the transfer. Result:
Relatives seem to want to be physically present to be able to exercise
natural care. A need for single rooms where relatives can be present and the
patient is screened from the outside world, and tranquil surroundings reduce
tension. One relative said: when the threads of life are pulled out
conversation is urgent. Conclusions: The professionals must pay attention to
relatives in order to secure a successful transfer. Good dialogs give voice
to the anxiety that relatives' experiences and are essential in nursing
practice to patients and relatives.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cardiovascular nursing
intensive care unit
patient
ward
EMTREE MEDICAL INDEX TERMS
anxiety
conversation
coping behavior
exercise
nursing practice
phenomenology
rehabilitation
voice
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70431830
DOI
10.1016/S1474-5151(11)60092-3
FULL TEXT LINK
http://dx.doi.org/10.1016/S1474-5151(11)60092-3
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 616
TITLE
Performance of an automated external defibrillator during simulated
rotor-wing critical care transports
AUTHOR NAMES
Je S.M.
You J.S.
Chung T.N.
Park Y.S.
Chung S.P.
Park I.C.
AUTHOR ADDRESSES
(Je S.M.; You J.S.; Chung T.N.; Park Y.S.; Chung S.P.; Park I.C.,
incheol@yuhs.ac) Department of Emergency Medicine, Yonsei University College
of Medicine, 250 Seongsanno, (134 Sinchon-dong), Seodaemun-gu, 120-752
Seoul, South Korea.
CORRESPONDENCE ADDRESS
I.C. Park, Department of Emergency Medicine, Yonsei University College of
Medicine, 250 Seongsanno, (134 Sinchon-dong), Seodaemun-gu, 120-752 Seoul,
South Korea. Email: incheol@yuhs.ac
SOURCE
Resuscitation (2011) 82:4 (454-458). Date of Publication: April 2011
ISSN
0300-9572
BOOK PUBLISHER
Elsevier Ireland Ltd, P.O. Box 85, Limerick, Ireland.
ABSTRACT
Objective: This study aimed to evaluate whether an automated external
defibrillator (AED) was accurate enough to analyze the heart rhythm during a
simulated rotor wing critical care transport. We hypothesized that AED
analysis of the simulated rhythms during a helicopter flight would result in
significant errors (i.e., inappropriate shocks, analysis delay). Methods:
Three commercial AEDs were tested for analyzing the heart rhythm in a
helicopter using a manikin and a human volunteer. Ventricular fibrillation
(VF), sinus rhythm, and asystole were simulated by using an arrhythmia
simulator of the manikin. The intervals from analysis to shock
recommendation were collected on a stationary and in-motion helicopter.
Sensitivity and specificity of three AEDs were also calculated. Vibration
intensities were measured with a digital vibration meter placed on the chest
of the manikin/human volunteer both on the stretcher and on the floor of the
helicopter. Results: All AEDs correctly recommended shock delivery for the
cardiac rhythms of the manikin. Sensitivity for VF was 100.0% (95% CI
91.2-100.0) and specificity for sinus rhythm and asystole were 100.0% (95%
CI 91.2-100.0). Although the recorded ECG rhythms of the volunteer in an
in-motion helicopter showed baseline artifacts, all AEDs analyzed the
cardiac rhythm of the volunteer correctly and did not recommend shock
delivery. On the floor of the helicopter, the median measured vibration
intensity was 6.6m/s(2) (IQR 5.5-7.7m/s(2)) with significantly less
vibrations transmitted to the manikin/human volunteer chest (manikin median
3.1m/s(2), IQR 2.2-4.0m/s(2); human volunteer median 0.95m/s(2), IQR
0.65-1.25m/s(2)). Conclusion: This study suggested that current AEDs could
analyze the heart rhythm correctly during simulated helicopter transport.
Further studies using an animal model would be needed before applying to
patients. © 2011 Elsevier Ireland Ltd.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
automated external defibrillator
intensive care
EMTREE MEDICAL INDEX TERMS
accuracy
air medical transport
article
audiovisual equipment
electrocardiogram
heart arrest
heart arrhythmia
heart rhythm
heart ventricle fibrillation
helicopter
human
male
patient transport
priority journal
rotor wing critical care transport
sensitivity and specificity
shock
sinus rhythm
thorax
vibration
DEVICE TRADE NAMES
Heartstart MRx , United StatesPhillips
Lifegain HD1 , South Koreacu medical systems
Lifepak 12 , United StatesMedtronic
VitalSim , NorwayLaerdal
DEVICE MANUFACTURERS
(South Korea)cu medical systems
(Norway)Laerdal
(United States)Medtronic
(United States)Phillips
EMBASE CLASSIFICATIONS
Internal Medicine (6)
Cardiovascular Diseases and Cardiovascular Surgery (18)
Anesthesiology (24)
Biophysics, Bioengineering and Medical Instrumentation (27)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2011146981
MEDLINE PMID
21236548 (http://www.ncbi.nlm.nih.gov/pubmed/21236548)
PUI
L51227992
DOI
10.1016/j.resuscitation.2010.11.027
FULL TEXT LINK
http://dx.doi.org/10.1016/j.resuscitation.2010.11.027
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 617
TITLE
Introducing physician's assistants into PICU-disparities, solutions and
transferable lessons
AUTHOR NAMES
White H.
Round J.
AUTHOR ADDRESSES
(White H.; Round J.) Center for Medical and Healthcare Education, St.
George's, University of London, London, United Kingdom.
CORRESPONDENCE ADDRESS
H. White, Center for Medical and Healthcare Education, St. George's,
University of London, London, United Kingdom.
SOURCE
Archives of Disease in Childhood (2011) 96 SUPPL. 1 (A91-A92). Date of
Publication: April 2011
CONFERENCE NAME
Annual Conference of the Royal College of Paediatrics and Child Health,
RCPCH 2011
CONFERENCE LOCATION
Warwick, United Kingdom
CONFERENCE DATE
2011-04-05 to 2011-04-07
ISSN
0003-9888
BOOK PUBLISHER
BMJ Publishing Group
ABSTRACT
Aims: To identify transferable lessons from the introduction of Physicians
Assistants (PAs) into the Paediatric Intensive Care Unit (PICU) in a large
teaching hospital. The PICU had seen increasing admissions, but trainee
hours had reduced. Along with transition to consultant-delivered service,
three PAs were appointed in 2010 to provide long-term support to the
multidisciplinary team. PAs are well known in the US, but new to paediatrics
and PICU. Methods: We sought to capture staff opinions and measure the
function of PAs before starting, at 3 weeks and at 2 months after starting.
An anonymous questionnaire, an online survey and semi-structured interviews
were distributed to and conducted with all professionals working on the
PICU. Areas explored were function of PAs, the impact on the PICU and
teamworking. Results: Pre-start questionnaire-50% of the doctors and 30% of
the nurses answered the questionnaire. 10/20 responses stated the addition
of PA's would ease/augment their individual role. 17/30 responses expected
an overall positive impact on the unit and 13/30 expected an improvement in
quality/ continuity of patient care. 12/28 anticipated a threat, including
reduced training opportunities and deskilling. 12/39 expected confusion
regarding the role and lines of accountability of the PAs. 3 week online
questionnaire-despite being sent to all 52 permanent staff, only nine
completed the survey. Of the responses, two noted a positive impact,
highlighting their hard work and enthusiasm, releasing more clinical time
for patient care. 7/9 felt that the PAs would improve unit function in time.
Concern was again expressed around training opportunities. One respondent
detailed disparities in pay banding between PAs and nurses. 6/9 thought that
the trust should have invested in advanced nurse practitioners instead. At 2
months, semi-structured interviews have highlighted an emerging respect for
their contribution of function of the unit out of hours, patient assessment
and patient-related administration. Concern of disparities in pay/abilities
remains within some nurses. Conclusion: There are many solutions to
workforce challenges. PAs are expected to become a viable one, but their
introduction needs to encompass public relations and pay banding as well as
operational and training needs.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child health
college
pediatrics
physician assistant
EMTREE MEDICAL INDEX TERMS
consultation
human
intensive care unit
nurse
nurse practitioner
patient
patient assessment
patient care
physician
public relations
questionnaire
semi structured interview
student
teaching hospital
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70504242
DOI
10.1136/adc.2011.212563.212
FULL TEXT LINK
http://dx.doi.org/10.1136/adc.2011.212563.212
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 618
TITLE
I(3)-assist: Individual, interactive and integrated cardiopulmonary assist -
A concept
AUTHOR NAMES
Wagner G.
Schlanstein P.
Arens J.
Kopp R.
Bensberg R.
Rossaint R.
Schmitz-Rode T.
Steinseifer U.
AUTHOR ADDRESSES
(Wagner G.; Schlanstein P.; Arens J.; Schmitz-Rode T.; Steinseifer U.)
Department of Cardiovascular Engineering, Institute of Applied Medical
Engineering, RWTH Aachen University, Germany.
(Kopp R.; Bensberg R.; Rossaint R.) Department of Intensive Care Medicine,
University Hospital Aachen, RWTH Aachen University, Germany.
CORRESPONDENCE ADDRESS
G. Wagner, Department of Cardiovascular Engineering, Institute of Applied
Medical Engineering, RWTH Aachen University, Germany.
SOURCE
Artificial Organs (2011) 35:4 (A9). Date of Publication: April 2011
CONFERENCE NAME
7th International Conference on Pediatric Mechanical Circulatory Support
Systems and Pediatric Cardiopulmonary Bypass
CONFERENCE LOCATION
Philadelphia, PA, United States
CONFERENCE DATE
2011-05-05 to 2011-05-07
ISSN
0160-564X
BOOK PUBLISHER
Blackwell Publishing Inc.
ABSTRACT
Background: Current heart-lung-machines (HLMs) and extracorporeal life
support (ECLS) are available in a few, often only three, sizes of components
like oxygenators and heat exchangers. Considering the body weight range from
neonates to adults, suitable adaptations for patients' needs are mostly
impossible. Additionally, if components have to be replaced, e.g. due to
failure, the entire system needs to be stopped. As the components of HLMs
and ECLS are identical only in parts, another extracorporeal system must be
installed when changing over from HLM to ECLS, unavoidably causing
hemodilution. In order to diminish these known limitations we designed an
entirely new concept conjoining HLM and ECLS. Methods: I(3)-Assist aims at
developing a highly integrated and modular extracorporeal system which can
be adapted to individual treatment needs of the patient. To achieve an
optimized priming volume and contact surface, oxygenator and heat exchanger
modules in only one size will be provided. These modules can be combined by
the user to achieve the gas/heat exchange area suitable for the individual
patient (e.g. one for a neonate, five for a small or eight for a tall
adult). Additionally, all modules of an HLM/ECLS system will be exchangeable
under operating conditions. Thus, an immediate and seamless transition
between operation modes can be carried out and the system can be modified
according to changing individual needs during surgery and therapy. Due to
the highly integrated design the system can be placed near the operating
table and can be used for inter- and intrahospital transport. The key
feature of the design is the development of a safe and easy connection of
the different modules. First in vitro experiments (Fig. 1) demonstrate the
feasibility of the modular design regarding flow regulation and pressure
build-up. Results: Using flows from 100-800 mL/min the pressure loss over
each module was determined. The total loss was equal to conventional
oxygenators with integrated heat exchangers. The oxygenators represented
2/3, the heat exchanger 1/3 of the loss. Due to the passive custom made
dividing and collection units, each line was equally exposed to the systems
flow within a range of ± 3 %. Conclusions: The I(3)-Assist project is
focused on developing a highly integrated and modular system of
life-supporting functional units. This system can be used as a
heart-lung-machine (HLM), but also as an extracorporeal life support (ECLS),
and for inter-plus intrahospital transportation. Furthermore, the system can
be adapted to the individual and varying requirements of patients.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
assisted circulation
cardiopulmonary bypass
EMTREE MEDICAL INDEX TERMS
adaptation
adult
body weight
heart lung machine
heat
hemodilution
human
in vitro study
newborn
operating table
oxygenator
patient
surgery
therapy
traffic and transport
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70524783
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 619
TITLE
Transferring VLBW infants from the delivery room (DR) to the NICU. How
vigilant are we in avoiding hypoxia/hyperoxia during the first “golden
hour”?
AUTHOR NAMES
Simionato L.
Saraswat A.
Dawson J.A.
Thio M.
Davis P.G.
AUTHOR ADDRESSES
(Simionato L., lauren.simionato@thewomens.org.au; Saraswat A.; Davis P.G.)
Department of Obstetrics and Gynaecology, University of Melbourne,
Melbourne, Australia.
(Dawson J.A.; Thio M.; Davis P.G.) Division of Neonatal Services, Royal
Women's Hospital, Melbourne, Australia.
(Davis P.G.) Murdoch Childrens Research Institute, Melbourne, Australia.
CORRESPONDENCE ADDRESS
L. Simionato, Department of Obstetrics and Gynaecology, University of
Melbourne, Melbourne, Australia. Email: lauren.simionato@thewomens.org.au
SOURCE
Journal of Paediatrics and Child Health (2011) 47 SUPPL. 1 (16-17). Date of
Publication: April 2011
CONFERENCE NAME
15th Annual Congress of the Perinatal Society of Australia and New Zealand,
PSANZ 2011
CONFERENCE LOCATION
Hobart, TAS, Australia
CONFERENCE DATE
2011-04-10 to 2011-04-13
ISSN
1034-4810
BOOK PUBLISHER
Blackwell Publishing
ABSTRACT
Background: Clinicians are aware of the dangers of hyperoxia and hypoxia in
the DR and NICU. Less attention has been paid to the period of
transportation to and early stabilisation in the NICU. We aimed to
investigate the proportion of time infants spent with SpO(2) in the range
85-94% during this early postnatal period, continuing to 60 minutes after
birth. Method: A prospective observational study of clinical practice was
undertaken from August to November 2011. Infants <32 weeks gestation with no
congenital abnormalities were enrolled. A pulse oximeter (PO) sensor was
applied to the right hand after birth, remaining connected until 60 minutes
of age. Clinical activities (e.g. resuscitation, line insertion) were also
recorded during this time and matched with PO SpO(2) data for analysis.
Analysis of hyperoxic periods was only performed when infants were in
supplemental O(2). Clinicians were blinded to the aims of the study.
Results: 12 infants were studied (mean (SD) birth weight 1031 (258) g,
gestational age 29 (2) weeks]. Mean (SD) times spent in the transport cot
and NICU were 8.6 (4.1) minutes and 35.9 (4.7) minutes respectively. During
transport, median (IQR) SpO(2) was 94 (88-96) %, and in NICU 93 (90-96) %.
Infants had a SpO(2) < 85% for 9.3% of transport time, and a SpO(2) > 94%
for 33% of this time. In the NICU, mean 9.2% of SpO(2) was <85%, while
SpO(2) was >94% for 27.4% of this time. Conclusions: SpO(2) measurements
often fell outside the target range during the early postnatal period. We
noted that clinicians accept saturations higher than the “safe” range during
the first hour after birth.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Australia and New Zealand
delivery room
human
infant
society
very low birth weight
EMTREE MEDICAL INDEX TERMS
birth weight
clinical practice
congenital disorder
gestational age
hyperoxia
hypoxia
observational study
perinatal period
pregnancy
pulse oximeter
resuscitation
sensor
traffic and transport
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70656097
DOI
10.1111/j.1440-1754.2011.02046.x
FULL TEXT LINK
http://dx.doi.org/10.1111/j.1440-1754.2011.02046.x
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 620
TITLE
Intrahospital transportation of the seriously ill patient. The need for an
action guideline
ORIGINAL (NON-ENGLISH) TITLE
Transporte intrahospitalario del paciente grave. Necesidad de unaguía de
actuación
AUTHOR NAMES
Noa Hernández J.E.
González E.C.
Romero J.M.C.
Baños L.C.D.
AUTHOR ADDRESSES
(Noa Hernández J.E., jonoa@infomed.sld.cu; González E.C.; Romero J.M.C.;
Baños L.C.D.) Unidad de Cuidados Intensivos, Hospital Universitario Dr.
Miguel Enríquez, Ciudad de la Habana, Cuba.
CORRESPONDENCE ADDRESS
J.E. Noa Hernández, Unidad de Cuidados Intensivos, Hospital Universitario
Dr. Miguel Enríquez, Ciudad de la Habana, Cuba. Email: jonoa@infomed.sld.cu
SOURCE
Enfermeria Intensiva (2011) 22:2 (74-77). Date of Publication: April-June
2011
ISSN
1130-2399
1578-1291 (electronic)
BOOK PUBLISHER
Ediciones Doyma, S.L., Travesera de Gracia 17-21, Barcelona, Spain.
ABSTRACT
The basics caused by the transportation of a patient in serious condition
within the same hospital are varied, all of them involving a risk to the
patient's stability and a responsibility for the accompanying professionals.
The care that supposes the appropriate attention to the patient and the need
for coordination among the parties make it necessary to homogenize the
transfer criteria and those of the necessary previous maneuvers. This work
has been carried out based on the lack of an intervention system that guides
this practice. This work describes the possible intrahospital itineraries,
the transport of this kind of patient, the phases of this type of transport
as well as the most frequent physiologic alterations. The purpose of all
this is to develop an action algorithm for the serious patient's
intrahospital transportation and to reduce the incidence of adverse events
during this transfer. A classification system that makes it possible to
calculate the level of risk and to anticipate the care needs that a patient
may require during the transfer is presented. © 2010 Elsevier España, S.L. y
SEEIUC.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient transport
EMTREE MEDICAL INDEX TERMS
article
human
methodology
practice guideline
standard
LANGUAGE OF ARTICLE
Spanish
LANGUAGE OF SUMMARY
Spanish, English
MEDLINE PMID
21256064 (http://www.ncbi.nlm.nih.gov/pubmed/21256064)
PUI
L51238619
DOI
10.1016/j.enfi.2010.08.002
FULL TEXT LINK
http://dx.doi.org/10.1016/j.enfi.2010.08.002
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 621
TITLE
Serious injuries related to the Segway® personal transporter: A case series
AUTHOR NAMES
Boniface K.
McKay M.P.
Lucas R.
Shaffer A.
Sikka N.
AUTHOR ADDRESSES
(Boniface K.; McKay M.P., mmckay@mfa.gwu.edu; Lucas R.; Shaffer A.; Sikka
N.) Department of Emergency Medicine, George Washington University,
Washington, DC, United States.
CORRESPONDENCE ADDRESS
M. P. McKay, Center for Injury Prevention and Control, George Washington
University Medical Center, 2150 Pennsylvania Ave, Ste 2B-409, Washington, DC
20037, United States. Email: mmckay@mfa.gwu.edu
SOURCE
Annals of Emergency Medicine (2011) 57:4 (370-374). Date of Publication:
April 2011
ISSN
0196-0644
1097-6760 (electronic)
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
ABSTRACT
Study objective: We describe a case series of emergency department (ED)
visits for injuries related to the Segway® personal transporter. Methods:
This was a retrospective case review using a free-text search feature of an
electronic ED medical record to identify patients arriving April 2005
through November 2008. Data were hand extracted from the record, and further
information on admitted patients was obtained from the hospital trauma
registry. Results: Forty-one cases were included. The median age was 50
years, and 30 patients (73.2%) were women. Twenty-nine (70.7%) of the
patients resided outside the District of Columbia, Maryland, and Virginia,
and 32 (78.1%) arrived between June and September. Seven (17.1%) patients
had documented helmet use. Ten (24.4%) were admitted. Four patients (40% of
admitted patients) required admission to the ICU. Conclusion: The severity
of trauma in this case series of patients injured by the use of the
self-balancing personal transporter is significant. Further investigation
into the risks of use, as well as the optimal length and type of training or
practice, is warranted. A distinct E-code and Consumer Product Safety
Commission's product code is needed to enable further investigation of
injury risks for this mode of transportation. © 2010 American College of
Emergency Physicians.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
electrical equipment
emergency care
multiple trauma (disease management)
personal transporter
EMTREE MEDICAL INDEX TERMS
acetabulum fracture (disease management)
achilles tendon rupture (disease management)
adolescent
adult
aged
article
brain contusion (disease management)
case study
clavicle fracture (disease management)
clinical article
comminuted fracture (disease management, surgery)
device safety
disease registry
electronic medical record
emergency ward
face fracture (disease management, surgery)
female
head injury (disease management)
helmet
hospital admission
hospital charge
human
humerus fracture (disease management)
injury scale (disease management)
injury severity
intensive care unit
intraarticular fracture (disease management)
lumbar spine
male
malleolus fracture (disease management)
mandible fracture (disease management)
maxillary sinus
medical education
medical fee
medical record review
mouth injury (disease management)
nose fracture (disease management)
olecranon fracture (disease management)
pneumothorax (disease management)
priority journal
product safety
radius head fracture (disease management)
retrospective study
rib fracture (disease management)
scoring system
subarachnoid hemorrhage (disease management)
subdural hematoma (disease management)
tibia fracture (disease management, surgery)
traffic and transport
United States
zygoma arch fracture (disease management)
DEVICE TRADE NAMES
Segway , United Statessegway
DEVICE MANUFACTURERS
(United States)segway
EMBASE CLASSIFICATIONS
Neurology and Neurosurgery (8)
Otorhinolaryngology (11)
Public Health, Social Medicine and Epidemiology (17)
Biophysics, Bioengineering and Medical Instrumentation (27)
Orthopedic Surgery (33)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2011177032
MEDLINE PMID
20889236 (http://www.ncbi.nlm.nih.gov/pubmed/20889236)
PUI
L51094550
DOI
10.1016/j.annemergmed.2010.06.551
FULL TEXT LINK
http://dx.doi.org/10.1016/j.annemergmed.2010.06.551
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 622
TITLE
Accumulation and transport of microbial-size particles in a pressure
protected model burn unit: CFD simulations and experimental evidence
AUTHOR NAMES
Beauchêne C.
Laudinet N.
Choukri F.
Rousset J.
Benhamadouche S.
Larbre J.
Chaouat M.
Benbunan M.
Mimoun M.
Lajonchère J.
Bergeron V.
Derouin F.
AUTHOR ADDRESSES
(Beauchêne C., christian.beauchene@edf.fr; Rousset J.,
jean-luc.rousset@edf.fr; Benhamadouche S., sofiane.benhamadouche@edf.fr)
Electricité De France Research and Development, 6 quai Watier, 78400 Chatou,
France.
(Laudinet N., nicolas.laudinet@airinspace.com; Larbre J.,
Juliette.LARBRE@ineris.fr; Bergeron V., vance.bergeron@ens-lyon.fr)
Airinspace SAS, Montigny, France.
(Choukri F., firaschoukri@hotmail.fr; Derouin F.,
francis.derouin@sls.aphp.fr) Laboratory of Parasitology-Mycology,
Saint-Louis hospital, Assistance Publique-Hôpitaux de Paris and University
Paris, Diderot, France.
(Chaouat M., marc.chaouat@sls.aphp.fr; Mimoun M.,
maurice.mimoun@sls.aphp.fr) Burn Centre, Department of
Reconstructive/Plastic Surgery, Rothschild Hospital, Paris, France.
(Benbunan M., marc.benbunan@sls.aphp.fr) Cell Therapy Unit, Saint-Louis
hospital, Assistance Publique-Hôpitaux de Paris, France.
(Lajonchère J., direction@hpsj.fr) Hôpital Saint-Louis, Assistance
Publique-Hôpitaux de Paris, France.
(Bergeron V., vance.bergeron@ens-lyon.fr) CNRS UMR, Ecole Normale Supérieure
de Lyon, 46 allée d'Italie, 69007, Lyon, France.
CORRESPONDENCE ADDRESS
F. Derouin, Laboratory of Parasitology-Mycology, Saint-Louis hospital,
Assistance Publique-Hôpitaux de Paris, and University Paris, Diderot,
France. Email: francis.derouin@sls.aphp.fr
SOURCE
BMC Infectious Diseases (2011) 11 Article Number: 58. Date of Publication: 3
Mar 2011
ISSN
1471-2334 (electronic)
BOOK PUBLISHER
BioMed Central Ltd., Floor 6, 236 Gray's Inn Road, London, United Kingdom.
ABSTRACT
Background: Controlling airborne contamination is of major importance in
burn units because of the high susceptibility of burned patients to
infections and the unique environmental conditions that can accentuate the
infection risk. In particular the required elevated temperatures in the
patient room can create thermal convection flows which can transport
airborne contaminates throughout the unit. In order to estimate this risk
and optimize the design of an intensive care room intended to host severely
burned patients, we have relied on a computational fluid dynamic methodology
(CFD).Methods: The study was carried out in 4 steps: i) patient room design,
ii) CFD simulations of patient room design to model air flows throughout the
patient room, adjacent anterooms and the corridor, iii) construction of a
prototype room and subsequent experimental studies to characterize its
performance iv) qualitative comparison of the tendencies between CFD
prediction and experimental results. The Electricité De France (EDF)
open-source software Code_Saturne(® )(http://www.code-saturne.org) was used
and CFD simulations were conducted with an hexahedral mesh containing about
300 000 computational cells. The computational domain included the treatment
room and two anterooms including equipment, staff and patient. Experiments
with inert aerosol particles followed by time-resolved particle counting
were conducted in the prototype room for comparison with the CFD
observations.Results: We found that thermal convection can create
contaminated zones near the ceiling of the room, which can subsequently lead
to contaminate transfer in adjacent rooms. Experimental confirmation of
these phenomena agreed well with CFD predictions and showed that particles
greater than one micron (i.e. bacterial or fungal spore sizes) can be
influenced by these thermally induced flows. When the temperature difference
between rooms was 7°C, a significant contamination transfer was observed to
enter into the positive pressure room when the access door was opened, while
2°C had little effect. Based on these findings the constructed burn unit was
outfitted with supplemental air exhaust ducts over the doors to compensate
for the thermal convective flows.Conclusions: CFD simulations proved to be a
particularly useful tool for the design and optimization of a burn unit
treatment room. Our results, which have been confirmed qualitatively by
experimental investigation, stressed that airborne transfer of microbial
size particles via thermal convection flows are able to bypass the
protective overpressure in the patient room, which can represent a potential
risk of cross contamination between rooms in protected environments. © 2011
Beauchêne et al; licensee BioMed Central Ltd.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
burn unit
computational fluid dynamics
transport kinetics
EMTREE MEDICAL INDEX TERMS
aerosol
airborne particle
airflow
article
bioaccumulation
computer simulation
controlled study
experimental design
hospital design
hospital equipment
hospital personnel
intensive care unit
microbial contamination
particle size
prediction
process model
process optimization
risk assessment
room ventilation
software
temperature sensitivity
temperature stress
thermodynamics
EMBASE CLASSIFICATIONS
Surgery (9)
Biophysics, Bioengineering and Medical Instrumentation (27)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2011147684
MEDLINE PMID
21371304 (http://www.ncbi.nlm.nih.gov/pubmed/21371304)
PUI
L51308218
DOI
10.1186/1471-2334-11-58
FULL TEXT LINK
http://dx.doi.org/10.1186/1471-2334-11-58
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 623
TITLE
Bacterial colonization patterns in neonates transferred from neonatal
intensive care units
AUTHOR NAMES
Navarro L.R.
Pekelharing-Berghuis M.
de Waal W.J.
Thijsen S.F.
AUTHOR ADDRESSES
(Navarro L.R.; Pekelharing-Berghuis M.; de Waal W.J.) Department of
Pediatrics, Diakonessenhuis, Utrecht, Netherlands.
(Thijsen S.F., sthijsen@diakhuis.nl) Department of Medical Microbiology,
Diakonessenhuis, Utrecht, Netherlands.
CORRESPONDENCE ADDRESS
S.F. Thijsen, Department of Medical Microbiology, Diakonessenhuis,
Bosboomstraat 1, 3582 KE Utrecht, Netherlands. Email: sthijsen@diakhuis.nl
SOURCE
International Journal of Hygiene and Environmental Health (2011) 214:2
(167-171). Date of Publication: March 2011
ISSN
1438-4639
1618-131X (electronic)
BOOK PUBLISHER
Urban und Fischer Verlag Jena, P.O. Box 100537, Jena, Germany.
ABSTRACT
After an outbreak with Enterobacter cloacae we decided to routinely nurse
all neonates in isolation who were transferred from a neonatal intensive
care unit (NICU) to the neonatal unit of the Diakonessenhuis until cultures
for MRSA and antibiotic-resistant Gram-negative bacteria were negative. The
goal of this study was to determine (1) the colonization patterns with
(antibiotic-resistant) bacteria; (2) whether there is a trend in time and
(3) to identify predictors for colonization. Neonates from 2001 till 2006
transferred from a NICU to our neonatal unit were included. Patients were
monitored for infections. In total 287 neonates were included. The average
birth weight was 1990. g and gestational age 33 weeks and 3 days. Only one
patient was colonized with a highly resistant microorganism (HRMO) and no
MRSA was isolated. A NICU-stay longer than one week was the only independent
risk factor for bacterial colonization. Twenty-six percent of neonates were
colonized with bacteria resistant to amoxicillin/clavulanate. Five neonates
(1.7%) developed a bacterial infection after transfer, none of them caused
by an antibiotic-resistant microorganism present at transfer. No significant
trends in time were found. In conclusion, we found a low prevalence of HRMO
and a low incidence of bacterial infections in neonates after transfer from
a NICU. There was no significant increase in time in the prevalence of
colonization with (resistant) bacteria. A NICU-stay longer than a week was
an independent predictor for colonization with bacteria. Based on these
observations we have ended standard culturing and nursing in isolation of
these patients. © 2011 Elsevier GmbH.
EMTREE DRUG INDEX TERMS
antiinfective agent (drug therapy)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
antibiotic resistance
bacterial infection (drug therapy, epidemiology, prevention)
bacterium
cross infection (drug therapy, epidemiology, prevention)
epidemic
infection control
newborn intensive care
EMTREE MEDICAL INDEX TERMS
article
bacterial count
birth weight
Enterobacter cloacae
female
gestational age
growth, development and aging
human
incidence
length of stay
male
methodology
newborn
risk factor
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
21316303 (http://www.ncbi.nlm.nih.gov/pubmed/21316303)
PUI
L51271111
DOI
10.1016/j.ijheh.2011.01.001
FULL TEXT LINK
http://dx.doi.org/10.1016/j.ijheh.2011.01.001
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 624
TITLE
The authors reply
AUTHOR NAMES
Ramnarayan P.
Borrows E.L.
Montgomery M.
Lutman D.
Petros A.
AUTHOR ADDRESSES
(Ramnarayan P.; Borrows E.L.; Montgomery M.; Lutman D.; Petros A.)
Children's Acute Transport Service, Great Ormond Street Hospital, London,
United Kingdom.
CORRESPONDENCE ADDRESS
P. Ramnarayan, Children's Acute Transport Service, Great Ormond Street
Hospital, London, United Kingdom.
SOURCE
Pediatric Critical Care Medicine (2011) 12:2 (242-243). Date of Publication:
March 2011
ISSN
1529-7535
BOOK PUBLISHER
Lippincott Williams and Wilkins, 530 Walnut Street, Philadelphia, United
States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child care
immobilization
intensive care
patient transport
pediatric stabilization
EMTREE MEDICAL INDEX TERMS
community hospital
cost effectiveness analysis
health care cost
health care quality
hospital personnel
intensive care unit
letter
medical staff
outcome assessment
priority journal
tertiary health care
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2011170286
PUI
L361506785
DOI
10.1097/PCC.0b013e3182070d0d
FULL TEXT LINK
http://dx.doi.org/10.1097/PCC.0b013e3182070d0d
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 625
TITLE
ISMP medication error report analysis - Affirmative warnings may be better
understood than negative warnings; Standard neonatal intensive care unit
drug infusion concentrations; Limits placed on prescription transfers by
patients; Top drugs that cause violence; Vincristine caution statement
reworded
AUTHOR NAMES
Cohen M.R.
Smetzer J.L.
AUTHOR ADDRESSES
(Cohen M.R., mcohen@ismp.org; Smetzer J.L.) Institute for Safe Medication
Practices, 200 Lakeside Drive, Horsham, PA 19044, United States.
CORRESPONDENCE ADDRESS
M. R. Cohen, Institute for Safe Medication Practices, 200 Lakeside Drive,
Horsham, PA 19044, United States. Email: mcohen@ismp.org
SOURCE
Hospital Pharmacy (2011) 46:3 (157-160+165). Date of Publication: 1 Mar 2011
ISSN
0018-5787
BOOK PUBLISHER
Facts and Comparisons, 111 W. Port Plaza, Ste. 300, St. Louis, United
States.
EMTREE DRUG INDEX TERMS
mirtazapine (adverse drug reaction, drug therapy)
nimodipine (intravenous drug administration)
quetiapine (drug therapy)
varenicline (adverse drug reaction)
vincristine (intrathecal drug administration)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
medication error
EMTREE MEDICAL INDEX TERMS
article
behavior disorder (side effect)
drug contraindication
drug dose increase
dysthymia (drug therapy)
evening dosage
health care personnel
human
incident report
leukopenia (side effect)
medical practice
newborn intensive care
posttraumatic stress disorder (drug therapy)
prescription
violence
DRUG TRADE NAMES
chantix
remeron
seroquel
CAS REGISTRY NUMBERS
mirtazapine (61337-67-5)
nimodipine (66085-59-4)
quetiapine (111974-72-2)
varenicline (249296-44-4, 375815-87-5)
vincristine (57-22-7)
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Drug Literature Index (37)
Adverse Reactions Titles (38)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2011134868
PUI
L361399356
DOI
10.1310/hpj4603-157
FULL TEXT LINK
http://dx.doi.org/10.1310/hpj4603-157
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 626
TITLE
Attitudes of paediatric intensive care nurses to development of a nurse
practitioner role for critical care transport
AUTHOR NAMES
Davies J.
Bickell F.
Tibby S.M.
AUTHOR ADDRESSES
(Davies J., joanna.davies@gstt.nhs.uk) RGN RSCN Retrieval Nurse Practitioner
and Ward Manager Paediatric Intensive Care, Evelina Children's Hospital,
Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.
(Bickell F.) MHM RGN RNC South Thames Retrieval Co-ordinator Evelina
Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London,
United Kingdom.
(Tibby S.M.) Tibby MRCP Consultant Paediatric Intensivist Paediatric
Intensive Care, Evelina Children's Hospital, Guy's and St Thomas' NHS
Foundation Trust, London, United Kingdom.
CORRESPONDENCE ADDRESS
J. Davies, RGN RSCN Retrieval Nurse Practitioner and Ward Manager Paediatric
Intensive Care, Evelina Children's Hospital, Guy's and St Thomas' NHS
Foundation Trust, London, United Kingdom. Email: joanna.davies@gstt.nhs.uk
SOURCE
Journal of Advanced Nursing (2011) 67:2 (317-326). Date of Publication:
February 2011
ISSN
0309-2402
1365-2648 (electronic)
BOOK PUBLISHER
Blackwell Publishing Ltd, 9600 Garsington Road, Oxford, United Kingdom.
ABSTRACT
Aim. This paper is a report of a descriptive study of the attitudes and
opinions of nurses before and after the introduction of independent
Retrieval Nurse Practitioners into a critical care transport service for
children.Background. Little is known about nurses' attitudes to advanced
practice roles, particularly when these function as part of a team in a
high-risk, remote setting (distant to the base hospital). Increasing
knowledge in this area may give insight into ways of improving team working
and enhancing quality of patient care.Method. A qualitative questionnaire
was sent to nurses pre- (June 2006) and post- (July 2007) retrieval nurse
practitioner introduction. Questionnaires were analysed using an adapted
phenomenological method.Findings. The response rates were 62% (2006) and 48%
(2007). The main themes that emerged included fear, communication, trust,
team working, role conflict, role division and role boundaries. In the first
survey, most nurses anticipated difficulties during retrieval with retrieval
nurse practitioners and felt anxious about the prospect of being part of a
team with an independent retrieval nurse practitioner. However, by the
second survey (after retrieval nurse practitioner introduction), the
majority reported confidence in the retrieval nurse practitioners' knowledge
and skills.Conclusion. This advanced practice development has been a
challenge for the nurses and the retrieval nurse practitioners, but initial
anxieties and fears of a host of anticipated problems have been largely
dispelled as enhanced communication and team working were reported. © 2010
Blackwell Publishing Ltd.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health personnel attitude
intensive care
nurse attitude
nurse practitioner
patient transport
pediatric nursing
EMTREE MEDICAL INDEX TERMS
advanced practice nursing
article
child
clinical competence
female
human
intensive care unit
male
organization
organization and management
patient care
psychological aspect
public relations
qualitative research
United Kingdom
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
20946566 (http://www.ncbi.nlm.nih.gov/pubmed/20946566)
PUI
L361114062
DOI
10.1111/j.1365-2648.2010.05454.x
FULL TEXT LINK
http://dx.doi.org/10.1111/j.1365-2648.2010.05454.x
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 627
TITLE
ICU transfer after elective abdominal aortic aneurysm repair can be
succesfully reduced with a modified protocol. A fourteen year experience
from a University Hospital
AUTHOR NAMES
Bakoyiannis C.N.
Tsekouras N.S.
Georgopoulos S.
Klonaris C.
Bastounis E.E.
Filis K.
Papalambros E.
Bastounis E.
AUTHOR ADDRESSES
(Bakoyiannis C.N., bakogian@hotmail.com; Tsekouras N.S.; Georgopoulos S.;
Klonaris C.; Papalambros E.; Bastounis E.) First Department of Surgery,
University of Athens Medical School, Laiko General Hospital, Athens, Greece.
(Bastounis E.E.) Department of Bioengineering, University of California, San
Diego, CA, United States.
(Filis K.) 1st Department of Propaedeutic Surgery, Hippokrateion Hospital,
University of Athens, Athens, Greece.
CORRESPONDENCE ADDRESS
C. N. Bakoyiannis, First Department of Surgery, University of Athens Medical
School, Laiko General Hospital, Athens, Greece. Email: bakogian@hotmail.com
SOURCE
International Angiology (2011) 30:1 (43-51). Date of Publication: February
2011
ISSN
0392-9590
BOOK PUBLISHER
Edizioni Minerva Medica S.p.A., Corso Bramante 83-85, Torino, Italy.
ABSTRACT
Aim. To compare different selective criteria for Internal Care Unit (ICU)
admission in two different timeframes, after abdominal aortic aneurysm (AAA)
repair. A retrosprctive audit of acquired data was performed. Methods.
During a period of fourteen years (1994-2008), 1152 patients underwent an
elective open operation for infrarenal abdominal aortic aneurysm, in our
department. Six hundred and two patients (Group A) were treated in the
period January 1994-January 2003, and 550 patients (Group B) between January
2003 and August 2008. Post-operatively, all patients were transferred to
postanesthesia unit (PAU). After a 2 hours period of close observation, they
were transferred either to the ICU or to the surgical ward, according to
certain selective criteria (SC). In group A we used SC-A, for admission to
an ICU, and in group B we used new, stricter, criteria (SC-B). Thirty-day
mortality and morbidity, elective admissions to ICU, rate of subsequent ICU
admission, from ward to ICU, and the mean hospital and ICU length of stay,
were compared between the two groups. Results. The use of SC-B resulted in a
significant reduction of elective admissions to ICU (3.1% vs 8.5%, P<0.001).
Nevertheless, the portion of patients, which were transferred with a severe
postoperative complication from the ward to ICU, remained similar between
the two groups (1.1% vs 0,9%, in group A and B, respectively). All other
endpoints were similar in both groups. Conclusions. Modifying the protocol
of ICU transfer, after elective abdominal aortic aneurysm repair, we can
reduce the number of patients requiring ICU, without compromising patients'
safety.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
abdominal aortic aneurysm (surgery)
abdominal aortic aneurysm repair
aneurysm surgery
clinical protocol
elective surgery
intensive care unit
EMTREE MEDICAL INDEX TERMS
article
hospital admission
hospitalization
human
major clinical study
morbidity
mortality
patient safety
postoperative complication (complication)
postoperative period
recovery room
retrospective study
university hospital
EMBASE CLASSIFICATIONS
Surgery (9)
Cardiovascular Diseases and Cardiovascular Surgery (18)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2011228950
MEDLINE PMID
21248672 (http://www.ncbi.nlm.nih.gov/pubmed/21248672)
PUI
L361664076
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 628
TITLE
Improving patient transfer between the Intensive Care Unit and the
Medical/Surgical floor of a 200-bed hospital in southern California.
AUTHOR NAMES
Kibler J.
Lee M.
AUTHOR ADDRESSES
(Kibler J.) Kaiser Permanente-Orange County, USA.
(Lee M.)
CORRESPONDENCE ADDRESS
J. Kibler, Kaiser Permanente-Orange County, USA.
SOURCE
Journal for healthcare quality : official publication of the National
Association for Healthcare Quality (2011) 33:1 (68-76). Date of Publication:
2011 Jan-Feb
ISSN
1062-2551
ABSTRACT
This paper describes the work of a front-line team at a 200-bed hospital in
southern California to improve the patient transfer process between the
Intensive Care Unit (ICU) and the Medical/Surgical floors. Using a phased
approach of assessing the problem, identifying opportunities, testing ideas,
and then implementing successful ideas, the team was able to improve patient
transfer time from the ICU to the Medical/Surgical Floor once the bed is
assigned from 6 to < 2 hr and to reduce the number of patients experiencing
extreme delays (more than 12 hr waits since the bed is assigned) from 15% to
0%. Also, as a corollary of this work, nursing overtime was reduced by 25%
year to year between March 2008 and March 2009 and patient satisfaction
scores were improved. A key success factor of the front-line team was the
implementation of a sustainability plan where metric and process
accountability is specified, together with alert flags for the metrics and
actions to take if the alert flags are triggered. © 2010 National
Association for Healthcare Quality.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
patient care
patient transport
EMTREE MEDICAL INDEX TERMS
article
human
organization and management
time
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
21199074 (http://www.ncbi.nlm.nih.gov/pubmed/21199074)
PUI
L361490667
DOI
10.1111/j.1945-1474.2010.00101.x
FULL TEXT LINK
http://dx.doi.org/10.1111/j.1945-1474.2010.00101.x
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 629
TITLE
Factors associated with hypothermia during intra-hospital transport in
patients assisted in a Neonatal Intensive Care Unit
ORIGINAL (NON-ENGLISH) TITLE
Fatores associados à hipotermia durante o transporte intra-hospitalar em
pacientes internados em unidade de terapia intensiva neonatal
AUTHOR NAMES
Vieira A.L.P.
Santos A.M.N.
Okuyama M.K.
Miyoshi M.H.
Almeida M.F.B.
Guinsburg R.
AUTHOR ADDRESSES
(Vieira A.L.P.) Da Disciplina de Pediatria Neonatal da Unifesp, São
Paulo/SP, Brazil.
(Santos A.M.N., ameliamiyashiro@yahoo.com.br; Okuyama M.K.; Miyoshi M.H.;
Almeida M.F.B.; Guinsburg R.) Da Disciplina de Pediatria Neonatal, Do
Departamento de Pediatria da Unifesp, São Paulo, SP, Brazil.
CORRESPONDENCE ADDRESS
A. M. N. Santos, Da Disciplina de Pediatria Neonatal, Do Departamento de
Pediatria da Unifesp, 764 - Vila Clementino, São Paulo, SP, Brazil. Email:
ameliamiyashiro@yahoo.com.br
SOURCE
Revista Paulista de Pediatria (2011) 29:1 (13-20). Date of Publication:
January/March 2011
ISSN
0103-0582
BOOK PUBLISHER
Sao Paulo Pediatric Society, Alameda Santos 211, Cerq cesar, Sao Paulo,
Brazil.
ABSTRACT
Objective: To determine frequency and factors associated with hypothermia
during intra-hospital transports of patients assisted in a neonatal
intensive care unit (NICU). Methods: Cross-sectional study nested in a
prospective cohort of infants submitted to intra-hospital transports
performed by a trained team from January 1997 to December 2008 at a NICU of
a public university hospital. Transports of patients aged more than one year
and/or with weight higher than 10kg were excluded. Factors associated with
hypothermia during intra-hospital transports were studied by logistic
regression analysis.Results: Among the 1,197 transports performed during the
studied period, 1,191 (99.5%) met the inclusion criteria. The 640
transported infants had mean gestational age of 35.0±3.8 weeks and birth
weight of 2341±888g. They presented the following underline diseases: single
or multiple malformations (71.0%), infections (7.7%), peri/intraventricular
hemorrhage (5.5%), respiratory distress (4.0%) and others (11.1%). Patients
were transported for surgical procedures (22.6%), magnetic resonance
(10.6%), tomography imaging (20.9%), contrasted exams (18.2%), and others
(27.7%). Hypothermia occurred in 182 (15.3%) transports and was associated
with (OR; 95%CI): weight at transport <1000g (3.7; 1.4-9.9), weight at
transport 1000-2500g (1.5; 1.0-2.2), pre-transport axillary temperature
<36.5°C (2.0; 1.4-2.9), central nervous system malformation (2.8; 1.8-4.4);
use of supplemental oxygen (1.6; 1.0-2.5); mechanical ventilation prior to
transport (2.5; 1.5-4.0); transport for surgeries (1.7; 1.0-2.7) and the
years 2001, 2003 and 2006 (protection factors). Conclusions: Intra-hospital
transports presented increased risk for hypothermia, showing that this kind
of transport should be done by skilled teams with adequate equipment.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hypothermia (complication)
patient transport
EMTREE MEDICAL INDEX TERMS
apnea (complication)
article
artificial ventilation
birth weight
body temperature measurement
brain hemorrhage
congenital malformation
controlled study
cross-sectional study
female
gestational age
human
hyperglycemia (complication)
hyperoxia
infant
major clinical study
male
neonatal respiratory distress syndrome
newborn infection
newborn intensive care
nuclear magnetic resonance imaging
oxygen supply
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
Portuguese
LANGUAGE OF SUMMARY
English, Portuguese, Spanish
EMBASE ACCESSION NUMBER
2011248072
PUI
L361708007
DOI
10.1590/S0103-05822011000100003
FULL TEXT LINK
http://dx.doi.org/10.1590/S0103-05822011000100003
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 630
TITLE
Use of telemedicine and helicopter transport to improve stroke care in
remote locations
AUTHOR NAMES
Saler M.
Switzer J.A.
Hess D.C.
AUTHOR ADDRESSES
(Saler M.; Switzer J.A.; Hess D.C., dhess@mcg.edu) Department of Neurology,
Georgia Health Sciences University, 1122 15th Street, Augusta, GA 30912,
United States.
CORRESPONDENCE ADDRESS
D. C. Hess, Department of Neurology, Georgia Health Sciences University,
1122 15th Street, Augusta, GA 30912, United States. Email: dhess@mcg.edu
SOURCE
Current Treatment Options in Cardiovascular Medicine (2011) 13:3 (215-224).
Date of Publication: June 2011
ISSN
1092-8464
BOOK PUBLISHER
Springer Healthcare
ABSTRACT
Opinion statement: Intravenous recombinant tissue plasminogen activator is
the only medication approved by the US Food and Drug Administration for
treatment of acute stoke. Despite established efficacy, less than 3% of
stroke patients receive treatment, and that number is even smaller for
patients living in remote locations. This is in part due to a lack of
neurologists and stroke specialists in these rural communities. The
traditional model of "ship and drip" wastes crucial time, resulting in
delays or loss of treatment. In this review, we discuss strategies to
overcome geographic disparities in stroke care and improve acute treatment
in remote locations. Helicopter transport from field to stroke center is one
option to rapidly deliver patients to stroke centers. However, geography,
weather, and unnecessary transport are potential drawbacks. Alternatively,
"telestroke" facilitates remote evaluation of acute stroke patients via an
audiovisual link and transmission of computerized tomography images. Despite
the physical separation, stroke specialists are able to examine patients,
review brain imaging and make correct treatment decisions; transfer to a
stroke center can then be performed as appropriate. A cost-benefit analysis
of telestroke is needed, although the recent proliferation of telestroke
networks suggests an economic asset to some hospital systems. © 2011
Springer Science+Business Media, LLC.
EMTREE DRUG INDEX TERMS
tissue plasminogen activator (drug therapy, intravenous drug administration)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
cerebrovascular accident (drug therapy, diagnosis, drug therapy)
helicopter
telemedicine
EMTREE MEDICAL INDEX TERMS
article
computer assisted tomography
cost benefit analysis
health care cost
health care facility
health care management
health care quality
health care utilization
health service
human
medical decision making
medical specialist
rural health care
stroke patient
stroke unit
CAS REGISTRY NUMBERS
tissue plasminogen activator (105913-11-9)
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Health Policy, Economics and Management (36)
Drug Literature Index (37)
Neurology and Neurosurgery (8)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2011259958
PUI
L51337359
DOI
10.1007/s11936-011-0124-y
FULL TEXT LINK
http://dx.doi.org/10.1007/s11936-011-0124-y
COPYRIGHT
Copyright 2014 Elsevier B.V., All rights reserved.
RECORD 631
TITLE
We're heading to music city: 19(th) critical care transport medicine
conference
AUTHOR NAMES
Newman M.
Petersen P.
Wojdyla K.
AUTHOR ADDRESSES
(Newman M.; Petersen P.; Wojdyla K.)
CORRESPONDENCE ADDRESS
M. Newman,
SOURCE
Air Medical Journal (2011) 30:1 (32-33). Date of Publication:
January-February 2011
ISSN
1067-991X
1532-6497 (electronic)
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
medical education
EMTREE MEDICAL INDEX TERMS
article
emergency care
health care personnel
human
injury
medical profession
paramedical profession
priority journal
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2011018102
PUI
L361056943
DOI
10.1016/j.amj.2010.10.006
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2010.10.006
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 632
TITLE
Keeping patients safe during intrahospital transport
AUTHOR NAMES
Day D.
AUTHOR ADDRESSES
(Day D., daday@queens.org) Emergency Department, The Queens Medical Center,
Honolulu, HI, United States.
CORRESPONDENCE ADDRESS
D. Day, Emergency Department, The Queens Medical Center, 1301 Punchbowl St,
Honolulu, HI 96813, United States. Email: daday@queens.org
SOURCE
Critical Care Nurse (2010) 30:4 (18-32). Date of Publication: 2010
ISSN
0279-5442
BOOK PUBLISHER
American Association of Critical Care Nurses, 101 Columbia, Suite 100, Aliso
Viejo, United States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient care
patient transport
safety
EMTREE MEDICAL INDEX TERMS
article
artificial ventilation
devices
human
intensive care unit
methodology
monitoring
nursing
nursing assessment
organization and management
practice guideline
LANGUAGE OF ARTICLE
English
MEDLINE PMID
20436033 (http://www.ncbi.nlm.nih.gov/pubmed/20436033)
PUI
L362416331
DOI
10.4037/ccn2010446
FULL TEXT LINK
http://dx.doi.org/10.4037/ccn2010446
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 633
TITLE
The condition of neonatal transport to NICU in Mazandaran
AUTHOR NAMES
Nakhshab M.
Vosughi E.
AUTHOR ADDRESSES
(Nakhshab M., pegahch@yahoo.com) Department of Pediatrics, Faculty of
Medicine, Mazandaran University of Medical Science, Sari, Iran.
(Vosughi E., pegahch@yahoo.com) Mazandaran University of Medical Science,
Sari, Iran.
CORRESPONDENCE ADDRESS
M. Nakhshab, Department of Pediatrics, Faculty of Medicine, Mazandaran
University of Medical Science, Sari, Iran. Email: pegahch@yahoo.com
SOURCE
Journal of Mazandaran University of Medical Sciences (2010) 20:78 (49-57).
Date of Publication: 2010
ISSN
1735-9279
1735-9260 (electronic)
BOOK PUBLISHER
Mazandaran University of Medical Sciences, No.2, Moallem Square, Sari,
Mazandaran, Iran.
ABSTRACT
Background and purpose: Appropriate transport of ill neonates to the
tertiary level of Neonatal Intensive Care Units (NICUs) is an important
factor in their survival. Identifying important factors in neonatal
transport may have a major role in prognosis and survival rates of neonates.
The present study was designed to assess the current situation and problems
of ill neonates transport to the NICU of BuAli teaching hospital. Materials
and methods: In this descriptive study, data of all of the transported
neonates to Sari Buali NICU from throughout Mazandaran were collected for a
period of 6 months. Data collected include neonatal maternal demographic
information and neonatal outcome recorded at BuAli hospital and
stabilization of the neonate before transport and at arrival to BuAli
hospital and the situation of the referral hospital at the time of
admission, recorded by transport team from original hospital. Data were
analyzed using SPSS software. Results: In total, 148 neonates were
transferred to BuAli NICU, with the most prevalent gestational age between
28 to34 weeks (32.4%) and the majority in the first 24 hour of birth
(69.6%). The most frequent reason of transport was RDS (65.5%) and TTN
(12.8%). Only 50% of the patients had ABG, CXR and BS checked for
stabilization purposes before transport and 10.1% of them were hypothermic.
Sari Imam Khomeini hospital had the majority cases of transport (68.2%). The
referral hospital situation was appropriate except for the impaired elevator
(12.8%). Of those 148 neonates, 26 neonates (17.6%) died. In this study the
correlation between gestational age and APGAR score with neonatal mortality
was statistically significant. Conclusion: The process of current neonatal
transport in Mazandaran needs to be improved in terms of a regionalized
program, communication system, optimal equipment, skilled personnel, etc. It
is hoped that the findings of this study would be helpful to prepare a
practical program for neonatal transport in Mazandaran.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
newborn intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
Apgar score
article
blood gas analysis
correlation analysis
gestational age
hospital building
human
hypothermia
Iran
major clinical study
newborn
newborn mortality
outcome assessment
patient referral
respiratory distress syndrome
teaching hospital
thorax radiography
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
Persian
LANGUAGE OF SUMMARY
English, Persian
EMBASE ACCESSION NUMBER
2011051288
PUI
L361160984
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 634
TITLE
Critical care transport in a combat environment: building tactical trauma
transport teams before and during deployment.
AUTHOR NAMES
Hudson T.L.
Morton R.
AUTHOR ADDRESSES
(Hudson T.L.; Morton R.)
CORRESPONDENCE ADDRESS
T.L. Hudson, Email: gateway5362@hotmail.com
SOURCE
Critical care nurse (2010) 30:6 (57-66; quiz 67). Date of Publication: Dec
2010
ISSN
1940-8250 (electronic)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
intensive care
military nursing
nursing education
patient care
patient transport
EMTREE MEDICAL INDEX TERMS
article
cooperation
curriculum
education
evidence based practice
human
interpersonal communication
nurse attitude
organization and management
practice guideline
program development
public relations
quality control
teaching round
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
21123233 (http://www.ncbi.nlm.nih.gov/pubmed/21123233)
PUI
L360282253
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 635
TITLE
Post-intubation chest x-ray during pediatric/neonatal critical care
transport: Is itworththe wait?
AUTHOR NAMES
Garrett L.
Giuliano J.
Schwartz H.
Bigham M.
AUTHOR ADDRESSES
(Garrett L.; Bigham M.) Akron Children's Hospital, United States.
(Giuliano J.) Yale-New Haven Children'S Hospital, United States.
(Schwartz H.) Cincinnati Children's Hospital, United States.
CORRESPONDENCE ADDRESS
L. Garrett, Akron Children's Hospital, United States.
SOURCE
Critical Care Medicine (2010) 38 SUPPL. 12 (A15). Date of Publication:
December 2010
CONFERENCE NAME
40th Critical Care Congress of the Society of Critical Care Medicine
CONFERENCE LOCATION
San Diego, CA, United States
CONFERENCE DATE
2011-01-15 to 2011-01-19
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: The Institute of Medicine has identified 6 features of
high-quality healthcare, one of which is efficiency. In pedic/neo specialty
critical care transport (P/N SCCT) some believe that a post-intubation chest
xray (PI CXR) at the referral hospital is unnecessary and adds to transport
inefficiency. Published neo/pedi data from theORand ICUs have found high
rates ofETTmalpositioning (15-34%) using published ETT depth/size criteria
(PALS, NRP, Braselow) and report the insensitivity of clinical exam in
confirming correct ETT positioning. The purpose of this study is to explore
the value of PICXRin the P/N SCCT setting. Hypothesis:Wehypothesize that
PICXRin neo/pedi intubated by a P/N SCCT team is unnecessary and can be
eliminated to improve efficiency. Methods: This IRB-approved,
non-intervention study included all intubations performed by the P/N SCCT
team during over 18 months. A data tool was completed by the transport nurse
after each trip where intubation was required. Data were tabulated and
analyzed using Microsoft Excel and SPSS v17.0. Results: 77 patients (34
neo/43 pedi) were enrolled. The neo averaged 2.1±1.0kg with mean gestational
age of 31.9±5.1wks. Pedi averaged 9.8±11.7kg and 1.8±3.9yrs. PICXRwas
obtained in 66 of patients (85.3% neo, 86% pedi) and PI CXR showed
malpositioned ETT in 48.5% of patients. The trend of ETT malpositioning by
PI CXR was more common in neo vs pedi (55% vs 37%, p=0.10). Neo ETT
malpositions were more commonly deep whereas shallow ETT placement errors
were more common in pedi. Neo ETT were moved 0.7±0.5cm vs 0.9±0.5 cm in
pedi. Initial ETT depth was incorrectly calculated according to PALS (3x ETT
inner diameter)/NRP in 50% neo and 58% pedi. PI CXR verified acceptable ETT
positioning despite incorrectly calculated ETT depth in 41% neos and 56%
pedi. PI CXR with subsequent ETT repositioning in appropriately calculated
ETT occurred in both groups (neo 35% and pedi 72%, p=0.03). Conclusions: PI
CXR remains informative for infants/children intubated by the P/N SCCT team.
The trend showed ETT malpositioning was more common in neos. There are
opportunities for improvement in correctly calculating appropriate ETT depth
though this should not obviate the need for PI CXR.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
intubation
society
thorax radiography
EMTREE MEDICAL INDEX TERMS
gestational age
health care
hospital
hypothesis
intervention study
nurse
patient
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70317280
DOI
10.1097/01.ccm.0000390903.16849.8c
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000390903.16849.8c
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 636
TITLE
Measuring and improving disinfection in critical care transport vehicles
AUTHOR NAMES
Sulis C.
Estanislao R.
Frakes M.
Carling P.
Wedel S.
AUTHOR ADDRESSES
(Sulis C.; Carling P.) Boston Medical Center, United States.
(Estanislao R.; Frakes M.; Wedel S.) Boston MedFlight, United States.
CORRESPONDENCE ADDRESS
C. Sulis, Boston Medical Center, United States.
SOURCE
Critical Care Medicine (2010) 38 SUPPL. 12 (A19). Date of Publication:
December 2010
CONFERENCE NAME
40th Critical Care Congress of the Society of Critical Care Medicine
CONFERENCE LOCATION
San Diego, CA, United States
CONFERENCE DATE
2011-01-15 to 2011-01-19
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: Environmental contamination of medical equipment and high
touch surfaces is believed to play a role in pathogen transmission in
hospitals. There are hospital systems to assess completeness of cleaning. In
critical care transport (CCT) vehicles, teams are expected to disinfect
potentially contaminated surfaces after each transport and are taught that
disinfection is a key component of the infection control program and the
safety culture. Cleaning has not been assessed in CCT vehicles in the same
manner as in hospitals. Hypothesis: A novel method to evaluate cleaning of
CCT vehicles will provide objective data and improve performance. Methods:
An investigator evaluated ten targets common to all transport vehicles using
a previously validated fluorescent marking dye method. Cleaning was
considered 'complete' if the fluorescent mark was totally removed from the
target 24 hours after marking. Targets included wall and portable suction,
defibrillator (buttons, touch screen), ventilator (on/off switch, reset
buttons), and monitor (BP and EKG recorders, touch screen). After baseline
data collection, a review of updated disinfection practices was completed in
in response to the appearance of pandemic Influenza. Follow-up data were
collected 2, 8, and 14 months after that review. Results: 2310 standardized
targets (10 objects) were assessed for outcomes comparisons. Overall,
cleaning improved from 12% to 75% of all items evaluated, p <0.00005) and
improved in each vehicle type (rotor wing 12% to 79% of all items cleaned;
fixed wing 2% to 75%, ground 18% to 68%; p<0.00005 for all). There was not a
consistent pattern by vehicle type. By the end of the study, several targets
were cleaned > 90% of the time (the monitor screen and controls and the
ventilator controls) regardless of vehicle type. Conclusions: This is the
first use of an objective method to assess cleaning of CCT vehicles. After
identifying an opportunity for improvement, re-education and objective
feedback improved performance by more than 6-fold. Potential causes of
incomplete cleaning include shared responsibility for disinfection (no
single crew member assigned), ineffective technique, or competing priorities
related to patient management.
EMTREE DRUG INDEX TERMS
dye
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
disinfection
intensive care
society
EMTREE MEDICAL INDEX TERMS
contamination
defibrillator
education
feedback system
follow up
forelimb
hospital
hospital planning
hypothesis
infection control
information processing
medical device
pandemic influenza
pathogenesis
patient care
recorder
responsibility
safety
suction
ventilator
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70317297
DOI
10.1097/01.ccm.0000390903.16849.8c
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000390903.16849.8c
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 637
TITLE
Preoperative conditions as predictors of ICU transfer after interventional
cardiology in children with congenital heart disease
AUTHOR NAMES
Pino G.
De Miguel M.
Méndez D.
AUTHOR ADDRESSES
(Pino G.; De Miguel M.; Méndez D.) Department of Paediatric Anaesthesiology,
Children's Hospital Doce de Octubre, Madrid, Spain.
CORRESPONDENCE ADDRESS
G. Pino, Department of Paediatric Anaesthesiology, Children's Hospital Doce
de Octubre, Madrid, Spain.
SOURCE
Paediatric Anaesthesia (2010) 20:12 (1130). Date of Publication: December
2010
CONFERENCE NAME
European Congress of Paediatric Anaesthesiology, ESPA 2010
CONFERENCE LOCATION
Berlin, Germany
CONFERENCE DATE
2010-09-02 to 2010-09-04
ISSN
1155-5645
BOOK PUBLISHER
Blackwell Publishing Ltd
ABSTRACT
Introduction: The aim of this study is to investigate possible correlation
between the event of ICU transfer of paediatric patients after
interventional cardiology and three preoperative conditions of those
patients: age, congenital heart disease and catheterisation procedure.
Methods: Retrospective study of all cardiac interventional catheterisations
performed in the Children's Hospital Doce de Octubre (Madrid) from June 2008
to December 2009. A total of 263 patients were treated, being nenonates 27
of them, who were removed from the study because they must be always
transferred to ICU. Moreover, six patients went to the operating room due to
emergencies appeared during the catheterisation (two of them were neonates).
The rest of patients (232), have been classified following three different
preoperative conditions. Depending on the severity of their congenital heart
disease in: group A (ASD, VSD and PDA), with 97 patients (41.8%); and group
B (HLHS, TGA, Fallot, pulmonary atresia, aortic stenosis, atrioventricular
canal defects,...), with 135 patients (52.8%). Depending on the type of
catheterisation in: diagnosis, with 78 patients (33.6%); or interventional
(balloon angioplasty, closure of arterial ducts and atrial and ventricular
septal defects, coil embolisations, stents,...), with 154 patients (66.4%).
With the third criteria, the age, in: children younger than 2 years, with 70
patients (30.2%); and children with 2 years or older, 162 patients (69.8%).
Analysing the three criteria separately, it has been investigated if the
incidence of ICU transfer in these groups is significantly different from
the incidence on the total sample. The Pearson's Chi-square Test has been
used for evaluating the statistical significance. Results: From the sample
of 232 patients, 55 were transferred to the ICU (23.7%). According to the
congenital heart disease, 45 patients from group B were transferred to ICU
after the catheterisation (33.3%). According to the catheterisation
procedure, 38 patients that had interventional catheterisation were
transferred to the ICU (24.7%). Finally, regarding the age, 31 children
below 2 years went to ICU after the intervention (44.3%). Comparative
results can be seen in Figure 1. Conclusions: The most significant
preoperative criterion as predictor of the ICU transfer after a
catheterisation procedure appears to be the age (P < 0.0001). The congenital
heart disease also implies a significant variation in the incidence of ICU
transfer (P < 0.0034). But the results seem to indicate that the
catheterisation procedure does not have an impact in the probability of
going to the ICU (P < 0.78). Therefore, children below 2 years old have to
be considered as most probable candidates to need intensive care after an
interventional cardiology procedure, without discarding other preoperative
conditions.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
anesthesiology
cardiology
child
congenital heart disease
human
EMTREE MEDICAL INDEX TERMS
aortic stenosis
atrioventricular canal
catheterization
chi square test
diagnosis
emergency
heart ventricle septum defect
intensive care
newborn
operating room
patient
pediatric hospital
percutaneous transluminal angioplasty
pulmonary valve atresia
retrospective study
statistical significance
stent
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70485209
DOI
10.1111/j.1460-9592.2010.03446.x
FULL TEXT LINK
http://dx.doi.org/10.1111/j.1460-9592.2010.03446.x
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 638
TITLE
Predictors of icu transfer in patients who develop modified SIRS criteria
AUTHOR NAMES
Young M.
Hooper M.
Gowda S.
Bernard G.
Wheeler A.
Weavind L.
Rice T.
AUTHOR ADDRESSES
(Young M.; Hooper M.; Gowda S.; Bernard G.; Wheeler A.; Weavind L.; Rice T.)
Vanderbilt University Medical Center, United States.
CORRESPONDENCE ADDRESS
M. Young, Vanderbilt University Medical Center, United States.
SOURCE
Critical Care Medicine (2010) 38 SUPPL. 12 (A115). Date of Publication:
December 2010
CONFERENCE NAME
40th Critical Care Congress of the Society of Critical Care Medicine
CONFERENCE LOCATION
San Diego, CA, United States
CONFERENCE DATE
2011-01-15 to 2011-01-19
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: Sepsis is defined as the systemic inflammatory response
syndrome (SIRS) secondary to infection, and it commonly occurs in
hospitalized patients. Patient characteristics which predict transfer to an
ICU in patients with SIRS are not entirely understood. Hypothesis: We
hypothesized that demographics, baseline characteristics, and physiologic
parameters would predict the need for ICU transfer in a cohort of general
medical patients with modified SIRS criteria. Methods: We studied 207
patients on medical wards at Vanderbilt Hospital who met modified SIRS
criteria (at least one abnormal criterion being temperature or WBC count).
We compared 117 consecutive patients who required transfer to the MICU with
90 consecutive patients who did not. We collected data on baseline
demographics, comorbidities, physiologic condition, severity of illness, and
clinical outcomes. Results: Patients transferred to the ICU were similar in
age to those not transferred (54 vs. 58y, p = 0.11). Transferred patients
were more likely to be male (p < 0.049) and on chronic dialysis (p = 0.026),
and less likely to be immunosuppressed (p < 0.001) or have chronic lung
disease (p = 0.025). At the time they met SIRS criteria, patients
transferred to the ICU were more likely to be septic (p=0.014) and in shock
(p=0.001) with higher WBC count (13.8 vs. 7.4, p < 0.001), heart rate (120
vs. 94, p < 0.001), respiratory rate (31 vs. 20, p < 0.001), and temperature
(37.6 vs. 37.1, p = 0.001). The rate of positive blood cultures after
enrollment was similar between groups (p = 0.375). In regards to outcome,
patients requiring ICU transfer were more likely to be transferred to a
skilled-nursing facility (p=0.001) or die during the 28-day study period
(p<0.001). Conclusions: Our data suggests that in hospitalized patients
meeting modified SIRS criteria at a tertiary care medical center, male
gender and more severe derangements of individual SIRS criteria were
associated with ICU transfer. Chronic dialysis was also associated with ICU
transfer, but other comorbidities were not. We propose that additional
studies of patients in other hospital settings may lead to improved models
for predicting which patients with modified SIRS criteria should be
transferred to an ICU.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient
society
EMTREE MEDICAL INDEX TERMS
blood culture
breathing rate
chronic lung disease
dialysis
gender
general aspects of disease
heart rate
hospital
hospital patient
hypothesis
infection
leukocyte count
male
model
nursing home
sepsis
systemic inflammatory response syndrome
temperature
tertiary health care
ward
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70317616
DOI
10.1097/01.ccm.0000390903.16849.8c
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000390903.16849.8c
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 639
TITLE
Whenspace is an issue: Use of video assisted laryngoscopy by critical care
personnel in aeromedical transport
AUTHOR NAMES
Cambridge R.
Haisler R.
AUTHOR ADDRESSES
(Cambridge R.; Haisler R.) OSF St. Francis Medical Center, United States.
CORRESPONDENCE ADDRESS
R. Cambridge, OSF St. Francis Medical Center, United States.
SOURCE
Critical Care Medicine (2010) 38 SUPPL. 12 (A129). Date of Publication:
December 2010
CONFERENCE NAME
40th Critical Care Congress of the Society of Critical Care Medicine
CONFERENCE LOCATION
San Diego, CA, United States
CONFERENCE DATE
2011-01-15 to 2011-01-19
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: During critical care transport of a patient in a standard
civilian helicopter, airway management is hindered due to cramped
conditions.Video assisted (VA) laryngoscopy may offer an advantage over
traditional directly visualized (TDV) laryngoscopy for in-flight airway
placement. Hypothesis: Endotracheal intubation success and procedural time
is improved using VA laryngoscopy as compared to TDV laryngoscopy in a
suboptimal placed simulated patient. Methods: Study participants were asked
to attempt intubation twice (medical and trauma scenarios) on a mannequin
airway simulator in a civilian helicopter (Bell 230). Participants were
randomized to the VA or TDV group and sat in the forward facing seat with
the simulator's head against the rear bulkhead preventing standard operator
positioning. Participants attempted airway visualization and indicated when
they noted the best view of the larynx (based on the modified Cormack-Lehane
scale). The participant then attempted endotracheal intubation, calling out
when they completed their attempt. Tube location was verified by
investigators after the attempt, and larynx view and attempt completion
times were recorded. Results: Thirty subjects of varying training levels (EM
residents, CCRNs, and paramedics) participated (17 in VA group, 13 in TDV
group). No significant differences in training levels between the groups was
noted (p= 2.85). The VA group was more successful than the TDV group in
endotracheal intubation (33/34 (97.1%) vs. 21/26 (80.8%); p= 0.037). While
VA provided a faster mean optimal view of the larynx (8.8 seconds vs. 18.5
seconds; p= 19.7), the confidence intervals overlapped. The mean time to
intubation completion was similar for both methods (VA 25.87 seconds vs. TDV
25.64 seconds; p= 0.01). There were no significant differences in time to
best view (p= 0.65) or time to intubation completion (p= 0.18) for scenario
type. Conclusions: VA laryngoscopy provided a greater likelihood of
successful tracheal intubation as compared to TDV in a simulated helicopter
patient. VA laryngoscopy had no time advantage over TDV laryngoscopy for
laryngeal view or subsequent endotracheal tube placement.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
intensive care
laryngoscopy
personnel
society
videorecording
EMTREE MEDICAL INDEX TERMS
airway
confidence interval
endotracheal intubation
endotracheal tube
flight
helicopter
hypothesis
injury
intubation
larynx
patient
simulator
tube
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70317667
DOI
10.1097/01.ccm.0000390903.16849.8c
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000390903.16849.8c
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 640
TITLE
Improving adverse drug event detection in critically ill patients through
intensive care unit transfer summary screening
AUTHOR NAMES
Anthes A.
Kane-Gill S.
Harinstein L.
Smithburger P.
Seybert A.
AUTHOR ADDRESSES
(Anthes A.; Kane-Gill S.) University of Pittsburgh Medical Center, United
States.
(Harinstein L.) Cleveland Clinic, United States.
(Smithburger P.) University of Pittsburgh, School of Pharmacy, United
States.
(Seybert A.) University of Pittsburgh, United States.
CORRESPONDENCE ADDRESS
A. Anthes, University of Pittsburgh Medical Center, United States.
SOURCE
Critical Care Medicine (2010) 38 SUPPL. 12 (A137). Date of Publication:
December 2010
CONFERENCE NAME
40th Critical Care Congress of the Society of Critical Care Medicine
CONFERENCE LOCATION
San Diego, CA, United States
CONFERENCE DATE
2011-01-15 to 2011-01-19
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: Current ADE detection relies heavily on voluntary reporting
which results in underreporting. Hospital discharge notes have been studied
as a form of surveillance; however, ICU transfer summaries have not been
studied for this purpose. Improving ADE prevention strategies relies upon
improving detection. Hypothesis: ICU transfer summaries are an effective
tool for ADE detection. Methods: A retrospective electronic medical record
review was conducted among medical ICU patients. Inclusion criteria included
patients ≥ 18 years of age admitted between January through April 2009 with
an ICU length of stay ≥ 24 hours. Two scales were utilized to assess chart
documentation for ADEs: 1) Harvard Medical Practice Scale (MPS) and 2)
Leonard Evidence Assessment Scale. The Harvard MPS was used to rank the
strength or confidence of the wording in the medical record with a score of
4 (more than 50-50 but close), 5 (moderate/strong) or 6 (virtually certain)
indicating the presence of an ADE. The Leonard scale was used to score
causality and included objective markers such as presence of symptoms or if
an antidote or counteracting procedure occurred. Leonard scores of 1 out of
4 indicated unlikely ADE, 2 of 4 possible, 3 of 4 probable and 4 of 4 a
certain ADE. Results: Preliminary demographic information indicates 50% of
the patients were male with a mean age of 60.3 years (+/- 16). 258 unique
patients had ICU transfer summaries screened and evaluated for ADEs. 105
patients had at least 1 ADE with a total of 139 ADEs. The Harvard MPS scores
collected were 4 (39.6%), 5 (51.8%) and 6 (7.9%). The Leonard scores were 2
of 4 (17.3%), 3 of 4 (54.7%) and 4 of 4 (28.1%). Most common medications
associated with an ADE were furosemide, ciprofloxacin, warfarin and heparin.
Most common ADEs were Clostridium difficile, hypotension, acute kidney
injury and hyperglycemia. Conclusions: 41% of ICU transfer summaries
contained a description of an ADE; therefore, reviewing ICU transfer
summaries is a useful method of detecting ICU-specific ADEs and should be
considered as part of an ADE surveillance system. Understanding contributing
medications and resulting reactions of ADEs will aid in future prevention
strategies.
EMTREE DRUG INDEX TERMS
antidote
ciprofloxacin
furosemide
heparin
marker
warfarin
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
adverse drug reaction
critically ill patient
intensive care
intensive care unit
screening
society
EMTREE MEDICAL INDEX TERMS
documentation
drug therapy
electronic medical record
epidemiology
hospital discharge
hyperglycemia
hypotension
hypothesis
kidney injury
length of stay
male
medical practice
medical record
medical record review
patient
Peptoclostridium difficile
prevention
voluntary reporting
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70317694
DOI
10.1097/01.ccm.0000390903.16849.8c
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000390903.16849.8c
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 641
TITLE
Icu transfers from inpatient units: How many result from adverse events and
are they preventable?
AUTHOR NAMES
Miles A.
Jacobs B.
Stockwell D.
AUTHOR ADDRESSES
(Miles A.; Jacobs B.; Stockwell D.) Children's National Medical Center,
United States.
CORRESPONDENCE ADDRESS
A. Miles, Children's National Medical Center, United States.
SOURCE
Critical Care Medicine (2010) 38 SUPPL. 12 (A173). Date of Publication:
December 2010
CONFERENCE NAME
40th Critical Care Congress of the Society of Critical Care Medicine
CONFERENCE LOCATION
San Diego, CA, United States
CONFERENCE DATE
2011-01-15 to 2011-01-19
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: Unplanned transfers to an ICU from inpatient units may result
from adverse events (AEs). Preventative strategies to mitigate AEs leading
to ICU transfer can be implemented once risk factors are identified.
Hypothesis: We hypothesized that AEs account for a significant rate of ICU
transfers and that some may be preventable. Methods: A retrospective
observational study of ICU transfers from inpatient units during a 6 month
interval in a tertiary care children's hospital. Transfers were
electronically identified via the electronic health record then investigated
to establish if an AE had occurred. The preventability of the AE and
associated patient harm were determined. Predefined AEs included ICU
transfers in less than (<) 12 hours of hospital admission, re-admissions to
an ICU in less than (<) 24 hours after ICU discharge, and cardiopulmonary
arrest events. AEs that did not meet these criteria were examined for causes
and trends. Results: 249 ICU transfers occurred and 48 (19.3%) were
attributed to AEs. 29 (60.4%) were transfers in <12 hours of admission, 5
(10.4%) were ICU readmissions in <24 hours of ICU discharge, and 8 (16.7%)
were cardiopulmonary arrests. The remainder (12.5%) included postoperative
complications (3), medication effects (1), electrolyte derangements (1), and
hypotension (1). The most common diagnosis associated with AE related
transfer was respiratory distress (25, 52.1%) with 18 (72%) transfers in<12
hours of admission. 15 (31.3%) AEs were determined to be preventable. Of
these,12 (80%) involved inappropriate triage with 8 ICU transfers in <2 hrs
of admission and 4 ICU readmissions in <24 hours. Other preventable AEs
included 2 (13.3%) cardiopulmonary arrests, and 1 (6.7%) patient with
unresolved hyponatremia. Of all 48 AEs, 42 (87.5%) resulted in prolonged
hospitalization and temporary harm, and 6 (12.5%) required
treatment/intervention, resulting in temporary harm. Conclusions: Nearly
one-fifth of unplanned ICU transfers resulted from AEs and almost a third
were preventable. Interventions directed at triage processes are likely to
reduce these events as many occurred early in admission. More than half of
AE-related ICU transfers were associated with respiratory distress.
EMTREE DRUG INDEX TERMS
electrolyte
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital patient
intensive care
society
EMTREE MEDICAL INDEX TERMS
cardiopulmonary arrest
diagnosis
drug therapy
emergency health service
hospital admission
hospitalization
hyponatremia
hypotension
hypothesis
medical record
observational study
patient
pediatric hospital
postoperative complication
respiratory distress
risk factor
tertiary health care
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70317809
DOI
10.1097/01.ccm.0000390903.16849.8c
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000390903.16849.8c
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 642
TITLE
Multi-disciplinary quality improvement projects canresult inimprovementsin
transfer timesfrom the emergency department to the pediatric intensive care
unit
AUTHOR NAMES
Silverman A.
Carroll C.
Morgan-Gorman K.
Cahill J.
Koss M.
Sears-Russell N.
Howard K.
AUTHOR ADDRESSES
(Silverman A.; Carroll C.; Morgan-Gorman K.; Cahill J.; Koss M.;
Sears-Russell N.; Howard K.) Connecticut Children's Medical Center, United
States.
CORRESPONDENCE ADDRESS
A. Silverman, Connecticut Children's Medical Center, United States.
SOURCE
Critical Care Medicine (2010) 38 SUPPL. 12 (A27). Date of Publication:
December 2010
CONFERENCE NAME
40th Critical Care Congress of the Society of Critical Care Medicine
CONFERENCE LOCATION
San Diego, CA, United States
CONFERENCE DATE
2011-01-15 to 2011-01-19
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: Once a decision is made to admit a child to a pediatric
intensive care unit (PICU) from a pediatric emergency department (PED), it
is crucial that this intrahospital transfer occur in a timely fashion.We
identified reducing the time of transfer of these critically ill children as
an important quality improvement goal.Because of unit staff skills, level of
monitoring and specialized modalities of care provided in the PICU, there
was consensus amongst the staff of both units that rapid transfer to the
PICU had the potential to improve the quality of care. Hypothesis: We
hypothesized that we could reduce the transfer time from the PED to the PICU
by identifying the steps involved in the transfer process and implementing
changes in these processes. Methods: Physicians and nurses met on multiple
occasions to identify specific steps involved in the transfer process
starting in October 2009.Intervention were begun in November 2009.Transfer
times were defined as the period between the time of decision to admit the
child to the PICU and the time of arrival in the PICU.Those steps that had
the potential for creating delays were analyzed monthly in greater depth by
multidisciplinary teams of nursing and physician leaders.Outliers were
analyzed in order to identify systemic changes that could streamline
process. Results: Comparing October 2009 to July 2010, average time of
transfer decreased from 60 minutes (n = 22) to 47 minutes (n = 27) with a
monthly range during that period of 30-61 minutes.Transfers that occurred
in≤30 minutes increased from 20 to 38%with a monthly range of 14 to 50%.On
aggregate, transfer times decreased from 62 = 40 minutes (April-October
2009, n = 144) to 52 ± 33 minutes (November 2009-July 2010, n=222)
(p=0.02).Identifiable sources or delay were difficulty in starting IVs,
delays in physician-to-physician sign out, delays in nurse-to-nurse sign out
and medicine delivery from pharmacy. Conclusions: Multidisciplinary quality
improvement projects can result in decreased times for transfer from the PED
to the PICU.Having specific targets on the Balanced Scorecard of both units
and having regular physician and nurse review of performance can help
achieve significant improvements.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency ward
intensive care
intensive care unit
society
total quality management
EMTREE MEDICAL INDEX TERMS
child
consensus
critically ill patient
hypothesis
monitoring
nurse
nursing
patient transport
pharmacy
physician
skill
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70317327
DOI
10.1097/01.ccm.0000390903.16849.8c
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000390903.16849.8c
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 643
TITLE
Delay in transfer from the surgical ICU: Incidence, causes and financial
impact
AUTHOR NAMES
Johnson D.
Bittner E.
Schmidt U.
Pino R.
AUTHOR ADDRESSES
(Johnson D.; Bittner E.; Schmidt U.; Pino R.) Massachusetts General
Hospital/Anesthesia, Critical Care and Pain Medicine, Harvard Medical
School, United States.
CORRESPONDENCE ADDRESS
D. Johnson, Massachusetts General Hospital/Anesthesia, Critical Care and
Pain Medicine, Harvard Medical School, United States.
SOURCE
Critical Care Medicine (2010) 38 SUPPL. 12 (A28). Date of Publication:
December 2010
CONFERENCE NAME
40th Critical Care Congress of the Society of Critical Care Medicine
CONFERENCE LOCATION
San Diego, CA, United States
CONFERENCE DATE
2011-01-15 to 2011-01-19
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: Minimal literature exists regarding ICU patients who are
medically ready to leave the ICU but experience a significant delay before
transfer to the floor. This study analyzed the incidence, causes and costs
of delayed transfer from a surgical ICU. Hypothesis: Delayed transfer from
the surgical ICU is common, is multi-factorial in cause, and has a
significant financial impact. Methods: An IRB-approved prospective
observational study was conducted from 1/24/2010 to 7/31/2010 of all 731
patients transferred from a 20-bed SICU. Data were collected on patients
deemed medically ready for transfer to the floor who remained in the SICU
for at least one extra day. Reasons for delay were examined. Economic
analysis was performed to evaluate the additional costs of delayed transfer
from the SICU. This was based on the difference in cost of ICU care versus
floor care. Results: Transfer to the floor was delayed in 22% (n=160) of the
731 patients transferred from the SICU. Delays ranged from 1 to 6 days (mean
1.5 days). The estimated additional cost of delayed transfer during the
27-week study period was $791, 628 ($29, 319 per week). The most common
reasons for delay in transfer were: lack of available surgical floor bed
[71% (114/ 160)], lack of room appropriate for infectious contact
precautions [18% (28/ 160)], change of primary service (Surgery to Medicine)
[7% (11/160)], and lack of available patient attendant (“sitter” for mildly
delirious patients) [3% (5/160)]. There was a positive association between
the daily hospital census and the daily number of SICU beds occupied by
patients delayed in transfer (Spearman's rho- 0.27, p < 0.0001). Delayed
patients were significantly more likely than nondelayed patients to be
transferred during night shifts, between 19:00 to 06:59, [21% (33/160)
versus 12% (67/571), chi square = 10.6, p < 0.005]. Conclusions: Delay in
transfer from the SICU is common and costly. The most common reason for this
delay was insufficient availability of surgical floor beds. Delay in
transfer was associated with high hospital census, and delayed patients were
more likely than non-delayed patients to be transferred during night shifts.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
society
EMTREE MEDICAL INDEX TERMS
hospital
hypothesis
night
observational study
patient
population research
surgery
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70317331
DOI
10.1097/01.ccm.0000390903.16849.8c
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000390903.16849.8c
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 644
TITLE
Impact of hospital-based pediatric transport team closure on transports and
transport requests to a pediatric intensive care unit
AUTHOR NAMES
Cummings B.
Yager P.
Riley J.A.
Carew A.
Noviski N.
AUTHOR ADDRESSES
(Cummings B.; Yager P.; Riley J.A.; Carew A.; Noviski N.) Massachusetts
General Hospital, United States.
CORRESPONDENCE ADDRESS
B. Cummings, Massachusetts General Hospital, United States.
SOURCE
Critical Care Medicine (2010) 38 SUPPL. 12 (A30). Date of Publication:
December 2010
CONFERENCE NAME
40th Critical Care Congress of the Society of Critical Care Medicine
CONFERENCE LOCATION
San Diego, CA, United States
CONFERENCE DATE
2011-01-15 to 2011-01-19
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: The impact of closing a hospital-based pediatric specialized
transport team on pediatric intensive care unit (PICU) admissions has not
been previously published. In 2003, our pediatric transport team was
discontinued and an out-of-the hospital independent specialized transport
team vendor was contracted to provide pediatric critical care transports.
Hypothesis: Closure of a hospital-based pediatric transport team has a
negative effect on requests for transports and on transport admissions to
the PICU. Methods: Review of internal PICU transport database over 9 year
period. Transport volume data by fiscal year were compared between
pre-change (1999-2002), transition year (2003), and post-change (2004-2007)
period. The number of lost PICU admissions was estimated based on the
average transports pre- and post- closure and factoring in zero as well as
observed growth and refusal rates after the change. Results: During the
above period, there were no changes in number of referring hospitals,
hospital transfer agreements or affiliations. Transports numbers went from
an average of 160/year pre-change, to 109 during the transition year to an
average of 145/year post-change. Requests to transport critically ill
patients to the PICU increased from an average of 169/year pre-change to an
average of 175/year post-change in association with increased community
outreach efforts. However, our refusal rate for transport requests increased
from 5% pre-change to 17% post-change. The transport vendor was unavailable
for transport for 13% of requests. Assuming no growth in the number of
transport requests, we estimate the loss of 187 patients for the PICU over
the 5 years post-change period. Moreover, if we use the observed annual
growth rate of 13% in transports requests, we estimate the loss of 364
patients during the same period. Conclusions: Closure of a hospital-based
pediatric specialized transport team affected transport activity. This
impact should be taken in consideration and strategies to mitigate it put in
place, whenever a similar change is considered.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital
intensive care
intensive care unit
society
EMTREE MEDICAL INDEX TERMS
community
critically ill patient
data base
growth rate
hypothesis
organization
patient
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70317338
DOI
10.1097/01.ccm.0000390903.16849.8c
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000390903.16849.8c
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 645
TITLE
Quality improvement of doctors' shift-change handover in neuro-critical
care.
AUTHOR NAMES
Lyons M.N.
Standley T.D.
Gupta A.K.
AUTHOR ADDRESSES
(Lyons M.N.) Postgraduate Medical Centre, The Clinical School, Cambridge
University Hospitals NHS Foundation Trust, Addenbrooke's Hospital,
Cambridge, UK.
(Standley T.D.; Gupta A.K.)
CORRESPONDENCE ADDRESS
M.N. Lyons, Postgraduate Medical Centre, The Clinical School, Cambridge
University Hospitals NHS Foundation Trust, Addenbrooke's Hospital,
Cambridge, UK. Email: melinda_lyons@hotmail.com
SOURCE
Quality & safety in health care (2010) 19:6 (e62). Date of Publication: Dec
2010
ISSN
1475-3901 (electronic)
ABSTRACT
Clinical handover is a necessary process for the continuation of safe
patient care; however, deficiencies in the handover process can introduce
error. While the number of handover studies increases, few have validated
implemented improvements with repeated audit. To improve the morning
handover round on a busy critical care unit and assess sustainability of
improvement through repeated audit. A quality improvement process based on
prospective observational assessment of the doctor's shift-change handover
was carried out, assessing the content of clinical information and effects
of distractions, location and timing. The effect of a training session for
the junior doctors with the introduction of a standardised handover protocol
was assessed. The content of clinical information improved after the
training session with introduction of a standardised protocol, but returned
to baseline with a new cohort of untrained doctors. Distractions were
associated with increased handover times for individual patients and for
total handover time. Overall, handover time was shortest in the coffee room
compared with ward and lecture theatre handovers. Individual patient
handover time was positively correlated with clinical content scores. Four
indices of critical illness all positively correlated with increased
handover time. Early specific training is vital for quality clinical
handover. Distractions during handover cause inefficiency and can adversely
affect information transfer. Changing handover location according to local
environment can yield improved efficiency, structure and ease of management.
Adequate time must be allocated for clinical handover especially when
dealing with very sick and complex patients.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health care quality
intensive care
neurologic disease
patient transport
physician attitude
EMTREE MEDICAL INDEX TERMS
article
checklist
clinical audit
human
interview
manpower
methodology
observation
organization and management
prospective study
United Kingdom
LANGUAGE OF ARTICLE
English
MEDLINE PMID
20427308 (http://www.ncbi.nlm.nih.gov/pubmed/20427308)
PUI
L360284621
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 646
TITLE
The risk of intrahospital transport to patients.
AUTHOR NAMES
Bambi S.
AUTHOR ADDRESSES
(Bambi S.)
CORRESPONDENCE ADDRESS
S. Bambi,
SOURCE
Critical care nurse (2010) 30:6 (14; author reply 14-16). Date of
Publication: Dec 2010
ISSN
1940-8250 (electronic)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
nursing research
patient transport
safety
EMTREE MEDICAL INDEX TERMS
cause of death
epidemiology
human
methodology
mortality
note
organization and management
radiography
risk factor
LANGUAGE OF ARTICLE
English
MEDLINE PMID
21123229 (http://www.ncbi.nlm.nih.gov/pubmed/21123229)
PUI
L360282249
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 647
TITLE
Safe intrahospital transport of non-ICU patients
AUTHOR NAMES
Huber C.
AUTHOR ADDRESSES
(Huber C., chuber@ecri.org) Pennsylvania Patient Safety Reporting System
(PA-PSRS), Plymouth Meeting, PA, United States.
CORRESPONDENCE ADDRESS
C. Huber, Pennsylvania Patient Safety Reporting System (PA-PSRS), Plymouth
Meeting, PA, United States. Email: chuber@ecri.org
SOURCE
American Journal of Nursing (2010) 110:11 (66-69). Date of Publication:
November 2010
ISSN
0002-936X
BOOK PUBLISHER
Lippincott Williams and Wilkins, 530 Walnut Street,P O Box 327,
Philadelphia, United States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
interdisciplinary communication
patient transport
safety
EMTREE MEDICAL INDEX TERMS
article
human
patient care
risk reduction
standard
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
20980907 (http://www.ncbi.nlm.nih.gov/pubmed/20980907)
PUI
L360011431
DOI
10.1097/01.NAJ.0000390531.14314.1c
FULL TEXT LINK
http://dx.doi.org/10.1097/01.NAJ.0000390531.14314.1c
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 648
TITLE
Transport of critically III neonates with cardiac conditions
AUTHOR NAMES
Lee J.H.
Puthucheary J.
AUTHOR ADDRESSES
(Puthucheary J.) Children's Intensive Care Unit, Department of Paediatric
Subspecialties, KK Women's and Children's Hospital, Singapore.
(Lee J.H., leejanhau@hotmail.com) 100 Bukit Timah Road, Singapore 229899,
Singapore.
CORRESPONDENCE ADDRESS
J. H. Lee, 100 Bukit Timah Road, Singapore 229899, Singapore. Email:
leejanhau@hotmail.com
SOURCE
Air Medical Journal (2010) 29:6 (320-322). Date of Publication:
November-December 2010
ISSN
1067-991X
1532-6497 (electronic)
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
congenital heart disease (congenital disorder)
critical illness
EMTREE MEDICAL INDEX TERMS
aortic coarctation (congenital disorder)
article
clinical article
cyanotic heart disease (congenital disorder)
heart right ventricle double outlet (congenital disorder)
human
intensive care unit
newborn
priority journal
pulmonary valve stenosis (congenital disorder)
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
Cardiovascular Diseases and Cardiovascular Surgery (18)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2010609732
MEDLINE PMID
21055647 (http://www.ncbi.nlm.nih.gov/pubmed/21055647)
PUI
L359905345
DOI
10.1016/j.amj.2010.05.001
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2010.05.001
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 649
TITLE
Ventilatory support in the intensive care unit
AUTHOR NAMES
Strachan L.
Hughes M.
AUTHOR ADDRESSES
(Strachan L.; Hughes M.) Royal Infirmary, Glasgow, United Kingdom.
CORRESPONDENCE ADDRESS
L. Strachan, Royal Infirmary, Glasgow, United Kingdom.
SOURCE
Anaesthesia and Intensive Care Medicine (2010) 11:11 (469-473). Date of
Publication: November 2010
ISSN
1472-0299
BOOK PUBLISHER
Elsevier Ltd, Langford Lane, Kidlington, Oxford, United Kingdom.
ABSTRACT
This article focuses on a classification of modes of mechanical ventilation,
the indications for and complications of invasive and non-invasive
mechanical ventilation and adjuncts to mechanical ventilation. © 2010
Elsevier Ltd. All rights reserved.
EMTREE DRUG INDEX TERMS
aldosterone (endogenous compound)
angiotensin (endogenous compound)
atrial natriuretic factor
heliox
nitric oxide
prostacyclin (drug therapy)
renin (endogenous compound)
sildenafil (drug therapy)
surfactant
vasopressin (endogenous compound)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
aeration
airway conductance
airway obstruction (therapy)
artificial ventilation
aspiration
asthmatic state
breathing pattern
bronchopleural fistula (complication)
chronic obstructive lung disease
computer assisted tomography
decubitus (complication)
endocrine disease (complication)
endotracheal tube
exhaustion (therapy)
extracorporeal oxygenation
fluid retention
fluid therapy
functional residual capacity
gastrointestinal hemorrhage
gastrointestinal motility disorder (complication)
Guillain Barre syndrome
heart output
hypercapnia (therapy)
hypoxemia (therapy)
invasive procedure
kidney blood flow
kyphoscoliosis
motor neuron disease
necrosis (complication)
negative pressure ventilation
neurologic disease
neuropathy (complication)
non invasive procedure
obesity hypoventilation syndrome
oxygen consumption
oxygen toxicity (complication)
positive end expiratory pressure
priority journal
pulmonary hypertension (drug therapy)
short survey
sinusitis (complication)
splanchnic blood flow
trachea stenosis (complication)
tracheoesophageal fistula (complication)
venous thromboembolism (complication)
ventilated patient
ventilator associated pneumonia (complication)
ventilator induced lung injury (complication)
vocal cord disorder (complication)
CAS REGISTRY NUMBERS
aldosterone (52-39-1, 6251-69-0)
angiotensin (1407-47-2)
atrial natriuretic factor (85637-73-6)
heliox (58933-55-4)
nitric oxide (10102-43-9)
prostacyclin (35121-78-9, 61849-14-7)
renin (61506-93-2, 9015-94-5)
sildenafil (139755-83-2)
vasopressin (11000-17-2)
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2010593920
PUI
L359842954
DOI
10.1016/j.mpaic.2010.08.012
FULL TEXT LINK
http://dx.doi.org/10.1016/j.mpaic.2010.08.012
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 650
TITLE
Endotracheal tube intracuff pressure during helicopter transport
AUTHOR NAMES
Bessereau J.
Coulange M.
Jacquin L.
Fournier M.
Michelet P.
AUTHOR ADDRESSES
(Bessereau J.; Coulange M.; Jacquin L.; Fournier M.; Michelet P.) Intensive
Care Unit and Hyperbaric Medicine, Pôle RUSH, Ste-Marguerite Hospital,
Marseille, France.
CORRESPONDENCE ADDRESS
J. Bessereau, Intensive Care Unit and Hyperbaric Medicine, Pôle RUSH,
Ste-Marguerite Hospital, Marseille, France.
SOURCE
Annals of Emergency Medicine (2010) 56:5 (583-584). Date of Publication:
November 2010
ISSN
0196-0644
1097-6760 (electronic)
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
EMTREE DRUG INDEX TERMS
sodium chloride
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
endotracheal tube
endotracheal tube cuff
pressure
EMTREE MEDICAL INDEX TERMS
air medical transport
atmospheric pressure
bronchospasm
dysphagia
helicopter
human
hyperbaric oxygen therapy
intensive care unit
letter
manometry
mucosal disease
priority journal
sore throat
CAS REGISTRY NUMBERS
sodium chloride (7647-14-5)
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Biophysics, Bioengineering and Medical Instrumentation (27)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2010605012
MEDLINE PMID
21036300 (http://www.ncbi.nlm.nih.gov/pubmed/21036300)
PUI
L359886210
DOI
10.1016/j.annemergmed.2010.04.031
FULL TEXT LINK
http://dx.doi.org/10.1016/j.annemergmed.2010.04.031
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 651
TITLE
Emergency management of children with acute severe asthma requiring transfer
to intensive care
AUTHOR NAMES
Dehò A.
Lutman D.
Montgomery M.
Petros A.
Ramnarayan P.
AUTHOR ADDRESSES
(Dehò A.; Lutman D.; Montgomery M.; Petros A.; Ramnarayan P.,
ramnarayan@msn.com) Children's Acute Transport Service, Great Ormond Street
Hospital, London, United Kingdom.
CORRESPONDENCE ADDRESS
P. Ramnarayan, Children's Acute Transport Service, Great Ormond Street
Hospital, London, United Kingdom. Email: ramnarayan@msn.com
SOURCE
Emergency Medicine Journal (2010) 27:11 (834-837). Date of Publication:
November 2010
ISSN
1472-0205
1472-0213 (electronic)
BOOK PUBLISHER
BMJ Publishing Group, Tavistock Square, London, United Kingdom.
ABSTRACT
Purpose: Children presenting to emergency departments (ED) with acute severe
asthma unresponsive to initial medical therapy may require endotracheal
intubation and mechanical ventilation. There is little data on complications
during the acute management of children with life-threatening asthma,
particularly at hospitals where specialist paediatric staff are lacking. It
was hypothesised that a better understanding of complications, particularly
associated with intubation and mechanical ventilation, would improve acute
management in ED, aid quality improvement initiatives at district general
hospitals (DGH) and form the basis for educational interventions from
regional paediatric critical care units. Methods: A retrospective case note
review was performed for all children referred to a regional intensive care
retrieval service with status asthmaticus over a 2-year period. Initial
treatment, patient-related factors, indication for endotracheal intubation
and the type and occurrence of adverse events during acute management at the
DGH were studied. Bivariate and multivariate analyses were undertaken to
identify factors associated with the occurrence of complications. Results:
51 (85%) of the 60 children transferred to a paediatric intensive care unit
for acute severe asthma required intubation. 36 (70.5%) experienced one or
more complications during intubation and in the early phase of mechanical
ventilation. The most common complications were hypotension (requiring fluid
resuscitation and/or inotropic support) and severe bronchospasm with acute
hypercarbia. The indication for intubation significantly affected the
chances of a complication occurring during stabilisation. Conclusions: There
is considerable morbidity in asthmatic children who are referred to
paediatric intensive care. The majority of complications may be anticipated
and prevented resulting in improved management at DGH.
EMTREE DRUG INDEX TERMS
aminophylline (drug combination, intravenous drug administration)
corticosteroid (intravenous drug administration)
dopamine (drug therapy)
epinephrine (drug therapy)
fentanyl
ketamine (intravenous drug administration)
magnesium sulfate (intravenous drug administration)
midazolam
noradrenalin (drug therapy)
propofol
salbutamol (drug combination, inhalational drug administration, intravenous
drug administration)
sevoflurane
thiopental
vecuronium
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
asthma
EMTREE MEDICAL INDEX TERMS
adolescent
article
artificial ventilation
asthmatic state
atelectasis (complication)
bronchospasm (complication)
child
disease severity
emergency care
endotracheal intubation
fluid resuscitation
human
hypercapnia (complication)
hypotension (complication, drug therapy)
intensive care
major clinical study
patient transport
pneumothorax (complication)
priority journal
retrospective study
risk factor
treatment indication
CAS REGISTRY NUMBERS
adrenalin (51-43-4, 55-31-2, 6912-68-1)
aminophylline (317-34-0)
dopamine (51-61-6, 62-31-7)
fentanyl (437-38-7)
ketamine (1867-66-9, 6740-88-1, 81771-21-3)
magnesium sulfate (7487-88-9)
midazolam (59467-70-8)
noradrenalin (1407-84-7, 51-41-2)
propofol (2078-54-8)
salbutamol (18559-94-9, 35763-26-9)
sevoflurane (28523-86-6)
thiopental (71-73-8, 76-75-5)
vecuronium (50700-72-6)
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2010631502
MEDLINE PMID
20558488 (http://www.ncbi.nlm.nih.gov/pubmed/20558488)
PUI
L359978007
DOI
10.1136/emj.2009.082149
FULL TEXT LINK
http://dx.doi.org/10.1136/emj.2009.082149
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 652
TITLE
Where is the impact?
AUTHOR NAMES
Rampil I.J.
Rampil L.S.
AUTHOR ADDRESSES
(Rampil I.J., ira.rampil@sunysb.edu) Health Science Center, Stony Brook
University, Stony Brook, NY, United States.
(Rampil L.S.)
CORRESPONDENCE ADDRESS
I. J. Rampil, Health Science Center, Stony Brook University, Stony Brook,
NY, United States. Email: ira.rampil@sunysb.edu
SOURCE
Anesthesiology (2010) 113:4 (995). Date of Publication: October 2010
ISSN
0003-3022
1528-1175 (electronic)
BOOK PUBLISHER
Lippincott Williams and Wilkins, 530 Walnut Street,P O Box 327,
Philadelphia, United States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospitalization
intensive care
patient transport
respiratory care
EMTREE MEDICAL INDEX TERMS
anticipation
human
intensive care unit
letter
medical research
priority journal
pulse oximetry
respiratory therapist
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2010574244
MEDLINE PMID
20864837 (http://www.ncbi.nlm.nih.gov/pubmed/20864837)
PUI
L359775025
DOI
10.1097/ALN.0b013e3181eff877
FULL TEXT LINK
http://dx.doi.org/10.1097/ALN.0b013e3181eff877
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 653
TITLE
Where is the impact?
AUTHOR NAMES
Taenzer A.
Pyke J.
McGrath S.
Blike G.
AUTHOR ADDRESSES
(Taenzer A., andreas.h.taenzer@dartmouth.edu) Dartmouth Hitchcock Medical
Center, Lebanon, NH, United States.
(Pyke J.; McGrath S.; Blike G.)
CORRESPONDENCE ADDRESS
A. Taenzer, Dartmouth Hitchcock Medical Center, Lebanon, NH, United States.
Email: andreas.h.taenzer@dartmouth.edu
SOURCE
Anesthesiology (2010) 113:4 (995-996). Date of Publication: October 2010
ISSN
0003-3022
1528-1175 (electronic)
BOOK PUBLISHER
Lippincott Williams and Wilkins, 530 Walnut Street, Philadelphia, United
States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
human
intensive care unit
letter
medical education
medical research
mortality
patient safety
priority journal
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2010574245
PUI
L359775026
DOI
10.1097/ALN.0b013e3181eff877
FULL TEXT LINK
http://dx.doi.org/10.1097/ALN.0b013e3181eff877
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 654
TITLE
Transfer of critical care patients
ORIGINAL (NON-ENGLISH) TITLE
Die Verlegung intensivbehandlungspflichtiger Patienten
AUTHOR NAMES
Hiller B.
AUTHOR ADDRESSES
(Hiller B., benjamin.hiller@drk-kh-alzey.de) Anästhesie, DRK Krankenhaus
Alzey, Kreuznacherstraße 7-9, 55232 Alzey, Germany.
CORRESPONDENCE ADDRESS
B. Hiller, Anästhesie, DRK Krankenhaus Alzey, Kreuznacherstraße 7-9, 55232
Alzey, Germany. Email: benjamin.hiller@drk-kh-alzey.de
SOURCE
Notarzt (2010) 26:4 (145-149). Date of Publication: 2010
ISSN
0177-2309
1438-8693 (electronic)
BOOK PUBLISHER
Georg Thieme Verlag, Rudigerstrasse 14, Stuttgart, Germany.
ABSTRACT
Changes in the structure of medical care increase the amount of critical
care transports. In order to minimize the risk of these transports,
organizational preconditions have to be established, medical staff must be
trained adequately, especially equipped transportation vehicles must be
available, and the patient has to be prepared optimally. The continuation of
the individual critical care therapy under the conditions of transport has
to be guaranteed. Main focus of the preparation of the transport is a
detailed clarification of the patients condition and the circumstances of
transport. © Georg Thieme Verlag KG Stuttgart - New York.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
health care personnel
patient transport
EMTREE MEDICAL INDEX TERMS
article
hospital care
human
patient care
training
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
German
LANGUAGE OF SUMMARY
English, German
EMBASE ACCESSION NUMBER
2010448885
PUI
L359365144
DOI
10.1055/s-0030-1248483
FULL TEXT LINK
http://dx.doi.org/10.1055/s-0030-1248483
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 655
TITLE
Severe falciparum malaria patients transferred "late" to a high level icu in
india represents a difficult research capture point to comment on predictors
of mortality and related organ dysfunction
AUTHOR NAMES
McLachlan C.S.
Taylor C.B.
Li Y.
Willenberg L.
Matthews S.
Glass P.
Myburgh J.
AUTHOR ADDRESSES
(McLachlan C.S.; Taylor C.B.; Li Y.; Willenberg L.; Matthews S.; Glass P.;
Myburgh J.) The George Institute for Global Health Australia, Division of
Critical Care, Level 7, 341 George Street, Sydney, NSW 2000, Australia.
CORRESPONDENCE ADDRESS
C. S. McLachlan, The George Institute for Global Health Australia, Division
of Critical Care, Level 7, 341 George Street, Sydney, NSW 2000, Australia.
SOURCE
Singapore Medical Journal (2010) 51:9 (752-753). Date of Publication:
SEPTEMBER 2010
ISSN
0037-5675
BOOK PUBLISHER
Singapore Medical Association, 2 College Road, Level 2, Singapore,
Singapore.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
malaria falciparum
mortality
patient transport
EMTREE MEDICAL INDEX TERMS
acute kidney failure (complication, therapy)
cerebral malaria
disease severity
hemodialysis
human
India
letter
liver dysfunction (complication)
parasitemia
peritoneal dialysis
private hospital
sample size
EMBASE CLASSIFICATIONS
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
Internal Medicine (6)
Public Health, Social Medicine and Epidemiology (17)
Hematology (25)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2010652720
MEDLINE PMID
20938618 (http://www.ncbi.nlm.nih.gov/pubmed/20938618)
PUI
L360044630
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 656
TITLE
2010 critical care transport workplace and salary survey
AUTHOR NAMES
Greene M.J.
AUTHOR ADDRESSES
(Greene M.J.) Fitch and Associates, LLC, Platte City, MO, United States.
CORRESPONDENCE ADDRESS
M. J. Greene, Fitch and Associates, LLC, Platte City, MO, United States.
SOURCE
Air Medical Journal (2010) 29:5 (222-235). Date of Publication:
September-October 2010
ISSN
1067-991X
1532-6497 (electronic)
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
ABSTRACT
Critical care transport (CCT) leaders and managers from 300 organizations
were invited to participate in an online survey (participation rate, 34)
with approximately 150 questions covering a broad base of CCT
organizational, workplace, personnel, and salary matters. In addition to
medical team composition, recruitment and retention, training, education,
and benefits, the survey presents CCT crew salary data by job class by
Bowley's seven-figure summary, as well as average, minimum, and maximum
hourly rates. Salaries are reported in a national aggregate and by
Association of Air Medical Services region. © 2010 Air Medical Journal
Associates.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
air medical transport
compensation
health survey
medical education
medical service
online analysis
organization
priority journal
review
salary
total quality management
workplace
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2010486527
MEDLINE PMID
20826354 (http://www.ncbi.nlm.nih.gov/pubmed/20826354)
PUI
L359488534
DOI
10.1016/j.amj.2010.07.004
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2010.07.004
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 657
TITLE
Intrahospital transfer of critical care patients to MRI: Medical staff
knowledge and experience
AUTHOR NAMES
Mottram L.J.
Farling P.A.
Mcbrien M.B.
AUTHOR ADDRESSES
(Mottram L.J.; Farling P.A.; Mcbrien M.B.) Royal Hospital Belfast Health,
Social Care Trust, Belfast, United Kingdom.
CORRESPONDENCE ADDRESS
L.J. Mottram, Royal Hospital Belfast Health, Social Care Trust, Belfast,
United Kingdom.
SOURCE
Intensive Care Medicine (2010) 36 SUPPL. 2 (S150). Date of Publication:
September 2010
CONFERENCE NAME
23rd Annual Congress of the European Society of Intensive Care Medicine,
ESICM
CONFERENCE LOCATION
Barcelona, Spain
CONFERENCE DATE
2010-10-09 to 2010-10-13
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag
ABSTRACT
INTRODUCTION. Magnetic Resonance Imaging (MRI) is well established for a
variety of indications in the elective setting, but is being increasingly
utilized for imaging critically ill adults1. As a result, anaesthetists and
intensive care physicians who do not regularly work inMRI may be required to
manage such patients. Hospital transfers are associated with adverse
incidents in the critically ill2, and the risks are likely to bemagnified in
the isolated and potentially hazardousMRI environment. Wesought to determine
if gaps in training exist in this area of critical care transport.
OBJECTIVES. 1. To ascertain trainee and consultant experience in the MRI
setting. 2. To determine level of supervision for trainees in the elective
MRI setting as compared with critical care transfers to MRI. 3. To gain
insight into the learning resources used by medical staff on MRI to allow
existing training to be improved. METHODS. Two online surveys were conducted
in February 2010, with invitations to participate via e-mail. The survey
population included all anaesthesia and intensive care medicine consultants
in the local tertiary neurosciences centre and all trainees for these
specialties in the Northern Ireland Deanery. First year trainees were
excluded. RESULTS. The response rate was 61% for consultants and 50% for
trainees. In total, 35 consultants responded with over 50% having no
experience of MRI at consultant level, even though 70% worked in areas where
MRI skills could be required. 54 trainees completed the survey, with 70%
having experience of MRI in the elective setting, all of whom had been
directly supervised by a consultant. 65% of trainees had experience of
critical care transfers for MRI, but this was in an unsupervised capacity
more than 50% of the time. Despite this, 44% of trainees did not feel
competent to work in MRI unsupervised. Web based learning was found to be a
poorly utilised MRI training tool, partICUlarly among consultants.(Figure
presented) CONCLUSION. We have demonstrated a need to formalize training for
MRI in our institution and for trainees in the local deanery. We propose to
meet this need by a combination of e-learning and experiential sessions with
defined competencies. This should increase the cohort of physicians who can
provide optimal care(3,4) in this unique environment and subsequently
improve both service delivery and patient safety.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
medical staff
nuclear magnetic resonance imaging
patient
patient transport
society
EMTREE MEDICAL INDEX TERMS
anesthesia
consultation
critically ill patient
e-mail
environment
health care delivery
hospital
imaging
learning
patient safety
physician
population
risk
skill
student
Tertiary (period)
United Kingdom
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70290478
DOI
10.1007/s00134-010-1999-x
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-010-1999-x
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 658
TITLE
Extracorporeal oxygenation (ECMO) rescue in the treatment of severe ards
with a refractory hypoxemia
AUTHOR NAMES
Zogheib E.
Piccardo A.
Guinot P.
Buchalet C.
Petiot S.
Moubarak M.
Hubert V.
Besserve P.
Benamar A.
Monconduit J.
Caus T.
Dupont H.
AUTHOR ADDRESSES
(Zogheib E.; Guinot P.; Buchalet C.; Petiot S.; Moubarak M.; Hubert V.;
Besserve P.; Benamar A.; Dupont H.) University Hospital, Anesthesiology and
Intensive Care Department, Amiens, France.
(Piccardo A.; Caus T.) University Hospital, Cardiac Surgery Department,
Amiens, France.
(Monconduit J.) University Hospital, Pneumology Department, Amiens, France.
CORRESPONDENCE ADDRESS
E. Zogheib, University Hospital, Anesthesiology and Intensive Care
Department, Amiens, France.
SOURCE
Intensive Care Medicine (2010) 36 SUPPL. 2 (S358). Date of Publication:
September 2010
CONFERENCE NAME
23rd Annual Congress of the European Society of Intensive Care Medicine,
ESICM
CONFERENCE LOCATION
Barcelona, Spain
CONFERENCE DATE
2010-10-09 to 2010-10-13
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag
ABSTRACT
INTRODUCTION. Severe ARDS and refractory hypoxemia were defined with a PaO2/
fraction of inspired oxygen (FiO2) ratio of B100, or uncompensated
hypercapnea with a pH of \7.20 despite receiving optimal conventional
treatment. The ECMO can be used as a rescue treatment in these case.
OBJECTIVES. Evaluation of severe ARDS treated with extracorporeal
oxygenation (ECMO). All these ARDS were due to bacterial pneumonia or H1N1
influenza. METHODS. Over the last year (December 2009-January 2010), the
recourse to extracorporeal oxygenation (ECMO) was used in ten patients with
severe ARDS and severe hypoxemia. Two groups were defined: bacterial
pneumonia with ARDS (BP group, n = 5), and H1N1 influenza with ARDS (H1N1
group, n = 5). All ECMOs were implanted at the bedside to facilitate
intra-hospital or inter-hospital transfer, because of severe hypoxemia or
hemodynamic instability making impossible patient mobilization before ECMO.
RESULTS. All patients in the ARDS BP group were male. There was three female
and two male in the ARDS H1N1 group. The median [range] age was 54 years old
[18-57] (BP) versus 21 [28-45] (H1N1), p = 0.11. The most common associated
comorbidity in the group H1N1 was obesity (30 kg/m(2) [25-41] vs. 26
[17-30], p = 0.07). The time between the onset of respiratory symptoms and
implantation of ECMO were longer in the BP group (12 days [6-36] vs. 1
[1-13], p = 0.06). When comparing BP and H1N1 groups, duration of ECMO (14
days [6-30] vs. 20 [10-41], p = 0.84), duration of mechanical ventilation
(66 days [36-77] vs. 42 [15-75], p = 0.4), ICU length of stay (77 days
[38-92] vs. 48 [21-94], p = 0.6) and duration of hospitalisation (91 days
[38-112] vs. 56 [29-113], p = 0.46) were similar. In the BP group, 60%
survived to hospital discharge (1 patient died on ECMO, 1 patient died after
discharge from ICU). All patients of the H1N1 group survived to
hospitalization. All survivors of both groups were in good health condition
upon leaving the hospital. CONCLUSIONS. Given these good results, and
despite long periods of mechanical ventilation, ICU duration and hospital
length of stay, the standard respiratory ECMO support should be discussed
again in the algorithm treatment of ARDS with refractory hypoxemia.
EMTREE DRUG INDEX TERMS
methaqualone
oxygen
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
extracorporeal oxygenation
hypoxemia
intensive care
society
EMTREE MEDICAL INDEX TERMS
adult respiratory distress syndrome
algorithm
artificial ventilation
bacterial pneumonia
comorbidity
female
health
hospital
hospital discharge
hospitalization
hypercapnia
implantation
influenza
length of stay
male
mobilization
obesity
patient
pH
survivor
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70291305
DOI
10.1007/s00134-010-2001-7
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-010-2001-7
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 659
TITLE
Out of hospital transfer is an independent predictor of death or poor
outcome after intracerebral hemorrhage.
AUTHOR NAMES
Rincon F.
Akbar U.
Morino T.
Behrens D.
Schorr C.
Dellinger P.
Parrillo J.
Mirsen T.
AUTHOR ADDRESSES
(Rincon F.) Jefferson University, Philadelphia, United States.
(Akbar U.; Morino T.; Behrens D.; Schorr C.; Dellinger P.; Parrillo J.;
Mirsen T.) Cooper University Hospital, Camden, United States.
CORRESPONDENCE ADDRESS
F. Rincon, Jefferson University, Philadelphia, United States.
SOURCE
Neurocritical Care (2010) 13 SUPPL. 1 (S103). Date of Publication: September
2010
CONFERENCE NAME
8th Annual Meeting of the Neurocritical Care Society
CONFERENCE LOCATION
San Francisco, CA, United States
CONFERENCE DATE
2010-09-15 to 2010-09-18
ISSN
1541-6933
BOOK PUBLISHER
Humana Press
ABSTRACT
Introduction: Transfer of critically-ill patients from external Emergency
Department (OSH-ED) has the potential of delaying the admission to the
Intensive Care Unit (ICU). The effect of OSH-ED transfer on hospital
outcomes of ICH patients has not been studied. Methods: We designed a
retrospective cohort study using a prospectively compiled and maintained
registry (Cerner Project IMPACT). ICH patients admitted to our ICU from our
ED and OSH-ED within 24 hrs of stroke between 2003-2008 were selected for
the analysis. Data collected included demographics, admission physiologic
variables, Glasgow Coma Scale (GCS), APACHE-II, scores; and total ICU and
hospital length of stay (LOS). Primary outcome was functional status at
hospital discharge and secondary outcomes were ICU and hospital LOS. Poor
outcome was defined as death or severe disability at hospital discharge. To
assess for the impact of OSH-ED transfer on primary and secondary outcomes,
demographic and admission clinical variables were used to construct logistic
regression models using the outcome measure as a dependent variable.
Results: A total of 296 patients were selected. The mean age was 65±14
years, of which 47% were male, 63% were white, and 66% were transferred from
OSH-ED. The median hospital LOS was 6 days (Interquartile range [IQR]=4-11)
and median ICU-LOS was 2 days (IQR=1-4). Overall hospital mortality was 37%.
Transfer from OSH-ED was associated with a 75% probability of death or poor
outcome at hospital discharge. Multivariate regression analysis showed that
APACHE-II (OR, 1.2; 95% CI; 1.1-1.3), GCS ≤12 (OR, 2.8; 95% CI; 1.8-4.1),
and OSH-ED transfer (OR, 1.7; 95% CI; 1.1-2.5) were independently associated
with poor outcome. OSH-ED was not significantly associated with secondary
outcome measures. Conclusions: This data suggests that in ICH patients,
OSH-ED transfer is independently associated with poor outcome at hospital
discharge. Further research is needed as to identify the potential causes
for this effect.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
brain hemorrhage
death
hospital
society
EMTREE MEDICAL INDEX TERMS
APACHE
cerebrovascular accident
cohort analysis
critically ill patient
dependent variable
disability
emergency ward
functional status
Glasgow coma scale
hospital discharge
intensive care unit
length of stay
logistic regression analysis
male
model
mortality
patient
register
regression analysis
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70300724
DOI
10.1007/s12028-010-9426-2
FULL TEXT LINK
http://dx.doi.org/10.1007/s12028-010-9426-2
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 660
TITLE
Peribulbar blockade for retinopathyof prematurity out side the or
AUTHOR NAMES
Dagge A.
Grac¸a A.L.
Caramelo S.M.
Fonseca L.
AUTHOR ADDRESSES
(Dagge A.; Grac¸a A.L.; Fonseca L.) Anestesia, Cuidados Intensivos e
Emergencia, Centro Hospitalar do Porto-Hospital Santo Antonio, Porto,
Anestesia, Portugal.
(Caramelo S.M.) Emergencia e Dor, Centro Hospitalar de Tráis os Montes e
Alto Douro, Vila Real, Portugal.
CORRESPONDENCE ADDRESS
A. Dagge, Anestesia, Cuidados Intensivos e Emergencia, Centro Hospitalar do
Porto-Hospital Santo Antonio, Porto, Anestesia, Portugal.
SOURCE
Regional Anesthesia and Pain Medicine (2010) 35:5 (E81). Date of
Publication: September-October 2010
CONFERENCE NAME
29th Annual European Society of Regional Anaesthesia, ESRA Congress 2010
CONFERENCE LOCATION
Porto, Portugal
CONFERENCE DATE
2010-09-08 to 2010-09-11
ISSN
1098-7339
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Background: Retinopathy of prematurity (ROP) is an eye disease that affects
prematurely born babies, with an incidence of 78% in prematures with weight
from 750 to 990g1. It is caused by disorganized growth of retinal blood
vessels which result in scarring and retinal detachment. Both oxygen
toxicity and relative hypoxia can contribute to its development. In
prematures should be avoied proceadures that can affect their cardiovascular
and respiratory stability. Case Report: Thirty seven weeks of
post-conception age baby with weight of 2250g and retinopathy of prematurity
grade IV was proposed for retinian criotherapy.The anesthetic plan was
bilateral peribulbar blockade with single shot with 30G-needle. It was
administered 1 mL of ropivacaine 0,5 %. It was performed in the Intensive
Care Unit (ICU). All ASA monitoring standarts and assepsia care were
performed. The child was kept under the same mid-azolam and morfine
perfusions and mechanically ventilated with 100% FiO(2). The patient is the
2nd twin of gemelar gestation affected by Feto-Fetal Transfusion Syndrome.
By deterioration of the 1st twin with congestive heart failure it was
preformed a caesarean section at 26 weeks. It is reported the death of the
1st twin at birth in spite of the advanced life support measures. The 2nd
twin borned with 740g and Apgar Rate: 6/9/9. It was admitted ICU with
necessity of mechanical ventilation.She was discharged after 123 days,
clinically well, weighting 3380 g. Discussion: The chosen anesthetic plan
allowed greater hemodynamic stability and reduced the needs of another type
of analgesia in the 24 h after surgery without other analgesics.This
anesthetic technique allowed the execution of the proposed surgery
minimizing the risks of respiratory depres-sion.The procedure being
performed in the UCI allowed us to avoid the risks of the intra-hospital
transport.Referencies: GreGORy G. Pediatric Anesthesia, Churchil
Livingstone, 4° ed. Conclusions: Continuous local anaesthetic wound infusion
as part of multimodal pain treatment in patients after subpectoral breast
augmentation is a valuable method.
EMTREE DRUG INDEX TERMS
anesthetic agent
morphine
ropivacaine
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
prematurity
regional anesthesia
society
EMTREE MEDICAL INDEX TERMS
analgesia
baby
blood transfusion reaction
breast augmentation
case report
cesarean section
child
congestive heart failure
death
deterioration
eye disease
hospital
hypoxia
infusion
intensive care unit
intrauterine blood transfusion
monitoring
needle
oxygen toxicity
pain
patient
pediatric anesthesia
perfusion
pregnancy
retina blood vessel
retina detachment
retrolental fibroplasia
risk
scar formation
surgery
twins
weight
wound
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70287319
DOI
10.1097/AAP.0b013e3181f3582c
FULL TEXT LINK
http://dx.doi.org/10.1097/AAP.0b013e3181f3582c
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 661
TITLE
Going it alone: the beginning of a nurse-led retrieval service.
AUTHOR NAMES
Herring S.
AUTHOR ADDRESSES
(Herring S.) Evelina Children's Hospital, London.
CORRESPONDENCE ADDRESS
S. Herring, Evelina Children's Hospital, London.
SOURCE
Paediatric nursing (2010) 22:7 (22-24). Date of Publication: Sep 2010
ISSN
0962-9513
ABSTRACT
Training for experienced paediatric intensive care nurses to work as
retrieval nurse practitioners is being offered by the South Thames Retrieval
Service. To date, nine such practitioners have been assessed as competent to
practise independently and in their first three and a half years of practice
have transferred 366 critically ill children. Potential obstacles included:
limitations to prescribing, resistance to nurses performing a traditional
medical role and adaptation in the paediatric intensive care unit
environment. Continuing evaluation is essential to ensure a high standard of
care.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
nurse practitioner
nursing practice
patient transport
pediatric nursing
EMTREE MEDICAL INDEX TERMS
article
child
human
intensive care unit
organization and management
program development
United Kingdom
LANGUAGE OF ARTICLE
English
MEDLINE PMID
20954525 (http://www.ncbi.nlm.nih.gov/pubmed/20954525)
PUI
L359898836
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 662
TITLE
Transport times did not change between 2004 and 2009 but thrombolysis rates
increased from 10 to 18%. Results from the Austrian National Acute
Stroke-Unit Registry
AUTHOR NAMES
Brainin M.
Tatschl C.
Teuschl Y.
Seyfang L.
Matz K.
Eckhardt R.
AUTHOR ADDRESSES
(Brainin M.; Teuschl Y.; Seyfang L.) Department for Clinical Medicine and
Preventive Medicine, Danube University Krems, Austria.
(Tatschl C.; Matz K.; Eckhardt R.) LKH, Tulln, Austria.
CORRESPONDENCE ADDRESS
M. Brainin, Department for Clinical Medicine and Preventive Medicine, Danube
University Krems, Austria.
SOURCE
European Journal of Neurology (2010) 17 SUPPL. 3 (65). Date of Publication:
September 2010
CONFERENCE NAME
14th Congress of the European Federation of Neurological Societies, EFNS
CONFERENCE LOCATION
Geneva, Switzerland
CONFERENCE DATE
2010-09-25 to 2010-09-28
ISSN
1351-5101
BOOK PUBLISHER
Blackwell Publishing Ltd
ABSTRACT
Introduction: Successful intervention in acute stroke depends on early
arrival at the stroke unit. The aim of this study was to identify
time-dependent factors for referral and thrombolysis treatment in acute
stroke units and to define the gains for direct referral versus referral via
another hospital. Methods:Analysis of data from theAustrian NationalAcute
Stroke-Unit Registry. Results: Data of 40,660 stroke patients were
registered at one of 29 acute stroke units in the time between January 2003
and May 2009. Exact time of onset was known for 18,223 (58%) patients. 85
percent were admitted directly and 15% were transferred from other
hospitals. The admission rates within two hours were 58% and 33% for
patients admitted directly and those referred from another hospital,
respectively. Accordingly, direct admission to hospitals equipped with
stroke units increased the relative chance of thrombolytic treatment by odds
1.4. The rate of patients admitted within 2 hours did not change between
2004 and 2009, however, thrombolysis rates increased in the same time period
significantly from 10%to 18%. Extending the time window for thrombolysis to
4h arrivals may further increase thrombolysis rate up to 21%. Conclusion:
Direct referral to an acute stroke unit bears highest chance for
thrombolysis treatment. While the transport times for patients referred to
acute stroke units within 2 hours from onset remained constant between 2004
and 2009, corresponding thrombolysis rates had risen from 10% to 18%.
Extension of the time window including four hour referrals would further
increase this rate to 21%.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
blood clot lysis
health care organization
register
stroke unit
EMTREE MEDICAL INDEX TERMS
cerebrovascular accident
hospital
patient
stroke patient
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70274063
DOI
10.1111/j.1468-1331.2010.03231.x
FULL TEXT LINK
http://dx.doi.org/10.1111/j.1468-1331.2010.03231.x
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 663
TITLE
Erratum: Increase the donor pool: Transportation of a patient with fatal
head injury supported with extracorporeal membrane oxygenation (The Journal
of Trauma: Injury, Infection, and Critical Care)
AUTHOR NAMES
Tsai C.-S.
AUTHOR ADDRESSES
(Tsai C.-S.)
CORRESPONDENCE ADDRESS
C.-S. Tsai,
SOURCE
Journal of Trauma - Injury, Infection and Critical Care (2010) 69:3 (734).
Date of Publication: September 2010
ISSN
0022-5282
1529-8809 (electronic)
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
error
EMTREE MEDICAL INDEX TERMS
erratum
priority journal
EMBASE CLASSIFICATIONS
Neurology and Neurosurgery (8)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2010552250
PUI
L359703887
DOI
10.1097/TA.0b013e3181ec1016
FULL TEXT LINK
http://dx.doi.org/10.1097/TA.0b013e3181ec1016
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 664
TITLE
Use of the bow-tie method for a prospective risk analysis of in hospital
transportation of intensive care patients
AUTHOR NAMES
Van Slobbe-Bijlsma E.R.
Dongelmans D.A.
Van Der Sluijs A.F.
AUTHOR ADDRESSES
(Van Slobbe-Bijlsma E.R.; Dongelmans D.A.; Van Der Sluijs A.F.) Academic
Medical Center, University of Amsterdam, Intensive Care Medicine, Amsterdam,
Netherlands.
CORRESPONDENCE ADDRESS
E.R. Van Slobbe-Bijlsma, Academic Medical Center, University of Amsterdam,
Intensive Care Medicine, Amsterdam, Netherlands.
SOURCE
Intensive Care Medicine (2010) 36 SUPPL. 2 (S400). Date of Publication:
September 2010
CONFERENCE NAME
23rd Annual Congress of the European Society of Intensive Care Medicine,
ESICM
CONFERENCE LOCATION
Barcelona, Spain
CONFERENCE DATE
2010-10-09 to 2010-10-13
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag
ABSTRACT
INTRODUCTION. In hospital transportation of Intensive Care (IC) patients for
diagnostic procedures or therapeutic interventions is daily routine. The
majority of IC patients are mechanically ventilated and vasoactive
medication dependent. Transportation of these patients outside the safe
environment of the ICU is potentially harmful, because several risks are
present. OBJECTIVES. Incidents, related to the transportation of ICU
patients, with adverse outcome are rare. Nevertheless we believed that the
actual number of incidents is significantly higher than the ones reported in
our Incident Registration System. Therefore a prospective risk analysis was
performed, using the Bow-tie method. We used this method to improve patient
safety and quality of in hospital transportation of ICU patients. METHODS.
The Bow-tie method was performed at the ICU of the AcademicMedical Centre of
the University of Amsterdam, The The Netherlands. The ICU contains 32
operational beds and approximately 120 nurses and 30medical doctors are
employed. The study was performed by the Committee on Patient Safety and
Quality (CPSQ). Using the Bow-tie method, supported with purchased software
(BowtieXP by Governor's) multiple Bow-tie diagrams were made: (1)
Incidentswith the inevitably use of lifts, (2) Incidentswith bed-side
equipment, (3) Ventilation-related incidents, (4) Monitoring-related
incidents, (5) Incidents concerning lines and devices, (6) Medication-
related incidents and (7) Patient-related problems. An example of a Bow-tie
diagram:(Figure presented) RESULTS. The great majority of defence barriers,
as reported in the Bow-tie diagrams, were already effective. After analysis
a list of recommendations to improve patient safety and quality during
transportation was composed: 1. Revision of the Transportation protocol 2.
Implementation of a checklist together with at least 30 min preparation time
3. Improving education, certification and supervision by staff members 4.
Changes in design of bed-side equipment 5. Use of a lift (priority)-badge 6.
Improvement of the incident registration system. The results were presented
and discussed in our weekly meeting on patient safety and healthcare for all
ICU personnel. By the end of this year all the recommendations will be
implemented in our ICU. CONCLUSIONS. We improved the safety and quality of
in hospital transportation of ICU patients by performing a prospective risk
analysis. Bow-tie is a good instrument to identify health care risks.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital
intensive care
patient
risk assessment
society
traffic and transport
EMTREE MEDICAL INDEX TERMS
adverse outcome
air conditioning
certification
checklist
devices
diagnostic procedure
drug therapy
education
environment
health care
monitoring
Netherlands
nurse
patient safety
personnel
physician
registration
risk
safety
software
university
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70291472
DOI
10.1007/s00134-010-2001-7
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-010-2001-7
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 665
TITLE
Reducing contact-to-balloon-time by increasing the number of primary
transportations to PCI centers: Results from the myocardial infarction
network Goettingen
AUTHOR NAMES
Jacobshagen C.
Kern M.
Scholz K.-H.
Hasenfuss G.
Maier L.S.
AUTHOR ADDRESSES
(Jacobshagen C.; Kern M.; Hasenfuss G.; Maier L.S.) Department of
Cardiology, Georg-August-University Goettingen, Goettingen, Germany.
(Scholz K.-H.) Med. Klinik I Kardiologie, St. Bernward Krankenhaus,
Hildesheim, Germany.
CORRESPONDENCE ADDRESS
C. Jacobshagen, Department of Cardiology, Georg-August-University
Goettingen, Goettingen, Germany.
SOURCE
European Heart Journal (2010) 31 SUPPL. 1 (768). Date of Publication:
September 2010
CONFERENCE NAME
European Society of Cardiology, ESC Congress 2010
CONFERENCE LOCATION
Stockholm, Sweden
CONFERENCE DATE
2010-08-28 to 2010-09-01
ISSN
0195-668X
BOOK PUBLISHER
Oxford University Press
ABSTRACT
The acute revascularization of occluded vessels is of crucial importance for
the prognosis of patients presenting with STEMI. However, the treatment
times that are recommended by international guidelines are often not met.
FITT-STEMI (Feedback Intervention and Treatment Times in STEMI) is a
multicenter study to assess whether standardized data collection with
systematic feedback of the results of treatment can improve the quality of
care and prognosis in patients with STEMI. We investigated in our myocardial
infarction network of Goettingen, if an optimization of the EMS
transportation modalities can improve the contact-to-balloon time.
Therefore, we prospectively assessed the timing of acute treatment in our
heart center (24-h standby for PCI) in all patients with STEMI (symptoms
<24h). We analyzed all relevant time intervals in the rescue and treatment
chain from initial contact of the patient until the reopening of the
occluded coronary vessel. Following a 3-month period for data collection the
analyzed treatment times were presented in an interactive feedback event to
all groups involved in the treatment of STEMI patients. This procedure was
repeated in the same way every 3 months. In 18 months 444 patients with
assumed STEMI were included (69% male, average age 65.0 years). A total of
348 patients (78%) were treated with PCI, 19% had cardiogenic shock and 12%
were resuscitated. 79% of patients had a TIMI risk score ≥3. Due to the
systematic feedback events the number of primary transportations of STEMI
patients to our PCI center (bypassing smaller non-PCI hospitals) could be
increased from initially 48% to 71% after 18 months. This is noteworthy
since 2/3 of the patients came from the catchment area of smaller non-PCI
hospitals of the infarct network. The proportion of primary transports from
this area was initially only 23% and was increased to 59% within 18 months.
The contact-to-balloon time was reduced by 24 min for the entire group.
Informing the cath lab in advance by the emergency system (56% initially,
83% after 18 months), and bypassing the emergency room (50% initially, 67%
after 18 months) also contributed to the reduced contact-to-balloon time. In
conclusion, our data demonstrate that by feedback events with all systems
involved the proportion of primary transportations to PCI centers could be
increased in patients with STEMI. The emergency management of these patients
could be improved by informing the cath lab in advance and by bypassing the
emergency room. This leads to a reduction of the contact-to-balloon times
and may improve the prognosis of STEMI patients in the future.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cardiology
heart infarction
society
traffic and transport
EMTREE MEDICAL INDEX TERMS
cardiogenic shock
catchment
coronary blood vessel
coronary care unit
emergency
emergency ward
feedback system
hospital
infarction
information processing
male
multicenter study
patient
prognosis
revascularization
risk
ST segment elevation myocardial infarction
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70282459
DOI
10.1093/eurheartj/ehq289
FULL TEXT LINK
http://dx.doi.org/10.1093/eurheartj/ehq289
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 666
TITLE
Quality of transfers of critically ill patients within the hospital
AUTHOR NAMES
Tjen C.
Rowland D.
Dhrampal A.
Hutchinson S.
AUTHOR ADDRESSES
(Tjen C.; Rowland D.; Dhrampal A.; Hutchinson S.) Norfolk and Norwich
University Hospital, Norwich, United Kingdom.
CORRESPONDENCE ADDRESS
C. Tjen, Norfolk and Norwich University Hospital, Norwich, United Kingdom.
SOURCE
Critical Care (2010) 14 SUPPL. 1 (S158). Date of Publication: 2010
CONFERENCE NAME
30th International Symposium on Intensive Care and Emergency Medicine,
ISICEM
CONFERENCE LOCATION
Brussels, Belgium
CONFERENCE DATE
2010-03-09 to 2010-03-12
ISSN
1364-8535
BOOK PUBLISHER
BioMed Central Ltd.
ABSTRACT
Introduction: Transferring critically ill patients between clinical areas is
recognised to be potentially hazardous [1] and associated with poor outcome
[2]. This study addresses the standard of intrahospital transfer of sick
patients within our Trust including monitoring, equipment availability,
personnel and training. Methods: We surveyed senior ward staff on how they
would conduct the theoretical transfer of a deteriorating, hypoxic, shocked
patient to the ITU. Monitoring and equipment deemed necessary and its
perceived availability were recorded, as was transfer personnel. We then
prospectively reviewed actual transfers of patients with Early Warning
Scores (EWS) of 3 or greater. Results: Theoretical transfer data were
collected from 19 wards. Most (74%) requested oxygen saturation (SpO(2))
monitoring, while less than one-third wanted either non-invasive blood
pressure or ECG monitoring. Some wards expressed a need to borrow equipment,
while others felt this would lead to delay. Three wards considered any
monitoring unnecessary. Of 13 wards declining a defibrillator/cardiac
monitor, two did so due to lack of familiarity. Prospective data were
gathered from 32 transfers between September and November 2009. EWS ranged
from 3 to 9. The actual transfer monitoring mirrored the initial survey, but
for SpO(2) monitoring (44% vs 74%, respectively). A doctor was included by
10% for the theoretical transfer and in 16% of actual transfers. Less than
one-half of actual transfers had a trained member of the transfer team.
These patients were better monitored but the standard of transfers did not
correspond to EWS. Patients with higher EWS were neither better monitored
nor accompanied. Out of hours activity comprised 21% of actual transfers.
The bulk of patients were from the admission units and the majority went to
critical care or radiology. Conclusions: There is considerable movement of
sick patients around the hospital. Many transfers are performed by untrained
staff , without adequate monitoring, and many are out of hours. There is
poor understanding of risks of transfer and of appropriate monitoring. The
data suggest that deficits are due partly to equipment unavailability - we
are conducting a further audit to determine this. We propose additional
investment and training and are compiling intrahospital transfer guidelines
according to EWS.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
emergency medicine
hospital
intensive care
EMTREE MEDICAL INDEX TERMS
blood pressure
clinical audit
electrocardiogram
electrocardiography monitoring
investment
monitoring
oxygen saturation
patient
patient transport
personnel
physician
radiology
risk
ward
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70255714
DOI
10.1186/cc8703
FULL TEXT LINK
http://dx.doi.org/10.1186/cc8703
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 667
TITLE
Audit of severe acute maternal morbidity describing reasons for transfer and
potential preventability of admissions to ICU
AUTHOR NAMES
Lawton B.A.
Wilson L.F.
Dinsdale R.A.
Rose S.B.
Brown S.A.
Tait J.
Coles C.L.
McCaw A.
AUTHOR ADDRESSES
(Lawton B.A., bev.lawton@otago.ac.nz; Rose S.B.; Brown S.A.) Women's Health
Research Centre, University of Otago, Wellington, PO Box 7343, Wellington,
New Zealand.
(Wilson L.F.) Anaesthetic Department, Capital and Coast District Health
Board, Wellington South, New Zealand.
(Dinsdale R.A.) Intensive Care, Capital and Coast District Health Board,
Wellington South, New Zealand.
(Tait J.; Coles C.L.; McCaw A.) Women's and Children's Health Directorate,
Capital and Coast District Health Board, Wellington South, New Zealand.
CORRESPONDENCE ADDRESS
B. A. Lawton, Women's Health Research Centre, University of Otago,
Wellington, PO Box 7343, Wellington, New Zealand. Email:
bev.lawton@otago.ac.nz
SOURCE
Australian and New Zealand Journal of Obstetrics and Gynaecology (2010) 50:4
(346-351). Date of Publication: August 2010
ISSN
0004-8666
1479-828X (electronic)
BOOK PUBLISHER
Blackwell Publishing, 550 Swanston Street, Carlton South, Australia.
ABSTRACT
Background: Maternal mortality is a rare event in the developed world.
Assessment of severe acute maternal morbidity (SAMM) is therefore an
appropriate measure of the quality of maternity care. Aims: The aim of the
study was to conduct a retrospective audit of SAMM cases (pregnant women
admitted to a New Zealand Intensive Care Unit) to describe clinical,
socio-demographic characteristics, pregnancy outcomes and preventability.
Methods: Severe acute maternal morbidity cases were reviewed by a
multidisciplinary panel to determine reasons for admission to ICU, to
classify organ-system dysfunction and to determine whether the SAMM case was
preventable or not. Inclusion criteria were: admission to ICU between 2005
and 2007 during pregnancy or within 42 days of delivery. Results:
Twenty-nine SAMM cases were reviewed, of which 10 (35%) were deemed
preventable. The most common reasons for transfer to ICU were: the need for
invasive vascular monitoring, hypotension and disseminated intravascular
coagulation. The most frequent types of preventable events were: inadequate
diagnosisrecognition of high-risk status, inappropriate treatment,
communication problems and inadequate documentation. All five SAMM cases of
septicaemia were deemed preventable. Of the ten preventable cases, three
were Maori (50% of the Maori in total audit), four were Pacific (67% of the
Pacific in total audit) and three were women of 'other' ethnicities (17.6%,
3 of 17 in the audit). Conclusions: An audit of SAMM cases describing
reasons for transfer to ICU and preventability is feasible. We recommend
that a prospective national SAMM audit process be introduced in New Zealand
as a quality of care measure. © 2010 The Royal Australian and New Zealand
College of Obstetricians and Gynaecologists.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
maternal morbidity
EMTREE MEDICAL INDEX TERMS
adolescent
adult
article
clinical article
clinical audit
disease severity
disseminated intravascular clotting
female
high risk pregnancy
hospital admission
human
hypotension
intensive care unit
interpersonal communication
multiple organ failure
pregnancy outcome
priority journal
septicemia
EMBASE CLASSIFICATIONS
Obstetrics and Gynecology (10)
Public Health, Social Medicine and Epidemiology (17)
Cardiovascular Diseases and Cardiovascular Surgery (18)
Hematology (25)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2010450283
MEDLINE PMID
20716262 (http://www.ncbi.nlm.nih.gov/pubmed/20716262)
PUI
L359372334
DOI
10.1111/j.1479-828X.2010.01200.x
FULL TEXT LINK
http://dx.doi.org/10.1111/j.1479-828X.2010.01200.x
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 668
TITLE
Allergy documentation and transfer within critical care
AUTHOR NAMES
Hatton K.
Barrett N.
Lim J.
McKenzie C.
AUTHOR ADDRESSES
(Hatton K.) Chelsea and Westminster NHS Foundation Trust, London, United
Kingdom.
(Barrett N.; Lim J.; McKenzie C.) Guy's and St Thomas' NHS Foundation Trust,
London, United Kingdom.
CORRESPONDENCE ADDRESS
K. Hatton, Chelsea and Westminster NHS Foundation Trust, London, United
Kingdom.
SOURCE
Critical Care (2010) 14 SUPPL. 1 (S151). Date of Publication: 2010
CONFERENCE NAME
30th International Symposium on Intensive Care and Emergency Medicine,
ISICEM
CONFERENCE LOCATION
Brussels, Belgium
CONFERENCE DATE
2010-03-09 to 2010-03-12
ISSN
1364-8535
BOOK PUBLISHER
BioMed Central Ltd.
ABSTRACT
Introduction: Allergies to medication are common and potentially
lifethreatening [1]. Patients enter critical care with incomplete
information about their history. It is essential for safety that accurate
allergy status is documented early in the critical care stay. This clinical
audit (CA) was undertaken in a 43-bed, level 3 critical care unit to explore
compliance with local guidelines on allergy documentation. Methods: Critical
care patient episodes were obtained retrospectively for a 1-month period.
Timing of allergy documentation and drug prescribing was noted from the
critical care electronic system (ICIP). Allergy status prior to the critical
care admission and after discharge was noted from the ward drug chart.
Additional allergy data were identified from the hospital electronic patient
record (EPR). The CA was repeated 1 year after implementation of
recommendations. Results: Patient episodes were collated (initial CA n = 58,
repeat CA n = 79). A known drug/nondrug allergy was stated in 29.3% patient
episodes during the initial CA and 39.2% patient episodes in the repeat CA.
Allergy status was incomplete 24 hours after critical care admission for two
patients at the initial CA with a reduction to zero during the repeat.
Allergy status was incomplete prior to prescribing of a new drug in critical
care (excludes fluids, drugs required for emergency intubation) for 51.7% of
patient episodes in the initial CA. This figure reduced to 19.0% in the
repeat CA. Concordance between EPR and ICIP allergy at the outset was 68.8%,
which increased to 76.5% in the repeat CA. Concordance with the ward drug
chart preadmission and ICIP was 77.6%, increased to 93.9% at re-audit.
Conclusions: This CA suggests that up to one in three critical care patients
have a known allergy. The potential for harm is high. More than onehalf of
patients admitted to critical care did not have an allergy status documented
prior to prescribing a new drug. There was significant discordance between
the paper medication chart and ICIP allergy. A number of factors were
introduced following initial findings, including making the allergy status
mandatory on ICIP, not allowing the admission summary to be saved prior to
allergy documentation and ensuring current allergy documentation on EPR.
EMTREE DRUG INDEX TERMS
new drug
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
allergy
documentation
emergency medicine
intensive care
EMTREE MEDICAL INDEX TERMS
clinical audit
drug therapy
electron spin resonance
emergency
hospital
intubation
liquid
medical record
patient
prescription
safety
ward
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70255694
DOI
10.1186/cc8683
FULL TEXT LINK
http://dx.doi.org/10.1186/cc8683
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 669
TITLE
Airway management success and hypoxemia rates in air and ground critical
care transport: a prospective multicenter study.
AUTHOR NAMES
Thomas S.
Judge T.
Lowell M.J.
MacDonald R.D.
Madden J.
Pickett K.
Werman H.A.
Shear M.L.
Patel P.
Starr G.
Chesney M.
Domeier R.
Frantz P.
Funk D.
Greenberg R.D.
AUTHOR ADDRESSES
(Thomas S.) Department of Emergency Medicine, University of Oklahoma School
of Community Medicine, Tulsa, Oklahoma 74135, USA.
(Judge T.; Lowell M.J.; MacDonald R.D.; Madden J.; Pickett K.; Werman H.A.;
Shear M.L.; Patel P.; Starr G.; Chesney M.; Domeier R.; Frantz P.; Funk D.;
Greenberg R.D.)
CORRESPONDENCE ADDRESS
S. Thomas, Department of Emergency Medicine, University of Oklahoma School
of Community Medicine, Tulsa, Oklahoma 74135, USA. Email:
stephen-thomas@ouhsc.edu
SOURCE
Prehospital emergency care : official journal of the National Association of
EMS Physicians and the National Association of State EMS Directors (2010)
14:3 (283). Date of Publication: 2010 Jul-Sep
ISSN
1545-0066 (electronic)
ABSTRACT
OBJECTIVE: To assess critical care transport (CCT) crews' endotracheal
intubation (ETI) attempts, success rates, and peri-ETI oxygenation. METHODS:
Participants were adult and pediatric patients undergoing attempted advanced
airway management during the period from July 2007 to December 2008 by crews
from 11 CCT programs varying in geography, crew configuration, and casemix;
all crews had access to neuromuscular-blocking agents. Data collected
included airway management variables defined per national consensus
criteria. Descriptive analysis focused on ETI success rates (reported with
exact binomial 95% confidence intervals [CIs]) and occurrence of new
hypoxemia (oxygen saturation [SpO(2)] dropping below 90% during or after
ETI); to assess categorical variables, Fisher's exact test, Pearson chi(2),
and logistic regression were employed to explore associations between
predictor variables and ETI failure or new hypoxemia. For all tests, p <
0.05 defined significance. RESULTS: There were 603 total attempts at airway
management, with successful oral or nasal ETI in 582 cases, or 96.5% (95% CI
94.7-97.8%). In 182 cases (30.2%, 95% CI 26.5-34.0%), there were failed ETI
attempts prior to CCT crew arrival; CCT crew ETI success on these patients
(96.2%, 95% CI 92.2-98.4%) was just as high as in the patients in whom there
was no pre-CCT ETI attempt (p = 0.81). New hypoxemia occurred in only six
cases (1.6% of the 365 cases with ongoing SpO(2) monitoring; 95% CI
0.6-3.5%); the only predictor of new hypoxemia was pre-ETI hypotension (p <
0.001). A requirement for multiple ETI attempts by CCT crews was not
associated with new hypoxemia (Fisher's exact p = 0.13). CONCLUSIONS: CCT
crews' ETI success rates were very high, and even when ETI required multiple
attempts, airway management was rarely associated with SpO(2) derangement.
CCT crews' ETI success rates were equally high in the subset of patients in
whom ground emergency medical services (EMS) ETI failed prior to arrival of
transport crews.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
airway obstruction (therapy)
anoxia (epidemiology)
endotracheal intubation
patient transport
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
article
child
clinical trial
female
human
infant
male
methodology
middle aged
multicenter study
newborn
outcome assessment
pathophysiology
preschool child
prospective study
standard
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
20507218 (http://www.ncbi.nlm.nih.gov/pubmed/20507218)
PUI
L359528197
DOI
10.3109/10903127.2010.481758
FULL TEXT LINK
http://dx.doi.org/10.3109/10903127.2010.481758
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 670
TITLE
MEDEVAC: critical care transport from the battlefield.
AUTHOR NAMES
Higgins R.A.
AUTHOR ADDRESSES
(Higgins R.A.) California Army National Guard, Mather, C Company, 1st
Battalion, 168th Aviation Regiment, 3754 Femoyer St, CA 95655, USA.
CORRESPONDENCE ADDRESS
R.A. Higgins, California Army National Guard, Mather, C Company, 1st
Battalion, 168th Aviation Regiment, 3754 Femoyer St, CA 95655, USA. Email:
ruben.a.higgins@us.army.mil
SOURCE
AACN advanced critical care (2010) 21:3 (288-297). Date of Publication: 2010
Jul-Sep
ISSN
1559-7776 (electronic)
ABSTRACT
In current military operations, the survival rates of critically injured
casualties are unprecedented. An often hidden aspect of casualty care is
safe transport from the point of injury to a field hospital and subsequently
on to higher levels of care. This en route critical care, which is provided
by flight medics under the most austere and rigorous conditions, is a
crucial link in the care continuum. This article introduces the role and
capabilities of US Army MEDEVAC and reflects the author's recent experience
in Afghanistan as a flight medic. This article provides an assessment of the
operational issues, medical capabilities, and transport experiences to
provide a real-world view of critical care transport from the battlefield.
The MEDEVAC helicopter environment is one of the most difficult, if not the
most demanding, critical care environments. This overview brings to light a
small but important piece of the care continuum.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
injury (therapy)
intensive care
military medicine
military nursing
patient transport
soldier
EMTREE MEDICAL INDEX TERMS
Afghanistan
article
case report
health care delivery
human
methodology
nursing
organization and management
United States
war
LANGUAGE OF ARTICLE
English
MEDLINE PMID
20683230 (http://www.ncbi.nlm.nih.gov/pubmed/20683230)
PUI
L360272619
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 671
TITLE
Improvised chest tube valve for intra-hospital patient transportation.
AUTHOR NAMES
Flores-Franco R.A.
AUTHOR ADDRESSES
(Flores-Franco R.A.)
CORRESPONDENCE ADDRESS
R.A. Flores-Franco,
SOURCE
The Indian journal of chest diseases & allied sciences (2010) 52:3 (175;
author reply 175-176). Date of Publication: 2010 Jul-Sep
ISSN
0377-9343
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient transport
tube
wound drainage
EMTREE MEDICAL INDEX TERMS
equipment design
human
note
LANGUAGE OF ARTICLE
English
MEDLINE PMID
20949739 (http://www.ncbi.nlm.nih.gov/pubmed/20949739)
PUI
L359878118
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 672
TITLE
Critical path network. Bay Medical improves ED throughput via ICU.
AUTHOR ADDRESSES
SOURCE
Hospital case management : the monthly update on hospital-based care
planning and critical paths (2010) 18:7 (105-106). Date of Publication: Jul
2010
ISSN
1087-0652
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
intensive care unit
organization and management
patient transport
EMTREE MEDICAL INDEX TERMS
article
health services research
standard
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
20586177 (http://www.ncbi.nlm.nih.gov/pubmed/20586177)
PUI
L359244757
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 673
TITLE
Measuring critical care air support teams' performance during extended
periods of duty.
AUTHOR NAMES
Lamb D.
AUTHOR ADDRESSES
(Lamb D.) Royal Centre for Defence Medicine, Birmingham B29 6JD, United
Kingdom.
CORRESPONDENCE ADDRESS
D. Lamb, Royal Centre for Defence Medicine, Birmingham B29 6JD, United
Kingdom. Email: Di.Lamb@uhb.nhs.uk
SOURCE
AACN advanced critical care (2010) 21:3 (298-306). Date of Publication: 2010
Jul-Sep
ISSN
1559-7776 (electronic)
ABSTRACT
The Royal Air Force (RAF) Critical Care Air Support Teams (CCASTs)
aeromedically evacuate seriously injured service personnel. Long casualty
evacuation chains create logistical constraints that must be considered when
aeromedically evacuating patients. One constraint is the length of a CCAST
mission and its potential effect on team member performance. Despite no
evidence of patient care compromise, the RAF has commissioned a study to
investigate whether CCAST mission length influences performance. Describing
and understanding the role of a CCAST enabled fatigue to be defined. Factors
essential to studying fatigue were then identified that were used to develop
a theoretical model for designing a study to measure the effects of fatigue
on CCAST performance. Relevant factors include the patient's clinical
condition, team members' cognition and vigilance levels, and the
occupational aviation environment. Further factors influencing overall
performance include the duration and complexity of patient interventions,
mission length, circadian influences, and fatigue countermeasures.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
intensive care
military medicine
military nursing
patient transport
soldier
EMTREE MEDICAL INDEX TERMS
adaptive behavior
article
critical illness
evaluation study
fatigue (etiology, prevention)
health care delivery
human
mental stress
methodology
organization and management
task performance
United Kingdom
LANGUAGE OF ARTICLE
English
MEDLINE PMID
20683231 (http://www.ncbi.nlm.nih.gov/pubmed/20683231)
PUI
L360272620
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 674
TITLE
An inborn error of bile salt transport with features mimicking abusive head
trauma
AUTHOR NAMES
Hendrickson D.J.
Knisely A.S.
Coulter K.
Telander D.G.
Quan R.
Ruebner B.H.
Leigh M.J.
AUTHOR ADDRESSES
(Hendrickson D.J.; Coulter K.; Quan R.; Leigh M.J.) University of California
Davis Medical Center, Department of Pediatrics, Sacramento, CA, United
States.
(Knisely A.S.) Institute of Liver Studies, King's College Hospital, London,
United Kingdom.
(Telander D.G.) University of California Davis Medical Center, Department of
Ophthalmology and Vision Science, Sacramento, CA, United States.
(Ruebner B.H.) University of California Davis Medical Center, Department of
Pathology, Sacramento, CA, United States.
CORRESPONDENCE ADDRESS
D.J. Hendrickson, Northern Nevada Pediatrics, 75 Pringle Way, Suite 301,
Reno, NV 89502, United States.
SOURCE
Child Abuse and Neglect (2010) 34:7 (472-476). Date of Publication: July
2010
ISSN
0145-2134
BOOK PUBLISHER
Elsevier Ltd, Langford Lane, Kidlington, Oxford, United Kingdom.
EMTREE DRUG INDEX TERMS
alpha tocopherol
calcium (drug combination, drug therapy)
fresh frozen plasma
retinol
vitamin D (drug combination, drug therapy)
vitamin K group
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intrahepatic cholestasis (diagnosis, surgery)
EMTREE MEDICAL INDEX TERMS
anamnesis
article
bleeding
bone radiography
case report
child abuse
comparative genomic hybridization
computer assisted tomography
convalescence
craniotomy
disease course
ear disease
emergency ward
female
head injury (diagnosis)
homelessness
hospital discharge
human
inborn error of metabolism
infant
intensive care unit
laboratory test
liver transplantation
maternal disease
mental disease
ophthalmoscopy
physical examination
retina hemorrhage (diagnosis)
seizure
subdural hematoma (diagnosis, surgery)
vitamin D deficiency
vitamin K deficiency (drug therapy)
CAS REGISTRY NUMBERS
alpha tocopherol (1406-18-4, 1406-70-8, 52225-20-4, 58-95-7, 59-02-9)
calcium (14092-94-5, 7440-70-2)
retinol (68-26-8, 82445-97-4)
vitamin K group (12001-79-5)
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Drug Literature Index (37)
Gastroenterology (48)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2010350182
MEDLINE PMID
20627390 (http://www.ncbi.nlm.nih.gov/pubmed/20627390)
PUI
L50934525
DOI
10.1016/j.chiabu.2009.11.008
FULL TEXT LINK
http://dx.doi.org/10.1016/j.chiabu.2009.11.008
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 675
TITLE
The transport of critically ill patients by specialized team: A mobile ICU
AUTHOR NAMES
Liu D.-W.
AUTHOR ADDRESSES
(Liu D.-W., dwliu@medmail.com.cn)
CORRESPONDENCE ADDRESS
D.-W. Liu, Email: dwliu@medmail.com.cn
SOURCE
Chinese Critical Care Medicine (2010) 22:6 (321-322). Date of Publication:
June 2010
ISSN
1003-0603
BOOK PUBLISHER
Heilongjiang Institute of Science and Technology Information, 74 Yinhnag St,
Nangang-qu, Harbin, China.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
decision making
editorial
human
questionnaire
United Kingdom
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
Chinese
EMBASE ACCESSION NUMBER
2010395187
MEDLINE PMID
20594460 (http://www.ncbi.nlm.nih.gov/pubmed/20594460)
PUI
L359201289
DOI
10.3760/cma.j.issn.1003-0603.2010.06.001
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.issn.1003-0603.2010.06.001
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 676
TITLE
Neonatal outcome of 197 babies born after 706 frozen-thawed embryo transfer
cycles; comparing two different cryopreservation techiques
AUTHOR NAMES
Karagozoglu H.
Kahraman S.
Yelke H.
Karlikaya G.
Güler Y.
Kumtepe Y.
AUTHOR ADDRESSES
(Karagozoglu H.; Kahraman S.; Yelke H.; Karlikaya G.; Güler Y.; Kumtepe Y.)
Istanbul Memorial Hospital, ART and Genetics Center, Istanbul, Turkey.
CORRESPONDENCE ADDRESS
H. Karagozoglu, Istanbul Memorial Hospital, ART and Genetics Center,
Istanbul, Turkey.
SOURCE
Human Reproduction (2010) 25 SUPPL. 1 (i152). Date of Publication: June 2010
CONFERENCE NAME
26th Annual Meeting of the European Society of Human Reproduction and
Embryology, ESHRE
CONFERENCE LOCATION
Rome, Italy
CONFERENCE DATE
2010-06-27 to 2010-06-30
ISSN
0268-1161
BOOK PUBLISHER
Oxford University Press
ABSTRACT
Objective: With improvement in assisted reproductive technologies, the
number of transferred embryos has been reducing, which has resulted in more
embryos being available for freezing. Embryo cryopreservation provides an
increased cumulative pregnancy rate per oocyte retrieval, while decreasing
the risk of multiple gestations and the risk of ovarian hyperstimulation
syndrome. Our aim was to evaluate and compare the pregnancy and neonatal
outcomes in infants born after frozen-thawed embryo transfer cycles at our
centre after slow freezing-rapid thawing at cleavage stage (SF-group) and
ultra-rapid vitrification at blastocyst stage (V-group) between 2004 and
2008. Materials and Methods: This study was conducted retrospectively at
Istanbul Memorial Hospital ART and Reproductive Genetics Center between
January 2004 and Dezember 2008. Main outcome measures were post-thaw
survival of embryos, implantation and (multiple ) pregnancy rates, neonatal
outcome including congenital birth defects while comparing two
cryopreservation techniques. Mean female age was 30.6 ± 4.2 in SF-group and
31.2 ± 4.7 in V-group (n = 0.08). A total of 706 cycles yielding 197 live
born babies were included. Statistical analysis was performed using t-test,
chi-squared test and Monte Carlo-exact test. A p-value of < .05 was
considered as statistically significant. Results:A total of 1396 slow-frozen
cleavage stage embryos from 295 cycles were warmed and 1022 survived (78.0
%), which were used for embryo transfer. Mean number of embryos transferred
per cycle was 2.9 ± 0.7. The implantation (IR), clinical and ongoing
pregnancy rates, miscarriage, and live birh rates achieved were 15.7 %,35.6
%,26.1 %, 8.5 %,25.8 %, respectively. Of the 76 deliveries, singleton,
twins, and triplets comprised of 64.5%, 31.6%, 3.9%, respectively, and 24
(31.6%) were preterm (< 37 weeks) deliveries. Low birth weight (< 2500g)
(LBW) and very LBW (< 1500 g) rates are 21.7%, 15.1%, respectively. Out of
106 children live born, 50.9% were female and congenital major birth defects
were observed in 2.8 % of live borns. A total of 1487 vitrified blastocyst
stage embryos from 411 cycles were warmed and 1179 survived (84.1 %), which
were used for embryo transfer. Mean number of embryos transferred per cycle
was 2.6 ± 0.7. The implantation, clinical and ongoing pregnancy rates,
miscarriage, and live birth rates achieved were 21.4 %, 42.3 %, 30.9 %, 11.2
%,29.4 %, respectively. Of the 121 deliveries, singleton, twins, and
triplets comprised of 67.8 %, 28.9 %, 3.3 %, respectively, and 45 (37.2 %)
were preterm deliveries. LBW and very LBW rates are 20.1 %, 5.5 %,
respectively. Out of 164 children live born, 54.9 % were female and
congenital major birth defects were observed in 1.8 % of live borns. The
survival rate of vitrified blastocysts after warming was significantly
higher than slow frozen cleavage stage embryos (n < 0.001). The mean number
of transferred embryos was in V-group significantly lower than the SF-group
(n < 0.001). In spite of significantly higher IR in V-group than the
SF-group (n < 0.001), there was no significant difference in multiple
pregnancy rates between groups (n = 0.88). This data demonstrated a higher
birth weight after vitri-fied blastocyst transfer (n = 0.02). In addition
admission rate to intensive care unit was higher in SF-group newborns
(23.6%) than in V-group (11%).(p = 0.006) Conclusions: Vitrified blastocyst
transfer leads to increased implantation rates with a better neonatal
outcome with higher birth weight rates, especially the difference was
distinct in very low birthweight newborns. Therefore, higher rate transfer
to intensive care unit was required in infants born after slow freezing
cleavage stage embryo transfers. The incidence of major birth defects was
not different in both study groups.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
baby
cryopreservation
embryo transfer
embryology
reproduction
society
EMTREE MEDICAL INDEX TERMS
birth rate
birth weight
blastocyst
child
congenital malformation
embryo
female
freezing
genetics
hospital
implantation
infant
intensive care unit
live birth
low birth weight
multiple pregnancy
newborn
oocyte retrieval
ovary hyperstimulation
pregnancy
pregnancy rate
premature labor
risk
spontaneous abortion
statistical analysis
statistical significance
Student t test
survival
survival rate
technology
thawing
Turkey (republic)
twins
very low birth weight
vitrification
warming
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70245787
DOI
10.1093/humrep/de.25.s1.91
FULL TEXT LINK
http://dx.doi.org/10.1093/humrep/de.25.s1.91
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 677
TITLE
Prehospital notification from EMS enhances the shortening of transfer and
intra-hospital processing times for acute stroke patients
AUTHOR NAMES
Cha J.K.
Lee S.Y.
AUTHOR ADDRESSES
(Cha J.K.; Lee S.Y.) Dong-A University Hospital, Busan, South Korea.
CORRESPONDENCE ADDRESS
J.K. Cha, Dong-A University Hospital, Busan, South Korea.
SOURCE
Journal of Neurology (2010) 257 SUPPL. 1 (S198). Date of Publication: June
2010
CONFERENCE NAME
20th Meeting of the European Neurological Society
CONFERENCE LOCATION
Berlin, Germany
CONFERENCE DATE
2010-06-19 to 2010-06-23
ISSN
0340-5354
BOOK PUBLISHER
D. Steinkopff-Verlag
ABSTRACT
Little information is available about the effects of EMS hospital
notification on transfer and intrahospital processing times in acute
ischemic stroke. In this study, we retrospectively investigated the real
transfer and imaging processing times for suspect acute stroke (AS) patients
with EMS notification of needing intravenous tissue type plasminogen
activatior (IV t-PA) and those without. Also compared between patients with
and without notification were intrahospital processing times for receiving
t-PA. From December 2008 to August 2009, EMS transported 102 patients with
suspected AS to our stroke centre. During the same period, 33 patients
received IV t-PA without prehospital notification from EMS. Mean real
transfer time after EMS calls was 56.0±32.0 min. Patients with a transfer
distance of more than 40 km could not arrive at our centre within 60 min.
Among the 102 patients, 55 transferred via EMS to our ER for IV t-PA. The
positive predictive value for stroke (90.9% vs 68.1%, p=0.005) was much
higher and real transfer time was much faster in patients with an EMS t-PA
call (47.7±23.1 min, p=0.004) compared to those without one (56.3±32.4 min).
The 18 patients with prehospital notification who ultimately received t-PA
had a significantly reduced door-to-imaging (17.8±11.0 min vs 26.9±11.5 min,
p=0.01) and door-to-needle time (29.7 ± 9.6 vs 42.1 ± 18.1 min, p=0.01). Our
results indicate that prehospital notification could enable rapid dispatch
of AS patients needing IV t-PA to a stroke centre. In addition, it could
reduce intrahospital delays, particularly, imaging processing times.
EMTREE DRUG INDEX TERMS
plasminogen
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital
processing
society
stroke patient
EMTREE MEDICAL INDEX TERMS
brain ischemia
cerebrovascular accident
imaging
needle
patient
tissues
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70233994
DOI
10.1007/s00415-010-5575-7
FULL TEXT LINK
http://dx.doi.org/10.1007/s00415-010-5575-7
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 678
TITLE
Emergency transfer of in-patients to renal services - Admission illness
severity scoring may identify those at risk of needing early critical care
AUTHOR NAMES
Kanagasundaram N.S.
Tee S.A.
Brady M.
Grant L.
Cosgrove J.F.
AUTHOR ADDRESSES
(Kanagasundaram N.S.; Tee S.A.; Brady M.; Grant L.) Renal Services,
Newcastle upon Tyne Hospitals NHS Foundation Trust, United Kingdom.
(Kanagasundaram N.S.) Institute of Cellular Medicine, Newcastle University,
United Kingdom.
(Cosgrove J.F.) Peri-Operative/Critical Care Services, Newcastle upon Tyne
Hospitals NHS Foundation Trust, United Kingdom.
CORRESPONDENCE ADDRESS
N.S. Kanagasundaram, Renal Services, Newcastle upon Tyne Hospitals NHS
Foundation Trust, United Kingdom.
SOURCE
NDT Plus (2010) 3 SUPPL. 3 (iii54-iii55). Date of Publication: June 2010
CONFERENCE NAME
17th ERA-EDTA Congress - II DGfN Congress
CONFERENCE LOCATION
Munich, Germany
CONFERENCE DATE
2010-06-25 to 2010-06-28
ISSN
1753-0784
BOOK PUBLISHER
Oxford University Press
ABSTRACT
Introduction and Aims: Delayed transfer of in-patients for specialist renal
management may affect outcomes for both ESRD and AKI patients but their
arrival on the renal unit with unheralded critical illness is a risk to
patient safety and an unexpected burden on local critical care services. We
have already demonstrated the utility of the SOFA physiological severity
scoring tool in highlighting AKI transfers at risk of needing early critical
care. Use of the more familiar Modified Early Warning System (MEWS) would
harmonise practice but has yet to be assessed in emergency transfers. The
present study aimed to assess the utility of the admission MEWS in
identifying emergency in-patient transfers to the renal unit at risk of
needing early escalation of care. Methods: The local MEWS protocol carries a
maximum score of 18 if urine output criteria are excluded, with threshold
scores of ≥ 2 triggering increasing intensity/seniority of assessment. We
conducted a retrospective, observational study of all emergency in-patient
transfers from outside hospitals to our regional renal unit for the year
ending 14.10.2008. Direct transfers to our transplant unit were excluded.
The admission MEWS score (urine output criteria excluded) was calculated.
Data collection included admission source, prior level of care, admission
diagnosis and the need for escalation of care. Results: There were 136
emergency transfers with a median [range] admission MEWS score of 0 [0-5]).
These comprised 127 patients with median age 68 years [16-91]. There were 71
males and 36 receiving chronic dialysis. Seventy transfers were of patients
previously known to renal services with 65 for AKI. The admission sources
were: ward-level (n = 71), critical care (25), accident and
emergency/emergency admissions unit (39), coronary care (1). Eleven/136
transfers (MEWS: 1 [0-4]) subsequently required higher level care, a median
of 2 days [0-11] after renal unit admission. Seven of these had AKI. Four
patients required step-up care on the day of admission (MEWS: 1, 3, 4, 4).
Three had AKI with 1 ESRD patient admitted with hypertensive encephalopathy.
Two had arrived from ward-level care and 2 from accident and emergency. None
of the 79 patients with an admission MEWS of 0 required day-of-transfer
step-up of care in contrast to 7%, 10% and 27% of those with a MEWS of ≥ 1,
2 and 3, respectively. Conclusions: In-patient emergency transfers with a
higher admission MEWS score may carry a higher risk of needing early
escalation of care. Although the tool cannot determine the most appropriate
venue for transfer, if applied prior to transfer, it may provide an
objective rather than subjective guide to the receiving physicians about the
need for early liaison with critical care and senior renal colleagues, and
warn of the need for more frequent physiological observation on arrival on
the unit.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
edetic acid
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
disease severity
emergency
evoked response audiometry
human
intensive care
patient
risk
EMTREE MEDICAL INDEX TERMS
accident
critical illness
diagnosis
dialysis
hospital
hospital patient
hypertension encephalopathy
information processing
male
medical specialist
observational study
patient safety
patient transport
physician
transplantation
urine volume
ward
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70483548
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 679
TITLE
Chinese guidelines for the transport of critically ill patients, 2010
AUTHOR ADDRESSES
CORRESPONDENCE ADDRESS
Email: Kangyan@vip.sina.com
SOURCE
Chinese Critical Care Medicine (2010) 22:6 (328-330). Date of Publication:
June 2010
ISSN
1003-0603
BOOK PUBLISHER
Heilongjiang Institute of Science and Technology Information, 74 Yinhnag St,
Nangang-qu, Harbin, China.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
patient transport
EMTREE MEDICAL INDEX TERMS
human
Influenza A virus (H1N1)
intensive care unit
positive end expiratory pressure
practice guideline
short survey
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
Chinese
EMBASE ACCESSION NUMBER
2010395189
MEDLINE PMID
20594463 (http://www.ncbi.nlm.nih.gov/pubmed/20594463)
PUI
L359201291
DOI
10.3760/cma.j.issn.1003-0603.2010.06.004
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.issn.1003-0603.2010.06.004
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 680
TITLE
Pregnancy outcomes of naturally conceived singletons and singletons after
elective single embryo transfer (eSET) are comparable
AUTHOR NAMES
Delbaere I.
Gerris J.
De Neubourg D.
Vansteelandt S.
Martens G.
Verdonk P.
De Sutter P.
Temmerman M.
AUTHOR ADDRESSES
(Delbaere I.; Gerris J.) University Ghent Obstetrics and Gynaecology, Gent,
Belgium.
(De Neubourg D.; Verdonk P.) Middelheim Hospital, Obstetrics and
Gynaecology, Antwerp, Belgium.
(Vansteelandt S.) University Ghent Applied Mathematics and Informatics,
Ghent, Belgium.
(Martens G.) Study Centre Perinatal Epidemiology, Obstetrics and
Gynaecology, Brussels, Belgium.
(De Sutter P.; Temmerman M.) University Ghent Obstetrics and Gynaecology,
Ghent, Belgium.
CORRESPONDENCE ADDRESS
I. Delbaere, University Ghent Obstetrics and Gynaecology, Gent, Belgium.
SOURCE
Human Reproduction (2010) 25 SUPPL. 1 (i54). Date of Publication: June 2010
CONFERENCE NAME
26th Annual Meeting of the European Society of Human Reproduction and
Embryology, ESHRE
CONFERENCE LOCATION
Rome, Italy
CONFERENCE DATE
2010-06-27 to 2010-06-30
ISSN
0268-1161
BOOK PUBLISHER
Oxford University Press
ABSTRACT
Introduction: Outcome differences between naturally conceived babies and
children born after assisted reproduction have been studied extensively,
both in singleton and twin cohorts. Results from early studies in singletons
indicated that children after assisted reproduction are disadvantaged in
outcome parameters such as preterm birth, low birth weight and perinatal
death. These studies dated from the pre - single embryo transfer (SET) era,
where singletons generally resulted from multiple embryo transfer or
compulsory single embryo transfer (only one embryo available). Elective
single embryo transfer was introduced in the late - nineties in order to
halt the twin epidemic in assisted reproduction. When outcomes of singletons
after elective SET (eSET) were compared with outcomes of singletons after
double embryo transfer, substantially better outcomes were found in eSET -
singletons. In this study we want to assess to which extent outcomes of eSET
- singletons do or do not differ from naturally conceived singletons.
Material and Methods: This is a multicentre study, comparing 725 singletons
after eSET (cases) with 1450 naturally conceived singletons (controls).
Every case was matched to two controls for maternal age, child's year of
birth, sex of the child and mode of delivery. Databases of two infertility
centers provided the cases (university hospital Ghent and Middelheim
hospital Antwerp, Belgium), controls were extracted from the Flemish
population - based perinatal register (Study centre perinatal Epidemiology -
SPE, Belgium). Outcome indicators include gestational age, birth weight,
transfer to neonatal intensive care unit, stillbirth and neonatal death. The
Cochran-Mantel-Haenszel test was used for analysis. Results: The incidence
of preterm birth was similar in singletons after eSET (6.9%) and naturally
conceived singletons (7.0%). Likewise, no difference was found in low birth
weight; 5.8% in singletons after eSET and 7.1% in naturally conceived
singletons). Naturally conceived singletons had a higher chance to be
transferred to neonatal intensive care when compared with singletons after
eSET (15.7% versus 7.2% - RR 0.50; 95% CI 0.37 - 0.67). No statistically
significant difference was found between both groups for stillbirth (0.1% in
singletons after eSET and 0.4% in naturally conceived singletons - RR 0.29;
95% CI 0.04 - 2.32 and for neonatal death 0.1% in singletons after eSET and
0.3% in naturally conceived singletons (RR 0.40; 95% CI 0.05 - 3.43).
Conclusions: Our results indicate no difference in adverse pregnancy outcome
after assisted reproduction when comparing naturally conceived singletons
with singletons after eSET. Earlier studies demonstrated the advantages of
elective single embryo transfer in twin - prone patients in order to reduce
the number of twins after ART. This study adds evidence to the fact that
singleton pregnancies after eSET seem to be a different cohort than
singletons after DET or transfer of more than two embryos.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
embryo transfer
embryology
pregnancy outcome
reproduction
society
EMTREE MEDICAL INDEX TERMS
baby
Belgium
birth weight
child
data base
embryo
epidemic
epidemiology
gestational age
hospital
infertility
intensive care unit
low birth weight
Mantel Haenszel test
maternal age
newborn death
newborn intensive care
patient
perinatal death
population
pregnancy
register
stillbirth
twins
university hospital
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70245548
DOI
10.1093/humrep/de.25.s1.36
FULL TEXT LINK
http://dx.doi.org/10.1093/humrep/de.25.s1.36
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 681
TITLE
History of the neonatal transport: progress in organization during the last
thirty years
ORIGINAL (NON-ENGLISH) TITLE
Histoire du transport néonatal: progrès dans l'organisation au cours des 30
dernières années
AUTHOR NAMES
Chabernaud J.-L.
Ayachi A.
Lodé N.
Lelong-Tissier M.-C.
Diependaele J.-F.
Menthonnex E.
AUTHOR ADDRESSES
(Chabernaud J.-L., jean-louis.chabernaud@abc.aphp.fr) Service de réanimation
néonatale, Smur pédiatrique (Samu 92), CHU Antoine-Béclère (AP-HP), 157, rue
de la Porte-de-Trivaux, Clamart cedex, F-92141, France.
(Ayachi A.) Smur pédiatrique de Montreuil (Samu 93), CHU Avicennes Bobigny
(AP-HP) et CH Montreuil, 56, boulevard de Boissière, Montreuil cedex,
F-93105, France.
(Lodé N.) Smur pédiatrique de R.-Debré (Samu de Paris), CHU Robert Debré
(AP-HP), 48 boulevard Sérurier, Paris, F-75019, France.
(Lelong-Tissier M.-C.) Smur pédiatrique de Toulouse (Samu 31), CHU Hôpital
des enfants, 330, avenue de la Grande-Bretagne, TSA 70034, Toulouse cedex 9,
F-31059, France.
(Diependaele J.-F.) Smur pédiatrique de Lille (Samu 59), CHRU de Lille, 5,
avenue Oscar-Lambret, Lille cedex, F-59037, France.
(Menthonnex E.) Samu 38 Grenoble, SMUR de Grenoble (SAMU 38), CHU de
Grenoble, Pôle Urgences/SAMU-SMU, BP127, Grenoble cedex 9, F-38043, France.
CORRESPONDENCE ADDRESS
J.-L. Chabernaud, Service de réanimation néonatale, Smur pédiatrique (Samu
92), CHU Antoine-Béclère (AP-HP), 157, rue de la Porte-de-Trivaux, Clamart
cedex, F-92141, France. Email: jean-louis.chabernaud@abc.aphp.fr
SOURCE
Revue de médecine périnatale (2010) (1-9). Date of Publication: 2010
ISSN
1965-0833
1965-0841 (electronic)
ABSTRACT
Since the end of the seventies neonatal transfers in France and in most of
the europeans countries are organized and realized by specialized teams
often with the survey of pediatricians. The teams are « dedicated » for a
region or « on call » for a neonatal intensive care unit in a perinatal
network. In France, the law has changed following the « Perinatal Plan ».
Neonatal transport is now defined in two levels: medical team or teamswith
paramedics. In our country, the neonatal emergency transfer systems (Smur
pédiatrique) have taken an important part to the diffusion of technical
progress and care protocols during the last fifteen years, to improve
results and for perinatal regionalisation. They also have played a role in
the evaluation of the perinatal policies and in the education of
pediatricians, midwifes and nurses. © 2010 Springer.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
surfactant
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air conditioning
analgesia
emergency
sedation
EMTREE MEDICAL INDEX TERMS
diffusion
education
France
intensive care unit
newborn intensive care
nurse
pediatrician
policy
LANGUAGE OF ARTICLE
French
LANGUAGE OF SUMMARY
English, French
PUI
L50933185
DOI
10.1007/s12611-010-0067-7
FULL TEXT LINK
http://dx.doi.org/10.1007/s12611-010-0067-7
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 682
TITLE
Recommendations for the intra-hospital transport of critically ill patients
AUTHOR NAMES
Fanara B.
Manzon C.
Barbot O.
Desmettre T.
Capellier G.
AUTHOR ADDRESSES
(Fanara B., fan.ben@netcourrier.com; Manzon C., cyril.manzon@hotmail.fr;
Barbot O., obarbot@chu-besancon.fr; Desmettre T.,
tdesmettre@chu-besancon.fr; Capellier G., gilles.capellier@univ-fcomte.fr)
Department of Emergency Medicine, Jean Minjoz University Hospital, 25030
Besançon, France.
CORRESPONDENCE ADDRESS
G. Capellier, Department of Emergency Medicine, Jean Minjoz University
Hospital, 25030 Besançon, France. Email: gilles.capellier@univ-fcomte.fr
SOURCE
Critical Care (2010) 14:3 Article Number: R87. Date of Publication: 14 May
2010
ISSN
1364-8535
1466-609X (electronic)
BOOK PUBLISHER
BioMed Central Ltd., Floor 6, 236 Gray's Inn Road, London, United Kingdom.
ABSTRACT
Introduction: This study was conducted to provide Intensive Care Units and
Emergency Departments with a set of practical procedures (check-lists) for
managing critically-ill adult patients in order to avoid complications
during intra-hospital transport (IHT).Methods: Digital research was carried
out via the MEDLINE, EMBASE, CINAHL and HEALTHSTAR databases using the
following key words: transferring, transport, intrahospital or
intra-hospital, and critically ill patient. The reference bibliographies of
each of the selected articles between 1998 and 2009 were also
studied.Results: This review focuses on the analysis and overcoming of
IHT-related risks, the associated adverse events, and their nature and
incidence. The suggested preventive measures are also reviewed. A check-list
for quick execution of IHT is then put forward and justified.Conclusions:
Despite improvements in IHT practices, significant risks are still involved.
Basic training, good clinical sense and a risk-benefit analysis are
currently the only deciding factors. A critically ill patient, prepared and
accompanied by an inexperienced team, is a risky combination. The
development of adapted equipment and the widespread use of check-lists and
proper training programmes would increase the safety of IHT and reduce the
risks in the long-term. Further investigation is required in order to
evaluate the protective role of such preventive measures. © 2010 Fanara et
al.; licensee BioMed Central Ltd.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
patient transport
EMTREE MEDICAL INDEX TERMS
adverse outcome
article
checklist
emergency ward
human
intensive care
intensive care unit
medical education
patient safety
priority journal
risk benefit analysis
risk reduction
systematic review
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2011024656
MEDLINE PMID
20470381 (http://www.ncbi.nlm.nih.gov/pubmed/20470381)
PUI
L50913978
DOI
10.1186/cc9018
FULL TEXT LINK
http://dx.doi.org/10.1186/cc9018
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 683
TITLE
Therapeutic hypothermia on neonatal transport: 4-year experience in a single
NICU
AUTHOR NAMES
Fairchild K.
Sokora D.
Scott J.
Zanelli S.
AUTHOR ADDRESSES
(Fairchild K., kdf2n@virginia.edu; Sokora D.; Scott J.; Zanelli S.) Division
of Neonatology, Department of Pediatrics, University of Virginia, Hospital
Dr Box 800386, Charlottesville, VA 22908, United States.
CORRESPONDENCE ADDRESS
K. Fairchild, Division of Neonatology, Department of Pediatrics, University
of Virginia, Hospital Dr Box 800386, Charlottesville, VA 22908, United
States. Email: kdf2n@virginia.edu
SOURCE
Journal of Perinatology (2010) 30:5 (324-329). Date of Publication: May 2010
ISSN
0743-8346
1476-5543 (electronic)
BOOK PUBLISHER
Nature Publishing Group, Houndmills, Basingstoke, Hampshire, United Kingdom.
ABSTRACT
Objective: Therapeutic hypothermia instituted within 6 h of birth has been
shown to improve neurodevelopmental outcomes in term newborns with
moderate-to-severe hypoxic-ischemic encephalopathy (HIE). The majority of
infants who would benefit from cooling are born at centers that do not offer
the therapy, and adding the time for transport will result in delays in
therapy, that may lead to suboptimal or no neuroprotection for some
patients. Our objective was to evaluate the effect of our center's
experience with therapeutic hypothermia on neonatal transport.Study Design:
Retrospective review of all cases of therapeutic hypothermia at a single
neonatal intensive care unit from 2005 to 2009.Result: Of 50 infants with
HIE treated with hypothermia, 40 were outborn and 35 were cooled on
transport. The majority of patients were passively cooled by the referring
clinicians, then actively cooled by our transport team. Overcooling to 32°C
occurred in 34% of patients, but there were no significant differences in
admission vital signs or laboratory values between overcooled and
appropriately cooled infants. The average time after birth of initiation of
passive cooling was 1.4 h and active cooling was 2.7 h compared with the
time of admission to our unit of 5.9 h.Conclusion: We discuss the important
aspects of our program, including the education of referring and receiving
clinicians and avoidance of overcooling. © 2010 Nature Publishing Group All
rights reserved.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
induced hypothermia
newborn intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
brain disease (therapy)
clinical article
health care delivery
hospital admission
human
hypoxic ischemic encephalopathy (therapy)
infant
outcome assessment
patient referral
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Neurology and Neurosurgery (8)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2010258841
MEDLINE PMID
19847186 (http://www.ncbi.nlm.nih.gov/pubmed/19847186)
PUI
L50680453
DOI
10.1038/jp.2009.168
FULL TEXT LINK
http://dx.doi.org/10.1038/jp.2009.168
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 684
TITLE
Out of hospital transfer is an independent predictor of death or poor
outcome after intracerebral hemorrhage
AUTHOR NAMES
Rincon F.
Behrens D.
Morino T.
Lee E.
Schorr C.
Dellinger P.
Parrillo J.
Mirsen T.
AUTHOR ADDRESSES
(Rincon F.; Behrens D.; Morino T.; Lee E.; Schorr C.; Dellinger P.; Parrillo
J.; Mirsen T.) Cooper University Hospital, Camden, United States.
CORRESPONDENCE ADDRESS
F. Rincon, Cooper University Hospital, Camden, United States.
SOURCE
Cerebrovascular Diseases (2010) 29 SUPPL. 2 (284). Date of Publication: May
2010
CONFERENCE NAME
19th European Stroke Conference
CONFERENCE LOCATION
Barcelona, Spain
CONFERENCE DATE
2010-05-25 to 2010-05-28
ISSN
1015-9770
BOOK PUBLISHER
S. Karger AG
ABSTRACT
Introduction: Transfer of critically-ill patients from an outside Emergency
Department (OSH-ED) has the potential of delaying the admission to the
Intensive Care Unit (ICU). The effect of OSH-ED transfer on hospital outcome
of ICH patients has not been studied. Methods:We designed a retrospective
cohort study using a prospectively compiled and maintained registry (Cerner
Project IMPACT). ICH patients admitted to our ICU from our ED and from
OSH-ED within 24 hrs of stroke were selected for the analysis. Data
collected included demographics, admission physiologic variables, Glasgow
Coma Scale (GCS), APACHE-II, scores; and total ICU and hospital length of
stay (LOS). Primary outcome was functional status at hospital discharge and
secondary outcomes were ICU and hospital LOS. Poor outcome was defined as
death or severe disability at hospital discharge. To assess for the impact
of OSH-ED transfer on primary and secondary outcomes, demographic and
admission clinical variables were used to construct logistic regression
models using the outcome measure as a dependent variable. Results: A total
of 296 patients were selected. The mean age was 65±14 years, of which 47%
were male, 63% were white, and 66% were transferred from OSH-ED. The median
hospital LOS was 6 days (Interquartile range [IQR]=4-11) and median ICU-LOS
was 2 days (IQR=1-4). Overall hospital mortality was 37%. Transfer from
OSH-ED was associated with a 75% probability of death or poor outcome at
hospital discharge. Multivariate regression analysis showed that APACHE-II
(OR, 1.2; 95% CI; 1.1-1.3), GCS <12 (OR, 2.8; 95% CI; 1.8-4.1), and OSH-ED
transfer (OR, 1.7; 95% CI; 1.1-2.5) were independently associated with poor
outcome. OSH-ED was not significantly associated with secondary outcome
measures. Conclusion: This data suggests that in ICH patients, OSH-ED
transfer is independently associated with poor outcome at hospital
discharge. Further research is needed as to identify the potential causes
for this effect.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
brain hemorrhage
cerebrovascular accident
death
hospital
EMTREE MEDICAL INDEX TERMS
APACHE
cohort analysis
critically ill patient
dependent variable
disability
emergency ward
functional status
Glasgow coma scale
hospital discharge
intensive care unit
length of stay
logistic regression analysis
male
model
mortality
patient
register
regression analysis
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70330171
DOI
10.1159/000321266
FULL TEXT LINK
http://dx.doi.org/10.1159/000321266
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 685
TITLE
Comments
AUTHOR NAMES
Landy H.
AUTHOR ADDRESSES
(Landy H.)
CORRESPONDENCE ADDRESS
H. Landy, Miami, FL, United States.
SOURCE
Neurosurgery (2010) 66:5 (932). Date of Publication: May 2010
ISSN
0148-396X
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
EMTREE DRUG INDEX TERMS
carbon dioxide (endogenous compound)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
computer assisted tomography
patient transport
EMTREE MEDICAL INDEX TERMS
arterial pressure
brain hypoxia
brain injury
heart rate
human
intensive care unit
lung function
note
operating room
outcome assessment
oxygen saturation
oxygenation
priority journal
risk assessment
CAS REGISTRY NUMBERS
carbon dioxide (124-38-9, 58561-67-4)
EMBASE CLASSIFICATIONS
Neurology and Neurosurgery (8)
Radiology (14)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2010252051
PUI
L358732627
DOI
10.1227/01.NEU.0000368543.59446.A4
FULL TEXT LINK
http://dx.doi.org/10.1227/01.NEU.0000368543.59446.A4
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 686
TITLE
Bay Medical improves ED throughput via ICU.
AUTHOR ADDRESSES
SOURCE
Hospital peer review (2010) 35:5 (57-59). Date of Publication: May 2010
ISSN
0149-2632
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
community hospital
emergency health service
intensive care unit
organization and management
patient transport
EMTREE MEDICAL INDEX TERMS
article
health services research
human
patient satisfaction
standard
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
20449975 (http://www.ncbi.nlm.nih.gov/pubmed/20449975)
PUI
L358916745
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 687
TITLE
In-hospital intensive care unit transfers: Impact of bed availability
AUTHOR NAMES
Kelly S.G.
Hawley M.
O'Brien J.M.
AUTHOR ADDRESSES
(Kelly S.G.; Hawley M.; O'Brien J.M.) Ohio State University Medical Center,
Columbus, United States.
CORRESPONDENCE ADDRESS
S.G. Kelly, Ohio State University Medical Center, Columbus, United States.
SOURCE
American Journal of Respiratory and Critical Care Medicine (2010) 181:1
MeetingAbstracts. Date of Publication: 1 May 2010
CONFERENCE NAME
American Thoracic Society International Conference, ATS 2010
CONFERENCE LOCATION
New Orleans, LA, United States
CONFERENCE DATE
2010-05-14 to 2010-05-19
ISSN
1073-449X
BOOK PUBLISHER
American Thoracic Society
ABSTRACT
Rationale - While the utilization and need for intensive care unit (ICU)
beds has continued to rise, there are currently no national criteria for ICU
transfer. We studied factors associated with requesting an ICU bed,
including the availability of ICU beds, level of training and predictions
about patient outcome. Methods - We performed a survey study among a random
sample of internal and family medicine residents and attendings at two
hospitals in Columbus (one academic, one community-based). All subjects
received a vignette of a patient admitted to the medical ward with
community-acquired pneumonia whose condition worsened over 2 hours. Subjects
randomly received a vignette in which either one or seven ICU beds were
available. Respondents were asked whether they would request an ICU bed and
to make predictions about patient outcome using a visual analog scale.
Results - There was a wide range in the probability of requesting an ICU bed
(5th percentile to 95th percentile range 10-100%). Respondents were equally
likely to request an ICU bed when one or seven beds were available (63% vs.
58%, respectively; p=0.44). In unadjusted analyses, the probability of
requesting an ICU bed was significantly associated with the respondent being
a resident (19.8% more likely to request ICU bed, p=0.05), higher estimated
mortality without immediate ICU admission (0.9% per 1%-point increase in
predicted mortality, p<0.0001) and subsequent need for ICU admission if not
transferred immediately (1.1% per 1%-point increase in predicted subsequent
ICU need, p<0.0001). In a multivariable model, ICU bed availability was not
significantly associated with the probability of requesting an ICU bed (9.6%
less likely if only one bed available, p=0.10). However, the probability of
requesting an ICU bed was significantly higher with higher estimates of
subsequent need for ICU admission (1.1%-point higher per 1% increase in
predicted need for eventual ICU admission, p<0.0001) and among respondents
from the community-based hospital (13.8% higher, p=0.02). Conclusions -ICU
bed availability was not associated with the probability of requesting ICU
transfer. There was high variability in the probability of making such a
request. Transfer was most closely associated with respondent estimates of
subsequent need for ICU admission. Factors associated with predictions about
subsequent need for ICU care and the influence of bed availability on
decision-making by intensivists requires further study.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital
intensive care unit
society
EMTREE MEDICAL INDEX TERMS
community
community acquired pneumonia
decision making
family medicine
human
model
mortality
patient
prediction
random sample
vignette
visual analog scale
ward
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70839123
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 688
TITLE
Improving safety and documentation in intrahospital transport: Development
of an intrahospital transport tool for critically ill patients
AUTHOR NAMES
Jarden R.J.
Quirke S.
AUTHOR ADDRESSES
(Jarden R.J., rebecca.jarden@ccdhb.org.nz) Intensive Care Unit, Wellington
Hospital, Capital and Coast District Health Board, Wellington, New Zealand.
(Quirke S., sara.quirke@vuw.ac.nz) Graduate School of Nursing Midwifery and
Health, Victoria University of Wellington, New Zealand.
CORRESPONDENCE ADDRESS
R.J. Jarden, Intensive Care Unit, Wellington Hospital, Capital and Coast
District Health Board, Wellington, New Zealand. Email:
rebecca.jarden@ccdhb.org.nz
SOURCE
Intensive and Critical Care Nursing (2010) 26:2 (101-107). Date of
Publication: April 2010
ISSN
0964-3397
BOOK PUBLISHER
Churchill Livingstone, 1-3 Baxter's Place, Leith Walk, Edinburgh, United
Kingdom.
ABSTRACT
Transporting the critically ill patient is described within the literature
as a high-risk procedure. Both guidelines and minimum standards are
available to inform practice. However, a practical, clinically useful, and
evidence-based document (tool) for the ICU nurse to use when transporting a
critically ill patient was not identified in the literature. Consequently,
the development of an intrahospital transport tool is described. This
transport tool was designed to mitigate the risks associated with patient
transport by providing the Intensive Care Unit (ICU) nurse with an
integrated documentation record, incorporating patient assessment with a
procedural guideline. The result is a framework for the ICU nurse to use
throughout intrahospital transfers, informing and supporting them to provide
and document continuity of nursing care. The potential benefit of using this
tool is enhanced patient outcomes through safer ICU intrahospital transport
processes. © 2010 Elsevier Ltd. All rights reserved.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
medical record
patient transport
practice guideline
safety
EMTREE MEDICAL INDEX TERMS
article
documentation
human
intensive care unit
New Zealand
nursing assessment
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
20089403 (http://www.ncbi.nlm.nih.gov/pubmed/20089403)
PUI
L50768419
DOI
10.1016/j.iccn.2009.12.007
FULL TEXT LINK
http://dx.doi.org/10.1016/j.iccn.2009.12.007
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 689
TITLE
Transport times did not change between 2004 and 2009, but thrombolysis rates
increased from 10 to 18%: Results from the national acute stroke-unit
registry in Austria
AUTHOR NAMES
Brainin M.
Tatschl C.
Teuschl Y.
Seyfang L.
Matz K.
Eckhardt R.
AUTHOR ADDRESSES
(Brainin M.; Tatschl C.; Teuschl Y.; Seyfang L.; Matz K.; Eckhardt R.) Dpt
Neurology, Danube Clinic and Danube Univ., Tulln, Austria.
CORRESPONDENCE ADDRESS
M. Brainin, Dpt Neurology, Danube Clinic and Danube Univ., Tulln, Austria.
SOURCE
Stroke (2010) 41:4 (e347). Date of Publication: 1 Apr 2010
CONFERENCE NAME
2010 International Stroke Conference
CONFERENCE LOCATION
San Antonio, TX, United States
CONFERENCE DATE
2010-02-23 to 2010-02-26
ISSN
0039-2499
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Background: The Austrian acute stroke unit system was set up by considering
optimal transport times (in less than 45 minutes) thus ensuring optimal
access from all regions in the country. The aim of this study was to
identify time-dependent factors for referral and thrombolysis treatment in
an acute stroke unit and to define the gains for direct referral versus
referral via another hospital. Methods: Analysis of data from the Austrian
National Acute Stroke-Unit Registry. Results: Data of 40,660 stroke patients
registered at the 29 acute stroke units between January 2003 and May 2009
were analysed. Exact time of onset was known for 18,223 (58%) of patients.
Eighty-five percent were admitted directly and 15% were transferred from
other hospitals. The admission rates within two hours were 58% and 33% for
patients admitted directly and those referred from another hospital,
respectively; correspondingly, 71% and 49% were admitted within three hours
and 78% and 63% within four hours. Direct admission to a hospital equipped
with a stroke unit increased the chances of thrombolytic treatment by the
odds of 1.4 compared to patients transferred via another hospital. The rate
of patients admitted within 2 hours did not change between 2004 and 2009,
however thrombolysis rates increased in the same time period significantly
from 10% to 18%. Potential extension of the time window for thrombolysis to
4h arrivals would increase the thrombolysis rate to 21%. Conclusion: Direct
referral to an acute stroke unit bears highest chances for thrombolysis
treatment. While the transport times for patients referred to acute stroke
units within 2 hours from onset remained constant between 2004 and 2009,
corresponding thrombolysis rates had risen from 10% to 18%. Extension of the
time window including four hour referrals would further increase this rate
to 21%.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Austria
blood clot lysis
cerebrovascular accident
register
stroke unit
EMTREE MEDICAL INDEX TERMS
hospital
patient
stroke patient
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70429669
DOI
10.1161/01.str.0000366115.56266.0a
FULL TEXT LINK
http://dx.doi.org/10.1161/01.str.0000366115.56266.0a
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 690
TITLE
Intrahospital transport of children on extracorporeal membrane oxygenation:
Indications, process, interventions, and effectiveness
AUTHOR NAMES
Prodhan P.
Fiser R.T.
Cenac S.
Bhutta A.T.
Fontenot E.
Moss M.
Schexnayder S.
Seib P.
Chipman C.
Weygandt L.
Imamura M.
Jaquiss R.D.B.
Dyamenahalli U.
AUTHOR ADDRESSES
(Prodhan P., prodhanparthak@uams.edu; Fiser R.T.) Departmen of Pediatric
Critical Care Medicine, University of Arkansas for Medical Sciences, Little
Rock, AR, United States.
(Cenac S.; Bhutta A.T.; Fontenot E.; Seib P.; Chipman C.; Weygandt L.;
Imamura M.) Department of Pediatrics, University of Arkansas for Medical
Sciences, Arkansas Children's Hospital, Little Rock, AR, United States.
(Moss M.) Department of Pediatrics, Critical Care and Cardiology, University
of Arkansas for Medical Sciences College of Medicine, Little Rock, AR,
United States.
(Schexnayder S.) Department of Pediatrics and Internal Medicine, University
of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock,
AR, United States.
(Seib P.) Cardiac Cath Lab, Little Rock, AR, United States.
(Jaquiss R.D.B.) Department of Pediatric Cardiac Surgery, Arkansas
Children's Hospital, University of Arkansas for Medical Sciences, Little
Rock, AR, United States.
(Dyamenahalli U.) Department of Pediatric Cardiology and Cardiac
Intensivist, University of Arkansas for Medical Sciences, Little Rock, AR,
United States.
CORRESPONDENCE ADDRESS
P. Prodhan, Departmen of Pediatric Critical Care Medicine, University of
Arkansas for Medical Sciences, Little Rock, AR, United States. Email:
prodhanparthak@uams.edu
SOURCE
Pediatric Critical Care Medicine (2010) 11:2 (227-233). Date of Publication:
March 2010
ISSN
1529-7535
BOOK PUBLISHER
Lippincott Williams and Wilkins, 530 Walnut Street, Philadelphia, United
States.
ABSTRACT
OBJECTIVE:: To evaluate indications, process, interventions, and
effectiveness of patients undergoing intrahospital transport. Critically ill
patients supported with extracorporeal membrane oxygenation are transported
within the hospital to the radiology suite, cardiac catheterization suite,
operating room, and from one intensive care unit to another. No studies to
date have systematically evaluated intrahospital transport for patients on
extracorporeal membrane oxygenation. DESIGN:: Retrospective cohort analysis.
SETTING:: Cardiac intensive care unit in a tertiary care children's
hospital. PATIENTS:: All patients on extracorporeal membrane oxygenation who
required intrahospital transport between January 1996 and March 2007 were
included and analyzed. MEASUREMENTS AND MAIN RESULTS:: A total of 57
intrahospital transports for cardiac catheterization and head computed
tomography scans were analyzed. In 14 (70%) of 20 of patients with cardiac
catheterization, a management change occurred as a result of the diagnostic
cardiac catheterization. In ten (59%) of 17 patients, bedside
echocardiography was of limited value in defining the critical problem. In
the interventional group, the majority of transports were for atrial
septostomy. In the head computed tomography group, significant pathology was
identified, which led to management change. No major complications occurred
during these intrahospital transports. CONCLUSIONS:: Although transporting
patients on extracorporeal membrane oxygenation is labor intensive and
requires extensive logistic support, it can be carried out safely in
experienced hands and it can result in important therapeutic and diagnostic
yields. To our knowledge, this is the first study designed to evaluate
safety and efficacy of intrahospital transport for patients receiving
extracorporeal membrane oxygenation support. © 2010 by the Society of
Critical Care Medicine and the World Federation of Pediatric Intensive and
Critical Care Societies.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
extracorporeal oxygenation
patient transport
EMTREE MEDICAL INDEX TERMS
adolescent
article
blalock hanlon operation
child
clinical article
computer assisted tomography
critical illness
echocardiography
female
head
heart catheterization
heart surgery
human
infant
intensive care unit
male
operating room
point of care testing
preschool child
priority journal
school child
tertiary health care
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Cardiovascular Diseases and Cardiovascular Surgery (18)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2010172033
MEDLINE PMID
19593245 (http://www.ncbi.nlm.nih.gov/pubmed/19593245)
PUI
L358460128
DOI
10.1097/PCC.0b013e3181b063b2
FULL TEXT LINK
http://dx.doi.org/10.1097/PCC.0b013e3181b063b2
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 691
TITLE
Placental abnormalities in term neonates transported to a tertiary care
facility
AUTHOR NAMES
Pinar H.
Kostadinov S.
AUTHOR ADDRESSES
(Pinar H.; Kostadinov S.) Women and Infants Hospital of Rhode Island, Brown
Medical School, Providence, United States.
CORRESPONDENCE ADDRESS
H. Pinar, Women and Infants Hospital of Rhode Island, Brown Medical School,
Providence, United States.
SOURCE
Pediatric and Developmental Pathology (2010) 13:2 (139-140). Date of
Publication: March 2010
CONFERENCE NAME
Society for Pediatric Pathology (SPP)/Paediatric Pathology Society (PPS)
Combined Fall Meeting
CONFERENCE LOCATION
Philadelphia, PA, United States
CONFERENCE DATE
2009-10-14 to 2009-10-17
ISSN
1093-5266
BOOK PUBLISHER
Society for Pediatric Pathology
ABSTRACT
Background: Despite continuing advances in prenatal care and fetal
monitoring, the placenta remains a valuable source that may explain the
underlying pregnancy risk factors and conditions that result in adverse
pregnancy outcome. Although placental examination in sick neonates is
considered as standard of care, it is frequently not performed especially in
local hospitals with limited resources. As a result, when the neonatal
transport team does not take the initiative for retrieving the placenta
specimen, this valuable resource is lost. Hypothesis: We hypothesize that
placental examination of neonates transferred to a level III neonatal
intensive care unit (NICU) is underutilized. Design: We retrospectively
reviewed the data for inbound neonatal transfers to Women and Infants
hospital (WIH) of Rhode Island level IIIb NICU for the year of 2004. There
were 185 inbound neonatal transfers from 20 community hospitals from the
catchment area of WIH, which consists of Rhode Island, Southeastern
Massachusetts, and Northeastern Connecticut. All but four of the hospitals
had level I nurseries. The placental reports and slides were reviewed. Table
presented. Results: 112 (60%) of the transported cases were term ($37 weeks
gestational age). Only 12 (6.5%) placentas from the transported cases were
submitted for pathologic examination. These were all term. The distribution
of significant macroscopic and microscopic abnormalities in the examined
placentas is summarized in Table 1. There were significantly more male (75%)
than female (25%) neonates among the cases reviewed. The most common
placental findings were evidence of meconium exposure (75%), evidence of
intrauterine infection involving both maternal and fetal compartments (66%),
and fetal erythroblastemia (50%). One placenta showed six of the described
lesions. Rest of the placentas had multiple lesions and their numbers ranged
between three and four. Conclusions: We conclude that the placental
examination is underutilized in the care of neonates transported to a level
III NICU. Since the majority of these placentas show potentially significant
pathology, centers that are responsible from these transports should make a
conscious effort to retrieve these samples.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
newborn
pathology
society
tertiary health care
EMTREE MEDICAL INDEX TERMS
catchment
community hospital
examination
exposure
female
fetus monitoring
gestational age
hospital
hypothesis
infant
intensive care unit
intrauterine infection
male
meconium
newborn intensive care
nursery
placenta
pregnancy
pregnancy outcome
prenatal care
risk factor
United States
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70169713
DOI
10.2350/09-09-0710-MISC.1
FULL TEXT LINK
http://dx.doi.org/10.2350/09-09-0710-MISC.1
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 692
TITLE
Analysis of functional improvement in stroke patients relative to time of
transfer to rehabilitation
AUTHOR NAMES
Anderson C.
Kohler F.
Redmond H.
Dickson H.
Renton R.
AUTHOR ADDRESSES
(Anderson C.; Kohler F.) Braeside Hospital, Sydney, Australia.
(Redmond H.) Fairfield District Hospital, Sydney, Australia.
(Dickson H.; Renton R.) Liverpool Hospital, Sydney, Australia.
CORRESPONDENCE ADDRESS
C. Anderson, Braeside Hospital, Sydney, Australia.
SOURCE
Internal Medicine Journal (2010) 40 SUPPL. 1 (1-2). Date of Publication:
March 2010
CONFERENCE NAME
World Congress of Internal Medicine, WCIM 2010 in Conjunction with
Physicians Week
CONFERENCE LOCATION
Melbourne, VIC, Australia
CONFERENCE DATE
2010-03-20 to 2010-03-25
ISSN
1444-0903
BOOK PUBLISHER
Blackwell Publishing
ABSTRACT
There is some evidence that a delay in transfer of stroke patients to a
rehabilitation unit results in poorer functional outcomes. Previous work by
the Braeside/Liverpool/Fairfield Rehabilitation Research Group found no
correlation between timing of transfer and rehabilitation outcomes however
there were some methodological limitations of the study. This study attempts
to overcome some of these limitations. Objective: In modern stroke units
where allied health intervention is available and utilised, the timing of
transfer to a rehabilitation service is not a major determining factor in
functional outcome following stroke. Method: A total of 267 patients
admitted to our rehabilitation units following stroke were included in the
analysis. These patients were consecutive discharges between 1/1/2007 and
9/10/2009. Patients were admitted to one of two rehabilitation units in the
area: one unit is a rehabilitation ward in a general community hospital,
while the other is a rehabilitation unit in an adjacent freestanding
hospital. Referral and admitting criteria to the two rehabilitation units
are similar. Some patients are transferred between the units after receiving
initial therapy in one unit, in which case the two episodes were combined.
The data were analysed for differences in outcomes according to time taken
for transfer to a rehabilitation unit. For analysis the patients were
grouped according to their time to transfer into 3 day periods. Results: The
time between onset of stroke and admission to a rehabilitation unit varied
between 2 days to over 100 days. The two patients who were not transferred
for over 100 days were excluded from the analysis as they were extreme
outliers. The mean and median length of stay in the rehabilitation unit,
admission FIM scores, FIM differences and FIM efficiency are outlined in the
presentation. There were no significant differences between the groups for
length of stay, total admission FIM score, FIM difference or FIM efficiency.
Conclusion: Based on our data earlier transfer to a rehabilitation unit does
not enhance functional outcomes after stroke. This might be because
multidisciplinary rehabilitation is utilised in stroke units prior to
transfer for formal rehabilitation.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
internal medicine
physician
rehabilitation
stroke patient
EMTREE MEDICAL INDEX TERMS
cerebrovascular accident
community hospital
Functional Independence Measure
health
hospital
length of stay
patient
rehabilitation center
rehabilitation research
stroke unit
therapy
ward
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70126513
DOI
10.1111/j.1445-5994.2010.02186.x
FULL TEXT LINK
http://dx.doi.org/10.1111/j.1445-5994.2010.02186.x
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 693
TITLE
18th Critical Care Transport Medicine Conference April 12-14, 2010
AUTHOR NAMES
Newman M.
Petersen P.
Wojdyla K.
AUTHOR ADDRESSES
(Newman M.; Petersen P.; Wojdyla K.)
SOURCE
Air Medical Journal (2010) 29:2 (78-80). Date of Publication: March
2010/April 2010
ISSN
1067-991X
1532-6497 (electronic)
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
critically ill patient
emergency care
human
medical literature
medical society
paramedical personnel
priority journal
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2010143642
PUI
L358381677
DOI
10.1016/j.amj.2010.01.002
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2010.01.002
COPYRIGHT
Copyright 2013 Elsevier B.V., All rights reserved.
RECORD 694
TITLE
Unplanned intensive care unit transfers: A useful tool to improve quality of
care
AUTHOR NAMES
Bapoje S.
Gaudiani J.
Narayanan V.
Albert R.
AUTHOR ADDRESSES
(Bapoje S.; Gaudiani J.; Narayanan V.; Albert R.) Denver Health Medical
Center, Denver, United States.
CORRESPONDENCE ADDRESS
S. Bapoje, Denver Health Medical Center, Denver, United States.
SOURCE
Journal of Hospital Medicine (2010) 5 SUPPL. 1 (10-11). Date of Publication:
March 2010
CONFERENCE NAME
2010 Annual Meeting of the Society of Hospital Medicine, SHM 2010
CONFERENCE LOCATION
Washington, DC, United States
CONFERENCE DATE
2010-04-08 to 2010-04-11
ISSN
1553-5592
BOOK PUBLISHER
John Wiley and Sons Inc.
ABSTRACT
Background: Whether an unplanned intensive care unit transfer (UICUT)
results from an error in care and whether these transfers can be prevented
has not been previously investigated. We sought to determine the causes of
UlCUTs of patients to a medical ICU, whether they resulted from errors in
care, and when clinical deterioration was noted, whether an earlier or
different response might have prevented such transfers. Methods: This was a
single-center observational cohort study of all patients between 18 and 89
years of age with UlCUTs over a period of 1 year from July 2005 to June
2006. Exclusion criteria included patients transferring from outside
hospitals or from non-Medicine units, direct admissions to the ICU,
readmis-sions to the ICU, planned transfers following invasive procedures,
and patients who were pregnant or prisoners. We recorded demographics,
admission and transfer diagnoses, reasons for unplanned ICU transfers based
on a defined taxonomy (Table 1), presence of signs of clinical
deterioration, mortality, judgment by 3 independent reviewers about the
causes of the ICU transfer, and whether it could have been prevented.
Associations between baseline and outcome variables were assessed using the
x(2) test. Agreement between the reviewers was assessed using the K
statistic.(table present) Results: One hundred and fifty-two patients met
the study criteria. The most common diagnoses for a UICUT were respiratory
failure (24%) and acute coronary syndrome (11%). The reasons for UlCUTs are
listed in Table 1. Mortality was lower for patients when the transfer
occurred within 24 hours of admission (4% versus 22% mortality if transfer
was < 24 versus > 24 hours after admission, 0.29, P < 0.05, 95% CI
0.09-0.89). Errors in care accounted for the transfer in 29 patients (19%),
but in 15 of 29 patients (52%) the errors were in triage as 14 of 15 (93%)
met ICU admission criteria while still in the emergency department. One
hundred and six patients (70%) had 1 or more signs of clinical deterioration
within the 12 hours preceding the ICU transfer. For these patients, all 3
reviewers agreed and concluded that 94 of 109 patients (89%) even with a
different or earlier intervention would still have needed a transfer to the
ICU. Interobserver reliability for the 3 reviewers was good, with K = 0.60
(95% CI 0.33,0.87); K = 0.82 (95% CI 0.59,1.05); and K = 0.63 (95% CI
0.38,0.88). Conclusions: Examining the causes of UlCUTs revealed a target
for improving the quality of care in our institution. As many as 19% of such
transfers were potentially preventable. Our data do not support the use of
rapid response teams to reduce UlCUTs.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital medicine
intensive care unit
society
EMTREE MEDICAL INDEX TERMS
acute coronary syndrome
cohort analysis
decision making
deterioration
diagnosis
emergency health service
emergency ward
hospital
human
invasive procedure
mortality
outcome variable
patient
prisoner
rapid response team
reliability
respiratory failure
taxonomy
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L71753100
DOI
10.1002/jhm.705
FULL TEXT LINK
http://dx.doi.org/10.1002/jhm.705
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 695
TITLE
Management of suspected myocarditis during critical-care transport
AUTHOR NAMES
Wolf G.K.
Frakes M.A.
Gallagher M.
Allan C.K.
Wedel S.K.
AUTHOR ADDRESSES
(Wolf G.K., gerhard.wolf@childrens.harvard.edu) Division of Critical Care
Medicine, Department of Anesthesia, Children's Hospital Boston, 300 Longwood
Ave., Boston, MA 02115, United States.
(Frakes M.A.; Gallagher M.; Wedel S.K.) Boston MedFlight, Hanscom Air Force
Base, Bedford, United States.
(Allan C.K.) Division of Cardiac Critical Care Medicine, Department of
Cardiology, Children's Hospital Boston, Boston, MA, United States.
CORRESPONDENCE ADDRESS
G. K. Wolf, Division of Critical Care Medicine, Department of Anesthesia,
Children's Hospital Boston, 300 Longwood Ave., Boston, MA 02115, United
States. Email: gerhard.wolf@childrens.harvard.edu
SOURCE
Pediatric Emergency Care (2010) 26:7 (512-517). Date of Publication: July
2010
ISSN
0749-5161
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Myocarditis and malignant dysrhythmias are unusual presentations in
pediatric patients. We report a series of 4 patients with myocarditis and
arrhythmia who presented to community emergency departments and were
transported to a pediatric tertiary-care center. Three of the patients
required extracorporeal life support. We discuss considerations for
stabilization and transport: airway and ventilation, hemodynamic support,
induction and sedation medication choices, transport decisions, and the
traits of an ideal receiving center. © 2010 by Lippincott Williams &
Wilkins.
EMTREE DRUG INDEX TERMS
amiodarone (drug combination)
dopamine (drug combination, drug therapy)
inotropic agent (drug therapy)
isoprenaline (drug therapy)
lidocaine (drug combination)
noradrenalin (drug combination, drug therapy)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
myocarditis (drug therapy, drug therapy)
patient transport
EMTREE MEDICAL INDEX TERMS
adolescent
airway
article
atrioventricular block (drug therapy)
bradycardia
case report
child
community care
diuresis
drug dose titration
drug megadose
emergency ward
extracorporeal oxygenation
female
fever
heart arrhythmia
heart muscle biopsy
heart ventricle function
hemodynamics
human
influenza
Lyme disease
lyme myocarditis (drug therapy)
lyme myocarditis (drug therapy)
male
medical decision making
nausea
rehydration
school child
sedation
tachycardia (drug therapy)
tertiary health care
vomiting
CAS REGISTRY NUMBERS
amiodarone (1951-25-3, 19774-82-4, 62067-87-2)
dopamine (51-61-6, 62-31-7)
isoprenaline (299-95-6, 51-30-9, 6700-39-6, 7683-59-2)
lidocaine (137-58-6, 24847-67-4, 56934-02-2, 73-78-9)
noradrenalin (1407-84-7, 51-41-2)
EMBASE CLASSIFICATIONS
Cardiovascular Diseases and Cardiovascular Surgery (18)
Drug Literature Index (37)
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2010402091
MEDLINE PMID
20622634 (http://www.ncbi.nlm.nih.gov/pubmed/20622634)
PUI
L359223974
DOI
10.1097/PEC.0b013e3181e5bfe1
FULL TEXT LINK
http://dx.doi.org/10.1097/PEC.0b013e3181e5bfe1
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 696
TITLE
Endotracheal tube cuff pressures in pediatric patients intubated before
aeromedical transport
AUTHOR NAMES
Tollefsen W.W.
Chapman J.
Frakes M.
Gallagher M.
Shear M.
Thomas S.H.
AUTHOR ADDRESSES
(Tollefsen W.W., wtollefsen@partners.org) Harvard Affiliated Emergency
Medicine, Brigham and Women's Hospital, Massachusetts General Hospital, 75
Francis St, Boston, MA 02115, United States.
(Chapman J.; Shear M.) Department of Emergency Medicine, Massachusetts
General Hospital, Boston, MA, United States.
(Frakes M.; Gallagher M.; Thomas S.H.) Boston MedFlight, Boston, MA, United
States.
(Thomas S.H.) Department of Emergency Medicine, University of Oklahoma,
School of Community Medicine, Tulsa, OK, United States.
CORRESPONDENCE ADDRESS
W. W. Tollefsen, Harvard Affiliated Emergency Medicine, Brigham and Women's
Hospital, Massachusetts General Hospital, 75 Francis St, Boston, MA 02115,
United States. Email: wtollefsen@partners.org
SOURCE
Pediatric Emergency Care (2010) 26:5 (361-363). Date of Publication: May
2010
ISSN
0749-5161
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Objectives: Prolonged endotracheal tube cuff pressures (ETTCPs) greater than
30 cm H(2)O can cause complications. With increasing utilization of cuffed
endotracheal tubes (ETTs) in pediatric patients comes the risk of
overinflation. We evaluated the incidence of elevated ETTCP in pediatric
patients intubated with cuffed ETTs, transported by a critical-care
transport service and attempted to identify whether elevated ETTCP was
associated with factors such as patient demographics, diagnostic category,
and intubator credentials. Methods: In this prospective study, assessment of
ETTCP was made upon transport crew arrival at the bedside. The study focused
on a consecutive sample of pediatric patients undergoing transport with
cuffed ETTs placed before transport team arrival. All patients had cuff
pressures assessed by the same cuff manometry device. Pressures found to be
greater than 30 cm H(2)O were corrected immediately. Results: Forty-one
percent of cases met the a priori defined cutoff for elevated ETTCP of 30 cm
H(2)O; 30% of those elevated cuff pressures were twice that cutoff (>60 cm
H(2)O). There were no associations between high ETTCP and any of the
following independent variables: demographics, physician versus nonphysician
intubator, and intubation location (ie, scene vs emergency department vs
intensive care unit). Conclusions: A significant number of pediatric
patients transported by a critical-care transport service had elevated
ETTCP. Furthermore, there was no clear risk factor for elevated cuff
pressures. This is further evidence that cuff pressures should be measured
in all patients. Further research should focus on the effect of educational
intervention and on the possible clinical results of elevated ETTCPs. © 2010
by Lippincott Williams & Wilkins.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
endotracheal intubation
endotracheal tube cuff pressure
EMTREE MEDICAL INDEX TERMS
adolescent
article
child
controlled study
demography
emergency health service
emergency ward
endotracheal tube
female
human
incidence
infant
intensive care unit
major clinical study
male
manometry
pressure measurement
risk assessment
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
Biophysics, Bioengineering and Medical Instrumentation (27)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2010276178
MEDLINE PMID
20404779 (http://www.ncbi.nlm.nih.gov/pubmed/20404779)
PUI
L50890469
DOI
10.1097/PEC.0b013e3181db224d
FULL TEXT LINK
http://dx.doi.org/10.1097/PEC.0b013e3181db224d
COPYRIGHT
Copyright 2015 Elsevier B.V., All rights reserved.
RECORD 697
TITLE
Transfer Time is not a major determinant of in-hospital mortality in Primary
PCI when performed in a well organized urban network
AUTHOR NAMES
Silvain J.
Vignalou J.-B.
Bellemain-Appaix A.
Landivier A.
Barthelemy O.
Beygui F.
Choussat R.
Ecollan P.
Collet J.-P.
Montalescot G.
AUTHOR ADDRESSES
(Silvain J.; Vignalou J.-B.; Bellemain-Appaix A.; Landivier A.; Barthelemy
O.; Beygui F.; Choussat R.; Ecollan P.; Collet J.-P.; Montalescot G.) APHP -
La Pitié-Salpetrière, Cardiologie - Pr KOMAJDA, Paris, France.
CORRESPONDENCE ADDRESS
J. Silvain, APHP - La Pitié-Salpetrière, Cardiologie - Pr KOMAJDA, Paris,
France.
SOURCE
Archives of Cardiovascular Diseases Supplements (2010) 2:1 (7). Date of
Publication: January 2010
CONFERENCE NAME
20th European Days - Annual Meeting of the French Society of Cardiology
CONFERENCE LOCATION
Paris, France
CONFERENCE DATE
2010-01-13 to 2010-01-16
ISSN
1878-6480
BOOK PUBLISHER
Elsevier Masson SAS
ABSTRACT
Aim: In STEMI, controversial data exist on the relative importance of
patient-dependent time (Symptom-Onset (SO) to first medical contact (FMC))
and Transfer Time (TT=time from FMC to sheath insertion). We assessed the
impact of TT on in-hospital (IH) mortality in a well organized urban network
using Mobile Intensive Care Units (MICU). Methods: In a web-based registry
(e-PARIS), we evaluated delay in care of 705 consecutive STEMI patients
transferred to the Pitié-Salpêtrière cath-lab for primary PCI. Results:
Population was 63±14 y/o, 75.6% were male, 46.9% had anterior MI, 16.7% were
in Killip class 2, and 3.8% had out-of-hospital cardiac arrest. Abciximab
was used in 82.4%, radial approach in 87.7% and stenting in 89.7% of
patients. Median time (IQR) from SO to FMC was 110 (248) min (102 (190) min
when FMC was MICU and 160 (381) min when FMC was a referring hospital,
p<0.0001). Median TT was 104 (75) min (95 (45) min for MICU and 151 (178
)min for patients transferred from a primary hospital, p<0.0001). When
divided into quartiles, increasing TT was associated with higher IH
mortality. This relation to IH mortality was striking in patients presenting
early (within 2 hours of SO), and not significant in late presenters (>2
hours of SO) (fig). After adjustment for baseline characteristics, TT was
not associated with mortality anymore suggesting that the sicker patients
had the longest TT. Conclusions: The association between TT and early
mortality is strongly dependent on patients' characteristics and time to
presentation. After adjustment for these parameters, TT does not appear to
be a major contributor of IH mortality in a well organized urban network for
primary PCI. Improving timeto-first medical contact may be more critical.
(Graph presented).
EMTREE DRUG INDEX TERMS
abciximab
trichloroethylene
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cardiology
mortality
society
EMTREE MEDICAL INDEX TERMS
heart arrest
hospital
intensive care unit
male
patient
population
register
ST segment elevation myocardial infarction
stent
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70185421
DOI
10.1016/S1878-6480(10)70022-7
FULL TEXT LINK
http://dx.doi.org/10.1016/S1878-6480(10)70022-7
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 698
TITLE
Difference in outcome in patients transferred to the ICU after rapid
response team intervention compared to standard critical care consult
AUTHOR NAMES
Cimino M.J.
Schorr C.
Milcarek B.
Debesa O.
Parrillo J.
Dellinger R.P.
AUTHOR ADDRESSES
(Cimino M.J.; Schorr C.; Milcarek B.; Debesa O.; Parrillo J.; Dellinger
R.P.) Cooper University Hospital, United States.
CORRESPONDENCE ADDRESS
M.J. Cimino, Cooper University Hospital, United States.
SOURCE
Critical Care Medicine (2009) 37:12 SUPPL. (A252). Date of Publication:
December 2009
CONFERENCE NAME
39th Critical Care Congress of the Society of Critical Care Medicine's
CONFERENCE LOCATION
Miami Beach, FL, United States
CONFERENCE DATE
2010-01-09 to 2010-01-13
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: Patients typically show abnormal signs and symptoms within 6
hours prior to an arrest. Failure to recognize these changes in condition
have been linked to poor outcomes. Implementation of a rapid response team
(RRT) brings critical care expertise to the bedside with the goal of earlier
intervention and decreasing morbidity. Hypothesis: Activating the RRT
improves outcomes for patients transferred to the ICU from a general medical
surgical or progressive careor stepdown unit compared to those transferred
with standard critical care consult. Methods: A retrospective review of the
Cerner Project IMPACT database for patients (pts) admitted to the ICU from a
general care floor, general care w/telemetry, progressive care unit or
stepdown unit during April 2008-April 2009. Pts were placed in two groups
based on activation of the RRT prior to transfer (RRT) vs standard (ST) ICU
consult prior to transfer. Comparisons fordemographics, acuity, LOS,
presenting clinical characteristics and outcome were made. Results: A total
of 627 admissions were included: RRT (n=133) and ST (n=494). No significant
differences were reported for age, gender, race, CPR within 24 hours of ICU
admission, patient type or days on mechanical ventilation (MV) in survivors.
RRT patients had longer pre-ICU LOS 10+/-12 vs 8+/-9 (p=0.01); higher APACHE
II score, RRT 20+/-9 vs ST 18+/-6 (p=0.04); greater MV within1 hour of ICU
adm, 55% vs 28% (p=<0.01); lower blood pressure within 1 hr of transfer, RRT
41% vs 26% (p=<0.01). More RRT patients were transferred from general care
floor and progressive care unit. Mortality was higher in RRT transfers,
42.9% vs 21.7% (p=<0.01). Conclusions: Patients transferred to the ICU
following RRT are sicker and have an increased mortality. However the RRT
association with greater mortality does not establish cause and effect.
Sinceinception of a RRT at our institution, a 40% decrease in the number of
“Code Calls” has been observed over a two year period.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient
society
EMTREE MEDICAL INDEX TERMS
APACHE
artificial ventilation
blood pressure
data base
gender
hypothesis
morbidity
mortality
physical disease by body function
survivor
telemetry
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70191894
DOI
10.1097/01.ccm.0000365439.11849.a2
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000365439.11849.a2
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 699
TITLE
Out of hospital transfer is an independent predictor of death or poor
outcome after acute stroke
AUTHOR NAMES
Rincon F.
Morino T.
Behrens D.
Lee E.
Schorr C.
Dellinger R.
Parrillo J.
Mirsen T.
AUTHOR ADDRESSES
(Rincon F.; Morino T.; Behrens D.; Lee E.; Schorr C.; Dellinger R.; Mirsen
T.) Cooper Hospital University Med Ctr, United States.
(Parrillo J.) Cooper University Hospital, UMC, Netherlands.
CORRESPONDENCE ADDRESS
F. Rincon, Cooper Hospital University Med Ctr, United States.
SOURCE
Critical Care Medicine (2009) 37:12 SUPPL. (A289). Date of Publication:
December 2009
CONFERENCE NAME
39th Critical Care Congress of the Society of Critical Care Medicine's
CONFERENCE LOCATION
Miami Beach, FL, United States
CONFERENCE DATE
2010-01-09 to 2010-01-13
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: Transfer of critically-illpatients from external Emergency
Department (OSH-ED) has the potential of delayingthe admission to the
Intensive Care Unit (ICU). The effect of OSH-ED transfer onhospital outcomes
of stroke patients has not been fully studied. Hypothesis: We hypothesized
that in acute stroke patients, transferfrom OSH-ED was associated with poor
hospital outcome and increased ICU andhospital length of stay (LOS).
Methods: We designed a retrospectivecohort study using a prospectively
compiled and maintained registry (CernerProject IMPACT). Patients admitted
to the ICU within 24 hrs of stroke from ourED and OSH-ED at a single center
from 2003-2008 with ischemic (AIS) orhemorrhagic stroke (ICH), were selected
for the analysis. Data collectedincluded demographics, admission physiologic
variables, Glasgow Coma Scale(GCS), APACHE-II, scores; and total ICU and
hospital length of stay (LOS). Primaryoutcome was functional status at
hospital discharge and secondary outcomes wereICU and hospital LOS. Poor
outcome was defined as death or severe disability athospital discharge. To
assess for the impact of OSH-ED transfer on primary andsecondary outcomes,
demographic and admission clinical variables were used toconstruct baseline
logistic regression models using the outcome measure as adependent variable.
Results: A total of 448 patientswere selected for analysis. The mean age was
65±14 years, of which 48% weremale and 65% white. There were 34% AIS, and
66% ICH. The median hospital LOSwas 7 days (Interquartile range [IQR]=4-11)
and median ICU-LOS was 2 days(IQR=1-3). Overall hospital mortality was 30%.
Transfer from OSH-ED wasassociated with a 65% probability of death or poor
outcome at hospitaldischarge (p=0.05). Multivariate regression analysis
showed that APACHE-II (OR,1.2; 95% CI; 1.1-1.2), GCS <12 (OR, 2.80; 95% CI;
2.1-3.8), andOSH-ED Transfers (OR, 1.4; 95% CI; 1.1-1.8) were independently
associated withpoor outcome. OSH-ED was not significantly associated with
secondary outcomemeasures. Conclusions: This data suggests that inacute
stroke patients, OSH-ED is independently associated with poor outcome
athospital discharge. Further research is needed as to identify the
potentialcauses for this effect.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cerebrovascular accident
death
hospital
intensive care
society
EMTREE MEDICAL INDEX TERMS
APACHE
disability
emergency ward
functional status
Glasgow coma scale
hospital discharge
hypothesis
intensive care unit
length of stay
logistic regression analysis
model
mortality
patient
register
regression analysis
stroke patient
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70191971
DOI
10.1097/01.ccm.0000365439.11849.a2
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000365439.11849.a2
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 700
TITLE
Assessing pediatric outcomes for interfacility transport into the pediatric
intensive care unit by team type and mode of transport
AUTHOR NAMES
Meyer M.
Kuhn E.
Collins M.
Scanlon M.
AUTHOR ADDRESSES
(Meyer M.; Scanlon M.) Medical College of Wisconsin, United States.
(Kuhn E.; Collins M.) Children's Hospital and Health System, United States.
CORRESPONDENCE ADDRESS
M. Meyer, Medical College of Wisconsin, United States.
SOURCE
Critical Care Medicine (2009) 37:12 SUPPL. (A314). Date of Publication:
December 2009
CONFERENCE NAME
39th Critical Care Congress of the Society of Critical Care Medicine's
CONFERENCE LOCATION
Miami Beach, FL, United States
CONFERENCE DATE
2010-01-09 to 2010-01-13
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: Critically ill children often require interfacility transport
to Pediatric Intensive Care Units (PICU) from community emergency
departments (ED). The study purpose is to determine if severity of illness
adjusted outcomes are improved for children transported by a pediatric
specialty team (SPT) and if mode of transport influences outcomes.
Hypothesis: To determine if severity of illness adjusted outcomes are
improved for children transported by a pediatric specialty team (SPT) and if
mode of transport influences outcomes. Methods: We applied a retrospective
analysis of 5,308 PICU discharges from 10 hospitals where transport data
(team type, mode of transport) and PRISM 3 data were collected. Data were
obtained from VPS, LLC, a national pediatric critical care database.
Multiple logistic regression was used to determine factors related to PICU
mortality. PIM2 and PRISM3 were used to adjust for severity of illness.
Results: 2,539 PICU discharges were transported from a community ED directly
to a PICU. SPT transport patients tended to be more severely ill, less
likely to be Hispanic or have trauma, and more likely to have a respiratory
diagnosis. After adjustment for PIM 2, PRISM 3, demographic and/or
diagnostic variables, there was no statistically significant difference
between PICU mortality for SPT vs EMS (p=0.065, odds ratio for SPT 2.37, 95%
confidence interval 0.95-5.93) or between PICU unit based teams vs
institution lead teams (p=0.31, OR for FBT 1.63, 95% CI 0.64-4.15). For all
team types, mode of transport (rotor vs ground) was not statistically
significant (p=0.89, OR = 0.95, 95% CI 0.43-2.07). Conclusions: Based on our
multi-center analysis, children transported by SPT tend to be more severely
ill than those transported by EMS. These data suggest that neither the mode
of transport nor the type of patient transport team was related to
severity-adjusted PICU mortality, using admission PICU-determined severity
of illness variables at the accepting hospital. Transport specific variables
need to be identified to delineate team and mode of transport determinations
prospectively.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
intensive care unit
society
EMTREE MEDICAL INDEX TERMS
child
community
confidence interval
critically ill patient
data base
diagnosis
emergency ward
general aspects of disease
Hispanic
hospital
hypothesis
injury
mortality
multivariate logistic regression analysis
patient
patient transport
risk
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70192021
DOI
10.1097/01.ccm.0000365439.11849.a2
FULL TEXT LINK
http://dx.doi.org/10.1097/01.ccm.0000365439.11849.a2
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 701
TITLE
The long distance transport of critically ill children on extracorporeal
life support
AUTHOR NAMES
Thiruchelvam T.
Membrey M.
Shekerdemian L.
AUTHOR ADDRESSES
(Thiruchelvam T.; Membrey M.; Shekerdemian L.) Royal Childrens Hospital,
Melbourne, Australia.
CORRESPONDENCE ADDRESS
T. Thiruchelvam, Royal Childrens Hospital, Melbourne, Australia.
SOURCE
Cardiology in the Young (2009) 19 SUPPL. 2 (161). Date of Publication:
November 2009
CONFERENCE NAME
Cardiology 2009, 12th Annual Update on Pediatric and Congenital
Cardiovascular Disease
CONFERENCE LOCATION
Nassau, Bahamas
CONFERENCE DATE
2009-02-04 to 2009-02-08
ISSN
1047-9511
BOOK PUBLISHER
Cambridge University Press
ABSTRACT
Background: Since 2003 the Royal Children's Hospital has offered a mobile
ECLS service to cannulate and retrieve critically ill paediatric patients
who are too unstable for conventional transport. Our team consists of a PICU
Specialist, an ECLS nurse, a Perfusionist, and Cardiac Surgeon. Here we
describe our experience transporting infants and children sustained on
Extracorporeal Life Support (ECLS) to a national paediatric ECLS centre in
Melbourne, Australia. Patients and Methods: Retrospective review of 13
children, mean age 58 months (range 1 day to 16 years), who were transported
on ECLS to the Intensive Care Unit at The Royal Children's Hospital
Melbourne, between March 2003 and September 2008. Results: Our team
cannuated eleven patients at the referring ICU, three of whom required
transthoracic cannulation. Two children were cannulated by their referring
centre. Twelve children were placed on ECMO (veno-venous in 3, veno-arterial
in 9), and one was placed on Left Ventricular Assist Device. Seven patients
were retrieved from interstate PICUs by air (distance 755 km to 1675 km) and
six were transported from either a rural or metropolitan ICU by road. The
mean duration of retrieval was 12 hours (range 6 to 19 hours). Mean duration
of ECLS was 433 hours (range 86 to 1747 hours). Nine patients survived to
hospital discharge. There were no significant transport-related
complications. Conclusions: A specialist team can safely perform the
cannulation and long-distance transport of critically ill children on ECLS.
This does not abrogate the timely referral of potential ECLS candidates and
should be reserved for patients who would not otherwise tolerate transport.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cardiology
cardiovascular disease
child
critically ill patient
EMTREE MEDICAL INDEX TERMS
Australia
cannulation
devices
hospital discharge
infant
intensive care unit
medical specialist
nurse
patient
pediatric hospital
surgeon
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70089813
DOI
10.1017/S1047951109991739
FULL TEXT LINK
http://dx.doi.org/10.1017/S1047951109991739
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 702
TITLE
Intensive care admission and discharge - critical decision-making points.
AUTHOR NAMES
Lundgrén-Laine H.
Suominen H.
Kontio E.
Salanterä S.
AUTHOR ADDRESSES
(Lundgrén-Laine H.; Suominen H.; Kontio E.; Salanterä S.) Department of
Nursing Science, University of Turku, Turku, Finland.
CORRESPONDENCE ADDRESS
H. Lundgrén-Laine, Department of Nursing Science, University of Turku,
Turku, Finland. Email: helja.lundgren-laine@utu.fi
SOURCE
Studies in health technology and informatics (2009) 146 (358-361). Date of
Publication: 2009
ISSN
0926-9630
ABSTRACT
Delivery of intensive care has many critical points impacting the outcomes
of critically ill patients. Two important key events in intensive care are
patients' admission and discharge procedures. The decision making of
intensive care experts should be supported in these two points, in order to
attain good quality and safe care. We hypothesize that in the future this
decision-making process can be effectively supported with information
technology. To reveal the complex decision-making, we studied the
decision-making processes and information needs of intensive care charge
nurses during patients' admission and discharge procedures. We identified
several interconnected decision-making steps during these procedures.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
decision making
hospital admission
intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
article
Finland
human
nurse administrator
organization and management
LANGUAGE OF ARTICLE
English
MEDLINE PMID
19592865 (http://www.ncbi.nlm.nih.gov/pubmed/19592865)
PUI
L355355756
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 703
TITLE
An evaluation of predictive clinical indicators in patients transferred to
the ICU within 24 hours of initial admission to the general wards
AUTHOR NAMES
Chan T.W.
Rotello L.C.
Means M.
Morton J.
Roque T.
Purcell T.
AUTHOR ADDRESSES
(Chan T.W.; Rotello L.C.; Means M.; Morton J.; Roque T.; Purcell T.)
Suburban Hospital, Bethesda, United States.
CORRESPONDENCE ADDRESS
T.W. Chan, Suburban Hospital, Bethesda, United States.
SOURCE
Chest (2009) 136:4. Date of Publication: 1 Oct 2009
CONFERENCE NAME
American College of Chest Physicians Annual Meeting, CHEST 2009
CONFERENCE LOCATION
San Diego, CA, United States
CONFERENCE DATE
2009-10-31 to 2009-11-05
ISSN
0012-3692
BOOK PUBLISHER
American College of Chest Physicians
ABSTRACT
PURPOSE: Readmission to the ICU within 24 hours of transfer out(bounce
backs) is an accepted measure of quality, however the population of patients
initially admitted to the ward who subsequently require transfer to the ICU
within 24 hours has not been evaluated. We describe our experience with this
population of ' bounce in ' patients to the ICU. METHODS: Records of all
patients initially admitted to the ward who were subsequently transfered to
the ICU within a 24 hour period were evaluated to determine whether ICU
admission could have been predicted during the initial workup. RESULTS:
During a 7 month period 37 'bounce in' patients were identified. 15 of those
were identified as having had predictable ICU admission by virtue of initial
clinical condition or laboratory data. The remaining 22 patients had no data
indicative of predictable ICU admission or were transferred to the ICU for
reasons unrelated to their presenting diagnosis, such as need for emergent
surgery or development of unanticipated dysrrythmia in non-cardiac patients.
Of the 15 'bounce in' patients transferred to the ICU predictable
respiratory deterioration was the major factor identified. Several other
factors predicting ICU transfer included unexplained acidosis, seizure
associated with DT's and new onset atrial fibrillation. Followup included
education of the admitting services on the prudence of evaluation of these
patient populations for ICU admission prior to admission to the general
wards. CONCLUSION: A significant number of patients require transfer to the
ICU within 24 hours of admission to the hospital. This presumably results in
increased patient morbidity and length of stay. An evaluation of this
patient population has the potential to identify opportunities within an
institution for which an educational program for admitting services such as
hospitalists and ED physicians could be developed. CLINICAL IMPLICATIONS:
Initial admission of patients with predictive data for subsequent
deterioration directly to the ICU has the potential to diminish patient
morbidity and decrease length of stay for this population of 'bounce in'
patients to the ICU.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
clinical indicator
college
patient
physician
thorax
ward
EMTREE MEDICAL INDEX TERMS
acidosis
atrial fibrillation
cardiac patient
deterioration
diagnosis
education
follow up
hospital
hospital readmission
laboratory
length of stay
medical staff
morality
morbidity
population
seizure
surgery
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70203156
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 704
TITLE
The impact of light, noise, cage cleaning and in-house transport on welfare
and stress of laboratory rats
AUTHOR NAMES
Castelhano-Carlos M.J.
Baumans V.
AUTHOR ADDRESSES
(Castelhano-Carlos M.J., mjoao@ecsaude.uminho.pt) Life and Health Sciences
Research Institute (ICVS), School of Health Sciences, University of Minho,
4710-057 Braga, Portugal.
(Baumans V.) Department of Animals, Science and Society, Division of
Laboratory Animal Science, Utrecht University, Netherlands.
CORRESPONDENCE ADDRESS
M. J. Castelhano-Carlos, Life and Health Sciences Research Institute (ICVS),
School of Health Sciences, University of Minho, 4710-057 Braga, Portugal.
Email: mjoao@ecsaude.uminho.pt
SOURCE
Laboratory Animals (2009) 43:4 (311-327). Date of Publication: October 2009
ISSN
0023-6772
BOOK PUBLISHER
Royal Society of Medicine Press Ltd, P.O. Box 9002, London, United Kingdom.
ABSTRACT
Human interaction and physical environmental factors are part of the stimuli
presented to laboratory animals everyday, influencing their behaviour and
physiology and contributing to their welfare. Certain environmental
conditions and routine procedures in the animal facility might induce stress
responses and when the animal is unable to maintain its homeostasis in the
presence of a particular stressor, the animal's wellbeing is threatened.
This review article summarizes several published studies on the impact of
environmental factors such as light, noise, cage cleaning and in-house
transport on welfare and stress of laboratory rats. The behaviour and
physiological responses of laboratory rats to different environmental
housing conditions and routine procedures are reviewed. Recommendations on
the welfare of laboratory rats and refinements in experimental design are
discussed and how these can influence and improve the quality of scientific
data.
EMTREE DRUG INDEX TERMS
anxiolytic agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
animal welfare
cage
cleaning
light
noise
stress
EMTREE MEDICAL INDEX TERMS
air conditioning
animal housing
auditory stimulation
behavior
breeding
circadian rhythm
environmental factor
environmental impact
experimental rat
eye
eye photography
hearing
interpersonal communication
nonhuman
odor
physical activity
physiology
rat
review
sound
tranquilizing activity
vocalization
wellbeing
EMBASE CLASSIFICATIONS
Physiology (2)
Neurology and Neurosurgery (8)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2009512884
MEDLINE PMID
19505937 (http://www.ncbi.nlm.nih.gov/pubmed/19505937)
PUI
L355337415
DOI
10.1258/la.2009.0080098
FULL TEXT LINK
http://dx.doi.org/10.1258/la.2009.0080098
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 705
TITLE
Short term outcomes of US air force critical Care air transport team (CCATT)
patients evacuated from a combat setting between 2007 and 2008
AUTHOR NAMES
Beninati W.
Lairet J.
King J.
Vojta L.
Mccarthy M.
Gholdson A.
Henderson J.
AUTHOR ADDRESSES
(Beninati W.; Lairet J.; King J.; Vojta L.; Mccarthy M.; Gholdson A.;
Henderson J.) Wilford Hall Medical Center, Lackland AFB, United States.
CORRESPONDENCE ADDRESS
W. Beninati, Wilford Hall Medical Center, Lackland AFB, United States.
SOURCE
Chest (2009) 136:4. Date of Publication: 1 Oct 2009
CONFERENCE NAME
American College of Chest Physicians Annual Meeting, CHEST 2009
CONFERENCE LOCATION
San Diego, CA, United States
CONFERENCE DATE
2009-10-31 to 2009-11-05
ISSN
0012-3692
BOOK PUBLISHER
American College of Chest Physicians
ABSTRACT
PURPOSE: The purpose of this study is to describe the short term outcomes of
patients managed by the USAF CCATTs deployed between 2007 and 2008. METHODS:
This is a retrospective chart review of patients who were transported by
CCATT between March 1, 2007 and June 30, 2008. A standardized abstraction
form was used. Patients were classified as medical or trauma. For trauma:
mechanism of injury and the type of injury were recorded. Care given
inflight was documented including: mechanical ventilation, vassoactive
medications, and administration of blood products. Short term events in
flight included: death, oxyhemoglobin desaturation, hypotension, decline in
neurological status, and development of anuria or oliguria. RESULTS: 656
patient moves met inclusion criteria of which 425 (64.8%) were trauma and
231 (35.2%) were medical. Mechanical ventilation was required by 318
(48.5%), 68 (10.4%) received vasoactive medications, and 43 (6.6%) received
blood products during the flight. There were a total of 75 events on 65
patient transports (9.9%). Of these 19 were oxyhemoglobin desaturation, 29
were hypotension, 3 were decline in neurological status, and 23 were due to
anuria or oliguria. We did not encounter any deaths, loss of airway or chest
tubes during transport.Of the trauma subset, the mean age was 26.7 y/o (SD
7.8), 97.4% were Male. The mechanism of injury was blast in 309 (72.7%),
penetrating in 81 (19.1%) and blunt in 35 (8.2%). By type of injury: 269
were polytrauma, 80 amputations, 90 head injuries, 73 burns, 121
intraabdominal injuries and 98 intrathoracic injuries. The mean ISS was 22
(range 1 to 75).Of the 231 medical transports the mean age was 38.6 y/o (SD
13.5), 93.1% were male. The predominance of patients had cardiac disease 126
(54.6%). Other diagnoses included: pneumonia, sepsis, renal failure, GI
bleed and CVA. CONCLUSION: CCATTs are successful in transporting critically
injured and Ill troops with minimal short term complications. Further
studies should be performed to further validate these findings. CLINICAL
IMPLICATIONS: CCATTs are an effective platform to transport critically
injured/ill patients.
EMTREE DRUG INDEX TERMS
oxyhemoglobin
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air force
college
intensive care
patient
physician
thorax
EMTREE MEDICAL INDEX TERMS
airway
amputation
anuria
artificial ventilation
blood
cerebrovascular accident
death
diagnosis
drug therapy
fatty acid desaturation
flight
head injury
heart disease
hypotension
injury
kidney failure
male
medical record review
multiple trauma
oliguria
patient transport
pneumonia
sepsis
tube
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70203865
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 706
TITLE
Interhospitalar versus intrahospitalar transfer: Differential secondary
transfer to ICU and its implications in outcome
AUTHOR NAMES
Pinto A.
Almeida C.
Alves L.
Lucas R.
Gomes E.
Aragão I.
AUTHOR ADDRESSES
(Pinto A.; Almeida C.; Gomes E.; Aragão I.) Centro Hospitalar Do Porto,
Unidade de Cuidados Intensivos Polivalente, Porto, Portugal.
(Alves L.; Lucas R.) Faculdade de Medicina da Universidade Do Porto, Servic¸
O de Higiene e Epidemiologia, Porto, Portugal.
CORRESPONDENCE ADDRESS
A. Pinto, Centro Hospitalar Do Porto, Unidade de Cuidados Intensivos
Polivalente, Porto, Portugal.
SOURCE
Intensive Care Medicine (2009) 35 Suppl. 1 (S97). Date of Publication:
September 2009
CONFERENCE NAME
22nd Annual Congress of the European Society of Intensive Care Medicine,
ESICM
CONFERENCE LOCATION
Vienna, Austria
CONFERENCE DATE
2009-10-11 to 2009-10-14
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag
ABSTRACT
INTRODUCTION: Critically ill patients from secondary hospitals, where
intensive care services are either not available or limited, are
appropriately transferred to the intensive care units (ICUs) of tertiary
care centers. The investigation of the association between a differential
access to intensive care services and patient or hospital outcomes is
increasing markedly [1-4]. OBJECTIVES: The aim of this study was to compare
demographic, clinical characteristics, and outcomes of patients admitted to
tertiary-level intensive care units from a tertiary hospital ward
(intrahospital transfer) to patients transferred from a secondary hospital
ward (interhospital transfer). METHODS: Single centre retrospective study in
a 12 bed mixed ICU of a tertiary university hospital. During the study
period (2007-2008) 792 patients were admitted in the unit: the median of age
was 55 (38-70), the males were 63.4% and the mean of SAPSII was 44 ± 15.
From 498 randomly selected patients we enrolled all the 138 patients
admitted from a non-ICU hospital ward, divided in Group I: from our hospital
ward (n = 90) and Group II: from a secondary hospital ward (n = 46).
Emergency room admitted patients from ours or another hospital were not
included. Statistical analysis: Χ(2), Mann-Whitney, Fischer's test, unpaired
t Student. RESULTS: The age was higher in Group I [68.5 (52.7 vs. 76.3) vs.
56 (41.0-72.3), p 0.04]. The proportion of males was no different.
Post-operative admissions rate was higher in group I (34.5 vs. 5.9%, p <
0.01). At 24 h SAPSII (p 0.51), SOFA (p 0.67) were not different. Group II
presented a higher diversity of admission diagnoses. In both groups the most
frequent diagnoses were septic shock (50.0 vs. 54.3%, p 0.63) and severe
sepsis (30.0 vs. 10.9%, p 0.013). The length of stay, mortality, ventilator
associated pneumonia rate were not statistically different (p 0.61; p 0.73;
p 0.64, respectively). SOFA at discharge (excluding deaths) and readmission
rate (deaths and patients discharged to another hospital considered not at
risk the readmission) were not significantly different (p 0.37, p 0.47,
respectively) CONCLUSIONS: The interhospital transferred patients are
younger, but at admission severity of the disease is comparable. These
findings, within this case mix of patients, suggest there are not
significant differences in mortality, length of stay, ICU-nosocomial
respiratory infection or physiological disability at discharge between
intrahospital and interhospital transferred patients to our unit. In this
study we did not find a different impact in outcome considering these
differential sources of admission.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
society
EMTREE MEDICAL INDEX TERMS
case mix
critically ill patient
death
diagnosis
disability
emergency ward
hospital
hospital readmission
intensive care unit
length of stay
male
mortality
patient
patient transport
respiratory tract infection
retrospective study
risk
sepsis
septic shock
statistical analysis
student
Tertiary (period)
tertiary health care
university hospital
ventilator associated pneumonia
ward
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70190584
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 707
TITLE
Air transport of critically ill patients
AUTHOR NAMES
Fuke N.
AUTHOR ADDRESSES
(Fuke N.) Emergency and Intensive Care Center, Teikyo University, Chiba
Medicine Center, .
CORRESPONDENCE ADDRESS
N. Fuke, Emergency and Intensive Care Center, Teikyo University, Chiba
Medicine Center, .
SOURCE
Teikyo Medical Journal (2009) 32:5 (297-305). Date of Publication: September
2009
ISSN
0387-5547
BOOK PUBLISHER
Teikyo University School of Medicine, 11-1 Kaga 2-chome, Itabashi-ku, Tokyo,
Japan.
ABSTRACT
Moving of people is increasing in modern societies. Some may go around the
world for business's sake. Some who have chronic diseases would travel where
sophisticated medical service could not be available. Some may suffer from
injuries or diseases far away from their families or may need medical
treatment which exceeds local clinics or hospitals could provide. Urgent
evacuation or repatriation by air is necessary in such cases. Physicians or
nurses who participate in air medical transport of critically ill patients
are expected to have both skills and knowledges of intensive care and
aerospace medicine. International aeromedical service companies can prepare
a specialized aircraft fixed as "a flying ICU" depending on a situation but
the use of commercial aircraft, on the other hand, have benefits of lower
cost, frequent flights, long distant mobility. Cabin space as a medical
environment has several pitafalls. HYPOBARISM : Cabin pressure is maintained
at 8,000 ft above see level. This means about 0.8 atm and therefore it
causes gas expansion, which may worsen pneumothrax, ileus, or decompression
sickness. HYPOXIA : Lower atmosphere pressure causes oxygen partial pressure
lower despite the same concentration. Those who have chronic respiratory
disease, heart failure, or severe anemia may suffer from peripheral oxygen
deficit. DRYNESS : Cabin humidity is only 5-15 %. Dehydration induced by
insensitible perspiration may cause hemoconcentration/thrombus formation and
result in pulmonary embolism. Heart-and-moisture exchanger is essential by
the same reason for tracheomized or endotrachally intubated patients.
4)NOISE : Noise in a cabin make a stethoscope useless. SPACE UTILITY : A
bed-rest patient needs early entrance by a lift directly from the ground and
needs 2 seats' width and 3 rows' length following narrow aisle.
ELECTROMAGNETICAL INTERFERENCE : Every device used in a commercial airflight
must be dry battery-driven and must have no electromagnetic interference
with flying instruments.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
patient transport
EMTREE MEDICAL INDEX TERMS
aerospace medicine
air medical transport
anemia
article
bed rest
blood clotting
chronic respiratory tract disease
decompression sickness
dehydration
disease exacerbation
electromagnetism
family
flying
heart failure
hemoconcentration
hospital
human
humidity
hypobarism
hypoxia
ileus
injury
intensive care
intensive care unit
knowledge
lung embolism
medical service
noise
outpatient department
oxygen tension
skill
stethoscope
sweating
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Biophysics, Bioengineering and Medical Instrumentation (27)
LANGUAGE OF ARTICLE
Japanese
LANGUAGE OF SUMMARY
English, Japanese
EMBASE ACCESSION NUMBER
2009562607
PUI
L355516747
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 708
TITLE
Intrahospital transport of critically ill patients - A prospective pilot
study of critical events
AUTHOR NAMES
Mittal P.
Gurnani A.
AUTHOR ADDRESSES
(Mittal P.) Sevenhills Hospital, Nursing, Mumbai, India.
(Gurnani A.) Kailash Hospital and Research Centre, Critical Care and OT,
Noida, India.
CORRESPONDENCE ADDRESS
P. Mittal, Sevenhills Hospital, Nursing, Mumbai, India.
SOURCE
Intensive Care Medicine (2009) 35 Suppl. 1 (S260). Date of Publication:
September 2009
CONFERENCE NAME
22nd Annual Congress of the European Society of Intensive Care Medicine,
ESICM
CONFERENCE LOCATION
Vienna, Austria
CONFERENCE DATE
2009-10-11 to 2009-10-14
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag
ABSTRACT
INTRODUCTION AND OBJECTIVES: The critically ill patients on numerous
occasions need to be transported from one section of the hospital to the
other for diagnostic, therapeutic or operative procedures. During the
intrahospital transport, a number of critical events have been reported with
incidence ranging form 21 to 84%. These critical events mainly include
variation in blood pressure, airway obstruction, hypoxaemia, cardiac
dysrrhythmias and even frank cardiac or respiratory arrest. In addition,
lack of appropriate monitors and advanced supportive care and absence of
trained nurse(s) to transport a patient safely to areas within the hospital,
add to the adverse untoward events during Intrahospital transport. However,
the incidence of adverse outcomes from transport related complications is
not well documented. So this study was designed to documents the critical
events during the intrahospital transport of critically ill patients. An
attempt is also made to recommend guidelines for safe transportof these
patients. METHODS: 55 critically ill patients requiring movement within the
hospital were prospectively studied. Cardiovascular and respiratory
parameters including oxygen saturation (SpO2) and end tidal CO2 (ETCO2) were
recorded using a battery powered monitor (Propaq 102 EL, Protocol Inc., USA)
during the transport; ventilation wherever needed, was provided using a self
inflation bag by a nurse, however a critical care nurse accompanied all the
patients. A note was also made of complications related to equipment,
personnel and route itself. RESULTS: 85% of patients showed critical changes
in pulse (p < 0.001), 83% developed haemodynamic instability (p < 0.001).
72% showed significant fall in SpO2 (p < 0.001) and 93% of ventilator
dependent patients showed changes in ETCO2 (p < 0.00). Equipment related
complications were encountered in 60% of the moves (p < 0.001) while 31% of
the moves (p < 0.05) required a major intervention. Inexperienced Nurse
resulted in life- threatening situations during two moves. Severity of the
illness and total duration of transport contributed to frequency of
complications. The linear relationship was observed on regression analysis
between SpO(2) and time (p < 0.05). CONCLUSIONS: We recommend a portable
transport system with patient monitor, ventilator and resuscitative
equipments (with sufficient power backup) along with trained Nurse and prior
planning of the route for safe intrahospital transport of critically ill
patients.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
intensive care
pilot study
society
EMTREE MEDICAL INDEX TERMS
adverse outcome
air conditioning
airway obstruction
blood pressure
diagnosis
general aspects of disease
hospital
hypoxemia
nurse
oxygen saturation
patient
personnel
planning
pulse rate
regression analysis
respiratory arrest
ventilator
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70191223
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 709
TITLE
Transfer time is not a major determinant of in-hospital mortality in Primary
PCI when performed in a well organized urban network
AUTHOR NAMES
Silvain J.
Vignalou J.B.
Bellemain-Appaix A.
Landivier A.
Barthelemy O.
Beygui F.
Choussat R.
Ecollan P.
Collet J.P.
Montalesoct G.
AUTHOR ADDRESSES
(Silvain J.; Vignalou J.B.; Bellemain-Appaix A.; Landivier A.; Barthelemy
O.; Beygui F.; Choussat R.; Ecollan P.; Collet J.P.; Montalesoct G.)
Pitie-Salpetriere Hospital, AP-HP, Paris, France.
CORRESPONDENCE ADDRESS
J. Silvain, Pitie-Salpetriere Hospital, AP-HP, Paris, France.
SOURCE
European Heart Journal (2009) 30 SUPPL. 1 (924). Date of Publication:
September 2009
CONFERENCE NAME
European Society of Cardiology, ESC Congress 2009
CONFERENCE LOCATION
Barcelona, Spain
CONFERENCE DATE
2009-08-29 to 2009-09-02
ISSN
0195-668X
BOOK PUBLISHER
Oxford University Press
ABSTRACT
Aim: In STEMI, conflicting data exists on the relative importance of
patientdependent time (Symptom-Onset (SO) to first medical contact (FMC))
and Transfer Time (TT=time from FMC to sheath insertion). We assessed the
impact of TT on in-hospital (IH) mortality in a well organized urban network
using Mobile Intensive Care Units (MICU) Methods: In a web-based registry
(e-PARIS), we evaluated delay in care of 705 consecutive STEMI patients
transferred to the Pitié-Salpêtrière cath-lab for primary PCI. Results:
Population was 63±14 y/o, 75.6% were male, 46.9% had anterior MI, 16.7% were
in Killip class 2, and 3.8% had out-of-hospital cardiac arrest. Abciximab
was used in 82.4%, radial approach in 87.7% and stenting in 89.7% of
patients. Median time (± IQR) from SO to FMC was 110±248 min (102±190 min
when FMC was MICU and 160±381 min when FMC was a referring hospital,
p<0.0001). Median TT was 104±75 min (95±45 min for MICU and 151±178 min for
patients transferred from a primary hospital, p<0.0001). When divided into
quartiles, increasing TT was associated with higher IH mortality. This
relation to IH mortality was striking in patients presenting early (within 2
hours of SO), and not significant in late presenters (>2 hours of SO) (fig).
After multivariate analysis and adjustment for the baseline characteristics,
TT was not associated with mortality anymore suggesting that the sicker
patients had the longest TT (Graph presented). Conclusions: The association
between TT and early mortality is strongly dependent on patients'
characteristics and time to presentation. After adjustment for these
parameters, TT does not appear to be a major contributor of IH mortality in
a well organized urban network for primary PCI. Improving time-to-first
medical contact may be more critical.
EMTREE DRUG INDEX TERMS
abciximab
trichloroethylene
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cardiology
mortality
society
EMTREE MEDICAL INDEX TERMS
heart arrest
hospital
intensive care unit
male
multivariate analysis
patient
population
register
ST segment elevation myocardial infarction
stent
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70356702
DOI
10.1093/eurheartj/ehp416
FULL TEXT LINK
http://dx.doi.org/10.1093/eurheartj/ehp416
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 710
TITLE
Deficits in referral notes during inter-hospital transfer of critically ill
patients: An experience from a tertiary care centre in North India
AUTHOR NAMES
Azim A.
Gupta G.
Baronia A.
Singh R.
Poddar B.
AUTHOR ADDRESSES
(Azim A.; Gupta G.; Baronia A.; Singh R.; Poddar B.) Sanjay Gandhi
Postgraduate Institute of Medical Sciences, Critical Care Medicine, Lucknow,
India.
CORRESPONDENCE ADDRESS
A. Azim, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Critical
Care Medicine, Lucknow, India.
SOURCE
Intensive Care Medicine (2009) 35 Suppl. 1 (S24). Date of Publication:
September 2009
CONFERENCE NAME
22nd Annual Congress of the European Society of Intensive Care Medicine,
ESICM
CONFERENCE LOCATION
Vienna, Austria
CONFERENCE DATE
2009-10-11 to 2009-10-14
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag
ABSTRACT
INTRODUCTION: A patient is referred to a higher centre when services are
needed to maintain continuity of care. There are guidelines for the safe
inter and intrahospital transport of critically ill patients but no
guidelines are available for the minimal mandatory content of interhospital
referral notes of critically ill patients. This problem is manifold in
developing countries. OBJECTIVES: To educate the critical care physicians
regarding the deficits in the physicians referral notes with which
critically ill patients are referred from one centre to another. METHODS: It
is a prospective observational study on 96 out of hospital referred patients
transferred to our intensive care unit (ICU) over a period of 1 year. After
permission from the institutes ethical committee we reviewed the referral
summaries of these patients at the time of ICU admission regarding the
information available of clinical details, course in the previous hospital
and therapeutic interventions. Patients with more than 24 h of
hospitalization before transfer were included in the study. RESULTS: There
were 62 (64%) male and 34 (36%) female patients. Mean admission APACHE-II
was 15.89 and Mean SOFA was 8.20. All patients had more than two organ
failures and 77 (80%) patients were in circulatory shock (systolic blood
pressure < 90 mmHg) at time of admission. Presenting complaints and the
progression of signs and symptoms during the stay of the patient was not
mentioned in any discharge summary. Progression of the organ failures was
not mentioned in 86 (90%) patients. Neurological assessment was not
mentioned in 89 (93%) patients. 72 (75%) patients came with vasopressor
support but no information was available about the dose and duration of use
of vasoactive drugs. We received 79 (80%) intubated patients with the
average of one blood gas in 48-72 h without mention of ventilator settings.
In 86 (90%) patients, trends of vital parameters were not available and no
record of daily input /output was mentioned. There were no nutrition details
available in 89 (93%) patients. None of the referrals mentioned about DVT
prophylaxis, transfusions, glycemic control, dyselectrolytemia and any
critical incident. None of them commented about the criteria for initiating
antibiotics. 83 (86%) referral notes only commented about the clinical
status of the patient at the time of discharge along with the treatment and
investigations available on the day of referral to our hospital. CONCLUSION:
As the specialty of critical care is expanding in developing countries it is
utmost essential to educate the importance of communicating detailed patient
information on the referral note. It helps to maintain continuity of care,
resource utilization, prevents delay in institution of life saving therapies
and in early prognostication.
EMTREE DRUG INDEX TERMS
antibiotic agent
hypertensive factor
vasoactive agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
hospital
India
intensive care
society
tertiary health care
EMTREE MEDICAL INDEX TERMS
APACHE
blood gas
developing country
female
glycemic control
hospitalization
intensive care unit
male
nutrition
observational study
patient
patient care
patient information
physical disease by body function
physician
prophylaxis
shock
systolic blood pressure
therapy
transfusion
ventilator
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70190293
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 711
TITLE
Patterns of interfacility transfers in a non-trauma system setting: Does it
differ?
AUTHOR NAMES
Drimousis P.
Kleidi E.
Theodorou D.
Larentzakis A.
Toutouzas K.
Theodoraki M.E.
Katsaragakis S.
AUTHOR ADDRESSES
(Drimousis P.; Kleidi E.; Theodorou D.; Larentzakis A.; Toutouzas K.;
Theodoraki M.E.; Katsaragakis S.) University of Athens, Hippocration
Hospital, Surgical Intensive Care Unit, Athens, Greece.
CORRESPONDENCE ADDRESS
P. Drimousis, University of Athens, Hippocration Hospital, Surgical
Intensive Care Unit, Athens, Greece.
SOURCE
Intensive Care Medicine (2009) 35 Suppl. 1 (S66). Date of Publication:
September 2009
CONFERENCE NAME
22nd Annual Congress of the European Society of Intensive Care Medicine,
ESICM
CONFERENCE LOCATION
Vienna, Austria
CONFERENCE DATE
2009-10-11 to 2009-10-14
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag
ABSTRACT
INTRODUCTION: One major issue in trauma management is to get every patient
directly from the scene to the appropriate hospital for the injury he
sustained. Patterns of interfacility transfers have been thouroughly
investigated in trauma system settings, but scarce data are available about
transfers in non trauma system settings. OBJECTIVES: This study aims to
assess interfacility transfers that eventuate in the absence of a formal
trauma system and to estimate the potential benefits from the implementation
of a more organized process. METHODS: The 'Report of the Epidemiology and
Management of Trauma in Greece' is a one year project of trauma patient
reporting throughout the country. It provided data concerning the patterns
of interfacility transfers. In Greece there is no formal trauma system
employed and to our knowledge, all available data concerning the
epidemiology of trauma in the country are either extrapolations of relevant
data from other countries or based on police reports and individual hospital
reports. In this study, we attempted to evaluate the paterns of
interfacility transfers, Information reviewed included patient and injury
characteristics, need for an operation, intensive care unit (ICU) admittance
and mortality. Trauma patients were devided in two groups, the transfer
group was compared to the non-transfer group. Analysis employed descriptive
statistics and Chi-square test. Interfacility transfers were furthermore
assessed according to each health care facility's availability of five
requirements; Computed Tomography scanner, ICU, neurosurgeon, orthopedic and
vascular surgeon. RESULTS: Data on 8,524 patients were analyzed; 86.3% were
treated at the same facility, whereas 13.7% were transferred. In transferred
group there were more male, the mean age was lower than that of the non
transferred group and the injury severity score was higher. Transferred
patients were admitted to ICU more often, had a higher mortality rate but
were less operated on compared to non-transferred. The transfer rate from
facilities with none of the five requirements was 34.3%, whereas the rate of
those with at least one requirement was 12.4%. Facilities with at least
three requirements transferred 43.2% of their transfer volume to units of
equal resources. CONCLUSIONS: The assessment of interfacility transfers can
reflect current trends in a nontrauma system setting and could indicate
points for substantial improvement.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
injury
intensive care
society
EMTREE MEDICAL INDEX TERMS
chi square test
computed tomography scanner
epidemiology
Greece
health care facility
hospital
injury scale
intensive care unit
male
mortality
patient
police
statistics
surgeon
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70190458
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 712
TITLE
Should this stroke patient be transferred? Computed tomographic angiography
predicts use of tertiary interventional services
AUTHOR NAMES
Thomas L.E.
Goldstein J.N.
Hakimelahi R.
Gonzalez R.G.
AUTHOR ADDRESSES
(Thomas L.E.; Goldstein J.N.; Hakimelahi R.; Gonzalez R.G.) Massachusetts
General Hospital, Boston, United States.
CORRESPONDENCE ADDRESS
L.E. Thomas, Massachusetts General Hospital, Boston, United States.
SOURCE
Annals of Emergency Medicine (2009) 54:3 SUPPL. 1 (S70). Date of
Publication: September 2009
CONFERENCE NAME
American College of Emergency Physicians, ACEP 2009 Research Forum
CONFERENCE LOCATION
Boston, MA, United States
CONFERENCE DATE
2009-10-05 to 2009-10-06
ISSN
0196-0644
ABSTRACT
Study Objectives: Many organizations have recommended that primary and
comprehensive stroke centers be established to organize stroke care.
However, there are no formal guidelines for determining which patients
should be transferred to comprehensive stroke centers. A rapidly available
prediction tool for advanced interventional services would help community
hospitals determine which patients might benefit from transfer. Multislice
computed tomographic scanners are widely available in U.S. emergency
departments; we hypothesized that the finding of an occlusive thrombus in a
proximal cerebral artery on computed tomographic angiography (CTA) would
predict use of advanced neurointerventional services. Methods: Consecutive
ischemic stroke patients presenting within 24 hours of symptom onset to a
single academic emergency department in 2006, and who underwent emergent
CTA, were retrospectively reviewed. Proximal cerebral artery occlusions on
CTA were defined as distal/terminal (intracranial) internal carotid artery,
proximal (M1 or M2) middle cerebral artery, and/or basilar artery. Tertiary
care interventions including intra-arterial (IA) thrombolysis, mechanical
clot retrieval or removal, and any neurosurgical procedure were captured.
Results: During the study period, 283 patients presented within 24 hours of
symptom onset, and 207 (73%) received a CTA. 25% of patients received
intravenous tissue plasminogen activator, 2.4% received IA thrombolytics,
6.8% received a mechanical intervention, 3.3% underwent surgery, and 52%
were admitted to the neuroscience intensive care unit. 72 (35%) showed
evidence of a proximal cerebral artery occlusion on CTA, and 22 (11%)
received a tertiary neurointervention. Patients with proximal thrombi had
higher National Institutes of Health stroke scale scores than those without
this finding (17 (IQR 9-21) vs. 4 (IQR 2-9), p<0.0001). In addition, those
with proximal thrombi were more likely to receive an intervention (25% vs.
3%, p<0.001). They were more likely to undergo IA thrombolysis (8% vs. 1%, p
= 0.008), a mechanical intervention (19% vs. 0%, p<0.0001), or admission to
the neuroscience ICU (85% vs. 35%, p<0.0001). They were also more likely to
suffer in-hospital mortality (30% vs. 6%), and less likely to be discharged
home (10% vs. 48%) (p<0.001). Evidence of proximal occlusion on CTA predicts
use of IA thrombolysis with sensitivity 86%, specificity 67%, PPV 8% (5-9%),
and NPV 99% (97-99%). It predicts use of mechanical intervention with
sensitivity 100%, specificity 70%, PPV 19%, and NPV 100%. In multivariable
logistic regression controlling for age, sex, initial National Institutes of
Health Stroke Scale score, and time to presentation, the only independent
predictors of interventional services were increasing NIHSS (OR 1.1, 95%CI
1.01-1.2) and proximal clot on CTA (OR 5.8, 95%CI 1.7-20). Conclusion:
Proximal cerebral artery occlusion on CTA is a sensitive, but not specific,
independent predictor of use of advanced neurointerventional services. While
not all centers can perform a comprehensive CTA, almost all emergency
departments in the US can perform multislice CT scanning with contrast, and
have the ability to determine presence of a thrombus in a proximal cerebral
artery. CTA may be a valuable tool in determining which stroke patients
would benefit from transfer to a center with comprehensive
neurointerventional services.
EMTREE DRUG INDEX TERMS
tissue plasminogen activator
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
college
computed tomographic angiography
emergency physician
stroke patient
EMTREE MEDICAL INDEX TERMS
basilar artery
blood clot lysis
brain artery
brain ischemia
cerebrovascular accident
community hospital
computer assisted tomography
emergency ward
intensive care unit
internal carotid artery
logistic regression analysis
middle cerebral artery
mortality
multidetector computed tomography
National Institutes of Health Stroke Scale
neurosurgery
occlusion
occlusive cerebrovascular disease
organization
patient
prediction
surgery
Tertiary (period)
tertiary health care
thrombus
United States
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70251676
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 713
TITLE
Information transfer during ICU ward rounds - Analysis under cognitive
psychological aspects
AUTHOR NAMES
Kloecker K.M.
Schindler N.
Schindler A.W.
Vagts D.A.
AUTHOR ADDRESSES
(Kloecker K.M.; Schindler N.; Vagts D.A.) University Hospital Rostock, Dep.
of Anaesthesiology and Intensive Care Medicine, Rostock, Germany.
(Schindler A.W.) KMG Hospital Guestrow, Dep. of Anaesthesiology and
Intensive Care Medicine, Guestrow, Germany.
(Vagts D.A.) Hetzelstift Hospital, Dep. of Anaesthesiology and Intensive
Care Medicine, Weinstrasse, Neustadt, Germany.
CORRESPONDENCE ADDRESS
K.M. Kloecker, University Hospital Rostock, Dep. of Anaesthesiology and
Intensive Care Medicine, Rostock, Germany.
SOURCE
Intensive Care Medicine (2009) 35 Suppl. 1 (S111). Date of Publication:
September 2009
CONFERENCE NAME
22nd Annual Congress of the European Society of Intensive Care Medicine,
ESICM
CONFERENCE LOCATION
Vienna, Austria
CONFERENCE DATE
2009-10-11 to 2009-10-14
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag
ABSTRACT
BACKGROUND: During Ward Rounds on an Intensive Care Unit physicians are
confronted with a very high number and denseness of new information every
day. The question is wether the human brain is capable of processing this
flood of information, or if it exceeds the natural boundaries of human
concentration and memory? METHODS: We conducted a prospective, observational
study in the Intensive Care Unit of a university clinic with 18 beds. The
information transfer and process of ward rounds was analyzed with the help
of video recordings. Alltogether 8 ward round cycles were recorded, each
consisting of 4 sequent ward rounds within 24 h in a 3 shift system. In the
beginning of each cycle clinically relevant information of 5 patients were
established and standadized. This predetermined information served as the
default value in order to detect information loss throughout the 24 h. Out
of these five patients 2 were chosen from the beginning (randomely chosen
from Pat 1-4), one out of the middle (randomely chosen from Pat 8-11) and 2
from the end (randomely chosen from Pat 16-18) of the ward round, in order
to find fluctuations in the physicians ability to concentrate and memorize
information throughout the ward round, Except for the physician initially
passing over the information the rest of the ward round members did not know
which patients would be evaluated in the end. To test the physicians memory
they were asked to fill out a questionnaire immediately after the ward round
had ended on information that was given throughout the ward round. RESULTS:
During the first ward round an average of 15.27 informations were given per
patient. Of these only 11.42 (74.79%) were mentioned during the second ward
round. During the third ward round only 7.91 (51.80%) of these informations
were passed on and 8.30 (54.37%) during the fourth. A major loss of
information can be discovered. Of those patients discussed in the beginning
of the ward round 69.77% of the information was passed on during the course
of 24 h. Of those discussed in the middle only 55.05% and in the end 38.54%
of the initial information was passed on, even though the average time
needed for each patient remained the same throughout the whole ward round.
CONCLUSION: This shows, that towards the end of the ward round the
physicians' ability to concentrate decreased and the density of information
lessend. This study shows that the structure of the ward round as it is
organized up until now needs to be reconsidered.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
psychological aspect
society
ward
EMTREE MEDICAL INDEX TERMS
brain
density
flooding
hospital
human
intensive care unit
memory
observational study
patient
physician
processing
questionnaire
university
videorecording
wether
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70190637
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 714
TITLE
Pro/con debate: Do the benefits of regionalized critical care delivery
outweigh the risks of interfacility patient transport?
AUTHOR NAMES
Singh J.M.
MacDonald R.D.
AUTHOR ADDRESSES
(Singh J.M., jeff.singh@uhn.on.ca) Interdepartmental Division of Critical
Care and Department of Medicine, University of Toronto, Toronto Western
Hospital, 399 Bathurst Street, 2 McLaughlin - 411K, Toronto, ON M5T 2S8,
Canada.
(Singh J.M., jeff.singh@uhn.on.ca; MacDonald R.D., rmacdonald@ornge.ca)
Research and Development, Ornge Transport Medicine, 20 Carlson Court, Suite
400, Toronto, ON M9W 7K6, Canada.
(MacDonald R.D., rmacdonald@ornge.ca) Division of Emergency Medicine,
Department of Medicine, University of Toronto, 2075 Bayview Avenue, Toronto,
ON M4N 3M5, Canada.
CORRESPONDENCE ADDRESS
J.M. Singh, Interdepartmental Division of Critical Care and Department of
Medicine, University of Toronto, Toronto Western Hospital, 399 Bathurst
Street, 2 McLaughlin - 411K, Toronto, ON M5T 2S8, Canada. Email:
jeff.singh@uhn.on.ca
SOURCE
Critical Care (2009) 13:4 Article Number: 219. Date of Publication: 10 Aug
2009
ISSN
1364-8535
1466-609X (electronic)
BOOK PUBLISHER
BioMed Central Ltd., Floor 6, 236 Gray's Inn Road, London, United Kingdom.
ABSTRACT
You are providing input in planning for critical care services to a large
regional health authority. You are considering concentrating some critical
care services into high-volume regional centres of excellence, as has been
done in other fields of medicine. In your region, this would require several
centres with differing levels of expertise that are geographically
separated. Given there are inherent risks and time delays associated with
interfacility patient transport, you debate whether these potential risks
outweigh the benefits of regional centres of excellence. © 2009 BioMed
Central Ltd.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
regionalization
EMTREE MEDICAL INDEX TERMS
clinical practice
disease course
health care cost
health care delivery
health care quality
health service
human
intensive care unit
patient care
patient transport
priority journal
review
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2011596461
MEDLINE PMID
19678918 (http://www.ncbi.nlm.nih.gov/pubmed/19678918)
PUI
L362820163
DOI
10.1186/cc7883
FULL TEXT LINK
http://dx.doi.org/10.1186/cc7883
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 715
TITLE
Urinary glutathione S-transferase as an early marker for acute kidney injury
in patients admitted to intensive care with sepsis
AUTHOR NAMES
Walshe C.
Odejayi F.
Ng S.
Marsh B.
AUTHOR ADDRESSES
(Walshe C.; Odejayi F.; Ng S.; Marsh B.) Mater Misericordiae University
Hospital, Dublin, Ireland.
CORRESPONDENCE ADDRESS
C. Walshe, Mater Misericordiae University Hospital, Dublin, Ireland.
SOURCE
Critical Care (2009) 13 Suppl. 1 (S104). Date of Publication: 2009
CONFERENCE NAME
29th International Symposium on Intensive Care and Emergency Medicine
CONFERENCE LOCATION
Brussels, Belgium
CONFERENCE DATE
2009-03-24 to 2009-03-27
ISSN
1364-8535
BOOK PUBLISHER
BioMed Central Ltd.
ABSTRACT
Introduction: Acute kidney injury (AKI) is common in patients admitted to
intensive care. Diagnosis of AKI relies on serum creatinine and urine flow.
These have disadvantages of low specificity and sensitivity and a slow rate
of change. Renal damage results in release of tubular enzymes into the
urine. Measurement of urinary alpha glutathione S-transferase (αGST) and pi
glutathione S-transferase (πGST) may indicate AKI more acutely and
accurately than current methods of diagnosis. Methods: Urine was collected
from patients with a sepsis diagnosis 4 hourly over 48 hours. Urine was
frozen, and urinary πGST and αGST measured. Fluid and vasopressor management
was recorded, but managed independently. Serum creatinine was measured at 0,
24 and 48 hours. AKI was diagnosed using AKI Network criteria [1]. Results:
We present the first 35 patients recruited, 20 were male, 15 female. Median
patient age was 53 years. Median APACHE II score was 13. Median ICU length
of stay was 9 days. ICU mortality was 14%, hospital mortality 23%. AKI was
diagnosed in 26% of patients. Statistical significance was tested by
Wilcoxon signedrank test. Although the median πGST at 0 hours was elevated
(11.8 μg/l (non-AKI) versus 22 μg/l (AKI)) this was not statistically
significant between the two groups, P = 0.985. πGST did not demonstrate an
increased urinary level in AKI versus non-AKI (median values 0.89 μg/l vs.
3.4 μg/l at 0 hours). See Figure 1. Conclusions: A trend towards early
expression of πGST was identifiable in this study. This may indicate early
detection of AKI, (Graphe Presented) which may help guide therapeutic
interventions. πGST does not seem to be released as a biomarker using this
sepsis model, suggesting a more specific distal tubular injury. Further work
is required to determine levels of πGST in nonstressed kidneys.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
glutathione transferase
marker
EMTREE DRUG INDEX TERMS
biological marker
enzyme
glutathione transferase alpha
hypertensive factor
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency medicine
intensive care
kidney injury
patient
sepsis
EMTREE MEDICAL INDEX TERMS
APACHE
creatinine blood level
diagnosis
female
injury
kidney
length of stay
liquid
male
micturition
model
mortality
sensitivity and specificity
statistical significance
urine
urine level
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70188247
DOI
10.1186/cc7416
FULL TEXT LINK
http://dx.doi.org/10.1186/cc7416
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 716
TITLE
Early transfer to a high-volume ICU (upgrading) reduces mortality
AUTHOR NAMES
Van Der Molen P.
Van Straaten H.O.
Zandstra D.
Van Stijn I.
Bosman R.
Wester J.
Van Der Voort P.
AUTHOR ADDRESSES
(Van Der Molen P.; Van Straaten H.O.; Zandstra D.; Van Stijn I.; Bosman R.;
Wester J.; Van Der Voort P.) OLVG, Amsterdam, Netherlands.
CORRESPONDENCE ADDRESS
P. Van Der Molen, OLVG, Amsterdam, Netherlands.
SOURCE
Critical Care (2009) 13 Suppl. 1 (S193). Date of Publication: 2009
CONFERENCE NAME
29th International Symposium on Intensive Care and Emergency Medicine
CONFERENCE LOCATION
Brussels, Belgium
CONFERENCE DATE
2009-03-24 to 2009-03-27
ISSN
1364-8535
BOOK PUBLISHER
BioMed Central Ltd.
ABSTRACT
Introduction: The outcome of ICU treatment is improved in highvolume
compared with low-volume ICUs [1]. It is unclear whether transfer of
patients from a low-volume to a high-volume ICU (upgrading) improves outcome
and whether early transfer is beneficial. Methods: In a retrospective cohort
study the timing of upgrading was determined and related to mortality.
Included were all upgraded patients transported to our level 3 ICU between
2002 and 2008. The APACHE II score was determined in the first (Figure
presnted) 24 hours after admission to the high-volume ICU. Odds ratios, the
Mann-Whitney test and multiple regression were performed. Results: Three
hundred and eighty-five patients were included with a mean age of 62 years
(SD = 14.8) and mean APACHE II score of 22.5 (SD = 8.4). The median time to
transfer was 1 day (IQR = 4). Patients transported immediately after
stabilisation to the highvolume ICU (ICU length of stay (LOS) before
transfer = 0) had a mortality rate of 9% (Figure 1). Mortality in patients
with ICU LOS before transport >0 was 25% (P <0.001). In a multiple
regression analysis a higher APACHE II score was associated with increased
mortality (OR = 1.1, 95% CI = 1.0 to 1.2), as was APACHE II predicted
mortality. Immediate transfer was associated with a decrease in ICU
mortality (OR = 0.38; 95% CI = 0.18 to 0.80) and hospital mortality (OR =
0.51; 95% CI = 0.27 to 0.95). In patients with upgrading as the explicit
reason for transport the findings were the same (OR = 0.15; 95% CI = 0.03 to
0.71). Conclusions: In this retrospective cohort study patients who were
immediately transferred from a low-volume to a high-volume level 3 ICU had a
lower mortality compared with patients with delayed transfer, which was
independent of the APACHE score.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency medicine
intensive care
mortality
EMTREE MEDICAL INDEX TERMS
APACHE
cohort analysis
length of stay
multiple regression
patient
rank sum test
risk
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70188470
DOI
10.1186/cc7644
FULL TEXT LINK
http://dx.doi.org/10.1186/cc7644
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 717
TITLE
Hepatocellular damage following burn injury demonstrated by a more sensitive
marker: Alpha-glutathione s-transferase
AUTHOR NAMES
Ozturk G.
Ozturk N.
Aksoy H.
Akcay M.N.
Atamanalp S.S.
Acemoglu H.
AUTHOR ADDRESSES
(Ozturk G.; Akcay M.N.; Atamanalp S.S.) Department of General Surgery,
School of Medicine, Atatürk University, Erzurum, Turkey.
(Ozturk N.; Aksoy H.) Department of Biochemistry, School of Medicine,
Atatürk University, Erzurum, Turkey.
(Acemoglu H.) Department of Medical Education, School of Medicine, Atatürk
University, Erzurum, Turkey.
(Ozturk G.) Department of General Surgery, Medical Faculty, Atatürk
University, 25240 Erzurum, Turkey.
CORRESPONDENCE ADDRESS
G. Ozturk, Department of General Surgery, Medical Faculty, Atatürk
University, 25240 Erzurum, Turkey.
SOURCE
Journal of Burn Care and Research (2009) 30:4 (711-716). Date of
Publication: July-August 2009
ISSN
1559-047X
1559-0488 (electronic)
BOOK PUBLISHER
Lippincott Williams and Wilkins, 530 Walnut Street,P O Box 327,
Philadelphia, United States.
ABSTRACT
Following burn injury, some complex reactions are initiated that are mainly
managed by the liver and that can cause injury at the liver. Alpha
glutathione S-transferase (α-GST) is a sensitive marker that is very
sensitive in the monitoring of hepatocellular damage. We tried, in this
study, to demonstrate liver injury in burn patients using α-GST. Forty-four
patients with burn injury treated at the Burn Treatment and Care unit of the
Atatürk University Medical School between July 2006 and July 2007 were
included in the study. Patient data were collected. Three blood samples were
taken from the patients (at admittance [first sample], 120 hours after
admittance [second sample], and on the fourteenth day [third sample]) for
the analysis of α-GST, alanine amino transferase, aspartate amino
transferase activities, and albumin and c-reactive protein levels. There was
a statistically significant difference between α-GST activities of the study
group at admission (P < .001), on the fifth day (P < .001), and the 14th day
(P < .001) and those of the control group. There was a decrease in α-GST
activities during the hospitalization period. Alanine amino transferase and
aspartate amino transferase activities in all three samples of the study
group were not different from each other and from the values obtained from
the control group. The albumin levels of the study group were significantly
different from those of the control group. The c-reactive protein levels of
the study group were different from those of the control group at admission,
on the fifth day, and fourteenth day (P < .001, P < .001, and P < .01). Our
findings suggest that burn injury causes liver injury, and α-GST can be used
to demonstrate this. Copyright © 2009 by the American Burn Association.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
glutathione transferase alpha (endogenous compound)
EMTREE DRUG INDEX TERMS
alanine aminotransferase (endogenous compound)
albumin (endogenous compound)
ampicillin (drug combination, drug therapy)
aspartate aminotransferase (endogenous compound)
C reactive protein (endogenous compound)
cefazolin (drug combination, drug therapy)
cefoperazone (drug combination, drug therapy)
teicoplanin (drug combination, drug therapy)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
burn (drug therapy, drug therapy, surgery, therapy)
liver cell damage
EMTREE MEDICAL INDEX TERMS
adolescent
adult
article
blood sampling
burn infection (complication, drug therapy)
burn unit
controlled study
enzyme activity
fasciotomy
female
hospital admission
hospitalization
human
major clinical study
male
respiratory tract infection (complication, drug therapy)
sepsis (complication, drug therapy)
skin transplantation
thrombophlebitis (complication, drug therapy)
total parenteral nutrition
university hospital
wound infection (complication)
CAS REGISTRY NUMBERS
C reactive protein (9007-41-4)
alanine aminotransferase (9000-86-6, 9014-30-6)
ampicillin (69-52-3, 69-53-4, 7177-48-2, 74083-13-9, 94586-58-0)
aspartate aminotransferase (9000-97-9)
cefazolin (25953-19-9, 27164-46-1)
cefoperazone (62893-19-0, 62893-20-3)
teicoplanin (61036-62-2, 61036-64-4)
EMBASE CLASSIFICATIONS
Surgery (9)
Drug Literature Index (37)
Gastroenterology (48)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2009498883
MEDLINE PMID
19506503 (http://www.ncbi.nlm.nih.gov/pubmed/19506503)
PUI
L355292269
DOI
10.1097/BCR.0b013e3181abfd65
FULL TEXT LINK
http://dx.doi.org/10.1097/BCR.0b013e3181abfd65
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 718
TITLE
A computerized pharmacy generated medication reconciliation process for
transfer from the intensive care unit reduces discrepancies and order
writing time
AUTHOR NAMES
Caligiuri C.
Staub M.
Galloway L.
Blydt-Hansen T.
AUTHOR ADDRESSES
(Caligiuri C.; Staub M.) Department of Pharmaceutical Services, Health
Sciences Centre, Winnipeg, Canada.
(Galloway L.) Department of Quality, Children's Hospital, Winnipeg, Canada.
(Blydt-Hansen T.) Department of Pediatric and Child Health, Children's
Hospital, Winnipeg, Canada.
CORRESPONDENCE ADDRESS
C. Caligiuri, Department of Pharmaceutical Services, Health Sciences Centre,
Winnipeg, Canada.
SOURCE
Canadian Journal of Hospital Pharmacy (2009) 62:4 (345). Date of
Publication: July-August 2009
CONFERENCE NAME
CSHP Summer Educational Sessions (SES) 2009
CONFERENCE LOCATION
Winnipeg, MB, Canada
CONFERENCE DATE
2009-08-08 to 2009-08-11
ISSN
0008-4123
BOOK PUBLISHER
Canadian Society of Hospital Pharmacists
ABSTRACT
Rationale: The Safer HealthCare Now program has identified medication errors
as a critical area for improvement, especially at points of transfer between
wards for hospitalized patients. CSHP 2015 Objective 1.1 strives for
pharmacist medication reconciliation across the continuum of care.
Description of Concept: We sought to develop and implement a
multi-disciplinary transfer process to accurately communicate transfer
orders from the intensive care unit (ICU) to the receiving unit for
pediatric inpatients. Project Development: We developed a process for a
pharmacy computer system (Cerner) to generate a complete and accurate
medication reconciliation form to serve as a transfer order. On transfer
from ICU, a pharmacy technician prints this transfer order form for
completion by prescribers. The process was implemented January 2009.
Evaluation: We retrospectively reviewed a random selection of charts for
unintentional and undocumented intentional discrepancies by comparing ICU
orders to transfer orders at baseline, early implementation and post
implementation. We also surveyed prescribers about the length of time to
complete transfer orders before and after the new process and measured time
from transfer order printing to physician signing of transfer orders. (Table
presented) Feedback from 5 prescribers showed a decrease in time spent
writing transfer orders to an average of 5 minutes with the new process
(range of 1-10 minutes). The average time for completion of the new
medication reconciliation process was 27 minutes (range of 1-110 minutes)
Usefulness to Practice: The pharmacy computer system generated medication
reconciliation process reduced medication discrepancies and physician time
spent writing ICU transfer orders for hospitalized pediatric patients, and
moves towards CSHP 2015 Objective 1.1.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
drug therapy
intensive care unit
pharmacy
summer
writing
EMTREE MEDICAL INDEX TERMS
computer system
feedback system
health care
hospital patient
medication error
patient
pharmacist
pharmacy technician
physician
printing
ward
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70036045
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 719
TITLE
Lipid transfer proteins, inflammation and atherosclerosis
AUTHOR ADDRESSES
SOURCE
Atherosclerosis Supplements (2009) 10:2. Date of Publication: June 2009
CONFERENCE NAME
15th International Symposium on Atherosclerosis
CONFERENCE LOCATION
Boston, MA, United States
CONFERENCE DATE
2009-06-14 to 2009-06-18
ISSN
1567-5688
BOOK PUBLISHER
Elsevier Ireland Ltd
ABSTRACT
Lipid transfer proteins CETP and PLTP play roles in atherogenesis by
modifying the arterial wall cholesterol flow via altering concentration and
function of plasma lipoproteins and influencing inflammation. In this
regard, endotoxins impair the reverse cholesterol transport (RCT) system in
an endotoxemic rodent model (McGilliuddy FC. Circulation, 2009) supporting
the proinflammatory role of HDL reported in chronic diseases where
atherosclerosis is premature. Human population investigations favor low CETP
as atheroprotective; this is supported by animal models where overexpression
of huCETP is atherogenic due to HDL lowering but most likely due to
apoB-LP-cholesterol concentration increasing. Thus, in spite of CETP
facilitating the HDL-C-mediated RCT, apoB-LP-cholesterol concentration
reduction is the probable antiatherogenic mechanism of CETP inhibition. On
the other hand, although atherogenesis is linked to high experimental huCETP
expression, the latter protects mice from the harmful effects of a bacterial
polysaccharide infusion (Cazita PM. Shock, 2008). Also, Grion CMC (Londrina
Univ., Brazil) showed that the mortality rate of severely ill patients
admitted to an intensive care unit correlates with reduction of the plasma
CETP concentration. Thus, the roles played by CETP on atherosclerosis and
inflammation seem contradictory. High PLTP activity related to
atherosclerosis in three and was protective in one clinical study but
mechanisms involved could not be ascertained. In experimental animals the
relation of elevated plasma PLTP concentration with atherosclerosis was
confounded by HDL-C lowering and by unfavorable effects on several
inflammatory markers. Coincidently, PLTP also increases in human
experimental endotoxemia and in clinical sepsis (Levels JH, BBA, 2007).
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
lipid transfer protein
EMTREE DRUG INDEX TERMS
bacterial polysaccharide
cholesterol
cholesterol ester transfer protein
endotoxin
high density lipoprotein
marker
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
atherosclerosis
inflammation
EMTREE MEDICAL INDEX TERMS
animal model
artery wall
atherogenesis
Brazil
cholesterol transport
chronic disease
clinical study
endotoxemia
experimental animal
human
infusion
intensive care unit
lipoprotein blood level
model
mortality
mouse
patient
plasma
population
rodent
sepsis
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70105070
DOI
10.1016/S1567-5688(09)71614-9
FULL TEXT LINK
http://dx.doi.org/10.1016/S1567-5688(09)71614-9
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 720
TITLE
Transporting the critically ill
AUTHOR NAMES
Martin T.
AUTHOR ADDRESSES
(Martin T.) Winchester, .
CORRESPONDENCE ADDRESS
T. Martin, Winchester, .
SOURCE
Surgery (2009) 27:5 (195-200). Date of Publication: May 2009
ISSN
0263-9319
BOOK PUBLISHER
Elsevier Ltd, Langford Lane, Kidlington, Oxford, United Kingdom.
ABSTRACT
Over 10,000 intensive care patients are transferred each year in the UK. Of
these, about 90% are accompanied by staff from the referring hospital. The
escalating complexity of healthcare, the concentration of skills into
specialized regional centres, and the relative lack of intensive care bed
availability have all led to an increase in the frequency of transfer of
critically ill patients between hospitals. The care delivered in the
restricted environments encountered during patient transfer, whether it be
within or between hospitals, should at least attempt to emulate the detailed
attention provided in the hospital intensive care unit, and it is the
responsibility of the transport team to provide this care outside the ICU.
This is achieved by training staff, selecting appropriate equipment and
detailed planning. The likelihood of success is increased by anticipating
and preventing complications and avoiding hazards to both patient and the
transfer team. This article provides an overview of the hazards,
organization and planning of patient transfers, and highlights the
importance of interdisciplinary teamwork, good communications and
appropriate decision-making. It also examines the special situations
encountered during the transfer or retrieval of patients with complex needs,
such as those requiring intra-aortic balloon counterpulsation or
extracorporeal membrane oxygenation, and discusses the challenges and
opportunities that lie ahead. © 2009.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
aortic balloon
complication (prevention)
counterpulsation
extracorporeal oxygenation
health care delivery
health care facility
health care organization
health care planning
health care quality
health hazard
hospital bed
human
medical decision making
medical staff
patient care
patient referral
priority journal
review
teamwork
United Kingdom
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Cardiovascular Diseases and Cardiovascular Surgery (18)
Anesthesiology (24)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2009257366
PUI
L354653450
DOI
10.1016/j.mpsur.2009.03.004
FULL TEXT LINK
http://dx.doi.org/10.1016/j.mpsur.2009.03.004
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 721
TITLE
Critical care air transport team (CCATT) nurses' deployed experience.
AUTHOR NAMES
Brewer T.L.
Ryan-Wenger N.A.
AUTHOR ADDRESSES
(Brewer T.L.) Nursing Research, Nationwide Children's Hospital, 700
Children's Drive, Columbus, OH 43210-1289, USA.
(Ryan-Wenger N.A.)
CORRESPONDENCE ADDRESS
T.L. Brewer, Nursing Research, Nationwide Children's Hospital, 700
Children's Drive, Columbus, OH 43210-1289, USA.
SOURCE
Military medicine (2009) 174:5 (508-514). Date of Publication: May 2009
ISSN
0026-4075
ABSTRACT
The objective of this study was to use descriptive and phenomenological
methods with Critical Care Air Transport Team (CCATT) nurses to identify
knowledge and skills required to provide care for critically ill patients in
a combat environment. Unstructured interviews, focus groups, written
narratives, group interviews, participant observation, and review of
in-flight documentation of care were used to obtain data from 23 registered
nurses who had deployed with CCATT missions. Dimensions that emerged from
the data included: clinical and operational competence, personal, physical,
and psychosocial readiness, soldier and survival skills, leadership,
administrative concerns, group identification and integration, aircraft air
and evacuation familiarity, and nurse characteristics. This information
should be shared with CCATT trainers and unit personnel to better prepare
them for the realities of future deployments. Future research could
incorporate these data into a self-assessment scale to evaluate CCATT
nurses' readiness for future deployments.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
intensive care
military medicine
nurse attitude
EMTREE MEDICAL INDEX TERMS
article
attitude to health
human
information processing
interview
manpower
organization and management
LANGUAGE OF ARTICLE
English
MEDLINE PMID
20731282 (http://www.ncbi.nlm.nih.gov/pubmed/20731282)
PUI
L359677256
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 722
TITLE
Discussion
AUTHOR NAMES
Napolitano M.
AUTHOR ADDRESSES
(Napolitano M.)
SOURCE
Journal of Trauma - Injury, Infection and Critical Care (2009) 66:SUPPL. 4
(S170-S171). Date of Publication: April 2009
ISSN
0022-5282
1529-8809 (electronic)
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
acute lung injury
patient transport
respiratory distress
EMTREE MEDICAL INDEX TERMS
artificial ventilation
battle injury
clinical trial
extracorporeal oxygenation
human
intensive care unit
note
paramedical personnel
priority journal
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
CLINICAL TRIAL NUMBERS
ClinicalTrials.gov (NCT00474656)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2009399369
PUI
L355025210
DOI
10.1097/TA.0b013e31819cdf72
FULL TEXT LINK
http://dx.doi.org/10.1097/TA.0b013e31819cdf72
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 723
TITLE
Study of plasmid-mediated 16S rRNA methylase genes and drug-resistant
transferability of Acinetobacter baumannii isolated from burn ward
AUTHOR NAMES
Liu T.-X.
Xue X.-D.
Wei L.-H.
Zhang Y.-M.
AUTHOR ADDRESSES
(Liu T.-X.; Xue X.-D.; Wei L.-H., weilh-99@163.com; Zhang Y.-M.) First
Clinical Mediccal College, Lanzhou University, Lanzhou 730000, China.
CORRESPONDENCE ADDRESS
L.-H. Wei, First Clinical Mediccal College, Lanzhou University, Lanzhou
730000, China. Email: weilh-99@163.com
SOURCE
Chinese Journal of Burns (2009) 25:2 (98-102). Date of Publication: April
2009
ISSN
1009-2587
BOOK PUBLISHER
Editorial Board of Chinese Journal of Burns, 29 Gantanyan,Main Street,
Shapingba, District, Chongqing, China.
ABSTRACT
Objective: To investigate the drug-resistance of Acinetobacter baumannii
(Ab) isolated from patients in burn ward, and study the incidence of 16S
rRNA methylase genes mediated high-level aminoglycoside drug-resistance and
its mechanism of transfer. Methods A total of 40 Ab clinical isolates were
collected from burn ward in Gansu Province People's Hospital from May 2006
to Dec. 2007. The sensitivity of Ab for 20 antibiotics were determinated by
K-B agar diffusion. The minimal inhibitory concentrations (MIC) of amikacin,
gentamicin, tobramycin, netilmicin, isepamicin and kanamycin against Ab
strains were determinated by agar dilution. Five kinds of 16S rRNA methylase
genes including armA, rmtA, rmtB, rmtC, rmtD were amplified by PCR, the
positive PCR-products were purified and sequenced, and the plasmid were
extracted by alkaline lysis. The transferability of drug-resistence were
determinated by conjugation and plasmid transformation tests. Results The
drug-resistance rates of Ab against six aminoglycosides antibiotics was
72.5%, 72.5%, 70.0%, 67.5%, 70.0%, 70.0%, respectively. Twenty five strains
were resistant to six aminoglycosides antibiotics (62.5%), among which 10
isolates were armA-positive (40.0%); rmtA, rmtB, rmtC and rmtD-postive
isolates were not found. Ten transformants and 10 conjugants showed
high-level resistance against aminoglycosides antibiotics, all of which the
value of MIC ≥256 μg/mL carried armA gene. Conclusions: The drug-resistance
of Ab clinical isolates have high drug-resistance. 16S rRNA methylases gene
exists in Ab and locates in plasmid chromosome.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
aminoglycoside antibiotic agent
methyltransferase
RNA 16S
EMTREE DRUG INDEX TERMS
amikacin
gentamicin
isepamicin
kanamycin
netilmicin
tobramycin
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Acinetobacter baumannii
antibiotic resistance
EMTREE MEDICAL INDEX TERMS
agar diffusion
agar dilution
article
bacterial strain
bacterial transmission
bacterium isolation
burn patient
burn unit
China
controlled study
human
minimum inhibitory concentration
nonhuman
plasmid
polymerase chain reaction
CAS REGISTRY NUMBERS
amikacin (37517-28-5, 39831-55-5)
gentamicin (1392-48-9, 1403-66-3, 1405-41-0)
isepamicin (58152-03-7)
kanamycin (11025-66-4, 61230-38-4, 8063-07-8)
methyltransferase (9033-25-4)
netilmicin (56391-56-1, 56391-57-2)
tobramycin (32986-56-4)
EMBASE CLASSIFICATIONS
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
Surgery (9)
LANGUAGE OF ARTICLE
Chinese
LANGUAGE OF SUMMARY
English, Chinese
EMBASE ACCESSION NUMBER
2009351539
MEDLINE PMID
19799032 (http://www.ncbi.nlm.nih.gov/pubmed/19799032)
PUI
L354911375
DOI
10.3760/cma.j.issn.1009-2587.2009.02.009
FULL TEXT LINK
http://dx.doi.org/10.3760/cma.j.issn.1009-2587.2009.02.009
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 724
TITLE
Wartime critical care air transport.
AUTHOR NAMES
Bridges E.
Evers K.
AUTHOR ADDRESSES
(Bridges E.; Evers K.) Clinical Investigations Facility, 60 Medical Group,
Travis AFB, CA 94535, USA.
CORRESPONDENCE ADDRESS
E. Bridges, Clinical Investigations Facility, 60 Medical Group, Travis AFB,
CA 94535, USA.
SOURCE
Military medicine (2009) 174:4 (370-375). Date of Publication: Apr 2009
ISSN
0026-4075
ABSTRACT
OBJECTIVES: Describe the characteristics/enroute care of casualties
transported by USAF Critical Care Air Transport Teams (CCATT) during
Operation Enduring Freedom/Iraqi Freedom (OEF/OIF). METHODS: Retrospective
review of TRAC2ES and CCATT Mission Reports (Oct 2001-May 2006). RESULTS:
3492 patient moves (2439 patients). Moves by route: within Area of
Responsibility (AOR) (n = 261); AOR-Landstuhl (LRMC) (n = 1995),
Germany-CONUS (n = 1188). For AOR-LRMC: BI (64%), NBI (8%), Disease (25%).
Among injured (n = 1491), 69% suffered polytrauma, primarily d/t explosions.
Injury area: extremities (63%), head (55%), thorax (46%), abdomen (31%),
neck (17%). Injury type: soft tissue (64%), orthopedic (45%), thoracic
(35%), skull fracture (27%), brain injury (25%). Disease diagnoses: cardiac
(15%) and pulmonary (8%). CONCLUSIONS: This is the first analysis of OEF/OIF
CCATT patients. Phase 1 of this study demonstrates the strengths and
limitations of TRAC2ES and CCATT Mission Reports to describe the
characteristics/enroute care of this unique population.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
injury
intensive care
military medicine
EMTREE MEDICAL INDEX TERMS
article
classification
human
methodology
retrospective study
United States
war
LANGUAGE OF ARTICLE
English
MEDLINE PMID
19485106 (http://www.ncbi.nlm.nih.gov/pubmed/19485106)
PUI
L354989940
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 725
TITLE
A literature review of organisational, individual and teamwork factors
contributing to the ICU discharge process
AUTHOR NAMES
Lin F.
Chaboyer W.
Wallis M.
AUTHOR ADDRESSES
(Lin F., F.Lin@griffith.edu.au) School of Nursing and Midwifery, Griffith
Health, Griffith University, Gold Coast Campus, QLD 4222, Australia.
(Chaboyer W.) Research Centre for Clinical and Community Practice Innovation
(RCCCPI), Griffith University, Gold Coast, Australia.
(Wallis M.) Clinical Nursing Research, Gold Coast Health Service District,
School of Nursing and Midwifery, Gold Coast, Australia.
CORRESPONDENCE ADDRESS
F. Lin, School of Nursing and Midwifery, Griffith Health, Griffith
University, Gold Coast Campus, QLD 4222, Australia. Email:
F.Lin@griffith.edu.au
SOURCE
Australian Critical Care (2009) 22:1 (29-43). Date of Publication: February
2009
ISSN
1036-7314
BOOK PUBLISHER
Elsevier Ireland Ltd, P.O. Box 85, Limerick, Ireland.
ABSTRACT
Aim: It is everyday news that we need more intensive care unit (ICU) beds,
thus effective use of existing resources is imperative. The aim of this
literature review was to critically analyse current literature on how
organizational factors, individual factors and teamwork factors influence
the ICU discharge process. A better understanding of discharge practices has
the potential to ultimately influence ICU resource availability. Methods:
Databases including CINAHL, MEDLINE, PROQUEST, SCIENCE DIRECT were searched
using key terms such as ICU discharge, discharge process, ICU guidelines and
policies, discharge decision-making, ICU organisational factors, ICU and
human factors, and ICU patient transfer. Articles' reference lists were also
used to locate relevant literature. A total of 21 articles were included in
the review. Results: Only a small number of ICUs used written patient
discharge guidelines. Consensus, rather than empirical evidence, dictates
the importance of guidelines and policies. Premature discharge, discharge
after hours and discharge by triage still exist due to resources
constraints, even though the literature suggests these are associated with
increased mortality. Teamwork and team training appear to be effective in
improving efficiency and communication between professions or between
clinical areas. However, this aspect has rarely been researched in relation
to ICU patient discharge. Conclusion: Intensive care patient discharge is
influenced by organisational factors, individual factors and teamwork
factors. Organisational interventions are effective in reducing ICU
discharge delay and shortening patient hospital stay. More rigorous research
is needed to discover how these factors influence the ICU discharge process.
© 2008 Australian College of Critical Care Nurses Ltd.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital discharge
intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
human
organization and management
patient care
policy
review
risk management
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
19138531 (http://www.ncbi.nlm.nih.gov/pubmed/19138531)
PUI
L50384507
DOI
10.1016/j.aucc.2008.11.001
FULL TEXT LINK
http://dx.doi.org/10.1016/j.aucc.2008.11.001
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 726
TITLE
Assessing ICU transfers at night: a call to reduce mortality and readmission
risk.
AUTHOR NAMES
Morris P.E.
AUTHOR ADDRESSES
(Morris P.E.)
CORRESPONDENCE ADDRESS
P.E. Morris,
SOURCE
American journal of critical care : an official publication, American
Association of Critical-Care Nurses (2009) 18:1 (6-8). Date of Publication:
Jan 2009
ISSN
1062-3264
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital readmission
intensive care unit
mortality
patient care
patient transport
EMTREE MEDICAL INDEX TERMS
editorial
hospital personnel
human
personnel management
risk factor
standard
time
LANGUAGE OF ARTICLE
English
MEDLINE PMID
19116393 (http://www.ncbi.nlm.nih.gov/pubmed/19116393)
PUI
L550156709
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 727
TITLE
Intrahospital transport of critically ill patients
ORIGINAL (NON-ENGLISH) TITLE
Innerklinischer transport des kritisch kranken patienten
AUTHOR NAMES
Löw M.
Jaschinski U.
AUTHOR ADDRESSES
(Löw M., markus.loew@klinikum-augsburg.de; Jaschinski U.) Klinik für
Anästhesiologie und Operative Intensivmedizin, Klinikum Augsburg, Augsburg,
Germany.
(Löw M., markus.loew@klinikum-augsburg.de) Klinik für Anästhesiologie und
Operative Intensivmedizin, Klinikum Augsburg, Stenglinstr. 2, 86156
Augsburg, Germany.
CORRESPONDENCE ADDRESS
M. Löw, Klinik für Anästhesiologie und Operative Intensivmedizin, Klinikum
Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany. Email:
markus.loew@klinikum-augsburg.de
SOURCE
Anaesthesist (2009) 58:1 (95-108). Date of Publication: January 2009
ISSN
0003-2417
BOOK PUBLISHER
Springer Verlag, Tiergartenstrasse 17, Heidelberg, Germany.
ABSTRACT
Transport of critically ill patients from the ICU for diagnostic and
therapeutic purposes (e.g. CT, endoscopy, radiological catheter-assisted
interventions) is a challenge and has steadily increased over the years.
After risk-benefit analysis careful planning is the first step in minimizing
the risk of complications. Knowledge and skillful handling of the transport
equipment is mandatory to avoid life-threatening incidents as monitoring and
therapy have to be continued during the transport. Proper education and
experience in critical care medicine are additional characteristics of the
transport team. When these prerequisites are fulfilled a "non-transportable"
patient is just as unlikely as a "non-anesthetizable" patient. © 2009
Springer Medizin Verlag.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
patient transport
EMTREE MEDICAL INDEX TERMS
aortic balloon
extubation
human
hypoxia (diagnosis)
intensive care unit
muscle hypotonia (diagnosis)
patient monitoring
pneumothorax
positive end expiratory pressure
pulse oximetry
review
risk assessment
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
German
LANGUAGE OF SUMMARY
English, German
EMBASE ACCESSION NUMBER
2009049256
MEDLINE PMID
19156389 (http://www.ncbi.nlm.nih.gov/pubmed/19156389)
PUI
L50399724
DOI
10.1007/s00101-008-1499-3
FULL TEXT LINK
http://dx.doi.org/10.1007/s00101-008-1499-3
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 728
TITLE
Transfer of Patients Dependent on an Intra-aortic Balloon Pump Using
Critical Care Services
AUTHOR NAMES
Sinclair T.D.
Werman H.A.
AUTHOR ADDRESSES
(Sinclair T.D.) Emergency Department, The Ohio State University Medical
Center, Columbus, OH, United States.
(Werman H.A., hwerman@medflight.com) MedFlight of Ohio, Emergency Medicine,
The Ohio State University, Columbus, OH, United States.
CORRESPONDENCE ADDRESS
H.A. Werman, MedFlight of Ohio, Emergency Medicine, The Ohio State
University, Columbus, OH, United States. Email: hwerman@medflight.com
SOURCE
Air Medical Journal (2009) 28:1 (40-46). Date of Publication: January
2009/February 2009
ISSN
1067-991X
1532-6497 (electronic)
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
ABSTRACT
Introduction: The intra-aortic balloon pump (IABP) is a hemodynamic support
device that provides circulatory enhancement to patients whose cardiac
output is compromised. Special clinical skills are required for management
of the patient with an IABP in place. Few studies have discussed the
transport of the IABP-dependent patient. The current study was designed to
describe the transport of IABP-dependent patients, with a focus on
pretransport interventions, transport interventions, quality improvement,
and complications. Methods: A review of all transports from January 1, 2004,
through December 31, 2005, performed by a critical care transport program
with a nurse/paramedic crew offering mobile intensive care unit (ICU),
rotor-wing, and fixed-wing service was conducted. All patients who were
maintained on an intra-aortic balloon pump (IABP) were eligible for
inclusion. A certified perfusionist was available for consultation on all
transports. Information about the IABP, including the pump timing,
confirmation of balloon location, and inflation/deflation timing parameters,
was collected. Proper balloon placement was verified and recorded at the
sending hospital. Data were collected regarding interventions required
before and during transport and complications during transport. Descriptive
statistics were used. Results: During the study period, 173 transports
involving an IABP were performed. The average age was 60.8 years, and 67.8%
were men. Forty-one percent were flown by rotor-wing, 36.4% were transported
by the mobile ICU, and 21.4% were flown by the fixed-wing transport. In 1.2%
of cases, there was a change in transport mode. Twelve percent of patients
required some increase in oxygen supplementation, but only one patient
required intubation before transport by the transport crew. The most common
pretransport medications were heparin (69%), inotropes (55%), and other
infusions (46.8%). Twenty-two percent had no written confirmation of the
correct balloon placement. There were no significant complications found
during transport, including hemorrhage, loss of trigger signals, or cardiac
arrest. Twelve percent had some abnormalities in timing of balloon inflation
or deflation. Conclusion: IABP transports can be safely performed by a
nurse/paramedic critical care transport team with perfusionist consultation.
Few patients require significant intervention before transport. Attention
must be paid to balloon inflation and deflation timing despite the existence
of timing algorithms. Significant complications during transport were not
seen. Future studies should explore the overall outcome of IABP-dependent
patients and the role of transport mode on outcome. © 2009 Air Medical
Journal Associates.
EMTREE DRUG INDEX TERMS
heparin
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
aortic balloon
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
bleeding
health care quality
heart arrest
human
intensive care unit
intubation
medical practice
nurse
oxygen therapy
paramedical personnel
priority journal
CAS REGISTRY NUMBERS
heparin (37187-54-5, 8057-48-5, 8065-01-8, 9005-48-5)
EMBASE CLASSIFICATIONS
Internal Medicine (6)
Public Health, Social Medicine and Epidemiology (17)
Cardiovascular Diseases and Cardiovascular Surgery (18)
Anesthesiology (24)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2009004741
MEDLINE PMID
19131025 (http://www.ncbi.nlm.nih.gov/pubmed/19131025)
PUI
L354018660
DOI
10.1016/j.amj.2008.07.013
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2008.07.013
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 729
TITLE
Factors associated with unoffered trauma analgesia in critical care
transport
AUTHOR NAMES
Frakes M.A.
Lord W.R.
Kociszewski C.
Wedel S.K.
AUTHOR ADDRESSES
(Frakes M.A.; Lord W.R.) LIFE STAR, Hartford Hospital, PO Box 5037,
Hartford, CT 06102-5037, United States.
(Frakes M.A.; Kociszewski C.; Wedel S.K.) Boston MedFlight, Bedford, MA
01730, United States.
(Wedel S.K.) Boston Medical Center, Boston, MA 02118, United States.
(Lord W.R.) Connecticut Children's Medical Center, Hartford, CT 06106,
United States.
CORRESPONDENCE ADDRESS
M.A. Frakes, LIFE STAR, Hartford Hospital, PO Box 5037, Hartford, CT
06102-5037, United States.
SOURCE
American Journal of Emergency Medicine (2009) 27:1 (49-54). Date of
Publication: January 2009
ISSN
0735-6757
BOOK PUBLISHER
W.B. Saunders, Independence Square West, Philadelphia, United States.
ABSTRACT
Objective: Pain relief is a key out-of-hospital patient care outcome
measure, yet many trauma patients do not receive prompt analgesia. Although
specialty critical care transport (CCT) teams provide analgesia frequently,
successfully, and safely, there is still a population of CCT patients to
whom analgesia is not offered. We report the factors associated with
non-administration of analgesia and with analgesic effect in trauma patients
cared for by CCT teams. Methods: This is a retrospective review of
consecutive transport records for nonintubated trauma patients with
self-reported pain during specialty CCT care. Patient demographics, CCT
interventions, clinical traits, and pain self-reports are measured. Means
comparisons are made with a univariate analysis of variance, and odds ratios
(ORs) with 95% confidence intervals (CIs) are reported for between-group
comparisons. Results: Of the 209 enrolled patients, 169 (80.9%; 95% CI,
75.6%-86.2%) were treated (147 received analgesia and 22 offered analgesia
but refused). In patients with pain scale documentation (n = 145),
self-reported pain on a scale from 0 to 10 decreased from 6.8 ± 2.8 to 3.3 ±
2.4 (P ≤ .001). Three factors were associated with absence of analgesic
administration: initial pain level (OR for administration, 0.13; 95% CI,
0.04-0.40), pain scale documentation (OR, 0.31; 95% CI, 0.15-0.60), and
transport program (OR, 0.36; 95% CI, 0.17-0.74). No clinical factor was
associated with analgesia effectiveness in treated patients. Conclusion: The
identified factors may represent opportunities for CCT teams to optimize
analgesic treatment. © 2009 Elsevier Inc. All rights reserved.
EMTREE DRUG INDEX TERMS
fentanyl (drug therapy)
morphine (drug therapy)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
injury (drug therapy, epidemiology)
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
analgesia
article
child
controlled study
female
human
intensive care
major clinical study
male
pain assessment
patient care
priority journal
rating scale
retrospective study
risk assessment
CAS REGISTRY NUMBERS
fentanyl (437-38-7)
morphine (52-26-6, 57-27-2)
EMBASE CLASSIFICATIONS
Internal Medicine (6)
Public Health, Social Medicine and Epidemiology (17)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2008553952
MEDLINE PMID
19041533 (http://www.ncbi.nlm.nih.gov/pubmed/19041533)
PUI
L352720457
DOI
10.1016/j.ajem.2008.01.005
FULL TEXT LINK
http://dx.doi.org/10.1016/j.ajem.2008.01.005
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 730
TITLE
Specialty teams for neonatal transport to neonatal intensive care units for
prevention of morbidity and mortality
AUTHOR NAMES
Chang A.S.M.
Berry A.
Sivasangari S.
AUTHOR ADDRESSES
(Chang A.S.M., alvinchang72@hotmail.com) Department of Paediatrics, Selayang
Hospital, Batu Caves, Malaysia.
(Berry A.) NSW Neonatal and Paediatric Emergency Transport Service, Western
Sydney Area Health Service, Wentworthville, Australia.
(Sivasangari S.) Department of Paediatrics, Royal College of Medicine Perak,
Ipoh, Malaysia.
(Chang A.S.M., alvinchang72@hotmail.com) Department of Paediatrics, Selayang
Hospital, Lebuhraya Selayang-Kepong, Batu Caves, Selangor, 68100, Malaysia.
CORRESPONDENCE ADDRESS
A. S. M. Chang, Department of Paediatrics, Selayang Hospital, Lebuhraya
Selayang-Kepong, Batu Caves, Selangor, 68100, Malaysia. Email:
alvinchang72@hotmail.com
SOURCE
Cochrane Database of Systematic Reviews (2008) :4 Article Number: CD007485.
Date of Publication: 2008
ISSN
1469-493X
BOOK PUBLISHER
John Wiley and Sons Ltd, Southern Gate, Chichester, West Sussex, United
Kingdom.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
medical staff
morbidity
mortality
newborn intensive care
patient transport
prevention
EMTREE MEDICAL INDEX TERMS
airway obstruction
airway pressure
assisted ventilation
birth weight
brain disease
congenital disorder
disease severity
gestational age
health care facilities and services
human
hypoglycemia
hypotension
hypothermia
hypoxic ischemic encephalopathy
outcome assessment
oxygenation
pneumothorax
positive end expiratory pressure
review
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2008510625
PUI
L352583853
DOI
10.1002/14651858.CD007485
FULL TEXT LINK
http://dx.doi.org/10.1002/14651858.CD007485
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 731
TITLE
The role and effectiveness of a nurse practitioner led critical care
outreach service
AUTHOR NAMES
Pirret A.M.
AUTHOR ADDRESSES
(Pirret A.M., Pirret@xtra.co.nz) Department of Intensive Care Medicine,
Middlemore Hospital, New Zealand.
(Pirret A.M., Pirret@xtra.co.nz) School of Health, Social Services, Massey
University, New Zealand.
CORRESPONDENCE ADDRESS
A.M. Pirret, Department of Intensive Care Medicine, Middlemore Hospital, New
Zealand. Email: Pirret@xtra.co.nz
SOURCE
Intensive and Critical Care Nursing (2008) 24:6 (375-382). Date of
Publication: December 2008
ISSN
0964-3397
BOOK PUBLISHER
Churchill Livingstone, 1-3 Baxter's Place, Leith Walk, Edinburgh, United
Kingdom.
ABSTRACT
Research measuring the effectiveness of critical care outreach (CCOR) has
been mixed. The objective of this paper is to describe the role and
effectiveness of a nurse practitioner (NP) led critical care outreach
service (CCORS). Using a comparative study design, data on the number of
intensive care unit (ICU) readmissions <72 h were analysed 12 months prior
to, and 12 months following implementation of the service. Data was also
collected on length of stay and APACHE II scores of ICU readmissions <72 h,
ICU patient acuity, ICU readmission mortality, and ward medical emergency
team (MET) and cardiac arrest calls. Data on NP referrals were collected to
identify NP activities. Data analysis was completed using descriptive
statistics and run and control charts. There were 133 NP referrals, which
resulted in 525 patient visits. The most common interventions completed by
the NP during visits included requesting of diagnostic tests and
prescribing. Following introduction of the NP CCORS, there was a sustained
reduction in ICU readmissions <72 h. In conclusion, a NP led CCORS has a
positive effect on patient outcomes and supports development of further NP
positions. © 2008 Elsevier Ltd. All rights reserved.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency (epidemiology)
intensive care
nurse attitude
nurse practitioner
patient transport
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
APACHE
article
education
evaluation study
hospital readmission
human
length of stay
middle aged
mortality
New Zealand (epidemiology)
nursing
nursing evaluation research
organization and management
outcome assessment
patient referral
professional practice
statistics
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
18554911 (http://www.ncbi.nlm.nih.gov/pubmed/18554911)
PUI
L50175670
DOI
10.1016/j.iccn.2008.04.007
FULL TEXT LINK
http://dx.doi.org/10.1016/j.iccn.2008.04.007
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 732
TITLE
Supporting families through discharge from PICU to the ward: The development
and evaluation of a discharge information brochure for families
AUTHOR NAMES
Linton S.
Grant C.
Pellegrini J.
AUTHOR ADDRESSES
(Linton S., sophie.linton@rch.org.au; Grant C., chelsea.caffin@rch.org.au;
Pellegrini J., juliet.pellegrini@rch.org.au) PICU Liaison Nurse, Intensive
Care Unit, Royal Children's Hospital, Flemington Road, Parkville, 3052,
Australia.
CORRESPONDENCE ADDRESS
S. Linton, PICU Liaison Nurse, Intensive Care Unit, Royal Children's
Hospital, Flemington Road, Parkville, 3052, Australia. Email:
sophie.linton@rch.org.au
SOURCE
Intensive and Critical Care Nursing (2008) 24:6 (329-337). Date of
Publication: December 2008
ISSN
0964-3397
BOOK PUBLISHER
Churchill Livingstone, 1-3 Baxter's Place, Leith Walk, Edinburgh, United
Kingdom.
ABSTRACT
Introduction: Discharge from paediatric ICU and transfer to the ward can
evoke fear and anxiety. Along with the introduction of the ICU liaison nurse
role, the literature suggests that the provision of written information has
the greatest potential to reduce transfer anxiety. This paper will discuss
the issues associated with discharge from a paediatric ICU, the process of
identifying the information needs of families, the development of a written
brochure and evaluation of the brochure in practice. Results: Evaluation of
the 'discharge from ICU' brochure found, 95% of parents believed the
brochure was easy to read, understand and helpful in improving their
understanding of what to expect on the ward. 95% also found it useful to
have the transfer ward details written down prior to leaving the PICU. 85%
agreed the brochure helped to answer their questions in relation to the
transfer. Conclusion: The introduction of a brochure explaining the process
of discharge from ICU and what to expect on the wards received positive
feedback from families. The brochure provides families with generic
information regarding ICU transfer, however, it is important for the ICU
liaison nurse to promote discussion and tailor the information for the
particular experiences and needs of each patient and family situation. Crown
Copyright © 2008.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
attitude to health
intensive care unit
parent
patient care
patient transport
teaching
EMTREE MEDICAL INDEX TERMS
anxiety (etiology, prevention)
article
Australia
comprehension
education
evaluation study
human
human relation
interpersonal communication
needs assessment
nurse
nurse attitude
nursing evaluation research
organization and management
psychological aspect
publication
questionnaire
social support
standard
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
18657975 (http://www.ncbi.nlm.nih.gov/pubmed/18657975)
PUI
L50219924
DOI
10.1016/j.iccn.2008.06.002
FULL TEXT LINK
http://dx.doi.org/10.1016/j.iccn.2008.06.002
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 733
TITLE
Moving a hospital: Consequences for critical care services
AUTHOR NAMES
van Lelyveld-Haas L.E.M.
Tjan D.H.T.
Hendriksen J.
van Zanten A.R.H.
AUTHOR ADDRESSES
(van Lelyveld-Haas L.E.M.; Tjan D.H.T.; van Zanten A.R.H., zantena@zgv.nl)
Department of Intensive Care, Gelderse Vallei Hospital, Ede, Netherlands.
(Hendriksen J.) Department of Patient Care and Logistics, Gelderse Vallei
Hospital, Ede, Netherlands.
CORRESPONDENCE ADDRESS
A.R.H. van Zanten, Department of Intensive Care, Gelderse Vallei Hospital,
Ede, Netherlands. Email: zantena@zgv.nl
SOURCE
Netherlands Journal of Critical Care (2008) 12:1 (10-13). Date of
Publication: 2008
ISSN
1569-3511
BOOK PUBLISHER
NVIC - Netherlands Society of Intensive Care, Stationsweg 73 C, Ede,
Netherlands.
ABSTRACT
Introduction: Delivering optimal patient care in a three-location hospital
during the move to a single new building is complex. Limited information is
available in the literature on the medical and nursing implications of
moving hospitals, especially for critically ill patients. We assessed the
numbers of patients, special equipment and treatments on a regular day
versus the day of patient transportation. Methods: A two time-point survey
of in-hospital patients, equipment and treatments on a regular day versus
the day of patient transportation in a 525-bed secondary referral centre
with 12 ICU beds. Data from all in-hospital patients (wards and ICU) were
gathered four months before and on the day of the actual moving of patients.
Four days before the hospital move, admissions to general wards were
stopped, ICU admission was continued as normal. Results: The admission stop
prior to the move led to a reduction in the number of in-hospital patients
(118 patients (day of move) vs. 311 patients (regular day)). On the day of
the move significant case-mix differences were observed on comparison with a
regular day. Coronary Care patient numbers dropped markedly (2.6% vs. 0%).
More patients had to be transported in special beds (8.5% vs. 0.6%). Numbers
of ambulant patients and wheelchair patients were reduced (4.2% vs. 21.9%
and 11.0% vs. 31.2% respectively). In addition, more patients needed to be
accompanied by medical doctors (9.3% vs. 2.9%) and nurses (84.7% vs. 60.5%).
The number of DNR-orders was significantly higher than on a regular day
(28.9% vs. 10.3%). In the non-ICU environment special treatment frequency
(e.g. oxygen therapy and indwelling catheters) did change markedly. In the
ICU no decline in treatment intensity was noted. Conclusions: Physicians
making decisions regarding the care of ICU patients during hospital moving
should take into account that a hospital-wide admission stop will not lead
to important reductions of the numbers of patients to be transported from a
mixed ICU. On the other hand on regular wards, case-mix and use of special
beds, equipment, and personnel resources may differ markedly from regular
days. This may have implications for the planning process and allocation of
personnel and budgets. Copyright © 2008, Nederlandse Vereniging voor
Intensive Care. All Rights Reserved.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital service
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
ambulatory care
article
controlled study
critically ill patient
health survey
hospital admission
hospital bed capacity
hospital patient
hospital personnel
human
intensive care unit
major clinical study
medical care
medical decision making
medical record
nursing care
oxygen therapy
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2009067838
PUI
L354160711
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 734
TITLE
The availability of telecardiology consultations and transfer patterns from
a remote neonatal intensive care unit.
AUTHOR NAMES
Huang T.
Moon-Grady A.J.
Traugott C.
Marcin J.
AUTHOR ADDRESSES
(Huang T.; Moon-Grady A.J.; Traugott C.; Marcin J.) University of California
Davis Children's Hospital, Sacramento, California, USA.
CORRESPONDENCE ADDRESS
T. Huang, University of California Davis Children's Hospital, Sacramento,
California, USA.
SOURCE
Journal of telemedicine and telecare (2008) 14:5 (244-248). Date of
Publication: 2008
ISSN
1758-1109 (electronic)
ABSTRACT
We examined records of all admissions to an isolated community neonatal
intensive care unit (NICU) in California between 2001 and 2006. We also
reviewed the echocardiograms for diagnosis, disposition of patient and
necessity for transport. In 2004, a telemedicine link (mainly
store-and-forward) was established to a university children's hospital (UCH)
290 km away. The number of NICU patients having an echocardiogram increased
from 280 (27% of 1029 admissions) to 385 (40% of 963, P = <0.001) after
telemedicine became available. There was an increase in the proportion of
normal studies, from 31% to 37% (P = 0.03), and an increase in the number of
patients diagnosed with cardiac pathology from 192 (19% of all admissions)
to 241 (25%, P < 0.001). Twenty-four patients were transferred for cardiac
reasons during each three-year period; however seven pre-telemedicine
transfers were avoidable, compared with two post-telemedicine transfers (P =
0.06). There was a change in referral pattern (65% to the UCH
pre-telemedicine, compared with 78% post-telemedicine) although it was not
significant (P = 0.10). Thus the availability of the telecardiology link was
associated with increases in the utilization of echocardiography, in the
proportion of normal studies, and in the percentage of neonates diagnosed
with cardiac pathology without an increase in the number transferred for
cardiac reasons. There was a reduction in unnecessary transfers and a
strengthened relationship with the centre providing the telecardiology
service.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
congenital heart malformation
newborn intensive care
teleradiology
EMTREE MEDICAL INDEX TERMS
article
coronary care unit
echography
evaluation study
health care delivery
human
methodology
newborn
patient transport
statistics
United States
unnecessary procedure
LANGUAGE OF ARTICLE
English
MEDLINE PMID
18632999 (http://www.ncbi.nlm.nih.gov/pubmed/18632999)
PUI
L550225759
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 735
TITLE
Twenty-Five Years Later... Critical Care Transport, Birmingham, Alabama
AUTHOR NAMES
Demmons L.L.
AUTHOR ADDRESSES
(Demmons L.L.)
SOURCE
Air Medical Journal (2008) 27:6 (276-280). Date of Publication: November
2008/December 2008
ISSN
1067-991X
1532-6497 (electronic)
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
emergency health service
health care delivery
EMTREE MEDICAL INDEX TERMS
accident prevention
aircraft accident
airplane crew
airplane pilot
article
emergency care
health care facility
health care financing
health program
health service
human
medical device
medical staff
patient care
patient transport
personal experience
priority journal
safety
standard
United States
university hospital
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
Biophysics, Bioengineering and Medical Instrumentation (27)
Occupational Health and Industrial Medicine (35)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2008512241
MEDLINE PMID
18992686 (http://www.ncbi.nlm.nih.gov/pubmed/18992686)
PUI
L352587493
DOI
10.1016/j.amj.2008.08.008
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2008.08.008
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 736
TITLE
Knowledge transfer and practice change
AUTHOR NAMES
Leslie G.D.
AUTHOR ADDRESSES
(Leslie G.D.)
SOURCE
Australian Critical Care (2008) 21:4 (175-176). Date of Publication:
November 2008
ISSN
1036-7314
BOOK PUBLISHER
Elsevier Ireland Ltd, P.O. Box 85, Limerick, Ireland.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
nursing care
technology
EMTREE MEDICAL INDEX TERMS
Australia
editorial
human
intensive care unit
LANGUAGE OF ARTICLE
English
MEDLINE PMID
19117537 (http://www.ncbi.nlm.nih.gov/pubmed/19117537)
PUI
L352552550
DOI
10.1016/j.aucc.2008.10.001
FULL TEXT LINK
http://dx.doi.org/10.1016/j.aucc.2008.10.001
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 737
TITLE
Improving rehabilitation following transfer from ICU
AUTHOR NAMES
Ball C.
AUTHOR ADDRESSES
(Ball C., carol.ball@royalfree.nhs.uk) Royal Free Hampstead NHS Trust, Pond
St, London, NW3 2QN, United Kingdom.
(Ball C., carol.ball@royalfree.nhs.uk) City Community and Health Sciences,
City University, Northampton Square, London, EC1V 0HB, United Kingdom.
CORRESPONDENCE ADDRESS
C. Ball, Royal Free Hampstead NHS Trust, Pond St, London, NW3 2QN, United
Kingdom. Email: carol.ball@royalfree.nhs.uk
SOURCE
Intensive and Critical Care Nursing (2008) 24:4 (209-210). Date of
Publication: August 2008
ISSN
0964-3397
BOOK PUBLISHER
Churchill Livingstone, 1-3 Baxter's Place, Leith Walk, Edinburgh, United
Kingdom.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
aftercare
critical illness (rehabilitation)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
editorial
human
needs assessment
nurse attitude
organization and management
patient care
total quality management
LANGUAGE OF ARTICLE
English
MEDLINE PMID
18472264 (http://www.ncbi.nlm.nih.gov/pubmed/18472264)
PUI
L352378726
DOI
10.1016/j.iccn.2008.04.001
FULL TEXT LINK
http://dx.doi.org/10.1016/j.iccn.2008.04.001
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 738
TITLE
The critical care air transport program.
AUTHOR NAMES
Beninati W.
Meyer M.T.
Carter T.E.
AUTHOR ADDRESSES
(Beninati W.; Meyer M.T.; Carter T.E.) 59 Medical Operations Group (WB),
Wilford Hall Medical Center, Lackland Air Force Base, TX, USA.
CORRESPONDENCE ADDRESS
W. Beninati, 59 Medical Operations Group (WB), Wilford Hall Medical Center,
Lackland Air Force Base, TX, USA. Email: william.beninati@lackland.af.mil
SOURCE
Critical care medicine (2008) 36:7 Suppl (S370-376). Date of Publication:
Jul 2008
ISSN
1530-0293 (electronic)
ABSTRACT
BACKGROUND: The critical care air transport team program is a component of
the U.S. Air Force Aeromedical Evacuation system. A critical care air
transport team consists of a critical care physician, critical care nurse,
and respiratory therapist along with the supplies and equipment to operate a
portable intensive care unit within a cargo aircraft. DISCUSSION: This
capability was developed to support rapidly mobile surgical teams with high
capability for damage control resuscitation and limited capacity for
postresuscitation care. The critical care air transport team permits rapid
evacuation of stabilizing casualties to a higher level of care. The
aeromedical environment presents important challenges for the delivery of
critical care. All equipment must be tested for safety and effectiveness in
this environment before use in flight. The team members must integrate the
current standards of care with the limitation imposed by stresses of flight
on their patient. SUMMARY: The critical care air transport team capability
has been used successfully in a range of settings from transport within the
United States, to disaster response, to support of casualties in combat.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
intensive care
military medicine
patient care
patient transport
EMTREE MEDICAL INDEX TERMS
devices
disaster planning
forecasting
health service
human
international cooperation
nonbiological model
organization
organization and management
personnel management
practice guideline
program development
review
safety
United States
war
LANGUAGE OF ARTICLE
English
MEDLINE PMID
18594265 (http://www.ncbi.nlm.nih.gov/pubmed/18594265)
PUI
L352132287
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 739
TITLE
An audit of imaging and neck management of head injured patients at their
base hospital before transfer to a tertiary neurosurgical ITU
AUTHOR NAMES
Puxty A.
Pow C.
AUTHOR ADDRESSES
(Puxty A.; Pow C.) Department of Neuroanaesthesia, Southern General
Hospital, Glasgow, United Kingdom.
CORRESPONDENCE ADDRESS
A. Puxty, Department of Neuroanaesthesia, Southern General Hospital,
Glasgow, United Kingdom.
SOURCE
Journal of Neurosurgical Anesthesiology (2008) 20:3 (213-214). Date of
Publication: July 2008
CONFERENCE NAME
Annual Scientific Meeting of the Neuroanaethesia Society of Great Britain
and Ireland
CONFERENCE LOCATION
Birmingham, United Kingdom
CONFERENCE DATE
2008-05-08 to 2008-05-09
ISSN
0898-4921
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: In 2005, the Intensive Care Society (ICS) published guidelines
for the safe evaluation of patients who may have suffered cervical spine
injury after blunt trauma.(1) Studies have shown that patients with severe
traumatic head injury (Glasgow Coma Scale <8) have a 10.2% chance of a
coexisting cervical spine injury.(2) We investigated the initial management
of potential cervical spine injury in head injured patients transferred to a
neuroscience intensive care unit. Methods: This retrospective case note
review investigated 101 consecutive patients admitted to a tertiary referral
neurosurgical intensive care unit. Results: Eleven percent of all patients
had imaging recommended by ICS guidelines (Fig. 1) and 13% had their
cervical spine “cleared” appropriately prior to transfer to the regional
unit (Fig. 2). Thirty-two percent of patients had no hard collar in situ at
the time of admission and, of these, 47% had undergone no imaging of the
neck. Thirty-eight percent of all patients were injured in low falls (<2 m)
and 44% of these had no collar applied. The only patient in the series to
suffer a significant cord injury had sustained a low fall (Fig. 3). The type
of imaging performed at the referring hospital was variable (Fig. 4).
“figure presented” “figure presented” “figure presented” Conclusions:
Significant numbers of patients who were at risk of cervical spine injury
were transferred to our regional neuroscience intensive care unit with
inadequate imaging and/or no cervical spine protection. Low falls continue
to be a risk group for coincidental cervical spine injury that is frequently
overlooked. There is large variation in imaging carried out at referring
hospitals where better use of scanning facilities could help ensure more
expedient clearing of “at risk” cervical spines. “figure presented”.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
clinical audit
hospital
imaging
Ireland
neck
patient
society
United Kingdom
EMTREE MEDICAL INDEX TERMS
blunt trauma
cervical spine
cervical spine injury
Glasgow coma scale
head injury
high risk population
injury
intensive care
intensive care unit
protection
risk
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70035170
DOI
10.1097/ANA.0b013e318177341b
FULL TEXT LINK
http://dx.doi.org/10.1097/ANA.0b013e318177341b
COPYRIGHT
Copyright 2008 Elsevier B.V., All rights reserved.
RECORD 740
TITLE
Survey of transfer training amongst anaesthetic trainees in Leicester and
Nottingham
AUTHOR NAMES
Mohammad A.
Zafar N.
Boddy P.
Moppett I.
AUTHOR ADDRESSES
(Mohammad A.; Zafar N.) Nottingham and East Midland School of Anaesthesia, .
(Boddy P.) Leicester School of Anaesthesia, Leicester, United Kingdom.
(Moppett I.) Nottingham University Hospitals, NHS Trust, Nottingham, United
Kingdom.
CORRESPONDENCE ADDRESS
A. Mohammad, Nottingham and East Midland School of Anaesthesia, .
SOURCE
Journal of Neurosurgical Anesthesiology (2008) 20:3 (219-220). Date of
Publication: July 2008
CONFERENCE NAME
Annual Scientific Meeting of the Neuroanaethesia Society of Great Britain
and Ireland
CONFERENCE LOCATION
Birmingham, United Kingdom
CONFERENCE DATE
2008-05-08 to 2008-05-09
ISSN
0898-4921
BOOK PUBLISHER
Lippincott Williams and Wilkins
ABSTRACT
Introduction: Transfer of brain-injured patients is potentially hazardous
and, if not performed correctly, may lead to serious complications,
including secondary brain injury. Guidelines to improve the safety and
efficiency of patient transfers have been developed by the Intensive Care
Society(1) and the Association of Anaesthetists of Great Britain and Ireland
in association with the Neuroanaesthesia Society of Great Britain and
Ireland.(2) Our aim was to assess the extent of transfer training achieved
amongst anaesthetic trainees in 2 schools of anaesthesia-Leicester (a
non-neurosurgical teaching hospital) and Nottingham (regional neurosurgical
centre). Methods: One hundred eleven anaesthetic trainees were surveyed
using a structured questionnaire: 52 from Leicester and 59 from Nottingham.
The survey queried the respondents about their awareness of national
guidelines, transfer training received, number of inter-hospital and
intra-hospital transfers performed and whether they felt that the training
available in their region was adequate. “figure presented” “figure
presented” Results: There was little difference in the responses from the 2
centres. Only 52% of trainees have received any transfer training (Fig. 1)
and the training undertaken is variable (Fig. 2). Fifty-four percent of
those who took part in the survey were unaware of national guidelines
despite the number of transfers that they had undertaken (Figs. 3 and 4).
Only 9% of surveyed trainees felt that transfer training was adequate.
Conclusions: This survey revealed that training of transfer skills amongst
anaesthetic trainees falls well short of the recommendations. The similar
responses from 2 distinct training centres suggest that this is not a purely
“figure presented” “figure presented” local problem. More formalised
training and increased availability of transfer training courses are
required. These issues are being addressed by increasing the awareness of
transfer guidelines and checklists in the induction given to trainees and by
means of email circulars, website posting and local meetings.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
anesthetic agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Ireland
society
student
United Kingdom
EMTREE MEDICAL INDEX TERMS
anesthesia
brain
brain injury
checklist
e-mail
hospital
intensive care
patient
patient transport
safety
school
skill
structured questionnaire
teaching hospital
training
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
PUI
L70035185
DOI
10.1097/ANA.0b013e318177341b
FULL TEXT LINK
http://dx.doi.org/10.1097/ANA.0b013e318177341b
COPYRIGHT
Copyright 2008 Elsevier B.V., All rights reserved.
RECORD 741
TITLE
Facilitating in-hospital transport of trauma patients: Design of a trauma
life support trolley
AUTHOR NAMES
Saltzherr T.P.
Luitse J.S.K.
Hoogerwerf N.
Vernooij A.S.N.
Goslings J.C.
AUTHOR ADDRESSES
(Saltzherr T.P.; Luitse J.S.K.; Goslings J.C., j.c.goslings@amc.uva.nl)
Trauma Unit Department of Surgery, Academic Medical Center, Meibergdreef 9,
1105 AZ Amsterdam, Netherlands.
(Hoogerwerf N.) Department of Anesthesiology, Academic Medical Center,
Amsterdam, Netherlands.
(Vernooij A.S.N.) Department of Medical Technical Development, Academic
Medical Center, Amsterdam, Netherlands.
CORRESPONDENCE ADDRESS
J.C. Goslings, Trauma Unit Department of Surgery, Academic Medical Center,
Meibergdreef 9, 1105 AZ Amsterdam, Netherlands. Email:
j.c.goslings@amc.uva.nl
SOURCE
Injury (2008) 39:7 (809-812). Date of Publication: July 2008
ISSN
0020-1383
BOOK PUBLISHER
Elsevier Ltd, Langford Lane, Kidlington, Oxford, United Kingdom.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
equipment design
hospital equipment
patient transport
trauma life support trolley
EMTREE MEDICAL INDEX TERMS
angiography
article
capnometry
electrocardiogram
emergency ward
endotracheal tube
information processing
infusion system
injury
intensive care unit
oxygenation
priority journal
radiology
resuscitation
suction drainage
ventilator
volumetry
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
Biophysics, Bioengineering and Medical Instrumentation (27)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2008277773
MEDLINE PMID
18417129 (http://www.ncbi.nlm.nih.gov/pubmed/18417129)
PUI
L50119866
DOI
10.1016/j.injury.2008.01.010
FULL TEXT LINK
http://dx.doi.org/10.1016/j.injury.2008.01.010
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 742
TITLE
Critical care at Landstuhl Regional Medical Center.
AUTHOR NAMES
Fang R.
Pruitt V.M.
Dorlac G.R.
Silvey S.V.
Osborn E.C.
Allan P.F.
Flaherty S.F.
Perello M.M.
Wanek S.M.
Dorlac W.C.
AUTHOR ADDRESSES
(Fang R.; Pruitt V.M.; Dorlac G.R.; Silvey S.V.; Osborn E.C.; Allan P.F.;
Flaherty S.F.; Perello M.M.; Wanek S.M.; Dorlac W.C.) Landstuhl Regional
Medical Center, Landstuhl, Germany.
CORRESPONDENCE ADDRESS
R. Fang, Landstuhl Regional Medical Center, Landstuhl, Germany. Email:
Raymond.Fang@amedd.army.mil
SOURCE
Critical care medicine (2008) 36:7 Suppl (S383-387). Date of Publication:
Jul 2008
ISSN
1530-0293 (electronic)
ABSTRACT
BACKGROUND: Landstuhl Regional Medical Center is the largest U.S. medical
facility outside the United States, and it is the first permanently
positioned hospital outside the combat zone providing care to the wartime
sick and wounded. As of November 2007, Landstuhl Regional Medical Center
personnel have treated over 45,000 patients from Operations Enduring Freedom
and Iraqi Freedom. The current trauma/critical care service is a
multidisciplinary, intensivist-directed team caring for a diverse range of
clinical diagnoses to include battle injuries, diseases, and nonbattle
injuries. Admissions arise from an at-risk population of 500,000 widely
distributed over a geographic area encompassing three continents.
DISCUSSION: When compared with 2001, the average daily intensive care unit
census has tripled and the patient acuity level has doubled. Combat
casualties account for 85% of service admissions. The clinical practice at
this critical care hub continues to evolve as a result of wartime damage
control trauma care, robust critical care air transport capabilities, length
of stay, and other unique factors. The service's focus is to optimize
patients for an uneventful evacuation to the United States for definitive
care and family support. SUMMARY: Successful verification in 2007 as an
American College of Surgeons level II trauma center reflects a continuing
institutional commitment to providing the best possible care to the men and
women serving our nation in the global war on terror.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
intensive care
intensive care unit
military medicine
patient transport
public hospital
EMTREE MEDICAL INDEX TERMS
Afghanistan
article
education
enteric feeding
Germany
hospital admission
human
infection control
Iraq
length of stay
organization
organization and management
patient care
spine injury (prevention)
statistics
terrorism
thromboembolism (diagnosis, etiology, prevention)
total quality management
treatment outcome
United States
war
LANGUAGE OF ARTICLE
English
MEDLINE PMID
18594267 (http://www.ncbi.nlm.nih.gov/pubmed/18594267)
PUI
L352132289
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 743
TITLE
Concept analysis of relocation stress: focusing on patients transferred from
intensive care unit to general ward
AUTHOR NAMES
Son Y.J.
Hong S.K.
Jun E.Y.
AUTHOR ADDRESSES
(Son Y.J.; Hong S.K.; Jun E.Y.) Department of Nursing, Soonchunhyang
University, Cheonan, Korea.
CORRESPONDENCE ADDRESS
Y.J. Son, Department of Nursing, Soonchunhyang University, Cheonan, Korea.
SOURCE
Taehan Kanho Hakhoe chi (2008) 38:3 (353-362). Date of Publication: Jun 2008
ISSN
1598-2874
ABSTRACT
PURPOSE: This study was conducted to analyze and clarify the meaning of the
concept for relocation stress -focusing on patients transferred from an
intensive care unit to a general ward. METHODS: This study used Walker and
Avant's process of concept analysis. RESULTS: Relocation stress can be
defined by these attributes as follows: 1) involuntary decision about
relocation, 2) moving from a familiar and safe environment to an unfamiliar
one, 3) broken relationship of safety and familiarity, 4) physiological and
psychosocial change after relocation. The antecedents of relocation stress
consisted of these facts: 1) preparation degrees of transfer from the
intensive care unit to a general ward, 2) pertinence of the information
related to the transfer process, 3) change of major caregivers, 4) change in
numbers of monitoring devices, 5) change in the level of self-care. There
are consequences occurring as a result of relocation stress: 1) decrease in
patients' quality of life, 2) decrease in coping capacity, 3) loss of
control. CONCLUSION: Relocation stress is a core concept in intensive
nursing care. Using this concept will contribute to continuity of intensive
nursing care.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
mental stress
patient transport
EMTREE MEDICAL INDEX TERMS
adaptive behavior
article
caregiver
concept formation
health care facility
human
LANGUAGE OF ARTICLE
Korean
MEDLINE PMID
18604144 (http://www.ncbi.nlm.nih.gov/pubmed/18604144)
PUI
L550075151
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 744
TITLE
Hazards of intra-hospital transport (IHT)
AUTHOR NAMES
Siegel N.
Bird E.
AUTHOR ADDRESSES
(Siegel N.; Bird E.)
SOURCE
HERD (2008) 1:4 (133-136). Date of Publication: 1 Jun 2008
ISSN
1937-5867
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital
patient safety
EMTREE MEDICAL INDEX TERMS
human
LANGUAGE OF ARTICLE
English
MEDLINE PMID
22973618 (http://www.ncbi.nlm.nih.gov/pubmed/22973618)
PUI
L611780456
COPYRIGHT
Copyright 2016 Medline is the source for the citation and abstract of this
record.
RECORD 745
TITLE
Ketamine sedation during the treatment of retinopathy of prematurity
AUTHOR NAMES
Lyon F.
Dabbs T.
O'Meara M.
AUTHOR ADDRESSES
(Lyon F.; Dabbs T., timothy.dabbs@leedsth.nhs.uk) Department of
Ophthalmology, St James's University Hospital, Leeds, United Kingdom.
(O'Meara M.) Department of Anaesthetics, St James's University Hospital,
Leeds, United Kingdom.
CORRESPONDENCE ADDRESS
T. Dabbs, Department of Ophthalmology, St James's University Hospital,
Leeds, United Kingdom. Email: timothy.dabbs@leedsth.nhs.uk
SOURCE
Eye (2008) 22:5 (684-686). Date of Publication: May 2008
ISSN
0950-222X
1476-5454 (electronic)
BOOK PUBLISHER
Nature Publishing Group, Houndmills, Basingstoke, Hampshire, United Kingdom.
ABSTRACT
Aims: To report the use of ketamine sedation as an alternative anaesthetic
method for babies undergoing treatment for retinopathy of prematurity (ROP).
Methods: All babies who underwent treatment for ROP over a 2-year period
were included in this study. The babies preoperative weight, medical
condition, and ventilation status was recorded. Data were collected on their
ventilation status pre-, intra-, and postprocedure. Any change in their
cardiac or respiratory status during or in the subsequent 3 days following
the treatment was noted. Results: Eleven babies, 22 eyes, required treatment
over this period. The procedure was well tolerated with only three babies
having intraoperative complications, which all resolved spontaneously. Two
babies had postoperative complications requiring additional ventilation. In
no case was the procedure abandoned owing to anaesthetic complications.
Conclusions: The use of ketamine sedation allows the laser to be performed
in a ward setting and avoids the potential risk of general anaesthesia and
inter- and intra-hospital transfer. It has been found to produce few intra-
or postoperative complications for the infant, while providing satisfactory
conditions for the treatment of ROP.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
ketamine
EMTREE DRUG INDEX TERMS
atropine
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
retrolental fibroplasia (surgery)
sedation
EMTREE MEDICAL INDEX TERMS
anesthesia complication (complication)
article
artificial ventilation
body weight
breathing mechanics
clinical article
general anesthesia
health status
heart function
human
infant
intraoperative period
laser surgery
outcome assessment
patient safety
patient transport
peroperative complication (complication)
postoperative complication (complication)
postoperative period
preoperative evaluation
respiratory function
CAS REGISTRY NUMBERS
atropine (51-55-8, 55-48-1)
ketamine (1867-66-9, 6740-88-1, 81771-21-3)
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Ophthalmology (12)
Anesthesiology (24)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2008247586
MEDLINE PMID
17417623 (http://www.ncbi.nlm.nih.gov/pubmed/17417623)
PUI
L351712366
DOI
10.1038/sj.eye.6702717
FULL TEXT LINK
http://dx.doi.org/10.1038/sj.eye.6702717
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 746
TITLE
Nurse testified she was with pt. at time of cardiac arrest.
AUTHOR ADDRESSES
SOURCE
Nursing law's Regan report (2008) 48:12 (1). Date of Publication: May 2008
ISSN
1528-848X
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
coronary care unit
heart arrest (prevention)
malpractice
nursing staff
patient transport
EMTREE MEDICAL INDEX TERMS
article
compensation
human
legal aspect
medical staff
nursing
resuscitation
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
18590249 (http://www.ncbi.nlm.nih.gov/pubmed/18590249)
PUI
L352318539
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 747
TITLE
Rhabdomyolysis and respiratory failure: Rare presentation of carnitine
palmityl-transferase II deficiency
AUTHOR NAMES
Gentili A.
Iannella E.
Masciopinto F.
Latrofa M.E.
Giuntoli L.
Baroncini S.
AUTHOR ADDRESSES
(Gentili A., andrea_gentili@libero.it; Iannella E.; Masciopinto F.; Latrofa
M.E.; Giuntoli L.; Baroncini S.) Department of Paediatric Anaestheia and
Intensive Care, S. Orsola-Malpighi University Hospital, Via Massarenti 9,
40138 Bologna, Italy.
CORRESPONDENCE ADDRESS
A. Gentili, Department of Paediatric Anaestheia and Intensive Care, S.
Orsola-Malpighi University Hospital, Via Massarenti 9, 40138 Bologna, Italy.
Email: andrea_gentili@libero.it
SOURCE
Minerva Anestesiologica (2008) 74:5 (205-208). Date of Publication: May 2008
ISSN
0375-9393
BOOK PUBLISHER
Edizioni Minerva Medica S.p.A., Corso Bramante 83-85, Torino, Italy.
ABSTRACT
Carnitine palmityl-transferase (CPT) II deficiency is a rare disorder of the
fatty acid beta-oxidation cycle. CPT II deficiency can be associated with
rhabdomyolysis in particular conditions that increase the requirement for
fatty acid oxidation, such as low-carbohydrate and high-fat diet, fasting,
exposure to excessive cold, lack of sleep and prolonged exercise. The best
known CPT II deficiency is the muscular form with episodic muscle necrosis
and paroxysmal myoglobinuria after prolonged exercise. We report a case of a
four-year-old male child, who, after one day of hyperthermia and fasting,
developed a massive rhabdomyolysis beginning with acute respiratory failure
and later complicated by acute renal failure. Appropriate management in
Pediatric Intensive Care Unit (PICU) (mechanical ventilatory support, fluid
supply combined with mannitol and bicarbonate infusions, administration of
acetaminophen and antibiotics, and continuous venovenous haemofiltration)
brought about complete resolution with an excellent outcome. Biochemical
investigation of muscle biopsy and genetic analysis showed a deficiency of
CPT II. The onset of CPT II deficiency with respiratory failure is extremely
rare, but a correct and early diagnosis of rhabdomyolysis is the key to
successful treatment. A metabolic myopathy such as CPT II deficiency should
be suspected in children affected by rhabdomyolysis if trauma, crash,
infections, drugs or extreme exertion can be excluded.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
carnitine palmitoyltransferase (endogenous compound)
carnitine palmitoyltransferase ii (endogenous compound)
EMTREE DRUG INDEX TERMS
bicarbonate (drug combination, drug therapy)
ceftriaxone (drug combination, drug therapy)
creatine kinase (endogenous compound)
creatine kinase MB (endogenous compound)
creatinine (endogenous compound)
mannitol (drug combination, drug therapy)
midazolam (drug combination, drug therapy)
paracetamol (drug combination, drug therapy)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
acute respiratory failure (complication, diagnosis, drug therapy, therapy)
carnitine palmitoyltransferase II deficiency (diagnosis)
metabolic disorder (diagnosis)
rhabdomyolysis (complication, diagnosis, therapy)
EMTREE MEDICAL INDEX TERMS
acute kidney failure (complication, therapy)
article
artificial ventilation
case report
clinical feature
continuous hemofiltration
creatinine blood level
diet restriction
drug withdrawal
early diagnosis
fluid therapy
genetic analysis
human
human tissue
hyperthermia (drug therapy)
intensive care unit
kidney tubule necrosis
laboratory test
lethargy
male
muscle biopsy
muscle rigidity
muscle weakness
myalgia
physical examination
physiotherapy
preschool child
CAS REGISTRY NUMBERS
bicarbonate (144-55-8, 71-52-3)
carnitine palmitoyltransferase (9068-41-1)
ceftriaxone (73384-59-5, 74578-69-1)
creatine kinase (9001-15-4)
creatinine (19230-81-0, 60-27-5)
mannitol (69-65-8, 87-78-5)
midazolam (59467-70-8)
paracetamol (103-90-2)
EMBASE CLASSIFICATIONS
Neurology and Neurosurgery (8)
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Anesthesiology (24)
Urology and Nephrology (28)
Clinical and Experimental Biochemistry (29)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2008310237
MEDLINE PMID
18414363 (http://www.ncbi.nlm.nih.gov/pubmed/18414363)
PUI
L351895339
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 748
TITLE
Comparison of critically ill and injured children transferred from referring
hospitals versus in-house admissions
AUTHOR NAMES
Gregory C.J.
Nasrollahzadeh F.
Dharmar M.
Parsapour K.
Marcin J.P.
AUTHOR ADDRESSES
(Gregory C.J., christopher.gregory@ucdmc.ucdavis.edu; Nasrollahzadeh F.;
Dharmar M.; Parsapour K.) Department of Pediatrics, University of
California, Davis Children's Hospital, Davis, CA.
(Marcin J.P.) University of California, Davis Center for Health Services
Research in Primary Care, University of California, Davis, CA.
(Gregory C.J., christopher.gregory@ucdmc.ucdavis.edu) University of
California, Davis Medical Center, 2516 Stockton Blvd., Sacramento, CA 95817.
CORRESPONDENCE ADDRESS
C. J. Gregory, University of California, Davis Medical Center, 2516 Stockton
Blvd., Sacramento, CA 95817. Email: christopher.gregory@ucdmc.ucdavis.edu
SOURCE
Pediatrics (2008) 121:4 (e906-e911). Date of Publication: April 2008
ISSN
0031-4005
1098-4275 (electronic)
BOOK PUBLISHER
American Academy of Pediatrics, 141 Northwest Point Blvd, P.O. Box 927, Elk
Grove Village, United States.
ABSTRACT
OBJECTIVE. The purpose of this work was to compare the outcomes, severity of
illness, and resource use of patients transferred to PICUs from outside
hospitals to patients admitted from within the same hospital. METHODS. We
conducted a secondary analysis of patients from the 20 US PICUs in the most
recent Pediatric Intensive Care Unit Evaluations Software Recalibration
Database on a total of 13 017 emergent PICU admissions between January 2001
and January 2006. Dependent variables were PICU resource use and
risk-adjusted mortality. The main independent variable was the PICU
admission source: patients transferred from referring emergency departments
and inpatient wards versus in-house admissions from the same hospitals'
emergency departments and inpatient ward. RESULTS. Patients admitted from
referring emergency departments had higher use of vasoactive infusions
(7.31% vs 5.23%) and mechanical ventilation (33.45% vs 23.6%) than
same-hospital emergency department admissions. Compared with in- house ward
admissions, patients transferred from referring inpatient wards had higher
mechanical ventilation rates (45.05% vs 28.56%) and PICU lengths of stay
(8.0 vs 6.7 days). CONCLUSIONS. On average, children admitted to a cohort of
US PICUs from referring hospitals were more ill and required more intensive
care resources than patients admitted to the same PICUs from within the
institution. Hospital-level differences in PICU efficiency and severity of
illness were highly variable. These data highlight the need for standardized
PICU admission criteria to maximize hospital efficiency and suggest
opportunities for earlier intervention and consultation by hospitals with
PICU-level services to improve quality of care for critically ill children.
Copyright © 2008 by the American Academy of Pediatrics.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
hospital admission
patient referral
patient transport
EMTREE MEDICAL INDEX TERMS
article
artificial ventilation
child
consultation
controlled study
disease severity
emergency ward
female
groups by age
health care quality
home care
hospital patient
human
intensive care unit
length of stay
major clinical study
male
mortality
preschool child
priority journal
school child
software
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2009161564
MEDLINE PMID
18381519 (http://www.ncbi.nlm.nih.gov/pubmed/18381519)
PUI
L354416802
DOI
10.1542/peds.2007-2089
FULL TEXT LINK
http://dx.doi.org/10.1542/peds.2007-2089
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 749
TITLE
Clinical review: Critical care transport and austere critical care
AUTHOR NAMES
Rice D.H.
Kotti G.
Beninati W.
AUTHOR ADDRESSES
(Rice D.H.; Kotti G.; Beninati W., william.beninati@lackland.af.mil)
Uniformed Services University of the Health Sciences, Wilford Hall Medical
Center, 2200 Bergquist Drive, Lackland Air Force Base, TX 78236, United
States.
CORRESPONDENCE ADDRESS
W. Beninati, Uniformed Services University of the Health Sciences, Wilford
Hall Medical Center, 2200 Bergquist Drive, Lackland Air Force Base, TX
78236, United States. Email: william.beninati@lackland.af.mil
SOURCE
Critical Care (2008) 12:2 Article Number: 207. Date of Publication: 5 Mar
2008
ISSN
1364-8535
1466-609X (electronic)
BOOK PUBLISHER
BioMed Central Ltd., Floor 6, 236 Gray's Inn Road, London, United Kingdom.
ABSTRACT
The development of modern intensive care units (ICUs) has allowed the
survival of patients with advanced illness and injury, although at a cost of
substantial infrastructure. Natural disasters and military operations are
two common situations that can create critically ill patients in an
environment that is austere or has been rendered austere. This has driven
the development of two related strategies to care for these casualties.
Portable ICU capability can be rapidly established in the area of need,
providing relatively advanced capability but limited capacity and
sustainability. The other strategy is to rapidly evacuate critically ill and
injured patients following their initial stabilization. This permits medical
personnel in the austere location to focus resources on a larger number of
less critical patients. It also permits the most vulnerable patients to
receive care in an advanced center. This strategy requires careful planning
to overcome the constraints of the transport environment. The optimal
strategy has not been determined, but a combination of these two approaches
has been used in recent disasters and military operations and is promising.
The critical care delivered in an austere setting must be integrated with a
long-term plan to provide follow-on care. © 2008 BioMed Central Ltd.
EMTREE DRUG INDEX TERMS
analgesic agent
antiarrhythmic agent
antibiotic agent
antidote
antihypertensive agent
cardiovascular agent
hypertensive factor
inotropic agent
miscellaneous drugs and agents
respiratory tract agent
sedative agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health care delivery
intensive care
public health service
EMTREE MEDICAL INDEX TERMS
accidental injury
air medical transport
artificial ventilation
comorbidity
critically ill patient
disaster
emergency care
emergency health service
follow up
health care availability
health care personnel
health care planning
health care quality
hospital care
infection control
infection risk
integrated health care system
intensive care unit
long term care
medical care
patient care
personal experience
pharmaceutical care
practice guideline
priority journal
professional competence
professional practice
resuscitation
review
standardization
sustainable development
wound infection
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Health Policy, Economics and Management (36)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2009123379
MEDLINE PMID
18373882 (http://www.ncbi.nlm.nih.gov/pubmed/18373882)
PUI
L354295567
DOI
10.1186/cc6782
FULL TEXT LINK
http://dx.doi.org/10.1186/cc6782
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 750
TITLE
Outcomes of pediatric trauma patients transported from rural and urban
scenes
AUTHOR NAMES
McCowan C.L.
Swanson E.R.
Thomas F.
Handrahan D.L.
AUTHOR ADDRESSES
(McCowan C.L., Christy.mccowan@hsc.utah.edu) Emergency Department Clinical
Operations, University of Utah School of Medicine, Salt Lake City, UT,
United States.
(Swanson E.R.) University Health Care, Air Med Program, University of Utah
School of Medicine, Salt Lake City, UT, United States.
(Thomas F.) Intermountain Life Flight Adult Services, Shock and Trauma ICU,
LDS Hospital, Salt Lake City, UT, United States.
(Handrahan D.L.) UCR Statistical Data Center, LDS Hospital, Salt Lake City,
UT, United States.
CORRESPONDENCE ADDRESS
C.L. McCowan, Emergency Department Clinical Operations, University of Utah
School of Medicine, Salt Lake City, UT, United States. Email:
Christy.mccowan@hsc.utah.edu
SOURCE
Air Medical Journal (2008) 27:2 (78-83). Date of Publication: March
2008/April 2008
ISSN
1067-991X
1532-6497 (electronic)
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
ABSTRACT
Objectives: Mortality differences exist between victims of urban and rural
trauma. It is unknown if these differences persist in those patients who
survive to HEMS transport. This study examined the in-hospital mortality,
hospital LOS, and discharge status of pediatric blunt trauma victims
transported by HEMS from rural and urban scenes. Methods: Retrospective
review of pediatric (< 17) transports between 1997 and 2001. 130 rural and
419 urban pediatric patients transported to area trauma centers were
identified from HEMS and registry records. Results: Total mileage, flight
times, and scene times were significantly longer for rural flights (P <
0.05). There were no significant differences between the groups with regard
to age, gender, vitals, hospital/ICU days, and mortality. After controlling
for ISS and mechanism of injury, urban patients were 9 times more likely to
die compared to rural patients. Conclusions: Pediatric patients injured in
urban areas had shorter total flight and scene times than pediatric patients
flown from rural scenes. Higher adjusted in-hospital mortality rates in the
urban group were likely a result of faster EMS response and transport times,
which minimized out-of-hospital deaths. Factors prior to HEMS arrival may
have more impact on the increased mortality rates of rural blunt trauma
victims documented nationally. © 2008 Air Medical Journal Associates.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
childhood injury
patient transport
rural area
urban area
EMTREE MEDICAL INDEX TERMS
article
blunt trauma
child
female
hospitalization
human
intensive care unit
major clinical study
male
medical record review
mortality
priority journal
register
retrospective study
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2008109479
MEDLINE PMID
18328971 (http://www.ncbi.nlm.nih.gov/pubmed/18328971)
PUI
L351324168
DOI
10.1016/j.amj.2007.10.001
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2007.10.001
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 751
TITLE
The business case for building better hospitals through evidence-based
design.
AUTHOR NAMES
Sadler B.L.
DuBose J.
Zimring C.
AUTHOR ADDRESSES
(Sadler B.L.) Rady Children's Hospital, San Diego, LaJolla, CA 92037, USA.
(DuBose J.; Zimring C.)
CORRESPONDENCE ADDRESS
B.L. Sadler, Rady Children's Hospital, San Diego, LaJolla, CA 92037, USA.
Email: bsadler@chsd.org
SOURCE
HERD (2008) 1:3 (22-39). Date of Publication: 2008 Spring
ISSN
1937-5867
ABSTRACT
After establishing the connection between building well-designed
evidence-based facilities and improved safety and quality for patients,
families, and staff, this article presents the compelling business case for
doing so. It demonstrates why ongoing operating savings and initial capital
costs must be analyzed and describes specific steps to ensure that design
innovations are implemented effectively. Hospital leaders and boards are now
beginning to face a new reality: They can no longer tolerate preventable
hospital-acquired conditions such as infections, falls, and injuries to
staff or unnecessary intra-hospital patient transfers that can increase
errors. Nor can they subject patients and families to noisy, confusing
environments that increase anxiety and stress. They must effectively deploy
all reasonable quality improvement techniques available. To be optimally
effective, a variety of tactics must be combined and implemented in an
integrated way. Hospital leadership must understand the clear connection
between building well-designed healing environments and improved healthcare
safety and quality for patients, families, and staff, as well as the
compelling business case for doing so. Emerging pay-for-performance (P4P)
methodologies that reward hospitals for quality and refuse to pay hospitals
for the harm they cause (e.g., infections and falls) further strengthen this
business case. When planning to build a new hospital or to renovate an
existing facility, healthcare leaders should address a key question: Will
the proposed project incorporate all relevant and proven evidence-based
design innovations to optimize patient safety, quality, and satisfaction as
well as workforce safety, satisfaction, productivity, and energy efficiency?
When conducting a business case analysis for a new project, hospital leaders
should consider ongoing operating savings and the market share impact of
evidence-based design interventions as well as initial capital costs. They
should consider taking the 10 steps recommended to ensure an optimal,
cost-effective hospital environment. A return-on-investment (ROI) framework
is put forward for the use of individual organizations.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
evidence based practice
financial management
hospital design
patient safety
total quality management
EMTREE MEDICAL INDEX TERMS
article
commercial phenomena
cost control
economics
health care facility
health services research
human
leadership
medical error (prevention)
patient satisfaction
reimbursement
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
21161906 (http://www.ncbi.nlm.nih.gov/pubmed/21161906)
PUI
L360305579
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 752
TITLE
Passing the torch: the challenge of handoffs.
AUTHOR NAMES
Dracup K.
Morris P.E.
AUTHOR ADDRESSES
(Dracup K.; Morris P.E.)
CORRESPONDENCE ADDRESS
K. Dracup,
SOURCE
American journal of critical care : an official publication, American
Association of Critical-Care Nurses (2008) 17:2 (95-97). Date of
Publication: Mar 2008
ISSN
1062-3264
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient care
patient transport
safety
EMTREE MEDICAL INDEX TERMS
editorial
human
intensive care unit
interpersonal communication
organization and management
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
18310641 (http://www.ncbi.nlm.nih.gov/pubmed/18310641)
PUI
L351603168
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 753
TITLE
Long-distance transport of critically ill children on extracorporeal life
support in Australia
AUTHOR NAMES
Perez A.
Butt W.W.
Millar K.J.
Best D.
Thiruchelvam T.
Cochrane A.D.
Bennett M.
Shekerdemian L.S.
AUTHOR ADDRESSES
(Perez A.; Butt W.W.; Millar K.J.; Best D.; Thiruchelvam T.; Cochrane A.D.;
Bennett M.; Shekerdemian L.S.) Department of Intensive Care, Royal
Children's Hospital, Melbourne, VIC, Australia
SOURCE
Critical care and resuscitation : journal of the Australasian Academy of
Critical Care Medicine (2008) 10:1 (34). Date of Publication: 1 Mar 2008
ISSN
1441-2772
ABSTRACT
BACKGROUND: The Royal Children's Hospital, Melbourne, Victoria, provides
extracorporeal life support (ECLS) for infants and children from all around
Australia. Since 2003, we have offered a mobile ECLS service to retrieve
critically ill children whose condition is too unstable for conventional
transport. The retrieval team comprises a paediatric intensive care unit
specialist, an ECLS nurse specialist, a perfusionist and a cardiac
surgeon.PATIENTS AND METHODS: Retrospective review of eight children (aged
between 1 day and 8 years) who were transported on ECLS to the intensive
care unit at the Royal Children's Hospital, Melbourne, between 2003 and
2007.RESULTS: Seven patients underwent cannulation by our team in the
referring ICU, and one underwent cannulation by the referring centre before
our retrieval team arrived. Seven children were placed on ECMO (veno-venous
in two, veno-arterial in five), and one was placed on a left ventricular
assist device. Five children were retrieved from interstate ICUs by air, and
three were transported from a metropolitan ICU by road. The median distance
from the referral centre to Melbourne was 803 km, and the median duration of
retrieval was 13 hours. Median duration of ECLS was 270 hours. Five patients
survived to hospital discharge. There were no adverse outcomes related to
transport.CONCLUSIONS: This is the first report of ECLS transport in
Australia. In our experience, children who would not otherwise be
transportable can be safely transported long distances on ECLS, and should
be offered this if appropriate resources exist. However, this approach
should not replace the timely referral of patients who are likely to need
ECLS.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
extracorporeal oxygenation
EMTREE MEDICAL INDEX TERMS
child
devices
human
intensive care unit
retrospective study
Victoria
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
18304015 (http://www.ncbi.nlm.nih.gov/pubmed/18304015)
PUI
L611744336
COPYRIGHT
Copyright 2016 Medline is the source for the citation and abstract of this
record.
RECORD 754
TITLE
Neurosurgical emergency transfers to academic centers in Cook County: A
prospective multicenter study
AUTHOR NAMES
Byrne R.W.
Bagan B.T.
Slavin K.V.
Curry D.
Koski T.R.
Origitano T.C.
AUTHOR ADDRESSES
(Byrne R.W., rbyrne37@aol.com; Bagan B.T.) Department of Neurosurgery, Rush
University Medical Center, Chicago, IL, United States.
(Slavin K.V.) Department of Neurosurgery, University of Illinois at Chicago,
Chicago, IL, United States.
(Curry D.) Department of Surgery, Division of Neurosurgery, University of
Chicago, Chicago, IL, United States.
(Koski T.R.) Department of Neurosurgery, Northwestern University, Chicago,
IL, United States.
(Origitano T.C.) Department of Neurosurgery, Loyola University, Chicago, IL,
United States.
(Byrne R.W., rbyrne37@aol.com) Department of Neurosurgery, Rush University
Medical Center, 1725 West Harrison, Chicago, IL 60612, United States.
CORRESPONDENCE ADDRESS
R. W. Byrne, Department of Neurosurgery, Rush University Medical Center,
1725 West Harrison, Chicago, IL 60612, United States. Email:
rbyrne37@aol.com
SOURCE
Neurosurgery (2008) 62:3 (709-715). Date of Publication: March 2008
ISSN
0148-396X
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
ABSTRACT
OBJECTIVE: The absence of surgical subspecialty emergency care in the United
States is a growing public health concern. Neurosurgery is a field lacking
coverage in many areas of the country; however, this is generally thought to
be of greater concern in rural areas. Because of decreasing numbers of
neurosurgeons, medical malpractice, and liability concerns, neurosurgery
coverage is becoming a public health crisis in urban areas. Our objective
was to quantify neurosurgical emergency transfers to academic medical
centers in Cook County, IL, including patient demographics, reasons for
transfer, time lapse in transfer, and effects on patient condition. METHODS:
Data on neurosurgery emergency transfers was gathered prospectively by all
five of the academic neurosurgery departments in Cook County, IL, over a
2-month period. Patient demographics devoid of identifiers, diagnosis,
transfer origin, time lapse of transfer, and patient condition at the time
of transfer and at the receiving hospital were recorded. RESULTS:
Two-hundred thirty emergent neurosurgical transfers occurred during the
study period. The most common diagnoses were parenchymal intracerebral
hemorrhage (33%) and subarachnoid hemorrhage (28%). Sixty-six percent of
neurosurgical transfers to academic medical facilities originated at
hospitals without full-time neurosurgery coverage. The mean time to transfer
for all patients was 5 hours 10 minutes (standard deviation, 3 h 42 min;
range, 1-20 h 12 min). A decline in Glasgow Coma Scale score was seen in 29
patients. A shortage of neurosurgical intensive care unit beds occurred on
55% of the days in the study. Only 19% of the emergency cases were related
to cranial trauma, and only 3% of transfers came from Level 1 trauma
centers. CONCLUSION: A combination of factors has led to decreases in
availability of neurosurgical coverage in Cook County community hospital
emergency departments. This has placed an increased burden on neurosurgical
departments at academic centers, and, in some cases, delays led to a decline
in patient condition. Eighty-one percent of the cases were not related to
cranial trauma; thus, acute care trauma surgeons would be of little use.
Coordinated efforts among local governments, medical centers, and emergency
medical services to regionalize subspecialty services will be necessary to
manage this problem. Copyright © by the Congress of Neurological Surgeons.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency surgery
neurosurgery
patient transport
EMTREE MEDICAL INDEX TERMS
abscess
article
brain contusion
brain hemorrhage
brain infarction
cauda equina syndrome
cerebrospinal fluid fistula
cerebrovascular accident
cervical spine fracture
demography
encephalitis
epileptic state
Glasgow coma scale
head injury
human
hydrocephalus
hypophysis apoplexy
intensive care unit
major clinical study
medical specialist
neuroimaging
parenchyma
priority journal
prospective study
seizure
skull fracture
spinal cord compression
spinal cord injury
subarachnoid hemorrhage
traumatic brain injury
United States
university hospital
vasculitis
vasospasm
EMBASE CLASSIFICATIONS
Neurology and Neurosurgery (8)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2008196389
MEDLINE PMID
18425017 (http://www.ncbi.nlm.nih.gov/pubmed/18425017)
PUI
L351572727
DOI
10.1227/01.neu.0000317320.79106.7e
FULL TEXT LINK
http://dx.doi.org/10.1227/01.neu.0000317320.79106.7e
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 755
TITLE
Neurosurgical emergency transfers to academic centers in Cook County: A
prospective multicenter study - Commentary
AUTHOR NAMES
Wilberger J.E.
AUTHOR ADDRESSES
(Wilberger J.E.)
CORRESPONDENCE ADDRESS
J. E. Wilberger, Pittsburgh, PA, United States.
SOURCE
Neurosurgery (2008) 62:3 (715). Date of Publication: March 2008
ISSN
0148-396X
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency surgery
neurosurgery
patient transport
EMTREE MEDICAL INDEX TERMS
hospital bed capacity
human
intensive care unit
medical decision making
nervous system injury
note
priority journal
resource allocation
telemedicine
EMBASE CLASSIFICATIONS
Neurology and Neurosurgery (8)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2008196391
PUI
L351572729
DOI
10.1227/01.neu.0000317320.79106.7e
FULL TEXT LINK
http://dx.doi.org/10.1227/01.neu.0000317320.79106.7e
COPYRIGHT
Copyright 2008 Elsevier B.V., All rights reserved.
RECORD 756
TITLE
An emergency medical bag set for long-range aeromedical transportation.
AUTHOR NAMES
Barillo D.J.
Renz E.
Broger K.
Moak B.
Wright G.
Holcomb J.B.
AUTHOR ADDRESSES
(Barillo D.J.; Renz E.; Broger K.; Moak B.; Wright G.; Holcomb J.B.) Burn
Flight Team, US Army Institute of Surgical Research, Ft. Sam, Houston,
Texas, USA.
CORRESPONDENCE ADDRESS
D.J. Barillo, Burn Flight Team, US Army Institute of Surgical Research, Ft.
Sam, Houston, Texas, USA.
SOURCE
American journal of disaster medicine (2008) 3:2 (79-86). Date of
Publication: 2008 Mar-Apr
ISSN
1932-149X
ABSTRACT
The global war on terror has created the need for urgent long-range
aeromedical transport of severely wounded service members over distances of
several thousand miles from Afghanistan or Iraq to the United States. This
need is met by specialized medical transport teams such as US Air Force
Critical Care Air Transport Teams (CCATT) or by the US Army Burn Flight Team
(BFT). Both teams travel with multiple bags or cases of emergency equipment,
which are comprehensive but cumbersome. To avoid the need to search multiple
bags for equipment or drugs when an in-flight emergency occurs, many CCATT
and BFT physicians also carry a personal bag of emergency supplies for rapid
access. Over the last year, we have evolved and standardized an emergency
equipment bag designed to provide the supplies necessary for initial
management of emergencies that occur during flight and ground transport.
This or a similar emergency kit would be useful for inter or intrahospital
transport of critically ill or injured civilian patients, or for physicians
who respond to civil emergencies, such as members of Disaster Medical
Assistance Teams.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
military medicine
patient transport
EMTREE MEDICAL INDEX TERMS
article
devices
equipment design
human
intensive care
LANGUAGE OF ARTICLE
English
MEDLINE PMID
18522249 (http://www.ncbi.nlm.nih.gov/pubmed/18522249)
PUI
L352238507
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 757
TITLE
Intrahospital transports of critically ill patients: A special challenge of
hospital care
ORIGINAL (NON-ENGLISH) TITLE
Innerklinische transporte von kritisch kranken patienten: Eine besondere
herausforderung in der klinischen versorgung
AUTHOR NAMES
Wiese C.H.R.
Bartels U.
Fraatz W.
Bahr J.
Zausig Y.A.
Quintel M.
Graf B.M.
AUTHOR ADDRESSES
(Wiese C.H.R., cwiese@zari.de; Bartels U.; Fraatz W.; Bahr J.; Zausig Y.A.;
Quintel M.; Graf B.M.) Zentrum Anaesthesiologie, Rettungs- und
Intensivmedizin, Georg-August-Universität Göttingen, .
(Wiese C.H.R., cwiese@zari.de) Zentrum Anaesthesiologie, Rettungs- und
Intensivmedizin, Georg-August-Universität Göttingen, Robert-Koch-Straße 40,
37075 Göttingen, Germany.
CORRESPONDENCE ADDRESS
C. H. R. Wiese, Zentrum Anaesthesiologie, Rettungs- und Intensivmedizin,
Georg-August-Universität Göttingen, Robert-Koch-Straße 40, 37075 Göttingen,
Germany. Email: cwiese@zari.de
SOURCE
Anasthesiologie und Intensivmedizin (2008) 49:3 (125-133). Date of
Publication: March 2008
ISSN
0170-5334
BOOK PUBLISHER
DIOmed Verlags GmbH, Am Weichselgarten 30, Erlangen, Germany.
ABSTRACT
During the stay in hospital intrahospital transports (IHT) of critically ill
patients are often necessary for optimal patient care. The transport of
intensive care patients within the hospital may be associated with many
potential complications and risks. It is therefore necessary to minimize
risk factors before the onset of transport. Intensive Care Unit (ICU)
patients should be transported safely when adequate time is provided,
preparations are made prior to IHT, and human resources and technical
support are sufficiently available. Patients should be stabilized as good as
possible. The standard monitoring equipment of ICUs should be used over the
whole time of transport. This article focuses on the transport of critically
ill patients inside the hospital. We discuss the reasons for such
transports, possible complications during transports, and show how to avoid
complications. © Anästh Intensivmed 2008.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
intensive care
EMTREE MEDICAL INDEX TERMS
devices
hospital care
human
intensive care unit
monitoring
patient care
patient safety
patient transport
review
risk factor
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
German
LANGUAGE OF SUMMARY
English, German
EMBASE ACCESSION NUMBER
2008145606
PUI
L351427542
COPYRIGHT
Copyright 2008 Elsevier B.V., All rights reserved.
RECORD 758
TITLE
Adequacy of information transferred at resident sign-out (inhospital
handover of care): A prospective survey
AUTHOR NAMES
Borowitz S.M.
Waggoner-Fountain L.A.
Bass E.J.
Sledd R.M.
AUTHOR ADDRESSES
(Borowitz S.M., Witz@virginia.edu; Waggoner-Fountain L.A.) Department of
Pediatrics, University of Virginia, Charlottesville, VA, United States.
(Bass E.J.; Sledd R.M.) Department of Systems and Information Engineering,
University of Virginia, Charlottesville, VA, United States.
(Borowitz S.M., Witz@virginia.edu) Division of Pediatric Gastroenterology
and Nutrition, University of Virginia, Charlottesville, VA 22908, United
States.
CORRESPONDENCE ADDRESS
S.M. Borowitz, Division of Pediatric Gastroenterology and Nutrition,
University of Virginia, Charlottesville, VA 22908, United States. Email:
Witz@virginia.edu
SOURCE
Quality and Safety in Health Care (2008) 17:1 (6-10). Date of Publication:
February 2008
ISSN
1475-3898
BOOK PUBLISHER
BMJ Publishing Group, Tavistock Square, London, United Kingdom.
ABSTRACT
Background: During sign-out (handover of care), information and
responsibility about patients is transferred from one set of caregivers to
another. Few residency training programmes formally teach resident
physicians how to sign out or assess their ability to sign out, and little
research has examined the sign-out process. Objective: To characterise the
effectiveness of the sign-out process between resident physicians on an
acute care ward. Design/methods: Resident physicians rotating on a
paediatric acute care ward participated in a prospective study. Immediately
after an on-call night, they completed a confidential survey characterising
their night on call, the adequacy of the sign-out they received, and where
they went to get information they had not received during sign-out. Results:
158 of 196 (81%) potential surveys were collected. On 49/158 surveys (31%),
residents indicated something happened while on call they were not
adequately prepared for. In 40/49 instances residents did not receive
information during sign-out that would have been helpful, and in 33/40 the
situation could have been anticipated and discussed during sign-out. The
quality of sign-out (assessed using a five-point Likert scale from 1 =
inadequate to answer call questions to 5 = adequate to answer call
questions) on the nights when something happened the resident was not
adequately prepared for were significantly different than the nights they
felt adequately prepared (mean (SD) score 3.58 (0.92) and 4.48 (0.70); p =
0.001). There were no significant differences in: how busy the nights were;
numbers of patients on service at the beginning of the call shift; numbers
of admissions during a call shift; numbers of transfers to an intensive care
unit; whether residents were "cross-covering" or were members of the general
ward team; or whether the resident had cared for the patient previously.
Conclusion: Although sign-out between resident physicians is a frequent
activity, there are many times when important information is not
transmitted. Analysis of these "missed opportunities" can be used to help
develop an educational programme for resident physicians on how to sign out
more effectively.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency care
medical service
EMTREE MEDICAL INDEX TERMS
article
controlled study
health survey
human
intensive care unit
patient care
physician
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2008087169
MEDLINE PMID
18245212 (http://www.ncbi.nlm.nih.gov/pubmed/18245212)
PUI
L351262947
DOI
10.1136/qshc.2006.019273
FULL TEXT LINK
http://dx.doi.org/10.1136/qshc.2006.019273
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 759
TITLE
Pediatric critical care transport: Diagnostic uncertainty - No worries,
resource limitation - Worry
AUTHOR NAMES
Kissoon N.
AUTHOR ADDRESSES
(Kissoon N.) Acute and Critical Care Programs, Department of Pediatrics,
University of British Columbia, Vancouver, BC, Canada.
CORRESPONDENCE ADDRESS
N. Kissoon, Acute and Critical Care Programs, Department of Pediatrics,
University of British Columbia, Vancouver, BC, Canada.
SOURCE
Pediatric Critical Care Medicine (2008) 9:1 (116-117). Date of Publication:
January 2008
ISSN
1529-7535
BOOK PUBLISHER
Lippincott Williams and Wilkins, 530 Walnut Street, Philadelphia, United
States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
child care
editorial
hospital care
human
priority journal
resource management
uncertainty
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2008025386
MEDLINE PMID
18185124 (http://www.ncbi.nlm.nih.gov/pubmed/18185124)
PUI
L351080862
DOI
10.1097/01.PCC.0000298649.43544.6C
FULL TEXT LINK
http://dx.doi.org/10.1097/01.PCC.0000298649.43544.6C
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 760
TITLE
The influence of systemic hemodynamics and oxygen transport on cerebral
oxygen saturation in neonates after the Norwood procedure
AUTHOR NAMES
Li J.
Zhang G.
Holtby H.
Guerguerian A.-M.
Cai S.
Humpl T.
Caldarone C.A.
Redington A.N.
Van Arsdell G.S.
AUTHOR ADDRESSES
(Li J., jia.li@sickkids.ca; Zhang G.; Holtby H.; Guerguerian A.-M.; Humpl
T.; Caldarone C.A.; Redington A.N.; Van Arsdell G.S.) Heart Center, the
Hospital for Sick Children, Toronto, Ont., Canada.
(Cai S.) Data Center, Congenital Heart Surgeon's Society, Toronto, Ont.,
Canada.
CORRESPONDENCE ADDRESS
J. Li, Heart Center, the Hospital for Sick Children, Toronto, Ont., Canada.
Email: jia.li@sickkids.ca
SOURCE
Journal of Thoracic and Cardiovascular Surgery (2008) 135:1 (83-90.e2). Date
of Publication: January 2008
ISSN
0022-5223
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
ABSTRACT
Objectives: Ischemic brain injury is an important morbidity in neonates
after the Norwood procedure. Its relationship to systemic hemodynamic oxygen
transport is poorly understood. Methods: Sixteen neonates undergoing the
Norwood procedure were studied. Continuous cerebral oxygen saturation was
measured by near-infrared spectroscopy. Continuous oxygen consumption was
measured by respiratory mass spectrometry. Pulmonary and systemic blood
flow, systemic vascular resistance, oxygen delivery, and oxygen extraction
ratio were derived with measurements of arterial, and superior vena cava and
pulmonary venous gases and pressures at 2- to 4-hour intervals during the
first 72 hours in the intensive care unit. Results: Mean cerebral oxygen
saturation was 66% ± 12% before the operation, reduced to 51% ± 13% on
arrival in the intensive care unit, and remained low during the first 8
hours; it increased to 56% ± 9% at 72 hours, still significantly lower than
the preoperative level (P < .05). Postoperatively, cerebral oxygen
saturation was closely and positively correlated with systemic arterial
pressure, arterial oxygen saturation, and arterial oxygen tension and
negatively with oxygen extraction ratio (P < .0001 for all). Cerebral oxygen
saturation was moderately and positively correlated with systemic blood flow
and oxygen delivery (P < .0001 for both). It was weakly and positively
correlated with pulmonary blood flow (P = .001) and hemoglobin (P = .02) and
negatively correlated with systemic vascular resistance (P = .003). It was
not correlated with oxygen consumption (P > .05). Conclusions: Cerebral
oxygen saturation decreased significantly in neonates during the early
postoperative period after the Norwood procedure and was significantly
influenced by systemic hemodynamic and metabolic events. As such,
hemodynamic interventions to modify systemic oxygen transport may provide
further opportunities to reduce the risk of cerebral ischemia and improve
neurodevelopmental outcomes. © 2008 The American Association for Thoracic
Surgery.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
brain ischemia
Norwood procedure
EMTREE MEDICAL INDEX TERMS
arterial oxygen saturation
arterial oxygen tension
arterial pressure
artery diameter
article
brain injury
brain oxygen consumption
clinical article
controlled study
correlation analysis
female
hemodynamics
human
intensive care unit
lung blood flow
male
mass spectrometry
near infrared spectroscopy
newborn
outcome assessment
oxygen delivery device
oxygen saturation
oxygen transport
postoperative period
preoperative evaluation
priority journal
pulmonary vein
superior cava vein
systemic circulation
vascular resistance
EMBASE CLASSIFICATIONS
Neurology and Neurosurgery (8)
Cardiovascular Diseases and Cardiovascular Surgery (18)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2008005835
MEDLINE PMID
18179923 (http://www.ncbi.nlm.nih.gov/pubmed/18179923)
PUI
L351014119
DOI
10.1016/j.jtcvs.2007.07.036
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jtcvs.2007.07.036
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 761
TITLE
National audit of critical care resources in South Africa - Transfer of
critically ill patients
AUTHOR NAMES
Scribante J.
Bhagwanjee S.
AUTHOR ADDRESSES
(Scribante J., juan.scribante@wits.ac.za; Bhagwanjee S.) Department of
Anaesthesiology, University of the Witwatesrand, Johannesburg Hospital,
Johannesburg, South Africa.
CORRESPONDENCE ADDRESS
J. Scribante, Department of Anaesthesiology, University of the Witwatersand,
Johannesburg Hospital, Johannesburg, South Africa. Email:
juan.scribante@wits.ac.za
SOURCE
South African Medical Journal (2007) 97:12 III (1323-1326). Date of
Publication: December 2007
ISSN
0256-9574
BOOK PUBLISHER
South African Medical Association, Private Bag X1, Pinelands, South Africa.
ABSTRACT
Objectives. To establish the efficacy of the current system of referral of
critical care patients: (i) from public hospitals with no ICU or HCU
facilities to hospitals with appropriate facilities; and (ii) from public
and private sector hospitals with ICU or HCU facilities to hospitais with
appropriate facilities. Design and setting. A descriptive, non-interventive,
observational study design was used. An audit of all public and private
sector ICUs and HCUs in South Africa was undertaken. Results. A 100% sample
was obtained; 77% of public and 16% of private hospitals have no IC/HC
units. Spread of hospitals was disproportionate across provinces. There was
considerable variation (less than 1 hour - 6 hours) in time to collect
between provinces and between public hospitals that have or do not have
ICU/HCU facilities. In the private hospitals, the mean time to collect was
less than an hour. In public hospitals without an ICU, the distance to an
was 100 km or less for approximately 50% of hospitals, and less than 10% of
these hospitals were more than 300 km away. For hospitals with units (public
and private), the distance to an appropriate hospital was 100 km or less for
approximately 60% of units while for 10% of hospitals the distance was
greater than 300 km. For public hospitals without units the majority of
patients were transferred by non-ICU transport. In some instances both
public and private hospitals transferred ICU patients from one ICU to
another ICU in non-ICU transport. Conclusion. A combination of current
resource constraints, the vast distances in some regions of the country and
the historical disparities of health resource distribution represent a
unique challenge which demands a novel approach to equitable health care
appropriation.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
clinical audit
critical illness
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
controlled study
critically ill patient
descriptive research
human
intensive care unit
observational study
patient referral
private hospital
public hospital
resource allocation
South Africa
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2008049961
MEDLINE PMID
18265914 (http://www.ncbi.nlm.nih.gov/pubmed/18265914)
PUI
L351166290
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 762
TITLE
An exploration of the handover process of critically ill patients between
nursing staff from the emergency department and the intensive care unit.
AUTHOR NAMES
McFetridge B.
Gillespie M.
Goode D.
Melby V.
AUTHOR ADDRESSES
(McFetridge B.; Gillespie M.; Goode D.; Melby V.) School of Nursing,
University of Ulster, Magee Campus, Londonderry, UK.
CORRESPONDENCE ADDRESS
B. McFetridge, School of Nursing, University of Ulster, Magee Campus,
Londonderry, UK. Email: b.mcfetridge@ulster.ac.uk
SOURCE
Nursing in critical care (2007) 12:6 (261-269). Date of Publication: 2007
Nov-Dec
ISSN
1478-5153 (electronic)
ABSTRACT
The transfer of information between nurses from emergency departments (EDs)
and critical care units is essential to achieve a continuity of effective,
individualized and safe patient care. There has been much written in the
nursing literature pertaining to the function and process of patient
handover in general nursing practice; however, no studies were found
pertaining to this handover process between nurses in the ED environment and
those in the critical care environment. The aim was to explore the process
of patient handover between ED and intensive care unit (ICU) nurses when
transferring a patient from ED to the ICU. This study used a multi-method
design that combined documentation review, semistructured individual
interviews and focus group interviews. A multi-method approach combining
individual interviews, focus group interviews and documentation review was
used in this study. The respondents were selected from the ED and ICU of two
acute hospitals within Northern Ireland. A total of 12 respondents were
selected for individual interviews, three nurses from ED and ICU,
respectively, from each acute hospital. Two focus groups interviews were
carried out, each consisting of four ED and four ICU nurses, respectively.
Qualitative analysis of the data revealed that there was no structured and
consistent approach to how handovers actually occurred. Nurses from both ED
and ICU lacked clarity as to when the actual handover process began. Nurses
from both settings recognized the importance of the information given and
received during handover and deemed it to have an important role in
influencing quality and continuity of care. Nurses from both departments
would benefit from a structured framework or aide memoir to guide the
handover process. Collaborative work between the nursing teams in both
departments would further enhance understanding of each others' roles and
expectations.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
intensive care unit
nursing staff
patient transport
public relations
risk management
EMTREE MEDICAL INDEX TERMS
article
attitude to health
clinical trial
human
information processing
interpersonal communication
multicenter study
nurse attitude
organization and management
patient care
policy
practice guideline
United Kingdom
LANGUAGE OF ARTICLE
English
MEDLINE PMID
17983360 (http://www.ncbi.nlm.nih.gov/pubmed/17983360)
PUI
L350317928
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 763
TITLE
Barriers to the optimal resuscitation of patients with severe sepsis?
Transfer to a level I critical care center!
AUTHOR NAMES
Carlson D.E.
Chiu W.C.
Johnson S.B.
Scalea T.M.
AUTHOR ADDRESSES
(Carlson D.E.; Chiu W.C.; Johnson S.B.; Scalea T.M.) R. Adams Cowley Shock
Trauma Center, University of Maryland, School of Medicine, Baltimore, MD,
United States.
CORRESPONDENCE ADDRESS
D. E. Carlson, R. Adams Cowley Shock Trauma Center, University of Maryland,
School of Medicine, Baltimore, MD, United States.
SOURCE
Critical Care Medicine (2007) 35:11 (2644-2645). Date of Publication:
November 2007
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
resuscitation
sepsis
EMTREE MEDICAL INDEX TERMS
cardiovascular function
central venous pressure
clinical protocol
critical illness
early goal-directed therapy
editorial
emergency ward
hemorrhagic shock
intracranial pressure
mortality
nursing staff
patient care
patient monitoring
priority journal
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Cardiovascular Diseases and Cardiovascular Surgery (18)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2008114347
MEDLINE PMID
18075371 (http://www.ncbi.nlm.nih.gov/pubmed/18075371)
PUI
L351339032
DOI
10.1097/01.CCM.0000288080.93937.9D
FULL TEXT LINK
http://dx.doi.org/10.1097/01.CCM.0000288080.93937.9D
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 764
TITLE
Intra-hospital transport of critical patients
ORIGINAL (NON-ENGLISH) TITLE
Transporte intra-hospitalar do paciente crítico
AUTHOR NAMES
Pereira Jr. G.A.
De Carvalho J.B.
Ponte Filho A.D.
Malzone D.A.
Pedersoli C.E.
AUTHOR ADDRESSES
(Pereira Jr. G.A., gersonapj@gmail.com.br; Pedersoli C.E.) Unidade de
Emergência, Hospital Das Clínicas, USP, .
(Pereira Jr. G.A., gersonapj@gmail.com.br) Emergências Médicas e Habilidades
Cirúrgicas, Curso de Medicina, Universidade de Ribeirão Preto (UNAERP), .
(De Carvalho J.B.) UNAERP, .
(Ponte Filho A.D.) Hospital do Servidor Público Municipal de São Paulo, .
(Malzone D.A.) Ginecologia, UNAERP, .
(Pedersoli C.E.) Emergências Médicas e Atendimento Pré-hospitalar, Curso de
Medicina, UNAERP, .
(Pereira Jr. G.A., gersonapj@gmail.com.br) Rua Bernardino de Campos, 1000,
CEP 14030-150 - Ribeirão Preto - SP.
CORRESPONDENCE ADDRESS
G. A. Pereira Jr., Rua Bernardino de Campos, 1000, CEP 14030-150 - Ribeirão
Preto - SP. Email: gersonapj@gmail.com.br
SOURCE
Medicina (2007) 40:4 (500-508). Date of Publication: October/December 2007
ISSN
0076-6046
BOOK PUBLISHER
Faculdade de Medicina de Ribeirao Preto - U.S.P., Monte Alegre, Ribeirao
Preto, Brazil.
ABSTRACT
The medicine knowledge and development of new technologies for diagnoses and
treatment of patients had permitted the longevity of healthy people and of
those with acute or chronic illness. These technological advances are not
well distributed, but there are clearly improvements on the management of
patients in medical field leading to a lower mortality and a better quality
of life. With these improvements, hospitals needed to increase the area of
critical care settings. Patients have being beneficiated by these diagnose
technologies, most of them including image, but to access them, they need to
be transported out of a intensive care unit, needing to maintain the same
level of monitorization. That is the great importance on transportation of a
critical patient, and it has being neglected by most health professionals.
The objective of this article is to make a reflection of the various
moments, phases and care involving the intra-hospital transport, discussing
its various aspects.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
acute disease (disease management)
chronic disease (disease management)
critically ill patient
patient transport
EMTREE MEDICAL INDEX TERMS
conference paper
endotracheal tube
health practitioner
human
intensive care unit
mortality
nasogastric tube
quality of life
EMBASE CLASSIFICATIONS
Internal Medicine (6)
LANGUAGE OF ARTICLE
Portuguese
LANGUAGE OF SUMMARY
English, Portuguese
EMBASE ACCESSION NUMBER
2008251489
PUI
L351722997
COPYRIGHT
Copyright 2008 Elsevier B.V., All rights reserved.
RECORD 765
TITLE
Challenges of pediatric medical transport in the 21st century health-care
landscape
AUTHOR NAMES
Kunkel S.A.
Sinkin R.A.
AUTHOR ADDRESSES
(Kunkel S.A.) University of Virginia-Pegasus Medical Transport Network,
Charlottesville, VA, United States.
(Sinkin R.A., ras9q@virginia.edu) Department of Pediatrics, University of
Virginia, Charlottesville, VA, United States.
(Sinkin R.A., ras9q@virginia.edu) Department of Neonatology, Neonatal ICU,
Charlottesville, VA, United States.
(Sinkin R.A., ras9q@virginia.edu) Virginia-Pegasus Medical Transport
Network, Charlottesville, VA, United States.
(Sinkin R.A., ras9q@virginia.edu) UVA-Pegasus Medical Transport Network,
University of Virginia Medical Center, PO Box 800386, Charlottesville, VA
22908-0836, United States.
CORRESPONDENCE ADDRESS
R.A. Sinkin, UVA-Pegasus Medical Transport Network, University of Virginia
Medical Center, PO Box 800386, Charlottesville, VA 22908-0836, United
States. Email: ras9q@virginia.edu
SOURCE
Chest (2007) 132:4 (1113-1115). Date of Publication: October 2007
ISSN
0012-3692
BOOK PUBLISHER
American College of Chest Physicians, 3300 Dundee Road, Northbrook, United
States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient transport
EMTREE MEDICAL INDEX TERMS
child health care
editorial
health care delivery
human
intensive care unit
patient care
priority journal
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2007515930
MEDLINE PMID
17934111 (http://www.ncbi.nlm.nih.gov/pubmed/17934111)
PUI
L47620981
DOI
10.1378/chest.07-1427
FULL TEXT LINK
http://dx.doi.org/10.1378/chest.07-1427
COPYRIGHT
Copyright 2008 Elsevier B.V., All rights reserved.
RECORD 766
TITLE
Inhaled nitric oxide therapy during the transport of neonates with
persistent pulmonary hypertension or severe hypoxic respiratory failure
AUTHOR NAMES
Lowe C.G.
Trautwein J.G.
AUTHOR ADDRESSES
(Lowe C.G., clowe@chla.usc.edu) Department of Pediatrics, Children's
Hospital Los Angeles, University of Southern California, Los Angeles, CA,
United States.
(Trautwein J.G.) Pediatric Emergency Department, University Medical Center,
University of Nevada School of Medicine, Las Vegas, NV, United States.
CORRESPONDENCE ADDRESS
C.G. Lowe, Department of Pediatrics, Children's Hospital Los Angeles,
University of Southern California, Los Angeles, CA, United States. Email:
clowe@chla.usc.edu
SOURCE
European Journal of Pediatrics (2007) 166:10 (1025-1031). Date of
Publication: October 2007
ISSN
0340-6199
BOOK PUBLISHER
Springer Verlag, Tiergartenstrasse 17, Heidelberg, Germany.
ABSTRACT
Our aim was to determine whether starting inhaled nitric oxide (iNO) on
critically ill neonates with severe hypoxemic respiratory failure and/or
persistent pulmonary hypertension (PPH), at a referring hospital at the
start of transport, decreases the need for extracorporeal membrane
oxygenation (ECMO), lessens the number of hospital days and improves
survival in comparison with those patients who were started on iNO only at
the receiving facility. The study was a retrospective review of 94 charts of
neonates that had iNO initiated by the transport team at a referring
hospital or only at the tertiary neonatal intensive care unit (NICU) of the
receiving hospital. Data collected included demographics, mode of transport,
total number of hospital days, days on inhaled nitric oxide and ECMO use. Of
the 94 patients, 88 were included. Of these, 60 were started on iNO at the
referring facility (Field-iNO) and 28 were started at the receiving NICU
(CHLA-iNO). All patients survived transport to the receiving NICU. Death
rates and ECMO use were similar in both groups. Overall, patients who died
were younger and had lower birth weights and Apgar scores. For all surviving
patients who did not require ECMO, the length of total hospital stay (median
days 22 versus 38, P = 0.018), and the length of the hospital stay at the
receiving hospital (median days 18 versus 29, P = 0.006), were significantly
shorter for the Field-iNO patients than for the CHLA-iNO patients,
respectively. Earlier initiation of iNO may decrease length of hospital stay
in surviving neonates with PPH not requiring ECMO. © 2007 Springer-Verlag.
EMTREE DRUG INDEX TERMS
nitric oxide (drug therapy, inhalational drug administration)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
newborn hypoxia (drug therapy)
pulmonary hypertension (drug therapy)
respiratory failure (drug therapy)
EMTREE MEDICAL INDEX TERMS
Apgar score
article
disease severity
extracorporeal oxygenation
hospitalization
human
infant mortality
intensive care unit
low birth weight
patient transport
priority journal
survival rate
therapy delay
CAS REGISTRY NUMBERS
nitric oxide (10102-43-9)
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Cardiovascular Diseases and Cardiovascular Surgery (18)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2007418798
MEDLINE PMID
17205243 (http://www.ncbi.nlm.nih.gov/pubmed/17205243)
PUI
L47313066
DOI
10.1007/s00431-006-0374-y
FULL TEXT LINK
http://dx.doi.org/10.1007/s00431-006-0374-y
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 767
TITLE
Transfer of emergency neurosurgical patients: when and how?
ORIGINAL (NON-ENGLISH) TITLE
Quand faut-il décider d'un transfert en milieu neurochirurgical spécialisé ?
AUTHOR NAMES
Bruder N.
AUTHOR ADDRESSES
(Bruder N., nicolas.bruder@ap-hm.fr) Pôle d'anesthésie-réanimation, CHU de
la Timone-Adultes, 264, rue Saint-Pierre, 13385 Marseille, France.
CORRESPONDENCE ADDRESS
N. Bruder, Pôle d'anesthésie-réanimation, CHU de la Timone-Adultes, 264, rue
Saint-Pierre, 13385 Marseille, France. Email: nicolas.bruder@ap-hm.fr
SOURCE
Annales Francaises d'Anesthesie et de Reanimation (2007) 26:10 (873-877).
Date of Publication: October 2007
ISSN
0750-7658
BOOK PUBLISHER
Elsevier Masson SAS, 62 rue Camille Desmoulins, Issy les Moulineaux Cedex,
France.
ABSTRACT
The annual incidence of severe head injury lies between 9 and 25/100 000
inhabitants, depending on the criteria used for its definition. In most
countries, the shortage in neurosurgical ICU beds makes it impossible to
take in charge all patients with a severe brain injury. But the beneficial
effect of a specialized neurosurgical ICU on outcome after brain injury has
been demonstrated in several retrospective studies. Ideally, the best
strategy is to admit the patients with a severe head injury directly in a
neurosurgical centre. When this is not possible, the appropriate decision of
a secondary transfer relies on the quality of the relationships between
physicians in the community and the neurosurgical hospitals. Teleradiology
is the best method to avoid unnecessary transportation or deleterious delays
before transfer. In an era of decreasing medical budgets, technical
improvements to enhance medical cooperation should be encouraged. © 2007
Elsevier Masson SAS. All rights reserved.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
neurosurgery
EMTREE MEDICAL INDEX TERMS
article
brain injury
budget
head injury (epidemiology)
human
intensive care unit
teleradiology
EMBASE CLASSIFICATIONS
Neurology and Neurosurgery (8)
Anesthesiology (24)
LANGUAGE OF ARTICLE
French
LANGUAGE OF SUMMARY
French, English
EMBASE ACCESSION NUMBER
2007480895
MEDLINE PMID
17692495 (http://www.ncbi.nlm.nih.gov/pubmed/17692495)
PUI
L47503666
DOI
10.1016/j.annfar.2007.06.011
FULL TEXT LINK
http://dx.doi.org/10.1016/j.annfar.2007.06.011
COPYRIGHT
Copyright 2008 Elsevier B.V., All rights reserved.
RECORD 768
TITLE
Pediatric Critical Care Interfacility Transport
AUTHOR NAMES
Horowitz R.
Rozenfeld R.A.
AUTHOR ADDRESSES
(Horowitz R.; Rozenfeld R.A., rrozenfeld@northwestern.edu) Department of
Pediatrics, Northwestern University Feinberg School of Medicine, Chicago,
IL, United States.
(Horowitz R.) Pediatric Emergency Medicine, Children's Memorial Hospital,
Chicago, IL, United States.
(Rozenfeld R.A., rrozenfeld@northwestern.edu) Pediatric Critical Care
Medicine, Children's Memorial Hospital, Chicago, IL, United States.
CORRESPONDENCE ADDRESS
R.A. Rozenfeld, Department of Pediatrics, Northwestern University Feinberg
School of Medicine, Chicago, IL, United States. Email:
rrozenfeld@northwestern.edu
SOURCE
Clinical Pediatric Emergency Medicine (2007) 8:3 (190-202). Date of
Publication: September 2007
ISSN
1522-8401
BOOK PUBLISHER
W.B. Saunders Ltd, 32 Jamestown Road, London, United Kingdom.
ABSTRACT
Interfacility transport of critically ill pediatric patients requires
coordination among referring physicians/institutions, receiving
physicians/institutions, transport team personnel, and emergency medical
services. Specialized transport teams can facilitate these transports as
well as provide a unique service to the patients and their families.
Providing critical care to patients in a transport environment is very
different from providing this care in the intensive care unit or the
emergency department. Transport personnel must be trained and equipped to
provide this care in various environments, including ambulance, rotor wing,
and fixed wing aircraft. This article reviews the process of setting up a
pediatric critical care transport, team composition, equipment needs,
personnel requirements, safety issues, and legal issues related to the
interfacility transport of pediatric patients. © 2007 Elsevier Inc. All
rights reserved.
EMTREE DRUG INDEX TERMS
amiodarone
ampicillin
antiarrhythmic agent
antiasthmatic agent
anticonvulsive agent
antihypertensive agent
antiinfective agent
atropine
bronchodilating agent
ceftriaxone
cimetidine
dopamine
fentanyl
fosphenytoin sodium
gentamicin
hypnotic agent
ketamine
lidocaine
lorazepam
midazolam
morphine
narcotic agent
narcotic analgesic agent
neuromuscular blocking agent
prostaglandin
rocuronium
sedative agent
surfactant
thiopental
unindexed drug
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child care
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
accreditation
air medical transport
article
child health care
clinical protocol
continuing education
critically ill patient
drug storage
emergency health service
health care policy
human
in service training
informed consent
legal liability
medical device
medical documentation
medical record
medicolegal aspect
parental notification
practice guideline
safety
telecommunication
total quality management
CAS REGISTRY NUMBERS
amiodarone (1951-25-3, 19774-82-4, 62067-87-2)
ampicillin (69-52-3, 69-53-4, 7177-48-2, 74083-13-9, 94586-58-0)
atropine (51-55-8, 55-48-1)
ceftriaxone (73384-59-5, 74578-69-1)
cimetidine (51481-61-9, 70059-30-2)
dopamine (51-61-6, 62-31-7)
fentanyl (437-38-7)
fosphenytoin sodium (92134-98-0)
gentamicin (1392-48-9, 1403-66-3, 1405-41-0)
ketamine (1867-66-9, 6740-88-1, 81771-21-3)
lidocaine (137-58-6, 24847-67-4, 56934-02-2, 73-78-9)
lorazepam (846-49-1)
midazolam (59467-70-8)
morphine (52-26-6, 57-27-2)
rocuronium (119302-91-9)
thiopental (71-73-8, 76-75-5)
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
Health Policy, Economics and Management (36)
Drug Literature Index (37)
Forensic Science Abstracts (49)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2007499468
PUI
L47570812
DOI
10.1016/j.cpem.2007.07.001
FULL TEXT LINK
http://dx.doi.org/10.1016/j.cpem.2007.07.001
COPYRIGHT
Copyright 2008 Elsevier B.V., All rights reserved.
RECORD 769
TITLE
Medical complications of intra-hospital patient transports: implications for
architectural design and research
AUTHOR NAMES
Ulrich R.S.
Zhu X.
AUTHOR ADDRESSES
(Ulrich R.S.; Zhu X.) Roger S. Ulrich, PhD, 3137 TAMU, Texas A&M University,
College Station, TX 77843-3137 (rulrich@tamu.edu)
SOURCE
HERD (2007) 1:1 (31-43). Date of Publication: 1 Sep 2007
ISSN
1937-5867
ABSTRACT
Literature on healthcare architecture and evidence-based design has rarely
considered explicitly that patient outcomes may be worsened by
intra-hospital transport (IHT), which is defined as transport of patients
within the hospital. The article focuses on the effects of IHTs on patient
complications and outcomes, and the implications of such impacts for
designing safer, better hospitals. A review of 22 scientific studies
indicates that IHTs are subject to a wide range of complications, many of
which occur frequently and have distinctly detrimental effects on patient
stability and outcomes. The research suggests that higher patient acuity and
longer transport durations are associated with more frequent and serious
IHT-related complications and outcome effects. It appears no rigorous
research has compared different hospital designs and layouts with respect to
having possibly differential effects on transport-related complications and
worsened outcomes. Nonetheless, certain design implications can be extracted
from the existing research literature, including the importance of
minimizing transport delays due to restricted space and congestion, and
creating layouts that shorten IHT times for high-acuity patients. Limited
evidence raises the possibility that elevator-dependent vertical building
layouts may increase susceptibility to transport delays that worsen
complications. The strong evidence indicating that IHTs trigger
complications and worsen outcomes suggests a powerful justification for
adopting acuity-adaptable rooms and care models that substantially reduce
transports. A program of studies is outlined to address gaps in
knowledge.Key WordsPatient transports, transports within hospitals, patient
safety, evidence-based design, hospital design, healthcare architecture,
intra-hospital transport complications, acuity-adaptable care, elevators,
outcomes.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital
patient safety
EMTREE MEDICAL INDEX TERMS
human
patient transport
research
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
21157716 (http://www.ncbi.nlm.nih.gov/pubmed/21157716)
PUI
L611460458
COPYRIGHT
Copyright 2016 Medline is the source for the citation and abstract of this
record.
RECORD 770
TITLE
Smoked out: Emergency evacuation of an ICU
AUTHOR NAMES
Carey M.G.
AUTHOR ADDRESSES
(Carey M.G., mgcarey@buffalo.edu) School of Nursing, State University of New
York, Buffalo.
CORRESPONDENCE ADDRESS
M.G. Carey, School of Nursing, State University of New York, Buffalo. Email:
mgcarey@buffalo.edu
SOURCE
American Journal of Nursing (2007) 107:9 (54-57). Date of Publication:
September 2007
ISSN
0002-936X
BOOK PUBLISHER
Lippincott Williams and Wilkins
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
disaster planning
fire
intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
human
methodology
organization and management
review
LANGUAGE OF ARTICLE
English
MEDLINE PMID
17721151 (http://www.ncbi.nlm.nih.gov/pubmed/17721151)
PUI
L47329525
DOI
10.1097/01.NAJ.0000287511.31006.bd
FULL TEXT LINK
http://dx.doi.org/10.1097/01.NAJ.0000287511.31006.bd
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 771
TITLE
Introduction of a liaison nurse role in a tertiary paediatric ICU
AUTHOR NAMES
Caffin C.L.
Linton S.
Pellegrini J.
AUTHOR ADDRESSES
(Caffin C.L., chelsea.caffin@rch.org.au; Linton S.,
sophie.linton@rch.org.au; Pellegrini J., juliet.pellegrini@rch.org.au) PICU
Liaison Nurse, Intensive Care Unit, Royal Children's Hospital, Flemington
Road, Parkville, 3052, Australia.
CORRESPONDENCE ADDRESS
C.L. Caffin, PICU Liaison Nurse, Intensive Care Unit, Royal Children's
Hospital, Flemington Road, Parkville, 3052, Australia. Email:
chelsea.caffin@rch.org.au
SOURCE
Intensive and Critical Care Nursing (2007) 23:4 (226-233). Date of
Publication: August 2007
ISSN
0964-3397
BOOK PUBLISHER
Churchill Livingstone
ABSTRACT
Introduction: The Royal Children's Hospital in Melbourne is the only
dedicated paediatric hospital in Victoria (population 5 million). The role
of the PICU liaison nurse (LN) has been developed to bridge the gap between
PICU and the wards within the hospital with the aim of reducing the number
of readmissions to the PICU within 48 h of discharge. Results: The year of
the PICU LN trial (July 2004-June 2005), 1388 patients were discharged from
PICU. Sixty-seven patients had unplanned readmission within 48 h. This
readmission rate (4.8%) is lower than the readmission rate (5.4%) during the
year prior to the implementation of the PICU LN. Staff and parents were
surveyed at the end of the 12-month trial to evaluate the introduction of
the LN role. The response from the surveys was very positive, 98.5% of staff
believed the PICU LN to be beneficial and to have made a valuable impact on
PICU-ward transfers. Ninety-nine percent of surveyed parents agreed that the
LN role is a good idea. Conclusion: The PICU LN role at RCH has shown many
positive outcomes including improved communication, ward education, improved
patient outcomes and decreased readmission rates to ICU. © 2006 Elsevier
Ltd. All rights reserved.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
nurse
nurse attitude
patient care
patient transport
EMTREE MEDICAL INDEX TERMS
adolescent
adult
article
attitude to health
Australia
child
evaluation study
health personnel attitude
hospital readmission
human
infant
length of stay
newborn
nursing
nursing evaluation research
nursing methodology research
nursing staff
organization and management
parent
pediatric nursing
preschool child
psychological aspect
statistics
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
17276065 (http://www.ncbi.nlm.nih.gov/pubmed/17276065)
PUI
L47029780
DOI
10.1016/j.iccn.2006.12.001
FULL TEXT LINK
http://dx.doi.org/10.1016/j.iccn.2006.12.001
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 772
TITLE
Living in a Glasshouse... embracing care issues beyond ICU
AUTHOR NAMES
Leslie G.D.
AUTHOR ADDRESSES
(Leslie G.D.)
SOURCE
Australian Critical Care (2007) 20:3 (85-86). Date of Publication: August
2007
ISSN
1036-7314
BOOK PUBLISHER
Elsevier Ireland Ltd, P.O. Box 85, Limerick, Ireland.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient care
patient transport
EMTREE MEDICAL INDEX TERMS
Australia
editorial
human
intensive care unit
LANGUAGE OF ARTICLE
English
MEDLINE PMID
17627837 (http://www.ncbi.nlm.nih.gov/pubmed/17627837)
PUI
L47091540
DOI
10.1016/j.aucc.2007.06.002
FULL TEXT LINK
http://dx.doi.org/10.1016/j.aucc.2007.06.002
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 773
TITLE
In-house growth-promoting transport system for Neisseria gonorrhoeae
AUTHOR NAMES
Sharma D.
Sethi S.
Das Mehta S.
Sharma M.
AUTHOR ADDRESSES
(Sharma D.; Sethi S., sunilsethi10@hotmail.com; Sharma M.) Department of
Medical Microbiology, Postgraduate Institute of Medical Education and
Research, Chandigarh, India.
(Das Mehta S.) Department of Dermatology and Venerology, STD Polyclinic,
Chandigarh, India.
(Sethi S., sunilsethi10@hotmail.com) Department of Medical Microbiology,
Postgraduate Institute of Medical Education and Research, Chandigarh,
160012, India.
CORRESPONDENCE ADDRESS
S. Sethi, Department of Medical Microbiology, Postgraduate Institute of
Medical Education and Research, Chandigarh, 160012, India. Email:
sunilsethi10@hotmail.com
SOURCE
Journal of Clinical Microbiology (2007) 45:8 (2743-2744). Date of
Publication: August 2007
ISSN
0095-1137
BOOK PUBLISHER
American Society for Microbiology, 1752 N Street N.W., Washington, United
States.
ABSTRACT
Eno powder (GlaxoSmithKline), an antacid preparation readily available over
the counter, was used instead of a CO(2) generator for the growth of 15
strains of Neisseria gonorrhoeae obtained from men with urethritis. Due to
its easy accessibility and low cost, Eno powder can be useful in developing
countries for transporting clinical specimens from resource-poor peripheral
labs to reference laboratories. Copyright © 2007, American Society for
Microbiology. All Rights Reserved.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
antacid agent (drug analysis)
EMTREE DRUG INDEX TERMS
carbon dioxide
eno powder
unclassified drug
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
bacterial growth
Neisseria gonorrhoeae
EMTREE MEDICAL INDEX TERMS
article
cost
developing country
diagnostic accuracy
laboratory diagnosis
nonhuman
priority journal
strain identification
transport kinetics
urethritis (diagnosis, etiology)
DRUG TRADE NAMES
eno powder Glaxo SmithKline
DRUG MANUFACTURERS
Glaxo SmithKline
DEVICE TRADE NAMES
Bio-Bag Type C Becton Dickinson
Gono-Pak Bbl
JEMBEC Bbl
DEVICE MANUFACTURERS
Bbl
Becton Dickinson
CAS REGISTRY NUMBERS
carbon dioxide (124-38-9, 58561-67-4)
EMBASE CLASSIFICATIONS
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
Biophysics, Bioengineering and Medical Instrumentation (27)
Health Policy, Economics and Management (36)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2007412582
MEDLINE PMID
17537947 (http://www.ncbi.nlm.nih.gov/pubmed/17537947)
PUI
L47295521
DOI
10.1128/JCM.00344-07
FULL TEXT LINK
http://dx.doi.org/10.1128/JCM.00344-07
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 774
TITLE
Incidence of complications in intrahospital transport of critically ill
patients - Experience in an Austrian university hospital
AUTHOR NAMES
Lahner D.
Nikolic A.
Marhofer P.
Koinig H.
Germann P.
Weinstabl C.
Krenn C.G.
AUTHOR ADDRESSES
(Lahner D., daniel.lahner@meduniwien.ac.at; Nikolic A.; Marhofer P.; Koinig
H.; Germann P.; Weinstabl C.; Krenn C.G.) Department of Anesthesiology and
General Intensive Care, Medical University of Vienna, Vienna, Austria.
(Lahner D., daniel.lahner@meduniwien.ac.at) Department of Anesthesiology and
General Intensive Care, University of Vienna, Währinger Gürtel 18-20, 1090
Vienna, Austria.
CORRESPONDENCE ADDRESS
D. Lahner, Department of Anesthesiology and General Intensive Care,
University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria. Email:
daniel.lahner@meduniwien.ac.at
SOURCE
Wiener Klinische Wochenschrift (2007) 119:13-14 (412-416). Date of
Publication: July 2007
ISSN
0043-5325
BOOK PUBLISHER
Springer-Verlag Wien, Sachsenplatz 4-6, P.O. Box 89, Vienna, Austria.
ABSTRACT
BACKGROUND: During the past decade, considerable changes and advances have
been made in intrahospital transport of critically ill patients. Despite the
fact that intrahospital transport is nowadays regarded an extension of the
intensive care continuum, it still poses a risk for the patient. MATERIALS
AND METHODS: This prospective, observational study was designed to determine
the occurrence rate of transport-related complications in the altered
setting of intrahospital transports and to identify possible confounding
sources of increased risk. In an eight-month period, adults and infants from
anesthesiologic intensive care units were analyzed. RESULTS: A total of 226
patients underwent 452 intrahospital transports. The overall rate of
critical incidents was low (4.2%) and no direct association between
mortality and intrahospital transport was observed. In addition to the known
risk factors of ventilatory support with positive end-expiratory pressure
and requirement for catecholamine support, the necessity for intrahospital
transport in the acute vs. elective situation was found to significantly
increase the risk of complications. CONCLUSIONS: We conclude that advances
in the management of intrahospital transport of critically ill patients have
led to an overall decrease of complications. However, an undeniable risk
remains, especially in relation to disease severity and the urgency of such
transports. © 2007 Springer-Verlag.
EMTREE DRUG INDEX TERMS
catecholamine
nitric oxide
vasoactive agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
bronchospasm (complication)
heart arrest (complication)
hypertension (complication)
hypotension (complication)
patient transport
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
article
artificial ventilation
catheterization
child
controlled study
critically ill patient
extubation
female
human
incidence
intensive care unit
major clinical study
male
mortality
positive end expiratory pressure
resuscitation
risk factor
university hospital
CAS REGISTRY NUMBERS
nitric oxide (10102-43-9)
EMBASE CLASSIFICATIONS
Internal Medicine (6)
Public Health, Social Medicine and Epidemiology (17)
Cardiovascular Diseases and Cardiovascular Surgery (18)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English, German
EMBASE ACCESSION NUMBER
2007432515
MEDLINE PMID
17671822 (http://www.ncbi.nlm.nih.gov/pubmed/17671822)
PUI
L47356171
DOI
10.1007/s00508-007-0813-4
FULL TEXT LINK
http://dx.doi.org/10.1007/s00508-007-0813-4
COPYRIGHT
Copyright 2008 Elsevier B.V., All rights reserved.
RECORD 775
TITLE
Which children need to be transferred to the paediatric intensive care unit?
AUTHOR NAMES
Edwards E.D.
Fardy C.H.
AUTHOR ADDRESSES
(Edwards E.D.; Fardy C.H.)
SOURCE
Paediatrics and Child Health (2007) 17:7 (295-299). Date of Publication:
July 2007
ISSN
1751-7222
BOOK PUBLISHER
Churchill Livingstone, 1-3 Baxter's Place, Leith Walk, Edinburgh, United
Kingdom.
ABSTRACT
A paediatric intensive care service provides the necessary support,
interventions and treatment for children who have critical illness or
injury. The critically ill child has special medical needs and therefore
requires care from medical and nursing staff trained in both paediatrics and
intensive care. This is best provided in a service that conforms to agreed
guidelines and standards. This review discusses the guidelines for admission
to a paediatric intensive care unit (PICU), which must be modified and
adapted to each hospital's policy. They are not meant to be all-inclusive,
and it is recommended that professionals discuss each case with the tertiary
centre as some hospitals have both PICU and high-dependency unit beds and
can offer different types of service for the critically ill child. © 2007
Elsevier Ltd. All rights reserved.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
EMTREE MEDICAL INDEX TERMS
article
artificial ventilation
assisted ventilation
childhood injury
consultation
critical illness
deterioration
health care need
hospital admission
hospital bed
hospital policy
human
intubation
medical staff
nursing staff
practice guideline
standard
systematic review
tertiary health care
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2007320736
PUI
L47017006
DOI
10.1016/j.paed.2007.04.002
FULL TEXT LINK
http://dx.doi.org/10.1016/j.paed.2007.04.002
COPYRIGHT
Copyright 2008 Elsevier B.V., All rights reserved.
RECORD 776
TITLE
Reverse transport of children from a tertiary pediatric hospital
AUTHOR NAMES
McPherson M.L.
Jefferson L.S.
Smith E.O.
Sitler G.C.
Graf J.M.
AUTHOR ADDRESSES
(McPherson M.L.; Jefferson L.S.; Smith E.O.; Graf J.M., jgraf@bcm.edu)
Department of Pediatrics, Baylor College of Medicine, Houston, TX, United
States.
(McPherson M.L.) Center for Pediatric Health Services Research, Texas
Children's Hospital, Houston, TX, United States.
(Sitler G.C.) Texas Children's Hospital, Houston, TX, United States.
CORRESPONDENCE ADDRESS
J.M. Graf, Department of Pediatrics, Baylor College of Medicine, Houston,
TX, United States. Email: jgraf@bcm.edu
SOURCE
Air Medical Journal (2007) 26:4 (183-187). Date of Publication: July/August
2007
ISSN
1067-991X
1532-6497 (electronic)
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
ABSTRACT
Introduction: The purpose of this study was to determine the epidemiology
and resources used and to study the potential savings of pediatric reverse
transport patients. Methods: A case control study was performed with
patients undergoing a reverse or outbound transport from a large, pediatric
hospital. Twenty-five children undergoing reverse transport were compared
with matched controls. Lengths of stay and costs were compared between the
reverse transport and matched control patients. Results: Fifty-two percent
of the reverse transport patients returned home, whereas 32% went home for
end-of-life care and 16% went to other facilities. The average reverse
transport was more than 400 miles and cost $6,064. The reverse transport of
these patients did not save pediatric intensive care unit (PICU) days but
did result in a shorter hospital stay compared with the matched controls (10
vs. 19 days, P = .03). Decreased utilization of bed days came from less use
of intermediate care unit resources. Conclusions: Pediatric patients undergo
reverse transports for a variety of reasons, often for end-of-life care. The
ability to reverse transport pediatric patients may not save PICU bed days
but may offer pediatric tertiary care hospitals a means to provide more
intermediate care bed availability. © 2007 Air Medical Journal Associates.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child health care
health care cost
patient transport
EMTREE MEDICAL INDEX TERMS
article
child
child care
childhood mortality
clinical article
controlled study
cost control
emergency care
female
health care facility
hospital based case control study
hospital bed utilization
hospitalization
human
infant
intensive care unit
length of stay
male
pediatric hospital
priority journal
resource allocation
tertiary health care
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2007305067
MEDLINE PMID
17603946 (http://www.ncbi.nlm.nih.gov/pubmed/17603946)
PUI
L46971873
DOI
10.1016/j.amj.2006.10.009
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2006.10.009
COPYRIGHT
Copyright 2008 Elsevier B.V., All rights reserved.
RECORD 777
TITLE
Timing of presentation of the first signs of vascular compromise dictates
the salvage outcome of free flap transfers
AUTHOR NAMES
Chen K.-T.
Mardini S.
Chuang D.C.-C.
Lin C.-H.
Cheng M.-H.
Lin Y.-T.
Huang W.-C.
Tsao C.-K.
Wei F.-C.
AUTHOR ADDRESSES
(Wei F.-C., fcw2007@adm.cgmh.org.tw) Department of Plastic Surgery, Chang
Gung Memorial Hospital, Chang Gung University, 5 Fu-Shing Street, Taoyuan,
Taiwan.
(Chen K.-T.; Mardini S.; Chuang D.C.-C.; Lin C.-H.; Cheng M.-H.; Lin Y.-T.;
Huang W.-C.; Tsao C.-K.)
CORRESPONDENCE ADDRESS
F.-C. Wei, Department of Plastic Surgery, Chang Gung Memorial Hospital,
Chang Gung University, 5 Fu-Shing Street, Taoyuan, Taiwan. Email:
fcw2007@adm.cgmh.org.tw
SOURCE
Plastic and Reconstructive Surgery (2007) 120:1 (187-195). Date of
Publication: July 2007
ISSN
0032-1052
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
ABSTRACT
BACKGROUND: Microsurgical free tissue transfer has become a reliable
technique. Nevertheless, 5 to 25 percent of transferred flaps require
re-exploration due to circulatory compromise. This study was conducted to
evaluate the timing of occurrence of flap compromise following free tissue
transfer, and its correlation with salvage outcome. METHODS: Between January
of 2002 and June of 2003, 1142 free flap procedures were performed and 113
flaps (9.9 percent) received re-exploration due to compromise. All patients
were cared for in the microsurgical intensive care unit for 5 days. Through
a retrospective review, timing of presentation of compromise was identified
and correlated with salvage outcome. RESULTS: Seventy-two flaps (63.7
percent) were completely salvaged and 23 (20.4 percent) were partially
salvaged. Eighteen flaps (15.9 percent) failed completely. Ninety-three
flaps (82.3 percent) presented with circulatory compromise within 24 hours;
108 (95.6 percent) presented with circulatory compromise within 72 hours,
and 92 flaps (85.2 percent) were salvaged within this period. One out of the
three flaps presenting with compromise 1 week postoperatively was salvaged.
Flaps presenting with compromise upon admission to the microsurgical
intensive care unit had significantly lower complete salvage rates as
compared with those without immediate abnormal signs (40.9 percent versus
69.2 percent, p = 0.01). CONCLUSIONS: The time of presentation of flap
compromise is a significant predictor of flap salvage outcome. Intensive
flap monitoring at a special microsurgical intensive care unit by
well-trained nurses and surgeons allows for early detection of vascular
compromise, which leads to better outcomes. ©2007American Society of Plastic
Surgeons.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
free tissue graft
vascular disease
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
article
child
controlled study
female
human
human tissue
intensive care unit
male
microsurgery
priority journal
retrospective study
salvage therapy
treatment outcome
EMBASE CLASSIFICATIONS
Dermatology and Venereology (13)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2007301013
MEDLINE PMID
17572562 (http://www.ncbi.nlm.nih.gov/pubmed/17572562)
PUI
L46956049
DOI
10.1097/01.prs.0000264077.07779.50
FULL TEXT LINK
http://dx.doi.org/10.1097/01.prs.0000264077.07779.50
COPYRIGHT
Copyright 2008 Elsevier B.V., All rights reserved.
RECORD 778
TITLE
Leaving critical care: facilitating a smooth transition.
AUTHOR NAMES
Boutilier S.
AUTHOR ADDRESSES
(Boutilier S.) University of South Florida, College of Nursing, Tampa, FL
33612, USA.
CORRESPONDENCE ADDRESS
S. Boutilier, University of South Florida, College of Nursing, Tampa, FL
33612, USA.
SOURCE
Dimensions of critical care nursing : DCCN (2007) 26:4 (137-142; quiz
143-144). Date of Publication: 2007 Jul-Aug
ISSN
0730-4625
ABSTRACT
Patient transfers from one area to another occur frequently within the
inpatient healthcare environment. During transfers, nurses pass on
information about patients to one another in a variety of ways. This article
discusses the types of patient transfers, the problems that can occur
throughout the transfer process, and strategies to decrease the identified
problems. The perspectives of both the nursing staff and patients/families
illustrate concerns related to patient transfers. The most important aspect
of the patient transfer is systematically communicating necessary
information to the receiving nurse in such a way that patient safety is not
compromised and continuity of care is enhanced.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
interpersonal communication
patient care
patient care planning
patient transport
safety
EMTREE MEDICAL INDEX TERMS
attitude to health
health personnel attitude
health service
human
medical error (prevention)
medical record
methodology
nurse attitude
nursing staff
organization and management
psychological aspect
review
total quality management
LANGUAGE OF ARTICLE
English
MEDLINE PMID
17577082 (http://www.ncbi.nlm.nih.gov/pubmed/17577082)
PUI
L47504577
DOI
10.1097/01.DCC.0000278762.46972.df
FULL TEXT LINK
http://dx.doi.org/10.1097/01.DCC.0000278762.46972.df
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 779
TITLE
Technology Solutions for High-Risk Tasks in Critical Care
AUTHOR NAMES
Baptiste A.
AUTHOR ADDRESSES
(Baptiste A., andrea.baptiste@va.gov) Patient Safety Center of Inquiry,
James A. Haley VAMC, Tampa, FL 33612, United States.
CORRESPONDENCE ADDRESS
A. Baptiste, Patient Safety Center of Inquiry, James A. Haley VAMC, Tampa,
FL 33612, United States. Email: andrea.baptiste@va.gov
SOURCE
Critical Care Nursing Clinics of North America (2007) 19:2 (177-186). Date
of Publication: June 2007
Safe Patient Handling, Book Series Title:
ISSN
0899-5885
BOOK PUBLISHER
W.B. Saunders
ABSTRACT
There are several high-risk nursing tasks in the critical care environment
discussed in this article. These tasks include lateral transfers,
repositioning patients up or side to side in bed, bed-to-chair or
-wheelchair transfers, pericare of bariatric patients, toileting in bed,
sustained limb holding for dressing wounds, and patient transport. Although
many, if not all, of these tasks currently are performed manually, there are
technological solutions available that undoubtedly can reduce the risks for
caregiver and patient injuries. These solutions should be implemented in
critical care to promote the safety of all involved in patient care. © 2007
Elsevier Inc. All rights reserved.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
biomechanics (adverse drug reaction)
biomedical technology assessment
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
bath
bed rest
body position
daily life activity
evidence based medicine
human
methodology
nurse attitude
nursing
nursing evaluation research
nursing staff
occupational health
organization and management
review
risk assessment
risk factor
safety
skin care
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
17512473 (http://www.ncbi.nlm.nih.gov/pubmed/17512473)
PUI
L46754778
DOI
10.1016/j.ccell.2007.02.011
FULL TEXT LINK
http://dx.doi.org/10.1016/j.ccell.2007.02.011
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 780
TITLE
Transfer surcharge
AUTHOR NAMES
Bekes C.
AUTHOR ADDRESSES
(Bekes C.) Cooper Health Systems, Camden, NJ, United States.
CORRESPONDENCE ADDRESS
C. Bekes, Cooper Health Systems, Camden, NJ, United States.
SOURCE
Critical Care Medicine (2007) 35:6 (1612-1613). Date of Publication: June
2007
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
patient transport
reimbursement
EMTREE MEDICAL INDEX TERMS
cost benefit analysis
editorial
emergency ward
financial management
hospital admission
human
length of stay
priority journal
risk assessment
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2007257431
MEDLINE PMID
17522534 (http://www.ncbi.nlm.nih.gov/pubmed/17522534)
PUI
L46809329
DOI
10.1097/01.CCM.0000266828.74601.46
FULL TEXT LINK
http://dx.doi.org/10.1097/01.CCM.0000266828.74601.46
COPYRIGHT
Copyright 2008 Elsevier B.V., All rights reserved.
RECORD 781
TITLE
Casualty evacuations: Transport of the severely injured
AUTHOR NAMES
Richardson M.W.
AUTHOR ADDRESSES
(Richardson M.W., mark.richardson@lackland.af.mil)
CORRESPONDENCE ADDRESS
Email: mark.richardson@lackland.af.mil
SOURCE
Journal of Trauma - Injury, Infection and Critical Care (2007) 62:6 SUPPL.
(S64-S65). Date of Publication: June 2007
ISSN
0022-5282
1529-8809 (electronic)
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
accident
emergency health service
EMTREE MEDICAL INDEX TERMS
air medical transport
conference paper
critical illness
human
intensive care unit
patient care
patient transport
priority journal
resuscitation
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2007285766
MEDLINE PMID
17556981 (http://www.ncbi.nlm.nih.gov/pubmed/17556981)
PUI
L46904338
DOI
10.1097/TA.0b013e318065adf3
FULL TEXT LINK
http://dx.doi.org/10.1097/TA.0b013e318065adf3
COPYRIGHT
Copyright 2008 Elsevier B.V., All rights reserved.
RECORD 782
TITLE
Aeromedical evacuation of burn patients from Iraq
AUTHOR NAMES
Renz E.M.
AUTHOR ADDRESSES
(Renz E.M., evan.renz@amedd.army.mil) US Army, US Army Institute of Surgical
Research, .
CORRESPONDENCE ADDRESS
E.M. Renz, US Army, US Army Institute of Surgical Research, . Email:
evan.renz@amedd.army.mil
SOURCE
Journal of Trauma - Injury, Infection and Critical Care (2007) 62:6 SUPPL.
(S74). Date of Publication: June 2007
ISSN
0022-5282
1529-8809 (electronic)
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
burn
burn patient
patient transport
EMTREE MEDICAL INDEX TERMS
air force
conference paper
Germany
human
injury severity
intensive care unit
Iraq
lung injury
priority journal
thermal injury
EMBASE CLASSIFICATIONS
Surgery (9)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2007285774
MEDLINE PMID
17556990 (http://www.ncbi.nlm.nih.gov/pubmed/17556990)
PUI
L46904346
DOI
10.1097/TA.0b013e318065af8f
FULL TEXT LINK
http://dx.doi.org/10.1097/TA.0b013e318065af8f
COPYRIGHT
Copyright 2008 Elsevier B.V., All rights reserved.
RECORD 783
TITLE
Surgical and intensive care needs of head-injured patients transferred to
the University Hospital of the West Indies
AUTHOR NAMES
Harding-Goldson H.E.
Crandon I.W.
McDonald A.H.
Augier R.
Fearon-Boothe D.
Rhoden A.
Meeks-Aitken N.
AUTHOR ADDRESSES
(Harding-Goldson H.E., hyacinth.harding-goldson@uwimona.edu.jm; Crandon
I.W.; McDonald A.H.; Augier R.; Fearon-Boothe D.; Rhoden A.; Meeks-Aitken
N.) Department of Surgery, Radiology, Anaesthesia and Intensive Care, The
University of the West Indies, Kingston 7, Jamaica.
CORRESPONDENCE ADDRESS
H.E. Harding-Goldson, Section of Anaesthesia and Intensive Care, Department
of Surgery, Radiology, Anaesthesia and Intensive Care, The University of the
West Indies, Kingston 7, Jamaica. Email:
hyacinth.harding-goldson@uwimona.edu.jm
SOURCE
West Indian Medical Journal (2007) 56:3 (230-233). Date of Publication: June
2007
ISSN
0043-3144
BOOK PUBLISHER
University of the West Indies, Mona, Kingston 7, Jamaica.
ABSTRACT
A cross-sectional, descriptive study utilizing data collected in the 'Trauma
Registry' of the Department of Surgery, Radiology, Anaesthesia and Intensive
Care at the University Hospital of the West Indies (UHWI) was undertaken to
document injury severity, surgical requirements and intensive care needs of
head-injured patients transferred to the UHWI over a three-year period. Of
144 patients studied, the majority (71%) wereyoung males. Overall, injury
tendedto be mild. Twenty-three patients (16.0%) had severe head injury and
27 patients (18.8%) were admitted to the intensive care unit. Concussion
with (33%) or without (36%) skullfracture was the commonest neurological
admission diagnosis. Associated non-neurological injuries in 33% were
primarily fractures. Fifty-six patients (39%) re-quired surgical
intervention. Craniotomies and open reduction and internal fixation of
fractures were the commonest procedures. The majority ofpatients (79.2%)
were discharged home; 56 (39%) made a good Glasgow outcome score recovery.
Seventeen patients (11.8%) died in hospital. As most of the transferred
patients with head injuries in this study had only mild injury, most
commonly concussions, and their prognosis was good, we recommend that
appropriate educational and training programmes and transfer policies be
implemented to minimize inappropriate transfers.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
head injury (surgery)
intensive care
skull surgery
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
article
brain contusion (surgery)
brain hemorrhage (surgery)
child
clinical education
concussion
controlled study
craniotomy
cross-sectional study
death
descriptive research
education program
female
Glasgow outcome scale
hospital admission
hospital discharge
hospital policy
human
infant
information processing
injury severity
intensive care unit
major clinical study
male
open reduction (procedure)
osteosynthesis
patient transport
prognosis
skull fracture (surgery)
traumatic brain injury (surgery)
university hospital
EMBASE CLASSIFICATIONS
Neurology and Neurosurgery (8)
Otorhinolaryngology (11)
Public Health, Social Medicine and Epidemiology (17)
Orthopedic Surgery (33)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English, Spanish
EMBASE ACCESSION NUMBER
2007587417
MEDLINE PMID
18072402 (http://www.ncbi.nlm.nih.gov/pubmed/18072402)
PUI
L350200065
COPYRIGHT
Copyright 2008 Elsevier B.V., All rights reserved.
RECORD 784
TITLE
Unexpected Events during the Intrahospital Transport of Critically Ill
Patients
AUTHOR NAMES
Papson J.P.N.
Russell K.L.
Taylor D.McD.
AUTHOR ADDRESSES
(Papson J.P.N., jonathan.papson@mh.org.au; Russell K.L.; Taylor D.McD.)
Emergency Department, Royal Melbourne Hospital (JPNP, KLR, DMT), Vic.,
Australia.
CORRESPONDENCE ADDRESS
J.P.N. Papson, Emergency Department, Royal Melbourne Hospital (JPNP, KLR,
DMT), Vic., Australia. Email: jonathan.papson@mh.org.au
SOURCE
Academic Emergency Medicine (2007) 14:6 (574-577). Date of Publication: June
2007
ISSN
1069-6563
BOOK PUBLISHER
Blackwell Publishing Ltd, 9600 Garsington Road, Oxford, United Kingdom.
ABSTRACT
Objectives: To examine unexpected events (UEs) that occur during the
intrahospital transport of critically ill emergency department patients.
Methods: This was a prospective observational study of consecutive
intrahospital transports between March 2003 and June 2004. The escorting
emergency physician completed the data collection document either during or
immediately after the transport. This document detailed equipment-related
UEs, patient instability and invasive line-related UEs, whether the UEs
required intervention, and whether the UEs were potentially life threatening
(serious UEs). Results: Of 339 transports observed, 230 (67.9%; 95%
confidence interval [CI] = 62.6% to 72.7%) were associated with 604 UEs.
Overall, there was a median of 1.0 UE per transport (range, 0-16). There
were 277 (45.9%; 95% CI = 41.8% to 49.9%) UEs related to equipment, 158
(26.2%; 95% CI = 22.7% to 29.9%) related to patient instability, 156 (25.8%;
95% CI = 22.4% to 29.6%) related to equipment lines, and 13 (2.2%, 95% CI =
1.2% to 3.8%) miscellaneous UEs. The most common UEs were oxygen saturation
probe failures, lead and line tangles, hypotension, and the wearing off of
sedation and/or paralysis. Most UEs (478 [79.1%]; 95% CI = 75.6% to 82.3%)
required an intervention. Emergency physicians had a significantly lower UE
rate than residents. Thirty serious UEs occurred; 5.0% (95% CI = 3.4% to
7.1%) of UEs and 8.9% (95% CI = 6.2% to 12.5%) of transports were associated
with a serious UE. The most common were severe hypotension, decreasing
consciousness requiring intubation, and increased intracranial pressure.
Conclusions: Unexpected events during the intrahospital transport of
critically ill patients from the emergency department are common and can be
potentially life threatening. Transporting physician experience is
associated with UE rate. Strict adherence to and review of existing
transport guidelines is recommended. © 2007 Society for Academic Emergency
Medicine.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital care
intensive care
EMTREE MEDICAL INDEX TERMS
article
confidence interval
emergency
human
hypotension
intracranial pressure
intubation
physician
priority journal
prospective study
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2007239305
MEDLINE PMID
17535981 (http://www.ncbi.nlm.nih.gov/pubmed/17535981)
PUI
L46755596
DOI
10.1197/j.aem.2007.02.034
FULL TEXT LINK
http://dx.doi.org/10.1197/j.aem.2007.02.034
COPYRIGHT
Copyright 2008 Elsevier B.V., All rights reserved.
RECORD 785
TITLE
Neurodevelopmental and growth outcomes of extremely low birth weight infants
who are transferred from neonatal intensive care units to level I or II
nurseries
AUTHOR NAMES
Lainwala S.
Perritt R.
Poole K.
Vohr B.
AUTHOR ADDRESSES
(Lainwala S., slainwala@wihri.org; Vohr B.) Department of Pediatrics, Women
and Infants Hospital, Providence, RI, United States.
(Perritt R.; Poole K.) Statistical and Epidemiology Unit, RTI International,
Research Triangle Park, NC, United States.
(Lainwala S., slainwala@wihri.org) Department of Pediatrics, Women and
Infants Hospital, 101 Dudley St, Providence, RI 02905, United States.
CORRESPONDENCE ADDRESS
S. Lainwala, Department of Pediatrics, Women and Infants Hospital, 101
Dudley St, Providence, RI 02905, United States. Email: slainwala@wihri.org
SOURCE
Pediatrics (2007) 119:5 (e1079-e1087). Date of Publication: May 2007
ISSN
0031-4005
0210-5721 (electronic)
BOOK PUBLISHER
American Academy of Pediatrics, 141 Northwest Point Blvd, P.O. Box 927, Elk
Grove Village, United States.
ABSTRACT
OBJECTIVE. Transfer of clinically stable infants to level I and II nurseries
alleviates demands on NICUs and allows better use of beds and resources.
This study compared growth, neurodevelopmental impairments, postdischarge
rehospitalization and deaths, and compliance for follow-up assessment at 18
to 22 months' corrected age of extremely low birth weight infants who
transferred to level I and II nurseries with those who continued to receive
care to discharge in a NICU. METHODS. A retrospective analysis of
prospectively collected data from the National Institute of Child Health and
Human Development Neonatal Research Network was performed. Between January
1998 and June 2002, 4896 infants born with birth weights of 401 to 1000 g
and cared for in 19 National Institute of Child Health and Human Development
Neonatal Research Network centers were included. The sample consisted of
4392 survivors who received continuing care in the NICU to discharge home
and 504 infants who were transferred to level I and II nurseries before
discharge home. Demographics, perinatal characteristics, growth, and
neurodevelopmental impairments were compared. Bivariate and logistic
regression analyses were performed. RESULTS. Transfer of infants to level I
and II nurseries was associated significantly with white race, private
insurance, outborn status, and lower neonatal morbidities and compliance for
follow-up compared with the NICU group. After adjusting for known
covariates, transfer to level I and II nurseries was not associated with
neurodevelopmental impairments or death; however, it was associated with
increased postdischarge rehospitalization. CONCLUSIONS. Extremely low birth
weight infants who are transferred to level I and II nurseries have similar
growth and neurodevelopmental outcomes to infants who are discharged from a
NICU. They are, however, more likely to be readmitted to the hospital and
are less compliant for follow-up. Establishment of consistent guidelines for
comprehensive discharge planning for level I and II nurseries may improve
follow-up compliance and reduce rehospitalization rates among these infants
who are transferred. Copyright © 2007 by the American Academy of Pediatrics.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child growth
extremely low birth weight
EMTREE MEDICAL INDEX TERMS
adolescent
adult
article
birth weight
bivariate analysis
blindness
brain disease
cerebral palsy
child care
controlled study
demography
developmental disorder
female
follow up
health insurance
hearing impairment
hospital discharge
hospital readmission
human
infant
major clinical study
male
mortality
nervous system development
newborn intensive care
newborn morbidity
nursery
patient care
patient compliance
perinatal care
priority journal
retrospective study
sepsis
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Neurology and Neurosurgery (8)
Developmental Biology and Teratology (21)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2007228390
MEDLINE PMID
17403821 (http://www.ncbi.nlm.nih.gov/pubmed/17403821)
PUI
L46715645
DOI
10.1542/peds.2006-0899
FULL TEXT LINK
http://dx.doi.org/10.1542/peds.2006-0899
COPYRIGHT
Copyright 2008 Elsevier B.V., All rights reserved.
RECORD 786
TITLE
Defibrillator availability on rotor-wing critical care transports
AUTHOR NAMES
Frakes M.A.
Neher S.W.
AUTHOR ADDRESSES
(Frakes M.A., mfrakes@harthosp.org) LIFE STAR, Hartford Hospital, Hartford,
CT, United States.
(Neher S.W.) Emergency Department, Middlesex Medical Center, Middletown, CT,
United States.
CORRESPONDENCE ADDRESS
M.A. Frakes, LIFE STAR, Hartford Hospital, Hartford, CT, United States.
Email: mfrakes@harthosp.org
SOURCE
Air Medical Journal (2007) 26:3 (144-146). Date of Publication: May/June
2007
ISSN
1067-991X
1532-6497 (electronic)
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
ABSTRACT
Introduction: Defibrillation is a time-critical and life-saving intervention
for patients in ventricular fibrillation or ventricular tachycardia. The
preparation of rotor-wing critical care transport teams to manage such
arrhythmias out of the transport vehicle is unclear. Methods: A mail and
telephone survey of 230 rotor-wing critical care transport programs.
Results: Transport teams take a defibrillator to the patient's side on scene
flights at 23.9% of programs, on interfacility flights at 48.3%, and after
off-load at the receiving hospital at 43.1% of programs. Monitor style and
utilization are associated with defibrillator deployment on scene flights,
interfacility flights, and at offload. The site of patient origin does not
affect transport team defibrillator availability on offload. Conclusions: It
is not completely clear that defibrillators are immediately available during
all phases of rotor-wing critical care transport. There are many
opportunities for additional investigation. © 2007 Air Medical Journal
Associates.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
defibrillator
intensive care
EMTREE MEDICAL INDEX TERMS
article
defibrillation
health program
health survey
heart arrest
heart ventricle fibrillation
heart ventricle tachycardia
hospital
human
patient care
postal mail
priority journal
telephone
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Cardiovascular Diseases and Cardiovascular Surgery (18)
Anesthesiology (24)
Biophysics, Bioengineering and Medical Instrumentation (27)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2007197726
MEDLINE PMID
17467568 (http://www.ncbi.nlm.nih.gov/pubmed/17467568)
PUI
L46630334
DOI
10.1016/j.amj.2006.09.006
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2006.09.006
COPYRIGHT
Copyright 2008 Elsevier B.V., All rights reserved.
RECORD 787
TITLE
Bispectral index monitoring during intrahospital transport
ORIGINAL (NON-ENGLISH) TITLE
Monitorización del índice biespectral en el transporte intrahospitalario.
AUTHOR NAMES
Hernández-Gancedo C.
Pestaña D.
Criado A.
AUTHOR ADDRESSES
(Hernández-Gancedo C.; Pestaña D.; Criado A.) Servicio de Anestesiología,
Reanimación y Unidad del Dolor, Hospital General Universitario La Paz,
Madrid.
CORRESPONDENCE ADDRESS
C. Hernández-Gancedo, Servicio de Anestesiología, Reanimación y Unidad del
Dolor, Hospital General Universitario La Paz, Madrid. Email:
mhgancedo@hotmail.com
SOURCE
Revista española de anestesiología y reanimación (2007) 54:3 (169-172). Date
of Publication: Mar 2007
ISSN
0034-9356
ABSTRACT
BACKGROUND AND OBJECTIVE: Risk of morbidity and mortality increases for
critically ill patients during transfers within the hospital. Such patients
often require sedation, and suboptimal sedation is associated with
hypertension, tachycardia, and ventilator dyssynchrony. The aim of this
study was to assess level of sedation as indicated by monitoring of the
bispectral (BIS) index during intrahospital transport of critical patients.
PATIENTS AND METHODS: Thirty patients who required transport to the critical
care unit within the hospital were studied prospectively. We recorded time
in transport, the agent used for sedation and the dosage, the BIS index,
mean arterial pressure (MAP), and heart rate before starting transport and
upon arrival at the critical care unit. The data were recorded by an
observer who was not assigned to patient care. RESULTS: The mean (SD)
transport time was 13.9 (4.2) minutes. Midazolam was used in 26 patients and
propofol in 4. Ten patients were given a bolus dose of cisatracurium before
transfer started. Significant increases were observed in the BIS index (from
47 to 78, (P < .001), MAP (from 73 to 91 mmHg, P < .001), and heart rate
(from 72 to 97 beats/min, P < .001) between the moment of starting transport
and arrival at the critical care unit. Changes in the BIS index correlated
significantly with changes in heart rate (r = 0.418, P = .024) but not with
changes in MAP (r = 0.249, P = .19). CONCLUSIONS: Monitoring the BIS index
during intrahospital transport of sedated, mechanically ventilated patients
may be useful for detecting inadequate sedation.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
hypnotic sedative agent (drug administration, drug therapy, pharmacology)
EMTREE DRUG INDEX TERMS
atracurium besilate (drug administration, drug therapy, pharmacology)
cisatracurium
drug derivative
midazolam (drug administration, drug therapy, pharmacology)
neuromuscular blocking agent (drug administration, drug therapy,
pharmacology)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
electroencephalography
electromyography
monitoring
patient transport
EMTREE MEDICAL INDEX TERMS
article
artificial ventilation
blood pressure
conscious sedation
drug effect
heart rate
human
intensive care
intensive care unit
methodology
prospective study
statistics
time
CAS REGISTRY NUMBERS
atracurium (64228-79-1)
cisatracurium (96946-41-7, 96946-42-8)
midazolam (59467-70-8)
LANGUAGE OF ARTICLE
Spanish
MEDLINE PMID
17436655 (http://www.ncbi.nlm.nih.gov/pubmed/17436655)
PUI
L46820956
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 788
TITLE
Reconsidering the transfer of patients from the intensive care unit to the
ward: A case study approach
AUTHOR NAMES
Wu C.-J.
Coyer F.
AUTHOR ADDRESSES
(Wu C.-J., c3.wu@qut.edu.au; Coyer F.) School of Nursing, Queensland
University of Technology, Victoria Park Road, Kelvin Grove, QLD 4059,
Australia.
(Wu C.-J., c3.wu@qut.edu.au) Intensive Care Unit/Coronary Care Unit, Mater
Adult Hospital, Brisbane, QLD, Australia.
CORRESPONDENCE ADDRESS
C.-J. Wu, School of Nursing (N Block), Queensland University of Technology,
Victoria Park Road, Kelvin Grove, QLD 4059, Australia. Email:
c3.wu@qut.edu.au
SOURCE
Nursing and Health Sciences (2007) 9:1 (48-53). Date of Publication: March
2007
ISSN
1441-0745
1442-2018 (electronic)
BOOK PUBLISHER
Blackwell Publishing, 550 Swanston Street, Carlton South, Australia.
ABSTRACT
Evidence indicates that the poorly managed transfer of a patient from the
intensive care unit (ICU) to the ward can lead to physical and psychological
complications for the patient, and often require ICU readmission and
rehospitalization. Reviewing this patient transfer process to improve the
quality of care would be a positive step towards enhancing patients'
recovery and providing skills to staff. The aim of this paper is to review
case studies of transferring ICU patients to general wards in order to
identify the shortcomings of this process. A literature review was conducted
to evaluate current practices in the ICU transfer process. The results of
this paper have clinical implications, suggest approaches to improve support
for patients and their carers, and provide strategies to improve the
transfer procedure. © 2007 The Authors; Journal Compilation © 2007 Blackwell
Publishing Asia Pty Ltd.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
clinical practice
health care quality
patient transport
EMTREE MEDICAL INDEX TERMS
caregiver
case study
coronary care unit
critically ill patient
hospital discharge
hospital personnel
hospital readmission
human
intensive care unit
nursing care
patient care
practice guideline
priority journal
review
teaching hospital
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2007077263
MEDLINE PMID
17300545 (http://www.ncbi.nlm.nih.gov/pubmed/17300545)
PUI
L46218465
DOI
10.1111/j.1442-2018.2007.00294.x
FULL TEXT LINK
http://dx.doi.org/10.1111/j.1442-2018.2007.00294.x
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 789
TITLE
Lack of correlation in welfare check distribution and transport patterns in
a rural critical care transport service
AUTHOR NAMES
Svenson J.E.
O'Connor J.E.
Lindsay M.B.
AUTHOR ADDRESSES
(Svenson J.E., jes@medicine.wisc.edu; Lindsay M.B.) Section of Emergency
Medicine, University of Wisconsin, Madison, WI 53792, United States.
(O'Connor J.E.) Med Flight, University of Wisconsin, Madison, WI 53792,
United States.
CORRESPONDENCE ADDRESS
J.E. Svenson, Section of Emergency Medicine, University of Wisconsin,
Madison, WI 53792, United States. Email: jes@medicine.wisc.edu
SOURCE
American Journal of Emergency Medicine (2007) 25:3 (345-347). Date of
Publication: March 2007
ISSN
0735-6757
BOOK PUBLISHER
W.B. Saunders, Independence Square West, Philadelphia, United States.
ABSTRACT
Introduction: Understanding patterns of use of emergency medical services is
important for planning adequate programs, budgets, and schedules.
Understanding the factors associated with use of these services can help
systems target high-risk populations or behaviors and allocate budgetary
resources appropriately. Previous data have shown an association between the
use of emergency health care use and distribution of welfare check
distribution in both the United States and Canada. These data have
limitations. In these studies, no attempt was made to investigate whether
this increase in use was for particular types of complaints (medical or
traumatic) or true outside of an urban community. The purpose of this study
was to investigate whether there were similar monthly associations in
patterns of use of a regional transport service for either medical or
traumatic complaints. Methods: Med Flight is a regional aeromedical service
operated by the University of Wisconsin. The service provides transport
services to all hospitals and emergency medical services for critically ill
or injured patients inside a radius of approximately 75 miles. The program
transports approximately 1200 patients per year. Data for all transports for
the years 1998-2004 were obtained. Daily numbers of transports were then
compared for all patients and subsets of those with specifically traumatic
or cardiac-related complaints. Results: There were 7756 transports during
the study period: 34% of the transports were trauma related; 30% were
cardiac related. There was a significant association between trauma-related
flights and both month of the year (P < .0001) and day of the week (P <
.001), but not for total or cardiac-related flights. There was no
association between day or week of the month and transports. Conclusion: In
contrast to previous studies, these findings show no association between use
of a regional transport service and time of the month. Determinants of use
of emergency services may differ between urban and nonurban areas. © 2007
Elsevier Inc. All rights reserved.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
correlation analysis
disease association
emergency care
female
health care distribution
health care utilization
heart disease
high risk population
human
injury
major clinical study
male
priority journal
rural population
urban population
welfare
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2007118412
MEDLINE PMID
17349912 (http://www.ncbi.nlm.nih.gov/pubmed/17349912)
PUI
L46356859
DOI
10.1016/j.ajem.2006.09.003
FULL TEXT LINK
http://dx.doi.org/10.1016/j.ajem.2006.09.003
COPYRIGHT
Copyright 2008 Elsevier B.V., All rights reserved.
RECORD 790
TITLE
Thirty-eight free fasciocutaneous flap transfers in acute burned-hand
injuries
AUTHOR NAMES
Pan C.-H.
Chuang S.-S.
Yang J.-Y.
AUTHOR ADDRESSES
(Pan C.-H.; Chuang S.-S., sschuang@ms1.hinet.net; Yang J.-Y.) Department of
Plastic Surgery, Chang Gung Memorial Hospital, Chang Gung University College
of Medicine, 5, Fu-Hsin Street, Kweishan, Taoyuan, Taiwan.
CORRESPONDENCE ADDRESS
S.-S. Chuang, Department of Plastic Surgery, Chang Gung Memorial Hospital,
Chang Gung University College of Medicine, 5, Fu-Hsin Street, Kweishan,
Taoyuan, Taiwan. Email: sschuang@ms1.hinet.net
SOURCE
Burns (2007) 33:2 (230-235). Date of Publication: March 2007
ISSN
0305-4179
BOOK PUBLISHER
Elsevier Ltd, Langford Lane, Kidlington, Oxford, United Kingdom.
ABSTRACT
The benefits of free flap transfers in the acute burn injury are early wound
closure, early mobility, reduced hospitalization, and possibly limb salvage.
This retrospective study will attempt to provide principles to the use of
free fasciocutaneous flap for the reconstruction of acute burned-hand
injuries. Between 1995 and 2004, 5521 patients were admitted to the burn
unit at Linkou Chang Gung Memorial Hospital. Of these, 38 patients (0.7%)
patients received free fasciocutaneous flap transfers. Each patient's chart
was reviewed the following data: age, gender, burn injury type, percentage
of the burned area to total body surface area, flap type, operations prior
to free flap coverage, the size and location of recipient area, timing of
free flap coverage, operative time, duration of hospital stay,
complications, flap survival and returning to work. All 38 free flaps
survived and healed well. Three flaps with partial necrosis due to wound
infections required subsequent debridement and skin grafting. Arterial
thrombosis occurred in one patient and was salvaged successfully. Minimal
donor-site morbidity with no intraoperative mortality was observed. Free
fasciocutaneous flap transfer is a safe, efficacious one-stage
reconstruction for acute burned-hands with satisfactory aesthetic and
functional outcomes. Flap survival is not affected neither by the etiologies
of burn nor the timing of free flap coverage. © 2006 Elsevier Ltd and ISBI.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
burn (surgery)
fasciocutaneous flap
EMTREE MEDICAL INDEX TERMS
adult
artery thrombosis
article
body surface
burn patient
burn unit
child
debridement
female
gender
hospital admission
hospitalization
human
major clinical study
male
medical record
morbidity
operation duration
patient satisfaction
postoperative complication (complication)
skin graft
skin necrosis
surgical mortality
work
wound healing
wound infection
EMBASE CLASSIFICATIONS
Surgery (9)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2007064976
MEDLINE PMID
17169493 (http://www.ncbi.nlm.nih.gov/pubmed/17169493)
PUI
L46186692
DOI
10.1016/j.burns.2006.06.022
FULL TEXT LINK
http://dx.doi.org/10.1016/j.burns.2006.06.022
COPYRIGHT
Copyright 2008 Elsevier B.V., All rights reserved.
RECORD 791
TITLE
Pushing boundaries in paediatric intensive care: training as a paediatric
retrieval nurse practitioner.
AUTHOR NAMES
Davies J.
Lynch F.
AUTHOR ADDRESSES
(Davies J.; Lynch F.) South Thames Retrieval Service, PICU, Evelina
Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.
CORRESPONDENCE ADDRESS
J. Davies, South Thames Retrieval Service, PICU, Evelina Children's
Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK. Email:
joanna.davies@gstt.nhs.uk
SOURCE
Nursing in critical care (2007) 12:2 (74-80). Date of Publication: 2007
Mar-Apr
ISSN
1478-5153 (electronic)
ABSTRACT
Traditionally in the UK, the transportation of the critically ill child to a
paediatric intensive care unit has been carried out by a medically led team
of doctors and nurses. However, in countries such as the USA and Canada,
appropriately trained nurse practitioners have proven to be competent in the
transportation of these vulnerable children. This nurse-led team model has
also been shown to be successful in the speciality of neonatal care in the
UK. The impact of changes in the National Health Service (NHS) has led to an
increased demand for the transportation of the child requiring paediatric
intensive or high-dependency care, the lifting of restrictions on nursing
practice and the reduction of doctors' hours in keeping with the European
Working Time Directive. This has led to one NHS Trust in the UK developing
the role of paediatric retrieval nurse practitioners (RNP): nurses who lead
the retrieval team. The purpose of this article is to describe a pilot
initiative to develop the role of RNPs. The comprehensive process of
recruitment, training and assessment of competency will be detailed.
Personal reflection on the project will also explore the pertinent nursing
issues around; role impact and definition, conflict and change management,
communication, legislation and personal and professional growth.
Recommendations for future initiatives will also be explored.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
nurse practitioner
nursing education
patient transport
EMTREE MEDICAL INDEX TERMS
child
education
human
organization and management
program development
review
United Kingdom
LANGUAGE OF ARTICLE
English
MEDLINE PMID
17883631 (http://www.ncbi.nlm.nih.gov/pubmed/17883631)
PUI
L350320515
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 792
TITLE
Initial management of multiple-injury patients
ORIGINAL (NON-ENGLISH) TITLE
Die erstversorgung des polytraumatisierten patienten
AUTHOR NAMES
Adams H.A.
Trentz O.
AUTHOR ADDRESSES
(Adams H.A.) Stabsstelle für Interdisziplinäre Notfall- und
Katastrophenmedizin, Medizinische Hochschule Hannover, .
(Trentz O.) Klinik für Unfallchirurgie, Universitätsspital Zürich, .
CORRESPONDENCE ADDRESS
H.A. Adams, Stabsstelle für Interdisziplinäre Notfall- und
Katastrophenmedizin, Medizinische Hochschule Hannover, .
SOURCE
Anasthesiologie und Intensivmedizin (2007) 48:2 (73-92). Date of
Publication: February 2007
ISSN
0170-5334
BOOK PUBLISHER
DIOmed Verlags GmbH, Am Weichselgarten 30, Erlangen, Germany.
ABSTRACT
Multiple injury is a potentially life-threatening syndrome involving
simultaneous injuries to various regions or organs with consecutive systemic
dysfunctions. The most important risks are hypovolaemia and tissue hypoxia.
The major tasks of the emergency physician are assessment of the patient and
trauma mechanism (first view), a meticulous basic examination, preservation
of gas exchange and the circulation, prevention of sequelae, prompt
transport, timely alerting of the hospital and the establishment of a brief
(indirect) anamnesis. Primarily, endotracheal intubation and controlled
ventilation serve to secure oxygenation and the airways and analgesia only
secondarily. After induction of anaesthesia, many seriously injured patients
require no further analgesia or sedation, and the life-saving endocrine
stress response must not be suppressed by inadequate application of
anaesthetics, while in patients with clinical signs of insufficient
anaesthesia a deepening of the anaesthesia is necessary. In patients with
traumatic-haemorrhagic and haemorrhagic shock, rapid stabilization of the
circulatory system through haemostasis and volume replacement must be
attempted. Circulatory therapy should aim for an SAP > 90 mm Hg and an HR <
100/min, and an SAP > 120 mm Hg to achieve an adequate CPP in patients with
craniocerebral trauma. In the event of uncontrolled bleeding, careful volume
replacement with permissive hypotension is required, until surgical or
interventional haemostasis can be established. In such cases, an SAP of
about 70 - 80 mm Hg (or an MAP > 50 mm Hg) is desirable. In the emergency
room, the responsible surgeon and anaesthesiologist should be provided with
an oral and written report by the emergency physician, This is followed by a
comprehensive examination of the patient by the specialists, the application
of a high-flow central venous catheter und initial diagnostic imaging.
During intrahospital transport, meticulous clinical and technical monitoring
of the patient and protection against hypothermia are imperative. Urgent
diagnostic procedures should be noted in writing and carried out without
delay. The advantages and disadvantages of therapeutic measures must be
carefully considered to ensure minimization of the traumatization. After
admission to the intensive care unit, the patient should be systematically
examined and assessed by the physician in charge at least once a day. A
special emergency room is necessary not only for the primary care of
multiple injury patients but also for other emergency patients. The
equipment must be such as to permit the securement of vital functions and
enable diagnostic and therapeutic interventions to be implemented, and a
specialized emergency team must be available at all times. In the interest
of the patient, interdisciplinary cooperation is imperative, and this is
improved by the institution of a team coordinator. © Anästh Intensivmed.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
anesthetic agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
multiple trauma (etiology)
EMTREE MEDICAL INDEX TERMS
analgesia
anesthesia induction
artificial ventilation
central venous catheter
diagnostic procedure
emergency physician
emergency ward
endotracheal intubation
head injury
hemorrhagic shock
human
hypothermia
hypovolemia
hypoxemia
oxygenation
pathophysiology
patient assessment
primary medical care
review
risk assessment
stress
traumatic shock
EMBASE CLASSIFICATIONS
General Pathology and Pathological Anatomy (5)
Surgery (9)
Anesthesiology (24)
LANGUAGE OF ARTICLE
German
LANGUAGE OF SUMMARY
English, German
EMBASE ACCESSION NUMBER
2007090492
PUI
L46261882
COPYRIGHT
Copyright 2008 Elsevier B.V., All rights reserved.
RECORD 793
TITLE
Horizontal gene transfer in a polyclonal outbreak of carbapenem-resistant
Acinetobacter baumannii
AUTHOR NAMES
Valenzuela J.K.
Thomas L.
Partridge S.R.
Van Der Reijden T.
Dijkshoorn L.
Iredell J.
AUTHOR ADDRESSES
(Valenzuela J.K.; Thomas L.; Partridge S.R.; Iredell J.,
joni@icpmr.wsahs.nsw.gov.au) Centre for Infectious Diseases and
Microbiology, University of Sydney, Sydney, NSW 2145, Australia.
(Thomas L.) Institute for Clinical Pathology and Medical Research, Westmead
Hospital, Sydney, NSW 2145, Australia.
(Van Der Reijden T.; Dijkshoorn L.) Department of Infectious Diseases,
Leiden University Medical Center, Leiden, Netherlands.
(Iredell J., joni@icpmr.wsahs.nsw.gov.au) Centre for Infectious Diseases and
Microbiology, ICPMR Building, Westmead Hospital, Wentworthville, NSW 2145,
Australia.
CORRESPONDENCE ADDRESS
J. Iredell, Centre for Infectious Diseases and Microbiology, ICPMR Building,
Westmead Hospital, Wentworthville, NSW 2145, Australia. Email:
joni@icpmr.wsahs.nsw.gov.au
SOURCE
Journal of Clinical Microbiology (2007) 45:2 (453-460). Date of Publication:
February 2007
ISSN
0095-1137
BOOK PUBLISHER
American Society for Microbiology, 1752 N Street N.W., Washington, United
States.
ABSTRACT
In the last few years, phenotypically carbapenem resistant Acinetobacter
strains have been identified throughout the world, including in many of the
hospitals and intensive care units (ICUs) of Australia. Genotyping of
Australian ICU outbreak-associated isolates by pulsed-field gel
electrophoresis of whole genomic DNA indicated that different strains were
cocirculating within one hospital. The carbapenem-resistant phenotype of
these and other Australian isolates was found to be due to
carbapenem-hydrolyzing activity associated with the presence of the
bla(OXA-23) gene. In all resistant strains examined, the bla(OXA-23) gene
was adjacent to the insertion sequence ISAba1 in a structure that has been
found in Acinetobacter baumannii strains of a similar phenotype from around
the world; bla(OXA-51)-like genes were also found in all A. baumannii
strains but were not consistently associated with ISAba1, which is believed
to provide the promoter required for expression of linked antibiotic
resistance genes. Most isolates were also found to contain additional
antibiotic resistance genes within the cassette arrays of class 1 integrons.
The same cassette arrays, in addition to the ISAba1-bla (OXA-23) structure,
were found within unrelated strains, but no common plasmid carrying these
accessory genetic elements could be identified. It therefore appears that
antibiotic resistance genes are readily exchanged between cocirculating
strains in epidemics of phenotypically indistinguishable organisms.
Epidemiological investigation of major outbreaks should include whole-genome
typing as well as analysis of potentially transmissible resistance genes and
their vehicles. Copyright © 2007, American Society for Microbiology. All
Rights Reserved.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
carbapenem
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Acinetobacter baumannii
antibiotic resistance
epidemic
horizontal gene transfer
nucleotide sequence
EMTREE MEDICAL INDEX TERMS
antibiotic resistance gene
article
Australia
bacterial gene
bacterial genome
bacterial strain
bacterium isolate
blaoxa 23 gene
blaoxa 51 like gene
drug hydrolysis
human
integron
intensive care unit
nonhuman
phenotype
priority journal
pulsed field gel electrophoresis
CAS REGISTRY NUMBERS
carbapenem (83200-96-8)
MOLECULAR SEQUENCE NUMBERS
GENBANK (AF201828, AJ132105, AJ620678, AY288523, AY554200, AY795964,
DQ029069, EF015496, EF015497, EF015498, EF015500)
EMBASE CLASSIFICATIONS
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2007093590
MEDLINE PMID
17108068 (http://www.ncbi.nlm.nih.gov/pubmed/17108068)
PUI
L46272061
DOI
10.1128/JCM.01971-06
FULL TEXT LINK
http://dx.doi.org/10.1128/JCM.01971-06
COPYRIGHT
Copyright 2008 Elsevier B.V., All rights reserved.
RECORD 794
TITLE
Doppler signal interpretation in free tissue transfer: A computer simulator
for resident and nursing education
AUTHOR NAMES
Thornton B.P.
Marek C.
Stewart D.H.
Vasconez H.C.
AUTHOR ADDRESSES
(Thornton B.P.) Kentucky Aesthetic and Plastic Surgery Institute, Lexington,
KY, United States.
(Marek C.) Plastic Surgery Associates, Lexington, KY, United States.
(Stewart D.H.; Vasconez H.C.) Division of Plastic Surgery, University of
Kentucky, Lexington, KY, United States.
(Thornton B.P.) Norton Healthcare Pavilion, 315 East Broadway, Louisville,
KY 40202, United States.
CORRESPONDENCE ADDRESS
B.P. Thornton, Norton Healthcare Pavilion, 315 East Broadway, Louisville, KY
40202, United States.
SOURCE
Journal of Reconstructive Microsurgery (2007) 23:2 (75-78). Date of
Publication: February 2007
ISSN
0743-684X
BOOK PUBLISHER
Thieme Medical Publishers, Inc., 333 7th Avenue, New York, United States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
computer simulation
free tissue graft
nursing education
residency education
EMTREE MEDICAL INDEX TERMS
edema
graft perfusion
human
intensive care unit
postoperative period
priority journal
reliability
review
training
EMBASE CLASSIFICATIONS
Surgery (9)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2007136589
MEDLINE PMID
17330202 (http://www.ncbi.nlm.nih.gov/pubmed/17330202)
PUI
L46418449
DOI
10.1055/s-2007-970186
FULL TEXT LINK
http://dx.doi.org/10.1055/s-2007-970186
COPYRIGHT
Copyright 2008 Elsevier B.V., All rights reserved.
RECORD 795
TITLE
Transferring critically ill patients out of hospital improves the
standardized mortality ratio: A simulation study
AUTHOR NAMES
Kahn J.M.
Kramer A.A.
Rubenfeld G.D.
AUTHOR ADDRESSES
(Kahn J.M., jkahn@cceb.med.upenn.edu; Rubenfeld G.D.) Division of Pulmonary
and Critical Care, Harborview Medical Center, University of Washington,
Seattle, WA, United States.
(Kramer A.A.) Cerner Corporation, Kansas City, MO, United States.
(Kahn J.M., jkahn@cceb.med.upenn.edu) Division of Pulmonary, Allergy, and
Critical Care, University of Pennsylvania, School of Medicine, 3600 Spruce
St, Philadelphia, PA 19104, United States.
CORRESPONDENCE ADDRESS
J.M. Kahn, Division of Pulmonary, Allergy, and Critical Care, University of
Pennsylvania, School of Medicine, 3600 Spruce St, Philadelphia, PA 19104,
United States. Email: jkahn@cceb.med.upenn.edu
SOURCE
Chest (2007) 131:1 (68-75). Date of Publication: January 2007
ISSN
0012-3692
BOOK PUBLISHER
American College of Chest Physicians, 3300 Dundee Road, Northbrook, United
States.
ABSTRACT
Background: Transferring critically ill patients to other acute care
hospitals may artificially impact benchmarking measures. We sought to
quantify the effect of out-of-hospital transfers on the standardized
mortality ratio (SMR), an outcome-based measure of ICU performance. Methods:
We performed a cohort study and Monte Carlo simulation using data from 85
ICUs participating in the acute physiology and chronic health evaluation
(APACHE) clinical information system from 2002 to 2003. The SMR (observed
divided by expected hospital mortality) was calculated for each ICU using
APACHE FV risk adjustment. A set number of patients was randomly assigned to
be transferred out alive rather than experience their original outcome. The
SMR was recalculated, and the mean simulated SMR was compared to the
original. Results: The mean (± SD) baseline SMR was 1.06 ± 0.19. In the
simulation, increasing the number of transfers by 2% and 6% over baseline
decreased the SMR by 0.10 ± 0.03 and 0.14 ± 0.03, respectively. At a 2%
increase, 27 ICUs had a decrease in SMR of > 0.10, and two ICUs had a
decrease in SMR of > 0.20. Transferring only one additional patient per
month was enough to create a bias of > 0.1 in 27 ICUs. Conclusions:
Increasing the number of acute care transfers by a small amount can
significantly bias the SMR, leading to incorrect inference about ICU
quality. Sensitivity to the variation in hospital discharge practices
greatly limits the use of the SMR as a quality measure.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critically ill patient
mortality
patient transport
EMTREE MEDICAL INDEX TERMS
APACHE
article
cohort analysis
health care quality
hospital discharge
human
intensive care unit
major clinical study
Monte Carlo method
outcome assessment
priority journal
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2007042265
MEDLINE PMID
17218558 (http://www.ncbi.nlm.nih.gov/pubmed/17218558)
PUI
L46122976
DOI
10.1378/chest.06-0741
FULL TEXT LINK
http://dx.doi.org/10.1378/chest.06-0741
COPYRIGHT
Copyright 2008 Elsevier B.V., All rights reserved.
RECORD 796
TITLE
Post-resuscitation stabilization and transportation
ORIGINAL (NON-ENGLISH) TITLE
Estabilización posresucitación y transporte
AUTHOR NAMES
López-Herce Cid J.
Canillo Álvarez A.
Calvo Macías C.
AUTHOR ADDRESSES
(López-Herce Cid J., pielvi@ya.com; Canillo Álvarez A.) Sección de Cuidados
Intensivos Pediátricos, Hospital General Universitario Gregorio Marañón,
Madrid, Spain.
(Calvo Macías C.) Servicio de Críticos y Urgencias Pediátricas, Hospital
Materno-Infantil de Málaga, Spain.
(López-Herce Cid J., pielvi@ya.com) Sección de Cuidados Intensivos
Pediátricos, Hospital General Universitario Gregorio Marañón, Dr. Castelo,
47, 28009 Madrid, Spain.
CORRESPONDENCE ADDRESS
J. López-Herce Cid, Sección de Cuidados Intensivos Pediátricos, Hospital
General Universitario Gregorio Marañón, Dr. Castelo, 47, 28009 Madrid,
Spain. Email: pielvi@ya.com
SOURCE
Anales de Pediatria (2006) 65:6 (578-585). Date of Publication: December
2006
ISSN
1695-4033
BOOK PUBLISHER
Ediciones Doyma, S.L., Travesera de Gracia 17-21, Barcelona, Spain.
ABSTRACT
Cardiopulmonary resuscitation does not end with restoration of spontaneous
circulation; rather, it must be continued with the application of all the
measures that allow organ function to be maintained. The initial goal of
hemodynamic treatment is to achieve normal blood pressure for the patient's
age by means of fluids and/or vasoactive drugs. The aim of respiratory
treatment is to normalize ventilation and oxygenation without causing
further lung injury, avoiding hyperoxia and hyperventilation as well as
hypoxia and hypercapnia. Neurological stabilization aims to reduce secondary
brain damage, by avoiding hypertension and hypotension, maintaining normal
ventilation and oxygenation, and treating hyperglycemia, agitation and
seizures. Although no specific studies in children are available, data from
adults have shown that early moderate hypothermia attenuates brain damage
secondary to cardiorespiratory arrest, without increasing complications.
After the arrest, the need for analgesia and/or sedation must be considered.
The process of transportation to the pediatric intensive care unit (PICU)
requires the following steps: stablizing the patient, checking for and
stabilizing fractures and external wounds, ensuring a stable aiway and
intravenous lines, assessing the need for nasogatric and bladder tubes,
taking blood samples for analyses, contacting the PICU and informing the
staff about the child's condition, choosing the optimal vehicle for
transportation according to the child's condition and the distance, checking
pediatric equipment and medications, selecting experienced staff and,
finally, maintaining close surveillance and monitoring during
transportation.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient transport
resuscitation
EMTREE MEDICAL INDEX TERMS
agitation
analgesia
blood pressure
blood sampling
brain damage (prevention)
cardiopulmonary insufficiency
hemodynamics
human
hypercapnia (prevention)
hyperglycemia (therapy)
hyperoxia
hypertension (prevention)
hyperventilation (prevention)
hypotension (prevention)
hypothermia
hypoxia (prevention)
intensive care unit
lung injury
lung ventilation
neuroprotection
oxygenation
review
sedation
seizure (therapy)
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Neurology and Neurosurgery (8)
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Cardiovascular Diseases and Cardiovascular Surgery (18)
Anesthesiology (24)
LANGUAGE OF ARTICLE
Spanish
LANGUAGE OF SUMMARY
English, Spanish
EMBASE ACCESSION NUMBER
2007044728
MEDLINE PMID
17340787 (http://www.ncbi.nlm.nih.gov/pubmed/17340787)
PUI
L46132818
COPYRIGHT
Copyright 2008 Elsevier B.V., All rights reserved.
RECORD 797
TITLE
Transfer of resistance to meropenem and other antibiotics from nosocomial
Stenotrophomonas maltophilia strains to broad spectrum of recipient strains
ORIGINAL (NON-ENGLISH) TITLE
Transfer rezistencie na meropeném a ďalšie antibiotiká z nozokomiálnych
kmeňov stenotrophomonas maltophilia na široké spektrum recipientných kmeňov
AUTHOR NAMES
Babálová M.
Blahová J.
Ježek P.
Králiková K.
Krčméry V.
Menkyna R.
AUTHOR ADDRESSES
(Babálová M., marta.babalova@szu.sk; Blahová J.; Králiková K.; Krčméry V.;
Menkyna R.) Národného Referenčného, Laboratória Pre Surveillance
Antibiotickej Rezistencie, Katedry Chemoterapie Slovenskej Zdravotnickej
Univerzity, Bratislave, Slovakia.
(Ježek P.) Oddelenia Klinickej Mikrobiológie NsP Příbram, Czech Republic.
(Babálová M., marta.babalova@szu.sk) Slovenská Zdravotnícka Univerzita,
Limbová 14, 833 03 Bratislava 37, Slovakia.
CORRESPONDENCE ADDRESS
M. Babálová, Slovenská Zdravotnícka Univerzita, Limbová 14, 833 03
Bratislava 37, Slovakia. Email: marta.babalova@szu.sk
SOURCE
Lekarsky Obzor (2006) 55:9 (362-365). Date of Publication: 2006
ISSN
0457-4214
BOOK PUBLISHER
Slovenska zdravotnicka univerzita, Limbova 12, , Slovakia.
ABSTRACT
Background: In several countries including Slovak Republic and Czech
Republic, meropenem resistant bacteria begin to appear in increasing numbers
in seriously ill hospitalized patients. Therefore, it is important to obtain
information concerning the transferability of resistance to this maximally
important and effective antibiotic. Set and Methods: We studied in mixed
cultures of donor and recipient strains the transferability of resistance to
meropenem and of other important antibiotics from two resistant strains of
Stenotrophomonas maltophilia to an extended number of recipient strains
including Pseudomonas aeruginosa and Proteus mirabilis. Donor strains were
isolated in intensive care units of a large Regional Hospital in Příbram.
Czech Republic. Results: Both strains transferred directly their resistance
to meropenem and to other antibiotics to the recipient strains of P.
mirabilis and P. aeruginosa. Nevertheless, the number of recipient strains,
as well as the number of transferred determinants of resistance varied in
individual pairs of donor and recipient strains. Thus, each donor strain
transferred different elements of transferable antibiotic resistance.
Conclusions: In the study a first case of a direct transfer of the
determinant of meropenem to a set of recipient strains including P.
aeruginosa was demonstrated. This fact points to the existence of a broad
host range of transferred determinants of resistance. An important event of
this process is the use of fairly extended set of recipient strains
including those of P. aeruginosa. Results of this study demonstrate the
unwanted situation that the genes of resistance to meropenem are mobilized
for transfer also in hospitals of our region.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
meropenem
EMTREE DRUG INDEX TERMS
aztreonam
cefalotin
cefepime
cefoperazone
cefotaxime
kanamycin
rifampicin
ticarcillin
EMTREE MEDICAL INDEX TERMS
antibiotic resistance
article
bacterial strain
bacterium culture
controlled study
Czech Republic
hospital infection
intensive care unit
nonhuman
Proteus mirabilis
Pseudomonas aeruginosa
Stenotrophomonas maltophilia
CAS REGISTRY NUMBERS
aztreonam (78110-38-0)
cefalotin (153-61-7, 58-71-9)
cefepime (88040-23-7)
cefoperazone (62893-19-0, 62893-20-3)
cefotaxime (63527-52-6, 64485-93-4)
kanamycin (11025-66-4, 61230-38-4, 8063-07-8)
meropenem (96036-03-2)
rifampicin (13292-46-1)
ticarcillin (29457-07-6, 34787-01-4, 4697-14-7)
EMBASE CLASSIFICATIONS
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
LANGUAGE OF ARTICLE
Slovak
LANGUAGE OF SUMMARY
English, Slovak
EMBASE ACCESSION NUMBER
2006611735
PUI
L44912068
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 798
TITLE
Horizontal transfer of Shiga toxin and antibiotic resistance genes among
Escherichia coli strains in house fly (Diptera: Muscidae) gut
AUTHOR NAMES
Petridis M.
Bagdasarian M.
Waldor M.K.
Walker E.
AUTHOR ADDRESSES
(Petridis M., mpetridi@jhsph.edu; Walker E.) Department of Entomology,
Michigan State University, East Lansing, MI 48824, United States.
(Petridis M., mpetridi@jhsph.edu; Bagdasarian M.; Walker E.) Department of
Microbiology and Molecular Genetics, Michigan State University, East
Lansing, MI 48824, United States.
(Petridis M., mpetridi@jhsph.edu) Johns Hopkins University, Department of
Molecular Microbiology and Immunology, Bloomberg School of Public Health,
Baltimore, MD 21205, United States.
(Waldor M.K.) Division of Geographic Medicine and Infectious Diseases, New
England Medical Center #233, 750 Washington St., Boston, MA 02111, United
States.
CORRESPONDENCE ADDRESS
M. Petridis, Johns Hopkins University, Department of Molecular Microbiology
and Immunology, Bloomberg School of Public Health, Baltimore, MD 21205,
United States. Email: mpetridi@jhsph.edu
SOURCE
Journal of Medical Entomology (2006) 43:2 (288-295). Date of Publication:
2006
ISSN
0022-2585
BOOK PUBLISHER
Entomological Society of America
ABSTRACT
Whether the house fly, Musca domestica L., gut is a permissive environment
for horizontal transfer of antibiotic resistance and virulence genes between
strains of Escherichia coli is not known. House flies were immobilized and
force fed suspensions of defined, donor strains of E. coli containing
chloramphenicol resistance genes on a plasmid, or lysogenic,
bacteriophage-born Shiga toxin gene stx1 (bacteriophage H-19B::Ap1).
Recipient strains were E. coli lacking these mobile elements and genes but
having rifampicin as a selectable marker. Plasmid transfer occurred at rates
of 10(-2) per donor cell in the fly midgut and 10(-3) in the fly crop after
1 h of incubation postfeeding. Bacteriophage transfer rate was ≈10(-6) per
donor cell without induction, but induction with mitomycin C increased rates
of transfer to 10 (-2) per donor cell. These findings show that genes
encoding antibiotic resistance or toxins will transfer horizontally among
bacteria in the house fly gut via plasmid transfer or phage transduction.
The house fly gut may provide a favorable environment for the evolution and
emergence of pathogenic bacterial strains through acquisition of antibiotic
resistance genes or virulence factors. © 2006 Entomological Society of
America.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
verotoxin 1
EMTREE DRUG INDEX TERMS
primer DNA
rifampicin
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
antibiotic resistance
Escherichia coli
horizontal gene transfer
house fly
EMTREE MEDICAL INDEX TERMS
animal
article
bacterial count
bacteriophage
bacterium conjugation
chemistry
classification
comparative study
gastrointestinal tract
genetic marker
genetic transduction
genetics
methodology
microbiology
phenotype
plasmid
polymerase chain reaction
CAS REGISTRY NUMBERS
rifampicin (13292-46-1)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
16619613 (http://www.ncbi.nlm.nih.gov/pubmed/16619613)
PUI
L44743539
DOI
10.1603/0022-2585(2006)043[0288:HTOSTA]2.0.CO;2
FULL TEXT LINK
http://dx.doi.org/10.1603/0022-2585(2006)043[0288:HTOSTA]2.0.CO;2
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 799
TITLE
Adverse events experienced while transferring the critically ill patient
from the emergency department to the intensive care unit
AUTHOR NAMES
Gillman L.
Leslie G.
Williams T.
Fawcett K.
Bell R.
McGibbon V.
AUTHOR ADDRESSES
(Gillman L., Lucia.gillman@health.wa.gov.au; Leslie G.) Royal Perth
Hospital, Edith Cowan University, Perth, WA 6001, Australia.
(Williams T.) Centre for Nursing Evidence Based Practice, Department of
Education and Research, Royal Perth Hospital, Perth, WA 6001, Australia.
(Fawcett K.; Bell R.) Emergency Department, Royal Perth Hospital, Perth, WA
6001, Australia.
(McGibbon V.) Intensive Care Unit, Royal Perth Hospital, Perth, WA 6001,
Australia.
CORRESPONDENCE ADDRESS
L. Gillman, Royal Perth Hospital, Edith Cowan University, Perth, WA 6001,
Australia. Email: Lucia.gillman@health.wa.gov.au
SOURCE
Emergency Medicine Journal (2006) 23:11 (858-861). Date of Publication:
November 2006
ISSN
1472-0205
BOOK PUBLISHER
BMJ Publishing Group, Tavistock Square, London, United Kingdom.
ABSTRACT
Objectives: To determine the incidence and nature of adverse events and
delay to patient transfer from emergency department to intensive care unit
(ICU) in a metropolitan tertiary hospital. Method: A 6-month prospective
observational study in conjunction with a retrospective chart audit on all
emergency department patients admitted to ICU, including those admitted via
theatre or after a computed tomography scan. Results: Equipment problems was
the most common adverse event occurring in 9% of patient transfers (n =
290). Hypothermia events occurred in 7% of transfers, cardiovascular events
in 6% of patient transfers, delays to transfer >20 min occurred in 38% of
the prospectively audited cases, with 14% waiting > 1 h. One patient was
found to have an incorrect patient identification band during a preoperative
check. Conclusions: This study generally reported lower rates of adverse
events than noted in previous studies involving critically ill transfers.
The most significant finding was the application of an incorrect patient
identification band and has prompted a review of practice. The establishment
of benchmark indicators for adverse events and delays in transfer will be
useful for future audits.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
article
cardiovascular disease
clinical audit
controlled study
disease course
emergency ward
human
hypothermia
intensive care unit
major clinical study
medical error
patient identification
priority journal
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2006543536
MEDLINE PMID
17057138 (http://www.ncbi.nlm.nih.gov/pubmed/17057138)
PUI
L44696841
DOI
10.1136/emj.2006.037697
FULL TEXT LINK
http://dx.doi.org/10.1136/emj.2006.037697
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 800
TITLE
Determination of closest appropriate destination facility for air and
critical care medical transportation
AUTHOR NAMES
Position Statement of the Air Medical Physician Association
AUTHOR ADDRESSES
(Position Statement of the Air Medical Physician Association)
SOURCE
Air Medical Journal (2006) 25:6 (276-277). Date of Publication:
November/December 2006
ISSN
1067-991X
1532-6497 (electronic)
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
patient care
EMTREE MEDICAL INDEX TERMS
article
decision making
emergency care
health care facility
intensive care
patient transport
physician
policy
priority journal
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2006519129
MEDLINE PMID
17071417 (http://www.ncbi.nlm.nih.gov/pubmed/17071417)
PUI
L44615499
DOI
10.1016/j.amj.2006.09.005
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2006.09.005
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 801
TITLE
Management of obese patients in the intensive care unit: technical aspects
ORIGINAL (NON-ENGLISH) TITLE
Prise en charge des patients obèses en réanimation : aspects techniques
AUTHOR NAMES
Clec'h C.
Gonzalez F.
Cohen Y.
AUTHOR ADDRESSES
(Clec'h C., christophe.clech@avc.aphp.fr; Gonzalez F.; Cohen Y.) Service de
réanimation, hôpital Avicenne, 125, route de Stalingrad, 93009 Bobigny
cedex, France.
CORRESPONDENCE ADDRESS
C. Clec'h, Service de réanimation, hôpital Avicenne, 125, route de
Stalingrad, 93009 Bobigny cedex, France. Email: christophe.clech@avc.aphp.fr
SOURCE
Reanimation (2006) 15:6 (445-448). Date of Publication: Nov 2006
ISSN
1624-0693
ABSTRACT
Anatomic patterns of obesity are responsible for various and potentially
deleterious technical problems. Particularly, airway management, vascular
access, monitoring, routine investigations, intrahospital transfers, as well
as nursing and positioning can be challenging. A global therapeutic
approach, which takes these technical problems into account is undoubtedly
mandatory for improving the outcome of obese patients admitted to the
intensive care unit. © 2006 Société de réanimation de langue française.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
obesity
EMTREE MEDICAL INDEX TERMS
human
laboratory test
nursing
patient monitoring
patient transport
short survey
vascular access
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
French
LANGUAGE OF SUMMARY
French, English
EMBASE ACCESSION NUMBER
2006566248
PUI
L44765316
DOI
10.1016/j.reaurg.2006.09.010
FULL TEXT LINK
http://dx.doi.org/10.1016/j.reaurg.2006.09.010
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 802
TITLE
Utility of serial computed tomography imaging in pediatric patients with
head trauma
AUTHOR NAMES
Durham S.R.
Liu K.C.
Selden N.R.
AUTHOR ADDRESSES
(Durham S.R., srd@hitchcock.org) Dartmouth-Hitchcock Medical Center, One
Medical Center Drive, Lebanon, NH 03766, United States.
(Liu K.C.; Selden N.R.)
CORRESPONDENCE ADDRESS
S.R. Durham, Dartmouth-Hitchcock Medical Center, One Medical Center Drive,
Lebanon, NH 03766, United States. Email: srd@hitchcock.org
SOURCE
Journal of Neurosurgery (2006) 105 PEDIATRICS:SUPPL. 5 (365-369). Date of
Publication: November 2006
ISSN
0022-3085
0022-3085 (electronic)
BOOK PUBLISHER
American Association of Neurological Surgeons, 1224 West Main Street Suite
450, Charlottesville, United States.
ABSTRACT
Object. The purpose of this study was to evaluate the risk of progression of
traumatic intracranial lesions in children by comparing initial and
subsequent computed tomography (CT) scans. Reserving repeated CT imaging for
patients who harbor higher-risk lesions may reduce overall radiation
exposure, the need for sedative agents, and cost. Methods. The authors
performed a retrospective cohort study in 268 patients younger than 18 years
of age who underwent repeated CT scanning within 24 hours of their initial
CT scanning procedure. The risk of progression between the initial and
repeated CT scanning sessions and the need for delayed neurosurgical
intervention were determined for each lesion type. In 54 patients (20.1%)
the normal findings on the initial CT study did not change on subsequent
imaging. In 61 (28.5%) of the 214 patients in whom abnormal findings were
present on the initial scan, progression was demonstrated. Patients with
epidural hematoma (EDH; odds ratio [OR] 12.29), subdural hematoma (SDH; OR
3.18), cerebral edema (OR 9.34), and intraparenchymal hemorrhage (IPH; OR
18.3) were found to be at a significantly increased risk for progression and
to require delayed neurosurgical intervention (OR 11.91). No significantly
increased risk was found for patients with subarachnoid hemorrhage (SAH),
intraventricular hemorrhage (IVH), diffuse axonal injury (DAI), or skull
fracture. Conclusions. Repeated CT imaging in children with high-risk
lesions such as EDH, SDH, cerebral edema, and IPH is recommended. However,
in children with low-risk lesions, such as SAH, IVH, DAI, and isolated skull
fractures but no sign of clinical deterioration, repeated imaging may be
less likely to alter the clinical management scheme. The limited benefits of
undertaking repeated imaging in these patients should be weighed against the
risks of radiation exposure, sedation, intrahospital transportation, and
patient monitoring.
EMTREE DRUG INDEX TERMS
sedative agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
traumatic brain injury
EMTREE MEDICAL INDEX TERMS
adolescent
adult
article
axonal injury
brain edema
brain hemorrhage
child
computer assisted tomography
controlled study
epidural hematoma
female
head injury
health care cost
human
infant
major clinical study
male
medical assessment
priority journal
radiation exposure
risk assessment
skull fracture
subarachnoid hemorrhage
subdural hematoma
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Neurology and Neurosurgery (8)
Radiology (14)
Orthopedic Surgery (33)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2006624256
MEDLINE PMID
17328259 (http://www.ncbi.nlm.nih.gov/pubmed/17328259)
PUI
L44954764
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 803
TITLE
"Stay, just a little bit longer...".
AUTHOR NAMES
Leslie G.D.
AUTHOR ADDRESSES
(Leslie G.D.)
CORRESPONDENCE ADDRESS
G.D. Leslie,
SOURCE
Australian critical care : official journal of the Confederation of
Australian Critical Care Nurses (2006) 19:4 (119). Date of Publication: Nov
2006
ISSN
1036-7314
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health care delivery
intensive care unit
length of stay
patient transport
safety
EMTREE MEDICAL INDEX TERMS
Australia
editorial
health service
hospital bed utilization
hospital discharge
human
organization and management
progressive patient care
statistics
LANGUAGE OF ARTICLE
English
MEDLINE PMID
17165489 (http://www.ncbi.nlm.nih.gov/pubmed/17165489)
PUI
L45004745
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 804
TITLE
Assessment of the relationship between cerebral and splanchnic oxygen
saturations measured by near-infrared spectroscopy and direct measurements
of systemic haemodynamic variables and oxygen transport after the Norwood
procedure
AUTHOR NAMES
Li J.
Van Arsdell G.S.
Zhang G.
Cai S.
Humpl T.
Caldarone C.A.
Holtby H.
Redington A.N.
AUTHOR ADDRESSES
(Redington A.N., andrew.redington@sickkids.ca) Division of Cardiology,
Hospital for Sick Children, 555 University Avenue, Toronto, Ont. M5G 1X8,
Canada.
(Li J.; Van Arsdell G.S.; Zhang G.; Cai S.; Humpl T.; Caldarone C.A.; Holtby
H.; Redington A.N., andrew.redington@sickkids.ca) Cardiac Program, Hospital
for Sick Children, Toronto, Ont., Canada.
CORRESPONDENCE ADDRESS
A.N. Redington, Division of Cardiology, Hospital for Sick Children, 555
University Avenue, Toronto, Ont. M5G 1X8, Canada. Email:
andrew.redington@sickkids.ca
SOURCE
Heart (2006) 92:11 (1678-1685). Date of Publication: November 2006
ISSN
1355-6037
BOOK PUBLISHER
BMJ Publishing Group, Tavistock Square, London, United Kingdom.
ABSTRACT
Objectives: To evaluate the clinical utility of near-infrared spectroscopic
(NIRS) monitoring of cerebral (ScO(2)) and splanchnic (SsO (2)) oxygen
saturations for estimation of systemic oxygen transport after the Norwood
procedure. Methods: ScO(2) and SsO(2) were measured with NIRS cerebral and
thoracolumbar probes (in humans). Respiratory mass spectrometry was used to
measure systemic oxygen consumption (V̇O (2)). Arterial (SaO(2)), superior
vena caval (SvO2) and pulmonary venous oxygen saturations were measured at 2
to 4 h intervals to derive pulmonary (Qp) and systemic blood flow (Qs),
systemic oxygen delivery (DO(2)) and oxygen extraction ratio (ERO(2)). Mixed
linear regression was used to test correlations. A study of 7 pigs after
cardiopulmonary bypass (study 1) was followed by a study of 11 children
after the Norwood procedure (study 2). Results: Study 1. ScO(2) moderately
correlated with SvO(2), mean arterial pressure, Qs, DO(2) and ERO(2) (slope
0.30, 0.64. 2.30, 0.017 and -32.5, p < 0.0001) but not with SaO(2), arterial
oxygen pressure (PaO(2)), haemoglobin and V̇O(2). Study 2. ScO(2) correlated
well with SvO (2), SaO(2), PaO(2) and mean arterial pressure (slope 0.43,
0.61, 0.99 and 0.52, p < 0.0001) but not with haemoglobin (slope 0.24, p >
0.05). ScO(2) correlated weakly with V̇O(2) (slope -0.07, p = 0.05) and
moderately with Qs, DO(2) and ERO(2) (slope 3.2, 0.03, -33.2, p < 0.0001).
SsO(2) showed similar but weaker correlations. Conclusions: ScO(2) and
SsO(2) may reflect the influence of haemodynamic variables and oxygen
transport after the Norwood procedure. However, the interpretation of NIRS
data, in terms of both absolute values and trends, is difficult to rely on
clinically.
EMTREE DRUG INDEX TERMS
hemoglobin (endogenous compound)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
heart hemodynamics
heart muscle oxygen consumption
EMTREE MEDICAL INDEX TERMS
animal experiment
arterial oxygen saturation
arterial oxygen tension
article
brain oxygen tension
controlled study
coronary care unit
female
human
human experiment
infant
male
mass spectrometry
mean arterial pressure
near infrared spectroscopy
newborn
nonhuman
Norwood procedure
oxygen consumption
oxygen transport
priority journal
splanchnic blood flow
superior cava vein
systemic circulation
CAS REGISTRY NUMBERS
hemoglobin (9008-02-0)
EMBASE CLASSIFICATIONS
General Pathology and Pathological Anatomy (5)
Cardiovascular Diseases and Cardiovascular Surgery (18)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2006523381
MEDLINE PMID
16621884 (http://www.ncbi.nlm.nih.gov/pubmed/16621884)
PUI
L44629186
DOI
10.1136/hrt.2005.087270
FULL TEXT LINK
http://dx.doi.org/10.1136/hrt.2005.087270
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 805
TITLE
Is your patient ready for transport? Developing an ICU patient transport
decision scorecard.
AUTHOR NAMES
Esmail R.
Banack D.
Cummings C.
Duffett-Martin J.
Rimmer K.
Shultz J.
Thurber T.
Hulme T.
AUTHOR ADDRESSES
(Esmail R.; Banack D.; Cummings C.; Duffett-Martin J.; Rimmer K.; Shultz J.;
Thurber T.; Hulme T.) Calgary Health Region, Foothills Medical Centre, AB.
CORRESPONDENCE ADDRESS
R. Esmail, Calgary Health Region, Foothills Medical Centre, AB. Email:
rosmin.esmail@calgaryhealthregion.ca
SOURCE
Healthcare quarterly (Toronto, Ont.) (2006) 9 Spec No (80-86). Date of
Publication: Oct 2006
ISSN
1710-2774
ABSTRACT
Transport of patients from the intensive care unit (ICU) to another area of
the hospital can pose serious risks if the patient has not been assessed
prior to transport. Recently, the Department of Critical Care Medicine,
Calgary Health Region, experienced two adverse events during transport. A
subgroup of the Department's Patient Safety and Adverse Events team
developed an ICU patient transport decision scorecard. This tool was tested
through Plan-Do-Study-Act cycles and further revised using human factors
principles. Staff, especially novice nurses, found the tool extremely useful
in determining patient preparedness for transport.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
decision making
intensive care unit
patient transport
safety
EMTREE MEDICAL INDEX TERMS
article
Canada
health services research
human
organization and management
program development
LANGUAGE OF ARTICLE
English
MEDLINE PMID
17087174 (http://www.ncbi.nlm.nih.gov/pubmed/17087174)
PUI
L44983739
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 806
TITLE
Reduction of musculoskeletal injuries in intensive care nurses using
ceiling-mounted patient lifts.
AUTHOR NAMES
Silverwood S.
Haddock M.
AUTHOR ADDRESSES
(Silverwood S.; Haddock M.) Richmond Health Services, British Columbia.
CORRESPONDENCE ADDRESS
S. Silverwood, Richmond Health Services, British Columbia.
SOURCE
Dynamics (Pembroke, Ont.) (2006) 17:3 (19-21). Date of Publication: 2006
Fall
ISSN
1497-3715
ABSTRACT
The musculoskeletal injury (MSI) rate in the Richmond Hospital Intensive
Care Unit (ICU) increased significantly in 2000 and 2001 by 130%. As part of
a quality initiative program, the problem was identified, assessed, and a
plan was developed that involved the installation of ceiling-mounted patient
lifts (CMPL) and the incorporation of a patient positioning sling. The
evaluation process included a survey given to the ICU nursing staff prior to
the implementation of the CMPL and repeated three, six, and 18 months after
implementation. The survey included questions about discomfort, fatigue, and
frustration levels before and after a 12-hour shift, as well as any medical
interventions such as use of medications, physician visits, physiotherapy,
and massage therapy for work-related issues. The use of the lifts
contributed to lower scores in fatigue, pain and frustration in addition to
a reduction in medical visits. The results also demonstrated a significant
reduction in work-related time loss claims while promoting a positive
workplace environment.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
biomechanics (adverse drug reaction)
health personnel attitude
musculoskeletal disease (epidemiology, etiology, prevention)
nursing staff
occupational disease (epidemiology, etiology, prevention)
patient transport
EMTREE MEDICAL INDEX TERMS
absenteeism
article
bed rest
bioengineering
body position
Canada (epidemiology)
equipment design
fatigue (etiology, prevention)
frustration
human
intensive care
job satisfaction
longitudinal study
methodology
nurse attitude
nursing
nursing evaluation research
nursing methodology research
occupational health
organization and management
pain (etiology, prevention)
psychological aspect
workload
workplace
LANGUAGE OF ARTICLE
English
MEDLINE PMID
17009569 (http://www.ncbi.nlm.nih.gov/pubmed/17009569)
PUI
L44686699
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 807
TITLE
Pretransport and posttransport characteristics and outcomes of neonates who
were admitted to a cardiac intensive care unit
AUTHOR NAMES
Yeager S.B.
Horbar J.D.
Greco K.M.
Duff J.
Thiagarajan R.R.
Laussen P.C.
AUTHOR ADDRESSES
(Yeager S.B., scott.yeager@vtmednet.org; Greco K.M.) Department of
Pediatrics, University of Vermont, School of Medicine, Burlington, VT,
United States.
(Horbar J.D.) Center for Patient Safety in Neonatal Intensive Care, Vermont
Oxford Network, Burlington, VT, United States.
(Duff J.; Thiagarajan R.R.; Laussen P.C.) Department of Cardiology,
Children's Hospital Boston, Boston, MA, United States.
(Yeager S.B., scott.yeager@vtmednet.org) Division of Pediatric Cardiology,
University of Vermont School of Medicine, FAHC Patrick 581, Burlington, VT
05401, United States.
CORRESPONDENCE ADDRESS
S.B. Yeager, Division of Pediatric Cardiology, University of Vermont School
of Medicine, FAHC Patrick 581, Burlington, VT 05401, United States. Email:
scott.yeager@vtmednet.org
SOURCE
Pediatrics (2006) 118:3 (1070-1077). Date of Publication: September 2006
ISSN
0031-4005
0210-5721 (electronic)
BOOK PUBLISHER
American Academy of Pediatrics, 141 Northwest Point Blvd, P.O. Box 927, Elk
Grove Village, United States.
ABSTRACT
OBJECTIVE. The objective for this study was to characterize the impact and
the safety of transporting neonates with known or suspected cardiac
abnormalities. METHODS. We reviewed retrospectively the charts and
computerized records of 192 admissions to a cardiac ICU in 2002. Patients
were included when they were <28 days of age at admission and were
transported from adjacent obstetric facilities (local N = 70) or other
inpatient medical facilities (transport N = 122). Demographic, clinical,
pharmacologic, laboratory, and diagnostic information was obtained before
transport (when available) and within 3 hours of arrival. Arrival status was
considered optimal when measured metabolic and clinical parameters all were
within range. Outcome variables included days on ventilator, days in ICU,
days in hospital, and death. RESULTS. Of local admissions, 31 (44%) patients
had 61 suboptimal arrival values, including pH <7.25 (n = 11), saturation
<70% (n = 12), and temperature <36°C (n = 9). There were 69 undocumented
values in 39 patients. Of transported patients, 55 (45%) had 86 suboptimal
arrival values, including pH <7.25 (n = 8), saturation <70% (n = 14), and
temperature <36°C (n = 13). There were 98 undocumented values in 53
patients. No in-transport deaths or catastrophic events occurred. Local
admissions were more likely to have a prenatal diagnosis of heart disease
and had more complex disease and higher mortality. Other outcome parameters
were not significantly different between the 2 groups. Low admission
arterial saturation, pH, and core temperature were not correlated with
adverse outcome measures. CONCLUSIONS. Although we did not encounter major
transport complications, opportunities exist to optimize arrival status and
improve surveillance and documentation. Copyright © 2006 by the American
Academy of Pediatrics.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child hospitalization
heart disease
patient transport
EMTREE MEDICAL INDEX TERMS
article
controlled study
core temperature
correlation analysis
data analysis
health survey
human
major clinical study
mortality
newborn
newborn intensive care
outcome assessment
outcome variable
oxygen saturation
pH
prenatal diagnosis
priority journal
statistical analysis
terminal disease
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
Cardiovascular Diseases and Cardiovascular Surgery (18)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2007030262
MEDLINE PMID
16951000 (http://www.ncbi.nlm.nih.gov/pubmed/16951000)
PUI
L46090048
DOI
10.1542/peds.2006-0719
FULL TEXT LINK
http://dx.doi.org/10.1542/peds.2006-0719
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 808
TITLE
A problem with delivering CPAP during patient transport [17]
AUTHOR NAMES
Sandby-Thomas M.
AUTHOR ADDRESSES
(Sandby-Thomas M., msandbythomas@btinternet.com) University Hospital of
Wales, Cardiff CF14 4XN, United Kingdom.
CORRESPONDENCE ADDRESS
M. Sandby-Thomas, University Hospital of Wales, Cardiff CF14 4XN, United
Kingdom. Email: msandbythomas@btinternet.com
SOURCE
Anaesthesia (2006) 61:8 (816-817). Date of Publication: August 2006
ISSN
0003-2409
1365-2044 (electronic)
BOOK PUBLISHER
Blackwell Publishing Ltd, 9600 Garsington Road, Oxford, United Kingdom.
EMTREE DRUG INDEX TERMS
oxygen
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient transport
positive end expiratory pressure
EMTREE MEDICAL INDEX TERMS
critically ill patient
human
intensive care unit
letter
medical device
oxygen supply
oxygenation
radiology department
tracheostomy
ventilator
wakefulness
DEVICE TRADE NAMES
Oxylog 2000 , United KingdomDrager
DEVICE MANUFACTURERS
(United Kingdom)Drager
CAS REGISTRY NUMBERS
oxygen (7782-44-7)
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Anesthesiology (24)
Biophysics, Bioengineering and Medical Instrumentation (27)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2006328143
MEDLINE PMID
16867111 (http://www.ncbi.nlm.nih.gov/pubmed/16867111)
PUI
L44027429
DOI
10.1111/j.1365-2044.2006.04733.x
FULL TEXT LINK
http://dx.doi.org/10.1111/j.1365-2044.2006.04733.x
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 809
TITLE
Intensive care and beyond: improving the transitional experiences for
critically ill patients and their families
AUTHOR NAMES
Chaboyer W.
AUTHOR ADDRESSES
(Chaboyer W., W.Chaboyer@griffith.edu.au) Research Centre for Clinical
Practice Innovation, Griffith University, Gold Coast Campus, Australia.
CORRESPONDENCE ADDRESS
W. Chaboyer, Research Centre for Clinical Practice Innovation, Griffith
University, Gold Coast Campus, Australia. Email: W.Chaboyer@griffith.edu.au
SOURCE
Intensive and Critical Care Nursing (2006) 22:4 (187-193). Date of
Publication: August 2006
ISSN
0964-3397
BOOK PUBLISHER
Churchill Livingstone
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
attitude to health
critical illness
family
intensive care
nurse
patient transport
EMTREE MEDICAL INDEX TERMS
adaptive behavior
aftercare
anxiety (prevention)
caregiver
cost of illness
editorial
health personnel attitude
human
life event
nurse attitude
nursing
organization and management
patient care
psychological aspect
survivor
total quality management
LANGUAGE OF ARTICLE
English
MEDLINE PMID
16782338 (http://www.ncbi.nlm.nih.gov/pubmed/16782338)
PUI
L44103579
DOI
10.1016/j.iccn.2006.05.001
FULL TEXT LINK
http://dx.doi.org/10.1016/j.iccn.2006.05.001
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 810
TITLE
Perceptions of critical care outreach within a network.
AUTHOR NAMES
Plowright C.
Fraser J.
Smith S.
Buras-Rees S.
Dennington L.
King D.
MacLellan C.
Seymour P.
Scott G.
Brindle A.
AUTHOR ADDRESSES
(Plowright C.; Fraser J.; Smith S.; Buras-Rees S.; Dennington L.; King D.;
MacLellan C.; Seymour P.; Scott G.; Brindle A.) Medway NHS Trust.
CORRESPONDENCE ADDRESS
C. Plowright, Medway NHS Trust.
SOURCE
Nursing times (2006) 102:29 (36-40). Date of Publication: 2006 Jul 18-24
ISSN
0954-7762
ABSTRACT
AIM: The purpose of this study was to establish healthcare professionals'
perceptions of critical care outreach. METHOD: A multi-site survey approach
was used to collect qualitative data. RESULTS: Most respondents felt that
outreach assisted with patient care by enabling the admission and smooth
discharge to and from the critical care units and providing useful education
and training that changed practice. Respondents also thought that the audits
undertaken by the outreach teams benefited patient care. CONCLUSION:
Overall, outreach was considered by healthcare professionals to enhance
patient care and improve practice.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health personnel attitude
intensive care
nursing staff
patient care
patient transport
EMTREE MEDICAL INDEX TERMS
article
education
evaluation study
general hospital
health care quality
human
needs assessment
nursing
nursing education
nursing methodology research
organization and management
psychological aspect
public hospital
public relations
qualitative research
questionnaire
social support
standard
United Kingdom
LANGUAGE OF ARTICLE
English
MEDLINE PMID
16895249 (http://www.ncbi.nlm.nih.gov/pubmed/16895249)
PUI
L44303420
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 811
TITLE
Impact of the reinforcement of a Methicillin-Resistant Staphylococcus aureus
Control Programme: A 3-year evaluation by several indicators in a French
University Hospital
AUTHOR NAMES
Eveillard M.
Lancien E.
De Lassence A.
Branger C.
Barnaud G.
Benlolo J.-A.
Joly-Guillou M.-L.
AUTHOR ADDRESSES
(Eveillard M., mathieu.eveillard@lmr.ap-hop-paris.fr; Lancien E.; Branger
C.; Barnaud G.; Benlolo J.-A.; Joly-Guillou M.-L.) Department of
Microbiology and Hygiene, Intensive Care Unit, Hôpital Louis Mourier AP-HP,
178 rue des Renouillers, Colombes F-92700, France.
(De Lassence A.) Intensive Care Unit, Hôpital Louis Mourier AP-HP, 178 rue
des Renouillers, Colombes F-92700, France.
(Eveillard M., mathieu.eveillard@lmr.ap-hop-paris.fr) Department of
Microbiology and Hygiene, Hôpital Louis Mourier (Assistance Publique -
Hôpitaux de Paris), 178 rue des Renouillers, Colombes F-92700, France.
CORRESPONDENCE ADDRESS
M. Eveillard, Department of Microbiology and Hygiene, Hôpital Louis Mourier
(Assistance Publique - Hôpitaux de Paris), 178 rue des Renouillers, Colombes
F-92700, France. Email: mathieu.eveillard@lmr.ap-hop-paris.fr
SOURCE
European Journal of Epidemiology (2006) 21:7 (551-558). Date of Publication:
July 2006
ISSN
0393-2990
1573-7284 (electronic)
BOOK PUBLISHER
Springer Netherlands, Van Godewijckstraat 30, Dordrecht, Netherlands.
ABSTRACT
Our objective was to evaluate the impact of the reinforcement of a
methicillin-resistant Staphylococcus aureus (MRSA) control programme and to
assess the impact of risk adjustment on the interpretation of data. A
stepwise, retrospective analysis of 3-year prospectively collected data was
performed in a 600-bed French teaching hospital in the Parisian area. A
reinforcement of a pre-existing programme for limiting the spread of MRSA
was implemented in 2002 and 2003 by increasing the frequency of the feedback
of surveillance data, by using alcohol-based disinfectants, and by
increasing patient screening. Different indicators were used to follow the
change over time of MRSA transmission: the proportion of MRSA acquired in
our hospital, the incidence of newly acquired MRSA/1,000 patient-days (PD)
(incidence of newly acquired MRSA), the incidence of newly acquired MRSA
isolated in at least one clinical specimen/1,000 PD (incidence of newly
acquired clinical MRSA), and a risk-adjusted indicator, the incidence of
newly acquired-MRSA isolated in at least one clinical specimen/1,000 PD of
carriers identified at admission (incidence related to the risk of
acquisition). The change over time of these indicators was studied with the
chi-square test for trend. During the study, all indicators decreased
significantly, with a mean drop of 0.07/1,000 PD for the incidence of newly
acquired clinical MRSA, and a mean drop of 3.0/1,000 PD for the incidence
related to the risk of acquisition. The proportion of MRSA acquired in our
hospital decreased from 49.3% in 2002 to 24.1% in 2004. Concurrently,
between 2002 and 2004, the number of patients screened on admission to
hospital or at the time of intra-hospital transfer increased by 31% and the
consumption of waterless alcohol-based hand disinfectants increased by 244%.
The decreasing trend of all indicators emphasizes the effectiveness of the
reinforcement of our MRSA control programme. From 2002 to 2004, the trend of
the indicator related to the risk of acquisition over time is similar to
those of other indicators. Further studies should be useful to assess if
risk-adjustment is absolutely necessary when tracking rates within a single
institution. © 2006 Springer Science+Business Media B.V.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
alcohol derivative
disinfectant agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
infection control
methicillin resistant Staphylococcus aureus
Staphylococcus infection (epidemiology, etiology, prevention)
EMTREE MEDICAL INDEX TERMS
article
bacterial transmission
bacterium carrier
bacterium culture
bacterium identification
bacterium isolate
bacterium isolation
chi square test
disinfection
evaluation study
France
health program
hospital admission
hospital infection (etiology, prevention)
human
incidence
nonhuman
outcome assessment
trend study
university hospital
EMBASE CLASSIFICATIONS
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2006509075
MEDLINE PMID
16915525 (http://www.ncbi.nlm.nih.gov/pubmed/16915525)
PUI
L44578333
DOI
10.1007/s10654-006-9024-y
FULL TEXT LINK
http://dx.doi.org/10.1007/s10654-006-9024-y
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 812
TITLE
Transporting critically ill patients: new opportunities for nurses.
AUTHOR NAMES
Mackintosh M.
AUTHOR ADDRESSES
(Mackintosh M.) Cardiothoracic Intensive Care, Freeman Hospital, Newcastle
upon Tyne.
CORRESPONDENCE ADDRESS
M. Mackintosh, Cardiothoracic Intensive Care, Freeman Hospital, Newcastle
upon Tyne. Email: magron169@onetel.com
SOURCE
Nursing standard (Royal College of Nursing (Great Britain) : 1987) (2006)
20:36 (46-48). Date of Publication: 2006 May 17-23
ISSN
0029-6570
ABSTRACT
This article examines the inter-hospital and intra-hospital transport of
critically ill patients in relation to recent guidelines and recommendations
for the safe transfer of patients. The impact of new legislation on existing
practice and the implications for developing new nursing roles are also
discussed.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
patient transport
EMTREE MEDICAL INDEX TERMS
article
human
nurse attitude
public health
social change
United Kingdom
LANGUAGE OF ARTICLE
English
MEDLINE PMID
16755893 (http://www.ncbi.nlm.nih.gov/pubmed/16755893)
PUI
L44068096
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 813
TITLE
Efficacy of fentanyl analgesia for trauma in critical care transport
AUTHOR NAMES
Frakes M.A.
Lord W.R.
Kociszewski C.
Wedel S.K.
AUTHOR ADDRESSES
(Frakes M.A., mfrakes@harthosp.org; Lord W.R.) LIFE STAR, Hartford Hospital,
Hartford, CT 06102-5037, United States.
(Frakes M.A., mfrakes@harthosp.org; Kociszewski C.; Wedel S.K.) Boston
MedFlight, Boston, MA 01730, United States.
CORRESPONDENCE ADDRESS
M.A. Frakes, LIFE STAR, Hartford Hospital, Hartford, CT 06102-5037, United
States. Email: mfrakes@harthosp.org
SOURCE
American Journal of Emergency Medicine (2006) 24:3 (286-289). Date of
Publication: May 2006
ISSN
0735-6757
BOOK PUBLISHER
W.B. Saunders, Independence Square West, Philadelphia, United States.
ABSTRACT
Introduction: Pain relief is one of the most important interventions for
out-of-hospital patient care providers. This paper documents the need for
and benefits from the administration of fentanyl to trauma patients during
critical care transport. Methods: We underwent a retrospective review of the
transport charts of 100 trauma patients who received fentanyl analgesia
during transport and who were able to use a numeric response scale to rate
their pain from 0 to 10. Results: Mean initial pain report was 7.6 ± 2.2
units, relieved to 3.7 ± 2.8 units by a mean total fentanyl dose of 1.6 ±
0.8 μg/kg (P < .001). Neither initial pain level nor pain relief differed
between male and female patients, but did differ between patients
originating at the site of injury and those transferred between hospitals.
Fentanyl dose correlated poorly with the magnitude of pain relief (r =
0.22), but a dose greater than 2 μg/kg provided more relief than lower doses
(5.1 ± 2.1 vs 3.6 ± 2.4, P < .02). Conclusion: Fentanyl analgesia from these
critical care transport teams provided significant pain relief to trauma
patients. Pain reduction was greater for patients who received more than 2.0
μg/kg of fentanyl. © 2006 Elsevier Inc. All rights reserved.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
analgesic agent (drug dose, drug therapy)
fentanyl (drug dose, drug therapy)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
injury
intensive care
patient care
patient transport
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
analgesia
article
child
correlation analysis
drug efficacy
drug megadose
female
hospital
human
low drug dose
major clinical study
male
medical record review
pain (drug therapy)
pain assessment
priority journal
rating scale
sex difference
CAS REGISTRY NUMBERS
fentanyl (437-38-7)
EMBASE CLASSIFICATIONS
Neurology and Neurosurgery (8)
Anesthesiology (24)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2006195694
MEDLINE PMID
16635698 (http://www.ncbi.nlm.nih.gov/pubmed/16635698)
PUI
L43621844
DOI
10.1016/j.ajem.2005.11.021
FULL TEXT LINK
http://dx.doi.org/10.1016/j.ajem.2005.11.021
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 814
TITLE
Clinical research and critical care transport: How to get started
AUTHOR NAMES
Thompson C.B.
Panacek E.A.
AUTHOR ADDRESSES
(Thompson C.B., cbthompson@unmc.edu; Panacek E.A.)
SOURCE
Air Medical Journal (2006) 25:3 (107-111). Date of Publication: May/June
2006
ISSN
1067-991X
1532-6497 (electronic)
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
clinical research
intensive care
EMTREE MEDICAL INDEX TERMS
article
clinical practice
clinical protocol
emergency care
evidence based practice
feasibility study
human
information processing
medical decision making
medical literature
newborn care
null hypothesis
patient transport
prediction
priority journal
publication
reliability
research ethics
statistical analysis
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2006204459
MEDLINE PMID
16679250 (http://www.ncbi.nlm.nih.gov/pubmed/16679250)
PUI
L43642211
DOI
10.1016/j.amj.2006.02.004
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2006.02.004
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 815
TITLE
Practicing neonatology in a blackout: the University Hospital NICU in the
midst of Hurricane Katrina: caring for children without power or water.
AUTHOR NAMES
Barkemeyer B.M.
AUTHOR ADDRESSES
(Barkemeyer B.M.) Division of Neonatology, Department of Pediatrics,
Louisiana State University Health Sciences Center, New Orleans, Louisiana,
USA.
CORRESPONDENCE ADDRESS
B.M. Barkemeyer, Division of Neonatology, Department of Pediatrics,
Louisiana State University Health Sciences Center, New Orleans, Louisiana,
USA. Email: bbarke@lsuhsc.edu
SOURCE
Pediatrics (2006) 117:5 Pt 3 (S369-374). Date of Publication: May 2006
ISSN
1098-4275 (electronic)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
disaster
neonatology
newborn intensive care
patient care
patient transport
EMTREE MEDICAL INDEX TERMS
article
emergency health service
high frequency ventilation
human
methodology
newborn
organization and management
power supply
telecommunication
United States
university hospital
water supply
LANGUAGE OF ARTICLE
English
MEDLINE PMID
16735267 (http://www.ncbi.nlm.nih.gov/pubmed/16735267)
PUI
L43809116
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 816
TITLE
Sweating it out in a level III regional NICU: disaster preparation and
lessons learned at the Ochsner Foundation Hospital.
AUTHOR NAMES
Ginsberg H.G.
AUTHOR ADDRESSES
(Ginsberg H.G.) Neonatal Intensive Care Unit, Alton Ochsner Foundation
Hospital, New Orleans, LA 70121, USA.
CORRESPONDENCE ADDRESS
H.G. Ginsberg, Neonatal Intensive Care Unit, Alton Ochsner Foundation
Hospital, New Orleans, LA 70121, USA. Email: hginsberg@ochsner.org
SOURCE
Pediatrics (2006) 117:5 Pt 3 (S375-380). Date of Publication: May 2006
ISSN
1098-4275 (electronic)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
disaster
newborn intensive care
patient care
patient transport
teaching hospital
EMTREE MEDICAL INDEX TERMS
article
disaster planning
emergency health service
human
methodology
neonatology
newborn
organization and management
power supply
telecommunication
United States
water supply
LANGUAGE OF ARTICLE
English
MEDLINE PMID
16735268 (http://www.ncbi.nlm.nih.gov/pubmed/16735268)
PUI
L43809117
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 817
TITLE
Critical care transport teams: searching for evidence of effectiveness
AUTHOR NAMES
McDonald A.C.
AUTHOR ADDRESSES
(McDonald A.C.) Division of Emergency Medicine, Department of Medicine,
University of Toronto, Toronto, Ont., Canada.
(McDonald A.C.) Department of Emergency Services, Sunnybrook Women's College
Health Sciences Centre, Toronto, Ont. M4N 3M5, Canada.
CORRESPONDENCE ADDRESS
A.C. McDonald, Division of Emergency Medicine, Department of Medicine,
University of Toronto, Toronto, Ont., Canada.
SOURCE
Journal of Critical Care (2006) 21:1 (17-18). Date of Publication: Mar 2006
ISSN
0883-9441
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
government
health care policy
health care quality
health service
human
intensive care unit
length of stay
mortality
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2006189942
PUI
L43606764
DOI
10.1016/j.jcrc.2005.12.009
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jcrc.2005.12.009
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 818
TITLE
National Consensus Conference. The rehabilitation management of traumatic
brain injury patients during the acute phase: Criteria for referral and
transfer from intensive care units to rehabilitative facilities (Modena June
20-21, 2000)
AUTHOR NAMES
Taricco M.
De Tanti A.
Boldrini P.
Gatta G.
AUTHOR ADDRESSES
(Taricco M., mataari@tin.it) Functional Recovery and Rehabilitation Unit,
Passirana di Rho (Milan), Italy.
(De Tanti A.) Cardinal Ferrari Centre, Fontanellato (Parma), Italy.
(Boldrini P.) Rehabilitation Unit, ULSS 9, Treviso, Italy.
(Gatta G.) Rehabilitative Medicine Unit, Civil Hospital, Ravenna, Italy.
(Taricco M., mataari@tin.it) U.O. Recupero e Rieducazione Funzionale,
Azienda Ospedaliera G. Salvini, Via Settembrini 1, 20020 Passirana di Rho,
Rho (Milano), Italy.
CORRESPONDENCE ADDRESS
M. Taricco, U.O. Recupero e Rieducazione Funzionale, Azienda Ospedaliera G.
Salvini, Via Settembrini 1, 20020 Passirana di Rho, Rho (Milano), Italy.
Email: mataari@tin.it
SOURCE
Europa Medicophysica (2006) 42:1 (73-84). Date of Publication: March 2006
ISSN
0014-2573
BOOK PUBLISHER
Edizioni Minerva Medica S.p.A., Corso Bramante 83-85, Turin, Italy.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
traumatic brain injury (rehabilitation)
EMTREE MEDICAL INDEX TERMS
conference paper
disease classification
human
intensive care unit
medical literature
medical research
EMBASE CLASSIFICATIONS
Neurology and Neurosurgery (8)
Public Health, Social Medicine and Epidemiology (17)
Rehabilitation and Physical Medicine (19)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2006223892
MEDLINE PMID
16565689 (http://www.ncbi.nlm.nih.gov/pubmed/16565689)
PUI
L43700254
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 819
TITLE
Pulmonary edema in meningococcal septicemia associated with reduced
epithelial chloride transport
AUTHOR NAMES
Eisenhut M.
Wallace H.
Barton P.
Gaillard E.
Newland P.
Diver M.
Southern K.W.
AUTHOR ADDRESSES
(Eisenhut M., michael_eisenhut@yahoo.com; Wallace H.; Gaillard E.; Southern
K.W.) Institute of Child Health, University of Liverpool, .
(Southern K.W.) Paediatric Respiratory Medicine, Institute of Child Health,
University of Liverpool, .
(Barton P.; Newland P.) Royal Liverpool Children's NHS Trust, Alder Hey
Hospital, .
(Diver M.) Clinical Biochemistry, Royal Liverpool University Hospital,
Liverpool, United Kingdom.
(Eisenhut M., michael_eisenhut@yahoo.com) 5 Prestwood Crescent, Liverpool
L14 2ED, United Kingdom.
CORRESPONDENCE ADDRESS
M. Eisenhut, 5 Prestwood Crescent, Liverpool L14 2ED, United Kingdom. Email:
michael_eisenhut@yahoo.com
SOURCE
Pediatric Critical Care Medicine (2006) 7:2 (119-124). Date of Publication:
March 2006
ISSN
1529-7535
BOOK PUBLISHER
Lippincott Williams and Wilkins, 530 Walnut Street, Philadelphia, United
States.
ABSTRACT
Objectives: To test the hypothesis that meningococcal septicemia-related
pulmonary edema is associated with a systemic abnormality of epithelial
sodium and chloride transport and to investigate an association with
hormones regulating Na(+) transport. Design: Prospective observational
study. Setting: The 24-bed pediatric intensive care unit and pediatric wards
of Royal Liverpool Children's Hospital. Patients: Consecutive children
admitted to the pediatric intensive care unit and pediatric wards with a
diagnosis of meningococcal septicemia and children (controls) with
noninfectious critical illness receiving ventilatory support in the
pediatric intensive care unit. Measurements and Main Results: We measured
sweat and saliva electrolytes, renal electrolyte excretion, nasal potential
difference, and aldosterone, thyroxine, and cortisol levels. Pulmonary edema
was diagnosed by chest radiography and its severity quantified by
calculation of ventilation index at admission and duration of mechanical
ventilation. We recruited 17 patients with severe meningococcal septicemia
(nine patients with pulmonary edema), 14 patients with mild meningococcal
septicemia, and 20 controls. Sweat andsaliva Na(+) and Cl(-) concentrations
and renal Na(+) excretion were significantly (p < .05) higher in patients
with pulmonary edema compared with controls. Nasal potential difference and
amiloride response in patients with pulmonary edema were not significantly
different to controls, but response to a low Cl(-) solution was reduced in
the nasal airway of patients with pulmonary edema (p < .05). Sweat and
saliva chloride concentrations correlated significantly and better with
ventilation index and duration of ventilation than sodium concentrations.
Aldosterone, thyroxine, and cortisol levels were not significantly different
between groups. Conclusions: We have confirmed that meningococcal
septicemia-related pulmonary edema is associated with reduced systemic
sodium and chloride transport. Features of reduced Cl (-) transport were
most closely associated with markers of respiratory compromise, and this was
supported by the reduced chloride channel function detected on nasal
potential difference measurement. Copyright © 2006 by the Society of
Critical Care Medicine and the World Federation of Pediatric Intensive and
Critical Care Societies.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
chloride (endogenous compound)
EMTREE DRUG INDEX TERMS
aldosterone (endogenous compound)
amiloride
electrolyte (endogenous compound)
hydrocortisone (endogenous compound)
sodium ion (endogenous compound)
thyroxine (endogenous compound)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
chloride transport
lung edema (diagnosis)
meningococcosis (etiology)
septicemia (etiology)
EMTREE MEDICAL INDEX TERMS
airway
artificial ventilation
clinical article
controlled study
critical illness
disease association
disease severity
female
hormonal regulation
hospital admission
human
intensive care unit
lung alveolus epithelium
male
potential difference
preschool child
priority journal
prospective study
quantitative analysis
review
saliva level
sodium transport
sweat
thorax radiography
treatment duration
urinary excretion
CAS REGISTRY NUMBERS
aldosterone (52-39-1, 6251-69-0)
amiloride (2016-88-8, 2609-46-3)
chloride (16887-00-6)
hydrocortisone (50-23-7)
sodium ion (17341-25-2)
thyroxine (7488-70-2)
EMBASE CLASSIFICATIONS
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
General Pathology and Pathological Anatomy (5)
Pediatrics and Pediatric Surgery (7)
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2006163505
MEDLINE PMID
16446600 (http://www.ncbi.nlm.nih.gov/pubmed/16446600)
PUI
L43506385
DOI
10.1097/01.PCC.0000200944.98424.E0
FULL TEXT LINK
http://dx.doi.org/10.1097/01.PCC.0000200944.98424.E0
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 820
TITLE
The nursing role in ICU outreach: an international exploratory study.
AUTHOR NAMES
Endacott R.
Chaboyer W.
AUTHOR ADDRESSES
(Endacott R.; Chaboyer W.) School of Nursing & Midwifery, La Trobe
University, Victoria 3086, Australia.
CORRESPONDENCE ADDRESS
R. Endacott, School of Nursing & Midwifery, La Trobe University, Victoria
3086, Australia. Email: ruth.endacott@plymouth.ac.uk
SOURCE
Nursing in critical care (2006) 11:2 (94-102). Date of Publication: 2006
Mar-Apr
ISSN
1362-1017
ABSTRACT
It is widely acknowledged that many critically ill patients are managed
outside of designated critical care units. One strategy adopted in Australia
and England to assess and manage risk in these patients is the intensive
care unit (ICU) outreach or liaison nurse service. This article examines how
ICU outreach/liaison roles in Australia and England operate in the context
of Manley's theoretical framework for advanced nursing practice. Descriptive
case study design using semi-structured interviews and job descriptions as
sources of evidence. Findings of interviews with six Australian ICU Liaison
nurses are already published; this study replicated the Australian study
with four ICU Consultant Nurses in England and mapped interview and job
description data from both countries onto Manley's conceptual framework for
advanced practice/consultant nurse. Four themes emerged from the English
data: patient interventions, support for ward staff, liaison between ward
and ICU staff and hospital-wide impact. The first three of these comprised
the core service common to the roles in both countries. Manley's four
subroles (expert practitioner, consultant, educator and researcher) were
present across both countries. However, the interview and job description
data demonstrated that there were lower expectations in Australia that the
roles would lead to staff development and build capacity across the hospital
system. Similarly, formal education for ward staff such as ALERT and CRiSP
courses were more developed in UK. Our data demonstrate that the role
undertaken in England and Australia is sufficiently comparable to use as a
research intervention in international studies across the two countries.
However, the macro service level differs. Job descriptions across both
countries emphasized the need to influence hospital policy; however, the ICU
consultant nurses in England might be considered better placed to achieve
this through role title and access to the hospital executive. In both
countries, the roles would benefit from systematic evaluation of the impact
on outcomes. This is particularly important for longer-term integration of
the role in the health services in both countries.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital subdivisions and components
intensive care unit
nurse
nurse attitude
patient transport
public relations
EMTREE MEDICAL INDEX TERMS
aftercare
article
attitude to health
Australia
comparative study
cultural factor
education
health personnel attitude
human
interpersonal communication
model
nursing methodology research
nursing staff
nursing theory
organization and management
psychological aspect
questionnaire
social support
United Kingdom
verbal communication
work
LANGUAGE OF ARTICLE
English
MEDLINE PMID
16555757 (http://www.ncbi.nlm.nih.gov/pubmed/16555757)
PUI
L43582522
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 821
TITLE
Interfacility transportation of the critical care patient and its medical
direction.
AUTHOR ADDRESSES
SOURCE
Annals of emergency medicine (2006) 47:3 (305). Date of Publication: Mar
2006
ISSN
1097-6760 (electronic)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
administrative personnel
editorial
human
organization and management
patient care
practice guideline
standard
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
16492517 (http://www.ncbi.nlm.nih.gov/pubmed/16492517)
PUI
L43464690
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 822
TITLE
The support of severe respiratory failure beyond the hospital and during
transportation
AUTHOR NAMES
Kashani K.B.
Farmer J.C.
AUTHOR ADDRESSES
(Kashani K.B.) Division of Nephrology, University of Southern California,
Los Angeles, CA, United States.
(Farmer J.C., farmer.j@mayo.edu) Department of Critical Care Medicine,
Program in Translational Immunovirology and Biodefense, Mayo Clinic,
Rochester, MN, United States.
CORRESPONDENCE ADDRESS
J.C. Farmer, Department of Critical Care Medicine, Program in Translational
Immunovirology and Biodefense, Mayo Clinic, Rochester, MN, United States.
Email: farmer.j@mayo.edu
SOURCE
Current Opinion in Critical Care (2006) 12:1 (43-49). Date of Publication:
February 2006
ISSN
1070-5295
1531-7072 (electronic)
BOOK PUBLISHER
Lippincott Williams and Wilkins, 530 Walnut Street, Philadelphia, United
States.
ABSTRACT
Purpose of review: Given the number and variety of calamities in the past
few years, providing support for critically ill and injured casualties has
become a global priority. This article reviews and describes the challenges
faced in providing critical care and respiratory support in an austere
environment and during medical transport. The primary focus to be discussed
is mechanical ventilation. Recent findings: The United States Air Force has
developed a programme called the Critical Care Aeromedical Transport Teams.
These teams provide dynamic and sophisticated critical care in austere
environments, including during medical transport. The Critical Care
Aeromedical Transport Teams programme provides a framework for the
discussion of supporting respiratory failure in these settings. We will
discuss the team concept of operations, the equipment assemblage, methods
and techniques of intensive care unit patient care in this setting, and
caveats and pitfalls as they pertain to respiratory failure, mechanical
ventilation, and respiratory monitoring. Summary: The support of respiratory
failure with mechanical ventilation during a disaster is complex and
challenging. The key to success is pre-planning, flexibility, and
portability. Programmes such as the Critical Care Aeromedical Transport
Teams can be a useful model for the development of appropriate civil
response capabilities in critical care for use during a disaster. © 2006
Lippincott Williams & Wilkins.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
artificial ventilation
respiratory failure (therapy)
EMTREE MEDICAL INDEX TERMS
air force
alarm monitor
assisted ventilation
disaster
education program
health care personnel
human
intensive care unit
positive end expiratory pressure
respiratory function
review
staff training
systematic review
United States
ventilator
EMBASE CLASSIFICATIONS
Internal Medicine (6)
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2006196105
MEDLINE PMID
16394783 (http://www.ncbi.nlm.nih.gov/pubmed/16394783)
PUI
L43623920
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 823
TITLE
Evacuation of trauma patients solely to Level 1 centers: Is the question
patient or trauma center survival?
AUTHOR NAMES
Spira R.M.
Reissman P.
Goldberg S.
Hersch M.
Einav S.
AUTHOR ADDRESSES
(Spira R.M., traumaszmc@yahoo.com; Reissman P.; Goldberg S.) Department of
General Surgery, Shaare Zedek Medical Center, P.O. Box 3235, Jerusalem
91031, Israel.
(Hersch M.; Einav S.) Intensive Care Unit, Shaare Zedek Medical Center, P.O.
Box 3235, Jerusalem 91031, Israel.
(Spira R.M., traumaszmc@yahoo.com; Reissman P.; Goldberg S.; Hersch M.;
Einav S.) Faculty of Health Sciences, Ben-Gurion University of the Negev,
Beer Sheva, Israel.
CORRESPONDENCE ADDRESS
R.M. Spira, Dept. of Surgery, Shaare Zedek Medical Center, P.O. Box 3235,
Jerusalem 91031, Israel. Email: traumaszmc@yahoo.com
SOURCE
Israel Medical Association Journal (2006) 8:2 (131-133). Date of
Publication: February 2006
ISSN
1565-1088
BOOK PUBLISHER
Israel Medical Association, 2 Twin Towers,11th Floor,35 Jabotinsky Street,PO
Box 3566, Ramat Gan, Israel.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
injury (surgery)
patient transport
EMTREE MEDICAL INDEX TERMS
accreditation
article
blood transfusion
blunt trauma (surgery)
disease severity
health care delivery
health care facility
health care system
hospital admission
hospital care
hospitalization
human
intensive care unit
length of stay
neurosurgery
patient care
penetrating trauma (surgery)
rehabilitation medicine
scoring system
surgeon
survival
treatment planning
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Forensic Science Abstracts (49)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2006093017
MEDLINE PMID
16544740 (http://www.ncbi.nlm.nih.gov/pubmed/16544740)
PUI
L43280134
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 824
TITLE
Evacuation to a trauma center or a non-trauma center? Is there any doubt?
AUTHOR NAMES
Stein M.
AUTHOR ADDRESSES
(Stein M., mshtein@clalit.org.il) Department of Surgery, Rabin Medical
Center, Trauma Services, Beilinson Campus, Petah Tiqva 49100, Israel.
(Stein M., mshtein@clalit.org.il) Sackler Faculty of Medicine, Tel Aviv
University, Ramat Aviv, Israel.
CORRESPONDENCE ADDRESS
M. Stein, Trauma Services, Dept. of Surgery, Rabin Medical Center, Beilinson
Campus, Petah Tiqva 49100, Israel. Email: mshtein@clalit.org.il
SOURCE
Israel Medical Association Journal (2006) 8:2 (134-136). Date of
Publication: February 2006
ISSN
1565-1088
BOOK PUBLISHER
Israel Medical Association, 2 Twin Towers,11th Floor,35 Jabotinsky Street,PO
Box 3566, Ramat Gan, Israel.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
injury (surgery)
patient transport
EMTREE MEDICAL INDEX TERMS
article
clinical protocol
emergency ward
health care facility
health care quality
hospital admission
hospital care
hospital management
human
intensive care unit
Israel
operating room
patient care
register
resuscitation
traumatology
victim
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Forensic Science Abstracts (49)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2006093018
MEDLINE PMID
16544741 (http://www.ncbi.nlm.nih.gov/pubmed/16544741)
PUI
L43280135
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 825
TITLE
Optimal equipment for medical transport of patients suffering cardiovascular
diseases
ORIGINAL (NON-ENGLISH) TITLE
Équipement optimal pour un transport médicalisé en pathologie
cardiovasculaire
AUTHOR NAMES
Sauval P.
An K.
AUTHOR ADDRESSES
(Sauval P., patrick.sauval@nck.ap-hop-paris.fr; An K.) SAMU de Paris, SMUR
Necker, 149 rue de Sèvres, 75015 Paris.
CORRESPONDENCE ADDRESS
P. Sauval, SAMU de Paris, SMUR Necker, 149 rue de Sèvres, 75015 Paris.
Email: patrick.sauval@nck.ap-hop-paris.fr
SOURCE
Medecine Therapeutique - Cardio (2006) 2:1 (131-136). Date of Publication:
Jan 2006
ISSN
1774-8747
ABSTRACT
The French Society of Anesthesia and Intensive Care (SFAR) as well as SAMU
de France have published recommendations for medical transportation.
National rules have been established to regulate medical transportation
standards. According to the guidelines, the medical personnel involved in
the transport shall include a MD, a nurse and an ambulance driver. The
recommended equipment to transfer patients with cardiovascular disease
should provide monitoring, treatment or help for the diagnosis. In France,
this type of transport is usually accomplished by SMUR. The equipment should
allow for cardiopulmonary resuscitation. Thus, congestive heart failure,
heart attack and pulmonary embolism frequently require means of artificial
ventilation. The equipment involved in cardiovascular intensive care should
improve diagnostic accuracy, monitoring and some emergency medical emergency
actions. Many technological improvements have been added to this basic
equipment such as biological analysis and in situ echocardiography. In the
very near future, clinical data obtained on site from the patient will
probably be directly transmitted to the receiving service in hospital, as
already happens with pre-hospital ECG. The shared medical records can be
consulted at the patient's bedside and the new data collected during
transportation (either texts or images) could be added. The optimal use of
equipment and the medical training of the personnel responsible for
transportation are an invaluable aid in the response to secure
cardiovascular emergencies, the primary cause of mortality and handicap.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
devices
patient transport
EMTREE MEDICAL INDEX TERMS
artificial ventilation
cardiovascular disease
congestive heart failure
diagnostic accuracy
echocardiography
emergency care
heart infarction
human
intensive care unit
lung embolism
medical device
medical education
medical personnel
medical record
patient monitoring
practice guideline
resuscitation
review
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Cardiovascular Diseases and Cardiovascular Surgery (18)
Anesthesiology (24)
Biophysics, Bioengineering and Medical Instrumentation (27)
LANGUAGE OF ARTICLE
French
LANGUAGE OF SUMMARY
English, French
EMBASE ACCESSION NUMBER
2006192881
PUI
L43616389
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 826
TITLE
Establishing a rural emergency medical retrieval service
AUTHOR NAMES
Whitelaw A.S.
Hsu R.
Corfield A.R.
Hearns S.
AUTHOR ADDRESSES
(Whitelaw A.S.; Hsu R.; Corfield A.R., alasdair.corfield@rah.scot.nhs.uk;
Hearns S.) Royal Alexandra Hospital, Corsebar Road, Paisley PA2 9PN, United
Kingdom.
CORRESPONDENCE ADDRESS
A.R. Corfield, Department of Emergency Medicine, Royal Alexandra Hospital,
Corsebar Road, Paisley PA2 9PN, United Kingdom. Email:
alasdair.corfield@rah.scot.nhs.uk
SOURCE
Emergency Medicine Journal (2006) 23:1 (76-78). Date of Publication: January
2006
ISSN
1472-0205
BOOK PUBLISHER
BMJ Publishing Group, Tavistock Square, London, United Kingdom.
ABSTRACT
In 2004 the Argyll and Clyde health board established the Emergency Medical
Retrieval Service to support its rural community hospitals. This article
describes both why the service was established and its aims. This service
covers a geographically extensive area, with approximately 85 000 people
living in remote locations. Rural general practitioners in six community
hospitals provide initial patient assessment and resuscitation. Providing
emergency care and safe transfer of seriously ill and injured patients
presenting to these community hospitals is a significant challenge. All
parties involved felt that there was a need to provide a service to
transport critically ill and injured patients from these remote locations to
definitive care. The idea of the team is to bring the resuscitation room to
the patient in the rural setting. With this aim and in order to implement
the Intensive Care Society guidelines for the transport of critically ill
patients, it was decided that consultants in Emergency Medicine and
Anaesthetics with an interest in critical care would staff the service
medically. This service is unique within the UK and the authors aim to
report our findings from ongoing research and audit in future papers.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
patient transport
rural area
EMTREE MEDICAL INDEX TERMS
article
general practitioner
health care delivery
intensive care unit
patient assessment
practice guideline
priority journal
resuscitation
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2006018725
MEDLINE PMID
16373814 (http://www.ncbi.nlm.nih.gov/pubmed/16373814)
PUI
L43056375
DOI
10.1136/emj.2005.025528
FULL TEXT LINK
http://dx.doi.org/10.1136/emj.2005.025528
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 827
TITLE
Transfer of the hematopoietic stem cell transplant patient to the intensive
care unit: Does it really matter?
AUTHOR NAMES
Naeem N.
Reed M.D.
Creger R.J.
Youngner S.J.
Lazarus H.M.
AUTHOR ADDRESSES
(Naeem N.; Creger R.J.; Lazarus H.M., hillard.lazarus@case.edu) Department
of Medicine, Division of Hematology-Oncology, 11100 Euclid Avenue,
Cleveland, OH 44106, United States.
(Reed M.D.) Department of Pediatrics, Division of Pediatric Pharmacology and
Critical Care, Cleveland, OH, United States.
(Youngner S.J.) Department of Psychiatry, University Hospitals of Cleveland,
Rainbow Babies and Childrens Hospital, 11100 Euclid Avenue, Cleveland, OH
44106, United States.
CORRESPONDENCE ADDRESS
H.M. Lazarus, Department of Medicine, University Hospitals of Cleveland,
11100 Euclid Avenue, Cleveland, OH 44106, United States. Email:
hillard.lazarus@case.edu
SOURCE
Bone Marrow Transplantation (2006) 37:2 (119-133). Date of Publication:
January 2006
ISSN
0268-3369
1476-5365 (electronic)
BOOK PUBLISHER
Nature Publishing Group, Houndmills, Basingstoke, Hampshire, United Kingdom.
ABSTRACT
We critically reviewed published English language literature and concluded
that from 1998 onward the survival of hematopoietic stem cell transplant
(SCT) patients who experienced intensive care unit (ICU) transfer has
improved. The factors associated with increased mortality during ICU stay
included increased patient age, allogeneic transplant, intubation/mechanical
ventilation, multiorgan system failure (MOSF), presumed/documented
infection, graft-versus-host disease, and higher APACHE and O-PRISM score at
ICU transfer. This encouraging outcome trend reflects evolving advances such
as use of recombinant hematopoietic growth factors, use of mobilized blood
cells rather than marrow, protective strategies for acute lung injury and
early goal-directed therapy for sepsis syndrome. Patient selection bias
(which patients were transferred and which were not sent to an ICU) also
plays a role in ICU survival rates. New strategies to improve upon SCT
patient outcome include use of a scoring system to predict mortality, better
therapies for MOSF and integration of ICU components and multispecialist
involvement earlier in the clinical course to prevent severe complications
such as respiratory failure. SCT recipients comprise a heterogeneous group;
to further advance this field, prospective multicenter trials involving
larger populations from many centers are needed to reduce the biases of
retrospective and single-center reports. © 2006 Nature Publishing Group. All
rights reserved.
EMTREE DRUG INDEX TERMS
recombinant growth factor
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
allogeneic hematopoietic stem cell transplantation
intensive care
patient care
EMTREE MEDICAL INDEX TERMS
acute lung injury (complication, prevention)
age
APACHE
artificial ventilation
blood cell
cell motility
disease course
disease severity
drug use
graft versus host reaction (complication, etiology)
human
infection (complication, etiology)
intensive care unit
medical literature
medical specialist
mortality
multiple organ failure (complication, etiology)
outcomes research
patient selection
prediction
priority journal
prospective study
retrospective study
review
scoring system
sepsis (complication)
survival rate
EMBASE CLASSIFICATIONS
Cancer (16)
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
Hematology (25)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2006037171
MEDLINE PMID
16273112 (http://www.ncbi.nlm.nih.gov/pubmed/16273112)
PUI
L43108803
DOI
10.1038/sj.bmt.1705222
FULL TEXT LINK
http://dx.doi.org/10.1038/sj.bmt.1705222
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 828
TITLE
Performance of the faces anxiety scale in patients transferred from the ICU
AUTHOR NAMES
Gustad L.T.
Chaboyer W.
Wallis M.
AUTHOR ADDRESSES
(Gustad L.T., lise.tuset.gustad@rikshospitalet.no) Rikshospitalet University
Hospital, Department of Anaesthesiology, Intensive Care Units, 0027 Oslo,
Norway.
(Chaboyer W.; Wallis M.) Griffith University, Research Centre for Clinical
Practice Innovation, Gold Coast Health Service District, PMB50, Gold Coast,
QLD 9726, Australia.
CORRESPONDENCE ADDRESS
L.T. Gustad, Rikshospitalet University Hospital, Department of
Anaesthesiology, Intensive Care Units, 0027 Oslo, Norway. Email:
lise.tuset.gustad@rikshospitalet.no
SOURCE
Intensive and Critical Care Nursing (2005) 21:6 (355-360). Date of
Publication: December 2005
ISSN
0964-3397
BOOK PUBLISHER
Churchill Livingstone
ABSTRACT
Intensive Care Unit (ICU) patients are often not able to respond to long
self-report instruments, therefore, in order to assess anxiety accurately, a
short and easy to use measure is required. The Faces Anxiety Scale (FAS)
developed by McKinley et al. [McKinley S, Coote K, Stein-Parbury J.
Development and testing of a faces scale for the assessment of anxiety in
critically ill patients. J Adv Nurs 2003;41(1):73-9.] has promised to be
such an instrument. This study assessed the construct validity of the FAS
against the well validated anxiety subscale of the Hospital Anxiety and
Depression Scale (HADS), in an ICU population ready for transfer to the
ward. The study was a part of a larger study of transfer anxiety. The FAS
showed good correlation with the anxiety sub-scale of the HADS which
strengthened over time. The FAS was easy and quick to use and seemed to
measure anxiety in ICU patients that were ready to move to the wards,
however, further testing in a larger sample and with sicker ICU patients is
required. © 2005 Elsevier Ltd. All rights reserved.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
anxiety (diagnosis, etiology)
critical illness
facial expression
patient transport
psychological rating scale
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
article
Australia
classification
comparative study
female
hospitalization
human
longitudinal study
male
methodology
middle aged
nonparametric test
nursing assessment
nursing evaluation research
psychological aspect
psychometry
questionnaire
standard
teaching hospital
validation study
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
16102967 (http://www.ncbi.nlm.nih.gov/pubmed/16102967)
PUI
L41723000
DOI
10.1016/j.iccn.2005.06.006
FULL TEXT LINK
http://dx.doi.org/10.1016/j.iccn.2005.06.006
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 829
TITLE
Airway surface liquid and mucociliary transport. Can general anaesthesia
affect their function?
ORIGINAL (NON-ENGLISH) TITLE
Płynna wyściółka dróg oddechowych i transport śluzowo-rzeskowy. Czy
znieczulenie ogólne moze wpływać na ich funkcje?
AUTHOR NAMES
Smuszkiewicz P.
Tyrakowski T.
Drobnik L.
AUTHOR ADDRESSES
(Smuszkiewicz P.; Drobnik L.) Klinika Anestezjologii, Intensywnej Terapii i
Leczenia Bólu AM, ul. Przybyszewskiego 49, 60-355 Poznań, Poland.
(Tyrakowski T.) Zakład Patobiochemii i Chemii Klinicznej CM, Uniwersytetu
im. M. Kopernika, Bydgoszczy, Poland.
CORRESPONDENCE ADDRESS
P. Smuszkiewicz, Klinika Anestezjologii, Intensywnej Terapii i Leczenia Bólu
AM, ul. Przybyszewskiego 49, 60-355 Poznań, Poland.
SOURCE
Anestezjologia Intensywna Terapia (2005) 37:3 (200-206). Date of
Publication: 2005
ISSN
0209-1712
ABSTRACT
Mucus clearance is an important component of the lung's innate defence
against disease, and the ability of the airways to clear mucus is strongly
dependent on the volume of liquid on airway surfaces. Airway epithelium
regulates ion concentration, volume and electric potential of the airways'
surface liquid. Mucus hydration is determined by the volume of liquid
present on airway surfaces, which in turn may be modified by active ion
transport. The latter can be markedly compromised by various anaesthesia
activities, such as decreased temperature and humidity of inspired gases and
mechanical ventilation. Halothane, enflurane and isoflurane impair ciliary
beat frequency and mucus transport by depressing chloride epithetial ion
transport. Propofol increases calcium ion concentration, therefore
preserving ciliary transport and mucus clearance and should be recommended
for longer sedation in intensive care settings. Mechanical ventilation with
large tidal volumes and high oxygen concentration leads to decreased fluid
clearance in the lung, increases permeability for small particles and
impairs Na-K-ATPase activity. In conclusion, general anaesthesia and
mechanical ventilation impair the airway surface liquid function, and can
contribute to the development of respiratory complications in the
perioperative period.
EMTREE DRUG INDEX TERMS
adenosine triphosphatase (potassium sodium) (endogenous compound)
calcium ion (endogenous compound)
enflurane
halothane
isoflurane
oxygen
propofol
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
general anesthesia
mucociliary transport
EMTREE MEDICAL INDEX TERMS
artificial ventilation
concentration (parameters)
enzyme activity
human
humidity
intensive care unit
ion transport
mucociliary clearance
mucus secretion
postoperative period
respiratory epithelium
respiratory function
respiratory tract disease (complication)
review
sedation
CAS REGISTRY NUMBERS
calcium ion (14127-61-8)
enflurane (13838-16-9)
halothane (151-67-7, 66524-48-9)
isoflurane (26675-46-7)
oxygen (7782-44-7)
propofol (2078-54-8)
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Anesthesiology (24)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
Polish
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2006093106
PUI
L43280223
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 830
TITLE
Does intermediate care minimize relocation stress for patients leaving the
ICU?
AUTHOR NAMES
Beard H.
AUTHOR ADDRESSES
(Beard H.) High Dependency Unit, West Suffolk Hospital NHS Trust, Hardwick
Lane, Bury St Edmunds, Suffolk.
CORRESPONDENCE ADDRESS
H. Beard, High Dependency Unit, West Suffolk Hospital NHS Trust, Hardwick
Lane, Bury St Edmunds, Suffolk. Email: helen.beard@wsh.nhs.uk
SOURCE
Nursing in critical care (2005) 10:6 (272-278). Date of Publication: 2005
Nov-Dec
ISSN
1362-1017
ABSTRACT
Relocation stress is a phenomenon in which physical and psychological
disturbances are experienced following transfer from one environment to
another [Carpenito LJ. (2000). Nursing Diagnosis. Application to Clinical
Practice, 8th edn]. The purpose of this review was to identify whether a
period of intermediate care minimizes the problems associated with
relocation stress after discharge from the intensive care unit (ICU) and
before transfer to the ward. Methods of retrieving the literature involved
identifying key terms, utilizing a range of databases and applying specific
criteria in order to delineate the boundaries of the search. Using
electronic and manual search methods, 11 studies were selected, both primary
and secondary research. Following tabulation and critiquing of the studies,
the findings of the review suggest that the factors which contribute towards
relocation stress are the loss of one-to-one nursing, a reduction of visible
monitoring equipment, lack of continuity of care and inadequate preparation
of the patient for the transfer. The evidence also indicates that in order
to minimize these factors, early planning and preparation of the patient for
transfer are required, incorporating strategies of gradual reduction in
nursing attention and monitoring equipment and the provision of information.
Although the benefits of intermediate care are established as being advanced
monitoring, appropriate nurse-to-patient ratio, heightened demonstration of
expert knowledge and skill, there is no sufficient evidence to indicate a
period of intermediate care that can ease the transition from the ICU to the
ward.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
mental stress (etiology, prevention)
patient transport
EMTREE MEDICAL INDEX TERMS
adaptive behavior
attitude to health
control
fear
health personnel attitude
health service
human
monitoring
nurse attitude
nursing
nursing research
nursing staff
organization and management
patient care
patient care planning
patient education
progressive patient care
psychological aspect
review
risk factor
workload
LANGUAGE OF ARTICLE
English
MEDLINE PMID
16255334 (http://www.ncbi.nlm.nih.gov/pubmed/16255334)
PUI
L41849611
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 831
TITLE
Risk factors of respiratory function deterioration after intrahospital
transport in critically ill patients [2]
ORIGINAL (NON-ENGLISH) TITLE
Facteurs de risque d'aggravation respiratoire des patients de réanimation
ventilés lors des transports intrahospitaliers
AUTHOR NAMES
Mohammedi I.
Belkhouja K.
Robert D.
AUTHOR ADDRESSES
(Mohammedi I., ismael.mohammedi@chu-lyon.fr; Belkhouja K.; Robert D.)
Service de Réanimation, Pavillon N, Hôpital Edouard-Herriot, Place
d'Arsonval, 69003 Lyon, France.
CORRESPONDENCE ADDRESS
I. Mohammedi, Service de Réanimation, Pavillon N, Hôpital Edouard-Herriot,
Place d'Arsonval, 69003 Lyon, France. Email: ismael.mohammedi@chu-lyon.fr
SOURCE
Annales Francaises d'Anesthesie et de Reanimation (2005) 24:10 (1314-1315).
Date of Publication: October 2005
ISSN
0750-7658
BOOK PUBLISHER
Elsevier Masson SAS, 62 rue Camille Desmoulins, Issy les Moulineaux Cedex,
France.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient transport
respiratory function
EMTREE MEDICAL INDEX TERMS
artificial ventilation
critical illness
hemodynamics
hospitalization
human
letter
prospective study
resuscitation
risk factor
sedation
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
French
EMBASE ACCESSION NUMBER
2005467569
MEDLINE PMID
16019184 (http://www.ncbi.nlm.nih.gov/pubmed/16019184)
PUI
L41463423
DOI
10.1016/j.annfar.2005.05.015
FULL TEXT LINK
http://dx.doi.org/10.1016/j.annfar.2005.05.015
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 832
TITLE
Widespread transfer of resistance genes between bacterial species in an
intensive care unit: Implications for hospital epidemiology
AUTHOR NAMES
Al Naiemi N.
Duim B.
Savelkoul P.H.M.
Spanjaard L.
De Jonge E.
Bart A.
Vandenbroucke-Grauls C.M.
De Jong M.D.
AUTHOR ADDRESSES
(Al Naiemi N.; Duim B., b.duim@amc.uva.nl; Spanjaard L.; Bart A.;
Vandenbroucke-Grauls C.M.; De Jong M.D.) Academic Medical Center, Department
of Medical Microbiology, Amsterdam, Netherlands.
(De Jonge E.) Academic Medical Center, Department of Intensive Care,
Amsterdam, Netherlands.
(Savelkoul P.H.M.; Vandenbroucke-Grauls C.M.) VU University Medical Center,
Medical Microbiology and Infection Control, Amsterdam, Netherlands.
(Duim B., b.duim@amc.uva.nl) Academic Medical Center, Dept. of Medical
Microbiology, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands.
(De Jong M.D.) Oxford University Clinical Research Unit, Hospital for
Tropical Diseases, Ho Chi Minh City, Viet Nam.
CORRESPONDENCE ADDRESS
B. Duim, Academic Medical Center, Dept. of Medical Microbiology,
Meibergdreef 9, 1105 AZ Amsterdam, Netherlands. Email: b.duim@amc.uva.nl
SOURCE
Journal of Clinical Microbiology (2005) 43:9 (4862-4864). Date of
Publication: September 2005
ISSN
0095-1137
BOOK PUBLISHER
American Society for Microbiology, 1752 N Street N.W., Washington, United
States.
ABSTRACT
A transferable plasmid encoding SHV-12 extended-spectrum β-lactamase,
TEM-116, and aminoglycoside resistance was responsible for two sequential
clonal outbreaks of Enterobacter cloacae and Acinetobacter baumannii
bacteria. A similar plasmid was present among isolates of four different
bacterial species. Recognition of plasmid transfer is crucial for control of
outbreaks of multidrug-resistant nosocomial pathogens. Copyright © 2005,
American Society for Microbiology. All Rights Reserved.
EMTREE DRUG INDEX TERMS
aminoglycoside (endogenous compound)
beta lactamase (endogenous compound)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
antibiotic resistance
intensive care unit
EMTREE MEDICAL INDEX TERMS
Acinetobacter baumannii
article
bacterial strain
Enterobacter cloacae
epidemic
gene
gene transfer
genetic resistance
hospital infection
human
multidrug resistance
nonhuman
nucleotide sequence
plasmid
priority journal
SHV 12 gene
SHV 2 gene
TEM 1 gene
TEM 116 gene
CAS REGISTRY NUMBERS
beta lactamase (9073-60-3)
MOLECULAR SEQUENCE NUMBERS
GENBANK (AF550415, AY422214)
EMBASE CLASSIFICATIONS
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2005415412
MEDLINE PMID
16145160 (http://www.ncbi.nlm.nih.gov/pubmed/16145160)
PUI
L41298296
DOI
10.1128/JCM.43.9.4862-4864.2005
FULL TEXT LINK
http://dx.doi.org/10.1128/JCM.43.9.4862-4864.2005
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 833
TITLE
Transfer of head-injured patients in Jamaica: Is there a problem?
AUTHOR NAMES
Crandon I.W.
Harding H.
McDonald A.H.
Bruce C.A.R.
Fearon-Boothe D.
Rhoden A.
Meeks-Aitken N.
AUTHOR ADDRESSES
(Crandon I.W., ivor.crandon@uwimona.edu.jm; Harding H.; McDonald A.H.; Bruce
C.A.R.; Fearon-Boothe D.; Rhoden A.; Meeks-Aitken N.) Department of Surgery,
Radiology, Anaesthesia and Intensive Care, Faculty of Medical Sciences, The
University of the West Indies, Kingston 7, Jamaica.
CORRESPONDENCE ADDRESS
I.W. Crandon, Department of Surgery, Radiology, Anaesthesia and Intensive
Care, Faculty of Medical Sciences, The University of the West Indies,
Kingston 7, Jamaica. Email: ivor.crandon@uwimona.edu.jm
SOURCE
West Indian Medical Journal (2005) 54:4 (220-224). Date of Publication:
September 2005
ISSN
0043-3144
BOOK PUBLISHER
University of the West Indies, Mona, Kingston 7, Jamaica.
ABSTRACT
Head-injured patients are often transferred to the University Hospital of
the West Indies (UHWI) for tertiary care. There is no standardized, agreed
protocol governing their transfer. During the three-year period January 1998
to December 2000, 144 head injured patients were transferred to the UHWI
from other institutions. They were 70% male, had a mean age of 34 years and
spent a mean of 13 days in hospital. Eighteen per cent were admitted to the
Intensive Care Unit, where they spent a mean of nine days. On arrival, mean
pulse rate was 92 ± 22 beats/minute, mean systolic blood pressure was 130 ±
27 mmHg and mean diastolic was 76 ± 19mmHg. Twenty-eight per cent of
patients had a pulse rate above 100/min on arrival and 13.8% had systolic
blood pressure below 60 mmHg. The Glasgow Coma Scale score was unrecorded at
the referring institution in 70% of cases and by the receiving officers at
the UHWI in 23% of cases. Intubation was done on only half of those who were
eligible. Junior staff members initiated and carried out transfers whenever
this was documented. The types of vehicles and monitoring equipment used
could not be determined in most instances. Fifty-eight percent of patients
had minor head injuries, 12%, severe injury and 33%, associated injuries
requiring a variety of surgical procedures by multiple specialties. Most
patients (80.6%) were discharged home but 11.8% died in hospital. Transfer
of head-injured patients, many with multiple injuries is not being performed
in a manner consistent with modern medical practice. There is urgent need
for implementation of a standardized protocol for the transfer of such
patients in Jamaica.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
head injury
patient transport
EMTREE MEDICAL INDEX TERMS
adolescent
adult
article
blood pressure measurement
child
clinical protocol
female
Glasgow coma scale
health care policy
hospital discharge
hospitalization
human
institutional care
intensive care unit
intubation
Jamaica
length of stay
major clinical study
male
mortality
pulse rate
standardization
EMBASE CLASSIFICATIONS
Neurology and Neurosurgery (8)
Public Health, Social Medicine and Epidemiology (17)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English, Spanish
EMBASE ACCESSION NUMBER
2005544934
MEDLINE PMID
16312186 (http://www.ncbi.nlm.nih.gov/pubmed/16312186)
PUI
L41715657
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 834
TITLE
Aeromedical evacuation and critical patient care
ORIGINAL (NON-ENGLISH) TITLE
Havadan tibbi tahliye ve kritik hasta bakimi
AUTHOR NAMES
Türkan H.
Yilmaz S.
Şener S.
AUTHOR ADDRESSES
(Türkan H.; Yilmaz S.; Şener S.) GATA Acil, Tip Anabilim Dali, Ankara,
Turkey.
(Türkan H.; Yilmaz S.; Şener S.) Gülhane Military, Medical Faculty,
Department of Emergency Care, Ankara, Turkey.
CORRESPONDENCE ADDRESS
H. Türkan, Gülhane Military, Medical Faculty, Department of Emergency Care,
Ankara, Turkey.
SOURCE
SENDROM (2005) 17:9 (47-57). Date of Publication: Sep 2005
ISSN
1016-5134
ABSTRACT
Medical evacuation, especially aeromedical evacuation (AME) is arranged for
safety and immediate transportation of injured or critically ill patient
whose minutes and hours are seriously important. Although AME is easiness
and significant time is gained by flight health crew and the patient, flight
surgeons have to come to an agreement that disadvantages of AME should not
exceed the advantages. Flight stressors (eg. vibration), physiological and
pathological changes caused by altitude on patient should be taken into
consideration and it should not to be forgotten to control the airway and to
stabilize the hemodynamic parameters before the aircraft taken off.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
patient transport
EMTREE MEDICAL INDEX TERMS
aircraft
altitude
aviation
hemodynamics
high risk patient
human
injury
patient care
review
safety
vibration
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
Turkish
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2005490279
PUI
L41545963
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 835
TITLE
Intra-unit patient transports: Time, motion, and cost impact on hospital
efficiency
AUTHOR NAMES
Hendrich A.L.
Lee N.
AUTHOR ADDRESSES
(Hendrich A.L.) Clinical Excellence Operations, Ascension Health, St. Louis,
MO, United States.
(Lee N.) Rapid Modeling Corporation, Cincinnati, OH, United States.
CORRESPONDENCE ADDRESS
A.L. Hendrich, Clinical Excellence Operations, Ascension Health, St. Louis,
MO, United States.
SOURCE
Nursing Economics (2005) 23:4 (157-164). Date of Publication: July/August
2005
ISSN
0746-1739
BOOK PUBLISHER
Anthony J. Jannetti Inc.
ABSTRACT
▶ This study of intra-hospital patient transfer analyzes the process, time,
personnel, and cost of the transport procedure. ▶ Opportunities exist to
increase the efficiency of the execution of this discrete process as well as
gain overall system efficiency in terms of bed utilization and management. ▶
The study revealed only 12% effi ciency in the transfer process. ▶ Delays
due to administrative requirements, unavailable resources, disruptions, and
communication breakdown were cited as causes of the low productivity in the
current process. ▶ Careful consideration for the three primary reasons for
transfer - need for additional technology, need for higher skilled staff,
and need for higher hours per patient day - offer the opportunity to rethink
the drivers of transfer through technology planning, staff training, and
staffing flexibility.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital management
hospital personnel
patient transport
EMTREE MEDICAL INDEX TERMS
article
clinical competence
communication disorder
documentation
education
health care cost
hospital bed capacity
hospital bed utilization
human
information processing
medical record
nonbiological model
nursing administration research
organization and management
patient care
personnel management
psychological aspect
risk assessment
standard
system analysis
task performance
total quality management
treatment outcome
workload
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
16189980 (http://www.ncbi.nlm.nih.gov/pubmed/16189980)
PUI
L41555734
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 836
TITLE
Intrahospital transport of a patient with acute exacerbation of chronic
obstructive pulmonary disease under noninvasive ventilation [1]
AUTHOR NAMES
Kluge S.
Baumann H.J.
Kreymann G.
AUTHOR ADDRESSES
(Kluge S., skluge@uke.uni-hamburg.de; Baumann H.J.; Kreymann G.) Department
of Medicine, University Hospital Eppendorf, Martinistrasse 52, 20246
Hamburg, Germany.
CORRESPONDENCE ADDRESS
S. Kluge, Department of Medicine, University Hospital Eppendorf,
Martinistrasse 52, 20246 Hamburg, Germany. Email: skluge@uke.uni-hamburg.de
SOURCE
Intensive Care Medicine (2005) 31:6 (886). Date of Publication: June 2005
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag, Tiergartenstrasse 17, Heidelberg, Germany.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
chronic obstructive lung disease
lung ventilation
patient transport
EMTREE MEDICAL INDEX TERMS
acute respiratory failure
airway pressure
blood gas analysis
clinical feature
disease exacerbation
electrocardiography monitoring
endotracheal intubation
face mask
heart catheterization
heart ventriculography
human
intensive care unit
length of stay
letter
non invasive measurement
oxygen saturation
patient monitoring
pH measurement
positive end expiratory pressure
respiratory acidosis
ST segment depression
ventilator
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2005290995
MEDLINE PMID
15834706 (http://www.ncbi.nlm.nih.gov/pubmed/15834706)
PUI
L40897549
DOI
10.1007/s00134-005-2626-0
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-005-2626-0
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 837
TITLE
The Zwolle global experience on primary percutaneous coronary intervention.
AUTHOR NAMES
De Luca G.
Suryapranata H.
de Boer M.J.
AUTHOR ADDRESSES
(De Luca G.; Suryapranata H.; de Boer M.J.) Department of Cardiology, Isala
Klinieken, De Weezenlanden Hospital, Zwolle, The Netherlands.
CORRESPONDENCE ADDRESS
G. De Luca, Department of Cardiology, Isala Klinieken, De Weezenlanden
Hospital, Zwolle, The Netherlands. Email: g.deluca@diagram-zwolle.nl
SOURCE
Italian heart journal : official journal of the Italian Federation of
Cardiology (2005) 6:6 (453-458). Date of Publication: Jun 2005
ISSN
1129-471X
ABSTRACT
Timely restoration of antegrade blood flow in the infarct-related artery of
patients with ST-segment elevation myocardial infarction (STEMI) results in
myocardial salvage and improved survival. We describe the Zwolle approach
with regard to prehospital phase, the first 15 min in hospital, initial
pharmacological therapy, angiography, angioplasty, risk stratification,
rehabilitation and secondary prevention. Confirmation of the diagnosis by
12-lead electrocardiography by either general practitioners or ambulance
paramedics allows substantial reduction in the time-delay to first balloon
inflation, as the hospital and the catheterization laboratory can be
prepared in advance, and the emergency room and the coronary care unit with
their unavoidable delays can be skipped on the way to acute angiography. In
our setting all patients with STEMI are treated at the time of diagnosis
(before or during transportation) with heparin (5000 IU) and aspirin (500
mg) intravenously, with additional oral bolus (300 mg) of clopidogrel and
additional 5000 IU heparin at the time of angiography. Our attitude is that
an optimal balloon angioplasty result should never be jeopardized just for
somewhat lower rate of target vessel revascularization during the first year
after the acute event. In particular, attention should be paid to side
branches, which may be of more clinical relevance in this setting than with
elective angioplasty. Additional mechanical devices, such as distal
protection devices and/or thrombosuction, should be mostly used when
relevant thrombotic material is visible, with concomitant higher risk of
distal embolization, particularly in high-risk patients. Finally, the use of
the Zwolle risk score may help to identify low-risk patients who could be
safely discharged within 36-48 hours after primary angioplasty, with a
significant reduction in the costs of hospitalization.
EMTREE DRUG INDEX TERMS
fibrinolytic agent (drug therapy)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
fibrinolytic therapy
heart infarction (therapy)
patient transport
transluminal coronary angioplasty
EMTREE MEDICAL INDEX TERMS
angiocardiography
coronary care unit
electrocardiography
human
methodology
pathophysiology
radiography
review
risk assessment
standard
time
LANGUAGE OF ARTICLE
English
MEDLINE PMID
16008149 (http://www.ncbi.nlm.nih.gov/pubmed/16008149)
PUI
L41467212
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 838
TITLE
Transitional care after the intensive care unit: current trends and future
directions.
AUTHOR NAMES
Chaboyer W.
James H.
Kendall M.
AUTHOR ADDRESSES
(Chaboyer W.; James H.; Kendall M.) Research Centre for Clinical Practice
Innovation, Griffith University, Gold Coast, Australia.
CORRESPONDENCE ADDRESS
W. Chaboyer, Research Centre for Clinical Practice Innovation, Griffith
University, Gold Coast, Australia.
SOURCE
Critical care nurse (2005) 25:3 (16-18, 20-22, 24-26 passim; quiz 29). Date
of Publication: Jun 2005
ISSN
0279-5442
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
progressive patient care
EMTREE MEDICAL INDEX TERMS
ambulatory care
Australia
forecasting
hospital discharge
human
model
needs assessment
nurse
nurse attitude
nursing theory
organization and management
patient care
psychological aspect
review
United Kingdom
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
15946925 (http://www.ncbi.nlm.nih.gov/pubmed/15946925)
PUI
L41181031
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 839
TITLE
Development and implementation of a protocol for transfers out of the
pediatric intensive care unit.
AUTHOR NAMES
Van Waning N.R.
Kleiber C.
Freyenberger B.
AUTHOR ADDRESSES
(Van Waning N.R.; Kleiber C.; Freyenberger B.) University of Iowa Hospital
and Clinics, Iowa City, Iowa, USA.
CORRESPONDENCE ADDRESS
N.R. Van Waning, University of Iowa Hospital and Clinics, Iowa City, Iowa,
USA.
SOURCE
Critical care nurse (2005) 25:3 (50-55). Date of Publication: Jun 2005
ISSN
0279-5442
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
clinical protocol
intensive care
patient transport
pediatric nursing
EMTREE MEDICAL INDEX TERMS
article
attitude to health
child
child hospitalization
evaluation study
evidence based medicine
family
health care quality
human
interpersonal communication
needs assessment
nurse attitude
nurse patient relationship
nursing
nursing evaluation research
nursing methodology research
organization and management
patient education
psychological aspect
questionnaire
standard
teaching
LANGUAGE OF ARTICLE
English
MEDLINE PMID
15946928 (http://www.ncbi.nlm.nih.gov/pubmed/15946928)
PUI
L41181034
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 840
TITLE
"Two way transport" of neonates to the Pediatric Intensive Care Unit of the
University Hospital Split
ORIGINAL (NON-ENGLISH) TITLE
Prijevoz novorocrossed d signenčadi "k sebi" jedinice Intenzivnog Liječenja
djece Kliničke Bolnice Split
AUTHOR NAMES
Meštrović J.
Polić B.
Radonić M.
Stričević L.
Omazić A.
Baraka K.
Markić J.
Stipančević H.
Krželj V.
Balarin L.
AUTHOR ADDRESSES
(Meštrović J., julije.mestrovic@st.htnet.hr; Polić B.; Stričević L.; Omazić
A.) Jedinica Intenzivnog Lijecenja Djece, Klinika za Dječje Bolesti,
Klinička Bolnica Split, Split, Croatia.
(Radonić M.) Odjel za Pedijatriju, Opća Bolnica Dubrovnik, Croatia.
(Baraka K.) Odjel za Neonatologiju, Opća Bolnica Zadar, Croatia.
(Markić J.; Krželj V.; Balarin L.) Klinika za Dječje Bolesti, Klinička
Bonica Split, Split, Croatia.
(Stipančević H.) Institut Pomorske Medicine, HRM, Split, Croatia.
(Meštrović J., julije.mestrovic@st.htnet.hr) Jedinica Intenzivog Lijecenja
Djece, Klinika za Dječje Bolesti, KB Split, Spinčićeva 1, 21000 Split,
Croatia.
CORRESPONDENCE ADDRESS
J. Meštrović, Jedinica Intenzivog Lijecenja Djece, Klinika za Dječje
Bolesti, KB Split, Spinčićeva 1, 21000 Split, Croatia. Email:
julije.mestrovic@st.htnet.hr
SOURCE
Paediatria Croatica (2005) 49:1 (25-29). Date of Publication: 2005
ISSN
1330-1403
BOOK PUBLISHER
Children's Hospital Zagreb, Klaiceva 16, Zagreb, Croatia.
ABSTRACT
The best way to transport seriously ill neonates is by "two way transport".
It means that the transport team from the referring hospital comes for the
child to take over ongoing care. The treatment begins immediately, in the
community hospital where the child was born, and the transport is arranged
when the best possible conditions are achieved. We present the "two way
transport" that links the Pediatric intensive care unit of the University
hospital Split and the Air Force Base Divulje in Kaštela with Departments of
Neonatology of General Hospital Dubrovnik and General Hospital Zadar. Over
an eighteen months period, from February 2003, to August 2004, we
transported fourteen neonates to the Pediatric Intensive Care Unit of the
University Hospital Split. According to calculations of the Neonatal
Therapeutic Intervention Scoring System (NTISS), estimated seriousness of
their conditions was extremely high and life threatening. The clinical
condition of the neonates remained without deterioration by the end of
transport. Our system contributes to establishing and shaping "two way
transport" in Croatia.
EMTREE DRUG INDEX TERMS
albumin
antibiotic agent
atropine
diazepam
dobutamine
dopamine
epinephrine
fentanyl
furosemide
gluconate calcium
glucose
heparin
naloxone
phenobarbital (intravenous drug administration)
prostaglandin E1
sodium chloride
surfactant
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
university hospital
EMTREE MEDICAL INDEX TERMS
article
calculation
childbirth
clinical article
community hospital
Croatia
disease severity
female
human
male
Neonatal Therapeutic Intervention Scoring System
newborn
patient care
practice guideline
scoring system
CAS REGISTRY NUMBERS
adrenalin (51-43-4, 55-31-2, 6912-68-1)
atropine (51-55-8, 55-48-1)
diazepam (439-14-5)
dobutamine (34368-04-2, 52663-81-7)
dopamine (51-61-6, 62-31-7)
fentanyl (437-38-7)
furosemide (54-31-9)
gluconate calcium (299-28-5)
glucose (50-99-7, 84778-64-3)
heparin (37187-54-5, 8057-48-5, 8065-01-8, 9005-48-5)
naloxone (357-08-4, 465-65-6)
phenobarbital (50-06-6, 57-30-7, 8028-68-0)
prostaglandin E1 (745-65-3)
sodium chloride (7647-14-5)
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
unknown
LANGUAGE OF SUMMARY
English, unknown
EMBASE ACCESSION NUMBER
2005197969
PUI
L40592840
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 841
TITLE
Tsunami disaster and infection: Beware what pathogens the transport delivers
to your intensive care unit!
AUTHOR NAMES
Masur H.
Murray P.
AUTHOR ADDRESSES
(Masur H.) Critical Care Medicine, National Institutes of Health, Bethesda,
MD, United States.
(Murray P.) Clinical Pathology, National Institutes of Health, Bethesda, MD,
United States.
CORRESPONDENCE ADDRESS
H. Masur, Critical Care Medicine, National Institutes of Health, Bethesda,
MD, United States.
SOURCE
Critical Care Medicine (2005) 33:5 (1179-1180). Date of Publication: May
2005
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
EMTREE DRUG INDEX TERMS
sea water
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
disaster
intensive care unit
tsunami
EMTREE MEDICAL INDEX TERMS
Aeromonas
chickenpox (epidemiology)
diarrhea (etiology)
editorial
endemic disease (epidemiology)
enteric virus
Gram negative bacterium
health care facility
human
influenza (epidemiology)
Legionella
measles (epidemiology)
Mycobacterium marinum
nonhuman
priority journal
Pseudomonas
Salmonella
Vibrio
water contamination
wound infection
EMBASE CLASSIFICATIONS
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
Environmental Health and Pollution Control (46)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2005212221
MEDLINE PMID
15891375 (http://www.ncbi.nlm.nih.gov/pubmed/15891375)
PUI
L40638218
DOI
10.1097/01.CCM.0000163271.78189.0F
FULL TEXT LINK
http://dx.doi.org/10.1097/01.CCM.0000163271.78189.0F
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 842
TITLE
Geisinger checklist speeds transfer of heart attack patients.
AUTHOR ADDRESSES
SOURCE
Performance improvement advisor (2005) 9:4 (40-42, 37). Date of Publication:
Apr 2005
ISSN
1543-6160
ABSTRACT
In cardiology, there is a saying that "time is muscle." The longer it takes
to reopen a heart attack patient's blocked artery, the more damage is done
to the heart muscle. Cardiologists and emergency department physicians at
Geisinger Medical Center are working together to shorten the time that it
takes for patients to receive angioplasty, thus saving more heart muscle.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
angioplasty
coronary care unit
heart infarction (therapy)
patient transport
EMTREE MEDICAL INDEX TERMS
article
human
organization and management
time
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
15945291 (http://www.ncbi.nlm.nih.gov/pubmed/15945291)
PUI
L40889538
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 843
TITLE
Adverse effect on a referral intensive care unit's performance of accepting
patients transferred from another intensive care unit
AUTHOR NAMES
Combes A.
Luyt C.-E.
Trouillet J.-L.
Chastre J.
Gibert C.
AUTHOR ADDRESSES
(Combes A.; Luyt C.-E.; Trouillet J.-L.; Chastre J.; Gibert C.) Serv. de
Reanimation Med., Hop. Pitie-Salpetriere, Paris, France.
CORRESPONDENCE ADDRESS
A. Combes, Serv. de Reanimation Med., Hop. Pitie-Salpetriere, Paris, France.
SOURCE
Critical Care Medicine (2005) 33:4 (705-710). Date of Publication: April
2005
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
ABSTRACT
Objective: To determine whether observed and predicted mortality for
intensive care unit (ICU) transfer admissions is different from non-ICU
transfer admissions and how that might affect ICU performance evaluation.
Design, Setting, and Patients: We retrospectively analyzed the charts of
3,416 patients admitted to our tertiary referral ICU from January 1995 to
December 2001 and evaluated the effect on our performance (based on the
Simplified Acute Physiology Score II risk model) of accepting patients
transferred from another hospital's ICU. Main Results: During the study
period, 597 patients (17%) had been transferred from a non-ICU setting in
another hospital (hospital transfer) and 408 (12%) from another hospital's
ICU (ICU transfer). ICU mortality and standardized mortality ratios were
significantly higher for ICU-transfer patients than for hospital-transfer or
directly admitted patients: 34% vs. 23% vs. 17% (p < .0001) and 0.95 (95%
confidence interval, 0.83-1.08), 0.82 (95% confidence interval, 0.71-0.95),
and 0.62 (95% confidence interval, 0.55-0.68), respectively. ICU-transfer
patients had 3.6-fold longer mean ICU stays and 1.9-fold longer durations of
mechanical ventilation than directly admitted patients. Hospital-transfer
(odds ratio = 1.89) and ICU-transfer patients (odds ratio = 2.41) had
significantly higher mortality rates, even after adjustment for case mix and
disease severity. Consequently, a benchmarking program adjusting only for
these latter variables, but not admission source, would penalize our ICU by
39 excess deaths per 1,000 admissions as compared with another ICU admitting
no transfer patients. Finally, patients transferred from the ward of another
hospital had significantly higher mortality rates (odds ratio = 1.56) as
compared with patients directly admitted from the ward of our hospital,
confirming the "transfer effect" for this homogeneous patients' subgroup.
Conclusions: Admission source remains a strong and independent predictor of
ICU death, despite adjustment for case mix and disease severity at ICU
admission. Specifically, accepting numerous ICU-transfer patients, for whom
the probability of ICU death is the most underestimated by a system
adjusting only for case mix and disease severity, can adversely affect the
evaluation of referral centers' performance. Future benchmarking and
profiling systems should evaluate and adequately account for the
ICU-transfer factor to provide healthcare payers and consumers with more
accurate and valid information on the true performance of referral centers.
Copyright © 2005 by the Society of Critical Care Medicine and Lippincott
Williams & Wilkins.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital admission
hospitalization
intensive care unit
patient referral
EMTREE MEDICAL INDEX TERMS
article
artificial ventilation
disease severity
length of stay
medical record
mortality
patient transport
prediction
priority journal
retrospective study
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2005169802
MEDLINE PMID
15818092 (http://www.ncbi.nlm.nih.gov/pubmed/15818092)
PUI
L40504375
DOI
10.1097/01.CCM.0000158518.32730.C5
FULL TEXT LINK
http://dx.doi.org/10.1097/01.CCM.0000158518.32730.C5
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 844
TITLE
Danish parents' experiences when their new born or critically ill small
child is transferred to the PICU-a qualitative study.
AUTHOR NAMES
Hall E.O.
AUTHOR ADDRESSES
(Hall E.O.) Department of Nursing Science, Aarhus University, Aarhus,
Denmark.
CORRESPONDENCE ADDRESS
E.O. Hall, Department of Nursing Science, Aarhus University, Aarhus,
Denmark. Email: eh@nursingscience.au.dk
SOURCE
Nursing in critical care (2005) 10:2 (90-97). Date of Publication: 2005
Mar-Apr
ISSN
1362-1017
ABSTRACT
The aim of this study was to describe Danish parents' experiences when their
newborn or small child was critically ill. Thirteen parents were
interviewed. Data were analysed using qualitative content analysis. The
child's transfer to the paediatric intensive care unit (PICU) meant either
help or death for the parents. The back transfer was experienced as joy and
despair. The parents had confidence in most nurses, and they were kind,
helpful, informative and capable. Less capable and distressed nurses made
the parents feel uncomfortable and insecure. Parents need help and support
during their child's transfer to and from the PICU. Critical care nurses
have to discuss the policy of family-centred care.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
life event
parent
patient transport
EMTREE MEDICAL INDEX TERMS
adult
article
Denmark
female
human
human relation
infant
male
newborn
nurse patient relationship
psychological aspect
LANGUAGE OF ARTICLE
English
MEDLINE PMID
15839240 (http://www.ncbi.nlm.nih.gov/pubmed/15839240)
PUI
L40857178
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 845
TITLE
Appropriate admissions to the appropriate unit: a decision tree approach.
AUTHOR NAMES
Matukaitis J.
Stillman P.
Wykpisz E.
Ewen E.
AUTHOR ADDRESSES
(Matukaitis J.; Stillman P.; Wykpisz E.; Ewen E.) Patient Care Services,
Critical Care, Newark, DE 19713, USA.
CORRESPONDENCE ADDRESS
J. Matukaitis, Patient Care Services, Critical Care, Newark, DE 19713, USA.
Email: jmatukaitis@christianacare.org
SOURCE
American journal of medical quality : the official journal of the American
College of Medical Quality (2005) 20:2 (90-97). Date of Publication: 2005
Mar-Apr
ISSN
1062-8606
ABSTRACT
An intermediate care decision tree tool was developed to meet the demand for
intermediate care beds. Concurrently, a charging process was developed to
support the acuity adaptable model of care, allowing the patient to remain
in the same bed from admission to discharge, regardless of level of care
required, adjusting nurse-to-patient ratios as acuity changes. Since
beginning this pilot, 96% to 100% of the patients admitted to intermediate
care from the emergency department met the criteria. Wait time from request
to admission was reduced from 5.5 hours to 2.5 hours. A reduction in nursing
costs was noted. The average number of patients waiting daily in the
emergency department for an intermediate care bed has been reduced by
approximately 80%. A significant difference in length of stay was not noted.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
decision tree
health economics
hospital admission
intensive care unit
nursing home
patient transport
EMTREE MEDICAL INDEX TERMS
economics
human
length of stay
review
statistics
time
LANGUAGE OF ARTICLE
English
MEDLINE PMID
15851387 (http://www.ncbi.nlm.nih.gov/pubmed/15851387)
PUI
L40596791
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 846
TITLE
Transport ventilators: a guide for critical-care transportation, aeromedical
& prehospital operations.
AUTHOR NAMES
DiLuigi K.J.
AUTHOR ADDRESSES
(DiLuigi K.J.) Temple University Hospital, Philadelphia, PA, USA.
CORRESPONDENCE ADDRESS
K.J. DiLuigi, Temple University Hospital, Philadelphia, PA, USA.
SOURCE
Emergency medical services (2005) 34:1 (67-70, 104). Date of Publication:
Jan 2005
ISSN
0094-6575
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
emergency health service
intensive care
patient transport
practice guideline
ventilator
EMTREE MEDICAL INDEX TERMS
article
human
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
15743123 (http://www.ncbi.nlm.nih.gov/pubmed/15743123)
PUI
L40399465
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 847
TITLE
The provision of sophisticated critical care beyond the hospital: Lessons
from physiology and military experiences that apply to civil disaster
medical response
AUTHOR NAMES
Grissom T.E.
Farmer J.C.
AUTHOR ADDRESSES
(Grissom T.E.) Ctr. Sustainment Trauma Readiness S., Baltimore, MD, United
States.
(Grissom T.E.) R. A. Cowley Shock Trauma Center, Univ. of Maryland Medical
Center, Baltimore, MD.
(Farmer J.C.) Department of Medicine, Div. Pulmon. and Critical Care Med.,
Rochester, MN, United States.
(Farmer J.C.) Prog. Translational I., Mayo Clinic, Rochester, MN, United
States.
CORRESPONDENCE ADDRESS
T.E. Grissom, Ctr. Sustainment Trauma Readiness S., Baltimore, MD, United
States.
SOURCE
Critical Care Medicine (2005) 33:1 SUPPL. (S13-S21). Date of Publication:
January 2005
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
ABSTRACT
Objective: The provision of sophisticated medical care in an austere
environment is challenging. During and after a mass casualty event, it is
likely that critical care services will be needed beyond an intensive care
unit (ICU) setting. The objective of this article is to explore existing ICU
care systems such as military aeromedical transport that may be applicable
to disaster medicine and to providing critical care outside of an ICU
setting. Results: The U.S. Air Force Critical Care Aeromedical Transport
(CCAT) Teams were developed in 1994 in response to an unmet military need
for long-range air transport of critically ill and injured patients. This
system has transported several thousand ICU patients and is an applicable
model for the future development of extrahospital critical care capabilities
needed during a disaster. We also discuss civilian aeromedical critical care
systems, the types of medical devices used, and their applicability to
disaster medical response. Conclusion: The U.S. Air Force CCAT Team program,
as well as many civilian critical care air ambulance services, provides a
workable starting point for the development of disaster medical critical
care response capabilities for disaster medical systems.
EMTREE DRUG INDEX TERMS
antacid agent
atropine
chlorpromazine
diazepam
digoxin
dimenhydrinate
diphenhydramine
dopamine
epinephrine
furosemide
glucose
glyceryl trinitrate
haloperidol
heparin
isoprenaline
morphine sulfate
naloxone
oxycodone plus paracetamol
paracetamol
pethidine
phenytoin
potassium chloride
propranolol
pseudoephedrine
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air medical transport
army
disaster
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
air force
airplane crew
devices
electrocardiography monitoring
human
infusion system
intensive care unit
medical care
medical device
nurse
paramedical personnel
patient monitoring
physician
priority journal
review
United States
ventilator
CAS REGISTRY NUMBERS
adrenalin (51-43-4, 55-31-2, 6912-68-1)
atropine (51-55-8, 55-48-1)
chlorpromazine (50-53-3, 69-09-0)
diazepam (439-14-5)
digoxin (20830-75-5, 57285-89-9)
dimenhydrinate (523-87-5)
diphenhydramine (147-24-0, 58-73-1)
dopamine (51-61-6, 62-31-7)
furosemide (54-31-9)
glucose (50-99-7, 84778-64-3)
glyceryl trinitrate (55-63-0)
haloperidol (52-86-8)
heparin (37187-54-5, 8057-48-5, 8065-01-8, 9005-48-5)
isoprenaline (299-95-6, 51-30-9, 6700-39-6, 7683-59-2)
morphine sulfate (23095-84-3, 35764-55-7, 64-31-3)
naloxone (357-08-4, 465-65-6)
paracetamol (103-90-2)
pethidine (28097-96-3, 50-13-5, 57-42-1)
phenytoin (57-41-0, 630-93-3)
potassium chloride (7447-40-7)
propranolol (13013-17-7, 318-98-9, 3506-09-0, 4199-09-1, 525-66-6)
pseudoephedrine (345-78-8, 7460-12-0, 90-82-4)
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2005037022
MEDLINE PMID
15640673 (http://www.ncbi.nlm.nih.gov/pubmed/15640673)
PUI
L40116593
DOI
10.1097/01.CCM.0000151063.85112.5A
FULL TEXT LINK
http://dx.doi.org/10.1097/01.CCM.0000151063.85112.5A
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 848
TITLE
Barriers to screening infants for retinopathy of prematurity after discharge
or transfer from a neonatal intensive care unit
AUTHOR NAMES
Attar M.A.
Gates M.R.
Iatrow A.M.
Lang S.W.
Bratton S.L.
AUTHOR ADDRESSES
(Attar M.A.; Gates M.R.; Iatrow A.M.; Lang S.W.; Bratton S.L.) Dept. of
Pediat./Communic. Diseases, University of Michigan, Ann Arbor, MI, United
States.
(Attar M.A.) Mott Hospital, 1500 E. Medical Center Drive, Ann Arbor, MI
48109-0254, United States.
CORRESPONDENCE ADDRESS
M.A. Attar, Mott Hospital, 1500 E. Medical Center Drive, Ann Arbor, MI
48109-0254, United States.
SOURCE
Journal of Perinatology (2005) 25:1 (36-40). Date of Publication: January
2005
ISSN
0743-8346
BOOK PUBLISHER
Nature Publishing Group, Houndmills, Basingstoke, Hampshire, United Kingdom.
ABSTRACT
Objective: To assess neonatal intensive care unit (NICU) practices affecting
screening and follow-up for retinopathy of prematurity (ROP). Methods:
Retrospective study of infants at risk for ROP, eligible for back transport,
admitted to a regional NICU from January 1, 1999 until May 31, 2002.
Patients failed to receive needed follow-up for ROP after discharge or
transfer from a NICU, if we could not verify their ROP screening follow-up
within 1 month. Results: A total of 74 infants were identified to need
follow-up eye care. Infants who did not receive the follow-up care had
greater mean gestational age (mean SD; 30.7±2.3 vs 29.6±2.5 weeks, p = 0.05)
and birth weights (mean SD; 1581±366 vs 1360±508 g, p = 0.007), compared to
infants who received the recommended care. Infants transported back to the
community hospital were significantly more likely to miss follow-up eye care
compared to infants discharged from the regional center (relative risk 2.81,
95% confidence interval (CI) (1.09 to 7.20)). Infants not screened for ROP
in the NICU had greater risk for missing follow-up care compared to infants
who had their first retinal examination in the NICU (relative risk 4.25, 95%
CI (1.42 to 12.73)). Conclusions: Infants transferred back or discharged
from the NICU before ROP screening represent a high-risk group for not
receiving follow-up eye care. © 2005 Nature Publishing Group All rights
reserved.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
retrolental fibroplasia (diagnosis)
screening test
EMTREE MEDICAL INDEX TERMS
article
birth weight
community hospital
confidence interval
controlled study
follow up
gestational age
high risk population
hospital admission
hospital discharge
human
infant
major clinical study
medical practice
newborn intensive care
patient transport
risk assessment
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Ophthalmology (12)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2005068995
MEDLINE PMID
15496873 (http://www.ncbi.nlm.nih.gov/pubmed/15496873)
PUI
L40207653
DOI
10.1038/sj.jp.7211203
FULL TEXT LINK
http://dx.doi.org/10.1038/sj.jp.7211203
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 849
TITLE
Respiratory critical care in emergency medicine: Non-invasive mechanical
ventilation in urgencies, emergencies and sanitary transport. Indications
and methodology
ORIGINAL (NON-ENGLISH) TITLE
Ventilación mecánica no invasiva en urgencias, emergencias y transporte
sanitario. Indicaciones y metodología
AUTHOR NAMES
Esquinas Rodríguez A.M.
González Díaz G.
Ayuso Baptista F.
Minaya García J.A.
Artacho Ruiz R.
Salguero Piedras M.
Suero Méndez C.
Del Campo E.
Simó Gisbert J.
Piera I Olives J.
Ferre Jornet R.
Llorente Rojo A.C.
Folgado Pérez M.I.
Pordomingo Rodríguez D.
Cabriada Nuño V.
AUTHOR ADDRESSES
(Esquinas Rodríguez A.M., esquinas@ono.com; González Díaz G.; Ayuso Baptista
F.; Minaya García J.A.; Artacho Ruiz R.; Salguero Piedras M.; Suero Méndez
C.; Del Campo E.; Simó Gisbert J.; Piera I Olives J.; Ferre Jornet R.;
Llorente Rojo A.C.; Folgado Pérez M.I.; Pordomingo Rodríguez D.; Cabriada
Nuño V.) Unidad de Cuidados Intensivos, Hospitales Morales Meseguer, Murcia,
Spain.
(Esquinas Rodríguez A.M., esquinas@ono.com) Grupo de Ventilacion No Invasiva
en Emergencias, Urgencias y Transporte Sanitario, Unidad de Cuidados
Intensivos, Hospitales Morales Meseguer, Avda. Marques de los Velez, s/n,
30008 Murcia, Spain.
CORRESPONDENCE ADDRESS
A.M. Esquinas Rodríguez, Grupo de Ventilacion No Invasiva en Emergencias,
Urgencias y Transporte Sanitario, Unidad de Cuidados Intensivos, Hospitales
Morales Meseguer, Avda. Marques de los Velez, s/n, 30008 Murcia, Spain.
Email: esquinas@ono.com
SOURCE
Puesta al Dia en Urgencias, Emergencias y Catastrofes (2005) 6:1 (33-44).
Date of Publication: Jan 2005
ISSN
1576-0316
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
acute respiratory failure (therapy)
artificial ventilation
emergency treatment
patient transport
EMTREE MEDICAL INDEX TERMS
asthma (therapy)
chronic obstructive lung disease (therapy)
critical illness
emergency medicine
face mask
human
oxygen therapy
patient monitoring
pneumonia
positive end expiratory pressure
practice guideline
review
treatment indication
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Anesthesiology (24)
Internal Medicine (6)
LANGUAGE OF ARTICLE
Spanish
EMBASE ACCESSION NUMBER
2005240191
PUI
L40740242
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 850
TITLE
Treatment of coronary heart disease.
AUTHOR NAMES
Stubbs J.
Barrett D.
AUTHOR ADDRESSES
(Stubbs J.; Barrett D.) West Midlands South CHD Collaborative.
CORRESPONDENCE ADDRESS
J. Stubbs, West Midlands South CHD Collaborative.
SOURCE
Professional nurse (London, England) (2005) 20:5 (28-30). Date of
Publication: Jan 2005
ISSN
0266-8130
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
coronary artery disease (therapy)
patient transport
transluminal coronary angioplasty
EMTREE MEDICAL INDEX TERMS
article
coronary care unit
evaluation study
health care policy
health care quality
health services research
hospital admission
hospital bed utilization
human
national health service
organization
organization and management
patient care
patient referral
patient selection
quality control
time
United Kingdom
LANGUAGE OF ARTICLE
English
MEDLINE PMID
15682993 (http://www.ncbi.nlm.nih.gov/pubmed/15682993)
PUI
L40282218
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 851
TITLE
Recently published papers: Clunk-click every trip, smile, but don't stop for
a drink on the way
AUTHOR NAMES
Stacey J.
Venn R.
AUTHOR ADDRESSES
(Stacey J., jonathan_stacey@hotmail.com; Venn R.) Department of Critical
Care, Worthing General Hospital, Lyndhurst Road, Worthing, United Kingdom.
CORRESPONDENCE ADDRESS
J. Stacey, Department of Critical Care, Worthing General Hospital, Lyndhurst
Road, Worthing, United Kingdom. Email: jonathan_stacey@hotmail.com
SOURCE
Critical Care (2004) 8:6 (408-410). Date of Publication: December 2004
ISSN
1364-8535
BOOK PUBLISHER
BioMed Central Ltd., 34 - 42 Cleveland Street, London, United Kingdom.
ABSTRACT
Reviews of the risks associated with intrahospital transfer and prolonged
spinal immobilization made uncomfortable reading in August. Studies on the
timing of tracheotomy and a potential role for exogenous surfactant will
have done little to allay controversy. We are reminded of the neutrality of
the Swiss, and gain valuable insight into prognostic tools in mechanically
ventilated patients with cirrhotic liver disease. © 2004 BioMed Central Ltd.
EMTREE DRUG INDEX TERMS
artificial lung surfactant
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient transport
risk assessment
EMTREE MEDICAL INDEX TERMS
artificial ventilation
hospital service
human
immobilization
intensive care
interpersonal communication
liver cirrhosis
medical decision making
positive end expiratory pressure
priority journal
prognosis
publication
review
spine stabilization
Switzerland
tracheotomy
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2005022565
MEDLINE PMID
15566602 (http://www.ncbi.nlm.nih.gov/pubmed/15566602)
PUI
L40073666
DOI
10.1186/cc3002
FULL TEXT LINK
http://dx.doi.org/10.1186/cc3002
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 852
TITLE
Modalities for maternal transfer in the event of postpartum hemorrhage
ORIGINAL (NON-ENGLISH) TITLE
Modalités d'un transfert maternel dans le cadre d'une hémorragie post-partum
AUTHOR NAMES
Bagou G.
AUTHOR ADDRESSES
(Bagou G., gilles.bagou@chu-lyon.fr) SAMU Régional de Lyon, Hôpital
Édouard-Herriot, 69437 Lyon Cedex 03, France.
CORRESPONDENCE ADDRESS
G. Bagou, SAMU Régional de Lyon, Hôpital Édouard-Herriot, 69437 Lyon Cedex
03, France. Email: gilles.bagou@chu-lyon.fr
SOURCE
Journal de Gynecologie Obstetrique et Biologie de la Reproduction (2004)
33:8 SUPPL. (4S89-4S92). Date of Publication: December 2004
ISSN
0368-2315
BOOK PUBLISHER
Elsevier Masson SAS, 62 rue Camille Desmoulins, Issy les Moulineaux Cedex,
France.
ABSTRACT
In the event of a postpartum bleeding, the decision to undertake a medical
transfer should be made in concertation by the different physicians
involved: the hospital that requests the transfer, the Emergency Medical and
Mobile Service, the receiver. The choice of a health care provider depends
on the health care facilities, the possibility to admit the patient and the
time parameter. A transfer is contraindicated for patients with an unstable
hemodynamic state and when hemostatic surgery is essential. During
transportation, only cardiopulmonary techniques are allowed. Patient
monitoring, anesthesia and resuscitation during the embolization process
should be done by the critical care team in the hospital and not by
emergency physicians and nurses. As a precaution, after the team has
assessed the situation locally and before it worsens, a transfer, including
intra uterine transfer, should be discussed and completed toward a health
care facility equipped to provide rapid and varied emergency care. When
postpartum bleeding occurs after an unexpected birth out of the hospital,
rapid medical transportation toward a health care facility equipped to
provide varied emergency care is required. The emergency care unit should be
informed prior to the transfer.
EMTREE DRUG INDEX TERMS
sulprostone (drug therapy)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient transport
postpartum hemorrhage (drug therapy, therapy)
EMTREE MEDICAL INDEX TERMS
anesthesia
artificial embolization
emergency health service
health care facility
hemodynamics
hemostasis
hospital
intensive care unit
medical decision making
patient monitoring
resuscitation
review
CAS REGISTRY NUMBERS
sulprostone (60325-46-4, 96420-78-9)
EMBASE CLASSIFICATIONS
Obstetrics and Gynecology (10)
Anesthesiology (24)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
French
LANGUAGE OF SUMMARY
English, French
EMBASE ACCESSION NUMBER
2005008241
MEDLINE PMID
15577734 (http://www.ncbi.nlm.nih.gov/pubmed/15577734)
PUI
L40030207
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 853
TITLE
Omissions and errors during oxygen therapy of hospitalized patients in a
large city of Greece
AUTHOR NAMES
Brokalaki H.
Matziou V.
Zyga S.
Kapella M.
Tsaras K.
Brokalaki E.
Myrianthefs P.
AUTHOR ADDRESSES
(Brokalaki H., heropan@nurs.uoa.gr; Matziou V.; Tsaras K.) Nursing Faculty,
Natl./Kapodistrian Univ. of Athens, 123 Papadiamandopoulou Str., GR-11528
Athens, Greece.
(Zyga S.; Kapella M.) Hippokrateion Gen. Hosp. of Athens, Athens, Greece.
(Brokalaki E.) Dermatology Clinic, Koln University, Koln, Germany.
(Myrianthefs P.) KAT General Hospital, Athens, Greece.
CORRESPONDENCE ADDRESS
H. Brokalaki, Nursing Faculty, Natl./Kapodistrian Univ. of Athens, 123
Papadiamandopoulou Str., GR-11528 Athens, Greece. Email: heropan@nurs.uoa.gr
SOURCE
Intensive and Critical Care Nursing (2004) 20:6 (352-357). Date of
Publication: December 2004
ISSN
0964-3397
BOOK PUBLISHER
Churchill Livingstone
ABSTRACT
Omissions and errors are commonly found concerning hospital oxygen use and
the use of nebulizers. The aim of the study was to record oxygen use in
seven hospitals located in a large district city of Greece. Another aim was
to record the use of nebulizers in the same hospitals. We included 105 head
nurses (HNs) working in seven hospitals of a large city district of Greece.
Data were collected after interviewing each HN using a questionnaire and
completing an anonymous data form. Data are expressed as percentages and
analyzed using the chi-square test. We found that 41% of HN believed O(2) is
a gas that improves patient's dyspnea. The majority of the nurses (88.6%)
stated that there was no protocol for O(2) therapy in the departments in
which they worked. We found that O(2) therapy was commonly started,
modified, discontinued by nurses in the absence of a medical order. Oxygen
therapy was commonly not guided by arterial blood gas (ABG) analysis. We
also found that there are no guidelines to prevent O(2) therapy interruption
during intra-hospital transportation, and that few measures were taken to
prevent O(2) explosion. In 95.2% of the departments the nebulizers were
filled with tap water and were not changed on a daily basis (81.2%). Our
results indicate that educational programmes, nursing protocols and
guidelines are becoming mandatory in our country in order to ensure the
proper use of O(2) therapy and nebulizers. © 2004 Elsevier Ltd. All rights
reserved.
EMTREE DRUG INDEX TERMS
oxygen (drug therapy)
tap water
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
medical error
oxygen therapy
EMTREE MEDICAL INDEX TERMS
article
blood gas analysis
chi square test
clinical protocol
data analysis
disinfection
dyspnea (drug therapy)
education program
Greece
hospital department
hospital patient
human
information processing
instrument sterilization
intensive care
interview
medical decision making
medical record
nebulizer
nurse
patient transport
practice guideline
questionnaire
CAS REGISTRY NUMBERS
oxygen (7782-44-7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
15567676 (http://www.ncbi.nlm.nih.gov/pubmed/15567676)
PUI
L39618481
DOI
10.1016/j.iccn.2004.07.003
FULL TEXT LINK
http://dx.doi.org/10.1016/j.iccn.2004.07.003
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 854
TITLE
Training and assessment of competency of trainees in the transfer of
critically ill patients [3]
AUTHOR NAMES
Spencer C.
Watkinson P.
McCluskey A.
AUTHOR ADDRESSES
(Spencer C.; Watkinson P.; McCluskey A., amccluskey@mcmail.com) Stepping
Hill Hospital, Stockport SK2 2JE, United Kingdom.
CORRESPONDENCE ADDRESS
C. Spencer, Stepping Hill Hospital, Stockport SK2 2JE, United Kingdom.
SOURCE
Anaesthesia (2004) 59:12 (1248). Date of Publication: December 2004
ISSN
0003-2409
BOOK PUBLISHER
Blackwell Publishing Ltd, 9600 Garsington Road, Oxford, United Kingdom.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
EMTREE MEDICAL INDEX TERMS
anesthesiology
anesthesist
artificial ventilation
clinical audit
competence
continuing education
critical illness
education program
experience
human
intensive care unit
learning
letter
medical literature
mortality
patient transport
practice guideline
questionnaire
safety
staff training
task performance
time
workplace
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2004521717
MEDLINE PMID
15549995 (http://www.ncbi.nlm.nih.gov/pubmed/15549995)
PUI
L39600171
DOI
10.1111/j.1365-2044.2004.04017.x
FULL TEXT LINK
http://dx.doi.org/10.1111/j.1365-2044.2004.04017.x
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 855
TITLE
A four-year survey of transfers from Aarhus Hospital with accompanying
anaesthesiology staff
ORIGINAL (NON-ENGLISH) TITLE
En fireårig prospektiv registrering af anæstesiledsagede transporter fra
Århus Amtssygehus
AUTHOR NAMES
Christiansen A.
Juelsgaard P.
AUTHOR ADDRESSES
(Christiansen A., aagchr@stofanet.dk) Nygade 24, 1. th., DK-8000 Århus C,
Denmark.
(Christiansen A., aagchr@stofanet.dk; Juelsgaard P.) Århus
Universitetshospital, Århus Sygehus, Anæstesiologisk Afdeling, .
CORRESPONDENCE ADDRESS
A. Christiansen, Nygade 24, 1. th., DK-8000 Århus C, Denmark. Email:
aagchr@stofanet.dk
SOURCE
Ugeskrift for Laeger (2004) 166:47 (4261-4264). Date of Publication: 15 Nov
2004
ISSN
0041-5782
BOOK PUBLISHER
Almindelige Danske Laegeforening, Tromdhjemsgade 9, Copenhagen, Denmark.
ABSTRACT
Introduction: The growth in specialization and centralization of the Danish
health care system has resulted in an increase in patient transfers of the
critically ill over a greater distance. In Denmark, an anaesthesiology nurse
and a resident traditionally accompany these transfers. There are only very
limited national guidelines for the transfer of critically ill patients in
Denmark. Materials and methods: In the period 1 January 1999-31 December
2002, transfers with accompanying staff from the Department of
Anaesthesiology of Aarhus Hospital were registered regarding patients'
background and transport data. Results: 284 transfers were registered.
Throughout the observation period there was an increase in the ASA score
(median of 3.4) (range 1-5) and number of transfers. 75% of the transfers
were made from 3:00 to 8:00 p.m. or on weekends. The median transport time
was 80 (range 25-660) min. In 22.2% of cases did an anaesthesiologist
accompany the patient. A worsening of the patient's condition was observed
in 7.5% of cases. Discussion: This research indicates an increase in the
number and a worsening of condition in those requiring accompaniment by the
staff of the Anaesthesiology Department. The workload is mostly outside the
»daytime roster« hours, thus diminishing the transferring hospital's acute
care resources. It is still »the most inexperienced physicians accompanying
the sickest patients«. This research emphasizes the need for national
recommendations for the transport of critically ill patients and formalized
training within this area, as well as an increasing need for specially
trained transfer and retrieval teams and mobile intensive care units.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
anesthesiology
hospital personnel
patient transport
EMTREE MEDICAL INDEX TERMS
anesthesist
article
critical illness
Denmark
health care system
hospital cost
human
intensive care unit
medical education
medical society
medical specialist
nurse
practice guideline
residency education
scoring system
training
workload
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
Danish
LANGUAGE OF SUMMARY
English, Danish
EMBASE ACCESSION NUMBER
2004511428
MEDLINE PMID
15587359 (http://www.ncbi.nlm.nih.gov/pubmed/15587359)
PUI
L39572362
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 856
TITLE
Surgical aspects of Operation Bali Assist: initial wound surgery on the
tarmac and in flight.
AUTHOR NAMES
Read D.
Ashford B.
AUTHOR ADDRESSES
(Read D.; Ashford B.) Department of Surgery, Royal Darwin Hospital, Darwin,
NT, Australia.
CORRESPONDENCE ADDRESS
D. Read, Department of Surgery, Royal Darwin Hospital, Darwin, NT,
Australia. Email: DavidJ.Read@nt.gov.au
SOURCE
ANZ journal of surgery (2004) 74:11 (986-991). Date of Publication: Nov 2004
ISSN
1445-1433
ABSTRACT
BACKGROUND: The explosion of three bombs on 12 October 2002 in Kuta, Bali
resulted in mass casualties akin to those seen in war. The aim of the
present report is to describe the sequence of events of Operation Bali
Assist including triage, resuscitation and initial wound surgery in Bali at
Sanglah Hospital in the aeromedical staging facility (ASF), Denpasar airport
and the evacuation to Darwin. METHODS: A descriptive report is provided of
the event and includes; resuscitation, anaesthesia, initial burns surgery
management including escharotomy and fasciotomy, head injury management and
importance of supplies and medical records with a description of the
evacuation to Darwin. RESULTS: Operation Bali Assist involved five C130
Hercules aircraft and aeromedical evacuation medical and nursing teams
managing 66 casualties in the Denpasar area and their evacuation to Royal
Darwin Hospital with ketamine the most useful anaesthetic agent and cling
film the most useful burns dressing. Twelve procedures were performed at the
ASF including seven escharotomies, three fasciotomies and two closed
reductions. One escharotomy was performed in flight. DISCUSSION: The
important lessons learnt from the exercise is the inclusion of a surgeon in
the aeromedical evacuation team, the importance of debridement and delayed
primary closure, the usefulness of cling film as a burns dressing and the
importance of continuous assessment. Future disaster planning exercises need
to consider a patient age mix that might be expected in a shopping mall,
rather than the young adult encountered in Bali, a more familiar age mix for
Australian Defence Force medical staff.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
blast injury (surgery)
burn (surgery)
disaster
patient transport
terrorism
EMTREE MEDICAL INDEX TERMS
air medical transport
anesthesia
article
Australia
fascia (surgery)
head injury (therapy)
human
Indonesia
intensive care unit
organization and management
resuscitation
LANGUAGE OF ARTICLE
English
MEDLINE PMID
15550089 (http://www.ncbi.nlm.nih.gov/pubmed/15550089)
PUI
L39702861
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 857
TITLE
Fluoroquinolone resistance from a transferable plasmid in Acinetobacter
calcoaceticus [3]
AUTHOR NAMES
Joshi S.G.
Litake G.M.
Ghole V.S.
Niphadkar K.B.
AUTHOR ADDRESSES
(Joshi S.G., surejoshi@yahoo.com; Niphadkar K.B.) Department of Clinical
Microbiology, King Edward Memorial Hospital, Pune, India.
(Litake G.M.; Ghole V.S.) Molecular Biology Laboratory, Division of
Biochemistry, University of Pune, Ganeshkhind Road, Pune, India.
CORRESPONDENCE ADDRESS
S.G. Joshi, Department of Clinical Microbiology, King Edward Memorial
Hospital, Pune, India. Email: surejoshi@yahoo.com
SOURCE
Indian Journal of Pathology and Microbiology (2004) 47:4 (593-594). Date of
Publication: October 2004
ISSN
0377-4929
BOOK PUBLISHER
Indian Association of Pathologists and Microbiologists, Sector 32-A,
Chandigarh, India.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
ciprofloxacin (drug comparison)
lomefloxacin (drug comparison)
norfloxacin (drug comparison)
ofloxacin (drug comparison)
pefloxacin (drug comparison)
quinoline derived antiinfective agent (drug comparison)
EMTREE DRUG INDEX TERMS
antibiotic agent (drug comparison)
beta lactam antibiotic (drug comparison)
beta lactamase inhibitor (drug comparison)
nalidixic acid (drug comparison)
quinolone derivative (drug comparison)
tetracycline (drug comparison)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Acinetobacter calcoaceticus
antibiotic resistance
EMTREE MEDICAL INDEX TERMS
Acinetobacter
bacterial infection (drug resistance, etiology)
bacterial meningitis (drug resistance, etiology)
bacterium isolation
cerebrospinal fluid examination
Escherichia coli
Gram negative bacterium
Gram positive bacterium
intensive care unit
Klebsiella pneumoniae
letter
minimum inhibitory concentration
multidrug resistance
nonhuman
plasmid
Staphylococcus aureus
CAS REGISTRY NUMBERS
ciprofloxacin (85721-33-1)
lomefloxacin (98079-51-7)
nalidixic acid (389-08-2)
norfloxacin (70458-96-7)
ofloxacin (82419-36-1)
pefloxacin (70458-92-3)
tetracycline (23843-90-5, 60-54-8, 64-75-5)
EMBASE CLASSIFICATIONS
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2006177699
MEDLINE PMID
16295408 (http://www.ncbi.nlm.nih.gov/pubmed/16295408)
PUI
L43568727
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 858
TITLE
Use of a specialized transport team for intrahospital transport of
critically ill patients.
AUTHOR NAMES
McLenon M.
AUTHOR ADDRESSES
(McLenon M.) Surgical Critical Care at Washington Hospital Center in
Washington, DC, USA.
CORRESPONDENCE ADDRESS
M. McLenon, Surgical Critical Care at Washington Hospital Center in
Washington, DC, USA. Email: macmel@cablespeed.com
SOURCE
Dimensions of critical care nursing : DCCN (2004) 23:5 (225-229). Date of
Publication: 2004 Sep-Oct
ISSN
0730-4625
ABSTRACT
The transport of critically ill patients is challenging for nurses and
patients alike. It is imperative that patient safety be the primary focus.
The use of a specialized transport team can help to alleviate many of the
adverse effects of the transport.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient care
patient transport
EMTREE MEDICAL INDEX TERMS
critical illness (therapy)
evidence based medicine
human
methodology
monitoring
nursing
nursing assessment
nursing evaluation research
organization and management
professional standard
review
LANGUAGE OF ARTICLE
English
MEDLINE PMID
15722846 (http://www.ncbi.nlm.nih.gov/pubmed/15722846)
PUI
L41893349
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 859
TITLE
Reducing family members' anxiety and uncertainty in illness around transfer
from intensive care: an intervention study.
AUTHOR NAMES
Mitchell M.L.
Courtney M.
AUTHOR ADDRESSES
(Mitchell M.L.; Courtney M.) School of Nursing, Griffith University,
Australia.
CORRESPONDENCE ADDRESS
M.L. Mitchell, School of Nursing, Griffith University, Australia. Email:
marion.mitchell@griffith.edu.au
SOURCE
Intensive & critical care nursing : the official journal of the British
Association of Critical Care Nurses (2004) 20:4 (223-231). Date of
Publication: Aug 2004
ISSN
0964-3397
ABSTRACT
INTRODUCTION: This intervention study examines anxiety and uncertainty in
illness in families transferring from intensive care to a general ward.
METHODS: The pre-test, post-test design purposively allocated family members
to a control (n = 80) and intervention group (n = 82). The intervention
group experienced a structured individualised transfer method whereas the
control group received existing ad hoc transfer methods. Families were
surveyed before and after transfer. RESULTS: Families' uncertainty was
significantly related to their state anxiety (P < 0.000), the relationship
to the patient (P = 0.022), and the unexpected nature of patients' admission
(P < 0.000). Anxiety increased significantly with reduced social support (P
= 0.002). Following transfer, anxiety reduced significantly for both groups
whereas uncertainty reduced significantly for the intervention group (P =
0.03). CONCLUSION: Families at the time of transfer experience uncertainty
and anxiety, which are significantly related in this study. The intervention
significantly reduced uncertainty scores. When the family member was a
parent, when admissions were unexpected, and those with fewer social
supports represent potential 'at risk' groups whose adaptation to transfer
may limit their coping ability. The structured individualised method of
transfer is recommended with further research of ICU families to further
examine the dimension of uncertainty and how it affects patient outcomes.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
anxiety (prevention)
family
patient transport
publication
social support
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
analysis of variance
article
Australia
clinical trial
controlled clinical trial
controlled study
female
human
intensive care unit
male
middle aged
psychological aspect
LANGUAGE OF ARTICLE
English
MEDLINE PMID
15288876 (http://www.ncbi.nlm.nih.gov/pubmed/15288876)
PUI
L39321807
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 860
TITLE
Intra-hospital transport of critically ill patients: Minimising risk
AUTHOR NAMES
Shirley P.J.
Bion J.F.
AUTHOR ADDRESSES
(Shirley P.J.) Intensive Care Unit, Royal London Hospital, Whitechapel,
London, E1 1BB, United Kingdom.
(Bion J.F., J.F.Bion@bham.ac.uk) Univ. Dept. Anaesthesia Intensive C., Queen
Elizabeth Hospital, Birmingham, B15 2TH, United Kingdom.
CORRESPONDENCE ADDRESS
J.F. Bion, Univ. Dept. Anaesthesia Intensive C., Queen Elizabeth Hospital,
Birmingham, B15 2TH, United Kingdom. Email: J.F.Bion@bham.ac.uk
SOURCE
Intensive Care Medicine (2004) 30:8 (1508-1510). Date of Publication: August
2004
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag, Tiergartenstrasse 17, Heidelberg, Germany.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
hospital
patient transport
risk reduction
EMTREE MEDICAL INDEX TERMS
competence
editorial
health hazard
human
intensive care unit
patient care
professional practice
risk assessment
safety
skill
staff training
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2004354563
MEDLINE PMID
15197442 (http://www.ncbi.nlm.nih.gov/pubmed/15197442)
PUI
L39094949
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 861
TITLE
Incidents relating to the intra-hospital transfer of critically ill
patients: An analysis of the reports submitted to the Australian Incident
Monitoring Study in Intensive Care
AUTHOR NAMES
Beckmann U.
Gillies D.M.
Berenholtz S.M.
Wu A.W.
Pronovost P.
AUTHOR ADDRESSES
(Beckmann U., mdub@alinga.newcastle.edu.au) Australian Incident Monitoring
S., .
(Pronovost P.) Agy. for Hlthcare. Res. and Quality, .
(Berenholtz S.M.) Natl. Heart, Lung and Blood Inst., .
(Beckmann U., mdub@alinga.newcastle.edu.au; Wu A.W.) Division of
Anaesthesia, John Hunter Hospital, Newcastle Regional Mail Centre, Locked
Bag 1, Newcastle, NSW 2300, Australia.
(Gillies D.M.) Division of Surgery, John Hunter Hospital, Newcastle Regional
Mail Centre, Locked Bag 1, Newcastle, NSW 2300, Australia.
(Berenholtz S.M.; Pronovost P.) Dept. Anesth. and Critical Care Med., School
of Medicine, Johns Hopkins University, 600 North Wolfe Street, Baltimore, MD
21287-7294, United States.
(Wu A.W.) Dept. of Hlth. Policy and Management, Johns Hopkins Bloomberg Sch.
Pub. H., 624 North Wolfe Street, Baltimore, MD 21205, United States.
CORRESPONDENCE ADDRESS
U. Beckmann, Division of Anaesthesia, John Hunter Hospital, Newcastle
Regional Mail Centre, Locked Bag 1, Newcastle, NSW 2300, Australia. Email:
mdub@alinga.newcastle.edu.au
SOURCE
Intensive Care Medicine (2004) 30:8 (1579-1585). Date of Publication: August
2004
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag, Tiergartenstrasse 17, Heidelberg, Germany.
ABSTRACT
Objective: Transportation of critically ill patients within the hospital
poses important risks. We sought to identify causes, outcomes and
contributing factors associated with intra-hospital transport. Design:
Cross-sectional case review. Setting: Incident reports submitted to the
Australian Incident Monitoring Study in Intensive Care (AIMS-ICU).
Measurement and main results: Between 1993 and 1999, 176 reports were
submitted describing 191 incidents. Seventy-five reports (39%) identified
equipment problems, relating prominently to battery/power supply, transport
ventilator and monitor function, access to patient elevators and intubation
equipment. Hundred sixteen reports (61%) identified patient/staff management
issues including poor communication, inadequate monitoring, incorrect set-up
of equipment, artificial airway malpositioning and incorrect positioning of
patients. Serious adverse outcomes occurred in 55 reports (31%) including
major physiological derangement (15%), patient/relative dissatisfaction
(7%), prolonged hospital stay (4%), physical/psychological injury (3%) and
death (2%). Of 900 contributing factors identified, 46% were system-based
and 54% human-based. Communication problems, inadequate protocols,
in-servicing/training and equipment were prominent equipment-related
incidents. Errors of problem recognition and judgement, failure to follow
protocols, inadequate patient preparation, haste and inattention were common
management-related incidents. Rechecking the patient and equipment, skilled
assistance and prior experience were important factors limiting harm.
Conclusions: Intra-hospital transport poses an important risk to ICU
patients. The adequate provision of highly qualified staff, specially
designed and well maintained equipment, as well as continuous monitoring are
essential to avoid/mitigate these incidents. Professional societies and
local units should adopt guidelines/protocols for intra-hospital
transportation. Monitoring of incidents should aid in the continuous
improvement in patient safety. © Springer-Verlag 2004.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
hospital care
medical practice
EMTREE MEDICAL INDEX TERMS
clinical protocol
death
devices
hospitalization
human
incidence
injury
intensive care unit
interpersonal communication
patient monitoring
patient satisfaction
patient transport
physical disease
power supply
prevalence
psychological aspect
review
skill
ventilator
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
Biophysics, Bioengineering and Medical Instrumentation (27)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2004354573
MEDLINE PMID
14991102 (http://www.ncbi.nlm.nih.gov/pubmed/14991102)
PUI
L39094959
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 862
TITLE
Intensive care within the context of military long-distance transport
ORIGINAL (NON-ENGLISH) TITLE
Intensivtherapie im militärischen langstreckentransport
AUTHOR NAMES
Hossfeld B.
Rohowsky B.
Rödig E.
Lampl L.
AUTHOR ADDRESSES
(Hossfeld B., bjoern.hossfeld@extern.uni-ulm.de; Lampl L.)
Bundeswehrkrankenhaus Ulm, Abt. Anasthesiol. und Intensivmed., .
(Rohowsky B.) Lufttransportkommando Münster, .
(Rödig E.) Luftwaffenamt, Abt. Luft-u. Raumfahrtmedizin, Fliegerarztlicher
Dienst der Bw., .
(Hossfeld B., bjoern.hossfeld@extern.uni-ulm.de) Abt. Anasthesiol. und
Intensivmed., Bundeswehrkrankenhaus, 89070 Ulm, Germany.
CORRESPONDENCE ADDRESS
B. Hossfeld, Abt. Anasthesiol. und Intensivmed., Bundeswehrkrankenhaus,
89070 Ulm, Germany. Email: bjoern.hossfeld@extern.uni-ulm.de
SOURCE
Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie (2004) 39:5
(256-264). Date of Publication: May 2004
ISSN
0939-2661
BOOK PUBLISHER
Georg Thieme Verlag, Rudigerstrasse 14, Stuttgart, Germany.
ABSTRACT
Due to the changed task spectrum of the German Federal Armed Forces with
participation in international deployments for UN and NATO the concept of
Aeromedical Evacuation (MedEvac) gained a new quality for the Air Force as
well as for the Medical Corps. The transport of mostly severely injured or
critically ill patients requires both, medical equipment which has to be
permanently adapted to the national standard, and qualified
intensive-care-personnel. At present, the aircrafts used for such
deployments are four C-160 Transall, one CL-601 Challenger and two Airbus
A310, which, if necessary, can be equipped with one or more intensive-care
"patient transportation units" (PTU). Contrary to the two other aircrafts,
the CL-601 Challenger is only equipped for the intensive-care transport of
one individual patient. The PTU corresponds to the technical equipment of
the intensive care unit of a level-1-trauma centre and ensures an
intensive-care therapy on highest level also during longer transportation.
The work with this equipment, the characteristics of the long-distance air
transport and the special situation of the military deployment causes
special demands on the qualifications of the assigned personnel. Primarily
planned for the repatriation of injured or ill soldiers, in the mean time,
this concept is also essential for the medevac of civilian victims after
mass casualties worldwide.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
air force
aircraft
army
human
military medicine
practice guideline
review
United Nations
victim
EMBASE CLASSIFICATIONS
Internal Medicine (6)
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
German
LANGUAGE OF SUMMARY
English, German
EMBASE ACCESSION NUMBER
2004241871
MEDLINE PMID
15156416 (http://www.ncbi.nlm.nih.gov/pubmed/15156416)
PUI
L38720382
DOI
10.1055/s-2004-814463
FULL TEXT LINK
http://dx.doi.org/10.1055/s-2004-814463
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 863
TITLE
Perinatal transport: Problems in neonatal intensive care capacity
AUTHOR NAMES
Gill A.B.
Bottomley L.
Chatfield S.
Wood C.
AUTHOR ADDRESSES
(Gill A.B., bryan.gill@leedsth.nhs.uk) Peter Congdon Neonatal Unit, Leeds
General Infirmary, Leeds LS2 9NS, United Kingdom.
(Gill A.B., bryan.gill@leedsth.nhs.uk; Bottomley L.) Peter Congdon Neonatal
Unit, Leeds General Infirmary, Leeds, United Kingdom.
(Chatfield S.) Neonatal Unit, Bradford Royal Infirmary, Bradford, United
Kingdom.
(Wood C.) Neonatal Unit, Hull Maternity Hospital, Hull, United Kingdom.
CORRESPONDENCE ADDRESS
A.B. Gill, Peter Congdon Neonatal Unit, Leeds General Infirmary, Leeds LS2
9NS, United Kingdom. Email: bryan.gill@leedsth.nhs.uk
SOURCE
Archives of Disease in Childhood: Fetal and Neonatal Edition (2004) 89:3
(F220-F223). Date of Publication: May 2004
ISSN
0003-9888
1359-2998 (electronic)
BOOK PUBLISHER
BMJ Publishing Group, Tavistock Square, London, United Kingdom.
ABSTRACT
Objective: To assess the quantity and nature of transfers within the
Yorkshire perinatal service, with the aim of identifying suitable outcome
measures for the assessment of future service improvements. Design/Setting:
Collection of data on perinatal transfers from all neonatal and maternity
units located in the Yorkshire region of the United Kingdom from May to
November 2000. Patients: Expectant mothers (in utero transfers) and neonates
(ex utero transfers). Interventions: None Main Outcome Measures:
Quantification of in utero and ex utero transfers; the reasons for and
resources required to support transfers; the nature of each transfer (acute,
specialist, non-acute, into or out of region). Results: In the period
studied, there were 800 transfers (337 in utero; 463 ex utero); 306
transfers were "acute" (80% of transfers in utero), 214 because of
specialist need, and 280 "non-acute". Some 37% of capacity transfers
occurred from the two level 3 units in the region. Of 254 transfers out of
the 14 neonatal units for intensive care, 44 (17.3%) were transferred to
hospitals outside the normal neonatal commissioning boundaries. Conclusions:
The study highlights a continuing apparent lack of capacity within the
neonatal service in the Yorkshire region, resulting in considerable numbers
of neonatal and maternal transfers.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
newborn intensive care
patient transport
perinatal care
EMTREE MEDICAL INDEX TERMS
article
human
information processing
maternal care
outcomes research
priority journal
United Kingdom
EMBASE CLASSIFICATIONS
Obstetrics and Gynecology (10)
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2004195354
MEDLINE PMID
15102724 (http://www.ncbi.nlm.nih.gov/pubmed/15102724)
PUI
L38570150
DOI
10.1136/adc.2003.028159
FULL TEXT LINK
http://dx.doi.org/10.1136/adc.2003.028159
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 864
TITLE
Interhospital and intrahospital transport of the critically and injured ill
patients
ORIGINAL (NON-ENGLISH) TITLE
Interhospitalni i intrahospitalni transport kriticno povredenih i obolelih.
AUTHOR NAMES
Filipović N.
Surbatović M.
Stanković N.
Jovanović K.
AUTHOR ADDRESSES
(Filipović N.; Surbatović M.; Stanković N.; Jovanović K.) Vojnomedicinska
akademija, Klinika za anesteziologiju i intenzivnu terapiju, Beograd.
CORRESPONDENCE ADDRESS
N. Filipović, Vojnomedicinska akademija, Klinika za anesteziologiju i
intenzivnu terapiju, Beograd. Email: anes@EUnet.yu
SOURCE
Vojnosanitetski pregled. Military-medical and pharmaceutical review (2004)
61:3 (311-314). Date of Publication: 2004 May-Jun
ISSN
0042-8450
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
injury
patient transport
EMTREE MEDICAL INDEX TERMS
adolescent
adult
article
human
methodology
middle aged
monitoring
LANGUAGE OF ARTICLE
unknown
MEDLINE PMID
15330305 (http://www.ncbi.nlm.nih.gov/pubmed/15330305)
PUI
L39680693
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 865
TITLE
The safe transfer of care
AUTHOR NAMES
Sullivan E.E.
AUTHOR ADDRESSES
(Sullivan E.E., eesullivan@partners.org) PACU, Brigham and Women's Hospital,
Boston, MA, United States.
(Sullivan E.E., eesullivan@partners.org) 137 Tiffany Rd, Norwell, MA 02061,
United States.
CORRESPONDENCE ADDRESS
E.E. Sullivan, 137 Tiffany Rd, Norwell, MA 02061, United States. Email:
eesullivan@partners.org
SOURCE
Journal of Perianesthesia Nursing (2004) 19:2 (108-110). Date of
Publication: April 2004
ISSN
1089-9472
BOOK PUBLISHER
W.B. Saunders
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health care
patient transport
EMTREE MEDICAL INDEX TERMS
anamnesis
anesthesia
competence
health care personnel
human
intensive care unit
medical documentation
medical information system
medical practice
medical record
nursing
operating room
patient monitoring
physical examination
short survey
standardization
LANGUAGE OF ARTICLE
English
MEDLINE PMID
15069650 (http://www.ncbi.nlm.nih.gov/pubmed/15069650)
PUI
L38456675
DOI
10.1016/j.jopan.2004.01.004
FULL TEXT LINK
http://dx.doi.org/10.1016/j.jopan.2004.01.004
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 866
TITLE
Guidelines for the transport of critically ill patients
AUTHOR NAMES
Gupta S.
Bhagotra A.
Gulati S.
Sharma J.
AUTHOR ADDRESSES
(Gupta S.; Bhagotra A.; Gulati S.; Sharma J.) PG. Dept. Anaesth./Intensive
Care, Govt. Medical College, Jammu J/K, India.
CORRESPONDENCE ADDRESS
S. Gupta, PG. Dept. Anaesth./Intensive Care, Govt. Medical College, Jammu
J/K, India.
SOURCE
JK Science (2004) 6:2 (109-112). Date of Publication: April/June 2004
ISSN
0972-1177
BOOK PUBLISHER
JK Science, Shiv Bhawan, Hari Market, P.O. Box 158, Jammu, India.
EMTREE DRUG INDEX TERMS
adenosine
alfentanil
aminophylline
amiodarone
atropine
bicarbonate
captopril
cefotaxime
dexamethasone
diazepam
digoxin
dobutamine
epinephrine
etomidate
flumazenil
furosemide
gluconate calcium
heparin
isoprenaline
isosorbide dinitrate
lidocaine
magnesium sulfate
methylprednisolone
morphine
noradrenalin
phenobarbital
propofol
suxamethonium
unindexed drug
vecuronium
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
patient transport
practice guideline
EMTREE MEDICAL INDEX TERMS
article
artificial ventilation
blood pressure measurement
breathing rate
electrocardiography monitoring
emergency treatment
heart arrhythmia (complication)
heart rate
human
hypotension (complication)
hypoxia (complication)
infusion system
intensive care unit
intracranial hypertension (complication)
manpower
medical decision making
medical device
medical documentation
patient care
patient monitoring
resuscitation
risk assessment
safety
teamwork
treatment planning
CAS REGISTRY NUMBERS
adenosine (58-61-7)
adrenalin (51-43-4, 55-31-2, 6912-68-1)
alfentanil (69049-06-5, 71195-58-9)
aminophylline (317-34-0)
amiodarone (1951-25-3, 19774-82-4, 62067-87-2)
atropine (51-55-8, 55-48-1)
bicarbonate (144-55-8, 71-52-3)
captopril (62571-86-2)
cefotaxime (63527-52-6, 64485-93-4)
dexamethasone (50-02-2)
diazepam (439-14-5)
digoxin (20830-75-5, 57285-89-9)
dobutamine (34368-04-2, 52663-81-7)
etomidate (15301-65-2, 33125-97-2, 51919-80-3)
flumazenil (78755-81-4)
furosemide (54-31-9)
gluconate calcium (299-28-5)
heparin (37187-54-5, 8057-48-5, 8065-01-8, 9005-48-5)
isoprenaline (299-95-6, 51-30-9, 6700-39-6, 7683-59-2)
isosorbide dinitrate (87-33-2)
lidocaine (137-58-6, 24847-67-4, 56934-02-2, 73-78-9)
magnesium sulfate (7487-88-9)
methylprednisolone (6923-42-8, 83-43-2)
morphine (52-26-6, 57-27-2)
noradrenalin (1407-84-7, 51-41-2)
phenobarbital (50-06-6, 57-30-7, 8028-68-0)
propofol (2078-54-8)
suxamethonium (306-40-1, 71-27-2)
vecuronium (50700-72-6)
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
Biophysics, Bioengineering and Medical Instrumentation (27)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2004329046
PUI
L39004378
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 867
TITLE
Meeting patient and relatives' information needs upon transfer from an
intensive care unit: The development and evaluation of an information
booklet
AUTHOR NAMES
Paul F.
Hendry C.
Cabrelli L.
AUTHOR ADDRESSES
(Paul F., fiona.paul@tuht.scot.nhs.uk) Ninewells Hospital, Dundee, United
Kingdom.
(Hendry C.) School of Nursing and Midwifery, University of Dundee, Ninewells
Hospital, Dundee, United Kingdom.
(Cabrelli L.) Intensive Care Unit, Ninewells Hospital, Dundee, United
Kingdom.
(Paul F., fiona.paul@tuht.scot.nhs.uk) Ninewells Hospital, Dundee DD1 9SY,
United Kingdom.
CORRESPONDENCE ADDRESS
F. Paul, Ninewells Hospital, Dundee DD1 9SY, United Kingdom. Email:
fiona.paul@tuht.scot.nhs.uk
SOURCE
Journal of Clinical Nursing (2004) 13:3 (396-405). Date of Publication:
March 2004
ISSN
0962-1067
BOOK PUBLISHER
Blackwell Publishing Ltd
ABSTRACT
Background. Transfer from the intensive care unit to a ward is associated
with a significant degree of relocation stress for patients and relatives.
This can be stressful for ward nurses due to the dependency levels of
patients and the ensuing increased workload. Furthermore the patient may
require care, not normally undertaken in that clinical area, e.g.
tracheostomy care. Patients may forget the verbal information given to them
at the time of transfer and often have limited or no memory of the intensive
care unit experience. This can cause anxiety and compound the feelings of
stress associated with transfer. Many patients suffer psychological and
physiological problems after intensive care unit, which can affect their
recovery and quality of life. Aims. The aim of the study was to develop an
evidence-based information booklet for patients and relatives preparing for
transfer from intensive care units. Design. This collaborative study used an
exploratory design with elements of the action research cycle. The study,
conducted in three phases, involved identifying patients' and relatives'
information needs around the time of transfer; designing and developing an
information booklet; and the introduction and evaluation of the booklet into
practice. Methods. Semistructured interviews were used to elicit the views
of patients and relatives regarding their information needs. Members of the
multidisciplinary team were involved in identifying and reviewing booklet
content. Results. Evaluation identified positive outcomes relating to
patients' and relatives' satisfaction with the information and enhanced
communication with other wards and health care professionals. The study also
highlighted the need for more staff education in relation to patients and
relatives needs when transferring to a ward. Conclusions. This study has
demonstrated the value of providing patients and relatives with written
information regarding transfer from intensive care units. Furthermore the
study confirmed the feasibility and importance of including patients and
relatives in the process of booklet development to ensure that their needs
for information are being met. Relevance to clinical practice. Providing
written information as part of a structured discharge plan is recommended.
It provides patients and relatives with a resource that they can refer to at
any time and that enhances verbal communication. The purpose of this
information is to inform and empower patients so that they are better
prepared for the transfer and recovery period.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
medical information system
patient transport
EMTREE MEDICAL INDEX TERMS
clinical research
evidence based medicine
health practitioner
human
interpersonal communication
interview
outcomes research
patient satisfaction
relative
review
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
15009342 (http://www.ncbi.nlm.nih.gov/pubmed/15009342)
PUI
L38470876
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 868
TITLE
Putting cardiac surgery patients on the "fast track".
AUTHOR NAMES
Farley T.
AUTHOR ADDRESSES
(Farley T.) Duke University Health System, Durham, NC, USA.
CORRESPONDENCE ADDRESS
T. Farley, Duke University Health System, Durham, NC, USA.
SOURCE
Nursing (2004) 34:3 (19). Date of Publication: Mar 2004
ISSN
0360-4039
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
heart surgery
intensive care unit
patient selection
patient transport
EMTREE MEDICAL INDEX TERMS
article
human
nursing
nursing assessment
organization and management
policy
practice guideline
time
LANGUAGE OF ARTICLE
English
MEDLINE PMID
15179997 (http://www.ncbi.nlm.nih.gov/pubmed/15179997)
PUI
L38753555
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 869
TITLE
A practical tool to reduce medication errors during patient transfer from an
intensive care unit
AUTHOR NAMES
Pronovost P.
Hobson D.B.
Earsing K.
Lins E.S.
Rinke M.L.
Emery K.
Berenholtz S.M.
Lipsett P.A.
Dorman T.
AUTHOR ADDRESSES
(Pronovost P., ppronovo@jhmi.edu; Hobson D.B.; Earsing K.; Lins E.S.; Rinke
M.L.; Emery K.; Berenholtz S.M.; Lipsett P.A.; Dorman T.) Johns Hopkins
Medical Institution, Johns Hopkins School of Medicine, 901 South Bond St.,
Baltimore, MD 21231, United States.
CORRESPONDENCE ADDRESS
P. Pronovost, Johns Hopkins Medical Institution, 901 South Bond St.,
Baltimore, MD 21231, United States. Email: ppronovo@jhmi.edu
SOURCE
Journal of Clinical Outcomes Management (2004) 11:1 (26-33). Date of
Publication: Jan 2004
ISSN
1079-6533
ABSTRACT
• Objective: To decrease medication errors that occur during the transfer of
patients from a surgical intensive care unit (ICU) by institution of a
computerized medication reconciliation tool. • Design: Prospective cohort
study. Setting and participants: Patients admitted to a 16-bed surgical ICU
in an academic medical center. • Measurement: Proportion of medical records
with at least 1 error identified. Secondary outcomes included compliance
with the tool and number of medication orders changed. • Results: Over the
1-year study period, 1455 medication reconciliation forms were completed.
636 medication orders were changed as a result of the medication form, and
299 (21%) individual patients required at least 1 change. An average of 12.2
orders were changed per week, affecting an average of 6 patients per week.
There was a high rate of compliance with the form. • Conclusion: The
implementation of a simple, inexpensive tool is associated with a decrease
in medication errors that reach patients during transfer from a surgical
ICU.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
electronic medical record
intensive care unit
medication error
patient transport
EMTREE MEDICAL INDEX TERMS
article
cohort analysis
computer system
controlled study
hospital admission
human
medical record
outcomes research
patient compliance
prospective study
surgical ward
university hospital
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Biophysics, Bioengineering and Medical Instrumentation (27)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2004245209
PUI
L38735531
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 870
TITLE
Air medical and critical care transport program down under
AUTHOR ADDRESSES
SOURCE
Air Medical Journal (2004) 23:1 (16). Date of Publication: Jan 2004
ISSN
1067-991X
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
aerospace medicine
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
Australia
competence
e-mail
education program
human
medical information
New Zealand
note
organization and management
paramedical personnel
priority journal
professional standard
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2004096367
PUI
L38256473
DOI
10.1016/j.amj.2003.10.006
FULL TEXT LINK
http://dx.doi.org/10.1016/j.amj.2003.10.006
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 871
TITLE
Guidelines for the inter- and intrahospital transport of critically ill
patients
AUTHOR NAMES
Warren J.
Fromm Jr. R.E.
Orr R.A.
Rotello L.C.
Mathilda Horst H.
AUTHOR ADDRESSES
(Warren J.; Fromm Jr. R.E.; Orr R.A.; Rotello L.C.; Mathilda Horst H.) Amer.
Coll. of Critical Care Med., .
(Warren J.) Northwest Community Hospital, Arlington Heights, IL, United
States.
(Fromm Jr. R.E.) Baylor College of Medicine, Houston, TX, United States.
(Orr R.A.) Children's Hospital of Pittsburgh, University of Pittsburgh,
School of Medicine, Pittsburgh, PA.
(Rotello L.C.) Suburban Hospital, Bethesda, MD, United States.
(Mathilda Horst H.) Henry Ford Hospital, Detroit, MI, United States.
CORRESPONDENCE ADDRESS
J. Warren, Northwest Community Hospital, Arlington Heights, IL, United
States.
SOURCE
Critical Care Medicine (2004) 32:1 (256-262). Date of Publication: January
2004
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
ABSTRACT
Objective: The development of practice guidelines for the conduct of intra-
and interhospital transport of the critically ill patient. Data Source:
Expert opinion and a search of Index Medicus from January 1986 through
October 2001 provided the basis for these guidelines. A task force of
experts in the field of patient transport provided personal experience and
expert opinion. Study Selection and Data Extraction: Several prospective and
clinical outcome studies were found. However, much of the published data
comes from retrospective reviews and anecdotal reports. Experience and
consensus opinion form the basis of much of these guidelines. Results of
Data Synthesis: Each hospital should have a formalized plan for intra- and
Interhospital transport that addresses a) pretransport coordination and
communication; b) transport personnel; c) transport equipment; d) monitoring
during transport; and e) documentation. The transport plan should be
developed by a multidisciplinary team and should be evaluated and refined
regularly using a standard quality improvement process. Conclusion: The
transport of critically ill patients carries inherent risks. These
guidelines promote measures to ensure safe patient transport. Although both
intra- and interhospital transport must comply with regulations, we believe
that patient safety is enhanced during transport by establishing an
organized, efficient process supported by appropriate equipment and
personnel.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
patient transport
EMTREE MEDICAL INDEX TERMS
clinical observation
experience
health program
hospital
human
interpersonal communication
literature
medical documentation
medical information
medical personnel
medical society
patient monitoring
priority journal
review
risk assessment
safety
treatment outcome
visuomotor coordination
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2004045839
MEDLINE PMID
14707589 (http://www.ncbi.nlm.nih.gov/pubmed/14707589)
PUI
L38125591
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 872
TITLE
Top 10 ways to prepare for a pediatric critical care transport
AUTHOR NAMES
Shields R.
AUTHOR ADDRESSES
(Shields R., robert.shields@tch.harvard.edu) Critical Care Transport Team,
Children's Hospital, Boston, MA, United States.
(Shields R., robert.shields@tch.harvard.edu) 14 Morton Ave, Saugus, MA
01906, United States.
CORRESPONDENCE ADDRESS
R. Shields, 14 Morton Ave, Saugus, MA 01906, United States. Email:
robert.shields@tch.harvard.edu
SOURCE
Journal of Emergency Nursing (2003) 29:6 (574-575). Date of Publication:
December 2003
ISSN
0099-1767
BOOK PUBLISHER
Mosby Inc.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
pediatrics
EMTREE MEDICAL INDEX TERMS
airway conductance
child
environmental exposure
human
immobilization
medical device
medical record
nasogastric tube
note
nursing
patient care
sedation
splinting
thermoregulation
vascular patency
LANGUAGE OF ARTICLE
English
MEDLINE PMID
14631349 (http://www.ncbi.nlm.nih.gov/pubmed/14631349)
PUI
L37541031
DOI
10.1016/S0099-1767(03)00347-7
FULL TEXT LINK
http://dx.doi.org/10.1016/S0099-1767(03)00347-7
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 873
TITLE
The transfer of capacities in cardiology: Is it the solution to coming
difficulties in terms of medical demography that the French general
hospitals will have to face in their departments of cardiology?
ORIGINAL (NON-ENGLISH) TITLE
Les transferts de compétence en cardiologie: La solution aux difficultés
démographiques médicales à venir dans les services de cardiologie des
hôpitaux généraux Français?
AUTHOR NAMES
Dujardin J.J.
AUTHOR ADDRESSES
(Dujardin J.J., jjacques.dujardin@ch-douai.fr) Sereviceece de Cardiologie,
Centre Hospitalier de Douai, BP 740, 59507 Douai Cedex, France.
CORRESPONDENCE ADDRESS
J.J. Dujardin, Sereviceece de Cardiologie, Centre Hospitalier de Douai, BP
740, 59507 Douai Cedex, France. Email: jjacques.dujardin@ch-douai.fr
SOURCE
Annales de Cardiologie et d'Angeiologie (2003) 52:5 (282-284). Date of
Publication: November 2003
ISSN
0003-3928
BOOK PUBLISHER
Elsevier Masson SAS, 62 rue Camille Desmoulins, Issy les Moulineaux Cedex,
France.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cardiology
demography
France
general hospital
EMTREE MEDICAL INDEX TERMS
Canada
comparative study
coronary care unit
editorial
human
manpower
nurse practitioner
physician assistant
United Kingdom
United States
EMBASE CLASSIFICATIONS
Internal Medicine (6)
Cardiovascular Diseases and Cardiovascular Surgery (18)
LANGUAGE OF ARTICLE
French
EMBASE ACCESSION NUMBER
2003464110
MEDLINE PMID
14714340 (http://www.ncbi.nlm.nih.gov/pubmed/14714340)
PUI
L37409054
DOI
10.1016/S0003-3928(03)00095-7
FULL TEXT LINK
http://dx.doi.org/10.1016/S0003-3928(03)00095-7
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 874
TITLE
Evacuation of the intensive care unit in case of danger
ORIGINAL (NON-ENGLISH) TITLE
Die räumung von intensivstationen im gefahrenfall
AUTHOR NAMES
Marx F.
AUTHOR ADDRESSES
(Marx F., dr.frank.marx@t-online.de) Rettungsdienst, Berufsfeuerwehr
Duisburg, Wintgensstr. 111, D-47055 Duisburg, Germany.
CORRESPONDENCE ADDRESS
F. Marx, Rettungsdienst, Berufsfeuerwehr Duisburg, Wintgensstr. 111, D-47055
Duisburg, Germany. Email: dr.frank.marx@t-online.de
SOURCE
Journal fur Anasthesie und Intensivbehandlung (2003) 10:1 (181-182). Date of
Publication: 2003
ISSN
0941-4223
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hazard
intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
conference paper
Germany
medical documentation
medical literature
practice guideline
ventilator
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
German
EMBASE ACCESSION NUMBER
2003418857
PUI
L37270979
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 875
TITLE
The impact of early transfer bias in a growth study among neonatal intensive
care units
AUTHOR NAMES
Olsen I.E.
Richardson D.K.
Schmid C.H.
Ausman L.M.
Dwyer J.T.
AUTHOR ADDRESSES
(Olsen I.E., olseni@email.chop.edu) Department of Nutrition, Beth Israel
Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02212, United
States.
(Ausman L.M.; Dwyer J.T.) Gerald J./Dorothy R. Friedman S., Tufts
University, 153 Harrison Avenue, Boston, MA 02111, United States.
(Richardson D.K.) Department of Neonatology, Beth Israel Deaconess Medical
Center, 330 Brookline Avenue, Boston, MA 02215, United States.
(Richardson D.K.; Dwyer J.T.) Dept. Hlth. Plcy./Mgmt./Matern./C., Harvard
School of Public Health, 677 Huntington Avenue, Boston, MA 02111, United
States.
(Schmid C.H.) Biostatistics Research Center, Division of Clinical Care
Research, Tufts-New England Medical Center, 750 Washington Street, Boston,
MA 02111, United States.
(Schmid C.H.; Ausman L.M.; Dwyer J.T.) School of Medicine, Tufts University,
Tufts-New England Medical Center, 750 Washington Street, Boston, MA 02111,
United States.
(Ausman L.M.; Dwyer J.T.) US Department of Agriculture, Hum. Nutr. Research
Center on Aging, Tufts University, 153 Harrison Avenue, Boston, MA 02111,
United States.
(Dwyer J.T.) Frances Stern Nutrition Center, Tufts-New England Medical
Center, 750 Washington Street, Boston, MA 02111, United States.
(Olsen I.E., olseni@email.chop.edu) Children's Hospital of Philadelphia,
Div. of Gastroenterol. and Nutrition, 3535 Market Street, Philadelphia, PA
19104, United States.
CORRESPONDENCE ADDRESS
I.E. Olsen, Children's Hospital of Philadelphia, Div. of Gastroenterol. and
Nutrition, 3535 Market Street, Philadelphia, PA 19104, United States. Email:
olseni@email.chop.edu
SOURCE
Journal of Clinical Epidemiology (2003) 56:10 (998-1005). Date of
Publication: 1 Oct 2003
ISSN
0895-4356
BOOK PUBLISHER
Elsevier USA, 6277 Sea Harbor Drive, Orlando, United States.
ABSTRACT
Background and Objective: Transfer of infants between hospitals or their
discharge home may bias comparisons of the performance across neonatal
intensive care units (NICUs). This study attempts to show the potential size
of transfer bias in the context of a large cohort study and describe
strategies for minimizing this type of bias. Methods: To limit transfer bias
in a neonatal growth study of extremely premature infants in six tertiary
NICUs, we restricted eligibility to infants <30 weeks gestation at birth and
substituted matched replacements for early transfers (infants transferred or
discharged prior to day of life 16). Results: The restriction strategy was
successful, reducing the overall early transfer rate from 16.4 to 3.6% and
the range of transfer rates among individual NICUs from 0.6-32.7% to
0-11.0%. Replacement by matched substitutes had a much smaller effect
because of the small number of early transfers and our inability to match on
all factors distinguishing early transfers. Conclusion: Sampling strategies
to minimize infants lost to follow-up were more successful than replacement
strategies in limiting transfer bias in a NICU growth study. Although
complete elimination of bias is likely impossible, valid studies require
efforts to minimize, quantify, and test the effect of transfer bias. © 2003
Elsevier Inc. All rights reserved.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
epidemiological data
hospital discharge
newborn intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
cohort analysis
controlled study
follow up
gestational age
human
newborn
normal human
prematurity
priority journal
procedures
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Obstetrics and Gynecology (10)
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2003418394
MEDLINE PMID
14568632 (http://www.ncbi.nlm.nih.gov/pubmed/14568632)
PUI
L37268088
DOI
10.1016/S0895-4356(03)00168-9
FULL TEXT LINK
http://dx.doi.org/10.1016/S0895-4356(03)00168-9
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 876
TITLE
Critical Care Nursing Expertise during Air Transport
AUTHOR NAMES
Topley D.K.
Schmelz J.
Henkenius-Kirschbaum J.
Horvath K.J.
AUTHOR ADDRESSES
(Topley D.K.; Schmelz J.; Henkenius-Kirschbaum J.; Horvath K.J.) Wilford
Hall Medical Center, 2200 Berquist Drive, Lackland Air Force Base, TX 78236,
United States.
CORRESPONDENCE ADDRESS
D.K. Topley, Wilford Hall Medical Center, 2200 Berquist Drive, Lackland Air
Force Base, TX 78236, United States.
SOURCE
Military Medicine (2003) 168:10 (822-826). Date of Publication: October 2003
ISSN
0026-4075
BOOK PUBLISHER
Association of Military Surgeons of the US, 9320 Old Georgetown Road,
Bethesda, United States.
ABSTRACT
The purpose of this study was to describe the practical knowledge possessed
by registered nurses that are part of the Air Force's Critical Care Air
Transport Team (CCATT) and distinguish salient features of CCATT knowledge
to critical care nursing in the hospital. This research study used
descriptive, exploratory methods. Twelve CCATT nurses, identified as
experts, were included in the study. Data were collected using written
narratives by each participant; group interviews in which nurses discussed
the written narratives; and individual interviews. Data were analyzed using
interpretive phenomenology. Four major themes developed from the data. The
knowledge embedded in CCATT nursing included: preflight preparation,
in-flight assessment and environment, characteristics of CCATT nurse, and
hospital vs. in-flight nursing practice. CCATT nurses improvise and provide
nursing care based on past experiences using a broad critical care knowledge
base. This has led to the development of a unique body of knowledge for
nursing care. The areas of assessment and preparation described by the CCATT
nurses can serve as a template for the Air Force's CCATT training program
and CCATT orientation checklists. This study also identified several topics
for future research.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
nursing
patient transport
EMTREE MEDICAL INDEX TERMS
air force
article
comparative study
hospital care
human
medical education
nurse
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2003428882
MEDLINE PMID
14620647 (http://www.ncbi.nlm.nih.gov/pubmed/14620647)
PUI
L37305321
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 877
TITLE
Lack of clear channels of communication in patient transfer between care
facilities leads to fragmentation in care
AUTHOR ADDRESSES
SOURCE
International Journal for Quality in Health Care (2003) 15:5 (441). Date of
Publication: October 2003
ISSN
1353-4505
BOOK PUBLISHER
Oxford University Press, Great Clarendon Street, Oxford, United Kingdom.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health care facility
hospital management
patient transport
EMTREE MEDICAL INDEX TERMS
case report
community hospital
hospital admission
hospital discharge
hospital personnel
human
infant
intensive care unit
note
patient information
priority journal
staff training
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2003414787
MEDLINE PMID
14527988 (http://www.ncbi.nlm.nih.gov/pubmed/14527988)
PUI
L37259381
DOI
10.1093/intqhc/mzg072
FULL TEXT LINK
http://dx.doi.org/10.1093/intqhc/mzg072
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 878
TITLE
Understanding uncertainty and minimizing families' anxiety at the time of
transfer from intensive care
AUTHOR NAMES
Mitchell M.L.
Courtney M.
Coyer F.
AUTHOR ADDRESSES
(Mitchell M.L., marion.mitchell@mailbox.gu.edu.au) School of Nursing,
Griffith University, Logan Campus, University Drive, Meadowbrook, QLD 4131,
Australia.
(Courtney M.; Coyer F.) School of Nursing, Queensland University of
Technology, Kelvin Grove, QLD, Australia.
CORRESPONDENCE ADDRESS
M. Mitchell, School of Nursing, Griffith University, Logan Campus,
University Drive, Meadowbrook, QLD 4131, Australia. Email:
marion.mitchell@mailbox.gu.edu.au
SOURCE
Nursing and Health Sciences (2003) 5:3 (207-217). Date of Publication:
September 2003
ISSN
1441-0745
BOOK PUBLISHER
Blackwell Publishing, 550 Swanston Street, Carlton South, Australia.
ABSTRACT
When general ward registered nurses (RN) receive patients from an intensive
care unit (ICU) they report that much of their time in the initial phases
revolves around meeting family needs (Farvis, 2002). Families experience
anxiety when leaving the security of the close monitoring seen in ICU
(Leith, 1999) and their anxiety reduces their ability to play a key role in
the patient's recovery (McShane, 1991; Leske, 1992) as it can impair their
decision-making (Cagan, 1988; Halm et al., 1993). By reducing a family's
anxiety, they may be more able to cope with the necessary transition to a
general ward and support the patient's recovery. A literature search from
1990 onwards was performed within the CINAHL, Medline and Cochrane databases
using the key words: intensive care, family, General System Theory,
uncertainty, anxiety and transfer. Further articles were retrieved from
citation references from the Web of Science or through the reference lists
of retrieved literature. Library catalogues were searched using the same key
words for books and book chapters. von Bertalanffy's General System Theory
provides a framework for understanding the importance of family in a
critical illness situation. Critical illness permits little or no time to
adapt, thus reducing the family's ability to cope with the situation.
Transfer out of ICU is a significant anxiety-producing event for families.
Uncertainty in illness is reported in other illness situations to reduce
family's adaptation to illness events, but has not been researched with an
ICU cohort of families. Seven out of the top 10 needs of ICU families are
information needs, highlighting the importance of communication regarding
progress and future plans. Nurses require an increased awareness that
transfer anxiety exists for families and to be knowledgable about ways to
reduce its occurrence. Research is required to evaluate the efficacy of
interventions to reduce anxiety for families and examine the level of
uncertainty in illness in this cohort.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
anxiety
family counseling
intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
adaptive behavior
awareness
book
clinical research
Cochrane Library
cohort analysis
convalescence
coping behavior
critical illness
experience
human
interpersonal communication
medical decision making
medical information
medical literature
Medline
nurse attitude
nursing staff
patient monitoring
priority journal
review
theory
time
treatment planning
ward
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2003349180
MEDLINE PMID
12877722 (http://www.ncbi.nlm.nih.gov/pubmed/12877722)
PUI
L37045796
DOI
10.1046/j.1442-2018.2003.00155.x
FULL TEXT LINK
http://dx.doi.org/10.1046/j.1442-2018.2003.00155.x
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 879
TITLE
Interfacility transport of patients admitted to the ICU: Perceived needs of
family members
AUTHOR NAMES
Perez L.
Alexander D.
Wise L.
AUTHOR ADDRESSES
(Perez L.; Alexander D.; Wise L.) Life Flight Med. Transport Program,
Stanford Hospital and Clinics, 300 Pasteur Dr., Stanford, CA 94305, United
States.
CORRESPONDENCE ADDRESS
L. Perez, Life Flight Medical Transport, Stanford Hospital and Clinics, 300
Pasteur Dr., Stanford, CA 94305, United States.
SOURCE
Air Medical Journal (2003) 22:5 (44-48). Date of Publication:
September/October 2003
ISSN
1067-991X
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
ABSTRACT
Introduction: Limited research has been published regarding the needs of
immediate family members with respect to the transport of critically ill
loved ones. Furthermore, very little information exists on transport teams
members' perception of the needs of the family members. Methods: During a
9-month period, a 25-item questionnaire was given to family members of adult
patients who were transported by air or ground. All patients were admitted
into an adult intensive care unit at a major university teaching hospital.
Family members were asked to rank the relative importance of each item with
regard to informational or situational needs. The identical questionnaire
was given to the critical care transport teams employed by the hospital. The
team members were asked to indicate what they thought the family members
ranked as important. Results: Forty-two of 100 family members (42%) returned
the questionnaire by mail. All 13 (100%) critical care transport team
members completed surveys as well. Statistical comparisons indicated that
family members and team members differed significantly on 13 of 25 items.
Team members generally underestimated the importance of these items to
family members. Conclusion: These findings suggest that, in this sample,
transporting crew members often misperceived family members informational
and situational needs.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health care delivery
health care facility
EMTREE MEDICAL INDEX TERMS
article
clinical research
controlled study
critical illness
family
health care need
health survey
hospital admission
human
intensive care
intensive care unit
medical information
patient transport
publication
questionnaire
teaching hospital
university hospital
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2003392996
MEDLINE PMID
14671773 (http://www.ncbi.nlm.nih.gov/pubmed/14671773)
PUI
L37185018
DOI
10.1016/S1067-991X(03)00026-9
FULL TEXT LINK
http://dx.doi.org/10.1016/S1067-991X(03)00026-9
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 880
TITLE
Trauma care systems in France
AUTHOR NAMES
Masmejean E.H.
Faye A.
Alnot J.-Y.
Mignon A.F.
AUTHOR ADDRESSES
(Masmejean E.H., emmanuel.masmejean@hop.egp.ap-hop-paris.fr)
Orthopaedics/Traumatology - Hand/U., Georges Pompidou European Hospital, 20
rue Leblanc, 75908 Paris Cedex 18, France.
(Faye A.) Department of Emergency Surgery, HEGP, Paris, France.
(Alnot J.-Y.) Dept. Orthoped. Surg./Traumatology, Bichat Hospital, Paris,
France.
(Mignon A.F.) Department of Anaesthesiology, Cochin Hospital, Paris, France.
CORRESPONDENCE ADDRESS
E.H. Masmejean, Orthopaedics/Traumatology - Hand/U., Georges Pompidou
European Hospital, 20 rue Leblanc, 75908 Paris Cedex 18, France. Email:
emmanuel.masmejean@hop.egp.ap-hop-paris.fr
SOURCE
Injury (2003) 34:9 (669-673). Date of Publication: September 2003
ISSN
0020-1383
BOOK PUBLISHER
Elsevier Ltd, Langford Lane, Kidlington, Oxford, United Kingdom.
ABSTRACT
The French Republic includes approximatively 60 millions inhabitants for
almost 550,000 km(2). Prehospital management is organised at departement
level (96). This management involves a regulatory system initiated from a
unique phone number (15 national). The medical regulator sends either
first-aid providers or a medical team. On-site care is highly developed and
prehospital medically assisted care is really the first phase of the
treatment of the injured. The team ensures that the victim is in the best
condition for transport and participates in monitoring. Intra-hospital care
begins either in an emergency room, with a physician qualified in Emergency
Medecine, or in a recovery room, with a surgical intensive-care team. There
is no specialisation in trauma in France. All specialist surgeons treat
those aspects of trauma pathology that concern them. All surgeons operate on
trauma patients and with regard to the organ concerned: digestive,
orthopaedic,.... The challenge nervertheless remains that of maintaining
facilities at a sufficient level to deal with everyday pathology, known for
the seriousness of its consequences in both human and financial terms,
within an increasingly sparse hospital infrastructure. Suggestions are
emerging in response to these preoccupations. Organisation at the European
level of hand emergency units (FESUM) is a targeted exemple. © 2003 Elsevier
Ltd. All rights reserved.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health care system
injury
EMTREE MEDICAL INDEX TERMS
convalescence
demography
disaster
emergency ward
finance
first aid
France
geography
hand surgery
health care
health care planning
health center
health service
health status
hospital
hospital department
hospital management
hospital organization
human
intensive care
medical education
medical specialist
medical staff
organ
outpatient
paramedical disciplines
patient care
patient monitoring
primary health care
priority journal
recovery room
responsibility
review
surgeon
telecommunication
traffic accident
traumatology
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
Health Policy, Economics and Management (36)
Forensic Science Abstracts (49)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2003340759
MEDLINE PMID
12951291 (http://www.ncbi.nlm.nih.gov/pubmed/12951291)
PUI
L37013639
DOI
10.1016/S0020-1383(03)00146-3
FULL TEXT LINK
http://dx.doi.org/10.1016/S0020-1383(03)00146-3
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 881
TITLE
Study reveals benchmarking flaws of many report cards, quality rankings.
AUTHOR ADDRESSES
SOURCE
Healthcare benchmarks and quality improvement (2003) 10:8 (85-88). Date of
Publication: Aug 2003
ISSN
1541-1052
ABSTRACT
Transferred patients have 38% longer ICU stays and 41% longer hospital
stays. Many databases used for report cards are administrative, not
clinical. Active awards are seen as more valid than passive ones.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health care quality
hospital
patient transport
quality control
EMTREE MEDICAL INDEX TERMS
article
awards and prizes
hospitalization
human
information dissemination
intensive care unit
organization and management
standard
statistics
United States
utilization review
LANGUAGE OF ARTICLE
English
MEDLINE PMID
12901317 (http://www.ncbi.nlm.nih.gov/pubmed/12901317)
PUI
L37015811
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 882
TITLE
Towards better care: An exploration of some barriers and solutions to
research transfer in the intensive care unit
AUTHOR NAMES
Angus D.C.
AUTHOR ADDRESSES
(Angus D.C., angusdc@ccm.upmc.edu) Clin. Res., Invest.,/Syst. M., Department
of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, United
States.
(Angus D.C., angusdc@ccm.upmc.edu) Scaife Hall, Critical Care Medicine,
University of Pittsburgh, 200 Lothrop Street, Pittsburgh, PA 15213, United
States.
CORRESPONDENCE ADDRESS
D.C. Angus, Scaife Hall, Critical Care Medicine, University of Pittsburgh,
200 Lothrop Street, Pittsburgh, PA 15213, United States. Email:
angusdc@ccm.upmc.edu
SOURCE
Current Opinion in Critical Care (2003) 9:4 (306-307). Date of Publication:
August 2003
ISSN
1070-5295
BOOK PUBLISHER
Lippincott Williams and Wilkins, 530 Walnut Street, Philadelphia, United
States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
EMTREE MEDICAL INDEX TERMS
artificial ventilation
critical illness
editorial
geriatric patient
human
patient care
pneumonia (complication)
research
respiratory distress (therapy)
ventilator associated pneumonia (complication)
EMBASE CLASSIFICATIONS
Internal Medicine (6)
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Public Health, Social Medicine and Epidemiology (17)
Gerontology and Geriatrics (20)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2003312539
MEDLINE PMID
12883286 (http://www.ncbi.nlm.nih.gov/pubmed/12883286)
PUI
L36930375
DOI
10.1097/00075198-200308000-00009
FULL TEXT LINK
http://dx.doi.org/10.1097/00075198-200308000-00009
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 883
TITLE
Can protocolised-weaning developed in the United States transfer to the
United Kingdom context: A discussion
AUTHOR NAMES
Blackwood B.
AUTHOR ADDRESSES
(Blackwood B., b.blackwood@qub.ac.uk) The Queen's University of Belfast,
School of Nursing/Midwifery, 50 Elmwood Avenue, Belfast BT9 6AZ, United
Kingdom.
CORRESPONDENCE ADDRESS
B. Blackwood, The Queen's University of Belfast, School of
Nursing/Midwifery, 50 Elmwood Avenue, Belfast BT9 6AZ, United Kingdom.
Email: b.blackwood@qub.ac.uk
SOURCE
Intensive and Critical Care Nursing (2003) 19:4 (215-225). Date of
Publication: August 2003
ISSN
0964-3397
BOOK PUBLISHER
Churchill Livingstone
ABSTRACT
Weaning patients from mechanical ventilation using standardised protocols
has been demonstrated to be safe and effective in reducing mechanical
ventilation time, intensive care unit (ICU) stay and costs. Studies
supporting this have all been conducted in the United States of America and
weaning protocols are not widely used in the United Kingdom. With such a
strong scientific evidence-base for protocolised-weaning, it is unclear why
the introduction of evidence-based practice in this area is so low in the
UK. There may be a number of reasons for this. First, it may be that the
evidence is considered not to apply to different settings, particularly
between the USA and UK where there are many differences in health care
cultures. Second, it is suggested that the strength of evidence is not the
only factor to account for when trying to introduce research evidence into
practice [Qual. Health Care 7 (1998) 149]. The context or environment into
which the research is to be implemented and how the implementation process
is facilitated are equally important factors to be considered. Kitson et al.
[Qual. Health Care 7 (1998) 149] argue that the interplay between the three
factors of evidence, context and facilitation, enable the successful
implementation of evidence-based practice. This discussion paper explores
the factors that influence the introduction of weaning protocols. The
discussion is structured around the three core elements from Kitson et al.'s
conceptual framework and it draws upon examples of UK and USA contextual
differences from Northern Ireland (NI) and Virginia (VA). © 2003 Elsevier
Ltd. All rights reserved.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
artificial ventilation
clinical protocol
EMTREE MEDICAL INDEX TERMS
article
clinical practice
cultural factor
evidence based medicine
health care cost
health care system
hospitalization
human
intensive care unit
medical research
risk assessment
standardization
United Kingdom
United States
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
MEDLINE PMID
12915111 (http://www.ncbi.nlm.nih.gov/pubmed/12915111)
PUI
L37069904
DOI
10.1016/S0964-3397(03)00053-3
FULL TEXT LINK
http://dx.doi.org/10.1016/S0964-3397(03)00053-3
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 884
TITLE
A review of emergency department fluid resuscitation of burn patients
transferred to a regional, verified burn center
AUTHOR NAMES
Hagstrom M.
Wirth G.A.
Evans G.R.D.
Ikeda C.J.
AUTHOR ADDRESSES
(Hagstrom M.; Wirth G.A.; Evans G.R.D.) Univ. CA Irvine Med. Ctr. Burn Ctr.,
San Francisco, CA, United States.
(Ikeda C.J.) St. Francis Memorial Hospital, San Francisco, CA, United
States.
(Evans G.R.D.) Division of Plastic Surgery, University of California, 101
The City Drive, Orange, CA 92868, United States.
CORRESPONDENCE ADDRESS
G.R.D. Evans, Division of Plastic Surgery, University of California, 101 The
City Drive, Orange, CA 92868, United States.
SOURCE
Annals of Plastic Surgery (2003) 51:2 (173-176). Date of Publication: 1 Aug
2003
ISSN
0148-7043
BOOK PUBLISHER
Lippincott Williams and Wilkins, 530 Walnut Street, Philadelphia, United
States.
ABSTRACT
The purpose of this study was to examine the adequacy of burn patient fluid
resuscitation in relationship to the American Burn Association formula
before arrival at a regional burn center. Further substratification of the
data was undertaken to compare total burn surface area and fluid volume
resuscitation as evaluated from the primary hospital's emergency department
staff vs. the burn intensive care unit staff. The charts of all patients
admitted to the burn center during 1 year were reviewed retrospectively.
Data were compiled to calculate the time of injury, time of arrival in the
referring emergency room, time in transit to the burn unit, and time of
arrival in the burn unit. The total number of patients evaluated in the
study was 41. Patients who were not referred from outside hospitals or who
had incomplete charts were excluded. The average time from initial burn to
transfer to the burn intensive care unit was 6.26 hours (range, 0.5-96
hours). The average total body surface area (TBSA) evaluated by the
referring emergency department staff was 23.9% (range, 5-70%) compared with
the burn intensive care unit staff evaluation average of 17.8% (range,
2-55%). Using the referring emergency department staff TBSA percentage,
evaluation of the data revealed that only 23% of patients fell within the
accepted range using the American Burn Association formula. Furthermore, 30%
of patients were overresuscitated whereas 47% were underresuscitated. Of the
overresuscitated patients, 1 patient was critically overresuscitated. In the
group of underresuscitated patients, five were critically underresuscitated.
Thirty-three percent of the patients' TBSA had a more than 50% discrepancy
between the burn unit and the emergency department calculations. The authors
conclude that better educating providers referring patients to regional burn
centers can make a marked improvement in the overall care of burn patients.
More important, early communication with the referring burn staff has been
encouraged. Early communication permits review of estimated TBSA burn
evaluations and permits cooperative calculations and optimal delivery of
early fluid resuscitation. Burn center practitioners can improve care of
patients before arrival by appropriately guiding the referring physician.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
burn (therapy)
emergency treatment
fluid therapy
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
body surface
calculation
child
clinical article
controlled study
critical illness
data analysis
emergency health service
evaluation study
hospital admission
hospital personnel
human
infant
intensive care unit
patient care
patient referral
physician
priority journal
review
time
EMBASE CLASSIFICATIONS
Surgery (9)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2003317001
MEDLINE PMID
12897521 (http://www.ncbi.nlm.nih.gov/pubmed/12897521)
PUI
L36944486
DOI
10.1097/01.SAP.0000058494.24203.99
FULL TEXT LINK
http://dx.doi.org/10.1097/01.SAP.0000058494.24203.99
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 885
TITLE
Transport services under stress: Patient air transfers due to industrial
action in Christchurch
AUTHOR NAMES
Dzendrowskyj P.
Bowie D.
Shaw G.
AUTHOR ADDRESSES
(Dzendrowskyj P., peter.Dzendrowskyj@middlemore.co.nz; Bowie D.; Shaw G.)
Intensive Care Unit, Christchurch Hospital, Christchurch, New Zealand.
(Dzendrowskyj P., peter.Dzendrowskyj@middlemore.co.nz) Intensive Care Unit,
Middlemore Hospital, Auckland, New Zealand.
CORRESPONDENCE ADDRESS
P. Dzendrowskyj, Intensive Care Unit, Middlemore Hospital, Auckland, New
Zealand. Email: peter.Dzendrowskyj@middlemore.co.nz
SOURCE
New Zealand Medical Journal (2003) 116:1177. Date of Publication: 11 Jul
2003
ISSN
1175-8716
1175-8716 (electronic)
BOOK PUBLISHER
New Zealand Medical Association, 26 The Terrace, P.O. Box 156, Wellington,
New Zealand.
ABSTRACT
Aims: On 2 and 3 December 2001, widespread industrial action by nursing
staff in the five public hospitals in Christchurch resulted in a minimal
number of nurses being available for inpatient care. The major hospital
affected was Christchurch Public Hospital. Mass transfer of patients (and
relatives) occurred, by road to local, private nursing homes, and by air to
hospitals throughout New Zealand. This caused disruption at both a local and
national level. This paper discusses the process by which air transfers took
place and the lessons learnt from the experience. Methods: The reduction of
inpatient numbers in this tertiary referral hospital was necessary in
anticipation of a full withdrawal of labour by the nursing staff. All
patients identified as potentially transferable were individually assessed
as to the risk of remaining in an understaffed hospital versus that of
transfer. The Intensive Care Unit (ICU) coordinated the triage of patients
and organised air transfers. All elective work was suspended. Following
strike action, all patients transferred were returned to Christchurch as
rapidly as possible. Results: Eighty four patients were identified for air
transfer. Eight were unfit for transfer and, of the remainder, 43 were
transferred with their relatives in a six-day period before the industrial
action began. This required the services of all medical air transport
facilities within New Zealand, placing the aeromedical retrieval services
under considerable stress. The hospital was reduced to 20% capacity at
strike commencement (from 650 beds to 148). Intensivists performed nursing
duties in the ICU. Conclusions: Two days of strike action resulted in 15
days of local and national disruption. Central coordination of all
aero-medical transfer services, hospital teams, ambulance and social
services was essential. The provision of 'family packages' was useful in
assisting with the marked disruption experienced by patients and relatives.
© NZMA.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital management
patient transport
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
article
aviation
female
health care delivery
health care facility
hospital personnel
hospital service
human
intensive care
intensive care unit
major clinical study
male
New Zealand
nursing staff
risk assessment
trade union
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2005440177
MEDLINE PMID
12861311 (http://www.ncbi.nlm.nih.gov/pubmed/12861311)
PUI
L41387002
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 886
TITLE
Transferred patients hurt referral hospitals' quality ratings.
AUTHOR NAMES
Levenson D.
AUTHOR ADDRESSES
(Levenson D.)
CORRESPONDENCE ADDRESS
D. Levenson,
SOURCE
Report on medical guidelines & outcomes research (2003) 14:12 (1-2, 5). Date
of Publication: 27 Jun 2003
ISSN
1050-5636
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health care quality
hospital
mortality
patient transport
EMTREE MEDICAL INDEX TERMS
accreditation
APACHE
article
comparative study
human
intensive care unit
quality control
statistics
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
12903638 (http://www.ncbi.nlm.nih.gov/pubmed/12903638)
PUI
L37015817
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 887
TITLE
Accepting critically ill transfer patients: adverse effect on a referral
center's outcome and benchmark measures.
AUTHOR NAMES
Rosenberg A.L.
Hofer T.P.
Strachan C.
Watts C.M.
Hayward R.A.
AUTHOR ADDRESSES
(Rosenberg A.L.; Hofer T.P.; Strachan C.; Watts C.M.; Hayward R.A.)
University of Michigan and the Department of Veterans Affairs Health
Services Research & Development Service, Veterans Affairs Ann Arbor
Healthcare System, Ann Arbor, Michigan 48109-0048, USA.
CORRESPONDENCE ADDRESS
A.L. Rosenberg, University of Michigan and the Department of Veterans
Affairs Health Services Research & Development Service, Veterans Affairs Ann
Arbor Healthcare System, Ann Arbor, Michigan 48109-0048, USA. Email:
arosen@umich.edu
SOURCE
Annals of internal medicine (2003) 138:11 (882-890). Date of Publication: 3
Jun 2003
ISSN
1539-3704 (electronic)
ABSTRACT
BACKGROUND: Common methods of benchmarking clinical performance rarely, if
ever, account for admission source and, in particular, the effect of a
patient being transferred from one medical center to another. Small biases
in comparisons of observed versus expected deaths can substantially affect
how high-quality institutions compare with peer hospitals. With the most
sophisticated and validated set of case-mix measures available for patients,
the intensive care unit is an ideal setting in which to study the effect of
a patient's being transferred from another hospital. OBJECTIVE: To determine
the extent of bias in benchmarking outcomes when performance measures do not
account for transfer patients' greater severity of illness. DESIGN:
Prospectively developed cohort study. SETTING: Medical intensive care unit
(MICU) at a tertiary care university hospital. PATIENTS: 4579 consecutive
admissions for 4208 patients from 1 January 1994 to 1 April 1998.
MEASUREMENTS: MICU and hospital lengths of stay, MICU readmission, and
hospital mortality rates. RESULTS: Compared with directly admitted patients,
MICU patients transferred from another hospital had significantly higher
Acute Physiology Scores at the time of admission and discharge (P = 0.001).
Even after full adjustment for case mix and severity of illness, transfer
patients had a 38% longer MICU stay (95% CI, 32% to 45%), a 41% longer
hospital stay (CI, 34% to 50%), and a 2.2 times greater odds of hospital
mortality (CI, 1.7 to 2.8) than directly admitted patients. With identical
efficiency and quality, a referral hospital with a 25% MICU transfer rate
compared with another with a 0% transfer rate would be penalized by 14
excess deaths per 1000 admissions when a benchmarking program adjusts only
for case mix and severity of illness and not for the source of admission.
CONCLUSIONS: In a setting with the most thorough diagnostic-based, case-mix
adjustment and the most physiologically precise severity-of-illness
information, accepting transfer patients can adversely affect efficiency and
quality benchmarks. Benchmarking and profiling efforts beyond intensive care
units must also recognize and account for this phenomenon; otherwise,
referral centers may have an incentive to refuse care for patients who could
benefit from being transferred to their facility.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
outcome assessment
patient transport
quality control
university hospital
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
APACHE
article
diagnosis related group
epidemiology
female
hospital readmission
hospitalization
human
intensive care unit
length of stay
male
middle aged
mortality
prospective study
standard
LANGUAGE OF ARTICLE
English
MEDLINE PMID
12779298 (http://www.ncbi.nlm.nih.gov/pubmed/12779298)
PUI
L36686481
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 888
TITLE
Summaries for patients. Accepting critically ill transfer patients.
AUTHOR ADDRESSES
SOURCE
Annals of internal medicine (2003) 138:11 (I42). Date of Publication: 3 Jun
2003
ISSN
1539-3704 (electronic)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
outcome assessment
patient transport
quality control
university hospital
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
article
epidemiology
female
hospital readmission
human
intensive care unit
length of stay
male
middle aged
mortality
patient education
prospective study
standard
LANGUAGE OF ARTICLE
English
MEDLINE PMID
12779311 (http://www.ncbi.nlm.nih.gov/pubmed/12779311)
PUI
L36686492
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 889
TITLE
Utilization, reliability, and clinical impact of point-of-care testing
during critical care transport: Six years of experience
AUTHOR NAMES
Gruszecki A.C.
Hortin G.
Lam J.
Kahler D.
Smith D.
Vines J.
Lancaster L.
Daly T.M.
Robinson C.A.
Hardy R.W.
AUTHOR ADDRESSES
(Gruszecki A.C.; Daly T.M.; Robinson C.A.; Hardy R.W., rhardy@path.uab.edu)
Department of Pathology, University of Alabama at Birmingham, Birmingham, AL
35233, United States.
(Hortin G.) Department of Laboratory Medicine, National Institutes of
Health, Bethesda, MD 20892, United States.
(Lam J.) Depts. of Med., Pathol., and Surgery, Gene Therapy Center,
University of Alabama at Birmingham, Birmingham, AL 35233, United States.
(Kahler D.; Smith D.; Vines J.; Lancaster L.) Dept. of Critical Care
Transport, University of Alabama at Birmingham, Birmingham, AL 35233, United
States.
(Hardy R.W., rhardy@path.uab.edu) Dept. of Pathol./Laboratory Medicine,
University of Alabama at Birmingham, WP230, 619 South 19th St., Birmingham,
AL 35233, United States.
CORRESPONDENCE ADDRESS
R.W. Hardy, Dept. of Pathol./Laboratory Medicine, University of Alabama at
Birmingham, WP230, 619 South 19th St., Birmingham, AL 35233, United States.
Email: rhardy@path.uab.edu
SOURCE
Clinical Chemistry (2003) 49:6 (1017-1019). Date of Publication: 1 Jun 2003
ISSN
0009-9147
BOOK PUBLISHER
American Association for Clinical Chemistry Inc., 2101 L Street NW, Suite
202, Washington, United States.
EMTREE DRUG INDEX TERMS
glucose (endogenous compound)
hemoglobin (endogenous compound)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
laboratory test
patient transport
point of care testing
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
article
blood gas analysis
child
electrolyte balance
glucose blood level
health care cost
health care quality
hemoglobin determination
human
major clinical study
newborn
oxygen blood level
DEVICE TRADE NAMES
i_STAT i STAT
DEVICE MANUFACTURERS
i STAT
CAS REGISTRY NUMBERS
glucose (50-99-7, 84778-64-3)
hemoglobin (9008-02-0)
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Biophysics, Bioengineering and Medical Instrumentation (27)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2003215417
MEDLINE PMID
12766018 (http://www.ncbi.nlm.nih.gov/pubmed/12766018)
PUI
L36623501
DOI
10.1373/49.6.1017
FULL TEXT LINK
http://dx.doi.org/10.1373/49.6.1017
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 890
TITLE
Global presence: USAF aeromedical evacuation and critical care air
transport.
AUTHOR NAMES
Pierce P.F.
Evers K.G.
AUTHOR ADDRESSES
(Pierce P.F.; Evers K.G.) University of Michigan School of Nursing, 400
North Ingalls Ann Arbor, MI 48109, USA.
CORRESPONDENCE ADDRESS
P.F. Pierce, University of Michigan School of Nursing, 400 North Ingalls Ann
Arbor, MI 48109, USA. Email: pfpierce@umich.edu
SOURCE
Critical care nursing clinics of North America (2003) 15:2 (221-231). Date
of Publication: Jun 2003
ISSN
0899-5885
ABSTRACT
Flight nursing, whether as an AE nurse or as a CCAT team member, is a
demanding profession that extracts tremendous energy, competes with family
and recreational time, and sets high expectations. On reflection, however,
most crewmembers claim it is the most rewarding experience in their
professional life. The opportunity to be a part of history, to provide care
and transport to American servicemen and women in times of extreme need, and
to accomplish the mission safely despite the circumstances and personal cost
is an unparalleled experience and one that hold tremendous pride.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
aerospace medicine
health
intensive care
military nursing
patient transport
EMTREE MEDICAL INDEX TERMS
education
human
nurse attitude
organization
organization and management
patient care
review
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
12755188 (http://www.ncbi.nlm.nih.gov/pubmed/12755188)
PUI
L36680360
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 891
TITLE
Horizontal gene transfer-emerging multidrug resistance in hospital bacteria
AUTHOR NAMES
Dzidic S.
Bedekovic V.
AUTHOR ADDRESSES
(Dzidic S., dzidic@rudjer.irb.hr) Institute Rudjer Boskovic, Department of
Molecular Genetics, Bijenicka c54, 1002, Zagreb, Croatia.
(Bedekovic V.) Zagreb School of Medicine, Department of Otolaryngology,
Univ. Hospital Sestre Milosrdnice, Zagreb, Croatia.
CORRESPONDENCE ADDRESS
S. Dzidic, Institute Rudjer Boskovic, Department of Molecular Genetics,
Bijenicka c54, 1002, Zagreb, Croatia. Email: dzidic@rudjer.irb.hr
SOURCE
Acta Pharmacologica Sinica (2003) 24:6 (519-526). Date of Publication: 1 Jun
2003
ISSN
1671-4083
BOOK PUBLISHER
Blackwell Publishing Ltd, 9600 Garsington Road, Oxford, United Kingdom.
ABSTRACT
The frequency and spectrum of antibiotic resistant infections have increased
worldwide during the past few decades. This increase has been attributed to
a combination of microbial characteristics, the selective pressure of
antimicrobial use, and social and technical changes that enhance the
transmission of resistant organisms. The resistance is acquired by
mutational change or by the acquisition of resistance-encoding genetic
material which is transfered from another bacteria. The spread of antibiotic
resistance genes may be causally related to the overuse of antibiotics in
human health care and in animal feeds, increased use of invasive devices and
procedures, a greater number of susceptible hosts, and lapses in infection
control practices leading to increased transmission of resistant organisms.
The resistance gene sequences are integrated by recombination into several
classes of naturally occurring gene expression cassettes and disseminated
within the microbial population by horizontal gene transfer mechanisms:
transformation, conjugation or transduction. In the hospital, widespread use
of antimicrobials in the intensive care units (ICU) and for
immunocompromised patients has resulted in the selection of
multidrug-resistant organisms. Methicilin-resistant Staphylococci,
vancomycin resistant Enterococci and extended-spectrum beta-lactamase (ESBL)
producing Gram negative bacilli are identified as major problem in
nosocomial infections. Recent surveillance studies have demonstrated trend
towards more seriously ill patients suffering from multidrug-resistant
nosocomial infections. Emergence of multiresistant bacteria and spread of
resistance genes should enforce the aplication of strict prevention
strategies, including changes in antibiotic treatment regimens, hygiene
measures, infection prevention and control of horizontal nosocomial
transmission of organisms.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
antiinfective agent
EMTREE DRUG INDEX TERMS
beta lactamase (endogenous compound)
vancomycin
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
antibiotic resistance
horizontal gene transfer
hospital infection (epidemiology, etiology, prevention)
multidrug resistance
EMTREE MEDICAL INDEX TERMS
animal food
antibiotic therapy
article
bacterial gene
bacterial mutation
bacterial transmission
conjugation
critical illness
device infection
Enterococcus
epidemiological data
gene cassette
gene expression
gene sequence
genetic code
genetic transduction
genetic transformation
Gram negative bacterium
health care
hospital hygiene
host susceptibility
human
immune deficiency
infection control
intensive care unit
methicillin resistant Staphylococcus aureus
nonhuman
prevalence
prophylaxis
social aspect
CAS REGISTRY NUMBERS
beta lactamase (9073-60-3)
vancomycin (1404-90-6, 1404-93-9)
EMBASE CLASSIFICATIONS
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
Internal Medicine (6)
Public Health, Social Medicine and Epidemiology (17)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2003239362
MEDLINE PMID
12791177 (http://www.ncbi.nlm.nih.gov/pubmed/12791177)
PUI
L36713503
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 892
TITLE
An accident of intra-hospital transport
ORIGINAL (NON-ENGLISH) TITLE
Un accident de transport intrahospitalier
AUTHOR NAMES
Sicot C.
Baranger D.
AUTHOR ADDRESSES
(Sicot C., csicot@lesoumedical.fr; Baranger D.) Le Sou-Médical, 130, rue du
Faubourg-Saint-Denis, 75466 Paris Cedex 10, France.
CORRESPONDENCE ADDRESS
C. Sicot, Le Sou-Médical, 130, rue du Faubourg-Saint-Denis, 75466 Paris
Cedex 10, France. Email: csicot@lesoumedical.fr
SOURCE
Reanimation (2003) 12:3 (268-270). Date of Publication: May 2003
ISSN
1624-0693
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
accident
patient transport
EMTREE MEDICAL INDEX TERMS
court
decision making
hospital
hospital management
human
intensive care
law
law suit
legal liability
safety
short survey
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Forensic Science Abstracts (49)
Surgery (9)
LANGUAGE OF ARTICLE
French
EMBASE ACCESSION NUMBER
2003259196
PUI
L36775632
DOI
10.1016/S1624-0693(03)00053-7
FULL TEXT LINK
http://dx.doi.org/10.1016/S1624-0693(03)00053-7
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 893
TITLE
Out of the box: Group rethinks ECMO transport for girl's sake
AUTHOR NAMES
Valdez B.
AUTHOR ADDRESSES
(Valdez B.) Mercy Air Services, Inc., Fontana, CA, United States.
CORRESPONDENCE ADDRESS
B. Valdez, Mercy Air Services, Inc., Fontana, CA, United States.
SOURCE
Air Medical Journal (2003) 22:3 (22-24). Date of Publication: May/June 2003
ISSN
1067-991X
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
extracorporeal oxygenation
patient transport
EMTREE MEDICAL INDEX TERMS
airplane pilot
case report
female
fever
flight
heart disease
heart muscle necrosis
heart transplantation
helicopter
hospital admission
human
intensive care unit
medical device
medical personnel
note
pediatric hospital
preschool child
risk assessment
survival
thorax surgery
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Cardiovascular Diseases and Cardiovascular Surgery (18)
Biophysics, Bioengineering and Medical Instrumentation (27)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2003234630
MEDLINE PMID
12748527 (http://www.ncbi.nlm.nih.gov/pubmed/12748527)
PUI
L36700625
DOI
10.1016/S1067-991X(03)70003-0
FULL TEXT LINK
http://dx.doi.org/10.1016/S1067-991X(03)70003-0
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 894
TITLE
Minimum standards for intrahospital transport of critically ill patients.
AUTHOR ADDRESSES
SOURCE
Emergency medicine (Fremantle, W.A.) (2003) 15:2 (202-204). Date of
Publication: Apr 2003
ISSN
1035-6851
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
emergency treatment
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
critical illness (therapy)
documentation
health care quality
human
personnel management
practice guideline
rescue personnel
standard
LANGUAGE OF ARTICLE
English
MEDLINE PMID
12675634 (http://www.ncbi.nlm.nih.gov/pubmed/12675634)
PUI
L37079372
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 895
TITLE
Impact of the "Doctor-Heli" system for emergency and critical care medicine
in otolaryngology
AUTHOR NAMES
Okami K.
Miyamoto T.
Onuki J.
Iida M.
Takahashi M.
Yamamoto I.
Nakagawa Y.
Inokuchi S.
AUTHOR ADDRESSES
(Okami K.; Miyamoto T.; Onuki J.; Iida M.; Takahashi M.) Department of
Otolaryngology, Tokai University School of Medicine, Isehara, Japan.
(Yamamoto I.; Nakagawa Y.; Inokuchi S.) Ctr. of Emergency/Critical Care
Med., Tokai University Hospital, Isehara, Japan.
CORRESPONDENCE ADDRESS
K. Okami, Department of Otolaryngology, Tokai University School of Medicine,
Isehara, Japan.
SOURCE
Journal of Otolaryngology of Japan (2003) 106:1 (17-20). Date of
Publication: 2003
ISSN
0030-6622
BOOK PUBLISHER
Oto-Rhino-Laryngological Society of Japan Inc., 23-14, 3-Chome Takanawa,
Minato-ku, Tokyo, Japan.
ABSTRACT
We reported the "Doctor-Heli" (medical service helicopter) system at the
center of emergency and critical care medicine at Tokai University Hospital.
From October 1999 to March 2001, the service had transported 485 patients,
shortening the time to critical care and improving patient-prognosis. We
report a case of cervical and laryngeal trauma occurring during a suicide
attempt successfully treated thanks to the rapid start of critical care
enabled by use of the helicopter. The service has proven its utility in
otolaryngology and head and neck surgery.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
cervical spine injury
helicopter
human
larynx injury
prognosis
suicide
EMBASE CLASSIFICATIONS
Otorhinolaryngology (11)
LANGUAGE OF ARTICLE
Japanese
LANGUAGE OF SUMMARY
English, Japanese
EMBASE ACCESSION NUMBER
2003077218
MEDLINE PMID
12647319 (http://www.ncbi.nlm.nih.gov/pubmed/12647319)
PUI
L36205608
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 896
TITLE
Transfer from ward to PICU: a standard.
AUTHOR NAMES
Heward Y.
AUTHOR ADDRESSES
(Heward Y.) Birmingham Children's Hospital NHS Trust.
CORRESPONDENCE ADDRESS
Y. Heward, Birmingham Children's Hospital NHS Trust.
SOURCE
Paediatric nursing (2003) 15:1 (XI-XIII). Date of Publication: Feb 2003
ISSN
0962-9513
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health care quality
intensive care
patient transport
pediatric nursing
EMTREE MEDICAL INDEX TERMS
article
child
human
nursing
nursing evaluation research
organization and management
practice guideline
standard
United Kingdom
LANGUAGE OF ARTICLE
English
MEDLINE PMID
12655957 (http://www.ncbi.nlm.nih.gov/pubmed/12655957)
PUI
L36473047
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 897
TITLE
Delays in transfer to the ICU: A preventable adverse event?
AUTHOR NAMES
Kaboli P.J.
Rosenthal G.E.
AUTHOR ADDRESSES
(Kaboli P.J.; Rosenthal G.E.) Department of Internal Medicine, Univ. of Iowa
College of Medicine, Iowa City Vet. Aff. Medical Center, Iowa City, IA,
United States.
CORRESPONDENCE ADDRESS
P.J. Kaboli, Department of Internal Medicine, Univ. of Iowa College of
Medicine, Iowa City Vet. Aff. Medical Center, Iowa City, IA, United States.
SOURCE
Journal of General Internal Medicine (2003) 18:2 (155-156). Date of
Publication: 1 Feb 2003
ISSN
0884-8734
BOOK PUBLISHER
Springer New York LLC, 233 Springer Street, New York, United States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
EMTREE MEDICAL INDEX TERMS
cardiopulmonary arrest
clinical practice
death
disease exacerbation
disease severity
editorial
hospital admission
human
nursing staff
patient care
patient monitoring
risk
treatment outcome
ward
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2003100297
MEDLINE PMID
12542592 (http://www.ncbi.nlm.nih.gov/pubmed/12542592)
PUI
L36278954
DOI
10.1046/j.1525-1497.2003.21217.x
FULL TEXT LINK
http://dx.doi.org/10.1046/j.1525-1497.2003.21217.x
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 898
TITLE
Critical-care transport team improves care.
AUTHOR ADDRESSES
SOURCE
ED management : the monthly update on emergency department management (2003)
15:1 (6-7). Date of Publication: Jan 2003
ISSN
1044-9167
ABSTRACT
A critical-care transport team can prevent adverse outcomes, improve patient
flow, and reduce delays. The team carries equipment and medications that can
save a patient's life. Emergency department (ED) nurses can remain in the
department, instead of having to transport patients for diagnostic tests.
Transport nurses assist with resuscitations of trauma patients in the ED.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
health care quality
intensive care
patient care
patient transport
EMTREE MEDICAL INDEX TERMS
article
cost control
human
legal liability
organization and management
standard
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
12515110 (http://www.ncbi.nlm.nih.gov/pubmed/12515110)
PUI
L36480490
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 899
TITLE
Transportable versus fixed platform CT scanners: Comparison of costs
AUTHOR NAMES
Mayo-Smith W.W.
Rhea J.T.
Smith W.J.
Cobb C.M.
Gareen I.F.
Dorfman G.S.
AUTHOR ADDRESSES
(Mayo-Smith W.W., wmayo-smith@lifespan.org; Smith W.J.; Cobb C.M.; Dorfman
G.S.) Department of Radiology, Rhode Island Hospital, Brown University
School of Medicine, 593 Eddy St, Providence, RI 02903, United States.
(Gareen I.F.) Center for Statistical Sciences, Brown University, Providence,
RI, United States.
(Rhea J.T.)
CORRESPONDENCE ADDRESS
W.W. Mayo-Smith, Department of Radiology, Rhode Island Hospital, Brown
University School of Medicine, 593 Eddy St, Providence, RI 02903, United
States. Email: wmayo-smith@lifespan.org
SOURCE
Radiology (2003) 226:1 (63-68). Date of Publication: 1 Jan 2003
ISSN
0033-8419
BOOK PUBLISHER
Radiological Society of North America Inc., 820 Jorie Boulevard, Oak Brook,
United States.
ABSTRACT
PURPOSE: To compare the aggregate hospital technical costs of a
transportable computed tomographic (CT) scanner used to image patients in an
intensive care unit with those of a fixed platform CT scanner in the
radiology department. MATERIALS AND METHODS: Direct fixed costs (ie, machine
and service contract costs) and direct variable costs (ie, personnel costs)
were calculated. Indirect costs, including space costs and departmental
overhead, were calculated. Total costs were calculated as the sum of
indirect, direct fixed, and direct variable costs. Personnel costs were
calculated from time-motion analyses involving 95 patients who underwent
brain CT with either a transportable (n = 51) or a fixed platform (n = 44)
CT scanner. Costs per examination were calculated by using both low- and
high-examination-volume models and compared with use of the Wilcoxon rank
sum test. RESULTS: The total cost per examination for the transportable
scanner ranged from $108.98 to $167.20 for the high- and low-volume models.
Total cost per examination for the fixed platform scanner ranged from $75.24
to $112.39 for the highand low-volume models. For the transportable scanner,
direct fixed, variable, and overhead costs were $87.05, $70.73, and $9.42
per examination, respectively, with the low-volume model. The corresponding
costs for the fixed platform scanner were $46.66, $55.69, and $10.04,
respectively. CONCLUSION: The technical cost of using an in-hospital
transportable CT scanner is higher than that of using a fixed platform
scanner. © RSNA, 2002.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
computed tomography scanner
cost effectiveness analysis
EMTREE MEDICAL INDEX TERMS
article
comparative study
health care personnel
health economics
hospital cost
intensive care unit
priority journal
radiologist
radiology department
socioeconomics
DEVICE TRADE NAMES
Tomoscan M , United StatesPhilips
DEVICE MANUFACTURERS
(United States)Philips
EMBASE CLASSIFICATIONS
Radiology (14)
Biophysics, Bioengineering and Medical Instrumentation (27)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2003062454
MEDLINE PMID
12511669 (http://www.ncbi.nlm.nih.gov/pubmed/12511669)
PUI
L36163908
DOI
10.1148/radiol.2261012047
FULL TEXT LINK
http://dx.doi.org/10.1148/radiol.2261012047
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 900
TITLE
Reducing anxiety in patients and families discharged from ICU.
AUTHOR NAMES
Choate K.
Stewart M.
AUTHOR ADDRESSES
(Choate K.; Stewart M.) Alfred Hospital, Victoria.
CORRESPONDENCE ADDRESS
K. Choate, Alfred Hospital, Victoria.
SOURCE
Australian nursing journal (July 1993) (2002) 10:5 (29). Date of
Publication: Nov 2002
ISSN
1320-3185
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
anxiety (prevention)
hospital discharge
intensive care unit
nurse patient relationship
patient transport
EMTREE MEDICAL INDEX TERMS
article
Australia
family
human
human relation
psychological aspect
LANGUAGE OF ARTICLE
English
MEDLINE PMID
12503383 (http://www.ncbi.nlm.nih.gov/pubmed/12503383)
PUI
L35534986
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 901
TITLE
Clinical evaluation of the Life Support for Trauma and Transport (LSTAT™)
platform
AUTHOR NAMES
Johnson K.
Pearce F.
Westenskow D.
Ogden L.L.
Farnsworth S.
Peterson S.
White J.
Slade T.
AUTHOR ADDRESSES
(Johnson K., kjohnson@remi.med.utah.edu; Ogden L.L.; Farnsworth S.; Peterson
S.; White J.; Slade T.) Department of Anesthesiology, University of Utah
School of Medicine, Salt Lake City, UT, United States.
(Pearce F.) Department of Resuscitative Medicine, Division of Military
Casualty Research, Walter Reed Army Institute of Research, Silver Spring,
MD, United States.
(Westenskow D.) Departments of Biomedical Engineering and Anesthesiology,
University of Utah School of Medicine, Salt Lake City, UT, United States.
CORRESPONDENCE ADDRESS
K. Johnson, Department of Anesthesiology, Univ. of Utah School of Medicine,
Salt Lake City, UT, United States. Email: kjohnson@remi.med.utah.edu
SOURCE
Critical Care (2002) 6:5 (439-446). Date of Publication: October 2002
ISSN
1364-8535
BOOK PUBLISHER
BioMed Central Ltd., 34 - 42 Cleveland Street, London, United Kingdom.
ABSTRACT
Introduction. The Life Support for Trauma and Transport (LSTAT™) is a
self-contained, stretcher-based miniature intensive care unit designed by
the United States Army to provide care for critically injured patients
during transport and in remote settings where resources are limited. The
LSTAT contains conventional medical equipment that has been integrated into
one platform and reduced in size to fit within the dimensional envelope of a
North Atlantic Treaty Organization (NATO) stretcher. This study evaluated
the clinical utility of the LSTAT in simulated and real clinical
environments. Our hypothesis was that the LSTAT would be equivalent to
conventional equipment in detecting and treating life-threatening problems.
Methods. Thirty-one anesthesiologists and recovery room nurses compared the
LSTAT with conventional monitors while managing four simulated critical
events. The time required to reach a diagnosis and treatment was recorded
for each simulation. Subsequently, 10 consenting adult patients were placed
on the LSTAT after surgery for postoperative care in the recovery room.
Questionnaires about aspects of LSTAT functionality were completed by nine
nurses who cared for the patients placed on the LSTAT. Results. In all of
the simulations, there was no clinically significant difference in the time
to diagnosis or treatment between the LSTAT and conventional equipment. All
clinicians reported that they were able to manage the simulated patients
properly with the LSTAT. Nursing staff reported that the LSTAT provided
adequate equipment to care for the patients monitored during recovery from
surgery and were able to detect critical changes in vital signs in a timely
manner. Discussion. Preliminary evaluation of the LSTAT in simulated and
postoperative environments demonstrated that the LSTAT provided appropriate
equipment to detect and manage critical events in patient care. Further work
in assessing LSTAT functionality in a higher-acuity environment is
warranted.
EMTREE DRUG INDEX TERMS
furosemide (drug therapy)
glyceryl trinitrate (sublingual drug administration)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
hospital equipment
patient transport
EMTREE MEDICAL INDEX TERMS
anesthesist
article
artificial ventilation
blood transfusion
cardioversion
controlled study
equipment design
heart disease (diagnosis, drug therapy, therapy)
human
hypothesis
intensive care
intensive care unit
intravenous drug administration
lung disease (diagnosis, drug therapy, therapy)
medical device
monitoring
nursing staff
oxygen therapy
patient care
patient monitoring
pericardiocentesis
postoperative care
priority journal
questionnaire
thorax drainage
United States
DEVICE TRADE NAMES
LSTAT , United StatesIntegrated Medical Systems
Model Narkomed AV2+ , United StatesDrager
Model Propaq Encore , United StatesProtocol Systems Inc
Resuscitation Circuit Model , United StatesVital Signs
DEVICE MANUFACTURERS
(United States)Drager
(United States)Hewlett Packard
(United States)Integrated Medical Systems
(United States)Protocol Systems Inc
(United States)Vital Signs
CAS REGISTRY NUMBERS
furosemide (54-31-9)
glyceryl trinitrate (55-63-0)
EMBASE CLASSIFICATIONS
Internal Medicine (6)
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Anesthesiology (24)
Biophysics, Bioengineering and Medical Instrumentation (27)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2002351591
MEDLINE PMID
12398785 (http://www.ncbi.nlm.nih.gov/pubmed/12398785)
PUI
L35106286
DOI
10.1186/cc1538
FULL TEXT LINK
http://dx.doi.org/10.1186/cc1538
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 902
TITLE
Effects of intra-hospital transport of severely head injured patients on the
parameters of cerebral perfusion
ORIGINAL (NON-ENGLISH) TITLE
Effets des transferts intra-hospitaliers de patients traumatisés crâniens
graves sur les paramètres de perfusion cérébrale.
AUTHOR NAMES
Yeguiayan J.M.
Lenfant F.
Rapenne T.
Bouyssou H.
Freysz M.
AUTHOR ADDRESSES
(Yeguiayan J.M.; Lenfant F.; Rapenne T.; Bouyssou H.; Freysz M.)
CORRESPONDENCE ADDRESS
J.M. Yeguiayan,
SOURCE
Canadian journal of anaesthesia = Journal canadien d'anesthésie (2002) 49:8
(890-891). Date of Publication: Oct 2002
ISSN
0832-610X
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
head injury
patient transport
EMTREE MEDICAL INDEX TERMS
brain circulation
hemodynamics
human
intracranial pressure
letter
pathophysiology
prospective study
time
LANGUAGE OF ARTICLE
French
MEDLINE PMID
12374730 (http://www.ncbi.nlm.nih.gov/pubmed/12374730)
PUI
L35553631
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 903
TITLE
Fractional inspired oxygen on transport ventilators: An important
determinant of volume delivery during assist control ventilation with high
resistive load [1]
AUTHOR NAMES
Breton L.
Minaret G.
Aboab J.
Richard J.-C.
Guerin C.
AUTHOR ADDRESSES
(Breton L.; Minaret G.; Aboab J.; Richard J.-C.; Guerin C.) Medical
Intensive Care Unit, Rouen University Hospital, 1, Rue de Germont, 76000
Rouen, France.
CORRESPONDENCE ADDRESS
J.-C. Richard, Medical Intensive Care Unit, Rouen University Hospital, 1,
Rue de Germont, 76000 Rouen, France. Email: jrichard@invivo.edu
SOURCE
Intensive Care Medicine (2002) 28:8 (1181-1182). Date of Publication: 2002
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag, Tiergartenstrasse 17, Heidelberg, Germany.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
assisted ventilation
EMTREE MEDICAL INDEX TERMS
airway pressure
airway resistance
clinical practice
devices
intensive care unit
letter
positive end expiratory pressure
tidal volume
ventilator
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Anesthesiology (24)
Biophysics, Bioengineering and Medical Instrumentation (27)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2002319996
MEDLINE PMID
12400512 (http://www.ncbi.nlm.nih.gov/pubmed/12400512)
PUI
L34985249
DOI
10.1007/s00134-002-1390-7
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-002-1390-7
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 904
TITLE
A method of transporting critical care mass casualties.
AUTHOR NAMES
Hudson T.L.
Weichart T.
AUTHOR ADDRESSES
(Hudson T.L.; Weichart T.) United States Army Nurse Corp, White House
Medical Unit, Washington, DC, USA.
CORRESPONDENCE ADDRESS
T.L. Hudson, United States Army Nurse Corp, White House Medical Unit,
Washington, DC, USA.
SOURCE
Disaster management & response : DMR : an official publication of the
Emergency Nurses Association (2002) (26-28). Date of Publication: Sep 2002
ISSN
1540-2487
ABSTRACT
The use of a self-contained transport platform can aid in the efforts to
care for mass casualty victims. The platform is equipped with critical care
equipment and has the capabilities of documenting care electronically. It
has been used in a number of different settings and has allowed health care
personnel to provide more efficient, individualized care to a larger number
of victims.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
disaster
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
bed
documentation
human
methodology
military medicine
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
12685464 (http://www.ncbi.nlm.nih.gov/pubmed/12685464)
PUI
L36660484
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 905
TITLE
Evacuation of intensive care patients: Will it never be necessary?
ORIGINAL (NON-ENGLISH) TITLE
Zeitkritischer transport von intensiv-patienten: Ausgeschlossen!?
AUTHOR NAMES
Blazejak J.
Gretenkort P.
AUTHOR ADDRESSES
(Blazejak J.; Gretenkort P.)
SOURCE
Journal fur Anasthesie und Intensivbehandlung (2002) 9:1 (97-98). Date of
Publication: 2002
ISSN
0941-4223
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
disaster
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
conference paper
human
intensive care unit
neurotraumatology
newborn intensive care
patient monitoring
traumatology
EMBASE CLASSIFICATIONS
Internal Medicine (6)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
German
EMBASE ACCESSION NUMBER
2002287105
PUI
L34875257
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 906
TITLE
Transport of intensive care patients by helicopter
ORIGINAL (NON-ENGLISH) TITLE
Intensivtransport von patienten per helikopter
AUTHOR NAMES
Pöschl G.
Röder G.
Kemetzhofer P.
Pointinger H.
AUTHOR ADDRESSES
(Pöschl G.; Röder G.; Kemetzhofer P.; Pointinger H.)
SOURCE
Wiener Klinische Wochenschrift (2002) 114:10-11 A (36-38). Date of
Publication: 14 Jun 2002
ISSN
0043-5325
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
health care quality
helicopter
patient care
short survey
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
German
EMBASE ACCESSION NUMBER
2002213647
PUI
L34632809
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 907
TITLE
Evaluation of ventilators used during transport of ICU patients - A bench
study
AUTHOR NAMES
Zanetta G.
Robert D.
Guérin C.
AUTHOR ADDRESSES
(Zanetta G.; Robert D.; Guérin C., claude.guerin@chu-lyon.fr) Service de
Réanimation Médicale et Assistance Respiratoire, Hôpital de la Croix Rousse,
103 grande rue de la Croix-Rousse, 69004 Lyon, France.
CORRESPONDENCE ADDRESS
C. Guérin, Serv. de Reani. Med./Assist. Resp., Hopital de la Croix Rousse,
103 grande rue de la Croix-Rousse, 69004 Lyon, France. Email:
claude.guerin@chu-lyon.fr
SOURCE
Intensive Care Medicine (2002) 28:4 (443-451). Date of Publication: 2002
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag, Tiergartenstrasse 17, Heidelberg, Germany.
ABSTRACT
Objectives: To evaluate portable ventilators. Design and settings: Bench
study. Materials and methods: Five portable ventilators used for
transporting ICU patients [Osiris 1, (ventilator a), Osiris 2, (ventilator
b), Oxylog 1000, (ventilator c), Oxylog 2000, (ventilator d), AXR1a,
(ventilator e)] and three ICU ventilators which can be used for this purpose
[Horus, (ventilator f), T-Bird, (ventilator g), and SV 300, (ventilator h)]
were compared using a test lung regarding: 1) their capability to maintain
set tidal volumes (V(T)) of 300 ml, 500 ml, and 800 ml under a normal
condition A [resistance (R) 5 cmH(2)O/l/s and compliance (C) 100 ml/cmH(2)0]
and two abnormal conditions B (R 20-C 30) and C (R 50-C 100); 2) trapped
volume (expired V(T) relative to inspired V(T) at 0.7 s, 1 s, and 1.4 s), an
estimate of the expiratory resistance of both circuit and valve; and 3) the
triggering system assessed from the measurements of Δt, ΔP for two
inspiratory efforts at a PEEP of 0 cmH(2)0 and 5 cmH(2)0 in ventilators b,
d, f, g, and h. Flow and airway pressure were measured with an independent
physiologic recording system. Results: 1) V(T). For ventilators a-h, the
mean±SD changes of a set V(T) of 300 ml were -2.6±0.2%, -9.7±0.2%, 0±0%,
-6.1±0.2%, 1.0±0.3%, -2.1±1.7%, 0.3±0%, and -1.3±0.1% (P<0.001),
respectively, during condition B relative to A. Similar results were
obtained for a V(T) of 500 ml and 800 ml and during condition C relative to
A; 2) Trapped volume. For ventilators a-h, trapped volume averaged 1±1%,
20±0%, 30±0.4%, 20±1%, 1±0%, 19±0%, 15±0%, and 14±0% at 0.7 s (P<0.001) and
0.6±0%, 5±0%, 0.5±0%, 0±0%%, 0±0%, 0.6±0%, 0±0%, and 0±0% at 1.4 s (P=NS);
and 3) the triggering system of Oxylog 2000 was poor whereas it was of good
quality for Horus, T-Bird, SV 300, and Osiris 2. Conclusions: The small
portable ventilators presently investigated varied between each other and
were less accurate than ICU ventilators.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
ventilator
EMTREE MEDICAL INDEX TERMS
accuracy
airway pressure
article
breathing
comparative study
intensive care unit
lung compliance
lung resistance
respiratory airflow
tidal volume
DEVICE TRADE NAMES
AXR1a , Francebio ms
Horus , FranceTaema
Osiris 1 , FranceTaema
Osiris 2 , FranceTaema
Oxylog 1000 , GermanyDrager
Oxylog 2000 , GermanyDrager
SV 300 , GermanySiemens
T-Bird , United StatesBird
DEVICE MANUFACTURERS
(France)bio ms
(United States)Bird
(Germany)Drager
(Germany)Siemens
(France)Taema
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Biophysics, Bioengineering and Medical Instrumentation (27)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2002144353
MEDLINE PMID
11967599 (http://www.ncbi.nlm.nih.gov/pubmed/11967599)
PUI
L34328029
DOI
10.1007/s00134-002-1242-5
FULL TEXT LINK
http://dx.doi.org/10.1007/s00134-002-1242-5
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 908
TITLE
Intensive care transfers
AUTHOR NAMES
Hopkins P.
Wolff A.H.
AUTHOR ADDRESSES
(Hopkins P.) Department of Infectious Diseases, Hammersmith Hospital,
London, United Kingdom.
(Wolff A.H., ahwolff@47mvr.com) Barnet Hospital, London, United Kingdom.
CORRESPONDENCE ADDRESS
A.H. Wolff, Intensive Care, Barnet Hospital, London, United Kingdom. Email:
ahwolff@47mvr.com
SOURCE
Critical Care (2002) 6:2 (123-124). Date of Publication: 2002
ISSN
1364-8535
BOOK PUBLISHER
BioMed Central Ltd., 34 - 42 Cleveland Street, London, United Kingdom.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
controlled study
critical illness
developed country
developing country
health care delivery
health care financing
health care planning
health economics
health service
health survey
hospital bed capacity
human
information processing
intensive care unit
law
morbidity
mortality
note
patient monitoring
priority journal
register
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2002134959
MEDLINE PMID
11983037 (http://www.ncbi.nlm.nih.gov/pubmed/11983037)
PUI
L34296340
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 909
TITLE
Oxygen saturation during transfer [3]
AUTHOR NAMES
Wilson C.
Webber S.
AUTHOR ADDRESSES
(Wilson C.) Anaesthetics Department, Sheffield Children's Hospital, Western
Bank, Sheffield S10 2TH, United Kingdom.
(Webber S.) Royal Hallamshire Hospital, Sheffield, United Kingdom.
CORRESPONDENCE ADDRESS
C. Wilson, Anaesthetics Department, Sheffield Children's Hospital, Western
Bank, Sheffield S10 2TH, United Kingdom.
SOURCE
Paediatric Anaesthesia (2002) 12:3 (288). Date of Publication: 2002
ISSN
1155-5645
BOOK PUBLISHER
Blackwell Publishing Ltd, 9600 Garsington Road, Oxford, United Kingdom.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
oxygen saturation
patient transport
EMTREE MEDICAL INDEX TERMS
anesthesia
breathing
cost benefit analysis
diagnostic procedure
face mask
human
institutional care
intensive care unit
letter
oxygenation
postoperative period
priority journal
recovery room
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2002121746
MEDLINE PMID
11903949 (http://www.ncbi.nlm.nih.gov/pubmed/11903949)
PUI
L34264453
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 910
TITLE
Transport of the mechanically ventilated neonate.
AUTHOR NAMES
Bowen S.L.
AUTHOR ADDRESSES
(Bowen S.L.) All Children's Hospital, St. Petersburg, FL 33731-8920, USA.
CORRESPONDENCE ADDRESS
S.L. Bowen, All Children's Hospital, St. Petersburg, FL 33731-8920, USA.
Email: bowens@allkids.org
SOURCE
Respiratory care clinics of North America (2002) 8:1 (67-82). Date of
Publication: Mar 2002
ISSN
1078-5337
ABSTRACT
Although the primary focus of this article is on interhospital transport,
some of the same basic transport principles and management techniques apply
to intrahospital transport. The level of care provided during interhospital
and intrahospital transport should be based on the neonate's diagnosis,
clinical status, anticipated problems, and local, state, and national
standards and regulations. The transport team should have policies and
procedures to direct their practice. Documentation of the transport process
should be initiated with the referral call and continued until the
completion of transport. Planning and anticipation of problems are
essential, as is care of the family. The transport team should evaluate each
neonate's individual response to the transport.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
artificial ventilation
neonatal respiratory distress syndrome (therapy)
patient transport
EMTREE MEDICAL INDEX TERMS
critical illness (therapy)
devices
female
human
male
methodology
monitoring
mortality
newborn
newborn intensive care
review
risk assessment
risk factor
sensitivity and specificity
standard
survival rate
United States
ventilator
LANGUAGE OF ARTICLE
English
MEDLINE PMID
12184658 (http://www.ncbi.nlm.nih.gov/pubmed/12184658)
PUI
L35526317
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 911
TITLE
Relocation stress in critical care: a review of the literature.
AUTHOR NAMES
McKinney A.A.
Melby V.
AUTHOR ADDRESSES
(McKinney A.A.; Melby V.) Intensive Care Unit, Belfast City Hospital Trust,
Lisburn Rd, Belfast, Northern Ireland.
CORRESPONDENCE ADDRESS
A.A. McKinney, Intensive Care Unit, Belfast City Hospital Trust, Lisburn Rd,
Belfast, Northern Ireland. Email: aidinmckinney@hotmail.com
SOURCE
Journal of clinical nursing (2002) 11:2 (149-157). Date of Publication: Mar
2002
ISSN
0962-1067
ABSTRACT
1. Transfer to the ward following a period in intensive care may cause
stress for patients. 2. A review of the literature reveals that this
phenomenon has been described in a number of different ways, such as
transfer stress, transfer anxiety, translocation syndrome and, more
recently, relocation stress. 3. This paper reviews the various concepts
before arriving at a more operational definition of the phenomenon. 4. It
attempts to reveal what causes this phenomenon and to what extent it exists.
5. Patients' responses to transfer are identified and the physical and
psychological problems that have been associated with discharge from
intensive care are discussed. 6. Lists of interventions that the literature
suggests may reduce or prevent this phenomenon from occurring are reviewed.
7. Recommendations for practice development and further research are made.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
mental stress (etiology)
EMTREE MEDICAL INDEX TERMS
adaptive behavior
female
human
intensive care unit
male
nurse attitude
nursing
nursing assessment
patient transport
psychological aspect
review
risk assessment
risk factor
sensitivity and specificity
LANGUAGE OF ARTICLE
English
MEDLINE PMID
11903714 (http://www.ncbi.nlm.nih.gov/pubmed/11903714)
PUI
L35640538
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 912
TITLE
Evaluation of critically ill patients for transfer to long-term acute-care
facilities.
AUTHOR NAMES
Lusk R.
O'Bryan L.
AUTHOR ADDRESSES
(Lusk R.; O'Bryan L.) Hospital Division of Kindred Healthcare, Inc.
CORRESPONDENCE ADDRESS
R. Lusk, Hospital Division of Kindred Healthcare, Inc.
SOURCE
Lippincott's case management : managing the process of patient care (2002)
7:1 (24-26). Date of Publication: 2002 Jan-Feb
ISSN
1529-7764
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
case management
critical illness
intensive care unit
nursing home
patient transport
EMTREE MEDICAL INDEX TERMS
article
artificial ventilation
classification
economics
human
long term care
organization and management
patient selection
time
utilization review
LANGUAGE OF ARTICLE
English
MEDLINE PMID
11840055 (http://www.ncbi.nlm.nih.gov/pubmed/11840055)
PUI
L35579820
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 913
TITLE
Intrahospital transport of critically ill patients [3]
AUTHOR NAMES
Shirley P.J.
Stott S.A.
AUTHOR ADDRESSES
(Shirley P.J.; Stott S.A.) Dept. of Anaesthesia/Intensive Care, Aberdeen
Royal Infirmary, Aberdeen, United Kingdom.
CORRESPONDENCE ADDRESS
P.J. Shirley, Dept. of Anaesthesia/Intensive Care, Aberdeen Royal Infirmary,
Aberdeen, United Kingdom.
SOURCE
Anaesthesia and Intensive Care (2001) 29:6 (669). Date of Publication: 2001
ISSN
0310-057X
BOOK PUBLISHER
Australian Society of Anaesthetists, P.O. Box 600, Edgecliff, Australia.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
patient transport
EMTREE MEDICAL INDEX TERMS
clinical audit
consultation
controlled study
hospital equipment
human
intensive care
letter
major clinical study
medical staff
organization
practice guideline
publishing
United Kingdom
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2001435804
MEDLINE PMID
11771616 (http://www.ncbi.nlm.nih.gov/pubmed/11771616)
PUI
L33138628
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 914
TITLE
Intensive care air transport: The sky is the limit; or is it?
AUTHOR NAMES
Chang D.-M.
AUTHOR ADDRESSES
(Chang D.-M.) Department of Internal Medicine, Tri-Service General Hospital,
National Defense Medical Center, Taipei, Taiwan.
(Chang D.-M.) Department of Internal Medicine, 325 Cheng-Kung Rd., Sec. 2,
Neihu 114, Taipei, Taiwan.
CORRESPONDENCE ADDRESS
T.A. Dillard, Pulmonary/Critical Care Section, Medical College of Georgia,
Augusta, GA, United States.
SOURCE
Critical Care Medicine (2001) 29:11 (2227-2230). Date of Publication: 2001
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
aircraft
artificial ventilation
atmospheric pressure
blood gas analysis
editorial
hemodynamic monitoring
human
hypoxemia (complication)
lung injury (therapy)
nonhuman
priority journal
respiratory distress syndrome (therapy)
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2001405351
MEDLINE PMID
11700432 (http://www.ncbi.nlm.nih.gov/pubmed/11700432)
PUI
L33063559
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 915
TITLE
Information sought on faxed report [5]
AUTHOR NAMES
DePompeo D.
AUTHOR ADDRESSES
(DePompeo D.) The Valley Hospital, Ridgewood, NJ, United States.
CORRESPONDENCE ADDRESS
D. DePompeo, The Valley Hospital, Ridgewood, NJ, United States.
SOURCE
Journal of Emergency Nursing (2001) 27:6 (532). Date of Publication: 2001
ISSN
0099-1767
BOOK PUBLISHER
Mosby Inc.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency ward
fax
hospital management
information processing
medical record
patient transport
public relations
EMTREE MEDICAL INDEX TERMS
emergency health service
health care personnel
hospital admission
hospital subdivisions and components
human
information system
intensive care unit
letter
standard
LANGUAGE OF ARTICLE
English
MEDLINE PMID
11712004 (http://www.ncbi.nlm.nih.gov/pubmed/11712004)
PUI
L33150121
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 916
TITLE
Providing continuity of care for patients transferred from ICU.
AUTHOR NAMES
Haines S.
Crocker C.
Leducq M.
AUTHOR ADDRESSES
(Haines S.; Crocker C.; Leducq M.) Nottingham City Hospital NHS Trust.
CORRESPONDENCE ADDRESS
S. Haines, Nottingham City Hospital NHS Trust.
SOURCE
Professional nurse (London, England) (2001) 17:1 (17-21). Date of
Publication: Sep 2001
ISSN
0266-8130
ABSTRACT
Patients requiring treatments previously only undertaken in critical care
units are now being nursed in other ward areas. A study was carried out to
determine the difficulties that are faced by ward nurses caring for this
highly dependent patient group. Staff and patient stress were problems
experienced and there was a call for closer liaison between ICU and ward
staff.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
attitude to health
intensive care
nursing staff
patient care
EMTREE MEDICAL INDEX TERMS
article
burnout
female
human
male
nurse patient relationship
organization and management
patient transport
psychological aspect
workload
LANGUAGE OF ARTICLE
English
MEDLINE PMID
12030140 (http://www.ncbi.nlm.nih.gov/pubmed/12030140)
PUI
L35600064
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 917
TITLE
Intrahospital transport of critically ill patients: Complications and
difficulties
AUTHOR NAMES
Lovell M.A.
Mudaliar M.Y.
Klineberg P.L.
AUTHOR ADDRESSES
(Lovell M.A.; Mudaliar M.Y.; Klineberg P.L.) Anaesthetic Department,
Westmead Hospital, Westmead, NSW 2203, Australia.
CORRESPONDENCE ADDRESS
M.A. Lovell, Anaesthetic Department, Westmead Hospital, Westmead, NSW 2203,
Australia.
SOURCE
Anaesthesia and Intensive Care (2001) 29:4 (400-405). Date of Publication:
2001
ISSN
0310-057X
BOOK PUBLISHER
Australian Society of Anaesthetists, P.O. Box 600, Edgecliff, Australia.
ABSTRACT
An audit of 97 intrahospital transports of critically ill patients was
undertaken within Westmead Hospital. The aims of this audit were to assess
all factors that may lead to problems during intrahospital transports. At
the completion of a transport medical staff were asked to provide
information about their patient and their treatment, as well as any
difficulties they may have encountered. Overall, 62% of transports reported
some difficulty or complication. Of these, 31% were patient-related and 45%
were related to equipment or the transport environment. (15% encountered
problems in both areas). Many of the difficulties were preventable with
adequate pre-transport communication and planning. Other problems were
directly related to the increased severity of illness in these patients.
EMTREE DRUG INDEX TERMS
antihypertensive agent
bicarbonate
inotropic agent
insulin
muscle relaxant agent
nimodipine
sedative agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
patient transport
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
article
Australia
cardiovascular disease (complication)
central nervous system disease (complication)
clinical audit
complication (complication)
controlled study
disease severity
drug infusion
environmental factor
female
health care planning
human
interpersonal communication
major clinical study
male
medical device
medical staff
patient care
patient monitoring
respiratory tract disease (complication)
ventilator
CAS REGISTRY NUMBERS
bicarbonate (144-55-8, 71-52-3)
insulin (9004-10-8)
muscle relaxant agent (9008-44-0)
nimodipine (66085-59-4)
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2001282087
MEDLINE PMID
11512652 (http://www.ncbi.nlm.nih.gov/pubmed/11512652)
PUI
L32734393
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 918
TITLE
From unit to unit: Danish nurses' experiences of transfer of a small child
to and from an intensive care unit.
AUTHOR NAMES
Hall E.O.
AUTHOR ADDRESSES
(Hall E.O.) Institute of Nursing Science, Faculty of Health Sciences,
University of Aarhus, Denmark.
CORRESPONDENCE ADDRESS
E.O. Hall, Institute of Nursing Science, Faculty of Health Sciences,
University of Aarhus, Denmark. Email: eh@nursingscience.au.dk
SOURCE
Intensive & critical care nursing : the official journal of the British
Association of Critical Care Nurses (2001) 17:4 (196-205). Date of
Publication: Aug 2001
ISSN
0964-3397
ABSTRACT
In this study, Danish nurses' lived experience of transfer of a small child
to and from the intensive care unit was explored. While there has been
considerable research that has addressed transfer from the parents'
perspective, little literature was found which addressed the transfer of
small children from the nurses' perspective. A convenience sample of 19
nurses was interviewed once. Data were analysed following Spiegelberg's and
Van Manen's phenomenological methodologies. Four themes emerged: being
accountable; being supportive to the parents; being with the child; and
experiencing safety and insecurity. Seven subthemes expanded and clarified
the meaning of these themes. The study provides a thematic interpretation of
how Danish nurses experience in-hospital transfers. Overall, the nurses were
responsible to the transferred patient, the unhappy and worried parents, for
technical procedures and the hospital team 'at home' on their own unit.
However, responsibilities did not always include their colleagues on the
receiving unit. It is recommended that transfer experiences be discussed
more in clinical nursing, and that this explorative study needs to be
followed by more studies exploring nurses' experiences of transfer.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
newborn intensive care
patient transport
pediatric nursing
EMTREE MEDICAL INDEX TERMS
adult
article
Denmark
female
human
infant
middle aged
newborn
nurse
preschool child
psychological aspect
LANGUAGE OF ARTICLE
English
MEDLINE PMID
11868727 (http://www.ncbi.nlm.nih.gov/pubmed/11868727)
PUI
L35583582
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 919
TITLE
French and foreign recommendations for the practice of anaesthesia and
intensive care
ORIGINAL (NON-ENGLISH) TITLE
Recommandations françaises et étrangères sur la pratique de
l'anesthésie-réanimation
AUTHOR NAMES
Otteni J.C.
Desmonts J.M.
Haberer J.P.
AUTHOR ADDRESSES
(Otteni J.C.; Desmonts J.M.; Haberer J.P.) Serv. d'Anesthesie-Reanimation
Chir., Hopitaux Universitaires Strasbourg, Hopital de Hautepierre, 67098
Strasbourg Cedex, France.
CORRESPONDENCE ADDRESS
J.C. Otteni, Serv. d'Anesthesie-Reanimation Chir., Hopitaux Universitaires
Strasbourg, Hopital de Hautepierre, 67098 Strasbourg Cedex, France.
SOURCE
Annales Francaises d'Anesthesie et de Reanimation (2001) 20:6 (537-548).
Date of Publication: 2001
ISSN
0750-7658
BOOK PUBLISHER
Elsevier Masson SAS, 62 rue Camille Desmoulins, Issy les Moulineaux Cedex,
France.
ABSTRACT
This article reviews the development of Standards, Recommendations and
Guidelines for practice in anaesthesiology in France and other countries.
The French society for anaesthesia and intensive care (Sfar) has published,
since 1989, 11 basic Standards: 1) Recommendations for the monitoring of
patients during anaesthesia (June 1989, amended on January 1994) [APSF
Newsletter, Summer 1990, page 22]; 2) Recommendations for postanaesthesia
monitoring and care (September 1990); 3) Recommendations for preanaesthesia
care (September 1991); 4) Recommendations for anaesthetic apparatus and
checking before use (January 1994); 5) Recommendations for the equipment of
anaesthesia working places (January 1995); 6) Recommendations for the tasks
of the nurse anaesthetist (January 1995); 7) Recommendations for hygiene
standards in anaesthesia practice (December 1997); 8) Recommendations for
outpatient anaesthesia (September 1990); 9) Recommendations for the practice
of obstetrical analgesia (September 1992); 10) Recommendations for
interhospital physician-accompanied transfers (December 1992); 11)
Recommendations for intrahospital physician-accompanied transfers (February
1994). Additionally the Sfar produced or coproduced 9 Experts' conferences,
15 Consensus conferences and 5 Guidelines for clinical practice. © 2001
Éditions scientifiques et médicales Elsevier SAS.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
anesthesia
intensive care
EMTREE MEDICAL INDEX TERMS
anesthetic equipment
anesthetic recovery
France
health care organization
health care quality
hospital hygiene
nurse
obstetric anesthesia
outpatient care
patient monitoring
patient transport
practice guideline
premedication
review
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
French
LANGUAGE OF SUMMARY
English, French
EMBASE ACCESSION NUMBER
2001234788
MEDLINE PMID
11471501 (http://www.ncbi.nlm.nih.gov/pubmed/11471501)
PUI
L32606066
DOI
10.1016/S0750-7658(01)00412-9
FULL TEXT LINK
http://dx.doi.org/10.1016/S0750-7658(01)00412-9
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 920
TITLE
The evolutionary process of Medical Emergency Team (MET) implementation:
Reduction in unanticipated ICU transfers
AUTHOR NAMES
Salamonson Y.
Kariyawasam A.
Van Heere B.
O'Connor C.
AUTHOR ADDRESSES
(Salamonson Y.; Kariyawasam A.; Van Heere B.; O'Connor C.) ICU/CCU
Department, Campbelltown Hospital, P.O. Box 149, Campbelltown 2560, NSW,
Australia.
(Salamonson Y.) Division of Nursing, Faculty of Health, University of
Western Sydney Macarthur,, P.O. Box 555, Campbelltown 2560, NSW, Australia.
CORRESPONDENCE ADDRESS
Y. Salamonson, ICU/CCU Department, Campbelltown Hospital, P.O. Box 149,
Campbelltown 2560, NSW, Australia.
SOURCE
Resuscitation (2001) 49:2 (135-141). Date of Publication: 2001
ISSN
0300-9572
BOOK PUBLISHER
Elsevier Ireland Ltd, P.O. Box 85, Limerick, Ireland.
ABSTRACT
Objectives: To determine whether the introduction of the Medical Emergency
Team (MET) system designed to provide immediate help for seriously ill
patients: (i) changed the pattern of ICU patient transfers from the wards;
and (ii) improved hospital survival rates. Methods: Prospective information
on MET calls and unanticipated ICU transfers was collected for 3 years in a
suburban metropolitan hospital. Results: A 3-year review of MET showed the
number of MET calls doubled in the second and third year and the team was
activated for more than just the most extremely ill patients. Whilst the
frequency of calls for cardiopulmonary arrest remained constant (n=16),
increased use of the MET resulted in the proportion of calls for
cardiopulmonary arrest dropping from 30% in year 1 to 13% in year 3. A
slight decrease in the percentage of in-hospital deaths (0.74% in year 1 to
0.65% in year 3) was also demonstrated. The incidence of cardiopulmonary
arrest per hospital admission also decreased slightly (0.08-0.07%). Although
the overall number of ICU transfers remained constant, more seriously ill
patients were transferred to ICU via the MET system. This was accompanied by
a significant fall in unanticipated ICU transfers. Whilst the reduction in
hospital deaths was encouraging, this study could not demonstrate whether
the slight improvement in hospital survival rate over the 3 years was due to
the MET system. Conclusion: More information is needed to demonstrate that
the MET system improves patient survival. The study also highlights the
importance of taking proactive measures, which should include providing
in-service education on the benefits of early identification and treatment
of patients who are at risk of acute deterioration, raising awareness and
changing attitudes in hospitals when introducing system such as the MET. ©
2001 Elsevier Science Ireland Ltd.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
article
cardiopulmonary arrest
clinical article
controlled study
deterioration
early diagnosis
evolution
first aid
hospital admission
human
medical education
medical personnel
mortality
normal human
priority journal
survival rate
ward
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English, Portuguese
EMBASE ACCESSION NUMBER
2001203946
MEDLINE PMID
11382518 (http://www.ncbi.nlm.nih.gov/pubmed/11382518)
PUI
L32520925
DOI
10.1016/S0300-9572(00)00353-1
FULL TEXT LINK
http://dx.doi.org/10.1016/S0300-9572(00)00353-1
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 921
TITLE
Intensive care. Critical coverage of ICU discharge deaths.
AUTHOR NAMES
Mulholand H.
AUTHOR ADDRESSES
(Mulholand H.)
CORRESPONDENCE ADDRESS
H. Mulholand,
SOURCE
Nursing times (2001) 97:23 (10). Date of Publication: 2001 Jun 7-13
ISSN
0954-7762
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
intensive care unit
mortality
patient transport
EMTREE MEDICAL INDEX TERMS
article
health services research
human
length of stay
manpower
national health service
needs assessment
standard
United Kingdom (epidemiology)
utilization review
LANGUAGE OF ARTICLE
English
MEDLINE PMID
11954277 (http://www.ncbi.nlm.nih.gov/pubmed/11954277)
PUI
L35668183
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 922
TITLE
Transfer anxiety: preparing to leave intensive care.
AUTHOR NAMES
Coyle M.A.
AUTHOR ADDRESSES
(Coyle M.A.) Altnagelvin Hospital, Londonderry, Northern Ireland, UK.
CORRESPONDENCE ADDRESS
M.A. Coyle, Altnagelvin Hospital, Londonderry, Northern Ireland, UK. Email:
wilmin6@yahoo.com
SOURCE
Intensive & critical care nursing : the official journal of the British
Association of Critical Care Nurses (2001) 17:3 (138-143). Date of
Publication: Jun 2001
ISSN
0964-3397
ABSTRACT
There is much literature to substantiate the inadvertent emotional and
psychological trauma associated with critical care areas. However, alongside
this, there is a growing body of knowledge to show that these intense and
specialized areas are actually perceived as secure, safe and familiar
environments by some patients and family members. Transfer from the
intensive care unit is not always perceived in a positive light and often
the transition is dreaded by both the patient and his family. The evidence
would suggest that discharge from specialized care environments can actually
be as traumatic as admission. This phenomenon has become known as transfer
anxiety, relocation anxiety, or translocation anxiety. There is the
possibility that transfer may induce stress or distress in some patients,
especially when routines, environments and/or invasive monitoring procedures
are altered or ceased without prior knowledge, preparation or adequate
explanation. If healthcare personnel fail to identify and meet the
psychological needs of patients and families relocating from these areas,
the detrimental effects may extend far beyond discharge from ICU. For
relocating patients, transfer from the ICU can be presented as a positive
step. However, treatment to minimize transfer anxiety will only be
successful when all healthcare personnel recognize and react positively to
the psychological factors that affect patients adversely.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
anxiety (etiology)
critical illness
intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
hospital discharge
human
methodology
psychological aspect
review
risk factor
standard
LANGUAGE OF ARTICLE
English
MEDLINE PMID
11868684 (http://www.ncbi.nlm.nih.gov/pubmed/11868684)
PUI
L35482328
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 923
TITLE
Expertenforum der DGAI: Hemodynamic active drugs in critical care medicine -
Glossar, calculation of hemodynamics and oxygen transport
ORIGINAL (NON-ENGLISH) TITLE
Glossar und berechnungen von hämodynamik und sauerstofftransport
AUTHOR NAMES
Burchardi H.
AUTHOR ADDRESSES
(Burchardi H.) Zentrum Anästhesiologie, Rettungs- und Intensivmedizin,
Univ.-Klinikum Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany.
CORRESPONDENCE ADDRESS
H. Burchardi, Zentrum Anästhesiologie, Rettungs- und Intensivmedizin,
Univ.-Klinikum Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany.
SOURCE
Intensivmedizin und Notfallmedizin (2001) 38:3 (216-220). Date of
Publication: 2001
ISSN
0175-3851
EMTREE DRUG INDEX TERMS
acetylcysteine
arachidonic acid
beta adrenergic receptor
corticosteroid
corticotropin
cyclic GMP
endothelin 1
gamma interferon
glyceryl trinitrate
indocyanine green
interleukin 1
isosorbide 2 nitrate
lipopolysaccharide
messenger RNA
n(g) nitroarginine methyl ester
nitric oxide
nitric oxide synthase
nitroprusside sodium
nonsteroid antiinflammatory agent
phosphodiesterase
phospholipase
phospholipase A2
prostacyclin derivative
prostaglandin E1
prostaglandin E2
prostaglandin synthase
thrombocyte activating factor
tumor necrosis factor
tumor necrosis factor antibody
unindexed drug
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
EMTREE MEDICAL INDEX TERMS
article
calculation
cardiovascular system
hemodynamic monitoring
nomenclature
oxygen transport
CAS REGISTRY NUMBERS
acetylcysteine (616-91-1)
arachidonic acid (506-32-1, 6610-25-9, 7771-44-0)
corticotropin (11136-52-0, 9002-60-2, 9061-27-2)
cyclic GMP (7665-99-8)
gamma interferon (82115-62-6)
glyceryl trinitrate (55-63-0)
indocyanine green (3599-32-4)
isosorbide 2 nitrate (16106-20-0)
n(g) nitroarginine methyl ester (50903-99-6)
nitric oxide synthase (125978-95-2)
nitric oxide (10102-43-9)
nitroprusside sodium (14402-89-2, 15078-28-1)
phospholipase A2 (9001-84-7)
phospholipase (9013-93-8)
prostaglandin E1 (745-65-3)
prostaglandin E2 (363-24-6)
prostaglandin synthase (39391-18-9, 59763-19-8, 9055-65-6)
thrombocyte activating factor (64176-80-3, 65154-06-5)
EMBASE CLASSIFICATIONS
Cardiovascular Diseases and Cardiovascular Surgery (18)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
German
EMBASE ACCESSION NUMBER
2001161946
PUI
L32390956
DOI
10.1007/s003900170087
FULL TEXT LINK
http://dx.doi.org/10.1007/s003900170087
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 924
TITLE
Innovation and change: can you afford not to?
AUTHOR NAMES
Melia M.C.
Bieniek R.
Passauer M.B.
AUTHOR ADDRESSES
(Melia M.C.; Bieniek R.; Passauer M.B.) Saint Vincent Health Center, Erie,
PA, USA.
CORRESPONDENCE ADDRESS
M.C. Melia, Saint Vincent Health Center, Erie, PA, USA.
SOURCE
The Journal of cardiovascular management : the official journal of the
American College of Cardiovascular Administrators (2001) 12:3 (16-19). Date
of Publication: 2001 May-Jun
ISSN
1053-5330
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
coronary care unit
health care delivery
organization
patient transport
EMTREE MEDICAL INDEX TERMS
article
commercial phenomena
creativity
hospital bed capacity
human
organization and management
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
11392901 (http://www.ncbi.nlm.nih.gov/pubmed/11392901)
PUI
L33487530
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 925
TITLE
The unusual transfer of the "Spanish model" of organ donation to the United
Kingdom
ORIGINAL (NON-ENGLISH) TITLE
La insólita traslación del "modelo español" de donación de órganos al Reino
Unido.
AUTHOR NAMES
Matesanz R.
AUTHOR ADDRESSES
(Matesanz R.)
CORRESPONDENCE ADDRESS
R. Matesanz,
SOURCE
Nefrología : publicación oficial de la Sociedad Española Nefrologia (2001)
21:2 (99-103). Date of Publication: 2001 Mar-Apr
ISSN
0211-6995
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
donor
hospital personnel
international cooperation
transplantation
EMTREE MEDICAL INDEX TERMS
cultural anthropology
economics
editorial
hospital bed capacity
human
intensive care unit
kidney transplantation
organization and management
psychological aspect
public health
public opinion
Spain
standard
statistics
theoretical model
traffic accident
United Kingdom
utilization review
LANGUAGE OF ARTICLE
Spanish
MEDLINE PMID
11464661 (http://www.ncbi.nlm.nih.gov/pubmed/11464661)
PUI
L33505523
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 926
TITLE
Paediatric intensive care transfers (multiple letters)
AUTHOR NAMES
Murphy P.J.
Jenkins I.
Fraser J.
Marriage S.
Griffiths R.
Smith H.
AUTHOR ADDRESSES
(Murphy P.J.; Jenkins I.; Fraser J.; Marriage S.; Griffiths R.; Smith H.)
Royal Hospital for Sick Children, Bristol BS2 8BJ, United Kingdom.
CORRESPONDENCE ADDRESS
P.J. Murphy, Royal Hospital for Sick Children, Bristol BS2 8BJ, United
Kingdom.
SOURCE
Anaesthesia (2001) 56:1 (83-84). Date of Publication: 2001
ISSN
0003-2409
BOOK PUBLISHER
Blackwell Publishing Ltd, 9600 Garsington Road, Oxford, United Kingdom.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
pediatrics
EMTREE MEDICAL INDEX TERMS
airway obstruction (therapy)
anesthesia induction
anesthesist
child care
cooperation
critical illness
emergency medicine
epiglottitis
health care availability
human
intubation
letter
medical education
resource management
resuscitation
safety
standard
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Pediatrics and Pediatric Surgery (7)
Otorhinolaryngology (11)
Public Health, Social Medicine and Epidemiology (17)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2001046640
MEDLINE PMID
11167443 (http://www.ncbi.nlm.nih.gov/pubmed/11167443)
PUI
L32111880
DOI
10.1046/j.1365-2044.2001.01840-2.x
FULL TEXT LINK
http://dx.doi.org/10.1046/j.1365-2044.2001.01840-2.x
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 927
TITLE
Bed availability and transfer of critically ill patients
AUTHOR NAMES
Dobb G.J.
AUTHOR ADDRESSES
(Dobb G.J.) Royal Perth Hospital, University Department of Medicine,
University of Western Australia, Perth, WA, Australia.
CORRESPONDENCE ADDRESS
G.J. Dobb, Royal Perth Hospital, University Department of Medicine,
University of Western Australia, Perth, WA, Australia. Email:
geofdobb@rph.health.wa.gov.au
SOURCE
Medical Journal of Australia (2001) 174:3 (114-115). Date of Publication: 5
Feb 2001
ISSN
0025-729X
BOOK PUBLISHER
Australasian Medical Publishing Co. Ltd, Level 2, 26-32 Pyrmont Bridge Road,
Pyrmont, Australia.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness (disease management)
hospital bed
EMTREE MEDICAL INDEX TERMS
editorial
health care availability
health care cost
high risk patient
hospital bed capacity
human
intensive care
intensive care unit
patient transport
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2001064630
MEDLINE PMID
11247611 (http://www.ncbi.nlm.nih.gov/pubmed/11247611)
PUI
L32149353
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 928
TITLE
Risks associated with peri-operative use of alpha(2)-adrenoceptor agonists
AUTHOR NAMES
Quintin L.
Ghignone M.
AUTHOR ADDRESSES
(Quintin L.) Cardiovascular Anesthesia, CHU Nord, St Etienne, France.
(Quintin L.) Department of Physiology, School of Medicine, Lyon, France.
(Ghignone M.) Columbia Hospital, W Palm Beach, FL, United States.
CORRESPONDENCE ADDRESS
L. Quintin, Cardiovascular Anesthesia, CHU Nord, St. Etienne, France.
SOURCE
Bailliere's Best Practice and Research in Clinical Anaesthesiology (2000)
14:2 (347-368). Date of Publication: 2000
ISSN
1521-6896
ABSTRACT
Experimentally, α(2)-agonists keep intact the reactivity of the circulatory
system to hypotension or hypovolaemia. These findings have been reproduced
in humans outside the anaesthesia/critical care setting. Within the
anaesthesia/critical care setting, no studies directly tackle the problem of
circulatory reactivity to hypotension. Poor circulatory tolerance
(hypotension, bradycardia and low cardiac output) to systemic α(2)-agonists
has been reported in the anaesthetic setting. In contrast, however, most
reports in the literature suggest good tolerance. This discrepancy may be a
function of the intravascular volume status, the dosage of the
anaesthetic/sedative agents co-administered or the specific opiate used. The
opinion of the authors is that (a) the administration of α(2)-agonists
should be restricted to hypertensive/coronary patients or patients
presenting to or recovering from minor or major surgery in whom a high
benefit-to-risk ratio is expected, (b) appropriate volume loading before the
induction of anaesthesia or intra-hospital transport should be considered,
and (c) a reduction in anaesthetic/sedative and vasopressor requirements
should be considered. Key studies are lacking.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
alpha 2 adrenergic receptor stimulating agent (adverse drug reaction,
clinical trial, drug administration, drug comparison, drug dose, drug
interaction, drug therapy, epidural drug administration, intracisternal drug
administration, intradermal drug administration, intravenous drug
administration, oral drug administration, pharmacokinetics, pharmacology)
hypertensive agent (adverse drug reaction, drug combination, drug dose, drug
interaction, drug therapy, intravenous drug administration)
vasoactive agent (adverse drug reaction, drug dose, drug interaction, drug
therapy, intravenous drug administration)
EMTREE DRUG INDEX TERMS
adrenergic receptor blocking agent (adverse drug reaction)
alfentanil (drug comparison, drug dose, drug therapy)
atropine (adverse drug reaction, drug dose, drug interaction, drug therapy)
beta adrenergic receptor blocking agent (adverse drug reaction, drug
therapy)
cholinergic receptor blocking agent (drug therapy)
clonidine (adverse drug reaction, clinical trial, drug administration, drug
comparison, drug dose, drug interaction, drug therapy, epidural drug
administration, intracisternal drug administration, intradermal drug
administration, intravenous drug administration, oral drug administration,
pharmacokinetics, pharmacology)
dexmedetomidine (adverse drug reaction, drug administration, drug
comparison, intramuscular drug administration, intravenous drug
administration)
diltiazem (adverse drug reaction, drug therapy)
ephedrine (drug interaction, drug therapy)
fentanyl (adverse drug reaction, drug comparison, drug dose)
hexamethonium (adverse drug reaction)
isoflurane (drug combination, drug therapy)
isoprenaline (drug dose, drug interaction, drug therapy, intravenous drug
administration)
ketanserin (drug comparison)
midazolam (drug therapy)
mivazerol (adverse drug reaction, clinical trial, drug comparison, drug
therapy)
morphine (drug therapy)
neuroleptic agent (drug therapy)
opiate derivative (drug combination, drug comparison, drug dose, drug
interaction, drug therapy)
phenoxybenzamine (drug therapy)
phenylephrine (adverse drug reaction, drug interaction, drug therapy)
propofol (drug therapy)
propranolol (adverse drug reaction, drug combination, drug therapy)
remifentanil (drug combination, drug dose, drug therapy)
reserpine (drug combination, drug therapy)
unindexed drug
EMTREE MEDICAL INDEX TERMS
anesthesia
anesthesia induction
bradycardia (drug therapy, side effect)
clinical trial
dose response
drug absorption
drug antagonism
drug effect
drug inhibition
drug potentiation
drug tolerance
drug use
forward heart failure (drug therapy, side effect)
human
hypertension (drug therapy)
hypotension (drug therapy, side effect)
hypovolemia
intensive care
ischemic heart disease (drug therapy)
meta analysis
nonhuman
perioperative period
priority journal
review
sedation
surgical risk
CAS REGISTRY NUMBERS
alfentanil (69049-06-5, 71195-58-9)
atropine (51-55-8, 55-48-1)
clonidine (4205-90-7, 4205-91-8, 57066-25-8)
dexmedetomidine (113775-47-6)
diltiazem (33286-22-5, 42399-41-7)
ephedrine (299-42-3, 50-98-6)
fentanyl (437-38-7)
hexamethonium (60-26-4)
isoflurane (26675-46-7)
isoprenaline (299-95-6, 51-30-9, 6700-39-6, 7683-59-2)
ketanserin (74050-98-9)
midazolam (59467-70-8)
mivazerol (125472-02-8)
morphine (52-26-6, 57-27-2)
phenoxybenzamine (59-96-1, 63-92-3)
phenylephrine (532-38-7, 59-42-7, 61-76-7)
propofol (2078-54-8)
propranolol (13013-17-7, 318-98-9, 3506-09-0, 4199-09-1, 525-66-6)
remifentanil (132539-07-2)
reserpine (50-55-5, 8001-95-4)
EMBASE CLASSIFICATIONS
Cardiovascular Diseases and Cardiovascular Surgery (18)
Anesthesiology (24)
Clinical and Experimental Pharmacology (30)
Drug Literature Index (37)
Adverse Reactions Titles (38)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2000408909
PUI
L30843335
DOI
10.1053/bean.2000.0088
FULL TEXT LINK
http://dx.doi.org/10.1053/bean.2000.0088
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 929
TITLE
Protocol for intensive care transport
ORIGINAL (NON-ENGLISH) TITLE
Intensivtransport-protokoll: Empfehlung der DIVI und des bayerischen
staatsministeriums des innern
AUTHOR NAMES
Moecke Hp.
Anding K.
AUTHOR ADDRESSES
(Moecke Hp.; Anding K.) Institut fur Notfallmedizin, Rubenkamp 148, D-22291
Hamburg, Germany.
CORRESPONDENCE ADDRESS
Hp. Moecke, Institut fur Notfallmedizin, Rubenkamp 148, D-22291 Hamburg,
Germany.
SOURCE
Anasthesiologie und Intensivmedizin (2000) 41:10 (789-792). Date of
Publication: 2000
ISSN
0170-5334
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient transport
EMTREE MEDICAL INDEX TERMS
clinical protocol
Germany
human
intensive care
short survey
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
German
EMBASE ACCESSION NUMBER
2000388301
PUI
L30812214
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 930
TITLE
Protocol for transport of patients requiring intensive care
ORIGINAL (NON-ENGLISH) TITLE
Intensivtransport-Protokoll
AUTHOR NAMES
Moecke H.
AUTHOR ADDRESSES
(Moecke H.) Institut fur Notfallmedizin, Rubenkamp 148, 22291 Hamburg,
Germany.
CORRESPONDENCE ADDRESS
H. Moecke, Institut fur Notfallmedizin, Rubenkamp 148, 22291 Hamburg,
Germany.
SOURCE
Notfall Medizin (2000) 26:9 (414-417). Date of Publication: 2000
ISSN
0341-2903
ABSTRACT
In recent years, appreciably greater demands have been made on both the
medical and documentation-related aspects of the transport of patients
requiring intensive care. For a controlled transfer between the respective
departments and hospitals involved, all the details of the transport need to
be entered in a protocol. In order to ensure uniform standards, the DIVI
(German interdisciplinary organisation for intensive care and emergency
medicine) and the Bavarium Ministry for Internal Affairs have now drawn up
protocol recommendations, which will be discussed in detail.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient transport
EMTREE MEDICAL INDEX TERMS
clinical protocol
documentation
emergency medicine
human
intensive care
interhospital cooperation
medical decision making
short survey
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
German
LANGUAGE OF SUMMARY
English, German
EMBASE ACCESSION NUMBER
2000367317
PUI
L30775952
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 931
TITLE
Specific characteristics of the ventilator-supported patients during
intrahospital or interhospital transports (monitoring-alarms)
ORIGINAL (NON-ENGLISH) TITLE
Les specificites des alarmes et du monitorage des malades ventiles pendant
un transport intra- ou interhospitalier
AUTHOR NAMES
Dureuil B.
Roupie É.
AUTHOR ADDRESSES
(Dureuil B.) Département d'Anesthésie-réanimation Chirurgicale, Hôpital
Charles-Nicolle, 1, rue de Germont, 76031 Rouen.
(Roupie É.) Service d'Accueil et d'Urgence, Hôpital Henri-Mondor, 51, ave.
Marechalde-Lattre-de-T., 94010 Créteil, France.
CORRESPONDENCE ADDRESS
B. Dureuil, Dept. Anesth.-Reanimat. Chirurgicale, Hopital Charles-Nicolle,
1, rue de Germont, 76031 Rouen, France.
SOURCE
Reanimation Urgences (2000) 9:6 (477-480). Date of Publication: 2000
ISSN
1164-6756
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
artificial ventilation
EMTREE MEDICAL INDEX TERMS
article
capnometry
human
medical device
patient monitoring
patient transport
pulse oximetry
spirometry
DEVICE TRADE NAMES
AXR1a , Francebio ms
Babylog 2000 , GermanyDrager
Bird AVS Bird
Evita 2 Dura , GermanyDrager
Medumat , Germanyweinmann industry
NPB 740 , United StatesNellcor Puritan Bennett
Osiris , FranceTaema
Oxylog 2000 , GermanyDrager
DEVICE MANUFACTURERS
(France)bio ms
Bird
(Germany)Drager
(United States)Nellcor Puritan Bennett
(France)Taema
(Germany)weinmann industry
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Anesthesiology (24)
Biophysics, Bioengineering and Medical Instrumentation (27)
Internal Medicine (6)
LANGUAGE OF ARTICLE
French
EMBASE ACCESSION NUMBER
2000367616
PUI
L30776259
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 932
TITLE
Specific characteristics of neonates receiving mechanical ventilation during
intrahospital or interhospital transports (monitoring-alarms)
ORIGINAL (NON-ENGLISH) TITLE
Les specificites des alarmes et du monitorage des nouveau-nes ventiles
pendant un transport intraou interhospitalier
AUTHOR NAMES
Rozé J.C.
AUTHOR ADDRESSES
(Rozé J.C.) Service de Réanimation Néonatale et Pédiatique, Hôpital
Mère-Enfant, Hôtel-Dieu, 44035 Nantes cedex, France.
CORRESPONDENCE ADDRESS
J.C. Roze, Svc. Reanimation Neonatale Pedia., Hopital Mere-Enfant, CHU de
Nantes, 44035 Nantes Cedex, France.
SOURCE
Reanimation Urgences (2000) 9:6 (481-482). Date of Publication: 2000
ISSN
1164-6756
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
artificial ventilation
neonatal respiratory distress syndrome (therapy)
EMTREE MEDICAL INDEX TERMS
article
end tidal carbon dioxide tension
human
newborn
patient monitoring
patient transport
pulse oximetry
respiratory distress syndrome (therapy)
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
French
EMBASE ACCESSION NUMBER
2000367617
PUI
L30776260
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 933
TITLE
Paediatric intensive care transfers: 1
AUTHOR NAMES
Kenny M.
Peters M.
Harmer M.
AUTHOR ADDRESSES
(Kenny M.; Peters M.; Harmer M.) Department of Anaesthetics, University of
Wales, College of Medicine, Heath Park, Cardiff CF14 4XN, United Kingdom.
CORRESPONDENCE ADDRESS
M. Harmer, Department of Anaesthetics, University of Wales, College of
Medicine, Heath Park, Cardiff CF14 4XN, United Kingdom.
SOURCE
Anaesthesia (2000) 55:10 (1025). Date of Publication: 2000
ISSN
0003-2409
BOOK PUBLISHER
Blackwell Publishing Ltd, 9600 Garsington Road, Oxford, United Kingdom.
EMTREE DRUG INDEX TERMS
benzodiazepine (drug therapy)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
acute epiglottitis (therapy)
intensive care
EMTREE MEDICAL INDEX TERMS
artificial ventilation
child
child care
critical illness
febrile convulsion (drug therapy, therapy)
head injury
hospital admission
human
length of stay
letter
medical practice
paralysis
patient referral
patient transport
resuscitation
sedation
CAS REGISTRY NUMBERS
benzodiazepine (12794-10-4)
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Pediatrics and Pediatric Surgery (7)
Otorhinolaryngology (11)
Neurology and Neurosurgery (8)
Drug Literature Index (37)
Epilepsy Abstracts (50)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2000373435
MEDLINE PMID
11228660 (http://www.ncbi.nlm.nih.gov/pubmed/11228660)
PUI
L30784189
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 934
TITLE
Paediatric intensive care transfers: 2
AUTHOR NAMES
Gudgeon J.
Harmer M.
AUTHOR ADDRESSES
(Gudgeon J.; Harmer M.) Department of Anaesthetics, University of Wales,
College of Medicine, Heath Park, Cardiff CF14 4XN, United Kingdom.
CORRESPONDENCE ADDRESS
M. Harmer, Department of Anaesthetics, University of Wales, College of
Medicine, Heath Park, Cardiff CF14 4XN, United Kingdom.
SOURCE
Anaesthesia (2000) 55:10 ([d]1025-1026). Date of Publication: 2000
ISSN
0003-2409
BOOK PUBLISHER
Blackwell Publishing Ltd, 9600 Garsington Road, Oxford, United Kingdom.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
obstructive airway disease (therapy)
EMTREE MEDICAL INDEX TERMS
child
child care
competence
critical illness
health care personnel
human
letter
mental stress
patient monitoring
patient referral
patient transport
pediatric anesthesia
respiratory tract intubation
resuscitation
teamwork
wellbeing
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Pediatrics and Pediatric Surgery (7)
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2000373436
MEDLINE PMID
11012501 (http://www.ncbi.nlm.nih.gov/pubmed/11012501)
PUI
L30784190
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 935
TITLE
Paediatric intensive care transfers 3
AUTHOR NAMES
Jones K.J.
Harmer M.
AUTHOR ADDRESSES
(Jones K.J.; Harmer M.) Department of Anaesthetics, University of Wales,
College of Medicine, Heath Park, Cardiff CF14 4XN, United Kingdom.
CORRESPONDENCE ADDRESS
M. Harmer, Department of Anaesthetics, University of Wales, College of
Medicine, Heath Park, Cardiff CF14 4XN, United Kingdom.
SOURCE
Anaesthesia (2000) 55:10 (1026). Date of Publication: 2000
ISSN
0003-2409
BOOK PUBLISHER
Blackwell Publishing Ltd, 9600 Garsington Road, Oxford, United Kingdom.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child care
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
anesthesist
centralization
epiglottitis
extubation
hospital management
human
letter
paralysis
pediatric anesthesia
sedation
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Pediatrics and Pediatric Surgery (7)
Health Policy, Economics and Management (36)
Otorhinolaryngology (11)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2000373437
MEDLINE PMID
11012502 (http://www.ncbi.nlm.nih.gov/pubmed/11012502)
PUI
L30784191
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 936
TITLE
When the family asks, 'what happened?'.
AUTHOR NAMES
Erlen J.A.
AUTHOR ADDRESSES
(Erlen J.A.) Department of Health Promotion and Development, Center for
Research in Chronic Disorders, School of Nursing, University of Pittsburgh,
Pittsburgh, Pennsylvania, USA.
CORRESPONDENCE ADDRESS
J.A. Erlen, Department of Health Promotion and Development, Center for
Research in Chronic Disorders, School of Nursing, University of Pittsburgh,
Pittsburgh, Pennsylvania, USA. Email: jae001@pitt.edu
SOURCE
Orthopaedic nursing / National Association of Orthopaedic Nurses (2000) 19:6
(68-71). Date of Publication: 2000 Nov-Dec
ISSN
0744-6020
ABSTRACT
Because of the high level of acuity of hospitalized patients, untoward
events can and do occur. Very often, nurses develop a caring relationship
with the families of these patients. As a result, the family may approach
the nurse about this negative turn of events. The questions that the family
raises may create an ethical dilemma for the nurse. The nurse may wonder how
to respond, feel powerless and "caught in the middle," and experience moral
distress because of constraints in the health care system. This article
discusses the ethical perspective of caring and the "nurse in the middle"
phenomenon. Several strategies to help nurses manage this issue include
consulting with a mentor, consulting with the institutional ethics
committee, and promoting an ethical climate within the health care setting.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
family
human relation
interpersonal communication
medical ethics
nursing staff
patient transport
EMTREE MEDICAL INDEX TERMS
empathy
human
intensive care unit
professional standard
psychological aspect
review
LANGUAGE OF ARTICLE
English
MEDLINE PMID
11899312 (http://www.ncbi.nlm.nih.gov/pubmed/11899312)
PUI
L35639249
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 937
TITLE
Mobile computerized tomography scanning in the neurosurgery intensive care
unit: Increase in patient safety and reduction of staff workload
AUTHOR NAMES
Gunnarsson T.
Theodorsson A.
Karlsson P.
Fridriksson S.
Bostrom S.
Persliden J.
Johansson I.
Hillman J.
AUTHOR ADDRESSES
(Gunnarsson T.; Theodorsson A.; Karlsson P.; Fridriksson S.; Bostrom S.;
Persliden J.; Johansson I.; Hillman J.) Department of Neurosurgery,
University Hospital, 581 85 Linkoping, Sweden.
CORRESPONDENCE ADDRESS
T. Gunnarsson, Department of Neurosurgery, University Hospital, 581 85
Linkoping, Sweden. Email: Thorsteinn.Gunnarsson@lio.se
SOURCE
Journal of Neurosurgery (2000) 93:3 (432-436). Date of Publication: 2000
ISSN
0022-3085
BOOK PUBLISHER
American Association of Neurological Surgeons, 1224 West Main Street Suite
450, Charlottesville, United States.
ABSTRACT
Object. Transportation of unstable neurosurgical patients involves risks
that may lead to further deterioration and secondary brain injury from
perturbations in physiological parameters. Mobile computerized tomography
(CT) head scanning in the neurosurgery intensive care (NICU) is a new
technique that minimizes the need to transport unstable patients. The
authors have been using this device since June 1997 and have developed their
own method of scanning such patients. Methods. The scanning procedure and
radiation safety measures are described. The complications that occurred in
89 patients during transportation and conventional head CT scanning at the
Department of Radiology were studied prospectively. These complications were
compared with the ones that occurred during mobile CT scanning in 50
patients in the NICU. The duration of the procedures was recorded, and an
estimation of the staff workload was made. Two patient groups, defined as
high- and medium-risk cases, were studied. Medical and/or technical
complications occurred during conventional CT scanning in 25% and 20% of the
patients in the high- and medium-risk groups, respectively. During mobile CT
scanning complications occurred in 4.3% of the high-risk group and 0% of the
medium-risk group. Mobile CT scanning also took significantly less time, and
the estimated personnel cost was reduced. Conclusions. Mobile CT scanning in
the NICU is safe. It minimizes the risk of physiological deterioration and
technical mishaps linked to intrahospital transport, which may aggravate
secondary brain injury. The time that patients have to remain outside the
controlled environment of the NICU is minimized, and the staff's workload is
decreased.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
computer assisted tomography
intensive care
EMTREE MEDICAL INDEX TERMS
article
clinical trial
devices
heart arrhythmia (complication)
hospital personnel
human
intracranial hypertension (complication)
major clinical study
priority journal
radiation dose
safety
seizure (complication)
time
workload
DEVICE TRADE NAMES
Tomoscan M , NetherlandsPhilips
DEVICE MANUFACTURERS
(Netherlands)Philips
EMBASE CLASSIFICATIONS
Neurology and Neurosurgery (8)
Radiology (14)
Biophysics, Bioengineering and Medical Instrumentation (27)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2000314821
MEDLINE PMID
10969941 (http://www.ncbi.nlm.nih.gov/pubmed/10969941)
PUI
L30677206
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 938
TITLE
New organisational concepts: Intensive-care transport helicopter
ORIGINAL (NON-ENGLISH) TITLE
Neue organisatorische versorgungskonzepte: Der intensivtransporthubschrauber
AUTHOR NAMES
Huf R.
Weninger E.
AUTHOR ADDRESSES
(Huf R.; Weninger E.) Chirurgische Klinik, Klin. Univ. Munchen -
Grosshadern, Marchioninistrasse 15, 81377 Munchen, Germany.
CORRESPONDENCE ADDRESS
R. Huf, Chirurgische Klinik, Klin. Univ. Munchen - Grosshadern,
Marchioninistrasse 15, 81377 Munchen, Germany.
SOURCE
Notarzt (2000) 16:4 (130-132). Date of Publication: 2000
ISSN
0177-2309
ABSTRACT
Airborne intensive-care transport is a new and safe link in the rescue
chain, as explained below. The incidence rate of cases where such airborne
transport is required at the relevant sites justified the cost and effort
involved. Continued safety and quality of such transport can be maintained
only if the entire personnel involved is highly trained to a maximum
possible degree of efficiency, whereas medicotechnical equipment must be
absolutely update in accordance with present-day quality standards of
intensive-care medicine.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
helicopter
patient transport
EMTREE MEDICAL INDEX TERMS
article
emergency health service
health care quality
human
intensive care
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
German
LANGUAGE OF SUMMARY
English, German
EMBASE ACCESSION NUMBER
2000299968
PUI
L30649838
DOI
10.1055/s-2000-3808
FULL TEXT LINK
http://dx.doi.org/10.1055/s-2000-3808
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 939
TITLE
The traveling intensive care unit patient: Road trips
AUTHOR NAMES
Braxton C.C.
Reilly P.M.
Schwab C.W.
AUTHOR ADDRESSES
(Braxton C.C.; Reilly P.M.; Schwab C.W.) Div. of Traumatol./Surg. Crit.
Care, Department of Surgery, Hosp. of University of Pennsylvania, 3440
Market Street, Philadelphia, PA 19104-3335, United States.
(Braxton C.C.; Reilly P.M.; Schwab C.W.)
CORRESPONDENCE ADDRESS
C.W. Schwab, Div. of Traumatol./Surg. Crit. Care, Department of Surgery,
Hosp. of University of Pennsylvania, 3440 Market Street, Philadelphia, PA
19104-3335, United States.
SOURCE
Surgical Clinics of North America (2000) 80:3 (949-956). Date of
Publication: 2000
ISSN
0039-6109
BOOK PUBLISHER
W.B. Saunders, Independence Square West, Philadelphia, United States.
ABSTRACT
Transport of critically ill or injured patients in the hospital is a
necessary part of ICU care. Although the overall severity of misadventures
occurring during patient transfer is minimal, potential complications risk
patient deterioration in settings that may not be equipped to handle
cardiovascular, respiratory, or neurologic emergencies safely. The critical
care team should provide the same level of monitoring and care to the
transported patient outside the ICU as he or she receives the unit. Each
hospital should have a system that meets acceptable standards for safe
transfer of the ICU patient, which minimizes risk and maximizes diagnostic
and treatment yield.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
artificial ventilation
clinical examination
human
hypoxia
intensive care
intracranial hypertension
patient monitoring
planning
priority journal
review
risk assessment
EMBASE CLASSIFICATIONS
Surgery (9)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2000215396
MEDLINE PMID
10897272 (http://www.ncbi.nlm.nih.gov/pubmed/10897272)
PUI
L30396982
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 940
TITLE
Paediatric intensive care transfers
AUTHOR NAMES
Griffiths R.
Smith H.
Harmer M.
AUTHOR ADDRESSES
(Griffiths R.; Smith H.; Harmer M.) Department of Anaesthetics, University
of Wales, College of Medicine, Heath Park, Cardiff CF14 4XN, United Kingdom.
CORRESPONDENCE ADDRESS
M. Harmer, Department of Anaesthetics, University of Wales, College of
Medicine, Heath Park, Cardiff CF14 4XN, United Kingdom.
SOURCE
Anaesthesia (2000) 55:6 (610). Date of Publication: 2000
ISSN
0003-2409
BOOK PUBLISHER
Blackwell Publishing Ltd, 9600 Garsington Road, Oxford, United Kingdom.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient transport
pediatrics
EMTREE MEDICAL INDEX TERMS
child
critical illness
human
intensive care
letter
patient care
resuscitation
safety
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2000198066
MEDLINE PMID
10866756 (http://www.ncbi.nlm.nih.gov/pubmed/10866756)
PUI
L30345055
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 941
TITLE
Resident training in pediatric critical care transport medicine: A survey of
pediatric residency programs
AUTHOR NAMES
Fazio R.F.
Wheeler D.S.
Poss W.B.
AUTHOR ADDRESSES
(Fazio R.F., wmacal@snd10.med.navy.mil; Wheeler D.S.; Poss W.B.) Depts. of
Pediat. and Clin. Invest., Naval Medical Center San Diego, San Diego, CA,
United States.
(Fazio R.F., wmacal@snd10.med.navy.mil) Clinical Investigation Department,
Medical Editing Division, Naval Medical Center San Diego, 34800 Bob Wilson
Drive, San Diego, CA 92134-1005, United States.
CORRESPONDENCE ADDRESS
R.F. Fazio, Clinical Investigation Department, Medical Editing Division,
Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA
92134-1005, United States. Email: wmacal@snd10.med.navy.mil
SOURCE
Pediatric Emergency Care (2000) 16:3 (166-169). Date of Publication: June
2000
ISSN
0749-5161
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
ABSTRACT
Objective: The Accreditation Council for Graduate Medical Education (ACGME)
Program Requirement for Pediatrics includes specific objectives that
pediatric residents participate in both the pre-hospital care of acutely ill
or injured patients and the stabilization and transport of patients to
critical care areas. Previously, residents were often included as the
physician component for many pediatric critical care transport teams.
Subsequent regionalization of transport services and development of nurse-
only transport teams prompted us to determine the current level of resident
participation in pediatric critical care transport as well as how individual
residency programs were meeting the educational objectives. Methods: A
questionnaire was mailed to each pediatric residency program listed in the
1996-1997 GME Directory. Information was obtained regarding the size of the
hospital and the residency program, the presence of a pediatric critical
care transport team, the number of annual transports, and transport team
leader. In addition, the use of pediatric residents for transports was
ascertained, as well as their specific role, training requirements, and
method of evaluation. Results: Data were received from 138 programs for a
return rate of 65%. Eighty percent of programs offered a pediatric critical
care transport service. Nurse-led teams were used for 51% of NICU and 44% of
PICU transports. Of the 82 NICU and 84 PICU teams that used residents, the
majority used them as team leaders (60% and 70%, respectively) with only the
minority requiring that they be at the PL-3 year or greater. The training
and/or certification required for resident participation in transports
varied among programs, with 85% requiring completion of a NICU or PICU
rotation, and 94% requiring NRP or PALS certification. Programs that did not
allow resident participation provided exposure to Transport Medicine by
various mechanisms, including lectures and emergency department (ED)
rotations. Conclusion: Pediatric resident participation in critical care
transport varies widely among pediatric critical care transport teams. The
degree to which residents participate in the transport team would appear to
have diminished in comparison to previous studies. Transport teams often use
other resources, such as nurses, fellows, or attendings, to lead their
transport teams. Pediatric resident exposure to and participation in
Transport Medicine varies among programs, as do the methods used to prepare
residents for their experience.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
residency education
EMTREE MEDICAL INDEX TERMS
article
education program
intensive care
pediatrics
questionnaire
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2000219076
MEDLINE PMID
10888453 (http://www.ncbi.nlm.nih.gov/pubmed/10888453)
PUI
L30407978
DOI
10.1097/00006565-200006000-00007
FULL TEXT LINK
http://dx.doi.org/10.1097/00006565-200006000-00007
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 942
TITLE
Discharge from intensive care: a view from the ward.
AUTHOR NAMES
Whittaker J.
Ball C.
AUTHOR ADDRESSES
(Whittaker J.; Ball C.) Intensive Care Unit, The London Hospital, Barts and
the London NHS Trust, UK.
CORRESPONDENCE ADDRESS
J. Whittaker, Intensive Care Unit, The London Hospital, Barts and the London
NHS Trust, UK.
SOURCE
Intensive & critical care nursing : the official journal of the British
Association of Critical Care Nurses (2000) 16:3 (135-143). Date of
Publication: Jun 2000
ISSN
0964-3397
ABSTRACT
Relocation stress is a common phenomenon in patients discharged from an
intensive care unit (ICU) to a ward. A variety of nursing interventions,
initiated by intensive care nurses, have been introduced following research
in this area. Ward nurses are ideally situated to minimize stress in this
patient population, yet their contribution has not been considered. The aim
of this study was to identify the experience of the ward nursing staff when
receiving a patient from the ICU. An exploratory pilot study was conducted
over a 6-month period. The sample group comprised nursing staff in two
wards, who regularly received ICU patients. Data collection methods were
triangulated and involved the use of open-ended questionnaires and
semi-structured interviews. Thirty-six questionnaires were sent, yielding a
36.1% (n = 13) response rate. Seven staff of various grades were
interviewed. Data analysis was undertaken using Burnard's (1991) Thematic
Content Analysis. Four major categories were identified in the analysis of
the data. These were emotions; problems; communication; and interventions.
However, the experience of ward staff receiving patients from intensive care
differed according to grade.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health personnel attitude
hospital discharge
intensive care
nursing staff
patient transport
EMTREE MEDICAL INDEX TERMS
adaptive behavior
article
attitude to health
education
human
in service training
needs assessment
nursing education
nursing methodology research
peer group
pilot study
psychological aspect
public relations
questionnaire
workload
LANGUAGE OF ARTICLE
English
MEDLINE PMID
10859622 (http://www.ncbi.nlm.nih.gov/pubmed/10859622)
PUI
L35584569
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 943
TITLE
The critical care research network: A partnership in community-based
research and research transfer
AUTHOR NAMES
Keenan S.P.
Martin C.M.
Kossuth J.D.
Eberhard J.
Sibbald W.J.
AUTHOR ADDRESSES
(Keenan S.P.; Martin C.M.; Kossuth J.D.; Eberhard J.; Sibbald W.J.) Richard
Ivey Critical Care Trauma C., Victoria Campus, London Health Sciences
Centre, London, Ont., Canada.
(Keenan S.P.) Ctr. Hlth. Eval. and Outcome Sci., St. Paul's Hospital 620-B,
1081 Burrad St, Vancouver, BC V6Z 1Y6, Canada.
(Keenan S.P.; Martin C.M.; Sibbald W.J.) Critical Care Research Network,
London, Ont., Canada.
CORRESPONDENCE ADDRESS
S.P. Keenan, Ctr. for Health Eval./Outcome Sci., St. Paul's Hospital, 1081
Burrad St, Vancouver, BC V6Z 1Y6, Canada.
SOURCE
Journal of Evaluation in Clinical Practice (2000) 6:1 (15-22). Date of
Publication: 2000
ISSN
1356-1294
BOOK PUBLISHER
Blackwell Publishing Ltd, 9600 Garsington Road, Oxford, United Kingdom.
ABSTRACT
The objectives of this study were to present a short history of the Critical
Care Research Network (CCR-Net), describe its approach to health services
research and to summarize completed and current research projects. In doing
this, we explored the question is this research network accomplishing its
goals? We reviewed the medical literature to identify studies on similar
types of Networks and also the evidence supporting the methodology used by
CCR-Net to conduct research using MEDLINE, HEALTHSTAR, CINAHL and the
keywords network and health care or healthcare, benchmarking and health care
or healthcare, and research transfer or research utilization. We also
reviewed the bibliographies of retrieved articles and our personal files. In
addition, we summarized the results of studies conducted by CCR-Net and
outlined those currently in progress. A review of the literature identified
studies on two similar networks that appeared to be succeeding. In addition,
the literature was also supportive of the general process used by CCR-Net,
although the level of evidence varied. Finally, the studies conducted to
date within CCR-Net follow the suggested methodology. At the time of this
preliminary communication CCR-Net appears to have adopted a valid approach
to health services research within the area of Critical Care Medicine.
Further direct evidence is required and appropriate studies are planned.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
community medicine
intensive care
EMTREE MEDICAL INDEX TERMS
article
clinical research
critical illness
evidence based medicine
health service
human
medical assessment
medical literature
priority journal
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2000121885
MEDLINE PMID
10807020 (http://www.ncbi.nlm.nih.gov/pubmed/10807020)
PUI
L30182752
DOI
10.1046/j.1365-2753.2000.00214.x
FULL TEXT LINK
http://dx.doi.org/10.1046/j.1365-2753.2000.00214.x
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 944
TITLE
Chest pain: current concepts and implications for critical care transport.
AUTHOR NAMES
Lowell M.J.
AUTHOR ADDRESSES
(Lowell M.J.)
CORRESPONDENCE ADDRESS
M.J. Lowell,
SOURCE
Air medical journal (2000) 19:2 (50-54). Date of Publication: 2000 Apr-Jun
ISSN
1067-991X
EMTREE DRUG INDEX TERMS
anticoagulant agent (drug administration)
antithrombocytic agent (drug administration)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
thorax pain (diagnosis, drug therapy, etiology)
EMTREE MEDICAL INDEX TERMS
air medical transport
aortic rupture (complication)
article
dissecting aneurysm (complication)
esophagus perforation (complication)
heart muscle ischemia (complication)
human
lung embolism (complication)
methodology
pneumothorax (complication)
LANGUAGE OF ARTICLE
English
MEDLINE PMID
11010377 (http://www.ncbi.nlm.nih.gov/pubmed/11010377)
PUI
L31356852
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 945
TITLE
Initial management and diagnostic strategy of severely head-injured patients
ORIGINAL (NON-ENGLISH) TITLE
Prise en charge du traumatise cranien grave dans les 24 premieres heures.
Reanimation et strategie diagnostique initiales
AUTHOR NAMES
Ricard-Hibon A.
Marty J.
AUTHOR ADDRESSES
(Ricard-Hibon A.; Marty J.) Serv. d'Anesthesie-reanimation-smur, Hop.
Beaujon, 100, bd Gen.-L., Clichy, France.
CORRESPONDENCE ADDRESS
A. Ricard-Hibon, Serv. d'Anesthesie-Reanimation-Smur, Hopital Beaujon, 100,
bd du General-Leclerc, 92110 Clichy, France.
SOURCE
Annales Francaises d'Anesthesie et de Reanimation (2000) 19:4 (286-295).
Date of Publication: April 2000
ISSN
0750-7658
BOOK PUBLISHER
Elsevier Masson SAS, 62 rue Camille Desmoulins, Issy les Moulineaux Cedex,
France.
ABSTRACT
Limitation of secondary insults after severe head injury is a permanent
concern during the early phase of head trauma management. The objectives are
to maintain mean arterial pressure between 80 and 100 mmHg, to avoid
hypoxaemia, and to maintain arterial PCO(2) near to 35 mmHg. Volume loading
can be necessary to improve arterial pressure, and is carried out with
isotonic critalloid (NaCl 9‰) or colloids, with the exclusion of all
hypotonic solutions (Ringer lactate or glucose). The use of catecholamines
is reserved for patients with unstable haemodynamics despite an adequate
volume loading. The rapid sequence induction is recommended for endotracheal
intubation and is followed by continuous analgesia-sedation to keep patient-
ventilator dysynchrony, but without compromising haemodynamic objectives.
Mannitol is used in case of life-threatening intracranial hypertension.
Conversely, specific treatment of intracranial hypertension, especially
hypocapnia, is not recommended. Initial diagnostic procedures include
cerebral tomodensitometry (TDM). However, TDM may be delayed in case of
haemorrhage, which requires a rapid treatment. Intrahospital transport for
additional explorations risks secondary insults, and thus requires close
monitoring to detect and treat in due time all adverse events. This
monitoring includes invasive arterial blood pressure assessment, use of
continuous capnography and repeated arterial blood gas measurements. The
usefulness of transcranial Doppler for initial management of head-trauma
patients needs further evaluation. (C) 2000 Editions scientifiques et
medicales Elsevier SAS.
EMTREE DRUG INDEX TERMS
catecholamine
mannitol
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
head injury (diagnosis)
injury scale
EMTREE MEDICAL INDEX TERMS
analgesia
arterial carbon dioxide tension
article
blood gas analysis
blood pressure monitoring
blood volume
capnometry
colloid
crystalloid
endotracheal intubation
hemodynamics
human
hypoxemia (prevention)
mean arterial pressure
radiodensitometry
sedation
CAS REGISTRY NUMBERS
mannitol (69-65-8, 87-78-5)
EMBASE CLASSIFICATIONS
Neurology and Neurosurgery (8)
Anesthesiology (24)
LANGUAGE OF ARTICLE
French
LANGUAGE OF SUMMARY
English, French
EMBASE ACCESSION NUMBER
2000173465
MEDLINE PMID
10836116 (http://www.ncbi.nlm.nih.gov/pubmed/10836116)
PUI
L30263764
DOI
10.1016/S0750-7658(99)00149-5
FULL TEXT LINK
http://dx.doi.org/10.1016/S0750-7658(99)00149-5
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 946
TITLE
Improving outcomes and reducing costs in intensive care.
AUTHOR ADDRESSES
SOURCE
Report on medical guidelines & outcomes research (2000) 11:4 (7-10, 12).
Date of Publication: 17 Feb 2000
ISSN
1050-5636
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cost control
intensive care
intensive care unit
length of stay
patient transport
EMTREE MEDICAL INDEX TERMS
article
drug cost
economics
emergency health service
health care quality
human
organization and management
patient care planning
time
treatment outcome
LANGUAGE OF ARTICLE
English
MEDLINE PMID
11768410 (http://www.ncbi.nlm.nih.gov/pubmed/11768410)
PUI
L33568525
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 947
TITLE
Bedside procedures: Solutions to the pitfalls of intrahospital transport
AUTHOR NAMES
Haupt M.T.
Rehm C.G.
AUTHOR ADDRESSES
(Haupt M.T.) Department of Medicine, Critical Care Medicine Service, Oregon
Health Sciences University, Portland, OR, United States.
(Rehm C.G.) Department of Surgery, Critical Care Medicine Service, Oregon
Health Sciences University, Portland, OR, United States.
CORRESPONDENCE ADDRESS
M.T. Haupt, Department of Medicine, Critical Care Medicine Service, Oregon
Health Sciences University, 3181 Southwest Sam Jackson Park Road, Portland,
OR 97201-3098, United States.
SOURCE
Critical Care Clinics (2000) 16:1 (1-6). Date of Publication: 2000
ISSN
0749-0704
BOOK PUBLISHER
W.B. Saunders, Independence Square West, Philadelphia, United States.
ABSTRACT
The technology to perform diagnostic and therapeutic procedures at the
bedside continues to advance. Because of documented hazards and the expense
of intrahospital transport, the bedside is becoming an appealing site for
procedures that are more commonly performed in radiologic, bronchoscopic,
other procedural suites, and the operating room.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient transport
EMTREE MEDICAL INDEX TERMS
arterial oxygen saturation
bronchoscopy
critical illness
intensive care
monitoring
patient care
priority journal
pulse oximetry
review
vascular access
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2000033897
MEDLINE PMID
10650497 (http://www.ncbi.nlm.nih.gov/pubmed/10650497)
PUI
L30048854
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 948
TITLE
If hospital policy jeopardizes a patient.
AUTHOR NAMES
Johnson L.J.
AUTHOR ADDRESSES
(Johnson L.J.)
CORRESPONDENCE ADDRESS
L.J. Johnson,
SOURCE
Medical economics (2000) 77:1 (165, 168). Date of Publication: 10 Jan 2000
ISSN
0025-7206
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
patient transport
policy
EMTREE MEDICAL INDEX TERMS
article
human
malpractice
organization and management
LANGUAGE OF ARTICLE
English
MEDLINE PMID
10787864 (http://www.ncbi.nlm.nih.gov/pubmed/10787864)
PUI
L31297112
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 949
TITLE
Practical realization of a patient accompanying concept in anesthesia and
intensive care
ORIGINAL (NON-ENGLISH) TITLE
Praktische umsetzung eines patientenbegleitenden arbeitsplatzkonzeptes fur
anasthesie und intensivmedizin
AUTHOR NAMES
Holst D.
Rudolph P.
Wendt M.
AUTHOR ADDRESSES
(Holst D., holst@mail.uni-greifswald.de) Klin. Anasthesiologie I.,
Ernst-Moritz-Arndt-Universität, Friedrich-Loeffler-Straße 23c, 17489
Greifswald, Germany.
(Rudolph P.; Wendt M.)
CORRESPONDENCE ADDRESS
D. Holst, Klin. fur Anasthesiol./Intensivmed.,
Ernst-Moritz-Arndt-Universitat, Friedrich-Loeffler-Strasse 23c, 17489
Greifswald, Germany. Email: holst@mail.uni-greifswald.de
SOURCE
Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie (2000) 35:1
(25-29). Date of Publication: January 2000
ISSN
0939-2661
BOOK PUBLISHER
Georg Thieme Verlag, Rudigerstrasse 14, Stuttgart, Germany.
ABSTRACT
Our current concept of stationary workplaces results in an interruption in
patient monitoring and treatment. Because transfers are invariably
associated with a reduction or interruption in the monitoring and treatment
chain, an endangerment to critically-ill patients, as well as a significant
increase in the mortality rates, can result. Design: In the new construction
of the Cardiac Clinic, the previous concept of immobile anesthesia and
intensive care workstations has been completely abandoned. The complete
treatment workstation, including monitoring and fluid management, is set up
on a bedside cart which accompanies the patients uninterrUptedly - from
anesthesia administration, to the operating room, to the ICU or recovery
room, as well as during elective or emergency interventions outside the ICU.
Transport times and complications from 995 transports (ASA III and IV) were
analysed and compared with 880 transports with the conventional system.
Results: During all intrahospital transfers with the mobile workplace, there
were no complications resulting from faulty operation or accidental
adjustment of the perfusors, or from disconnecting the monitoring,-,
respiration-, or infusion lines. On the whole, there were fewer cases of
circulatory instability during transport, since infusion treatment and
medication could be administered without interruption. All hemodynamic
parameters were recorded during transport, as were cardiac minute output and
right- and left-atrial filling pressures. The mobile workplace system allows
for the shortest possible transport and exchange times - 13.5 rain, as
compared to 42.5 min with the conventional system. The reconnection of
monitoring equipment with zeroing, adjustment of the alarm limits, as well
as exchanging perfusors and infusomats before and after transport is
eliminated entirely. Conclusion: This mobile workplace, in which all
components of the anesthesiological and intensive care workstations are
integrated, guarantees the highest possible level of patient safety, since
nothing has to be disconnected until the patient is transferred to a
normal-care ward. In addition to the improved ergonomic design of the
nurse's and doctor's workplace, substantial savings can also be made.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
anesthesia complication
intensive care
EMTREE MEDICAL INDEX TERMS
anesthetic recovery
article
critical illness
hemodynamic monitoring
human
major clinical study
patient monitoring
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
German
LANGUAGE OF SUMMARY
English, German
EMBASE ACCESSION NUMBER
2000066388
MEDLINE PMID
10689519 (http://www.ncbi.nlm.nih.gov/pubmed/10689519)
PUI
L30097371
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 950
TITLE
Perinatal transport practices: A survey of inborn versus outborn very
preterm infants admitted to European neonatal intensive care units
AUTHOR NAMES
Kollée L.A.A.
Chabernaud J.-L.
Van Reempts P.
Debauche C.
Zeitlin J.
AUTHOR ADDRESSES
(Kollée L.A.A.; Chabernaud J.-L.; Van Reempts P.; Debauche C.; Zeitlin J.)
SOURCE
Prenatal and Neonatal Medicine (1999) 4:SUPPL. 1 (61-72). Date of
Publication: 1999
ISSN
1359-8635
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
newborn intensive care
patient transport
perinatal care
prematurity
EMTREE MEDICAL INDEX TERMS
article
Europe
gestational age
health care policy
hospital admission
human
infant
intensive care unit
newborn
patient referral
priority journal
EMBASE CLASSIFICATIONS
Health Policy, Economics and Management (36)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2000080350
PUI
L30118265
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 951
TITLE
Blood flow does not limit peritoneal transport
AUTHOR NAMES
Flessner M.F.
Lofthouse J.
AUTHOR ADDRESSES
(Flessner M.F.; Lofthouse J.) Nephrology Unit, Department of Medicine, Univ.
of Rochester Medical Center, Rochester, NY, United States.
(Flessner M.F.) Univ. of Rochester Medical Center, Box 675, 601 Elmwood
Avenue, Rochester, NY 14642, United States.
CORRESPONDENCE ADDRESS
M.F. Flessner, Box 675, University Rochester Medical Center, 601 Elmwood
Avenue, Rochester, NY 14642, United States.
SOURCE
Peritoneal Dialysis International (1999) 19:SUPPL. 2 (S102-S105). Date of
Publication: 1999
ISSN
0896-8608
BOOK PUBLISHER
Multimed Inc., 66 Martin Street, Milton, Canada.
ABSTRACT
Objective: We investigated the assumption that blood flow to the
microvessels underlying the peritoneum does not limit solute or water
exchange between the blood and the dialysis fluid. Design: Small plastic
chambers were affixed to the serosal side of the liver, cecum, stomach, and
abdominal wall of anesthetized rats. Solutions that contained labeled
solutes or that were made hypertonic were placed into the chambers, which
restricted the area of transfer across the tissue to the base of the chamber
and which permitted calculation of mass or water transfer rates on the basis
of area. The local blood flow was monitored continuously with a laser
Doppler flowmeter during three periods of observation: control, after
50%-70% reduction of the blood flow, and postmortem. Results: Urea transfer
across all serosa, except for the liver, showed no difference in mean mass
transfer coefficient (cm/min) between control (0.0038-0.0046) and after 70%
flow reduction (0.0037-0.0040), but demonstrated a significant decrease with
blood flow equal to zero (0.0020). These tissues demonstrated small but
insignificant decreases in osmotic water flow into the chamber (0.7-0.9
μL/min/cm(2) under control conditions versus 0.4-0.7 μL/min/cm(2) with
reduced blood flow). The liver demonstrated limitations in water and solute
transport with a 70% decrease in blood flow. Conclusion: Because the liver
makes up a small part of the peritoneal area, we conclude that large drops
in blood flow do not limit overall solute or water transfer across the
peritoneum during dialysis, and therefore acute peritoneal dialysis may be
an appropriate modality for ICU patients in shock and renal failure.
EMTREE DRUG INDEX TERMS
dialysis fluid
urea (endogenous compound)
water (endogenous compound)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
blood flow
peritoneal cavity
water transport
EMTREE MEDICAL INDEX TERMS
abdominal wall
animal experiment
blood
cecum
conference paper
controlled study
Doppler flowmeter
intensive care unit
kidney failure (therapy)
liver
microvasculature
nonhuman
osmosis
peritoneal dialysis
priority journal
rat
shock (therapy)
stomach
water flow
CAS REGISTRY NUMBERS
urea (57-13-6)
water (7732-18-5)
EMBASE CLASSIFICATIONS
Urology and Nephrology (28)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2000010931
MEDLINE PMID
10406502 (http://www.ncbi.nlm.nih.gov/pubmed/10406502)
PUI
L30015460
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 952
TITLE
Variations in the organization of obstetric and neonatal intensive care in
Europe
AUTHOR NAMES
Papiernik E.
Zeitlin J.
Milligan D.W.A.
Carrapato M.R.G.
Van Reempts P.
Gadzinowski J.
Mazela J.
Cabero L.
Roura I.
Di Renzo G.C.
Moessinger A.
Kollée L.A.A.
Künzel W.
Velebil P.
AUTHOR ADDRESSES
(Papiernik E.; Zeitlin J.; Milligan D.W.A.; Carrapato M.R.G.; Van Reempts
P.; Gadzinowski J.; Mazela J.; Cabero L.; Roura I.; Di Renzo G.C.;
Moessinger A.; Kollée L.A.A.; Künzel W.; Velebil P.)
SOURCE
Prenatal and Neonatal Medicine (1999) 4:SUPPL. 1 (73-87). Date of
Publication: 1999
ISSN
1359-8635
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
newborn intensive care
patient transport
perinatal care
EMTREE MEDICAL INDEX TERMS
adult
birth rate
Europe
health care organization
high risk patient
human
newborn
practice guideline
priority journal
review
EMBASE CLASSIFICATIONS
Obstetrics and Gynecology (10)
Health Policy, Economics and Management (36)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2000080351
PUI
L30118266
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 953
TITLE
Recommendations for intra-hospital transport of the severely head injured
patient
AUTHOR NAMES
Ferdinande P.
AUTHOR ADDRESSES
(Ferdinande P.) European Society Intensive Care Med., Avenue Joseph Wybran
40, 1070 Brussels, Belgium.
CORRESPONDENCE ADDRESS
P. Ferdinande, European Society Intensive Care Med., Avenue Joseph Wybran
40, 1070 Brussels, Belgium. Email: esicm@pophost.eunet.be
SOURCE
Intensive Care Medicine (1999) 25:12 (1441-1443). Date of Publication: 1999
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag, Tiergartenstrasse 17, Heidelberg, Germany.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
head injury (disease management)
patient transport
EMTREE MEDICAL INDEX TERMS
human
note
practice guideline
EMBASE CLASSIFICATIONS
Neurology and Neurosurgery (8)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
2000015348
MEDLINE PMID
10660856 (http://www.ncbi.nlm.nih.gov/pubmed/10660856)
PUI
L30021175
DOI
10.1007/s001340051096
FULL TEXT LINK
http://dx.doi.org/10.1007/s001340051096
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 954
TITLE
Intrahospital transport of critically ill patients
AUTHOR NAMES
Waydhas C.
AUTHOR ADDRESSES
(Waydhas C., christian.waydhas@uni-essen.de) Klin. Poliklin. F.
Unfallchirurgie, University Hospital, University of Essen, Essen, Germany.
(Waydhas C., christian.waydhas@uni-essen.de) Klin. Poliklin. F.
Unfallchirurgie, University Hospital, University of Essen, Hufelandstr. 55,
45147 Essen, Germany.
CORRESPONDENCE ADDRESS
C. Waydhas, Klin./Poliklinik fur Unfallchirurgie, University Hospital,
University of Essen, Hufelandstr. 55, 45147 Essen, Germany. Email:
christian.waydhas@uni-essen.de
SOURCE
Critical Care (1999) 3:5 (R83-R89). Date of Publication: 1999
ISSN
1364-8535
BOOK PUBLISHER
BioMed Central Ltd., 34 - 42 Cleveland Street, London, United Kingdom.
ABSTRACT
Background: This review on the current literature of the intrahospital
transport of critically ill patients addresses type and incidence of adverse
effects, risk factors and risk assessment, and the available information on
efficiency and cost-effectiveness of transferring such patients for
diagnostic or therapeutic interventions within hospital. Methods and
guidelines to prevent or reduce potential hazards and complications are
provided. Methods: A Medline search was performed using the terms 'critical
illness', 'transport of patients', 'patient transfer', 'critical care',
'monitoring' and 'intrahospital transport', and all information concerning
the intrahospital transport of patients was considered. Results: Adverse
effects may occur in up to 70% of transports. They include a change in heart
rate, arterial hypotension and hypertension, increased intracranial
pressure, arrhythmias, cardiac arrest and a change in respiratory rate,
hypocapnia and hypercapnia, and significant hypoxaemia. No transport-related
deaths have been reported. In up to one-third of cases mishaps during
transport were equipment related. A long-term deterioration of respiratory
function was observed in 12% of cases. Patient-related risk indicators were
found to be a high Therapeutic Intervention Severity Score, mechanical
ventilation, ventilation with positive end-expiratory pressure and high
injury severity score. Patients' age, duration of transport, destination of
transport, Acute Physiology and Chronic Health Evaluation II score,
personnel accompanying the patient and other factors were not found to
correlate with an increased rate of complications. Transports for diagnostic
procedures resulted in a change in patient management in 40-50% of cases,
indicating a good risk:benefit ratio. Conclusions: To prevent adverse
effects of intrahospital transports, guidelines concerning the organization
of transports, the personnel, equipment and monitoring should be followed.
In particular, the presence of a critical care physician during transport,
proper equipment to monitor vital functions and to treat such disturbances
immediately, and close control of the patient's ventilation appear to be of
major importance. It appears useful to use specifically constructed carts
including standard intensive care unit ventilators in a selected group of
patients. To further reduce the rate of inadvertent mishaps resulting from
transports, alternative diagnostic modalities or techniques and performing
surgical procedures in the intensive care unit should be considered.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
patient transport
EMTREE MEDICAL INDEX TERMS
clinical protocol
disease severity
emergency health service
human
patient monitoring
priority journal
review
risk assessment
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1999363756
MEDLINE PMID
11094486 (http://www.ncbi.nlm.nih.gov/pubmed/11094486)
PUI
L29488975
DOI
10.1186/cc362
FULL TEXT LINK
http://dx.doi.org/10.1186/cc362
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 955
TITLE
Ethics in action. A nurse on a critical care unit has promised her
terminally ill patient that she will care for him until the end.
AUTHOR NAMES
Haddad A.
AUTHOR ADDRESSES
(Haddad A.) School of Pharmacy and Allied Health Professions, Creighton
University, Omaha, USA.
CORRESPONDENCE ADDRESS
A. Haddad, School of Pharmacy and Allied Health Professions, Creighton
University, Omaha, USA.
SOURCE
RN (1999) 62:11 (21-24). Date of Publication: Nov 1999
ISSN
0033-7021
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
medical ethics
nurse patient relationship
patient transport
terminal care
EMTREE MEDICAL INDEX TERMS
article
Death and Euthanasia
human
professional-patient relationship
psychological aspect
recumbency
LANGUAGE OF ARTICLE
English
MEDLINE PMID
10640126 (http://www.ncbi.nlm.nih.gov/pubmed/10640126)
PUI
L31277851
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 956
TITLE
Logistic adaptation of intra hospital transport of adults ARDS
ORIGINAL (NON-ENGLISH) TITLE
Adaptation logistique du transport intrahospitalier de l'adulte en syndrome
de detresse respiratoire aigue (SDRA)
AUTHOR NAMES
Corcelle P.
Bernardin G.
Mattéi M.
AUTHOR ADDRESSES
(Corcelle P.; Bernardin G.; Mattéi M.) Serv. de reanimation medicale, CHU,
hôpital de l'Archet 1, BP 3079, 06202 Nice Cedex 3, France.
CORRESPONDENCE ADDRESS
P. Corcelle, Service de Reanimation Medicale, CHU, Hopital de l'Archet 1, BP
3079, 06202 Nice Cedex 3, France.
SOURCE
RBM - Revue Europeenne de Technologie Biomedicale (1999) 21:7 (148-152).
Date of Publication: Oct 1999
ISSN
0222-0776
ABSTRACT
Patients with ARDS must be displaced under safety conditions equivalent to
those prevailing within the ICU; we have attempted to elaborate an
autonomous, compact unit allowing patient transport under these conditions
while easing the task of each of the care providers. This concept of
transportation is applied in the clinical setting by means of a basket
stretcher - carrying the patient - over which is adapted a mobile table
carrying the treatment and monitoring equipment; the whole combination is
installed on a cot. Once the patient is positioned in the basket
stretcher/table unit, the majority of investigations (CT scanning in
particular) can be conducted without any additional manipulation, with the
same standards of monitoring and care as those provided in the ICU. Handling
of the unit during transport only requires translational movements, which
makes work easier for the nursing staff, stretcher-bearers and radiology
technicians. The ultimate goal is to achieve a simple system allowing each
ICU to elaborate its own set-up in view of applying this concept. Created
for ARDS, our system can easily be applied to all patients in intensive care
for whom such drastic requirements (especially regarding ventilation) are
not always necessary.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
adult respiratory distress syndrome
EMTREE MEDICAL INDEX TERMS
article
computer assisted tomography
hospital care
human
intensive care unit
patient care
patient transport
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
French
LANGUAGE OF SUMMARY
English, French
EMBASE ACCESSION NUMBER
1999381531
PUI
L29513619
DOI
10.1016/S0222-0776(00)88264-4
FULL TEXT LINK
http://dx.doi.org/10.1016/S0222-0776(00)88264-4
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 957
TITLE
The intra-hospital transport of patients with increased intracranial
pressure
ORIGINAL (NON-ENGLISH) TITLE
Der innerklinische transport von patienten mit erhohtem intrakraniellen
druck
AUTHOR NAMES
Marx G.
Leuwer M.
Piepenbrock S.
Rueckoldt H.
AUTHOR ADDRESSES
(Marx G.; Leuwer M.; Piepenbrock S.; Rueckoldt H.) Zentrum für
Anaesthesiologie, Abteilung II, Medizinische Hochschule Hannover, .
CORRESPONDENCE ADDRESS
G. Marx, Zentrum fur Anaesthesiologie, Abteilung II, Medizinische Hochschule
Hannover, Hannover, Germany.
SOURCE
Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie, Supplement
(1999) 34:1 (S58-S61). Date of Publication: September 1999
ISSN
1430-7790
BOOK PUBLISHER
Georg Thieme Verlag, Rudigerstrasse 14, Stuttgart, Germany.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
head injury
intracranial hypertension
EMTREE MEDICAL INDEX TERMS
article
artificial ventilation
hospital care
human
patient care
patient monitoring
patient transport
EMBASE CLASSIFICATIONS
Neurology and Neurosurgery (8)
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
German
EMBASE ACCESSION NUMBER
1999354096
MEDLINE PMID
10542912 (http://www.ncbi.nlm.nih.gov/pubmed/10542912)
PUI
L29476758
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 958
TITLE
Complications of intrahospital transport of the critically ill patients:
Fact or fiction?
ORIGINAL (NON-ENGLISH) TITLE
Das transporttrauma: Fakt oder Fiktion?
AUTHOR NAMES
Zettl R.
Waydhas C.
Ruchholtz S.
Zintl B.
Schweiberer L.
AUTHOR ADDRESSES
(Zettl R.; Waydhas C.; Ruchholtz S.; Zintl B.; Schweiberer L.) Chir. Klinik
Klinikum Innenstadt, Ludwig-Maximilians-Univ. M., .
CORRESPONDENCE ADDRESS
R. Zettl, Chir. Klinik Klinikum Innenstadt, Ludwig-Maximilians-Univ.
Munchen, Munchen, Germany.
SOURCE
Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie, Supplement
(1999) 34:1 (S62-S65). Date of Publication: September 1999
ISSN
1430-7790
BOOK PUBLISHER
Georg Thieme Verlag, Rudigerstrasse 14, Stuttgart, Germany.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
patient transport
EMTREE MEDICAL INDEX TERMS
article
artificial ventilation
hospital care
human
intensive care
patient care
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
German
EMBASE ACCESSION NUMBER
1999354097
MEDLINE PMID
10542913 (http://www.ncbi.nlm.nih.gov/pubmed/10542913)
PUI
L29476759
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 959
TITLE
Comparison of commercial Amies transport systems with in-house Amies medium
for recovery of Neisseria gonorrhoeae
AUTHOR NAMES
Thompson D.S.
French S.A.
AUTHOR ADDRESSES
(Thompson D.S., thompsond@health.moh.gov.on.ca) Orillia Public Health
Laboratory, 750 Memorial Ave., Orillia, Ont. L3V 6K5, Canada.
(French S.A.)
CORRESPONDENCE ADDRESS
D.S. Thompson, Orillia Public Health Laboratory, 750 Memorial Ave., Orillia,
Ont. L3V 6K5, Canada. Email: thompsond@health.moh.gov.on.ca
SOURCE
Journal of Clinical Microbiology (1999) 37:9 (3020-3021). Date of
Publication: 1999
ISSN
0095-1137
BOOK PUBLISHER
American Society for Microbiology, 1752 N Street N.W., Washington, United
States.
ABSTRACT
Microbiologists are still encumbered by the variable performance of Amies
charcoal transport medium in recovery of Neisseria gonorrhoeae. The
objective of this study was to evaluate and select a good quality commercial
system to replace our in-house preparation. We adsorbed 0.1 ml of a
suspension from 30 gonococcal isolates onto each swab type and replaced the
swab into the transport medium. We plated the swabs to New York City medium
at 0, 24, 48, 72, and 96 h. We compared the survival of each isolate in the
commercial Amies transport systems with that in our in-house Amies transport
medium. The best recovery was observed with Copan transport systems. Some
systems are inadequate and unacceptable for culture of gonococci.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Neisseria gonorrhoeae
EMTREE MEDICAL INDEX TERMS
article
bacterium culture
bacterium isolate
culture medium
intermethod comparison
nonhuman
priority journal
quality control
transport medium
DEVICE TRADE NAMES
CultureSwab 1006607A , United StatesDifco
Culturette N7KA020 , United StatesBecton Dickinson
NCS 7F26A , CanadaStarplex
PHL 1390/2058/5028 , CanadaPublic Health Labs
Starswab 7G17A , CanadaStarplex
Transwab 97G28 , United KingdomMedical Wire and Equipment
Transystem 7029 , ItalyCopan
Transystem 7073 , ItalyCopan
Transystem 7323 , ItalyCopan
DEVICE MANUFACTURERS
(United States)Becton Dickinson
(Italy)Copan
(United States)Difco
(United Kingdom)Medical Wire and Equipment
(Canada)Public Health Labs
(Canada)Starplex
EMBASE CLASSIFICATIONS
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
Biophysics, Bioengineering and Medical Instrumentation (27)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1999291368
MEDLINE PMID
10449495 (http://www.ncbi.nlm.nih.gov/pubmed/10449495)
PUI
L29391930
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 960
TITLE
Preparing parents for their child's transfer from the PICU to the pediatric
floor.
AUTHOR NAMES
Bouvé L.R.
Rozmus C.L.
Giordano P.
AUTHOR ADDRESSES
(Bouvé L.R.; Rozmus C.L.; Giordano P.) School of Nursing, Georgia
Southwestern State University, Americus 31709, USA.
CORRESPONDENCE ADDRESS
L.R. Bouvé, School of Nursing, Georgia Southwestern State University,
Americus 31709, USA.
SOURCE
Applied nursing research : ANR (1999) 12:3 (114-120). Date of Publication:
Aug 1999
ISSN
0897-1897
ABSTRACT
The experimental study described here was conducted to examine a nursing
intervention intended to diminish the anxiety level of parents of children
being transferred from a pediatric intensive care unit (PICU) to a general
pediatric floor. The convenience sample included 50 parents of patients in a
PICU at a southeastern U.S. tertiary medical center. The sample was randomly
assigned to control and experimental groups. All subjects' anxiety levels
were measured using Spielberger's State-Trait Anxiety Inventory (STAI) 24 to
48 hours prior to the child's impending transfer. The experimental group
subsequently was given a transfer-preparation letter along with a verbal
explanation. Finally, both groups were retested using the STAI immediately
prior to the child's transfer. After controlling for trait anxiety, the
analysis of covariant results showed significantly lower anxiety levels
among the subjects who received the transfer-preparation letter than among
those who did not, F(1,47) = 18.65, p < .0005. The study concludes that
effective transfer preparation can significantly reduce the anxiety
experienced by parents who are facing the imminent transfer of their child
out of the PICU.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
anxiety (diagnosis, etiology, prevention)
child hospitalization
intensive care
parent
patient transport
EMTREE MEDICAL INDEX TERMS
adolescent
adult
article
clinical trial
controlled clinical trial
controlled study
education
female
human
male
methodology
middle aged
nursing
nursing evaluation research
pediatric nursing
psychological aspect
questionnaire
randomized controlled trial
teaching
LANGUAGE OF ARTICLE
English
MEDLINE PMID
10457621 (http://www.ncbi.nlm.nih.gov/pubmed/10457621)
PUI
L129455071
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 961
TITLE
Avoid COBRA's fangs. The Emergency Medical Treatment & Active Labor Act:
legislating appropriate critical care transports.
AUTHOR NAMES
Maggiore W.A.
AUTHOR ADDRESSES
(Maggiore W.A.)
CORRESPONDENCE ADDRESS
W.A. Maggiore,
SOURCE
JEMS : a journal of emergency medical services (1999) 24:8 (66-74, 76). Date
of Publication: Aug 1999
ISSN
0197-2510
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
patient transport
EMTREE MEDICAL INDEX TERMS
article
female
human
intensive care
labor
law
legal aspect
legal liability
physical examination
practice guideline
pregnancy
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
10557814 (http://www.ncbi.nlm.nih.gov/pubmed/10557814)
PUI
L129464313
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 962
TITLE
Regional protocols for the transfer and treatment of patients with head
injury
ORIGINAL (NON-ENGLISH) TITLE
I protocolli regionali di trasferimento ed il trattamento del trauma
cranico: L'Esperienza della Romagna
AUTHOR NAMES
Servadei F.
Veronesi V.
Giuliani G.
Giardini E.
Chieregato A.
AUTHOR ADDRESSES
(Servadei F.; Veronesi V.; Giuliani G.; Giardini E.; Chieregato A.) Div.
Neurochirur. Funz. Traumatol., Ospedale Maurizio Bufalini, 47023 Cesena,
Italy.
CORRESPONDENCE ADDRESS
F. Servadei, Div. Neurochirur. Funz. Traumatol., Ospedale Maurizio Bufalini,
47023 Cesena, Italy. Email: fservade@ausl-cesena.emr.it
SOURCE
Rivista Medica (1999) 5:1-2 (29-34). Date of Publication: 1999
ISSN
1127-6339
ABSTRACT
Concentrating head injured patients in a hospital with neurosurgery and
intensive care units has been confirmed in literature reports and recently
by Italian guidelines. A regional trauma system with head injuries treated
at the Bufalini Hospital in Cesena was analysed. The epidemiological aspects
were investigated and existing resources identified. Although
epidemiological findings disclosed the need for admission to intensive care
units for 180- 220 patients, only half the patients with severe head injury
were admitted to hospitals with specialist wards. A transfer protocol is
proposed correlated with the transmission of CT scans which offers the best
possible treatment for patients with head injury.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
head injury (diagnosis, epidemiology)
EMTREE MEDICAL INDEX TERMS
article
clinical protocol
computer assisted tomography
hospital admission
human
intensive care unit
major clinical study
nervous system injury (diagnosis, epidemiology)
neuroradiology
neurotraumatology
patient transport
practice guideline
EMBASE CLASSIFICATIONS
Radiology (14)
Public Health, Social Medicine and Epidemiology (17)
Neurology and Neurosurgery (8)
LANGUAGE OF ARTICLE
Italian
LANGUAGE OF SUMMARY
English, Italian
EMBASE ACCESSION NUMBER
1999195946
PUI
L29258655
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 963
TITLE
Intrahospital transport of critically ill children - Should we pay
attention?
AUTHOR NAMES
Venkataraman S.T.
AUTHOR ADDRESSES
(Venkataraman S.T.) Pediatric Critical Care, Children's Hospital of
Pittsburgh, 3705 Fifth Ave., Pittsburgh, PA, United States.
CORRESPONDENCE ADDRESS
S.T. Venkataraman, Pediatric Critical Care, Children's Hospital of
Pittsburgh, 3705 Fifth Ave., Pittsburgh, PA, United States.
SOURCE
Critical Care Medicine (1999) 27:4 (694-695). Date of Publication: 1999
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
artificial ventilation
child
critical illness
disease severity
editorial
end tidal carbon dioxide tension
human
intensive care unit
intermethod comparison
medical literature
medical staff
priority journal
risk assessment
tidal volume
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1999165136
MEDLINE PMID
10321655 (http://www.ncbi.nlm.nih.gov/pubmed/10321655)
PUI
L29218199
DOI
10.1097/00003246-199904000-00016
FULL TEXT LINK
http://dx.doi.org/10.1097/00003246-199904000-00016
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 964
TITLE
Patients' and family members' perceptions of transfer from intensive care
AUTHOR NAMES
Leith B.A.
AUTHOR ADDRESSES
(Leith B.A.) Montreal Neurological Hospital, Intensive Care Unit, 3801
University St, Montreal, Que. H3A 2B4, Canada.
CORRESPONDENCE ADDRESS
B.A. Leith, Montreal Neurological Hospital, Intensive Care Unit, 3801
University St, Montreal, Que. H3A 2B4, Canada.
SOURCE
Heart and Lung: Journal of Acute and Critical Care (1999) 28:3 (210-218).
Date of Publication: 1999
ISSN
0147-9563
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
ABSTRACT
OBJECTIVE: To describe patients' and family members' perceptions of transfer
from an intensive care unit (ICU). DESIGN: Qualitative component of a
descriptive, cross-sectional survey. SETTING: Two university-affiliated
tertiary care centres in western Canada. PARTICIPANTS: Fifty-three patients
and 35 family members who had been transferred from a medical ICU within the
previous 48 hours. MEASURES: Content analysis of responses to 3 open-ended
questions relating to transfer from the ICU. RESULTS: Patients and family
members had 3 major responses of transfer from the ICU: positive, neutral or
ambivalent, and negative. Although some patients and family members
perceived the transfer from the ICU as a sign of progress, many individuals
expressed concern about the sudden and dramatic change in the level of care
after transfer. CONCLUSION: Patients and family members perceived the
transfer from the ICU as a significant and sometimes negative event.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
comprehension
intensive care
EMTREE MEDICAL INDEX TERMS
article
family
human
morbidity
patient education
priority journal
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1999181425
MEDLINE PMID
10330217 (http://www.ncbi.nlm.nih.gov/pubmed/10330217)
PUI
L29239349
DOI
10.1016/S0147-9563(99)70061-0
FULL TEXT LINK
http://dx.doi.org/10.1016/S0147-9563(99)70061-0
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 965
TITLE
Use of flexible intermediate and intensive care to reduce multiple transfers
of patients.
AUTHOR NAMES
Besserman E.
Teres D.
Logan A.
Brennan M.
Cleaves S.
Bayly R.
Brochis D.
Nemeth B.
Grare J.
Ngo D.
AUTHOR ADDRESSES
(Besserman E.; Teres D.; Logan A.; Brennan M.; Cleaves S.; Bayly R.; Brochis
D.; Nemeth B.; Grare J.; Ngo D.) Department of Critical Care, Muhlenberg
Regional Medical Center, Plainfield, NJ, USA.
CORRESPONDENCE ADDRESS
E. Besserman, Department of Critical Care, Muhlenberg Regional Medical
Center, Plainfield, NJ, USA.
SOURCE
American journal of critical care : an official publication, American
Association of Critical-Care Nurses (1999) 8:3 (170-179). Date of
Publication: May 1999
ISSN
1062-3264
ABSTRACT
OBJECTIVE: To test an alternative flexible approach to traditional fixed
intermediate and intensive care to minimize transfers of patients. METHODS:
Patients admitted to a 28-bed nursing unit with intermediate care potential
and a 12-bed intensive care unit at a 300-bed teaching community hospital
were studied. The group included 524 patients with a discharge diagnosis
code for mechanical ventilation. During eight 3-week cycles, 1073 transfers
of patients were tabulated. A plan-do-study-act method was used to improve
weaning from mechanical ventilation and reduce the number of inappropriate
days in intensive care. Admissions and transfers to the 2 units for all
patients during the eight 3-week cycles were compared over time. Length of
stay and mortality were noted for all patients treated with conventional and
noninvasive ventilation. RESULTS: Direct admissions to the flexible
intermediate unit increased with no overall change in admissions to the
intensive care unit. Fewer patients needed conventional ventilation, and
more in both units were treated with noninvasive ventilation. The median
number of transfers per patient treated with mechanical ventilation
decreased from 1.94 to 1.20. Length of stay and mortality also decreased
among such patients. Some cost savings were attributable to the decrease in
the number of transfers. Transfers out of the hospital directly from the
intensive care unit increased from 2.24% to 4.43%. CONCLUSIONS: In a
community teaching hospital, flexible care policies decreased the number of
in-hospital transfers of patients treated with mechanical ventilation.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
artificial ventilation
community hospital
human
length of stay
methodology
mortality
organization and management
teaching hospital
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
10228658 (http://www.ncbi.nlm.nih.gov/pubmed/10228658)
PUI
L129420494
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 966
TITLE
Critical care of the burn patient
AUTHOR NAMES
Love R.
Nguyen T.T.
AUTHOR ADDRESSES
(Love R.; Nguyen T.T.) Warner Ave, Fountain Valley, CA 92708, United States.
CORRESPONDENCE ADDRESS
T.T. Nguyen, Warner Ave, Fountain Valley, CA 92708, United States.
SOURCE
Seminars in Anesthesia (1999) 18:1 (87-98). Date of Publication: 1999
ISSN
0277-0326
ABSTRACT
Comprehensive care of bum patients requires attention to details throughout
the acute phase of the patient's recovery to maximize survival. Team efforts
by surgeons, anesthesiologists, nurses, scientists, and a vast array of
therapists are making productive and social lives possible for many of these
bum victims. Overall, advances in the treatment of initial injuries and
their complications as well as new surgical techniques for closing wounds
and reducing scar tissue have increased burn patient's chances, not only of
survival but also of recovery and readjustment into society. However, many
problems still need to be solved, such as inhalation injury, hypermetabolism
with muscle wasting, and severe bum scarring. New therapies, such as
percussive ventilators, growth hormone, and newer methods of covering
wounds, will ultimately lead to further improvements in survival and
functional outcome.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
burn (surgery)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
compartment syndrome (complication)
epidemiological data
fasciotomy
hypermetabolism (complication)
metabolic rate
mortality
multiple organ failure
patient care
practice guideline
priority journal
resuscitation
review
thermal injury
wound care
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Surgery (9)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1999109520
PUI
L29142602
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 967
TITLE
Intrahospital transport of critically ill children
AUTHOR NAMES
Paret G.
Ben Abraham R.
Yativ O.
Vardi A.
Barzilay Z.
AUTHOR ADDRESSES
(Paret G.; Ben Abraham R.; Yativ O.; Vardi A.; Barzilay Z.) Dept. of
Pediatric Intensive Care and of Anesthesiology, Sheba Medical Center, Tel
Hashomer.
CORRESPONDENCE ADDRESS
G. Paret, Dept. of Pediatric Intensive Care and of Anesthesiology, Sheba
Medical Center, Tel Hashomer.
SOURCE
Harefuah (1999) 136:8 (609-611, 659). Date of Publication: 15 Apr 1999
ISSN
0017-7768
ABSTRACT
Prospective evaluation of intrahospital transportation of 33 critically ill
children to and from the pediatric intensive care unit was conducted over
the course of a month. Factors contributing to risk of transport were
assessed. There were 33 children (25 boys and 8 girls), 3 days to 15 years
of age. Reasons for admission included: disease and trauma in 19, and status
post operation in 11. The pretransport PRISM score was 4.84. 22 children
(66.6%) were being mechanically ventilated and 10 (30.3%) were being treated
with amines. Transport time ranged from 8-150 minutes. 15 of the transports
(45.4%) were urgent and a special intensive care team escorted 22 (66.6%).
Equipment mishaps and physiological deterioration occurred in 12 (36.3%) and
11 (30.3%) of the cases, respectively. The use of amines, mechanical
ventilation, longer transport time and high PRISM score were all associated
with physiological deterioration on transport.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child hospitalization
critical illness
patient transport
EMTREE MEDICAL INDEX TERMS
adolescent
article
child
female
human
infant
injury
male
newborn
postoperative complication
preschool child
LANGUAGE OF ARTICLE
Hebrew
MEDLINE PMID
10955068 (http://www.ncbi.nlm.nih.gov/pubmed/10955068)
PUI
L31363989
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 968
TITLE
Factors that contribute to complications during intrahospital transport of
the critically ill.
AUTHOR NAMES
Doring B.L.
Kerr M.E.
Lovasik D.A.
Thayer T.
AUTHOR ADDRESSES
(Doring B.L.; Kerr M.E.; Lovasik D.A.; Thayer T.) Vanderbilt University
Medical Center, USA.
CORRESPONDENCE ADDRESS
B.L. Doring, Vanderbilt University Medical Center, USA.
SOURCE
The Journal of neuroscience nursing : journal of the American Association of
Neuroscience Nurses (1999) 31:2 (80-86). Date of Publication: Apr 1999
ISSN
0888-0395
ABSTRACT
Transporting patients from the protective environment of the intensive care
(ICU) unit to other areas of the hospital has become increasingly common
since high technologic testing has become an integral part of health care
assessment. The hazards of moving critically ill patients by ambulance or
air transport are well recognized and standards of care have been developed
based on delineation of these risks. Despite the existing evidence of
hazards of interhospital hospital transport, less attention has been given
to the potential hazards associated with the intrahospital transport of
critically ill patients. A high incidence of serious hemodynamic or
respiratory alteration is associated with the intrahospital transport of
critically ill patients. In one third of critically ill intrahospital
transports, technical mishaps (eg, i.v. disconnects, which could potentially
lead to deleterious physiologic outcomes) may occur. As patient acuity
increases, there is a greater risk of hemodynamic instability. The purpose
of this study was to further investigate the patient complications during
transportation to and from the ICU to a diagnostic or treatment site. The
sample consisted of thirty-five critically ill patients from the
Neuro/Trauma ICU who required continuous physiological monitoring and had an
arterial catheter in place. The systemic blood pressure, heart rate and
peripheral oxygen saturation were monitored at nine time points throughout
the transport process. The incidence of defined technical mishaps that
occurred when the patient was off the unit were also recorded. Transport
factors examined included the length of time spent off the unit and the
number and level of personnel accompanying the patient. A within-subject
repeat measure design was used to examine the physiologic changes and
mishaps that occurred. Results indicate that while the majority of patients
experienced some physiologic responses as a result of transport, the
responses were not of sufficient magnitude to be classified as a
deleterious. Twenty-three technical mishaps, which included inadvertent
ventilator and electrocardiogram disconnects, power failures, interruption
of medication administration and disconnection of drainage devices were
observed. Factors related to these occurrences of technical mishaps were the
number of intravenous solutions and infusion pumps and the time spent
outside of the ICU environment.
EMTREE DRUG INDEX TERMS
oxygen
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
patient transport
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
article
factor analysis
female
hospital
human
intubation
male
metabolism
middle aged
standard
CAS REGISTRY NUMBERS
oxygen (7782-44-7)
LANGUAGE OF ARTICLE
English
MEDLINE PMID
14964607 (http://www.ncbi.nlm.nih.gov/pubmed/14964607)
PUI
L38309264
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 969
TITLE
A comparison of manual and mechanical ventilation during pediatric transport
AUTHOR NAMES
Dockery W.K.
Futterman C.
Keller S.R.
Sheridan M.J.
Akl B.F.
AUTHOR ADDRESSES
(Dockery W.K.) Department of Pediatrics, Inova Fairfax Hospital for
Children, Falls Church, VA, United States.
(Dockery W.K.; Futterman C.; Keller S.R.) Dept. of Pediatric Critical Care,
Inova Fairfax Hospital for Children, Falls Church, VA, United States.
(Akl B.F.) Department of Pediatrics and Surgery, Inova Fairfax Hospital for
Children, Falls Church, VA, United States.
(Sheridan M.J.) Institute of Research and Education, Inova Health System,
Falls Church, VA, United States.
CORRESPONDENCE ADDRESS
W.K. Dockery, Department of Pediatrics, Inova Fairfax Hospital for Children,
Falls Church, VA, United States.
SOURCE
Critical Care Medicine (1999) 27:4 (802-806). Date of Publication: April
1999
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
ABSTRACT
Objective: To compare the amount of variability in ventilation during
intrahospital transport of intubated pediatric patients ventilated either
manually or with a transport ventilator. Design: Prospective, randomized
study. Setting: Tertiary, multidisciplinary, pediatric intensive care unit.
Patients: Forty-nine pediatric postoperative heart patients who required
transport while still intubated. Interventions: Patients were randomized to
receive either manual ventilation during transport or ventilation by a
portable mechanical ventilator. Baseline ventilatory and hemodynamic
parameters were recorded before and during transport. Before and after
arterial blood gases were also obtained. All other aspects of care were
identical. Measurements and Main Results: There was a statistically
significant greater amount of variation in ventilation during transport with
manual technique as opposed to the mechanical ventilator. A Student's t-test
on pre- to post-blood gas differences showed a significantly lower PetCO(2)
(p = .02) in the manually ventilated patients when compared with the
mechanically ventilated patients. Values for PCO(2) were higher, but only
marginally significant (p = .08). Repeated measures analysis of variance
using these same pre- and post blood gas values confirmed the significant
decrease in PetCO(2) (p = .05). Minute to minute variation in PetCO(2)
during transport was greater and the mean values significantly lower in the
manually ventilated group (p < .05). Hemodynamic data were remarkably stable
when examined both before and after transport and on a minute to minute
basis during transport. Conclusions: Manual ventilation during intrahospital
transport results in greater fluctuation of ventilatory parameters from an
established baseline than does use of a transport ventilator. No clinically
significant changes in status occurred during the brief period of transport
studied.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
artificial ventilation
patient transport
EMTREE MEDICAL INDEX TERMS
adolescent
airway pressure
arterial gas
article
carbon dioxide tension
central venous pressure
child
clinical article
congenital heart malformation
controlled study
critical illness
end tidal carbon dioxide tension
endotracheal intubation
hemodynamic parameters
human
infant
intensive care
intermethod comparison
mean arterial pressure
newborn
patient monitoring
postoperative care
priority journal
risk assessment
ventilator
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1999165153
MEDLINE PMID
10321673 (http://www.ncbi.nlm.nih.gov/pubmed/10321673)
PUI
L29218216
DOI
10.1097/00003246-199904000-00040
FULL TEXT LINK
http://dx.doi.org/10.1097/00003246-199904000-00040
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 970
TITLE
Intrahospital transport of critically ill patients
ORIGINAL (NON-ENGLISH) TITLE
Transporte intrahospitalario del paciente critico
AUTHOR NAMES
Reig Valero R.
Belenguer Muncharaz A.
Bisbal Andrés E.
Abizanda Campos R.
Carregui Tusón R.
Pesqueira Alonso E.E.
AUTHOR ADDRESSES
(Reig Valero R.; Belenguer Muncharaz A.; Bisbal Andrés E.; Abizanda Campos
R.; Carregui Tusón R.; Pesqueira Alonso E.E.) Servei de Medicina Intensiva,
Hospital General de Castelló, Castelló, Spain.
(Abizanda Campos R.) Servei Med. Intensiva Hosp. Gen. C., Avda Benicàssim,
s/n, 12004 Castelló, Spain.
CORRESPONDENCE ADDRESS
R. Abizanda Campos, Servei de Medicina Intensiva, Hospital General de
Castello, Avda. Benicassim s-n, 12004 Castello, Spain.
SOURCE
Medicina Intensiva (1999) 23:3 (120-126). Date of Publication: Mar 1999
ISSN
0210-5691
ABSTRACT
The assisted intrahospital transport of critically ill patients is a common
attending procedure which represents an additional risk derived from leaving
the security room - the ICU - and also because patients are left to
unpreventable factors associated with portable equipment and the not always
easy intrahospital communications. The frequency of this type of
displacements is justified by the potential benefits derived from diagnostic
or therapeutic tests which cannot be performed at patient's bedside.
Therefore, an action strategy should be established in order to guarantee
that the patient overcomes the potential risks. The problems related to
intrahospital communications (both horizontally and vertically) with the
necessary equipment, with the necessary personnel and their qualifications,
and with monitoring of patients during the whole process are reviewed.
Finally, a systematic, detailed action programme leading to solve the
reported problems is provided.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
clinical practice
critical illness
patient transport
EMTREE MEDICAL INDEX TERMS
devices
diagnostic test
human
intensive care unit
interpersonal communication
patient monitoring
personnel
review
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
Spanish
LANGUAGE OF SUMMARY
Spanish, English
EMBASE ACCESSION NUMBER
1999153457
PUI
L29201783
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 971
TITLE
Development of a pediatric critical care transport team: Experience at a
military medical center
AUTHOR NAMES
Wheeler D.S.
Sperring J.L.
Vaux K.K.
Poss W.B.
AUTHOR ADDRESSES
(Wheeler D.S.; Sperring J.L.; Vaux K.K.; Poss W.B.) Depts. of Pediat. and
Clin. Research, Naval Medical Center San Diego, San Diego, CA, United
States.
CORRESPONDENCE ADDRESS
W.B. Poss, Dept. of Pediatr. and Clinic. Res., Naval Medical Center San
Diego, San Diego, CA, United States.
SOURCE
Military Medicine (1999) 164:3 (188-193). Date of Publication: March 1999
ISSN
0026-4075
BOOK PUBLISHER
Association of Military Surgeons of the US, 9320 Old Georgetown Road,
Bethesda, United States.
ABSTRACT
Introduction: A pediatric critical care transport program was initiated and
organized at Naval Medical Center San Diego in January 1994. The primary
goal of the program was to formally train military pediatric residents in
the early stabilization and transport of the critically ill neonatal and
pediatric patient. It was also felt that such a program would generate
significant cost savings to the Department of Defense. We present the
statistics, training protocol, and the cost savings. In addition, we
surveyed previous residents who had been involved with this program to
determine its perceived benefit. Methods: In the first phase of this
project, the pediatric critical care transport program database from January
1994 to December 1997 was reviewed. The number and types of transports were
recorded. Next, we determined cost savings for the transport program for
fiscal year 1996-1998 (the period for which fiscal data were available). In
the second phase of this project, we sent surveys to the 23 graduating
residents who had participated in the pediatric critical care transport
program. The survey sought to determine the perceived value of the transport
training experience and the degree to which that training is now being used.
All investigators were blinded to the responses. Statistical analysis
consisted of determining the percentage of each response. Results: During
the 4-year period reviewed, 404 transports were performed (198 neonatal and
206 pediatric). During fiscal year 1996-1998, there was a cost avoidance of
$1,962 per transport. In the second phase, 91% of the surveys were returned
and analyzed. The majority of residents were practicing in overseas or
isolated communities. All respondents rated their experience in the
pediatric critical care transport program as worthwhile and educational, and
they complemented their training in the neonatal and pediatric intensive
care units. Seventy-one percent of the respondents had transported a
critically ill neonate or child to another facility within the last year.
Conclusions: In summary, we report our experience with the development of a
pediatric critical care transport program. The Program was developed to
provide military pediatric residents instruction and experience in the
stabilization and transport of critically ill children. In addition, we were
able to demonstrate a significant cost avoidance.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child health care
EMTREE MEDICAL INDEX TERMS
article
child
critical illness
health care cost
human
military medicine
newborn
newborn intensive care
patient transport
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1999102746
MEDLINE PMID
10091491 (http://www.ncbi.nlm.nih.gov/pubmed/10091491)
PUI
L29133712
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 972
TITLE
Critical care transport: Outcome evaluation after interfacility transfer and
hospitalization
AUTHOR NAMES
Selevan J.S.
Fields W.W.
Chen W.
Petitti D.B.
Wolde-Tsadik G.
AUTHOR ADDRESSES
(Selevan J.S.; Fields W.W.; Chen W.; Petitti D.B.; Wolde-Tsadik G.) S.
California Permanente Med. Grp., 393 East Walnut Street, Pasadena, CA 91188,
United States.
CORRESPONDENCE ADDRESS
J.S. Selevan, S. California Permanente Med. Grp., 393 East Walnut Street,
Pasadena, CA 91188, United States.
SOURCE
Annals of Emergency Medicine (1999) 33:1 (33-43). Date of Publication: 1999
ISSN
0196-0644
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
ABSTRACT
Study objective: To test the hypothesis that interfacility transfer is not
associated with increased mortality, duration of stay, or readmission within
7 days. Methods: We matched 3,298 patients who were hospitalized for chest
pain or related complaints in Kaiser Permanente medical centers after
transfer from the emergency department of a non-plan hospital (transported
patients) with 3,298 patients of the same gender and age (±5 years) and with
the same principal diagnosis who were hospitalized within 6 months without
transfer in the same Kaiser Permanente medica center (directly admitted
patients). Patients were compared in terms of outcome measures: in-hospital
deaths, continued care in another facility, readmission within 7 days, in-
patient length of stay (LOS), and LOS in special care units. Results: The
adjusted odds ratios for in-hospital mortality and readmission within 7 days
were 1.0 (95% confidence interval, .8 to 1.4) and .9 (95% confidence
interval, .7 to 1.2), respectively. The adjusted mean difference in LOS was
- .1 days (95% confidence interval, -.2 to .1). Transported and directly
admitted cardiac patients were also compared for all examined outcome
measures at each of 10 medical centers. At a few medical centers, we
observed significant difference in LOS, special care LOS, and continued care
in another facility. However, all these differences were small, and most
were probably random errors. Conclusion: Conservative patient selection
criteria, pretransfer stabilization, and the use of appropriate equipment
and medical personnel have resulted in the interfacility transfer program's
achieving its goal of transferring high-risk patients without adverse impact
on clinical outcomes or resource use.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
heart arrhythmia (diagnosis)
hospitalization
intensive care
treatment outcome
EMTREE MEDICAL INDEX TERMS
article
conservative treatment
disease severity
heart failure (diagnosis)
heart muscle ischemia (diagnosis)
high risk population
human
major clinical study
medical care
medical personnel
mortality
myocardial disease (diagnosis)
patient transport
priority journal
thorax pain (diagnosis)
EMBASE CLASSIFICATIONS
Internal Medicine (6)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1999022214
MEDLINE PMID
9867884 (http://www.ncbi.nlm.nih.gov/pubmed/9867884)
PUI
L29028777
DOI
10.1016/S0196-0644(99)70414-2
FULL TEXT LINK
http://dx.doi.org/10.1016/S0196-0644(99)70414-2
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 973
TITLE
Secondary insults during intrahospital transport of neurosurgical intensive
care patients
AUTHOR NAMES
Bekar A.
Ipekoglu Z.
Türeyen K.
Bilgin H.
Korfali G.
Korfali E.
AUTHOR ADDRESSES
(Bekar A.; Ipekoglu Z.; Türeyen K.; Korfali E.) Department of Neurosurgery,
Uludag University, Bursa, Turkey.
(Bilgin H.; Korfali G.) Dept. of Anesth. and Reanimation, Uludag University,
Bursa, Turkey.
(Bekar A.) Department of Neurosurgery, Uludag University, School of
Medicine, TR-Görükle, Bursa, Turkey.
CORRESPONDENCE ADDRESS
A. Bekar, Department of Neurosurgery, Uludag University, School of Medicine,
TR-Gorukle, Bursa, Turkey.
SOURCE
Neurosurgical Review (1998) 21:2-3 (98-101). Date of Publication: 1998
ISSN
0344-5607
BOOK PUBLISHER
Springer Verlag, Tiergartenstrasse 17, Heidelberg, Germany.
ABSTRACT
Secondary insults occurring after injury have been prospectively assessed in
seven head-injured patients who required intrahospital transfer to a
computerized tomography unit for re-evaluation of their brain injury. During
transportation the intracranial pressure, blood pressure, and arterial blood
gases were monitored. A significant increase in intracranial pressure was
observed during transport (p < 0.01). The conclusion is that patients should
be ventilated and have appropriate sedation and analgesia. This could
provide some protection against secondary insults.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
head injury (complication)
EMTREE MEDICAL INDEX TERMS
article
human
injury scale
intensive care
intracranial pressure
patient transport
priority journal
surgical patient
Turkey (republic)
EMBASE CLASSIFICATIONS
Neurology and Neurosurgery (8)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1998412650
MEDLINE PMID
9795941 (http://www.ncbi.nlm.nih.gov/pubmed/9795941)
PUI
L28552704
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 974
TITLE
Does optimizing oxygen transport improve outcome in intensive care patients?
AUTHOR NAMES
Brazzi L.
Gattinoni L.
AUTHOR ADDRESSES
(Brazzi L.) Department of Anaesthesia, University of Milan, Milan, Italy.
(Gattinoni L.) Department of Anaesthesia, Ospedale Maggiore Policlinico,
IRCCS, Milan, Italy.
(Brazzi L.) Istituto di Anestesia e Rianimazione, Ospedale Maggiore
Policlinico, Via F. Sforza 35, 20122 Milano, Italy.
CORRESPONDENCE ADDRESS
L. Brazzi, Istituto di Anestesia e Rianimazione, Ospedale Maggiore
Policlinico, Via F. Sforza 35, 20122 Milano, Italy.
SOURCE
British Journal of Anaesthesia (1998) 81:SUPPL. 1 (46-49). Date of
Publication: 1998
ISSN
0007-0912
BOOK PUBLISHER
Oxford University Press, Great Clarendon Street, Oxford, United Kingdom.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
oxygen (endogenous compound)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hemodynamics
intensive care
oxygen transport
EMTREE MEDICAL INDEX TERMS
conference paper
critical illness
human
oxygen consumption
priority journal
treatment outcome
CAS REGISTRY NUMBERS
oxygen (7782-44-7)
EMBASE CLASSIFICATIONS
Internal Medicine (6)
Anesthesiology (24)
Hematology (25)
Clinical and Experimental Biochemistry (29)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1998419191
MEDLINE PMID
10318988 (http://www.ncbi.nlm.nih.gov/pubmed/10318988)
PUI
L28561304
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 975
TITLE
The outcome of patients with upper airway obstruction transported to a
regional paediatric intensive care unit
AUTHOR NAMES
Durward A.D.
Nicoll S.J.B.
Oliver J.
Tibby S.M.
Murdoch I.A.
AUTHOR ADDRESSES
(Durward A.D.; Nicoll S.J.B.; Oliver J.; Tibby S.M., s.tibby@umds.ac.uk;
Murdoch I.A.) Dept. of Paediatric Intensive Care, Guy's Tower, Guy's
Hospital, St Thomas Street, London SE1 9RT, United Kingdom.
CORRESPONDENCE ADDRESS
S.M. Tibby, Dept. of Paediatric Intensive Care, Guy's Tower, Guy's Hospital,
St Thomas Street, London SE1 9RT, United Kingdom. Email: s.tibby@umds.ac.uk
SOURCE
European Journal of Pediatrics (1998) 157:11 (907-911). Date of Publication:
1998
ISSN
0340-6199
BOOK PUBLISHER
Springer Verlag, Tiergartenstrasse 17, Heidelberg, Germany.
ABSTRACT
The diagnoses, transfer, management and outcome of patients with upper
airway obstruction (UAO) admitted from district general hospitals (DGH) to a
regional paediatric intensive care unit were retrospectively reviewed over a
3.5-year period. Sixty-seven patient episodes were analysed. Fifty-two cases
(78%) underwent tracheal intubation prior to transport with a low morbidity
for both procedures. The most common diagnosis was viral croup (n = 34, 51%)
with a median duration of intubation of 5 days, with subglottic stenosis
being the next most common category (n = 10, 15%), median duration of
intubation 7 days. Inhaled budesonide was used prior to intubation in 12
(35%) of those with croup, and inhaled bronchodilators in 28%, possibly
reflecting diagnostic uncertainty. Patients with croup treated with
budesonide were significantly less likely to require intubation (P = 0.04).
The re-intubation rate for patients with viral croup was uncomfortably high
at 16% (4/25) despite the routine use of prednisolone throughout the
intubation period. Successful extubation of patients with viral croup could
not be predicted by age (P = 0.31), length of intubation (P = 0.94),
endotracheal tube size, (P = 0.60) abnormalities on the chest X-ray (P =
1.0), or presence of secondary bacterial infection (P = 0.23). Conclusion.
Although viral croup remains the most common diagnostic category presenting
at the DGH level with severe UAO, a wide range of other diagnoses is seen.
Despite clear evidence of benefit, steroid administration to children
presenting at the DGH with viral croup has not become routine practice. Once
intubated, no reliable predictors of successful extubation were found
amongst this patient group.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
bronchodilating agent (drug therapy)
EMTREE DRUG INDEX TERMS
budesonide (drug therapy)
ipratropium bromide (drug therapy)
prednisolone (drug therapy)
salbutamol (drug therapy)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
patient transport
public hospital
upper respiratory tract obstruction (diagnosis, etiology, therapy)
EMTREE MEDICAL INDEX TERMS
article
bacterial infection (diagnosis)
child
croup (diagnosis, drug therapy)
endotracheal intubation
extubation
human
infant
inhalational drug administration
intravenous drug administration
major clinical study
newborn
oral drug administration
priority journal
subglottic stenosis (diagnosis)
thorax radiography
treatment outcome
CAS REGISTRY NUMBERS
budesonide (51333-22-3)
ipratropium bromide (22254-24-6)
prednisolone (50-24-8)
salbutamol (18559-94-9)
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Otorhinolaryngology (11)
Anesthesiology (24)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1998374591
MEDLINE PMID
9835435 (http://www.ncbi.nlm.nih.gov/pubmed/9835435)
PUI
L28506551
DOI
10.1007/s004310050965
FULL TEXT LINK
http://dx.doi.org/10.1007/s004310050965
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 976
TITLE
Predictors of respiratory function deterioration after transfer of
critically ill patients
AUTHOR NAMES
Marx G.
Vangerow B.
Hecker H.
Leuwer M.
Jankowski M.
Piepenbrock S.
Rueckoldt H.
AUTHOR ADDRESSES
(Marx G., marx.gernot@mh-hannover.de; Vangerow B.; Leuwer M.; Jankowski M.;
Piepenbrock S.; Rueckoldt H.) Department of Anaesthesia, Hannover Medical
School, D-30625 Hannover, Germany.
(Hecker H.) Department of Biometry, Hannover Medical School, D-30625
Hannover, Germany.
CORRESPONDENCE ADDRESS
G. Marx, Department of Anaesthesia, Hannover Medical School, D-30625
Hannover, Germany. Email: marx.gernot@mh-hannover.de
SOURCE
Intensive Care Medicine (1998) 24:11 (1157-1162). Date of Publication: 1998
ISSN
0342-4642
BOOK PUBLISHER
Springer Verlag, Tiergartenstrasse 17, Heidelberg, Germany.
ABSTRACT
Objectives: Critically ill patients are often transferred due to the growing
number of diagnostic procedures required to be performed outside the
intensive care unit. These transfers have proved to be very critical. The
aim of this study was to evaluate predictors for the deterioration of
respiratory function in critically ill patients after transfer. Design:
Prospective, clinical, observational study. Setting: 1800-bed university
teaching hospital. Subjects: 98 mechanically ventilated patients were
investigated during transfer. Measurement and main results: Before transfer,
all patients were classified according to the Acute Physiology and Chronic
Health Evaluation (APACHE) II score and the Therapeutic Intervention Scoring
System (TISS). Haemodynamics and arterial blood gases were measured at 11
different times. Arterial oxgen tension (PaO(2)), fractional inspired oxygen
(FIO(2)), PaO(2)/FIO(2) ratio, lowest PaO(2)/FIO(2) ratio, minimal PaO(2)
and maximal FIO(2), APACHE II score, TISS before transfer, age and duration
of transfer were analysed as potential predictors for deterioration of
respiratory function after transfer. Variables were analysed using
Classification and Regression Trees and Clustering by Response. In 54
transports (55%) there was a decrease in the PaO(2)/FIO(2) ratio, and a
decrease of more than 20% from baseline was noted in 23 of the transferred
patients (24%). Age > 43 years and FIO(2) > 0.5 were identified as
predictors for respiratory deterioration. Conclusions: Our predictors were
able to indicate deterioration after transfer correctly in 20 of 22 patients
(91%), combined with a false-positive rate in 17 of 49 (35%).
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
artificial ventilation
critical illness
lung function
patient transport
EMTREE MEDICAL INDEX TERMS
adolescent
adult
age
aged
arterial oxygen saturation
article
blood gas analysis
deterioration
female
hemodynamics
human
intensive care unit
major clinical study
male
scoring system
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1998404016
MEDLINE PMID
9876978 (http://www.ncbi.nlm.nih.gov/pubmed/9876978)
PUI
L28542930
DOI
10.1007/s001340050739
FULL TEXT LINK
http://dx.doi.org/10.1007/s001340050739
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 977
TITLE
Provision of intensive care for children. Effective transport systems are
essential.
AUTHOR NAMES
Berry A.
AUTHOR ADDRESSES
(Berry A.)
CORRESPONDENCE ADDRESS
A. Berry,
SOURCE
BMJ (Clinical research ed.) (1998) 317:7168 (1320; author reply 1321). Date
of Publication: 7 Nov 1998
ISSN
0959-8138
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
child
human
note
standard
United Kingdom
LANGUAGE OF ARTICLE
English
MEDLINE PMID
9804736 (http://www.ncbi.nlm.nih.gov/pubmed/9804736)
PUI
L128189590
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 978
TITLE
Dilemma in the ICU.
AUTHOR NAMES
Dean K.
AUTHOR ADDRESSES
(Dean K.)
CORRESPONDENCE ADDRESS
K. Dean,
SOURCE
The Florida nurse (1998) 46:7 (27-28). Date of Publication: Sep 1998
ISSN
0015-4199
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
artificial heart pacemaker
intensive care
malpractice
nursing staff
patient transport
EMTREE MEDICAL INDEX TERMS
article
case report
clinical competence
devices
fatality
human
legal aspect
legal liability
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
10614323 (http://www.ncbi.nlm.nih.gov/pubmed/10614323)
PUI
L31275127
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 979
TITLE
Haiti critical care air transport team mission
AUTHOR NAMES
Topley D.
AUTHOR ADDRESSES
(Topley D.) USAF, NC, 8210 Parkland Hills Dr., San Antonio, TX 78250, United
States.
CORRESPONDENCE ADDRESS
D. Topley, USAF, NC, 8210 Parkland Hills Dr., San Antonio, TX 78250, United
States.
SOURCE
Aviation Space and Environmental Medicine (1998) 69:7 (705-706). Date of
Publication: 1998
ISSN
0095-6562
BOOK PUBLISHER
Aerospace Medical Association, 320 S. Henry Street, Alexandria, United
States.
ABSTRACT
Critical care air transport delivers quality care to critically ill
patients. It supports the wartime and peacetime missions of the USAF. Nurses
practicing in this environment represent a unique voice of clinical care in
the aeromedical evacuation field. This role expands nursing practice beyond
the typical critical care environment that is hospital based. Critical care
nurses can meet the challenges of working within the aeromedical environment
through additional education and training. Critical care air transport
provides a specialized service that meets health care demands for these
special patients. I am proud to be a vital part of the CCATT at Wilford Hall
Medical Center and in the forefront of program development. We are medically
ready to serve in contingencies and humanitarian missions.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
dopamine
ketamine
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
aerospace medicine
aircraft
article
artificial ventilation
aviation
blood vessel catheterization
case report
gunshot injury (therapy)
Haiti
human
intravenous drug administration
male
medical personnel
nursing
patient monitoring
resuscitation
traumatology
treatment outcome
CAS REGISTRY NUMBERS
dopamine (51-61-6, 62-31-7)
ketamine (1867-66-9, 6740-88-1, 81771-21-3)
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1998234344
MEDLINE PMID
9681382 (http://www.ncbi.nlm.nih.gov/pubmed/9681382)
PUI
L28322020
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 980
TITLE
Spread of vancomycin-resistant enterococci: why did it happen in the United
States?
AUTHOR NAMES
Martone W.J.
AUTHOR ADDRESSES
(Martone W.J.) National Foundation for Infectious Diseases, Bethesda, MD
20814, USA.
CORRESPONDENCE ADDRESS
W.J. Martone, National Foundation for Infectious Diseases, Bethesda, MD
20814, USA. Email: wjmartone@aol.com
SOURCE
Infection control and hospital epidemiology : the official journal of the
Society of Hospital Epidemiologists of America (1998) 19:8 (539-545). Date
of Publication: Aug 1998
ISSN
0899-823X
ABSTRACT
The question of why vancomycin-resistant enterococci (VRE) became epidemic
in the United States can be answered on at least three basic levels: (1)
molecular and genetic, (2) factors affecting host-microbe interactions, and
(3) epidemiological. This article will address the epidemiological issues
and seek to defend the assertion that, once VRE had evolved, its spread
throughout hospitals in the United States was all but assured. Nosocomial
VRE outbreaks were reported first in the mid- and late-1980s. Since that
time, scientific reports of VRE have increased over 20-fold. Among hospitals
participating in the National Nosocomial Infection Surveillance System from
1989 to 1997, the percentage of enterococci reported as resistant to
vancomycin increased from 0.4% to 23.2% in intensive-care settings and from
0.3% to 15.4% in non-intensive-care settings. Factors leading to the spread
of VRE in US hospitals include (1) antimicrobial pressure, (2) sub-optimal
clinical laboratory recognition and reporting, (3) unrecognized "silent"
carriage and prolonged fecal carriage, (4) environmental contamination and
survival, (5) intrahospital and interhospital transfer of colonized
patients, (6) introduction of unrecognized carriers from community settings
such as nursing homes, and (7) inadequate compliance with hand washing and
barrier precautions. Guidelines developed by the Centers for Disease Control
and Prevention's Hospital Infection Control Practices Advisory Committee
address each of these factors. The impact of these guidelines on the spread
of VRE within individual institutions has been variable, and the overall
impact of the guidelines nationally is unknown.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
antiinfective agent (drug therapy)
vancomycin (drug therapy)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
antibiotic resistance
bacterial infection (drug therapy, epidemiology)
cross infection (drug therapy, epidemiology)
Enterococcus
EMTREE MEDICAL INDEX TERMS
disease carrier
disease transmission
drug effect
growth, development and aging
heterozygote
hospital
human
infection control
methodology
review
standard
statistics
United States (epidemiology)
CAS REGISTRY NUMBERS
vancomycin (1404-90-6, 1404-93-9)
LANGUAGE OF ARTICLE
English
MEDLINE PMID
9758052 (http://www.ncbi.nlm.nih.gov/pubmed/9758052)
PUI
L129363515
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 981
TITLE
An international Critical Care Air Transport flight: intervening in the
Korean airline crash.
AUTHOR NAMES
Topley D.
AUTHOR ADDRESSES
(Topley D.)
CORRESPONDENCE ADDRESS
D. Topley,
SOURCE
Aviation, space, and environmental medicine (1998) 69:8 (806-807). Date of
Publication: Aug 1998
ISSN
0095-6562
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
aerospace medicine
aircraft accident
military nursing
EMTREE MEDICAL INDEX TERMS
article
disaster
emergency
Guam
human
intensive care
international cooperation
Korea
patient care
preventive health service
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
9715973 (http://www.ncbi.nlm.nih.gov/pubmed/9715973)
PUI
L128300153
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 982
TITLE
Patients' outcomes: intrahospital transportation and monitoring of
critically ill patients by a specially trained ICU nursing staff.
AUTHOR NAMES
Stearley H.E.
AUTHOR ADDRESSES
(Stearley H.E.) University of Missouri Hospitals and Clinics, Columbia, USA.
CORRESPONDENCE ADDRESS
H.E. Stearley, University of Missouri Hospitals and Clinics, Columbia, USA.
SOURCE
American journal of critical care : an official publication, American
Association of Critical-Care Nurses (1998) 7:4 (282-287). Date of
Publication: Jul 1998
ISSN
1062-3264
ABSTRACT
BACKGROUND: Intrahospital transportation of critically ill patients can
contribute to patients' morbidity and mortality. OBJECTIVE: To determine
adverse outcomes associated with intrahospital transportation of critically
ill patients by a specially trained nursing transport team. METHODS:
Monitoring and intervention data were collected for 237 instances of
transportation of patients between a hospital's ICUs and radiology suites.
These results were compared with the results of national studies on
complication rates associated with intrahospital transportation of patients.
RESULTS: The patients moved by the specially trained transport team has a
15.5% overall complication rate, with 10.2% minor, 2.5% moderate
(compensated for with medications), and 2.8% severe complications that did
not respond to intervention. No medications of therapies were delayed, and
only 2 patients (0.8%) had decompensation that required the examinations to
be aborted. Reported national complication rates for intrahospital
transportation of patients are as high as 75%; the complications include
adverse events such as delayed administration of medications, significant
changes in vital signs, dislodgment of artificial airways and i.v.
catheters, and cardiopulmonary arrest. CONCLUSION: Use of a specially
trained ICU transport team can substantially reduce the rate of adverse
outcomes generated by the transportation of critically ill patients for
specialized radiological procedures.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
nursing staff
outcome assessment
patient transport
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
article
child
critical illness
female
human
infant
intensive care unit
male
middle aged
nursing
preschool child
LANGUAGE OF ARTICLE
English
MEDLINE PMID
9656042 (http://www.ncbi.nlm.nih.gov/pubmed/9656042)
PUI
L128286197
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 983
TITLE
Ventilator-associated pneumonia after transport from intensive care units -
A real risk
AUTHOR NAMES
Kollef M.H.
AUTHOR ADDRESSES
(Kollef M.H.) Department of Medicine, Pulmonary and Critical Care Division,
Washington Univ. School of Medicine, Barnes-Jewish Hospital, Saint Louis,
MO, United States.
CORRESPONDENCE ADDRESS
M.H. Kollef, Department of Medicine, Pulmonary and Critical Care Division,
Washington Univ. School of Medicine, Barnes-Jewish Hospital, Saint Louis,
MO, United States.
SOURCE
Cardiology Review (1998) 15:3 (41-43). Date of Publication: 1998
ISSN
1092-6607
ABSTRACT
To assess whether transporting patients out of the intensive care unit
setting is a risk factor for the development of ventilator-associated
pneumonia, we conducted a prospective cohort study of 521 patients admitted
to an intensive care unit who required mechanical ventilation for longer
than 12 hours. Among the 273 mechanically ventilated patients transported
out of the unit, ventilator-associated pneumonia developed in 24.2% compared
with 4.4% of the 248 patients not transported. Multivariate analysis
demonstrated that previous transport out of the intensive care unit was
independently associated with the development of ventilator-associated
pneumonia.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
patient transport
pneumonia (complication, epidemiology)
ventilator
EMTREE MEDICAL INDEX TERMS
article
artificial ventilation
aspiration pneumonia (complication, epidemiology)
cohort analysis
controlled study
disease association
female
hospital infection (complication, epidemiology)
human
major clinical study
male
multivariate analysis
risk factor
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Anesthesiology (24)
Internal Medicine (6)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1998172626
PUI
L28236941
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 984
TITLE
Intrahospital transport of the critically ill adult: a research review and
implications.
AUTHOR NAMES
Caruana M.
Culp K.
AUTHOR ADDRESSES
(Caruana M.; Culp K.) University of Iowa Hospitals and Clinics, Iowa City,
USA.
CORRESPONDENCE ADDRESS
M. Caruana, University of Iowa Hospitals and Clinics, Iowa City, USA.
SOURCE
Dimensions of critical care nursing : DCCN (1998) 17:3 (146-156). Date of
Publication: 1998 May-Jun
ISSN
0730-4625
ABSTRACT
Transporting the critically ill adult from the relative stability of the
critical care environment to a testing site or new area is a nursing
responsibility. Yet current research about the risks and benefits of
intrahospital transport is at times conflicting. This article provides an
analysis of available research on the critical elements involved in
intrahospital transport and suggests recommendations for clinical practice.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient care
patient transport
EMTREE MEDICAL INDEX TERMS
algorithm
human
methodology
organization and management
public relations
review
LANGUAGE OF ARTICLE
English
MEDLINE PMID
9633345 (http://www.ncbi.nlm.nih.gov/pubmed/9633345)
PUI
L129362547
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 985
TITLE
The Ontario Health Care Evaluation Network and the Critical Care Research
Network as vehicles for research transfer
AUTHOR NAMES
Sibbald W.J.
Kossuth J.D.
AUTHOR ADDRESSES
(Sibbald W.J.; Kossuth J.D.)
CORRESPONDENCE ADDRESS
W.J. Sibbald, London Health Sciences Centre, University of Western Ontario,
London, Ont., Canada.
SOURCE
Medical Decision Making (1998) 18:1 (9-16). Date of Publication: 1998
ISSN
0272-989X
BOOK PUBLISHER
SAGE Publications Inc., 2455 Teller Road, Thousand Oaks, United States.
ABSTRACT
Facilitating the successful and consistent use of research results to
support health care decisions is a formidable task. Barriers to effectively
transferring the results of research into the decision-making process have
been created between practitioners and researchers, who traditionally have
worked in isolation from each other. The need for them to work cooperatively
to break down these barriers is paramount as changes within the health care
environment increase. The Ontario Health Care Evaluation Network (OHCEN) and
the Critical Care Research Network (CCR-Net) have attempted to address these
concerns by bringing together teams of researchers, practitioners, and
administrative personnel with the purpose of equipping them with tools to
meet oncoming health care challenges.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
decision making
health care
research
EMTREE MEDICAL INDEX TERMS
conference paper
diffusion
education
evidence based medicine
information science
Internet
meta analysis
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1998028259
MEDLINE PMID
9456201 (http://www.ncbi.nlm.nih.gov/pubmed/9456201)
PUI
L28041633
DOI
10.1177/0272989X9801800103
FULL TEXT LINK
http://dx.doi.org/10.1177/0272989X9801800103
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 986
TITLE
Streamlined critical care transport on the shore.
AUTHOR NAMES
Parks K.
AUTHOR ADDRESSES
(Parks K.) Critical Care Services, Shore Health System, Easton, MD, USA.
CORRESPONDENCE ADDRESS
K. Parks, Critical Care Services, Shore Health System, Easton, MD, USA.
SOURCE
Nursing spectrum (D.C./Baltimore metro ed.) (1998) 8:1 (8). Date of
Publication: 12 Jan 1998
ISSN
1098-9153
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
human
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
9469098 (http://www.ncbi.nlm.nih.gov/pubmed/9469098)
PUI
L128226114
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 987
TITLE
Critical care transport team can reduce risks, boost bottom line.
AUTHOR ADDRESSES
SOURCE
ED management : the monthly update on emergency department management (1998)
10:1 (8-11). Date of Publication: Jan 1998
ISSN
1044-9167
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
patient transport
EMTREE MEDICAL INDEX TERMS
article
economics
financial management
intensive care
legal aspect
legal liability
organization and management
patient care
rescue personnel
risk management
standard
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
10176035 (http://www.ncbi.nlm.nih.gov/pubmed/10176035)
PUI
L128227120
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 988
TITLE
French mobile intensive care units and inhaled nitric oxide treated patients
ORIGINAL (NON-ENGLISH) TITLE
Utilisation du monoxyde d'azote chez l'adulte dans les unites mobiles
hospitalieres lors des transports secondaires medicalises en france
AUTHOR NAMES
Leclerc J.
Vallet B.
Goldstein P.
AUTHOR ADDRESSES
(Leclerc J.; Vallet B.) Dept. d'Anesthesie Reanimation C., CHKU, Hopital
Claude Huriez, Place de Verdun, 59037 Lille Cedex.
(Leclerc J.; Goldstein P.) SAMU Régional Centre 15, CHRU, 5 avenue Oscar
Lambret, 59037 Lille Cedex.
CORRESPONDENCE ADDRESS
J. Leclerc, DARC, 2, HCHPV, 59037 Lille Cedex, France.
SOURCE
JEUR (1997) 10:3 (130-134). Date of Publication: 1997
ISSN
0993-9857
ABSTRACT
Mobile intensive care units (MICU) could be more and more often required to
take care of patients treated with inhaled nitric oxide (NO) during their
secondary mission (ambulance transport from an hospital to an other one).
During those inter- or extra-hospital transfers from an intensive care unit,
it's mandatory to proceed with the dispensing of inhaled NO in order to
avoid a sudden weaning. Theoretical and practical knowledge concerning the
medical use of NO is essential for the medical team of the mobile intensive
care units.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
nitric oxide (drug therapy)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
adult respiratory distress syndrome (drug therapy)
drug indication
human
hypoxemia (drug therapy)
inhalational drug administration
priority journal
pulmonary hypertension (drug therapy)
review
CAS REGISTRY NUMBERS
nitric oxide (10102-43-9)
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Anesthesiology (24)
Drug Literature Index (37)
Internal Medicine (6)
LANGUAGE OF ARTICLE
French
LANGUAGE OF SUMMARY
English, French
EMBASE ACCESSION NUMBER
1997341707
PUI
L27473905
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 989
TITLE
The Munich intensive care transport system. Patient transport and intensive
care conditions
ORIGINAL (NON-ENGLISH) TITLE
Das Münchner Intensiv-Transport-System. Patiententransport und
Intensivbedingungen.
AUTHOR NAMES
Huf R.
Weninger E.
Schildberg F.W.
Peter K.
AUTHOR ADDRESSES
(Huf R.; Weninger E.; Schildberg F.W.; Peter K.) Chirurgische Klinik und
Poliklinik, Universität München, Klinikum Grosshadern.
CORRESPONDENCE ADDRESS
R. Huf, Chirurgische Klinik und Poliklinik, Universität München, Klinikum
Grosshadern.
SOURCE
Langenbecks Archiv für Chirurgie. Supplement. Kongressband. Deutsche
Gesellschaft für Chirurgie. Kongress (1997) 114 (1398-1400). Date of
Publication: 1997
ISSN
0942-2854
ABSTRACT
In November 1990 a new program for transporting critically ill patients by a
24-h specialized intensive care transportation system at the Munich Hospital
Grosshadern was established. All medical equipment similar to that in the
ICU allows invasive and non-invasive monitoring, drug administration, and a
sophisticated respiratory therapy, provided by a Siemens Servo 300
ventilator. Even extracorporal lung augmentation (ECLA) and cardiac pump
assistance by special mobile devices are possible during the transport.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
patient transport
preventive health service
EMTREE MEDICAL INDEX TERMS
aircraft
article
cost
economics
equipment design
Germany
heart assist device
hospital service
human
monitoring
ventilator
LANGUAGE OF ARTICLE
German
MEDLINE PMID
9574441 (http://www.ncbi.nlm.nih.gov/pubmed/9574441)
PUI
L128250672
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 990
TITLE
Audit of neonatal intensive care transport - Closing the loop
AUTHOR NAMES
Leslie A.J.
Stephenson T.J.
AUTHOR ADDRESSES
(Leslie A.J.) Departments of Neonatal Medicine, City Hospital, Queen's
Medical Centre, Nottingham.
(Stephenson T.J.) Department of Child Health, University Hospital,
Nottingham, United Kingdom.
(Leslie A.J.) Neonatal Emergency Transport Service, Department of Neonatal
Medicine, City Hospital, Hucknall Road, Nottingham NG5 1PB, United Kingdom.
CORRESPONDENCE ADDRESS
A.J. Leslie, Neonatal Emergency Transport Service, Dept. of Neonatal Med.
and Surgery, City Hospital, Hucknall Road, Nottingham NG5 1PB, United
Kingdom.
SOURCE
Acta Paediatrica, International Journal of Paediatrics (1997) 86:11
(1253-1256). Date of Publication: 1997
ISSN
0803-5253
BOOK PUBLISHER
Blackwell Publishing Ltd, 9600 Garsington Road, Oxford, United Kingdom.
ABSTRACT
To audit the effectiveness of changes in transport arrangements, data on
babies ventilated during transfer into a neonatal unit were compared between
two periods. During the first period, August 1991-February 1993, an ad hoc
transport team operated. Transport practice was changed in 1993 by forming a
nine-person nursing transport team, improving training and upgrading
monitoring. The second audit period was January 1994-July 1995. The groups
were not significantly different for birthweight, gestation or levels of
ventilation. Physiological variables were assessed with a 'transport score'.
Improved scores for temperature and pH were achieved on completion of
transfer in 1994-95 compared to 1991-93. Stabilizing prior to transfer took
longer in the 1994-95 period. No serious deteriorations occurred in transit
in the 1994-95 period, three in 1991-93. Audit facilitates identification of
problems in transport. Staff, education and equipment changes were
associated with improved audited outcomes.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
artificial ventilation
blood pH
medical personnel
patient monitoring
priority journal
scoring system
temperature
training
EMBASE CLASSIFICATIONS
Clinical and Experimental Biochemistry (29)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1997369030
MEDLINE PMID
9401523 (http://www.ncbi.nlm.nih.gov/pubmed/9401523)
PUI
L27509442
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 991
TITLE
Reports by the German Interdisciplinary Group of Intensive Care and
Emergency Medicine. New recommendations for medical qualifications in
transport of intensive care patients
ORIGINAL (NON-ENGLISH) TITLE
Mitteilungen aus der DIVI (Deutsche Interdisziplinäre Vereinigung für
Intensive- und Notfallmedizin). Neue Empfehlungen zur ärztlichen
Qualifikation bei Intensivtransporten.
AUTHOR ADDRESSES
SOURCE
Zentralblatt für Neurochirurgie (1997) 58:2 (95). Date of Publication: 1997
ISSN
0044-4251
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency medicine
intensive care
patient care
patient transport
EMTREE MEDICAL INDEX TERMS
article
curriculum
education
Germany
human
medical education
LANGUAGE OF ARTICLE
German
MEDLINE PMID
9334129 (http://www.ncbi.nlm.nih.gov/pubmed/9334129)
PUI
L127292516
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 992
TITLE
Patient transport from intensive care increases the risk of developing
ventilator-associated pneumonia
AUTHOR NAMES
Kollef M.H.
Von Harz B.
Prentice D.
Shapiro S.D.
Silver P.
John R.S.
Trovillion E.
AUTHOR ADDRESSES
(Kollef M.H.; Von Harz B.; Prentice D.; Shapiro S.D.; Silver P.; John R.S.;
Trovillion E.) Pulmonary and Critical Care Division, Washington Univ. School
of Medicine, Box 8052, 660 S Euclid Ave., St. Louis, MO 63110, United
States.
CORRESPONDENCE ADDRESS
M.H. Kollef, Pulmonary and Critical Care Division, Washington Univ. School
of Medicine, Box 8052, 660 S Euclid Ave., St. Louis, MO 63110, United
States.
SOURCE
Chest (1997) 112:3 (765-773). Date of Publication: 1997
ISSN
0012-3692
BOOK PUBLISHER
American College of Chest Physicians, 3300 Dundee Road, Northbrook, United
States.
ABSTRACT
Study objective: To determine whether patient transport out of the ICU is
associated with an increased risk of developing ventilator-associated
pneumonia. Design: Prospective cohort study. Setting: ICUs of Barnes-Jewish
Hospital, a university-affiliated teaching hospital. Patients: Five hundred
twenty-one ICU patients requiring mechanical ventilation for >12 h.
Intervention: Prospective patient surveillance and data collection.
Measurements and results: The primary outcome measure was the development of
ventilator-associated pneumonia. A total of 273 (52.4%) mechanically
ventilated patients required at least one transport out of the ICU while 248
(47.6%) patients did not undergo transport. Sixty-six (24.2%) of the
transported patients developed ventilator-associated pneumonia compared with
11 (4.4%) patients in the group not undergoing transport (relative risk=5.5;
95% confidence interval [CI]=2.9 to 10.1; p<0.001). Multiple logistic
regression analysis demonstrated that a preceding episode of transport out
of the ICU was independently associated with the development of ventilator-
associated pneumonia (adjusted odds ratio=3.8; 95% CI=2.6 to 5.5; p<0.001).
Other variables independently associated with the development of ventilator-
associated pneumonia included reintubation, presence of a tracheostomy,
administration of aerosols, and male gender. Conclusions: We conclude that
patient transport out of the ICU is associated with an increased risk for
the development of ventilator-associated pneumonia.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
artificial ventilation
hospital infection (complication, etiology)
pneumonia (complication, etiology)
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
article
controlled study
female
human
infection risk
intensive care unit
major clinical study
male
patient transport
priority journal
risk assessment
risk factor
EMBASE CLASSIFICATIONS
Internal Medicine (6)
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1997295034
MEDLINE PMID
9315813 (http://www.ncbi.nlm.nih.gov/pubmed/9315813)
PUI
L27410716
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 993
TITLE
Intrahospital transport of patients with increased intracranial pressure
ORIGINAL (NON-ENGLISH) TITLE
Innerklinische Transporte von Patienten mit erhohtem intrakraniellem Druck
AUTHOR NAMES
Engelhardt W.
AUTHOR ADDRESSES
(Engelhardt W.) Klinik für Anaesthesiologie, Universität Würzburg,
Josef-Schneider-Straße 2, D-97080 Würzburg, Germany.
CORRESPONDENCE ADDRESS
W. Engelhardt, Klinik fur Anaesthesiologie, Universitat Wurzburg,
Josef-Schneider-Strasse 2, D-97080 Wurzburg, Germany.
SOURCE
Anasthesiologie und Intensivmedizin (1997) 38:7-8 (385). Date of
Publication: 1997
ISSN
0171-1814
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
brain injury (diagnosis)
intracranial hypertension (diagnosis)
intracranial pressure
patient transport
EMTREE MEDICAL INDEX TERMS
conference paper
human
intensive care
EMBASE CLASSIFICATIONS
Cardiovascular Diseases and Cardiovascular Surgery (18)
Anesthesiology (24)
Neurology and Neurosurgery (8)
LANGUAGE OF ARTICLE
German
EMBASE ACCESSION NUMBER
1997250483
PUI
L27347962
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 994
TITLE
Clinical assessment and measurement of oxygen transport in the critical care
setting
AUTHOR NAMES
Breen D.
Bihari D.
AUTHOR ADDRESSES
(Breen D.; Bihari D., d.bihari@unsw.edu.au) Department of Intensive Care,
St. George Hospital, Gray Street, Sydney, NSW 2217, Australia.
CORRESPONDENCE ADDRESS
D. Bihari, Department of Intensive Care, St George Hospital, Gray Street,
Sydney, NSW 2217, Australia. Email: d.bihari@unsw.edu.au
SOURCE
Transfusion Science (1997) 18:3 (437-445). Date of Publication: September
1997
ISSN
0955-3886
BOOK PUBLISHER
Elsevier Ltd, Langford Lane, Kidlington, Oxford, United Kingdom.
ABSTRACT
Adequate delivery of oxygen to the tissues is an important factor both in
the initial resuscitation of the shocked patient and subsequently in the
development of multiple organ failure. The advent of the pulmonary artery
catheter has facilitated the calculation of global measurements of oxygen
transport at the bedside. Calculated oxygen delivery in fact represents
arterial oxygen dispatch rather than actual oxygen delivery to the respiring
tissues. Considerable controversy still surrounds the issue of resuscitation
of critically ill patients to predetermined goals for oxygen delivery and
consumption. More recently interest has arisen in other measures of oxygen
transport, in particular regional techniques such as the gastric tonometer.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
oxygen transport
EMTREE MEDICAL INDEX TERMS
catheter
human
intensive care
measurement
multiple organ failure
nonhuman
oxygen consumption
pulmonary artery
resuscitation
review
shock
tissue oxygenation
tonometry
EMBASE CLASSIFICATIONS
Physiology (2)
Anesthesiology (24)
Hematology (25)
Clinical and Experimental Biochemistry (29)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1997356152
MEDLINE PMID
10175157 (http://www.ncbi.nlm.nih.gov/pubmed/10175157)
PUI
L27492854
DOI
10.1016/S0955-3886(97)00042-8
FULL TEXT LINK
http://dx.doi.org/10.1016/S0955-3886(97)00042-8
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 995
TITLE
Monitoring the critically ill during transport
AUTHOR NAMES
Parke T.J.
Rimmer M.E.
AUTHOR ADDRESSES
(Parke T.J.; Rimmer M.E.) Dept. Anaesthetics Intensive Care, Royal Berkshire
Hospital, Reading, United Kingdom.
CORRESPONDENCE ADDRESS
T.J. Parke, Dept. Anaesthetics Intensive Care, Royal Berkshire Hospital,
Reading, United Kingdom.
SOURCE
Care of the Critically Ill (1997) 13:4 (150-152,154). Date of Publication:
1997
ISSN
0266-0970
ABSTRACT
Critically ill patients frequently need to be transported. Dedicated teams
can transfer seriously ill patients between hospitals without deterioration
in their condition. However, patients on the intensive care unit also
require transport to the radiology department, or to the operating theatre,
without the benefit of such specialised teams. This article will discuss the
danger of transporting critically ill patients. The need for patient
monitoring will then be considered. Finally, the different types of monitors
available will be examined.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
patient monitoring
patient transport
EMTREE MEDICAL INDEX TERMS
ambulatory monitoring
intensive care unit
short survey
EMBASE CLASSIFICATIONS
Biophysics, Bioengineering and Medical Instrumentation (27)
Internal Medicine (6)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1997241409
PUI
L27336939
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 996
TITLE
Emergency medical care for spectators attending National Football League
games.
AUTHOR NAMES
Roberts D.M.
Blackwell T.H.
Marx J.A.
AUTHOR ADDRESSES
(Roberts D.M.; Blackwell T.H.; Marx J.A.) Department of Emergency Medicine,
Carolinas Medical Center, Charlotte, NC 28232, USA.
CORRESPONDENCE ADDRESS
D.M. Roberts, Department of Emergency Medicine, Carolinas Medical Center,
Charlotte, NC 28232, USA.
SOURCE
Prehospital emergency care : official journal of the National Association of
EMS Physicians and the National Association of State EMS Directors (1997)
1:3 (149-155). Date of Publication: 1997 Jul-Sep
ISSN
1090-3127
ABSTRACT
OBJECTIVE: To analyze medical care facilities and resources available for
spectators attending football games in the current National Football League
(NFL) stadiums. METHODS: A prospective, structured questionnaire regarding
facilities, transportation, medications and equipment, personnel
configuration, compensation, and communications was mailed to all 28 NFL
organizations. Those falling to respond were interviewed by telephone using
the identical questionnaire. Data were compiled using Lotus 1-2-3. RESULTS:
Data were collected from all 28 NFL organizations. Because two teams use the
same stadium, results were calculated for 27 facilities (n = 27). The number
of stadium first aid rooms ranges from 1 to 7, with an average of 2.4 +/-
1.3 rooms per stadium (+/- 1 SD) and these vary in size from 120 to 2,000
square feet, with a mean of 434 +/- 377 square feet. Each room is equipped
with an average of 3.3 +/- 2.9 stretchers (or tables), with telephones being
present in 91% and sinks in 88% of all rooms. To provide contractual EMS
coverage, stadiums use standard EMS system designs, including private (n =
19), fire department-based (n = 7), municipal (city/county) (n = 5),
volunteer (n = 4), and hospital (n = 3). Nine stadiums employ more than one
type of provider. All stadiums have a minimum of one ambulance dedicated
on-site for spectators, with a range of 1 to 7, and a mean of 2.9 +/- 1.4.
Golf carts are used for intrafacility patient transportation in 17 stadiums,
with a range of 1 to 6, and a mean of 2.5 +/- 1.3. Advanced Cardiac Life
Support (ACLS) medications and equipment are present in all NFL stadiums and
are provided by the private EMS company (n = 16), stadium (n = 10), fire EMS
(n = 7), hospitals (n = 4), municipal EMS (n = 2), and the local NFL
organization (n = 1). Several facilities have more than one provider of ACLS
medications and equipment. The majority of stadiums dispense acetaminophen
(n = 25) and aspirin (n = 24). Some dispense antacids (n = 7) and
antihistamines (n = 6). The average stadium staffs 8 EMT-Bs, 7 EMT-Ps, 3
registered nurses, and 2 physicians. Nine stadiums pay a predesignated fee
per game to an agency to provide emergency care to spectators. Medical
personnel are compensated by an hourly rate (n = 15), a fixed rate per event
(n = 9), overtime wages (n = 3), or volunteerism (n = 4). Four NFL
organizations pay their medical personnel by more than one type of
compensation. Courtesy seats are provided to physicians and nurses in 1
stadium and to just physicians in 8 stadiums, with a range of 2 to 6 and a
mean of 3.3 +/- 1.3. All stadiums use two-way radios for the communication
and coordination of medical care in the stadium. Additionally, 20 use fixed
telephones in the first aid rooms, 3 use cellular telephones, and 2
incorporate a pager system to dispatch personnel within the stadium.
CONCLUSION: A wide variety of system designs, facilities, and personnel
configurations are used to provide emergency medical care for spectators
attending NFL games. This information may be useful for assisting those
individuals responsible for organizing stadium medical coverage.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
construction work and architectural phenomena
emergency health service
first aid
football
EMTREE MEDICAL INDEX TERMS
article
history
human
organization and management
prospective study
questionnaire
standard
statistics
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
9709358 (http://www.ncbi.nlm.nih.gov/pubmed/9709358)
PUI
L128298924
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 997
TITLE
Inhibition of ion transport in septic rat heart: (133)Cs(+) as an NMR active
K(+) analog
AUTHOR NAMES
Schornack P.A.
Song S.-K.
Hotchkiss R.
Ackerman J.J.H.
AUTHOR ADDRESSES
(Schornack P.A.; Song S.-K.; Ackerman J.J.H.) Department of Chemistry,
Washington University, St. Louis 63130.
(Song S.-K.; Hotchkiss R.) Department of Anesthesiology, Washington
University, School of Medicine, St. Louis, MO 63110, United States.
(Song S.-K.; Ackerman J.J.H.) Department of Medicine, Washington University,
School of Medicine, St. Louis, MO 63110, United States.
(Ackerman J.J.H.) Departments of Radiology, Washington University, School of
Medicine, St. Louis, MO 63110, United States.
CORRESPONDENCE ADDRESS
J.J.H. Ackerman, Dept. of Chemistry, Campus Box 1134, Washington University,
One Brookings Dr., St. Louis, MO 63130-4899, United States.
SOURCE
American Journal of Physiology - Cell Physiology (1997) 272:5 41-5
(C1635-C1641). Date of Publication: 1997
ISSN
0363-6143
BOOK PUBLISHER
American Physiological Society, 9650 Rockville Pike, Bethesda, United
States.
ABSTRACT
Sepsis, the systemic response to severe infection, and the resulting
multiorgan failure it induces are major contributors to intensive care unit
morbidity and mortality. A number of abnormalities in ion transport
processes and intracellular free Na(+) ([Na(+)](i)) and K(+) ([K(+)](i))
concentrations have been reported to occur during sepsis/endotoxemia. An
effect of sepsis on the Na(+)K(+)-ATPase may be an important contribution to
changes in intracellular ion balance and the resultant pathophysiology of
the disorder. The purpose of this study was to examine the effect of sepsis
on the Na(+)- K(+)-ATPase in the isolated perfused rat heart using
(133)Cs(+) nuclear magnetic resonance (NMR). Cs(+) is a K(+) analog, and
(133)Cs-NMR offers the opportunity to examine Na(+)-K(+)-ATPase activity in
the intact organ via tracer kinetics. Sepsis was induced in
halothane-anesthetized male Sprague- Dawley rats using the cecal ligation
and perforation (CLP) model. Twenty- four to thirty-six hours after surgery,
hearts from CLP or shamoperated rats were perfused with Krebs-Henseleit
buffer containing 1.25 mM Cs(+). The influx rate constant for Cs(+) was
decreased by 24% in septic rat hearts, i.e., 0.25 ± 0.08 (SD) mini(-1) for
controls and 0.19 ± 0.04 (SD) min(-1) for septic animals (P = 0.003). There
was no difference for Cs(+) efflux [0.005 ± 0.001 (SD) min(-1) for controls
and 0.005 ± 0.002 (SD) min(-1) for septic animals; P = 0.8]. These results
are consistent with an inhibition of the Na(+)-K(+)- ATPase pump during
sepsis/endotoxemia. A decrease in the activity of the Na(+)-K(+)-ATPase pump
may be responsible for or contribute to the changes in [Na(+)](i) and
[K(+)](i) during the disorder.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
cesium
potassium ion
EMTREE DRUG INDEX TERMS
adenosine triphosphatase (potassium sodium)
sodium ion
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
ion transport
sepsis
EMTREE MEDICAL INDEX TERMS
animal experiment
animal model
article
cell membrane transport
controlled study
enzyme activity
heart muscle perfusion
intensive care unit
male
multiple organ failure
nonhuman
nuclear magnetic resonance
priority journal
rat
CAS REGISTRY NUMBERS
cesium (7440-46-2)
potassium ion (24203-36-9)
sodium ion (17341-25-2)
EMBASE CLASSIFICATIONS
General Pathology and Pathological Anatomy (5)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1997177944
MEDLINE PMID
9176155 (http://www.ncbi.nlm.nih.gov/pubmed/9176155)
PUI
L27250401
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 998
TITLE
Interhospital and intrahospital transfer of the critically ill patient.
AUTHOR NAMES
Tan T.K.
AUTHOR ADDRESSES
(Tan T.K.) Department of Anaesthesia Glasgow Royal Infirmary, United
Kingdom.
CORRESPONDENCE ADDRESS
T.K. Tan, Department of Anaesthesia Glasgow Royal Infirmary, United Kingdom.
SOURCE
Singapore medical journal (1997) 38:6 (244-248). Date of Publication: Jun
1997
ISSN
0037-5675
ABSTRACT
AIM: This paper highlights hazards involved in moving critically ill
patients between locations, discusses minimalisation of risks involved and
the advantages of specialist teams. METHOD: This is a systematic review.
RESULTS AND CONCLUSIONS: Critically ill patients are moved within the
hospital because of the need for surgical procedures or to have fixed
facilities investigations performed. Interhospital movement of patients is
necessary for specialised care available elsewhere. This has increased with
centralisation of specialist services. This paper adopts a practical
approach to the transfer process. It establishes the goals of conducting a
safe transfer, highlights the deleterious effects of moving an ill patient,
the risks and pitfalls of a transfer, and how to minimise them. Attention is
drawn to the need for proper resuscitation and stabilisation of a patient
before transport. The quality and outcome of the transfer depend on the
experience of the transferring team and on adequate monitoring facilities.
The benefits of a specialist transfer team is suggested.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
patient care
patient transport
EMTREE MEDICAL INDEX TERMS
human
monitoring
practice guideline
resuscitation
review
risk factor
standard
LANGUAGE OF ARTICLE
English
MEDLINE PMID
9294336 (http://www.ncbi.nlm.nih.gov/pubmed/9294336)
PUI
L127300410
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 999
TITLE
Transfer of adults between intensive care units in the United Kingdom:
Postal survey
AUTHOR NAMES
Mackenzie P.A.
Smith E.A.
Wallace P.G.M.
AUTHOR ADDRESSES
(Mackenzie P.A.; Wallace P.G.M.) Directorate of Anaesthesia, Western
Infirmary, Glasgow G11 6NT, United Kingdom.
(Smith E.A.) Glasgow Roy. Infirm. Univ. NHS Trust, Glasgow G4 0SF, United
Kingdom.
CORRESPONDENCE ADDRESS
P.A. Mackenzie, Directorate of Anaesthesia, Western Infirmary, Glasgow G11
6NT, United Kingdom.
SOURCE
British Medical Journal (1997) 314:7092 (1455-1456). Date of Publication:
1997
ISSN
0959-8146
BOOK PUBLISHER
BMJ Publishing Group, Tavistock Square, London, United Kingdom.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
article
human
patient satisfaction
priority journal
United Kingdom
EMBASE CLASSIFICATIONS
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1997147391
MEDLINE PMID
9167562 (http://www.ncbi.nlm.nih.gov/pubmed/9167562)
PUI
L27207936
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1000
TITLE
Bed shortages. Regional intensive care unit transfer teams are needed.
AUTHOR NAMES
Wallace P.G.
Lawler P.G.
AUTHOR ADDRESSES
(Wallace P.G.; Lawler P.G.)
CORRESPONDENCE ADDRESS
P.G. Wallace,
SOURCE
BMJ (Clinical research ed.) (1997) 314:7077 (369). Date of Publication: 1
Feb 1997
ISSN
0959-8138
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital bed utilization
intensive care
EMTREE MEDICAL INDEX TERMS
human
letter
patient transport
LANGUAGE OF ARTICLE
English
MEDLINE PMID
9040339 (http://www.ncbi.nlm.nih.gov/pubmed/9040339)
PUI
L127229734
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1001
TITLE
Critically ill children: the case for short-term care in general intensive
care units.
AUTHOR NAMES
Bennett J.
AUTHOR ADDRESSES
(Bennett J.) Clinical Nurse Specialist IUC, Kettering General NHS Trust,
Northamptonshire, UK.
CORRESPONDENCE ADDRESS
J. Bennett, Clinical Nurse Specialist IUC, Kettering General NHS Trust,
Northamptonshire, UK.
SOURCE
Intensive & critical care nursing : the official journal of the British
Association of Critical Care Nurses (1997) 13:1 (53-57). Date of
Publication: Feb 1997
ISSN
0964-3397
ABSTRACT
This paper contests the claim that all children should be nursed in
paediatric intensive care units (PICUs). Although there is an undoubted need
for prolonged care to be undertaken within PICUs, they are a scarce resource
and many children's critical illness is of short duration. Following a
discussion on the negative aspects of transferring a critically ill child
this paper then establishes how a general intensive care unit (GICU) can
maintain-awareness and standards which make it a safe environment for
children with a short-term critical illness, as well as contribute towards
future management and practice.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child hospitalization
intensive care
length of stay
patient transport
pediatric nursing
EMTREE MEDICAL INDEX TERMS
child
education
health care organization
human
organization and management
psychological aspect
review
LANGUAGE OF ARTICLE
English
MEDLINE PMID
9095883 (http://www.ncbi.nlm.nih.gov/pubmed/9095883)
PUI
L127248521
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1002
TITLE
Collaboration between a referring hospital and a tertiary care center in
improving the transfer process for cardiac patients.
AUTHOR NAMES
Sivaram C.A.
Jarolim D.
Nasser A.
AUTHOR ADDRESSES
(Sivaram C.A.; Jarolim D.; Nasser A.) Section of Cardiology, Department of
Veterans Affairs Medical Center, Oklahoma City 73104-5018, USA.
CORRESPONDENCE ADDRESS
C.A. Sivaram, Section of Cardiology, Department of Veterans Affairs Medical
Center, Oklahoma City 73104-5018, USA.
SOURCE
The Joint Commission journal on quality improvement (1996) 22:12 (795-800).
Date of Publication: Dec 1996
ISSN
1070-3241
ABSTRACT
BACKGROUND: Transfer of cardiac patients between hospitals is a complex
process with many implications for quality of care. In the case of heart
disease, specialized procedures such as coronary angioplasty, coronary
bypass surgery, and valve replacement or repair require the performance of
cardiac catheterization and coronary arteriography in a catheterization
laboratory, as well as the availability of cardiac surgical services. The
Department of Veterans Affairs Medical Center (DVAMC) at Muskogee, Oklahoma,
transfers most cardiac patients requiring specialized diagnostic procedures
and advanced cardiac care to DVAMC at Oklahoma City, Oklahoma. Concerns
about the inefficiency of the transfer process led to the launch of a
quality improvement project in late 1992. CHANGES IN THE TRANSFER PROCESS:
Greater emphasis was placed on medical aspects compared to administrative
aspects of transfer, and ready access to the physicians at DVAMC at Oklahoma
City was provided. RESULTS: The time from request for transfer to the actual
transfer decreased. Before the quality improvement project, only 33% of
transfers of cardiac patients were completed within 24 hours-versus 78% in
1993 and 1994, 89% in 1995, and 84% in the first half of 1996. In addition,
DVAMC-Muskogee physician satisfaction regarding services at DVAMC-Oklahoma
City improved. CONCLUSION: Ongoing discussion between the cardiology team at
the accepting hospital and physicians at the referring hospital expanded the
continuum of care to both hospitals. Priority of transfers could be upgraded
at any time without unduly jeopardizing patient safety or increasing
resource utilization at the receiving center.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
coronary care unit
health care quality
heart disease (therapy)
patient transport
public relations
EMTREE MEDICAL INDEX TERMS
article
human
organization
organization and management
public hospital
standard
time management
United States
university hospital
LANGUAGE OF ARTICLE
English
MEDLINE PMID
8986561 (http://www.ncbi.nlm.nih.gov/pubmed/8986561)
PUI
L127203264
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1003
TITLE
Analysis of 200 critically ill children transported to and from a Pediatric
Intensive Care Unit
ORIGINAL (NON-ENGLISH) TITLE
Valoracion de 200 traslados de ninos criticos en una Unidad de Cuidados
Intensivos Pediatricos
AUTHOR NAMES
Rubio Quiñones F.
Hernández González A.
Quintero Otero S.
Pérez Ruiz J.
Ruiz Ruiz C.
Seidel A.
Fernández O'Dogherty S.
Pantoja Rosso S.
AUTHOR ADDRESSES
(Rubio Quiñones F.; Hernández González A.; Quintero Otero S.; Pérez Ruiz J.;
Ruiz Ruiz C.; Seidel A.; Fernández O'Dogherty S.; Pantoja Rosso S.) U.
Cuidados Intensivos Pediatricos, Servicio de Pediat. Hosp., Universitario
Puerta del Mar, Cádiz, Spain.
(Rubio Quiñones F.) U.C.I., Pediatría Hospital, Universitario Puerta del
Mar, Avda Ana de Viya. 21, 11009 Cádiz, Spain.
CORRESPONDENCE ADDRESS
F. Rubio Quinones, U.C.I. de Pediatria, Hospital Univ. Puerta del Mar,
Servicio de Pediatria, Avda. Ana de Viya, 21, 11009 Cadiz, Spain.
SOURCE
Anales Espanoles de Pediatria (1996) 45:3 (249-252). Date of Publication:
1996
ISSN
0302-4342
BOOK PUBLISHER
Ediciones Doyma, S.L., Travesera de Gracia 17-21, Barcelona, Spain.
ABSTRACT
Background: Pediatric intensive care units have developed as treatment areas
with a concentration of specialized equipment and personnel. Critically ill
children often need to be moved to and from these critical care areas for
diagnostic or therapeutic procedures. Such transport may pose additional
risk to the critically ill patient. Patients and methods: In order to assess
the problems encountered in our transport process, a prospective study was
performed. A questionnaire was undertaken to evaluate the transport of
critically ill children hospitalized in the Pediatric Intensive Care Unit of
the Hospital Universitario Prerta del Mar from Cadiz over an eleven month
period. Results: Two hundred children transported were evaluated.
Forty-seven (23.5%) were interhospital transported patients and one hundred
fifty-three (76.5%) were intrahospital transported patients. The most common
type of intrahospital transport involves transfers between the operating
room and the intensive care unit (73 patients, 36.5%). Deterioration in
respiratory, cardiovascular and other physiological systems was registered
in twenty-two patients (11%). One hundred four equipment-related mishaps
were noted in eighty-six patients (43%) during the transport process.
Dislodgement of intravenous catheters, loss of oxygen supply, endotracheal
tube problems and equipment malfunction were the most common mishaps noted.
Conclusions: Our results would suggest that more training regarding the
transport of the critically ill child are needed in our area.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
child
human
major clinical study
questionnaire
Spain
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
Spanish
LANGUAGE OF SUMMARY
English, Spanish
EMBASE ACCESSION NUMBER
1996323270
MEDLINE PMID
9019963 (http://www.ncbi.nlm.nih.gov/pubmed/9019963)
PUI
L26353930
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 1004
TITLE
Transportation on long distance of baby ventilated by Babylog 2 with
Babymix. Study of system to reduce fluid's consummation
ORIGINAL (NON-ENGLISH) TITLE
Transport sur de longues distances de nourrissons ventiles Babylog 2® avec
Babymix®. Etude d'un systeme pour economiser les fluides
AUTHOR NAMES
Rosenthal J.M.
Perie J.L.
Cadet E.
Hertogh C.
Lavaud J.
AUTHOR ADDRESSES
(Rosenthal J.M.) Maternité, Guadeloupe, France.
(Perie J.L.) Service des Urgences-Samu 97-1, Guadeloupe, France.
(Cadet E.) Serv. de Reanimation Neonatale, CHU Pap Abymes, Guadeloupe,
France.
(Hertogh C.) UFR STAPS, Antilles, Guyane, France.
(Lavaud J.) Smur Pédiatrique, Hopital Necker-Enfants-Malades, 149, rue de
Sèvres, 75005 Paris, France.
CORRESPONDENCE ADDRESS
J.M. Rosenthal, Maternite, CHU, Pap Abymes, Guadeloupe.
SOURCE
Urgences Medicales (1996) 15:4 (163-168). Date of Publication: 1996
ISSN
0923-2524
ABSTRACT
Each year, around 20 children are carried under mechanical ventilation from
Guadeloupe to Europe. Flight time is around 8 hours for 7200 km distance on
a regular carrier line. These children are transferred for complementary
investigation, impossible to do Guadeloupe or for long durable
hospitalization. Care continuities have to be assured during transportation,
especially for oxygenotherapy. In wanting to increase Babylog 2 respiratory
autonomy equipped with Babymix on long distances, we had studied a new
possibility of utilisation of the respirator. We reduced medical air
consummation for babies ventilated with FiO(2) inferior to 0.60. In this
method, the FiO(2) marked on Babymix is not the FiO(2) wanted. We used a
simple formula to adapt the FiO(2) (FiO(2) marked = 2 (FiO(2) wanted -
0,105). We gave to the children their real needs. These are the case results
of five children under artificial ventilation from Pointe-a-Pitre to Paris.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
artificial ventilation
intensive care unit
oxygen therapy
patient transport
EMTREE MEDICAL INDEX TERMS
article
clinical article
emergency medicine
France
human
infant
newborn
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
French
LANGUAGE OF SUMMARY
English, French
EMBASE ACCESSION NUMBER
1996328646
PUI
L26359757
DOI
10.1016/0923-2524(96)82413-1
FULL TEXT LINK
http://dx.doi.org/10.1016/0923-2524(96)82413-1
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1005
TITLE
Air force helicopters for transport of intensive care patients
AUTHOR NAMES
Mittermair H.G.
AUTHOR ADDRESSES
(Mittermair H.G.) Austrian Air Force, 4063 Horsching, Austria.
CORRESPONDENCE ADDRESS
H.G. Mittermair, Austrian Air Force, 4063 Horsching, Austria.
SOURCE
Acta Anaesthesiologica Scandinavica, Supplement (1996) 40:109 (113-114).
Date of Publication: 1996
ISSN
0515-2720
BOOK PUBLISHER
Blackwell Munksgaard, 1 Rosenorns Alle, P.O. Box 227, Copenhagen V, Denmark.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
helicopter
intensive care unit
traffic and transport
EMTREE MEDICAL INDEX TERMS
air force
conference paper
intensive care
priority journal
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1996296984
MEDLINE PMID
8901972 (http://www.ncbi.nlm.nih.gov/pubmed/8901972)
PUI
L26323118
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 1006
TITLE
Oxygen transport and oxygen metabolism in shock and critical illness:
Invasive and noninvasive monitoring of circulatory dysfunction and shock
AUTHOR NAMES
Shoemaker W.C.
AUTHOR ADDRESSES
(Shoemaker W.C.) Department of Surgery, LAC-USC Medical Center, 1200 North
State Street, Los Angeles, CA 90033, United States.
CORRESPONDENCE ADDRESS
W.C. Shoemaker, Department of Surgery, LAC-USC Medical Center, 1200 North
State Street, Los Angeles, CA 90033, United States.
SOURCE
Critical Care Clinics (1996) 12:4 (939-969). Date of Publication: 1996
ISSN
0749-0704
BOOK PUBLISHER
W.B. Saunders, Independence Square West, Philadelphia, United States.
ABSTRACT
The common underlying physiologic problem in shock is low flow from
hypovolemia or maldistributed microcirculatory flow from uneven
vasoconstriction, leading to inadequate tissue perfusion (hypoxia), often in
the face of increased metabolic demands. Noninvasive monitoring, which was
found to provide similar information to that of invasive monitoring, was
used in the earliest period of time shortly after admission to the emergency
department to provide objective physiologic criteria as therapeutic goals
for each of the three major circulatory components: cardiac, pulmonary, and
tissue perfusion functions. A clinical algorithm or branch-chain decision
tree for high-risk surgical patients was developed from decision rules based
on survivor and nonsurvivor patterns, outcome predictors, prospective
controlled clinical trials of the oxygen delivery/oxygen consumption
(DO(2)/VO(2)) concept, and the DO(2)/VO(2) responses of a wide variety of
therapeutic agents.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
alpha adrenergic receptor blocking agent (drug therapy, pharmacology)
inotropic agent (drug dose, drug therapy, pharmacology)
phosphodiesterase inhibitor (drug dose, drug therapy, pharmacology)
vasodilator agent (drug therapy, pharmacology)
EMTREE DRUG INDEX TERMS
amrinone (drug dose, drug therapy, pharmacology)
dobutamine (drug dose, drug therapy, pharmacology)
dopamine (drug therapy, pharmacology)
epinephrine (drug therapy, pharmacology)
glyceryl trinitrate (drug therapy, pharmacology)
hydralazine (drug therapy, pharmacology)
labetalol (drug therapy, pharmacology)
milrinone (drug dose, drug therapy, pharmacology)
nitroprusside sodium (drug therapy, pharmacology)
noradrenalin (drug therapy, pharmacology)
prostaglandin E1 (drug therapy, pharmacology)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
oxygen transport
shock (complication, diagnosis, drug therapy, therapy)
EMTREE MEDICAL INDEX TERMS
algorithm
clinical trial
controlled clinical trial
controlled study
critical illness
fluid therapy
heart output
hemodynamic monitoring
high risk patient
human
hypotension
intensive care unit
major clinical study
medical decision making
multiple organ failure
oxygen consumption
patient monitoring
postoperative complication
priority journal
randomized controlled trial
resuscitation
review
septic shock (complication, diagnosis, drug therapy, therapy)
surgical patient
thermodilution
tissue perfusion
CAS REGISTRY NUMBERS
adrenalin (51-43-4, 55-31-2, 6912-68-1)
amrinone (60719-84-8)
dobutamine (34368-04-2, 52663-81-7)
dopamine (51-61-6, 62-31-7)
glyceryl trinitrate (55-63-0)
hydralazine (304-20-1, 86-54-4)
labetalol (32780-64-6, 36894-69-6)
milrinone (78415-72-2)
nitroprusside sodium (14402-89-2, 15078-28-1)
noradrenalin (1407-84-7, 51-41-2)
prostaglandin E1 (745-65-3)
EMBASE CLASSIFICATIONS
Surgery (9)
Anesthesiology (24)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1996323026
MEDLINE PMID
8902378 (http://www.ncbi.nlm.nih.gov/pubmed/8902378)
PUI
L26353424
DOI
10.1016/S0749-0704(05)70286-4
FULL TEXT LINK
http://dx.doi.org/10.1016/S0749-0704(05)70286-4
COPYRIGHT
Copyright 2011 Elsevier B.V., All rights reserved.
RECORD 1007
TITLE
Risk factors associated with vancomycin-resistant Enterococcus faecium
infection or colonization in 145 matched case patients and control patients
AUTHOR NAMES
Riley L.W.
AUTHOR ADDRESSES
(Riley L.W.) Division of International Medicine, Cornell University Medical
College, 1300 York Avenue, New York, NY 10021, United States.
CORRESPONDENCE ADDRESS
L.W. Riley, Division of International Medicine, Cornell University Medical
College, 1300 York Avenue, New York, NY 10021, United States.
SOURCE
Clinical Infectious Diseases (1996) 23:4 (767-772). Date of Publication:
1996
ISSN
1058-4838
BOOK PUBLISHER
University of Chicago Press, 1427 E. 60th Street, Chicago, United States.
ABSTRACT
Risk factors and mortality associated with vancomycin-resistant Enterococcus
faecium (VREF) infection or colonization were examined at a tertiary care
hospital by comparing 145 patients who had VREF isolates (cases) to 145
patients with vancomycin-susceptible Enterococcus faecium (VSEF) isolates
(controls). The number of deaths per 100 person-days of hospitalization
after diagnosis did not differ significantly between VREF patients (1.2) and
VSEF patients (0.8). Multivariate analyses found that the duration of
hospitalization (≤7 days), intrahospital transfer between floors, use of
antimicrobials (i.e., vancomycin and third-generation cephalosporins), and
duration of vancomycin use (≤7 days) was independently associated with VREF
infection or colonization. This study, which has a large sample size,
confirms some earlier observations regarding risks for VREF infection or
colonization and identifies factors that may be potentially exploited to
develop interventional strategies for the control of this emerging
nosocomial problem.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
cephalosporin derivative
vancomycin
EMTREE DRUG INDEX TERMS
cefotaxime
ceftazidime
ceftriaxone
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Enterococcus faecalis
hospital infection
Streptococcus infection
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
antibiotic resistance
article
bacterial colonization
bacterium isolation
child
controlled study
female
hospitalization
human
infant
major clinical study
male
mortality
priority journal
risk factor
CAS REGISTRY NUMBERS
cefotaxime (63527-52-6, 64485-93-4)
ceftazidime (72558-82-8)
ceftriaxone (73384-59-5, 74578-69-1)
vancomycin (1404-90-6, 1404-93-9)
EMBASE CLASSIFICATIONS
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1996303794
MEDLINE PMID
8909842 (http://www.ncbi.nlm.nih.gov/pubmed/8909842)
PUI
L26331122
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1008
TITLE
Erratum: The 1995 update of recommendations for a standard technique for
measuring the single-breath carbon monoxide diffusing capacity (transfer
factor) (American Journal of Respiratory Critical Care Medicine (1996) 154
(265-266))
AUTHOR NAMES
Rosenberg E.
AUTHOR ADDRESSES
(Rosenberg E.) Department of Physiology/Biophysics, College of Medicine,
Howard University, Washington, DC, United States.
CORRESPONDENCE ADDRESS
E. Rosenberg, Department of Physiology/Biophysics, College of Medicine,
Howard University, Washington, DC, United States.
SOURCE
American Journal of Respiratory and Critical Care Medicine (1996) 154:3 I
(827-828). Date of Publication: 1996
ISSN
1073-449X
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
error
EMTREE MEDICAL INDEX TERMS
erratum
priority journal
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1996300253
PUI
L26327313
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1009
TITLE
Haematological patients transferred to the intensive care unit: what ICU
nurses need to know.
AUTHOR NAMES
Hollis H.
AUTHOR ADDRESSES
(Hollis H.)
CORRESPONDENCE ADDRESS
H. Hollis,
SOURCE
Intensive & critical care nursing : the official journal of the British
Association of Critical Care Nurses (1996) 12:5 (272-276). Date of
Publication: Oct 1996
ISSN
0964-3397
ABSTRACT
This article will consider the nursing care and treatment required by
haematology patients when transferred to an intensive care unit (ICU).
Background information on types of haematological malignancies, treatment
for and survival from these diseases will be presented. This will be
followed by considering some of the complications that may lead to admission
to ICU including tumour lysis syndrome, infections, disseminated
intravascular coagulation and haemorrhage and the side-effects of treatment
itself. Specialist needs of these patients when in an ICU will be addressed
and the patients' experience of the disease will be discussed to enable ICU
nurses to offer the best standard of care possible for such patients.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hematologic disease (complication)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
classification
health service
human
nursing
review
self help
LANGUAGE OF ARTICLE
English
MEDLINE PMID
8938080 (http://www.ncbi.nlm.nih.gov/pubmed/8938080)
PUI
L126306825
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1010
TITLE
Re: Intrahospital transportation.
AUTHOR NAMES
Elliott M.
AUTHOR ADDRESSES
(Elliott M.)
CORRESPONDENCE ADDRESS
M. Elliott,
SOURCE
Intensive & critical care nursing : the official journal of the British
Association of Critical Care Nurses (1996) 12:5 (311). Date of Publication:
Oct 1996
ISSN
0964-3397
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
oxygen therapy
patient transport
EMTREE MEDICAL INDEX TERMS
clinical protocol
human
letter
methodology
LANGUAGE OF ARTICLE
English
MEDLINE PMID
8938087 (http://www.ncbi.nlm.nih.gov/pubmed/8938087)
PUI
L126306832
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1011
TITLE
Allocation of scarce resources: ethical challenges, clinical realities.
AUTHOR NAMES
Terry P.
Rushton C.H.
AUTHOR ADDRESSES
(Terry P.; Rushton C.H.) Division of Pulmonary and Critical Care Medicine,
Johns Hopkins Asthma and Allergy Center, Johns Hopkins University,
Baltimore, Md. USA.
CORRESPONDENCE ADDRESS
P. Terry, Division of Pulmonary and Critical Care Medicine, Johns Hopkins
Asthma and Allergy Center, Johns Hopkins University, Baltimore, Md. USA.
SOURCE
American journal of critical care : an official publication, American
Association of Critical-Care Nurses (1996) 5:5 (326-330). Date of
Publication: Sep 1996
ISSN
1062-3264
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health care organization
intensive care unit
medical ethics
patient transport
EMTREE MEDICAL INDEX TERMS
article
artificial ventilation
case report
chronic obstructive lung disease (complication)
human
male
nurse patient relationship
nursing
organization and management
patient advocacy
policy
respiratory failure (etiology, therapy)
LANGUAGE OF ARTICLE
English
MEDLINE PMID
8870855 (http://www.ncbi.nlm.nih.gov/pubmed/8870855)
PUI
L127188880
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1012
TITLE
Alterations of end-tidal carbon dioxide during the intrahospital transport
of children
AUTHOR NAMES
Tobias J.D.
Lynch A.
Garrett J.
AUTHOR ADDRESSES
(Tobias J.D.) Depts. of Child Hlth. and Anesth., University of Missouri,
Columbia, MO, United States.
(Lynch A.) Division of Pediatric Critical Care, Vanderbilt University,
Nashville, TN, United States.
(Garrett J.) Division of Pediatric Critical Care, Sunrise Children's
Hospital, Las Vegas, NV, United States.
(Tobias J.D.) University of Missouri, Department of Child Health, M658
Health Sciences Center, One Hospital Drive, Columbia, MO 65212, United
States.
CORRESPONDENCE ADDRESS
J.D. Tobias, Department of Child Health, M658 Health Sciences Center,
University of Missouri, One Hospital Drive, Columbia, MO 65212, United
States.
SOURCE
Pediatric Emergency Care (1996) 12:4 (249-251). Date of Publication: August
1996
ISSN
0749-5161
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
ABSTRACT
Objective: To determine the effect of manual ventilation during
intrahospital transport on end-tidal carbon dioxide concentrations in
children. Design: Prospective study in children who required tracheal
intubation and mechanical ventilation/hyperventilation to maintain an
arterial partial pressure of CO(2) (PaCO(2)) of 25 to 30 torr for control of
intracranial pressure. Setting: Pediatric intensive care unit. Intervention:
During patient transport with manual ventilation, end-tidal CO(2) was
monitored with a side-streaming aspirating, infrared device. The person
responsible for manual ventilation was informed of the current ventilator
settings and the need to maintain a PaCO(2) of 25 to 30 torr, but was not
allowed to see the end-tidal CO(2) monitor. Results: The study population
included 12 patients ranging in age from seven months to 14 years (average
age 6.9 years) and in weight from 6.5 to 57 kg (average weight 28.9 kg). A
total of 1716 end-tidal CO(2) values were recorded during 286 minutes of
monitoring. Five hundred and thirty-one (31%) of the readings were in the
intended range of 25 to 30 torr. Four hundred (23%) were less than 20 torr,
665 (39%) were in the 20 to 24 torr range, and 119 (6.3%) were greater than
30 torr. Only five were greater than 40 torr. Conclusions: Unintentional
hyperventilation occurs during the intrahospital transport of children. End-
tidal CO(2) values less than 25 torr were noted 62% of the time.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
end tidal carbon dioxide tension
hyperventilation (complication)
EMTREE MEDICAL INDEX TERMS
adolescent
article
artificial ventilation
child
clinical article
endotracheal intubation
human
infant
intracranial pressure
patient transport
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1996306631
MEDLINE PMID
8858645 (http://www.ncbi.nlm.nih.gov/pubmed/8858645)
PUI
L26334105
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1013
TITLE
An outbreak of multiply-resistant Klebsiella pneumoniae in the Grampian
region of Scotland
AUTHOR NAMES
Hobson R.P.
MacKenzie F.M.
Gould I.M.
AUTHOR ADDRESSES
(Hobson R.P.; MacKenzie F.M.; Gould I.M.) Department of Medical
Microbiology, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, AB25 2ZN,
United Kingdom.
CORRESPONDENCE ADDRESS
I.M. Gould, Department of Medical Microbiology, Aberdeen Royal Infirmary,
Foresterhill, Aberdeen AB25 2ZN, United Kingdom.
SOURCE
Journal of Hospital Infection (1996) 33:4 (249-262). Date of Publication:
August 1996
ISSN
0195-6701
BOOK PUBLISHER
W.B. Saunders Ltd, 32 Jamestown Road, London, United Kingdom.
ABSTRACT
A predominantly hospital-based outbreak of multiply-resistant Klebsiella
pneumoniae capsular type K(2) (MRK) expressing expanded spectrum β-lactamase
(ESBL) activity and fully sensitive only to the carbapenems and amikacin is
described. The organism was isolated from 283 patients between March 1992
and September 1995. The outbreak started in the intensive care unit (ICU) of
a major acute hospital and spread through surgical wards, a medical ward, a
geriatric unit in a separate hospital and various other local hospitals.
Environmental screening revealed extensive ward contamination. The decline
of the outbreak after the spring of 1995 coincided with the re-emphasis of
standard infection control procedures and the launch of a works programme
aimed at addressing underlying sites of environmental contamination. Of the
283 cases, 166 (59.0%) were detected through a specially instigated case
finding programme. The MRK caused 11 cases of septicaemia, two postoperative
intra-abdominal abscesses, one case of postoperative meningitis, 102 cases
of urinary tract infection and 28 wound infections and was isolated from the
respiratory tracts of five patients with ventilator associated pneumonia.
The difficulty in controlling the outbreak is ascribed to heavy
environmental contamination, frequent inter- and intra-hospital patient
transfers and prolonged carriage of the outbreak strain.
EMTREE DRUG INDEX TERMS
amikacin (drug therapy)
antibiotic agent (drug therapy)
beta lactamase (endogenous compound)
carbapenem derivative (drug therapy)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital infection (drug resistance, drug therapy, etiology)
EMTREE MEDICAL INDEX TERMS
abdominal abscess (complication, epidemiology, etiology)
antibiotic resistance
article
assisted ventilation
bacterium contamination
case finding
enzyme activity
geriatric hospital
human
infection control
intensive care
Klebsiella pneumoniae
major clinical study
meningitis (complication, epidemiology, etiology)
patient transport
pneumonia (complication, epidemiology, etiology)
postoperative complication
respiratory system
screening
septicemia (epidemiology, etiology)
surgical ward
United Kingdom
urinary tract infection (epidemiology, etiology)
wound infection (epidemiology, etiology)
CAS REGISTRY NUMBERS
amikacin (37517-28-5, 39831-55-5)
beta lactamase (9073-60-3)
EMBASE CLASSIFICATIONS
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1996263717
MEDLINE PMID
8864938 (http://www.ncbi.nlm.nih.gov/pubmed/8864938)
PUI
L26285364
DOI
10.1016/S0195-6701(96)90011-0
FULL TEXT LINK
http://dx.doi.org/10.1016/S0195-6701(96)90011-0
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1014
TITLE
Is today's workplace conception still up-to-date? New management concepts
for anesthesia and intensive care medicine
ORIGINAL (NON-ENGLISH) TITLE
IST UNSER ARBEITSPLATZ-KONZEPT HEUTE NOCH ZEITGERECHT? NEUE ABLAUFKONZEPTE
IN DER ANASTHESIOLOGIE UND INTENSIVMEDIZIN
AUTHOR NAMES
Holst D.
Guth G.
Wendt M.
AUTHOR ADDRESSES
(Holst D.; Guth G.; Wendt M.) Klin. F. Anasthesiologie I., Klinikum
Karlsburg, Ernst-Moritz-Arndt-Univ. Greifswald, .
(Holst D.) Klin. F. Anasthesiologie I., Klinikum Karlsburg, Greifswalder
Straße 11, D-17495 Karlsburg, Germany.
CORRESPONDENCE ADDRESS
D. Holst, Klin. fur Anaesthesiol./Intensivmed., Klinikum Karlsburg,
Ernst-Moritz-Arndt-Universitat, Greifswalder Strasse 11, D-17495 Karlsburg,
Germany.
SOURCE
Anasthesiologie und Intensivmedizin (1996) 37:6 (322-327). Date of
Publication: 1996
ISSN
0170-5334
ABSTRACT
The continuous care of patients from emergency, diagnostic and operative
units up to the ICU is being provided by the department of anesthesiology.
Still our present work concept is in contradiction to the necessary
continuous care for critically ill patients. Transports between stationary
working places in theatre, the ICU or diagnostic centres unevitably go along
with interruption of monitoring and therapy: and leads towards a
considerable endangering of critically ill patients and a significant rise
of mortality. With a new monitoring- and therapy-place concept a steady
monitoring and fluid management is ensured. On a small bedside car the
complete side system of an intensive ward/operative bedplace as monitoring,
fluid management, suction also for thorax drains as well as a manual
emergency artificial respiration system with O(2)-supply will be integrated.
This car serves already as monitoring for the induction of the narcosis,
accompanied the patients to the operating room and postoperatively to the
intensive ward without the necessity of a disconnection. The whole
monitoring accompanied the patient for a possible reintervention or for
diagnostic measure in hospital. In addition to the considerable saving of
time by transports (for instance operating room - intensive care unit) and
the guarantee of a steady monitoring of the patient, the costs of this car
system are in the region of only one-third of today's usual wall-fixed or
ceiling-fixed medium supply.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
anesthesia
intensive care
patient transport
quality control
work environment
EMTREE MEDICAL INDEX TERMS
anesthesiological procedure
hospital cost
human
patient monitoring
short survey
workplace
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Biophysics, Bioengineering and Medical Instrumentation (27)
Surgery (9)
LANGUAGE OF ARTICLE
German
LANGUAGE OF SUMMARY
English, German
EMBASE ACCESSION NUMBER
1996196000
PUI
L26200273
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1015
TITLE
A study of newborn infants with severe heart defects. Longer transportation
did not increase the risks
ORIGINAL (NON-ENGLISH) TITLE
Studie av nyfödda med allvarliga hjärtfel. Längre transporter ökade inte
riskerna.
AUTHOR NAMES
Hellström-Westas L.
Hanséus K.
Klette H.
Lundström N.R.
Svenningsen N.
AUTHOR ADDRESSES
(Hellström-Westas L.; Hanséus K.; Klette H.; Lundström N.R.; Svenningsen N.)
Barn-och ungdomsmedicinska kliniken, Lasarettet.
CORRESPONDENCE ADDRESS
L. Hellström-Westas, Barn-och ungdomsmedicinska kliniken, Lasarettet.
SOURCE
Läkartidningen (1996) 93:18 (1734, 1739-1740). Date of Publication: 1 May
1996
ISSN
0023-7205
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
congenital heart malformation (complication, surgery)
patient transport
EMTREE MEDICAL INDEX TERMS
air medical transport
article
comparative study
coronary care unit
female
hospital management
human
male
newborn
newborn intensive care
organization and management
risk factor
statistics
Sweden
LANGUAGE OF ARTICLE
Swedish
MEDLINE PMID
8667791 (http://www.ncbi.nlm.nih.gov/pubmed/8667791)
PUI
L126236098
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1016
TITLE
Nurses' patient transfer report. Concept for the determination of the
nursing transfer status at a surgical intensive care unit
ORIGINAL (NON-ENGLISH) TITLE
Der pflegerische Verlegungsbericht. Konzept Zur Erhebung des pflegerischen
Verlegungsstatus auf einer operativen Intensivstation.
AUTHOR NAMES
Hofmann-Rösener V.M.
Furth P.
AUTHOR ADDRESSES
(Hofmann-Rösener V.M.; Furth P.)
CORRESPONDENCE ADDRESS
V.M. Hofmann-Rösener,
SOURCE
Krankenpflege Journal (1996) 34:4 (125-127). Date of Publication: Apr 1996
ISSN
0174-108X
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
patient care planning
patient transport
EMTREE MEDICAL INDEX TERMS
article
health status
human
public relations
LANGUAGE OF ARTICLE
German
MEDLINE PMID
8716052 (http://www.ncbi.nlm.nih.gov/pubmed/8716052)
PUI
L126268410
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1017
TITLE
Influence of referring physicians on interventions by a pediatric and
neonatal critical care transport team
AUTHOR NAMES
Kronick J.B.
Frewen T.C.
Kissoon N.
Lee R.
Sommerauer J.F.
Reid W.D.
Casier S.
Boyle K.
AUTHOR ADDRESSES
(Kronick J.B.; Frewen T.C.; Kissoon N.; Lee R.; Sommerauer J.F.; Reid W.D.;
Casier S.; Boyle K.) Paediatric Critical Care Unit, Child Health Research
Institute, University of Western Ontario, London, Ont., Canada.
(Kissoon N.) Wolfson Children's Hospital, Howard Bldg., 820 Prudential
Drive, Jacksonville, FL 32207, United States.
CORRESPONDENCE ADDRESS
N. Kissoon, Wolfson Children's Hospital, Howard Bldg, 820 Prudential Drive,
Jacksonville, FL 32207, United States.
SOURCE
Pediatric Emergency Care (1996) 12:2 (73-77). Date of Publication: April
1996
ISSN
0749-5161
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
ABSTRACT
The objective of this study was to determine the influence of: a)
pediatrician versus nonpediatrician referrals on a transport team's
therapeutic interventions and b) referring physician's year of graduation on
interventions performed by the transport team. From November 1987 through
December 1989 we prospectively compared the therapeutic interventions
performed by the critical care transport team on newborns and pediatric
patients with the referring physician's specialty and year of graduation.
The transport team (critical care physician [PL3 or greater], registered
respiratory therapist, critical care nurse), recorded all therapeutic
interventions, including both procedural and pharmacologic, for 213 newborn
and 149 consecutive pediatric transports. Referring physicians were
categorized as pediatricians and nonpediatricians. Data were analyzed by
analysis of variance, χ(2), or linear regression. All patients were admitted
to either the pediatric or the neonatal intensive care unit, and over 80% of
both age groups received assisted ventilation. Newborns referred by
nonpediatricians required significantly more procedural interventions (2.64
vs 1.91, P = 0.016) than those referred by pediatricians. The opposite
relationship was observed among pediatric patients in that children referred
by pediatricians received more frequent intervention (P = 0.008) than those
referred by nonpediatricians. There was a significant inverse relationship
between the referring physician's year of medical school graduation and the
number of therapeutic interventions (total interventions = 6.17 - 0.040 x
graduation year, P = 0.01) and procedural interventions (procedural
interventions = 3.54 - 0.024 x graduation year, P = 0.01). We found that the
referring physicians' medical training affected the number of interventions
their patients received. Similarly, patients were likely to receive more
interventions if the referral physician's training was not recent. These
data have educational implications and support the concepts of continuing
medical education, recertification, and maintenance of skills among
physicians providing care to critically ill newborns and pediatric patients.
EMTREE DRUG INDEX TERMS
antibiotic agent
anticonvulsive agent
atropine
bicarbonate
inotropic agent
morphine
pancuronium
respiratory tract agent
vasodilator agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
newborn intensive care
pediatrics
EMTREE MEDICAL INDEX TERMS
article
artificial ventilation
child
clinical audit
clinical trial
diagnosis related group
health care delivery
human
intubation
major clinical study
medical education
newborn
patient referral
patient transport
pediatrician
prospective study
resuscitation
vascular access
CAS REGISTRY NUMBERS
atropine (51-55-8, 55-48-1)
bicarbonate (144-55-8, 71-52-3)
morphine (52-26-6, 57-27-2)
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Anesthesiology (24)
Health Policy, Economics and Management (36)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1996127483
MEDLINE PMID
8859911 (http://www.ncbi.nlm.nih.gov/pubmed/8859911)
PUI
L26123822
DOI
10.1097/00006565-199604000-00001
FULL TEXT LINK
http://dx.doi.org/10.1097/00006565-199604000-00001
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1018
TITLE
Air transport of obstetric critical care patients to tertiary centers
AUTHOR NAMES
Elliott J.P.
Foley M.R.
Young L.
Balazs K.T.
Meiner L.
AUTHOR ADDRESSES
(Elliott J.P.; Foley M.R.; Young L.; Balazs K.T.; Meiner L.) Phoenix
Perinatal Associates, Division of Maternal-Fetal Medicine, Good Samaritan
Reg. Medical Center, Phoenix, AZ, United States.
(Elliott J.P.) Phoenix Perinatal Associates, 1111 East McDowell Road,
Phoenix, AZ 85006, United States.
CORRESPONDENCE ADDRESS
J.P. Elliott, Phoenix Perinatal Associates, 1111 East McDowell Road,
Phoenix, AZ 85006, United States.
SOURCE
Journal of Reproductive Medicine for the Obstetrician and Gynecologist
(1996) 41:3 (171-174). Date of Publication: 1996
ISSN
0024-7758
BOOK PUBLISHER
Journal of Reproductive Medicine Inc., 8342 Olive Boulevard, P.O. Box 12425,
St. Louis, United States.
ABSTRACT
OBJECTIVE: To evaluate critical care diagnoses and their frequency in an air
transport situation. STUDY DESIGN: A retrospective review was done of all
obstetric air transports performed by Samaritan AirEvac to tertiary
hospitals in Phoenix, Arizona, from January 1, 1990, to August 31, 1991.
RESULTS: In the 20-month study period, 1,541 maternal transports were
performed. Critical care diagnoses were found in 360 (23.4%) of the
patients. The following categories were used: hypertensive crisis, 188/360
(52%); hemorrhage, 131/360 (36%); trauma, 21/360 (6%); and respiratory
compromise, 11/360 (3%). CONCLUSION: Critical care diagnoses represented
about 25% of all obstetric air transports in this study. Our transport team
is made up of an obstetric flight nurse and another team member (adult
trauma nurse, neonatal flight nurse, flight respiratory therapist or flight
paramedic). Skill in both obstetric diagnosis and management and in critical
care is necessary in these situations.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
obstetric procedure
EMTREE MEDICAL INDEX TERMS
article
aviation
female
human
intensive care
major clinical study
priority journal
teaching hospital
EMBASE CLASSIFICATIONS
Obstetrics and Gynecology (10)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1996087120
MEDLINE PMID
8778415 (http://www.ncbi.nlm.nih.gov/pubmed/8778415)
PUI
L26087663
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1019
TITLE
Molecular epidemiology of Klebsiella pneumoniae producing SHV-5 β-
lactamase: Parallel outbreaks due to multiple plasmid transfer
AUTHOR NAMES
Prodinger W.M.
Fille M.
Bauernfeind A.
Stemplinger I.
Amann S.
Pfausler B.
Lass-Flori C.
Dierich M.P.
AUTHOR ADDRESSES
(Prodinger W.M.; Fille M.; Bauernfeind A.; Stemplinger I.; Amann S.;
Pfausler B.; Lass-Flori C.; Dierich M.P.) Institut fur Hygiene, University
of Innsbruck, Fritz-Pregl-Str. 3, A-6020 Innsbruck, Austria.
CORRESPONDENCE ADDRESS
W.M. Prodinger, Institut fur Hygiene, University of Innsbruck,
Fritz-Pregl-Str. 3, A-6020 Innsbruck, Austria.
SOURCE
Journal of Clinical Microbiology (1996) 34:3 (564-568). Date of Publication:
1996
ISSN
0095-1137
BOOK PUBLISHER
American Society for Microbiology, 1752 N Street N.W., Washington, United
States.
ABSTRACT
Over a period of 22 months, 32 patients treated in three independent
intensive care units of the Innsbruck University Hospital were infected with
extended-spectrum β-lactamase-producing members of the family
Enterobacteriaceae (30 Klebsiella pneumoniae isolates, 1 Klebsiella oxytoca
isolate, and 1 Escherichia coli isolate). As confirmed by sequencing of a
bla gene PCR fragment, all isolates expressed the SHV-5-type β-lactamase.
Genomic fingerprinting of epidemic strains with XbaI and pulsed-field gel
electrophoresis grouped 20 of 21 isolates from ward A into two consecutive
clusters which included 1 of 3 ward B isolates. All six K. pneumoniae
isolates from ward C formed a third cluster. Stool isolates of asymptomatic
patients and environmental isolates belonged to these clusters as well.
Additionally, 2,6110 routine K. pneumoniae isolates from the surrounding
provinces (population, 900,000) were screened for SHV-5 production. Only one
of six nonepidemic isolates producing SHV-5 β-lactamase was matched with the
outbreak strains by genomic fingerprinting. Plasmid fingerprinting, however,
revealed the epidemic spread of a predominant R-plasmid, with a size of
approximately 80 kb, associated with 29 of the 30 K. pneumoniae isolates.
This plasmid was also present in the single K. oxytoca and E. coli isolates
from ward C and in three nonepidemic isolates producing SHV-5. Our results
underline that strain typing exclusively on the genomic level can be
misleading in the epidemiological investigation of plasmid-encoded extended-
spectrum β-lactamases. Our evidence for multiple events of R-plasmid
transfer between species of the family Enterobacteriaceae in this nosocomial
outbreak stresses the need for plasmid typing, especially because SHV-5 β-
lactamase seems to be regionally spread predominantly via plasmid transfer.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
beta lactamase
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
gene transfer
Gram negative infection (diagnosis)
Klebsiella pneumoniae
EMTREE MEDICAL INDEX TERMS
article
clinical article
controlled study
epidemic
hospital infection (diagnosis)
human
intensive care unit
priority journal
R factor
CAS REGISTRY NUMBERS
beta lactamase (9073-60-3)
EMBASE CLASSIFICATIONS
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1996060487
MEDLINE PMID
8904415 (http://www.ncbi.nlm.nih.gov/pubmed/8904415)
PUI
L26065776
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1020
TITLE
Pediatric and neonatal critical care transport: A comparison of therapeutic
interventions
AUTHOR NAMES
Kronick J.B.
Frewen T.C.
Kissoon N.
Lee R.
Sommerauer J.F.
Reid W.D.
Casier S.
Boyle K.
AUTHOR ADDRESSES
(Kissoon N.) Wolfson Children's Hospital, Howard Bldg., 820 Prudential
Drive, Jacksonville, FL 32207, United States.
(Kronick J.B.; Frewen T.C.; Lee R.; Sommerauer J.F.; Reid W.D.; Casier S.;
Boyle K.)
CORRESPONDENCE ADDRESS
N. Kissoon, Wolfson Children's Hospital, Howard Bldg., 820 Prudential Drive,
Jacksonville, FL 32207, United States.
SOURCE
Pediatric Emergency Care (1996) 12:1 (23-26). Date of Publication: February
1996
ISSN
0749-5161
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
ABSTRACT
Objective: To compare the therapeutic interventions provided to newborn and
pediatric patients by a dedicated combined neonatal pediatric critical care
transport team. Method: From November 1987 through December 1989 we
prospectively compared the number of therapeutic interventions performed by
the critical care transport team on newborns and pediatric patients. The
transport team (critical care physician [PL3 or greater], pediatric
respiratory therapist, critical care nurse), recorded all therapeutic
interventions, including both procedural and pharmacologic, for 213 newborn
and 149 pediatric consecutive transports. Data were analyzed by analysis of
variance or χ(2) statistic. Results: All patients were admitted to either
the pediatric or the neonatal intensive care unit, and over 80% of both age
groups received assisted ventilation. Newborns commonly suffered from
respiratory diseases (159/213), while pediatric patients suffered from
respiratory (52/149), central nervous system (28/149), and traumatic
conditions (37/149). Airway maintenance procedural interventions
(intubation, ventilation) were the commonest in both groups, although more
frequent in neonates. Neonates received antibiotics and morphine (P < 0.05)
while pediatric patients received anticonvulsants and respiratory drugs (P <
0.05) more frequently. Newborns received significantly more interventions
than pediatric patients (average 3.56 vs 2.93, P < 0.05). Newborns also
received significantly more procedural interventions (2.06 vs 1.36, P = <
0.05) including intubation (34.7% vs 15.4%, P < 0.05) and the initiation of
mechanical ventilation (38% vs 22%, P < 0.05). Conclusions: Overall,
newborns received more interventions, including intubation, and ventilation
from the transport team than did pediatric patients. Our data suggest that
combined pediatric neonatal transport teams should be prepared to intervene
in a wide range of conditions from preterm respiratory distress to the
multiply traumatized adolescent.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
critical illness
emergency treatment
medical staff
paramedical personnel
pediatrics
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1996078372
MEDLINE PMID
8677174 (http://www.ncbi.nlm.nih.gov/pubmed/8677174)
PUI
L26073557
DOI
10.1097/00006565-199602000-00007
FULL TEXT LINK
http://dx.doi.org/10.1097/00006565-199602000-00007
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1021
TITLE
Impact of specialised paediatric retrieval teams. Intensive care provided by
local hospitals should be improved.
AUTHOR NAMES
Raffles A.
AUTHOR ADDRESSES
(Raffles A.)
CORRESPONDENCE ADDRESS
A. Raffles,
SOURCE
BMJ (Clinical research ed.) (1996) 312:7023 (120; author reply 121). Date of
Publication: 13 Jan 1996
ISSN
0959-8138
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child health care
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
child
human
note
patient care
preschool child
standard
United Kingdom
LANGUAGE OF ARTICLE
English
MEDLINE PMID
8555903 (http://www.ncbi.nlm.nih.gov/pubmed/8555903)
PUI
L126200262
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1022
TITLE
Fast Track recovery after aortocoronary bypass surgery: early extubation and
intensive care unit transfer.
AUTHOR NAMES
Jesurum J.T.
Alexander W.A.
Anderson J.J.
Houston S.
AUTHOR ADDRESSES
(Jesurum J.T.; Alexander W.A.; Anderson J.J.; Houston S.)
CORRESPONDENCE ADDRESS
J.T. Jesurum,
SOURCE
Seminars in perioperative nursing (1996) 5:1 (12-22). Date of Publication:
Jan 1996
ISSN
1056-8670
ABSTRACT
Fast Track is a practical method of delivering care to aortocoronary bypass
(ACB) patients with minimal risks to the patients or their care providers. A
prospective study designed by an interdisciplinary practice team will
evaluate the effects of an accelerated recovery program on clinical and
financial outcomes of ACB patients. Essential components of the accelerated
recovery program include early extubation, accelerated activity, and
appropriate patient selection. Preliminary results on early extubation are
discussed.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
coronary artery bypass graft
endotracheal intubation
intensive care
patient transport
postanesthesia nursing
progressive patient care
EMTREE MEDICAL INDEX TERMS
article
clinical pathway
human
nursing
organization and management
outcome assessment
prospective study
time
LANGUAGE OF ARTICLE
English
MEDLINE PMID
8696284 (http://www.ncbi.nlm.nih.gov/pubmed/8696284)
PUI
L126257256
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1023
TITLE
Mobile paediatric intensive care: The ethos of transfering critically ill
children
AUTHOR NAMES
Britto J.
Nadel S.
Levin M.
Habibi P.
AUTHOR ADDRESSES
(Britto J.; Nadel S.; Levin M.; Habibi P.) St Mary's Hospital, Paddington,
London, United Kingdom.
CORRESPONDENCE ADDRESS
J. Britto, St Mary's Hospital, Paddington, London, United Kingdom.
SOURCE
Care of the Critically Ill (1995) 11:6 (235-238). Date of Publication: 1995
ISSN
0266-0970
ABSTRACT
Specialised paediatric mobile intensive care teams (MICT) can rapidly
deliver intensive care to critically ill children awaiting transfer.
Involvement by the MICT in the patient's management begins at the time of
the initial request for transfer. The level of therapy and monitoring that
the child receives from the MICT, at the referring hospital, during the
period of stabilisation and transport should be similar to that of a
paediatric intensive care unit. The ethos of mobile intensive care not only
ensures minimal transport related morbidity and mortality but a decrease in
the severity of illness during transfer.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child health
critical illness
emergency medicine
patient transport
EMTREE MEDICAL INDEX TERMS
artificial ventilation
blood pressure monitoring
endotracheal intubation
human
intensive care
morbidity
mortality
patient care
patient referral
short survey
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1995364469
PUI
L25357621
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1024
TITLE
Parental perceptions of infant transfer from an NICU to a community nursery:
implications for research and practice.
AUTHOR NAMES
Page J.
Lunyk-Child O.
AUTHOR ADDRESSES
(Page J.; Lunyk-Child O.)
CORRESPONDENCE ADDRESS
J. Page,
SOURCE
Neonatal network : NN (1995) 14:8 (69-71). Date of Publication: Dec 1995
ISSN
0730-0832
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
attitude to health
newborn intensive care
parent
patient transport
EMTREE MEDICAL INDEX TERMS
human
newborn
newborn nursing
nursing research
psychological aspect
review
LANGUAGE OF ARTICLE
English
MEDLINE PMID
8552019 (http://www.ncbi.nlm.nih.gov/pubmed/8552019)
PUI
L126200719
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1025
TITLE
Clinical aspects of mucociliary transport in anesthesia and intensive-care
medicine
AUTHOR NAMES
Konrad F.
AUTHOR ADDRESSES
(Konrad F.) Abteilung Anasthesie Intensivmedizin, Kreiskrankenhaus
Sigmaringen, Akadem Lehrkrankenhaus Univ Tubingen, Postfach 240, 72488
Sigmaringen, Germany.
CORRESPONDENCE ADDRESS
F. Konrad, Abteilung Anasthesie Intensivmedizin, Kreiskrankenhaus
Sigmaringen, Akadem Lehrkrankenhaus Univ Tubingen, Postfach 240, 72488
Sigmaringen, Germany.
SOURCE
Applied Cardiopulmonary Pathophysiology (1995) 5:4 (249-255). Date of
Publication: 1995
ISSN
0920-5268
ABSTRACT
Because it is in direct contact with the environment, the respiratory system
is exposed to the continuous action of harmful substances. The mucociliary
escalator of the lungs is an important protective transport system by means
of which inhaled particles and microorganisms are removed from the
tracheobronchial system. Ventilated patients in the intensive-care unit
(ICU) frequently have impaired mucus transport, which is associated with the
development of retention of secretion and nosocomial pneumonia. Reduced
mucociliary clearance is often caused by multiple factors. Previous chronic
cigarette smoking or pre-existing chronic bronchitis, suction-induced
lesions of the mucus membrane, ventilation with high oxygen concentrations,
colonization by potentially pathogenic microorganisms, infection with
respiratory viruses, release of inflammatory mediators and inadequate
humidification of the inspired gases combine to form a formidable potential
insult to the mucociliary clearance mechanism. Beta-mimetics and
theophylline, in particular, have a favorable effect on mucociliary
transport, whereas the effect of mucolytic agents is controversial.
EMTREE DRUG INDEX TERMS
beta adrenergic receptor stimulating agent (pharmacology)
theophylline (pharmacology)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
anesthesia
intensive care
mucociliary transport
respiratory system
EMTREE MEDICAL INDEX TERMS
article
artificial ventilation
bacterial colonization
chronic bronchitis
cigarette smoking
environment
hospital infection (complication, etiology)
human
humidifier
inhalation
membrane damage (etiology)
mucociliary clearance
oxygen concentration
pneumonia (complication, etiology)
priority journal
respiratory mucosa
suction
tracheobronchial tree
CAS REGISTRY NUMBERS
theophylline (58-55-9, 5967-84-0, 8055-07-0, 8061-56-1, 99007-19-9)
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Anesthesiology (24)
Drug Literature Index (37)
General Pathology and Pathological Anatomy (5)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1996075499
PUI
L26070960
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1026
TITLE
Monitoring of O2 transport and tissue oxygenation in paediatric critical
care.
AUTHOR NAMES
Hüttemann E.
Reinhart K.
AUTHOR ADDRESSES
(Hüttemann E.; Reinhart K.) Department of Anesthesiology and Intensive Care
Medicine, University Hospital, Friedrich-Schiller-University Jena, Germany.
CORRESPONDENCE ADDRESS
E. Hüttemann, Department of Anesthesiology and Intensive Care Medicine,
University Hospital, Friedrich-Schiller-University Jena, Germany.
SOURCE
Paediatric anaesthesia (1995) 5:5 (281-286). Date of Publication: 1995
ISSN
1155-5645
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
oxygen
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
monitoring
oxygen consumption
EMTREE MEDICAL INDEX TERMS
adult
blood
child
human
infant
newborn
review
tissue distribution
CAS REGISTRY NUMBERS
oxygen (7782-44-7)
LANGUAGE OF ARTICLE
English
MEDLINE PMID
7489468 (http://www.ncbi.nlm.nih.gov/pubmed/7489468)
PUI
L126187121
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1027
TITLE
Transfer anxiety in patients with myocardial infarction.
AUTHOR NAMES
Jenkins D.A.
Rogers H.
AUTHOR ADDRESSES
(Jenkins D.A.; Rogers H.)
CORRESPONDENCE ADDRESS
D.A. Jenkins,
SOURCE
British journal of nursing (Mark Allen Publishing) (1995) 4:21 (1248-1252).
Date of Publication: 1995 Nov 23-Dec 13
ISSN
0966-0461
ABSTRACT
When patients are transferred from a coronary care unit to a general ward
they often experience transfer anxiety. A structured pre-transfer teaching
programme is suggested as a tool which may improve patient care.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
anxiety
heart infarction
patient education
patient transport
EMTREE MEDICAL INDEX TERMS
article
coronary care unit
human
nursing
psychological aspect
psychological model
LANGUAGE OF ARTICLE
English
MEDLINE PMID
8574101 (http://www.ncbi.nlm.nih.gov/pubmed/8574101)
PUI
L126207671
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1028
TITLE
Intrahospital transport of critically ill pediatric patients
AUTHOR NAMES
Wallen E.
Venkataraman S.T.
Grosso M.J.
Kiene K.
Orr R.A.
AUTHOR ADDRESSES
(Wallen E.; Venkataraman S.T.; Grosso M.J.; Kiene K.; Orr R.A.) Children's
Hospital of Pittsburgh, 3705, Fifth Avenue at Desoto Street, Pittsburgh, PA
15213, United States.
CORRESPONDENCE ADDRESS
S.T. Venkataraman, Children's Hospital of Pittsburgh, 3705, Fifth Avenue at
Desoto Street, Pittsburgh, PA 15213, United States.
SOURCE
Critical Care Medicine (1995) 23:9 (1588-1595). Date of Publication: 1995
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
ABSTRACT
Objectives: To determine the frequency of adverse events during
intrahospital transport; to determine the requirement of therapeutic
interventions during transport; to test the hypothesis that adverse events
that occur during intrahospital transport are due to the transport process
itself; and to determine the factors that predict the occurrence of adverse
events and the requirement of major therapeutic interventions during
transport. Design: A two-phase study in which data were prospectively
collected. In phase I, we examined the occurrence rate of adverse events,
the requirement for therapeutic interventions, and the factors that
predicted adverse events and the requirement of therapeutic interventions.
In phase II, we tested the hypothesis that adverse events during transport
were due to the transport process itself. Setting: A 250-bed university
children's hospital with a 50-bed intensive care unit (ICU). Patients: Phase
I of the study consisted of one hundred and eighty intrahospital transports
in 139 patients. These transports included patients who were transferred: a)
to the ICU from the operating room, emergency department, or the general
ward; b) from the ICU to the operating room; and c) from the ICU for
diagnostic or therapeutic procedures. Phase II of the study consisted of 89
transports in 85 patients. Interventions: None. Measurements and Main
Results: Vital signs and oxygen saturation were measured before and during
transport. In phase I, there were no adverse events in 23.9% of transports.
There was a significant change in at least one physiologic variable in 71.7%
of transports, and at least one equipment-related mishap in 10% of
transports. At least one major intervention was performed in 13.9% of
transports in response to physiologic deterioration or an equipment-related
mishap. There were no arrests or deaths during transport. The requirement
for a major procedure was 34.4% in mechanically ventilated patients vs. 9.5%
in nonventilated patients. Logistic regression analysis showed that both
pretransport Therapeutic Intervention Scoring System and the duration of
transport were significantly associated with the requirement of a major
intervention and physiologic deterioration, while only the duration of
transport was associated with an equipment- related event. The age of the
patient and the number of escorts accompanying the transport did not affect
the frequency of adverse events. Before transport in phase II study
patients, no patient became hypothermic, the changes in physiologic
variables were always <20%, and there was no change ≥5% in oxygen
saturation. Hypothermia occurred in 11.2% of transports. A ≥20% change in
heart rate (15.7%), blood pressure (21.3%), and respiratory rate (23.6%) was
seen only during transport. A ≥5% change in oxygen saturation (5.6%) was
seen only during transport. Conclusions: Serious physiologic deterioration
occurs during intrahospital transport of critically ill children. Severity
of illness and the duration of transport are associated with the occurrence
of adverse events during transport. The team composition and equipment
required on transport must be commensurate with the pretransport severity of
illness and the anticipated duration of transport.
EMTREE DRUG INDEX TERMS
carbon dioxide (endogenous compound)
neuromuscular blocking agent
oxygen (endogenous compound)
sedative agent
vasoactive agent
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
hospital
EMTREE MEDICAL INDEX TERMS
article
artificial ventilation
human
intubation
major clinical study
oxygen saturation
patient transport
priority journal
CAS REGISTRY NUMBERS
carbon dioxide (124-38-9, 58561-67-4)
oxygen (7782-44-7)
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Anesthesiology (24)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1995272515
MEDLINE PMID
7664562 (http://www.ncbi.nlm.nih.gov/pubmed/7664562)
PUI
L25269903
DOI
10.1097/00003246-199509000-00020
FULL TEXT LINK
http://dx.doi.org/10.1097/00003246-199509000-00020
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1029
TITLE
Critical care transport: an evolving role in EMS.
AUTHOR NAMES
Celia M.
Paluck J.N.
Smith R.L.
AUTHOR ADDRESSES
(Celia M.; Paluck J.N.; Smith R.L.) R Adams Cowley Shock Trauma Center,
Baltimore, MD, USA.
CORRESPONDENCE ADDRESS
M. Celia, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA.
SOURCE
JEMS : a journal of emergency medical services (1995) 20:8 (90-94). Date of
Publication: Aug 1995
ISSN
0197-2510
ABSTRACT
Critical care transport (CCT). It is defined as the movement of critically
ill patients from facilities where the patients' needs exceed available
resources to places that meet their needs, while maintaining a specialized
level of care. And it is a specialty that is becoming increasingly common in
today's managed care environment--an environment that emphasizes putting
people in network hospitals. It is also becoming a viable career move for
paramedics wishing to upgrade their skills and education.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
continuing education
health services research
human
legal liability
role playing
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
10144803 (http://www.ncbi.nlm.nih.gov/pubmed/10144803)
PUI
L125105429
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1030
TITLE
Intrahospital transportation of critical patients
ORIGINAL (NON-ENGLISH) TITLE
Transporte intrahospitalario en pacientes críticos.
AUTHOR NAMES
Martínez Magro M.L.
Lozano Quintana M.J.
López Castillo M.T.
Cuenca Solanas M.
AUTHOR ADDRESSES
(Martínez Magro M.L.; Lozano Quintana M.J.; López Castillo M.T.; Cuenca
Solanas M.)
CORRESPONDENCE ADDRESS
M.L. Martínez Magro,
SOURCE
Enfermería intensiva / Sociedad Española de Enfermería Intensiva y Unidades
Coronarias (1995) 6:3 (111-116). Date of Publication: 1995 Jul-Sep
ISSN
1130-2399
ABSTRACT
Critically ill patients often need to be transferred for a short period of
time for diagnostical or therapeutical reasons to other areas outside the
intensive care unit which are less safe than their own unit and suppose a
potential risk of deterioration in the patient's status. We analyse
prospectively the intrahospitalary transfer in 50 patients and study the
hemodynamic, ventilatory and neurological variations before and after the
transfer. 93.7% of our patients were transferred for diagnostical reasons,
basically to the radiodiagnosis service (85.4% for TAC performance), only
6.25% were transferred for therapeutical reasons, all of them to the
operating theatre. All the patients included in the study were subjected to:
-mechanic ventilation, electrocardiographic monitoring (ECG), invasive
arterial monitoring (TA), monitoring of arterial saturation of O2 using
pulsioximetry, drugs infusion through volumetric bombs and intracraneal
pressure monitoring through intra-ventricular catheter (in 18 cases). The
intrahospitalary transfer was performed with: -Portable ventilator, ECG
monitoring, TA, PIC and pulsioximetry. Before and after the transfer
different parameters were registered: -Inspiratory fraction of O2 (FiO2),
TA, cardiac frequency, PIC, arterial gasometry (pH, PAO2, PACO2). There were
no complications in any of the cases, the gasometric alterations were due to
the change of respiratory parameters for the transfer (increase of the FiO2
and prophylactic ventilation in all the cases). We recommend: -Use of the
portable ventilator, volumetric bombs, hemodynamic monitoring and
uninterrupted pulsioximetry and the presence of qualified staff (doctor and
ICU nurse) during the transfer.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
blood gas analysis
hemodynamics
human
methodology
monitoring
LANGUAGE OF ARTICLE
Spanish
MEDLINE PMID
7493286 (http://www.ncbi.nlm.nih.gov/pubmed/7493286)
PUI
L126182663
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1031
TITLE
Cooperative efforts between tertiary-care centers and outlying hospitals
boost imaging services and transfer technologies.
AUTHOR NAMES
Ripley R.C.
AUTHOR ADDRESSES
(Ripley R.C.) Cardiology Group of Middle Tennesse, Nashville, USA.
CORRESPONDENCE ADDRESS
R.C. Ripley, Cardiology Group of Middle Tennesse, Nashville, USA.
SOURCE
The Journal of cardiovascular management : the official journal of the
American College of Cardiovascular Administrators (1995) 6:3 (24-26). Date
of Publication: 1995 May-Jun
ISSN
1053-5330
ABSTRACT
Information maintained in the medical record is becoming computerized and is
thus accessible to real-time retrieval and correlation. The potential for
digital images lies not only in greater diagnostic power, but in the ability
to telecommunicate and share the images with all physicians managing the
patient, regardless of geographic location.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
coronary care unit
technology
telemedicine
EMTREE MEDICAL INDEX TERMS
article
cardiovascular disease (therapy)
health care quality
health insurance
heart catheterization
hospital
human
multihospital system
patient care
standard
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
10143351 (http://www.ncbi.nlm.nih.gov/pubmed/10143351)
PUI
L125089111
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1032
TITLE
Secondary systemic insults to the brain
ORIGINAL (NON-ENGLISH) TITLE
CONCEPT D'AGRESSION CEREBRALE SECONDAIRE D'ORIGINE SYSTEMIQUE (ACSOS)
AUTHOR NAMES
Moeschler O.
Boulard G.
Ravussin P.
AUTHOR ADDRESSES
(Moeschler O.; Boulard G.; Ravussin P.) Service d'Anesthesiologie, Centre
Hospitalier Univ. Vaudois, 1011 Lausanne, Switzerland.
CORRESPONDENCE ADDRESS
O. Moeschler, Service d'Anesthesiologie, Centre Hospitalier Univ. Vaudois,
1011 Lausanne, Switzerland.
SOURCE
Annales Francaises d'Anesthesie et de Reanimation (1995) 14:1 (114-121).
Date of Publication: 1995
ISSN
0750-7658
BOOK PUBLISHER
Elsevier Masson SAS, 62 rue Camille Desmoulins, Issy les Moulineaux Cedex,
France.
ABSTRACT
The prevention and treatment of secondary insults to the brain of systemic
origin in severely head injured patients remain of utmost importance. Head
injury remains the leading cause of traumatic death, being responsible for
50-60% of fatalities. Head-injured patients not only suffer from the primary
injury at the time of trauma, but also from the secondary, largely
ischaemic, brain damage that occurs later. Some of these insults are of
extracranial origin (or systemic), such as arterial hypotension, hypoxaemia,
hypercarbia and anaemia. Their impact on mortality and morbidity is
extremely high and requires greater efforts in improving the care of
head-injured patients. Systemic insults occur either before the patient
reaches hospital or during interfaculty transfer or, in a surprisingly large
number of cases, within hospital during emergency procedures, intrahospital
transport or during their stay in intensive care units. Hypoxaemia, although
quite easy to treat, is still common. This calls for better and earlier
protection of the airway, more systematic administration of oxygen to trauma
patients and wider use of pulse oximetry. Arterial hypotension has even more
dramatic consequences in severe head injury. Recent studies indicate that
short episodes of hypotension may induce severe brain ischaemia, that will
be present even after complete systemic haemodynamic restoration. The
treatment of hypotensive episodes should be immediate and agressive. In some
circumstances, restoration of an adequate cerebral perfusion pressure may
not be obtained sufficiently rapidly with fluids alone and may require early
use of vasopressors. Optimal haemodynamic resuscitation of the trauma
patient with haemorrhagic hypotension and severe head injury remains a
special challenge. Hypertonic saline, with or without additional colloids,
could be beneficial, especially in the prehospital setting. Numerous
experimental and a few recent clinical studies are promising but need
further clinical investigations.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
hypertensive agent (drug therapy)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
brain injury (complication, drug therapy, prevention, therapy)
brain ischemia (complication, drug therapy, prevention, therapy)
colloid
head injury
EMTREE MEDICAL INDEX TERMS
bleeding (complication, therapy)
complication
conference paper
drug therapy
hemodynamics
human
hypotension (complication, drug therapy, therapy)
intensive care
therapy
EMBASE CLASSIFICATIONS
Surgery (9)
Neurology and Neurosurgery (8)
Cardiovascular Diseases and Cardiovascular Surgery (18)
Anesthesiology (24)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
French
LANGUAGE OF SUMMARY
French, English
EMBASE ACCESSION NUMBER
1995089370
MEDLINE PMID
7677275 (http://www.ncbi.nlm.nih.gov/pubmed/7677275)
PUI
L25087968
DOI
10.1016/S0750-7658(05)80159-5
FULL TEXT LINK
http://dx.doi.org/10.1016/S0750-7658(05)80159-5
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 1033
TITLE
Transferable resistance to β-lactams in a nosocomial strain of Xanthomonas
maltophilia [1]
AUTHOR NAMES
Hupkova M.
Blahova J.
Kralikova J.
Kremery V.
AUTHOR ADDRESSES
(Hupkova M.; Blahova J.; Kralikova J.; Kremery V.) Preventive/Clinical
Medicine Inst., Limbova 14, 83301 Bratislava, Slovakia.
CORRESPONDENCE ADDRESS
M. Hupkova, Preventive/Clinical Medicine Inst., Limbova 14, 83301
Bratislava, Slovakia.
SOURCE
Antimicrobial Agents and Chemotherapy (1995) 39:4 (1011-1012). Date of
Publication: 1995
ISSN
0066-4804
BOOK PUBLISHER
American Society for Microbiology, 1752 N Street N.W., Washington, United
States.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
aztreonam (pharmacology)
beta lactam antibiotic (pharmacology)
cefotaxime (pharmacology)
ceftazidime (pharmacology)
imipenem (pharmacology)
EMTREE DRUG INDEX TERMS
amikacin (pharmacology)
carbenicillin (pharmacology)
clavulanic acid (pharmacology)
kanamycin (pharmacology)
ofloxacin (pharmacology)
rifampicin (pharmacology)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
Stenotrophomonas maltophilia
EMTREE MEDICAL INDEX TERMS
antibiotic resistance
antibiotic sensitivity
bacterium isolation
bacterium transduction
Escherichia coli
hospital infection (etiology)
human
human cell
intensive care unit
letter
priority journal
Proteus mirabilis
quantitative diagnosis
CAS REGISTRY NUMBERS
amikacin (37517-28-5, 39831-55-5)
aztreonam (78110-38-0)
carbenicillin (17230-86-3, 4697-36-3, 4800-94-6)
cefotaxime (63527-52-6, 64485-93-4)
ceftazidime (72558-82-8)
clavulanic acid (58001-44-8)
imipenem (64221-86-9)
kanamycin (11025-66-4, 61230-38-4, 8063-07-8)
ofloxacin (82419-36-1)
rifampicin (13292-46-1)
EMBASE CLASSIFICATIONS
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
Clinical and Experimental Pharmacology (30)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1995111144
MEDLINE PMID
7785971 (http://www.ncbi.nlm.nih.gov/pubmed/7785971)
PUI
L25109734
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1034
TITLE
Intrahospital transport of neuro ICU patients.
AUTHOR NAMES
Kalisch B.J.
Kalisch P.A.
Burns S.M.
Kocan M.J.
Prendergast V.
AUTHOR ADDRESSES
(Kalisch B.J.; Kalisch P.A.; Burns S.M.; Kocan M.J.; Prendergast V.)
University of Michigan School of Nursing, Ann Arbor 48109, USA.
CORRESPONDENCE ADDRESS
B.J. Kalisch, University of Michigan School of Nursing, Ann Arbor 48109,
USA.
SOURCE
The Journal of neuroscience nursing : journal of the American Association of
Neuroscience Nurses (1995) 27:2 (69-77). Date of Publication: Apr 1995
ISSN
0888-0395
ABSTRACT
Neuroscience intensive care unit (NICU) patients are frequently transported
out of the critical care environment for diagnostic and interventional
procedures. Four hundred and seventy-one such transports from seventeen
clinical centers were studied to identify the characteristics of
intrahospital transport. Data collected included the destination and
duration of transport, number and type of personnel involved, changes in
monitoring and treatment during transport, adverse patient responses and the
impact on patients left in the unit. Differences between transports
characterized as elective or emergent in nature were noted. Results validate
that intrahospital transport of NICU patients is both time and labor
intensive. The study also suggests that the optimal process for safe and
efficient transport is yet to be designed.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
central nervous system disease
intensive care
patient care
patient transport
EMTREE MEDICAL INDEX TERMS
article
devices
emergency
human
intensive care unit
monitoring
nursing
statistics
time
LANGUAGE OF ARTICLE
English
MEDLINE PMID
7622953 (http://www.ncbi.nlm.nih.gov/pubmed/7622953)
PUI
L125093321
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1035
TITLE
How to transfer a postoperative patient to the intensive care unit.
Strategies for documentation, evaluation, and management.
AUTHOR NAMES
Nearman H.S.
Popple C.G.
AUTHOR ADDRESSES
(Nearman H.S.; Popple C.G.) University Hospitals of Cleveland, USA.
CORRESPONDENCE ADDRESS
H.S. Nearman, University Hospitals of Cleveland, USA.
SOURCE
The Journal of critical illness (1995) 10:4 (275-280). Date of Publication:
Apr 1995
ISSN
1040-0257
ABSTRACT
Postoperative intensive care is often required for patients who have
underlying cardiac or respiratory dysfunction, who undergo major surgery, or
who experience major perioperative complications. The initial report should
list the patient's intravenous lines, catheters, and surgical drains or
tubes, as well as whether ventilation is needed; this allows the intensive
care unit (ICU) staff to set up appropriate equipment. On the patient's
arrival in the ICU, document the medical history, anesthetics given, surgery
performed, and intraoperative events. Perform an organ system review with
ongoing assessment at 15-minute intervals. Residual effects of anesthetic
agents can include respiratory depression, hypotension, and bradycardia.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
postoperative care
EMTREE MEDICAL INDEX TERMS
human
medical record
monitoring
nursing
organization and management
postoperative complication
review
LANGUAGE OF ARTICLE
English
MEDLINE PMID
10150500 (http://www.ncbi.nlm.nih.gov/pubmed/10150500)
PUI
L125085188
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1036
TITLE
Audit of neonatal intensive care transport [5]
AUTHOR NAMES
Whitfield J.M.
AUTHOR ADDRESSES
(Whitfield J.M.) Neonatology, Baylor College of Medicine, 1 Baylor Plaza,
Houston, TX 77030, United States.
CORRESPONDENCE ADDRESS
J.M. Whitfield, Neonatology, Baylor College of Medicine, 1 Baylor Plaza,
Houston, TX 77030, United States.
SOURCE
Archives of Disease in Childhood (1995) 72:1 (98). Date of Publication: 1995
ISSN
0003-9888
BOOK PUBLISHER
BMJ Publishing Group, Tavistock Square, London, United Kingdom.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
newborn intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
clinical audit
human
letter
newborn
priority journal
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1995043612
MEDLINE PMID
7717754 (http://www.ncbi.nlm.nih.gov/pubmed/7717754)
PUI
L25042313
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1037
TITLE
Audit of neonatal intensive care transport [3]
AUTHOR NAMES
Whitfield J.M.
AUTHOR ADDRESSES
(Whitfield J.M.) Baylor College Medicine, 1 Baylor Plaza, Houston, TX 77030,
United States.
CORRESPONDENCE ADDRESS
J.M. Whitfield, Baylor College Medicine, 1 Baylor Plaza, Houston, TX 77030,
United States.
SOURCE
Archives of Disease in Childhood (1995) 72:1 SUPPL. (F79-F80). Date of
Publication: 1995
ISSN
0003-9888
BOOK PUBLISHER
BMJ Publishing Group, Tavistock Square, London, United Kingdom.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
newborn intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
clinical audit
human
letter
priority journal
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1995043634
MEDLINE PMID
7743294 (http://www.ncbi.nlm.nih.gov/pubmed/7743294)
PUI
L25042335
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1038
TITLE
Intrahospital transportation of critically ill children
ORIGINAL (NON-ENGLISH) TITLE
Traslado intrahospitalario del niño críticamente enfermo.
AUTHOR NAMES
Cruzado García M.D.
Rubio Quiñones F.
Cruzado García M.J.
Ignacio García E.
Mateo Sánchez J.I.
AUTHOR ADDRESSES
(Cruzado García M.D.; Rubio Quiñones F.; Cruzado García M.J.; Ignacio García
E.; Mateo Sánchez J.I.)
CORRESPONDENCE ADDRESS
M.D. Cruzado García,
SOURCE
Enfermería intensiva / Sociedad Española de Enfermería Intensiva y Unidades
Coronarias (1995) 6:1 (20-24). Date of Publication: 1995 Jan-Mar
ISSN
1130-2399
ABSTRACT
The intrahospital transport of a critically ill child is always a risky
procedure. While it is being done, some complications which can worsen their
initial situation may appear, so the benefits that this transport can
provide must outweigh the possible risks. Preparing the patient and
succeeding in performing a safe transport need the use of the proper
equipment and human resources. Its degree of complexity and preparation must
be proportional to the situation of instability of the patient and to the
probability of increasing such instability, which implies performing a
careful evaluation of the child and its real and potential needs previously.
We also state some general ideas about the way of preparing and performing
this kind of intrahospital transport in its different stages.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
child
human
LANGUAGE OF ARTICLE
Spanish
MEDLINE PMID
7493271 (http://www.ncbi.nlm.nih.gov/pubmed/7493271)
PUI
L126182724
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1039
TITLE
Interruption of oxygen therapy during intrahospital transport of non-ICU
patients: Elimination of a common problem through caregiver education
AUTHOR NAMES
Stubbs C.R.
Crogan K.J.
Pierson D.J.
AUTHOR ADDRESSES
(Stubbs C.R.; Crogan K.J.; Pierson D.J.) Respiratory Care Department, 325
Ninth Avenue, Seattle, WA 98104, United States.
CORRESPONDENCE ADDRESS
C.R. Stubbs, Respiratory Care Department, 325 Ninth Avenue, Seattle, WA
98104, United States.
SOURCE
Respiratory Care (1994) 39:10 (968-972). Date of Publication: 1994
ISSN
0098-9142
BOOK PUBLISHER
Daedalus Enterprises Inc., 9425 North MacArthur Blvd, Suite 100, Irving,
United States.
ABSTRACT
BACKGROUND: Hospital inpatients frequently leave their rooms for diagnostic
procedures and for other reasons. For some, interruption of oxygen therapy
during transport could lead to serious complications. In our institution,
non-ICU patient transport is done mainly by nonclinical personnel from an
independent transport service. MATERIALS AND METHODS: We reviewed
respiratory care department and transport service records for 5 arbitrarily
selected days to determine the number of non-ICU patients receiving O(2)
therapy, the number of times these patients were transported, and the number
of occasions on which O(2) was used during the transport. We then
interviewed the primary nurse for each patient transported without O(2) and
reviewed the charts of those patients to determine whether this practice was
consistent with the therapy as it had been ordered. After our initial
investigation showed a high rate of transport without prescribed O(2), we
sent memoranda to all nursing units describing proper procedures for
transport of patients for whom O(2) had been ordered. We then repeated the
audit. Because the second audit showed the need, we conducted education
sessions with all nursing personnel on the affected units and posted
guidelines for O(2) use during transport. A third audit was then conducted.
In addition, we performed a telephone survey of respiratory care department
managers to learn the patient-transport practices in all hospitals in our
state with more than 200 beds, using a structured questionnaire. RESULTS:
During the initial 125 patient-days of O(2) therapy, O(2) accompanied
patients on only 30 of 55 transports (55%). After distribution of memoranda,
O(2) use increased to 28 of 35 transports (80%) during 82 patient-days. The
second educational effort resulted in O(2) use with all 35 transports (100%)
performed during 99 patient-days. Survey results from 24 hospitals with
225-680 beds showed that 11 (46%) had separate transport services and that
decisions on O(2) use during patient transport were generally made by
nursing staff. Although respiratory care departments supplied the O(2)
equipment, their personnel were involved in non-ICU transports in only 5/24
hospitals. CONCLUSIONS: Patients receiving O(2) therapy on acute-care wards
are often transported to other areas of the hospital without O(2). This
potentially dangerous practice can be corrected by respiratory care
practitioners through educational efforts targeted toward those responsible
for administering O(2) therapy in non-ICU hospital areas.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
nursing education
oxygen therapy
patient transport
respiratory care
EMTREE MEDICAL INDEX TERMS
article
caregiver
clinical audit
human
nursing staff
questionnaire
United States
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1994338396
MEDLINE PMID
10146115 (http://www.ncbi.nlm.nih.gov/pubmed/10146115)
PUI
L24329090
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1040
TITLE
Intrahospitalary transport of children in critical conditions
ORIGINAL (NON-ENGLISH) TITLE
TRANSPORTE INTRAHOSPITALARIO DE NINOS CRITICOS
AUTHOR NAMES
Rubio Quinones F.
Cruzado Garcia M.D.
AUTHOR ADDRESSES
(Rubio Quinones F.; Cruzado Garcia M.D.) Unidad de Cuidados Intens.
Pediatr., Hospital Univ. 'Puerta del Mar', Ana de Viya 21, 11009 Cadiz,
Spain.
CORRESPONDENCE ADDRESS
F. Rubio Quinones, Unidad de Cuidados Intens. Pediatr., Hospital Univ.
'Puerta del Mar', Ana de Viya 21, 11009 Cadiz, Spain.
SOURCE
Revista Espanola de Pediatria (1994) 50:299 (399-403). Date of Publication:
1994
ISSN
0034-947X
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child hospitalization
patient transport
EMTREE MEDICAL INDEX TERMS
disease severity
human
review
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
Spanish
EMBASE ACCESSION NUMBER
1994320782
PUI
L24320090
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1041
TITLE
The transport of neonates to an intensive care unit.
AUTHOR NAMES
Pieper C.H.
Smith J.
Kirsten G.F.
Malan P.
AUTHOR ADDRESSES
(Pieper C.H.; Smith J.; Kirsten G.F.; Malan P.) Department of Paediatrics
and Child Health, Tygerberg Hospital, W. Cape.
CORRESPONDENCE ADDRESS
C.H. Pieper, Department of Paediatrics and Child Health, Tygerberg Hospital,
W. Cape.
SOURCE
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
(1994) 84:11 Suppl (801-803). Date of Publication: Nov 1994
ISSN
0256-9574
ABSTRACT
OBJECTIVE: To describe the mode of transport, the type of patient
transferred and outcome as defined by death or discharge from hospital.
DESIGN: A retrospective study was done of all neonates transferred from
outside the designated drainage area of the hospital. SETTING: The study was
done at the level 3 Neonatal Intensive Care Unit at Tygerberg Hospital for
the period January-September 1992. PARTICIPANTS: From a total of 58 infants
52 were enrolled; they originated over a vast area of the western and
northern Cape Province. MAIN OUTCOME MEASURES: Reasons for transfer, mode of
transport and survival were measured. RESULTS: None of the infants died
during transport. In total 11 (21%) of the 52 died. Categorising outcome
according to transport method showed 100% survival of babies transported by
fixed-wing aircraft, 94% survival if transport was by helicopter, and 70%
survival if transported by ambulance. The non-survivors had a higher mean
gestational age (P < 0.05) than the survivors and included 8 (73%) with
asphyxia-related meconium aspiration syndrome. When the primary referral
diagnosis was considered, 8 (27%) of 29 infants with respiratory failure of
any cause, and 2 (28%) of those with neurological problems, died. All the
infants transported because of a surgical emergency survived. CONCLUSION:
These results show a high survival rate in transported infants, with the
highest mortality in the asphyxia-related meconium aspiration syndrome and
the infants transported by ambulance. The preponderance of infants with
meconium aspiration syndrome might reflect the standard of perinatal care
provided in the outlying regions of the western and northern Cape.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
newborn intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
cause of death
human
infant mortality
methodology
newborn
retrospective study
standard
LANGUAGE OF ARTICLE
English
MEDLINE PMID
8914542 (http://www.ncbi.nlm.nih.gov/pubmed/8914542)
PUI
L127192960
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1042
TITLE
A new dimension of the PACU: the dilemma of the ICU overflow patient.
AUTHOR NAMES
Johannes M.S.
AUTHOR ADDRESSES
(Johannes M.S.)
CORRESPONDENCE ADDRESS
M.S. Johannes,
SOURCE
Journal of post anesthesia nursing (1994) 9:5 (297-300). Date of
Publication: Oct 1994
ISSN
0883-9433
ABSTRACT
With the increase in the number of critically ill patients needing extended
periods of time in the ICU and the subsequent shortage of ICU beds,
hospitals have examined ways to use the PACU as an alternative for the
short-term critically ill patient. This article identifies common problems
encountered by the PACU staff, and the author suggests criteria for
establishing and implementing guidelines for successful integration of these
short-term critically ill patients without losing sight of the PACU's goals
and compromising patient care. The criteria for establishing guidelines were
based on the personal experience of the author in developing a program for
ICU overflow patients, as well as from experiences of other PACU nurses
working in PACUs where successful guidelines currently are used.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital bed capacity
intensive care
intensive care unit
patient transport
postanesthesia nursing
recovery room
EMTREE MEDICAL INDEX TERMS
article
clinical protocol
human
methodology
LANGUAGE OF ARTICLE
English
MEDLINE PMID
7807407 (http://www.ncbi.nlm.nih.gov/pubmed/7807407)
PUI
L125022060
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1043
TITLE
Paediatric intensive care transport
AUTHOR NAMES
Macrae D.J.
AUTHOR ADDRESSES
(Macrae D.J.) Paediatric Intensive Care Units, Hospital for Sick Children,
Great Ormond Street, London WC1N 3JH, United Kingdom.
CORRESPONDENCE ADDRESS
D.J. Macrae, Paediatric Intensive Care Units, Hospital for Sick Children,
Great Ormond Street, London WC1N 3JH, United Kingdom.
SOURCE
Archives of Disease in Childhood (1994) 71:2 (175-178). Date of Publication:
1994
ISSN
0003-9888
BOOK PUBLISHER
BMJ Publishing Group, Tavistock Square, London, United Kingdom.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
EMTREE MEDICAL INDEX TERMS
patient transport
pediatrics
priority journal
short survey
United Kingdom
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1994261117
MEDLINE PMID
7944547 (http://www.ncbi.nlm.nih.gov/pubmed/7944547)
PUI
L24261130
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1044
TITLE
Audit of neonatal intensive care transport
AUTHOR NAMES
Leslie A.J.
Stephenson T.J.
AUTHOR ADDRESSES
(Leslie A.J.; Stephenson T.J.) Dept. of Neonatal Medicine/Surgery, City
Hospital, Hucknall Road, Nottingham NG5 1PB, United Kingdom.
CORRESPONDENCE ADDRESS
A.J. Leslie, Dept. of Neonatal Medicine/Surgery, City Hospital, Hucknall
Road, Nottingham NG5 1PB, United Kingdom.
SOURCE
Archives of Disease in Childhood (1994) 71:1 SUPPL. (F61-F66). Date of
Publication: 1994
ISSN
0003-9888
BOOK PUBLISHER
BMJ Publishing Group, Tavistock Square, London, United Kingdom.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
newborn intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
clinical audit
human
newborn
priority journal
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Obstetrics and Gynecology (10)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1994234395
MEDLINE PMID
7605415 (http://www.ncbi.nlm.nih.gov/pubmed/7605415)
PUI
L24238554
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1045
TITLE
Mothers of chronically ill neonates and primary nurses in the NICU: transfer
of care.
AUTHOR NAMES
Scharer K.
Brooks G.
AUTHOR ADDRESSES
(Scharer K.; Brooks G.)
CORRESPONDENCE ADDRESS
K. Scharer,
SOURCE
Neonatal network : NN (1994) 13:5 (37-47). Date of Publication: Aug 1994
ISSN
0730-0832
ABSTRACT
The purpose of this study was to explore the relationship between nurse and
mother during the ill neonate's hospitalization and examine how this
relationship influenced the mother's parenting of her infant during the
hospitalization. Using qualitative methods, we separately interviewed ten
mothers and nine primary nurses about their relationships, their views on
each other, and the mothers' infant care. The tape-recorded interviews were
transcribed verbatim, themes were extracted, and categories were developed
for coding the data. As issues emerged, they were further explored in
follow-up interviews. We identified four stages in the process of
transferring the care of the infant from nurse to mother. The mother-nurse
relationships were influenced by both the nurses' and the mothers' typical
interactional patterns. Nurses had definite ideas about who was an "ideal"
mother. To the mothers, the nurses' competence and caring attitude toward
their infants were most important. The process by which the nurse and mother
interact to provide care for the infant and alter their roles during the
course of the hospitalization is linked to various factors and aspects of
the nurse-mother relationship.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child parent relation
chronic disease
human relation
mother
newborn nursing
nursing staff
primary health care
EMTREE MEDICAL INDEX TERMS
adult
article
human
methodology
newborn
newborn intensive care
nursing
nursing methodology research
psychological aspect
LANGUAGE OF ARTICLE
English
MEDLINE PMID
7854261 (http://www.ncbi.nlm.nih.gov/pubmed/7854261)
PUI
L125030693
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1046
TITLE
Hospital delays compound patient and transport delays
AUTHOR NAMES
Lenfant C.
AUTHOR ADDRESSES
(Lenfant C.) NIH, Bldg 31, Berthesda, MD 20892, United States.
CORRESPONDENCE ADDRESS
C. Armstrong, NIH, Bldg 31, Berthesda, MD 20892, United States.
SOURCE
Journal of the American Medical Association (1994) 271:10 (738). Date of
Publication: 1994
ISSN
0098-7484
EMTREE DRUG INDEX TERMS
fibrinolytic agent (drug therapy)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital
patient transport
EMTREE MEDICAL INDEX TERMS
acute heart infarction (diagnosis, drug therapy)
coronary care unit
electrocardiogram
emergency medicine
emergency ward
fibrinolytic therapy
human
note
priority journal
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Cardiovascular Diseases and Cardiovascular Surgery (18)
Health Policy, Economics and Management (36)
Drug Literature Index (37)
Internal Medicine (6)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1994079001
PUI
L24074510
DOI
10.1001/jama.271.10.738
FULL TEXT LINK
http://dx.doi.org/10.1001/jama.271.10.738
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1047
TITLE
A strategy for decreasing anxiety of ICU transfer patients and their
families.
AUTHOR NAMES
Maillet R.J.
Pata I.
Grossman S.
AUTHOR ADDRESSES
(Maillet R.J.; Pata I.; Grossman S.)
CORRESPONDENCE ADDRESS
R.J. Maillet,
SOURCE
NursingConnections (1993) 6:4 (5-8). Date of Publication: 1993 Winter
ISSN
0895-2809
ABSTRACT
With the growing number of clients transferred out of the intensive care
units (ICUs) following increasingly shorter stays, time constraints have
become a barrier to effective teaching. Written information that is readily
available to clients helps resolve this problem. A pamphlet (in Spanish and
English) was developed to ease the move for patients, families, and critical
care and medical nurses from a medical ICU (MICU) to a general floor.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
anxiety (prevention)
family
intensive care
patient education
patient transport
EMTREE MEDICAL INDEX TERMS
article
human
nursing
psychological aspect
publication
LANGUAGE OF ARTICLE
English
MEDLINE PMID
8133938 (http://www.ncbi.nlm.nih.gov/pubmed/8133938)
PUI
L24879280
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1048
TITLE
Transporting critically ill patients. American College of Critical Care
Medicine, Society of Critical Care Medicine, and American Association of
Critical-Care Nurses.
AUTHOR ADDRESSES
SOURCE
Health devices (1993) 22:12 (590-591). Date of Publication: Dec 1993
ISSN
0046-7022
ABSTRACT
Guidelines for transporting critically ill patients were published
simultaneously in the June 1993 issue of Critical Care Medicine
(21[6]:931-7) and the May 1993 issue of the American Journal of Critical
Care (2[3]:189-95). Developed by a task force composed of members from the
American College of Critical Care Medicine, the Society of Critical Care
Medicine, and the American Association of Critical-Care Nurses (AACN), these
guidelines, summarized below, outline the reasons and requirements for
transporting patients, including the personnel who should be involved and
the equipment (including monitors) that should accompany the patient. The
task force's recommendations are consistent with ECRI's previous
recommendations, also summarized below, but are more comprehensive and
stringent in some respects and provide additional details.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
critical illness
human
practice guideline
standard
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
8113073 (http://www.ncbi.nlm.nih.gov/pubmed/8113073)
PUI
L24876696
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1049
TITLE
Critical care pediatrician-led aeromedical transports: Physician
interventions and predictiveness of outcome
AUTHOR NAMES
Strauss R.H.
Rooney B.
AUTHOR ADDRESSES
(Strauss R.H.; Rooney B.) 1836 South Avenue, La Crosse, WI 54606, United
States.
CORRESPONDENCE ADDRESS
R.H. Strauss, 1836 South Avenue, La Crosse, WI 54606, United States.
SOURCE
Pediatric Emergency Care (1993) 9:5 (270-274). Date of Publication: 1993
ISSN
0749-5161
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
ABSTRACT
This article reviews the one-year experience (March 28, 1987 to March 27,
1988) of the pediatric transport service of the University of Wisconsin
Hospital and Clinics (UWHC). The UWHC pediatric transport team consisted of
a critical care flight nurse and a pediatric critical care attending
physician or fellow. The aims of the study were to: 1) determine the types
and number of interventions performed by the physicians to gauge the need
for physician presence on transport: and 2) determine which variables
(severity of illness scores, age, gender, distance from hospital) recorded
at the time of the referral telephone call best predicted outcome of the
patient. There were 109 children transported by helicopter during the
one-year study period. Thirty percent of the patients (43% of trauma
patients and 22% of medical patients) had no interventions at all, 18% of
medical patients and 10% of trauma patients were intubated, and 9% of
medical patients and no trauma patients had central venous catheters
inserted. Multivariate modeling determined that among medical patients,
outcome could be accurately predicted only 38% of the time if telephone
PRISM (Pediatric Risk of Mortality) scores were determined. Among trauma
patients, if gender, age, distance from UWHC, and telephone PRISM scores
were known, outcome could be predicted 74% of the time. Unless studies show
the benefit of pediatrician-accompanied transport, transports could probably
be done without critical care pediatricians. Severity of illness scoring at
this time is probably not sufficiently accurate to warrant its use for
deciding the appropriateness of transport of pediatric patients.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
pediatrician
EMTREE MEDICAL INDEX TERMS
age
article
central venous catheter
child
disease severity
female
gender
helicopter
human
infant
injury (epidemiology, therapy)
intubation
major clinical study
male
mortality
resuscitation
telephone
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1993306391
MEDLINE PMID
8247931 (http://www.ncbi.nlm.nih.gov/pubmed/8247931)
PUI
L23306377
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1050
TITLE
Continuing evolution of regionalized perinatal care: Community hospital
neonatal convalescent care
AUTHOR NAMES
Pittard III W.B.
Geddes K.M.
Ebeling M.
Hulsey T.C.
AUTHOR ADDRESSES
(Pittard III W.B.; Geddes K.M.; Ebeling M.; Hulsey T.C.) Department of
Pediatrics, Medical University of South Carolina, 171 Ashley Ave,
Charleston, SC 29425-3313, United States.
CORRESPONDENCE ADDRESS
W.B. Pittard III, Department of Pediatrics, Medical University of South
Carolina, 171 Ashley Ave, Charleston, SC 29425-3313, United States.
SOURCE
Southern Medical Journal (1993) 86:8 (903-907). Date of Publication: 1993
ISSN
0038-4348
BOOK PUBLISHER
Lippincott Williams and Wilkins, 530 Walnut Street, Philadelphia, United
States.
ABSTRACT
We describe the convalescent care of 169 back-transported (to community
hospitals) and 285 eligible but not back-transported very low birth weight
(VLBW) infants. Eligible infants who were not back transported to a level I
or II community hospital were transferred to a level II nursery within the
Medical University of South Carolina (MUSC) for convalescent care. Study
infants were admitted to the neonatal intensive care unit (NICU) at MUSC
from July 1985 through June 1989. They were admitted after maternal
transport to MUSC for imminent delivery (N = 159), out-born community
delivery (N = 55), or in-born MUSC delivery (N = 240). The mean ± SD birth
weight and gestational age and the NICU admission diagnoses for the
back-transported and non-back-transported neonates were similar. The mean ±
SD weight of neonates at the time they were back transported was
significantly greater than the weight of neonates at the time of
intrahospital transfer. In contrast, the discharge weight to home and total
days hospitalized were significantly less in the back-transported infants.
Five back-transported neonates (3%) and 12 non-back-transported neonates
(4%) were readmitted to the NICU. The back- transported infants used more
than 3,800 bed days at community hospitals that would otherwise have been
spent in the regional center, thus facilitating increased parental and
primary physician involvement in their care.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient transport
perinatal care
EMTREE MEDICAL INDEX TERMS
article
community hospital
convalescence
cost benefit analysis
human
major clinical study
newborn
newborn intensive care
priority journal
regionalization
very low birth weight (therapy)
EMBASE CLASSIFICATIONS
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1993246393
MEDLINE PMID
8351551 (http://www.ncbi.nlm.nih.gov/pubmed/8351551)
PUI
L23246379
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1051
TITLE
Transfer of critical patients to hospitals
ORIGINAL (NON-ENGLISH) TITLE
TRANSFERENCIA DE PACIENTES CRITICOS A HOSPITALES
AUTHOR NAMES
Alvarez J.A.
Ibarguren M.C.
Corral A.
Taboada M.
Freire M.
AUTHOR ADDRESSES
(Alvarez J.A.; Ibarguren M.C.; Corral A.; Taboada M.; Freire M.) Servicio
Especial de Urgencias, INSALUD, C/Lope de Rueda, 43, 28009 Madrid, Spain.
CORRESPONDENCE ADDRESS
J.A. Alvarez, Servicio Especial de Urgencias, INSALUD, C/Lope de Rueda, 43,
28009 Madrid, Spain.
SOURCE
Medicina Intensiva (1993) 17:3 (148-153). Date of Publication: 1993
ISSN
0210-5691
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency
intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
article
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
Spanish
LANGUAGE OF SUMMARY
English, Spanish
EMBASE ACCESSION NUMBER
1993139267
PUI
L23139253
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1052
TITLE
Transfer out of critical care: Freedom or fear?
AUTHOR NAMES
Saarmann L.
AUTHOR ADDRESSES
(Saarmann L.) School of Nursing, San Diego State University, San Diego, CA,
United States.
CORRESPONDENCE ADDRESS
L. Saarmann, School of Nursing, San Diego State University, San Diego, CA,
United States.
SOURCE
Critical Care Nursing Quarterly (1993) 16:1 (78-85). Date of Publication:
1993
ISSN
0887-9303
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
anxiety
intensive care
patient attitude
EMTREE MEDICAL INDEX TERMS
coping behavior
human
nurse patient relationship
patient transport
review
separation anxiety (etiology)
stress
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Psychiatry (32)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1993119155
MEDLINE PMID
8504366 (http://www.ncbi.nlm.nih.gov/pubmed/8504366)
PUI
L23119155
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1053
TITLE
The organization of a pediatric critical care transport program
AUTHOR NAMES
Pon S.
Notterman D.A.
AUTHOR ADDRESSES
(Pon S.; Notterman D.A.) New York Hospital, 525 East 68th Street, New York,
NY 10021, United States.
CORRESPONDENCE ADDRESS
S. Pon, New York Hospital, 525 East 68th Street, New York, NY 10021, United
States.
SOURCE
Pediatric Clinics of North America (1993) 40:2 (241-261). Date of
Publication: 1993
ISSN
0031-3955
BOOK PUBLISHER
W.B. Saunders, Independence Square West, Philadelphia, United States.
ABSTRACT
Highly specialized pediatric critical care centers have matured
significantly over the past two decades; however, access to this care is
limited to tertiary care facilities and constrained by geography. With the
advances of transport medicine, great distances can be spanned to bring
critical care to the patient and provide effective treatment and safe
transport systems where specialized care was previously unavailable. A
patchwork of diverse transport systems perform pediatric transports with
significant differences in the level of pediatric critical care. The optimal
transport system has yet to be fully defined, but many successful systems
share fundamental elements of organization.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
pediatrics
EMTREE MEDICAL INDEX TERMS
finance
health care personnel
medical device
medical education
organization
priority journal
responsibility
review
telecommunication
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1993111302
MEDLINE PMID
8451080 (http://www.ncbi.nlm.nih.gov/pubmed/8451080)
PUI
L23111302
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1054
TITLE
Ins and outs of intrafacility transfers.
AUTHOR NAMES
Colborn C.
Schulman E.
Casper M.
AUTHOR ADDRESSES
(Colborn C.; Schulman E.; Casper M.)
CORRESPONDENCE ADDRESS
C. Colborn,
SOURCE
Contemporary longterm care (1993) 16:5 (28, 95). Date of Publication: May
1993
ISSN
8750-9652
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
nursing home
patient advocacy
patient transport
EMTREE MEDICAL INDEX TERMS
article
health care facility
legal aspect
organization and management
progressive patient care
standard
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
10129659 (http://www.ncbi.nlm.nih.gov/pubmed/10129659)
PUI
L23936639
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1055
TITLE
Transfer of a patient with a ventricular assist device to a non-critical
care area
AUTHOR NAMES
Reedy J.E.
AUTHOR ADDRESSES
(Reedy J.E.) Dept. of Surgery, Saint Louis University Hospital, 3635 Vista
Avenue at Grand Blvd., St. Louis, MO 63110-0250, United States.
CORRESPONDENCE ADDRESS
J.E. Reedy, Dept. of Surgery, Saint Louis University Hospital, 3635 Vista
Avenue at Grand Blvd., St. Louis, MO 63110-0250, United States.
SOURCE
Heart and Lung: Journal of Critical Care (1993) 22:1 (71-76). Date of
Publication: 1993
ISSN
0147-9563
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
ABSTRACT
Ventricular assist device (VAD) support has traditionally been associated
with critically ill patients. Indeed, a VAD is inserted as the last hope for
patients with cardiogenic shock who are unresponsive to conventional
therapy. However, many patients bridged to potential cardiac transplantation
are no longer critically ill after hemodynamic stabilization is achieved
with VAD support. The focus of this article is to provide guidelines
established for the transfer and provision of quality nursing care for
patients with a VAD on a general cardiothoracic nursing floor.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
assisted circulation
patient transport
EMTREE MEDICAL INDEX TERMS
article
coronary care unit
critical illness
health care cost
nursing
patient education
priority journal
staff training
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1993046658
MEDLINE PMID
8420859 (http://www.ncbi.nlm.nih.gov/pubmed/8420859)
PUI
L23046658
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1056
TITLE
Improving the patient transfer process at Bellin Hospital.
AUTHOR ADDRESSES
SOURCE
The Quality letter for healthcare leaders (1993) 5:1 (4-5). Date of
Publication: Feb 1993
ISSN
1047-5311
ABSTRACT
Project: To facilitate timely and efficient transfers of patients on the
cardiac service. Principals: Nursing staff from the intensive care (ICU),
intermediate care (IMCU), and step down units. Process Improvement Method:
VALUE PLUS+, a scientific, problem-solving model developed at Bellin that
requires statistical thinking. Timeline: March 1990-August 1991. Key
Findings or Improvements: Mid-morning, early afternoon, and early evening
are the ideal times for patient transfers; late morning and mid-to-late
afternoon transfers should be avoided. Unit staff can plan transfers for
preferable times by predicting the number of transfers from ICU and IMCU,
based on a percentage of the previous day's census. Results: The number of
process steps to transfer a patient was reduced from 21 to 13. 80 percent of
transfers now occur during three designated time periods. The role of
transport staff has been expanded to free up nursing time.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
coronary care unit
health care quality
patient transport
volunteer
EMTREE MEDICAL INDEX TERMS
article
hospital bed capacity
nonbiological model
organization
organization and management
personnel management
problem solving
standard
statistics
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
10125550 (http://www.ncbi.nlm.nih.gov/pubmed/10125550)
PUI
L23894221
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1057
TITLE
Paediatric inter-facility transport: The parents' perspective
AUTHOR NAMES
Macnab A.J.
AUTHOR ADDRESSES
(Macnab A.J.) Paediatric Transport Programme, Paediatric Critical Care Unit,
British Columbia's Children's Hosp., 4480 Oak Street, Vancouver, BC V6H 3V4,
Canada.
CORRESPONDENCE ADDRESS
A.J. Macnab, Paediatric Transport Programme, Paediatric Critical Care Unit,
British Columbia's Children's Hosp., 4480 Oak Street, Vancouver, BC V6H 3V4,
Canada.
SOURCE
Social Work in Health Care (1992) 17:3 (21-30). Date of Publication: 1992
ISSN
0098-1389
BOOK PUBLISHER
Haworth Press Inc., 10 Alice Street, Binghamton, United States.
ABSTRACT
A telephone survey was conducted to evaluate the impact on families of
inter-facility paediatric transport to a tertiary care centre. The 54
families who responded were almost unanimous in their appreciation of the
transport service and the expertise of the attendants. However, many
experienced problems, including finances, child care, travel arrangements
and accommodation. Most problems were encountered by those who did not
accompany the child in the transport vehicle, lived at a distance so that
they could not commute and did not use hospital accommodation. Further
research is suggested to assess the extent of the problems families face and
to determine appropriate solutions.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health care facility
parent
patient transport
pediatric hospital
social work
EMTREE MEDICAL INDEX TERMS
article
child care
child parent relation
family life
health care system
hospitalization
human
intensive care unit
major clinical study
questionnaire
stress
travel
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1992370433
MEDLINE PMID
1465713 (http://www.ncbi.nlm.nih.gov/pubmed/1465713)
PUI
L22370415
DOI
10.1300/J010v17n03_02
FULL TEXT LINK
http://dx.doi.org/10.1300/J010v17n03_02
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1058
TITLE
An audit of a paediatric intensive care transfer unit
AUTHOR NAMES
Robb H.M.
Hallworth D.
Skeoch C.H.
Levy C.
AUTHOR ADDRESSES
(Robb H.M.; Hallworth D.; Skeoch C.H.; Levy C.) Consultant in Anaesthesia,
Royal Hospital for Sick Children, Yorkhill, Glasgow, United Kingdom.
CORRESPONDENCE ADDRESS
H.M. Robb, Consultant in Anaesthesia, Royal Hospital for Sick Children,
Yorkhill, Glasgow, United Kingdom.
SOURCE
British Journal of Intensive Care (1992) 2:8 (371+374-376+378-379). Date of
Publication: 1992
ISSN
0961-7930
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
clinical audit
intensive care unit
workload
EMTREE MEDICAL INDEX TERMS
article
hospital management
medical staff
pediatric hospital
United Kingdom
EMBASE CLASSIFICATIONS
Health Policy, Economics and Management (36)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1993146703
PUI
L23146689
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1059
TITLE
Hemodynamic changes, hydromineral metabolism and oxygen transport during
mechanical ventilation
ORIGINAL (NON-ENGLISH) TITLE
REPERCUSIONES HEMODINAMICAS, METABOLISMO HIDROMINERAL Y TRANSPORTE DE
OXIGENO DURANTE LA VENTILACION MECANICA
AUTHOR NAMES
Nicolas Franco S.
Gomez Rubi J.A.
Gonzalez Diaz G.
AUTHOR ADDRESSES
(Nicolas Franco S.; Gomez Rubi J.A.; Gonzalez Diaz G.) Servicio de Medicina
Intensiva, Hosp. Univ. 'Virgen de la Arrixaca, Ctra. Madrid Cartagena s/n,
El Palmar, Spain.
CORRESPONDENCE ADDRESS
S. Nicolas Franco, Servicio de Medicina Intensiva, Hosp. Univ. 'Virgen de la
Arrixaca, Ctra. Madrid Cartagena s/n, El Palmar, Spain.
SOURCE
Medicina Intensiva (1992) 16:8 (438-445). Date of Publication: 1992
ISSN
0210-5691
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
artificial ventilation
hemodynamics
intensive care unit
EMTREE MEDICAL INDEX TERMS
conference paper
hormone release
oxygen consumption
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
Spanish
LANGUAGE OF SUMMARY
English, Spanish
EMBASE ACCESSION NUMBER
1993149508
PUI
L23149494
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1060
TITLE
Optimization of the blood for oxygen transport and tissue perfusion in
critical care
AUTHOR NAMES
Wardrop C.A.J.
Holland B.M.
Jacobs S.
Jones J.G.
AUTHOR ADDRESSES
(Wardrop C.A.J.; Holland B.M.; Jacobs S.; Jones J.G.) Department of
Haematology, University Wales College of Medicine, Heath Park, Cardiff CF4
4XN, United Kingdom.
CORRESPONDENCE ADDRESS
C.A.J. Wardrop, Department of Haematology, University Wales College of
Medicine, Heath Park, Cardiff CF4 4XN, United Kingdom.
SOURCE
Postgraduate Medical Journal (1992) 68:SUPPL. 2 (S2-S6). Date of
Publication: 1992
ISSN
0032-5473
BOOK PUBLISHER
BMJ Publishing Group, Tavistock Square, London, United Kingdom.
ABSTRACT
In present practice, patients in intensive care are managed with subnormal
haematocrit values and oligovolaemia. Optimization of the blood for oxygen
transport in preterm infants in intensive care yields major benefits in
their prognosis. A rational basis is described for this optimization in
terms of the circulating blood volume and haematocrit, represented by
circulating red cell volume (mass). Extrapolation of these lessons in
haematological management is proposed for adult patients in critical care,
so as to reduce dependence on respiratory support and minimize clinical
complications and costs.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
oxygen (endogenous compound)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
blood volume
intensive care
oxygen transport
tissue perfusion
EMTREE MEDICAL INDEX TERMS
assisted ventilation
conference paper
erythrocyte volume
hematocrit
human
newborn intensive care
prematurity
priority journal
CAS REGISTRY NUMBERS
oxygen (7782-44-7)
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Hematology (25)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1992298085
MEDLINE PMID
1461866 (http://www.ncbi.nlm.nih.gov/pubmed/1461866)
PUI
L22298067
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1061
TITLE
The problems of intrahospital transfer of patients with trauma and one
solution: the "Trauma Transfer Backpack".
AUTHOR NAMES
Nayduch D.
Sullivan S.L.
AUTHOR ADDRESSES
(Nayduch D.; Sullivan S.L.)
CORRESPONDENCE ADDRESS
D. Nayduch,
SOURCE
Journal of emergency nursing: JEN : official publication of the Emergency
Department Nurses Association (1992) 18:5 (383-389). Date of Publication:
Oct 1992
ISSN
0099-1767
ABSTRACT
With long stays for computed tomographic scans and x-ray exams and long
trips to ICUs, patients with trauma may need extra fluids, drugs, or
equipment outside the emergency department. Putting everything in a backpack
saves time, leaves the nurse's hands free, and does not take up room on the
stretcher.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
long term care
multiple trauma
patient transport
EMTREE MEDICAL INDEX TERMS
article
devices
human
nursing
organization and management
LANGUAGE OF ARTICLE
English
MEDLINE PMID
1474732 (http://www.ncbi.nlm.nih.gov/pubmed/1474732)
PUI
L23849222
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1062
TITLE
Pressure support ventilation: Technology transfer from the intensive care
unit to the operating room
AUTHOR NAMES
Pearl R.G.
Rosenthal M.H.
AUTHOR ADDRESSES
(Pearl R.G.; Rosenthal M.H.) Department of Anesthesia, Stanford University
Medical Center, Stanford, CA 94305-5123, United States.
CORRESPONDENCE ADDRESS
R.G. Pearl, Department of Anesthesia, Stanford University Medical Center,
Stanford, CA 94305-5123, United States.
SOURCE
Anesthesia and Analgesia (1992) 75:2 (161-163). Date of Publication: 1992
ISSN
0003-2999
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
operating room
patient transport
positive end expiratory pressure
EMTREE MEDICAL INDEX TERMS
editorial
human
priority journal
technology
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1992240915
MEDLINE PMID
1632528 (http://www.ncbi.nlm.nih.gov/pubmed/1632528)
PUI
L22240914
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1063
TITLE
Intrahospital transport of critically ill, mechanically ventilated patients
AUTHOR NAMES
Branson R.D.
AUTHOR ADDRESSES
(Branson R.D.) Dept of Surgery, University of Cincinnati, Medical Center,
231 Bethesda Ave, Cincinnati, OH 45267-0550, United States.
CORRESPONDENCE ADDRESS
R.D. Branson, Dept of Surgery, University of Cincinnati, Medical Center, 231
Bethesda Ave, Cincinnati, OH 45267-0550, United States.
SOURCE
Respiratory Care (1992) 37:7 (775-795). Date of Publication: 1992
ISSN
0098-9142
BOOK PUBLISHER
Daedalus Enterprises Inc., 9425 North MacArthur Blvd, Suite 100, Irving,
United States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
artificial ventilation
critical illness
patient transport
EMTREE MEDICAL INDEX TERMS
conference paper
human
intensive care unit
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Cardiovascular Diseases and Cardiovascular Surgery (18)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1992230688
MEDLINE PMID
10145673 (http://www.ncbi.nlm.nih.gov/pubmed/10145673)
PUI
L22230687
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1064
TITLE
Primary care of patients with myocardial infarction
AUTHOR NAMES
Obayashi K.
AUTHOR ADDRESSES
(Obayashi K.)
CORRESPONDENCE ADDRESS
K. Obayashi,
SOURCE
Nihon Naika Gakkai zasshi. The Journal of the Japanese Society of Internal
Medicine (1992) 81:8 (1208-1212). Date of Publication: 10 Aug 1992
ISSN
0021-5384
EMTREE DRUG INDEX TERMS
diazepam (drug administration)
glyceryl trinitrate (drug administration)
tissue plasminogen activator (drug administration)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
heart infarction (prevention, therapy)
patient transport
EMTREE MEDICAL INDEX TERMS
article
coronary care unit
fibrinolytic therapy
heart arrhythmia (prevention, therapy)
human
oxygen therapy
CAS REGISTRY NUMBERS
diazepam (439-14-5)
glyceryl trinitrate (55-63-0)
tissue plasminogen activator (105913-11-9)
LANGUAGE OF ARTICLE
Japanese
MEDLINE PMID
1431460 (http://www.ncbi.nlm.nih.gov/pubmed/1431460)
PUI
L22974771
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1065
TITLE
Intrahospital transport of critically ill patients
AUTHOR NAMES
Venkataraman S.T.
Orr R.A.
AUTHOR ADDRESSES
(Venkataraman S.T.; Orr R.A.) 3705 Fifth Avenue, Pittsburgh, PA 15213,
United States.
CORRESPONDENCE ADDRESS
S.T. Venkataraman, 3705 Fifth Avenue, Pittsburgh, PA 15213, United States.
SOURCE
Critical Care Clinics (1992) 8:3 (525-531). Date of Publication: 1992
ISSN
0749-0704
BOOK PUBLISHER
W.B. Saunders, Independence Square West, Philadelphia, United States.
ABSTRACT
Intrahospital transport of critically ill patients must be considered as
part of the critical care continuum. The level of care provided must be
commensurate with the severity of illness. These transfers are intensive in
terms of utilization of personnel and resources. Advance preparation and
optimal coordination of the transport process go a long way toward safer
transfers of the critically ill.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
organization
review
technology
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1992220372
MEDLINE PMID
1638440 (http://www.ncbi.nlm.nih.gov/pubmed/1638440)
PUI
L22220371
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1066
TITLE
Emergency transport of critically ill children [3]
AUTHOR NAMES
Thomas D.
Henning R.
AUTHOR ADDRESSES
(Thomas D.; Henning R.) Flinders Medical Centre, Bedford Park, SA 5042,
Australia.
CORRESPONDENCE ADDRESS
D. Thomas, Flinders Medical Centre, Bedford Park, SA 5042, Australia.
SOURCE
Medical Journal of Australia (1992) 157:1 (66-67). Date of Publication: 1992
ISSN
0025-729X
BOOK PUBLISHER
Australasian Medical Publishing Co. Ltd, Level 2, 26-32 Pyrmont Bridge Road,
Pyrmont, Australia.
EMTREE DRUG INDEX TERMS
aminophylline (adverse drug reaction, drug therapy)
dexamethasone (drug therapy)
diazepam (drug administration, drug therapy)
epinephrine (adverse drug reaction, drug therapy)
phenytoin (adverse drug reaction, drug administration, drug therapy)
salbutamol (drug therapy)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child
critical illness
emergency
patient transport
EMTREE MEDICAL INDEX TERMS
age
asthma (drug therapy)
bronchitis (drug therapy)
cardiotoxicity (side effect)
croup (drug therapy, etiology)
disease classification
drug efficacy
endotracheal intubation
epileptic state (drug therapy)
heart arrhythmia (side effect)
inhalational drug administration
intensive care unit
interpersonal communication
intravenous drug administration
letter
lung dysplasia (drug therapy)
meningitis (drug therapy)
oxygen therapy
pallor (side effect)
patient monitoring
priority journal
rectal drug administration
shock (drug therapy)
CAS REGISTRY NUMBERS
adrenalin (51-43-4, 55-31-2, 6912-68-1)
aminophylline (317-34-0)
dexamethasone (50-02-2)
diazepam (439-14-5)
phenytoin (57-41-0, 630-93-3)
salbutamol (18559-94-9)
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Anesthesiology (24)
Drug Literature Index (37)
Adverse Reactions Titles (38)
Epilepsy Abstracts (50)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1992210536
MEDLINE PMID
1640897 (http://www.ncbi.nlm.nih.gov/pubmed/1640897)
PUI
L22210535
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1067
TITLE
Back transporting infants from neonatal intensive care units to community
hospitals for recovery care: Effect on total hospital charges
AUTHOR NAMES
Phibbs C.S.
Mortensen L.
AUTHOR ADDRESSES
(Phibbs C.S.; Mortensen L.) Center for Health Care Evaluation, Veterans
Affairs Medical Center, 795 Willow Rd, Menlo Park, CA 94025, United States.
CORRESPONDENCE ADDRESS
C.S. Phibbs, Center for Health Care Evaluation, Veterans Affairs Medical
Center, 795 Willow Rd, Menlo Park, CA 94025, United States.
SOURCE
Pediatrics (1992) 90:1 PART 1 (22-26). Date of Publication: 1992
ISSN
0031-4005
BOOK PUBLISHER
American Academy of Pediatrics, 141 Northwest Point Blvd, P.O. Box 927, Elk
Grove Village, United States.
ABSTRACT
Many neonates are referred to neonatal intensive care units (NICUs) for
specialized care far from their parents' residence. This distance can add to
the stress of the parents and reduce the contact of the parents with their
newborn. Small studies have found that back transporting these neonates to
hospitals closer to their homes is safe and cost-effective. Despite these
findings, the reluctance of many insurers to pay for back transports
prevents or delays many back transports. Insurers may not consider the
findings of the previous studies to be conclusive, given that the
comparisons were between small numbers of neonates back transported and
neonates who remained in tertiary care, and the potential for differences in
severity of illness between the groups is significant. In this study the
effect on hospital charges of back transports was examined by comparing the
charges for care in community hospitals with what these charges would have
been in a tertiary care center. The advantage of this method is that it
avoids case-mix differences between the groups and thus minimizes the
potential for small- sample bias. Data were collected for all back
transports from a NICU to non- tertiary care centers (n = 90) for a 9-month
period. We were able to obtain the itemized bills for the care at community
hospitals for 42 of these patients. Each bill was recalculated using the
charges for the NICU to determine potential for savings. The average charges
for recovery care were about $6200 lower at the community hospital than they
would have been at the NICU. When the charges for the back transport are
subtracted (mean = $1603), the average net savings are $4,600. These savings
are even larger ($6163) for neonates who stayed at the community hospital
for more than 7 days.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
community hospital
hospital cost
newborn intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
controlled study
cost effectiveness analysis
female
hospitalization
human
infant
length of stay
major clinical study
male
newborn
patient referral
priority journal
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Anesthesiology (24)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1992196226
MEDLINE PMID
1614772 (http://www.ncbi.nlm.nih.gov/pubmed/1614772)
PUI
L22196225
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1068
TITLE
A cart to provide high frequency jet ventilation during transport of
neonates
AUTHOR NAMES
Scuderi J.
Elton C.B.
Elton D.R.
AUTHOR ADDRESSES
(Scuderi J.; Elton C.B.; Elton D.R.) 3207 Berkley Forest Dr, Columbia, SC
29209-4111, United States.
CORRESPONDENCE ADDRESS
D.R. Elton, 3207 Berkley Forest Dr, Columbia, SC 29209-4111, United States.
SOURCE
Respiratory Care (1992) 37:2 (129-136). Date of Publication: 1992
ISSN
0098-9142
BOOK PUBLISHER
Daedalus Enterprises Inc., 9425 North MacArthur Blvd, Suite 100, Irving,
United States.
ABSTRACT
We report the evaluation of a cart we created to provide high frequency jet
ventilation (HFJV) to neonates during intrahospital or interhospital
transport. DESCRIPTION: The cart carries a conventional ventilator, jet
ventilator (JV), incubator, gas blender, 3 E cylinders of oxygen and 2 of
air, uninterruptible electric power supply (UPS), 2 syringe infusion pumps,
cardiac monitor, and oximeter. EVALUATION METHODS: To determine the
available operating time of the ventilators, we ran tests with 60% and 100%
oxygen, high and low ventilator settings, 2.5-mm and 3.5-mm endotracheal
tubes, and lung simulator set for low and high time constants. With five
different combinations of these variables, the system was run to exhaustion
of its gas supply. To determine the operating time limit of the UPS, we used
it to operate the JV until the low-battery alarm sounded. RESULTS: The UPS
always provided electrical power for at least 2 hours. In no case did a
single cylinder of oxygen fail to power the system for less than 20 min.
Because the cart carries 3 cylinders of oxygen and 2 of air, under the
conditions tested a minimum of 60 min of continuous operation, using 100%
oxygen, should be available during those portions of transports when the
system is away from hospital and ambulance bulk power sources and is
dependent on its own UPS and E cylinders of gas. EXPERIENCE: We have used
the cart on two occasions to transport a 30-week gestational age, 1-kg,
HFJV-dependent infant, first from ICU to surgery, then to another hospital
for cardiac catheterization. Total transport time was 3 hours; there were no
problems. The cart has also been used to transport three patients between
hospitals during ECMO, without HFJV. CONCLUSIONS: Our HFJV transport system
is adequate to transport an HFJV- dependent infant during the 30 to 60
minutes that may elapse when the cart is away from ambulance or hospital
sources of electricity and gas. Available operating time with an HFJV
transport system should be estimated conservatively; when an infant is
dependent on HFJV, it would be well to have aircraft backup in case of
ambulance breakdown or other contingencies.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
devices
jet ventilation
EMTREE MEDICAL INDEX TERMS
article
human
newborn
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Biophysics, Bioengineering and Medical Instrumentation (27)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1992169444
MEDLINE PMID
10145616 (http://www.ncbi.nlm.nih.gov/pubmed/10145616)
PUI
L22169443
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1069
TITLE
Intrahospital transport: A framework for assessment
AUTHOR NAMES
Fought S.G.
Nemeth L.
AUTHOR ADDRESSES
(Fought S.G.; Nemeth L.) Department of Physiological Nursing, Harborview
Medical Center, University of Washington, Seattle, WA, United States.
CORRESPONDENCE ADDRESS
S.G. Fought, Department of Physiological Nursing, Harborview Medical Center,
University of Washington, Seattle, WA, United States.
SOURCE
Critical Care Nursing Quarterly (1992) 15:1 (87-90). Date of Publication:
1992
ISSN
0887-9303
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
patient transport
EMTREE MEDICAL INDEX TERMS
article
education program
emergency medicine
health care manpower
health care quality
human
medical assessment
paramedical education
patient monitoring
risk factor
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1992168576
MEDLINE PMID
1568160 (http://www.ncbi.nlm.nih.gov/pubmed/1568160)
PUI
L22168575
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1070
TITLE
Patient dumping by specialized care facilities: compliance efforts riddled
with uncertainties.
AUTHOR NAMES
Brown L.C.
Paine S.J.
AUTHOR ADDRESSES
(Brown L.C.; Paine S.J.)
CORRESPONDENCE ADDRESS
L.C. Brown,
SOURCE
HealthSpan (1992) 9:6 (3-7). Date of Publication: Jun 1992
ISSN
0883-0452
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
patient transport
EMTREE MEDICAL INDEX TERMS
article
government
health care delivery
intensive care unit
legal aspect
physician attitude
public relations
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
10119737 (http://www.ncbi.nlm.nih.gov/pubmed/10119737)
PUI
L22952523
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1071
TITLE
Variables predicting the need for a pediatric critical care transport team
AUTHOR NAMES
McCloskey K.A.
Faries G.
King W.D.
Orr R.A.
Plouff R.T.
AUTHOR ADDRESSES
(McCloskey K.A.; Faries G.; King W.D.; Orr R.A.; Plouff R.T.) Children's
Hospital of Alabama, 1600 Seventh Avenue, South, Birmingham, AL 35233
CORRESPONDENCE ADDRESS
Children's Hospital of Alabama, 1600 Seventh Avenue, South, Birmingham, AL
35233
SOURCE
Pediatric Emergency Care (1992) 8:1 (1-3). Date of Publication: 1992
ISSN
0749-5161
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
ABSTRACT
To determine when a pediatric critical care transport team is required to
transport a patient to a referral center, this cross-sectional study
evaluated 369 consecutive pediatric transports by stepwise multiple logistic
regression analysis of six variables: age, vital signs, seizure activity,
current endotracheal intubation, respiratory distress, and respiratory
diagnosis. Models were developed for three outcome variables: 1) Major
procedures were required in 8.9% of cases. The predicted probability of
needing a major procedure was increased for intubated patients (probability
of 12.9%), patients <1 year of age with unstable vital signs (12.9%), and
patients meeting both these criteria (23.2%). 2) A posttransport assessment
of need for a physician on the team was positive in 43% of cases. The
probability of needing a physician was increased for intubated patients
(probability of 68.8%), patients <1 year of age with unstable vital signs
(58.7%), and patients meeting both these criteria (79.9%). 3) Category 1
drugs, ie, medications requiring ICU monitoring, were used in 19% of
transports. The probability of this occurring was increased for intubated
patients with stable vital signs (probability of 24.7%) and for intubated
patients with unstable vital signs (41.4%). None of the other pretransport
variables, alone or in pairs, was a significant predictor of any of the
three outcome variables. The data indicate that intubation, age, and vital
sign status can be used in predicting whether a transport team is needed.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
patient transport
EMTREE MEDICAL INDEX TERMS
age
article
childhood
endotracheal intubation
human
infant
prediction
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1992088294
MEDLINE PMID
1603682 (http://www.ncbi.nlm.nih.gov/pubmed/1603682)
PUI
L22088293
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1072
TITLE
Development and implications of an interdisciplinary quality assurance
monitor on unplanned transfers into the intensive care units.
AUTHOR NAMES
Posa P.J.
Yonkee D.E.
Fields W.L.
AUTHOR ADDRESSES
(Posa P.J.; Yonkee D.E.; Fields W.L.)
CORRESPONDENCE ADDRESS
P.J. Posa,
SOURCE
Journal of nursing care quality (1992) 6:2 (51-55). Date of Publication: Jan
1992
ISSN
1057-3631
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health care quality
intensive care unit
patient care
patient transport
EMTREE MEDICAL INDEX TERMS
article
human
information processing
medical record
methodology
organization and management
standard
LANGUAGE OF ARTICLE
English
MEDLINE PMID
1728330 (http://www.ncbi.nlm.nih.gov/pubmed/1728330)
PUI
L22876434
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1073
TITLE
Critical care transport of a cardiac infant: a case study.
AUTHOR NAMES
Demmons L.L.
McGreevy T.
AUTHOR ADDRESSES
(Demmons L.L.; McGreevy T.)
CORRESPONDENCE ADDRESS
L.L. Demmons,
SOURCE
Neonatal network : NN (1991) 10:4 (39-44). Date of Publication: Dec 1991
ISSN
0730-0832
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
congenital heart malformation (therapy)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
case report
human
incubator
male
multiple malformation syndrome (therapy)
newborn
nursing
LANGUAGE OF ARTICLE
English
MEDLINE PMID
1766425 (http://www.ncbi.nlm.nih.gov/pubmed/1766425)
PUI
L22880738
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1074
TITLE
Elective intrahospital admissions versus acute interhospital transfers to a
surgical intensive care unit: Cost and outcome prediction
AUTHOR NAMES
Borlase B.C.
Baxter J.K.
Kenney P.R.
Forse R.A.
Benotti P.N.
Blackburn G.L.
AUTHOR ADDRESSES
(Borlase B.C.; Baxter J.K.; Kenney P.R.; Forse R.A.; Benotti P.N.; Blackburn
G.L.) General Surgery/Critical Care, New England Deaconess Hospital, 110
Francis St., Boston, MA 02215, United States.
CORRESPONDENCE ADDRESS
B.C. Borlase, General Surgery/Critical Care, New England Deaconess Hospital,
110 Francis St., Boston, MA 02215, United States.
SOURCE
Journal of Trauma (1991) 31:7 (915-919). Date of Publication: 1991
ISSN
0022-5282
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
ABSTRACT
After a decade of intense fiscal scrutiny, appropriate utilization of
intensive care resources remains controversial. In particular, the financial
impact of patients transferred to a tertiary surgical intensive care unit
(SICU) from a community hospital (interhospital) is unknown, especially when
compared with elective (intrahospital) SICU admissions admitted from the
tertiary center itself. We prospectively studied outcome and costs in 82
consecutive tertiary SICU admissions. Half were transferred acutely from
community hospitals and half were transferred from within the hospital or
postoperatively. Severity of illness (APACHE II) was scored on day 1, at the
same time of the day (9:00-10:00 AM) and by one attending surgeon (BCB).
Acute transfer patients had a significantly elevated mortality (36%) when
compared with elective admissions (12%) (p < 0.05). When stratified by
APACHE II score, acute transfers had twice the mortality for equivalent
APACHE II scores (p < 0.05). Acute transfer patients with APACHE II scores
greater than 19 had an 89% mortality; those nonsurvivors cost $128,652 each.
From these results we conclude the following: (1) Acute transfer patients
have a significantly elevated mortality when compared with elective
intrahospital admissions with equivalent APACHE II day-1 scores; (2)
patients transferred acutely to tertiary SICUs are significantly more
costly, irrespective of outcome; (3) admission source (elective vs. acute
transfer) should be seriously considered when evaluating patient outcome and
cost in a SICU.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cost
intensive care unit
prediction
EMTREE MEDICAL INDEX TERMS
conference paper
controlled study
human
human tissue
major clinical study
mortality
priority journal
scoring system
survival
EMBASE CLASSIFICATIONS
Surgery (9)
Orthopedic Surgery (33)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1992119189
MEDLINE PMID
2072429 (http://www.ncbi.nlm.nih.gov/pubmed/2072429)
PUI
L22119188
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1075
TITLE
Medication use during neonatal and pediatric critical care transport
AUTHOR NAMES
Sumpton J.E.
Kronick J.B.
AUTHOR ADDRESSES
(Sumpton J.E.; Kronick J.B.) Department of Pediatrics, Children's Hospital
of Western Ont., 800 Commissioners Road East, London, Ont., N6C 2V5
CORRESPONDENCE ADDRESS
Department of Pediatrics, Children's Hospital of Western Ont., 800
Commissioners Road East, London, Ont., N6C 2V5
SOURCE
Canadian Journal of Hospital Pharmacy (1991) 44:3 (153-156). Date of
Publication: 1991
ISSN
0008-4123
BOOK PUBLISHER
Canadian Society of Hospital Pharmacists, 30 Concourse Gate, Unit 3, Ottawa,
Canada.
ABSTRACT
The Pediatric Critical Care Unit (PCCU) at the Children's Hospital of
Western Ontario provides a transport service and team (critical care
physician, critical care nurse, respiratory therapist) which transports
critically ill newborns, infants, and children. The purpose of this study
was to identify the medications used during transport and to determine
age-related differences. Results of a prospective study of all drugs
administered by the transport team to 174 patients during their
stabilization and transport from November 1, 1987 through October 31, 1988
are presented. One hundred and twenty-one (69.5%) patients received at least
one medication. The most frequently administered medications were
antibiotics (38.5% of patients), followed by morphine (27.0%),
anticonvulsants (23.6%), neuromuscular blockers (14.4%), respiratory drugs
(11.5%), inotropes (10.9%), and sedatives (7.5%). Miscellaneous medications
were administered to 48.8% of patients. The use of different classes of
drugs varied with age; anticonvulsants were most frequently administered to
children, sedatives and respiratory medications to infants, and antibiotics
and miscellaneous medications to newborns. The wide range of medications
used may reflect the diversity of diseases causing critical illness which
reinforces that transport teams must have access to and knowledge of a
variety of medications. The formulary of medications taken by the critical
care transport team is included.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
aminophylline
antibiotic agent
anticonvulsive agent
epinephrine
inotropic agent
morphine
neuromuscular blocking agent
salbutamol
sedative agent
EMTREE DRUG INDEX TERMS
ampicillin
atropine
diazepam
gentamicin
lorazepam
pancuronium
paracetamol
phenobarbital
phenytoin
suxamethonium
thiopental
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
drug use
emergency medicine
patient transport
EMTREE MEDICAL INDEX TERMS
article
child
human
intensive care
newborn
CAS REGISTRY NUMBERS
adrenalin (51-43-4, 55-31-2, 6912-68-1)
aminophylline (317-34-0)
ampicillin (69-52-3, 69-53-4, 7177-48-2, 74083-13-9, 94586-58-0)
atropine (51-55-8, 55-48-1)
diazepam (439-14-5)
gentamicin (1392-48-9, 1403-66-3, 1405-41-0)
lorazepam (846-49-1)
morphine (52-26-6, 57-27-2)
paracetamol (103-90-2)
phenobarbital (50-06-6, 57-30-7, 8028-68-0)
phenytoin (57-41-0, 630-93-3)
salbutamol (18559-94-9)
suxamethonium (306-40-1, 71-27-2)
thiopental (71-73-8, 76-75-5)
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
French, English
EMBASE ACCESSION NUMBER
1991264533
MEDLINE PMID
10112743 (http://www.ncbi.nlm.nih.gov/pubmed/10112743)
PUI
L21263839
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1076
TITLE
No duty to admit emergency patient when intensive care unit is full.
AUTHOR ADDRESSES
SOURCE
Journal of health and hospital law : a publication of the American Academy
of Hospital Attorneys of the American Hospital Association (1991) 24:10
(322). Date of Publication: Oct 1991
ISSN
1046-4360
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
malpractice
patient transport
EMTREE MEDICAL INDEX TERMS
article
hospital bed utilization
human
infant
legal aspect
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
10183531 (http://www.ncbi.nlm.nih.gov/pubmed/10183531)
PUI
L21875120
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1077
TITLE
Intrahospital transport of critically ill adults: potential physiologic
changes and nursing implications.
AUTHOR NAMES
Tice P.
AUTHOR ADDRESSES
(Tice P.)
CORRESPONDENCE ADDRESS
P. Tice,
SOURCE
Focus on critical care / American Association of Critical-Care Nurses (1991)
18:5 (424-428). Date of Publication: Oct 1991
ISSN
0736-3605
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
critical illness
heart
lung
patient transport
EMTREE MEDICAL INDEX TERMS
article
hemodynamics
human
intracranial pressure
nursing care
oxygen consumption
physiology
LANGUAGE OF ARTICLE
English
MEDLINE PMID
1936370 (http://www.ncbi.nlm.nih.gov/pubmed/1936370)
PUI
L21872710
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1078
TITLE
The relation between oxygen transport and consumption can be upset in
intensive care patients
ORIGINAL (NON-ENGLISH) TITLE
Relationen syrgastransport och-konsumtion kan rubbas hos
intensivvårdspatienter.
AUTHOR NAMES
Lind L.
Skoog G.
Mälstam J.
AUTHOR ADDRESSES
(Lind L.; Skoog G.; Mälstam J.) Samtliga vid anestesikliniken, länssjukhuset
Gävle.
CORRESPONDENCE ADDRESS
L. Lind, Samtliga vid anestesikliniken, länssjukhuset Gävle.
SOURCE
Läkartidningen (1991) 88:35 (2751-2753). Date of Publication: 28 Aug 1991
ISSN
0023-7205
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
oxygen
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
oxygen consumption
EMTREE MEDICAL INDEX TERMS
article
cardiogenic shock (therapy)
human
metabolism
physiology
prognosis
respiratory failure (therapy)
septic shock (therapy)
shock (therapy)
traumatic shock (therapy)
CAS REGISTRY NUMBERS
oxygen (7782-44-7)
LANGUAGE OF ARTICLE
Swedish
MEDLINE PMID
1895823 (http://www.ncbi.nlm.nih.gov/pubmed/1895823)
PUI
L21864677
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1079
TITLE
Safe intraclinical transfer of intensive-care patients - A concept to avoid
monitoring and treatment gaps
ORIGINAL (NON-ENGLISH) TITLE
DER SICHERE INNERKLINISCHE TRANSPORT VON INTENSIVPATIENTEN. EIN KONZEPT ZUR
VERMEIDUNG VON UBERWACHUNGS- UND THERAPIELUCKEN
AUTHOR NAMES
Schirmer U.
Heinrich H.
Siebeneich H.
Vandermeersch E.
AUTHOR ADDRESSES
(Schirmer U.; Heinrich H.; Siebeneich H.; Vandermeersch E.)
Universitatsklinik fur Anasthesiologie, Klinikum der Universitat Ulm,
Steinhovelstrasse 9, D-7900 Ulm
CORRESPONDENCE ADDRESS
Universitatsklinik fur Anasthesiologie, Klinikum der Universitat Ulm,
Steinhovelstrasse 9, D-7900 Ulm
SOURCE
Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie (1991) 26:2
(112-115). Date of Publication: 1991
ISSN
0939-2661
BOOK PUBLISHER
Georg Thieme Verlag, Rudigerstrasse 14, Stuttgart, Germany.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
risk factor
EMTREE MEDICAL INDEX TERMS
article
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
German
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1991191683
MEDLINE PMID
1873411 (http://www.ncbi.nlm.nih.gov/pubmed/1873411)
PUI
L21192371
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1080
TITLE
Total materials flow control system: intra-hospital transport service
control system.
AUTHOR NAMES
Watanabe M.
Yoshizawa M.
AUTHOR ADDRESSES
(Watanabe M.; Yoshizawa M.) St. Marianna University School of Medicine.
CORRESPONDENCE ADDRESS
M. Watanabe, St. Marianna University School of Medicine.
SOURCE
Japan-hospitals : the journal of the Japan Hospital Association (1991) 10
(49-52). Date of Publication: Jul 1991
ISSN
0910-1004
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
automation
hospital equipment
hospital management
EMTREE MEDICAL INDEX TERMS
article
Japan
medical record
methodology
public relations
LANGUAGE OF ARTICLE
English
MEDLINE PMID
10111644 (http://www.ncbi.nlm.nih.gov/pubmed/10111644)
PUI
L21844403
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1081
TITLE
Critical care transport: aircraft and medicine.
AUTHOR NAMES
Powell D.G.
AUTHOR ADDRESSES
(Powell D.G.) Foothills Provincial General Hospital, Calgary.
CORRESPONDENCE ADDRESS
D.G. Powell, Foothills Provincial General Hospital, Calgary.
SOURCE
Dimensions in health service (1991) 68:4 (17-18, 33). Date of Publication:
May 1991
ISSN
0317-7645
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
aircraft
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
Canada
cost benefit analysis
economics
human
organization and management
standard
LANGUAGE OF ARTICLE
English
MEDLINE PMID
1905652 (http://www.ncbi.nlm.nih.gov/pubmed/1905652)
PUI
L21841494
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1082
TITLE
Critical care transport.
AUTHOR NAMES
Bock-Laudenslager C.
Johnson L.M.
AUTHOR ADDRESSES
(Bock-Laudenslager C.; Johnson L.M.)
CORRESPONDENCE ADDRESS
C. Bock-Laudenslager,
SOURCE
Focus on critical care / American Association of Critical-Care Nurses (1991)
18:2 (109). Date of Publication: Apr 1991
ISSN
0736-3605
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital department
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
human
letter
methodology
organization and management
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
2022281 (http://www.ncbi.nlm.nih.gov/pubmed/2022281)
PUI
L21821412
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1083
TITLE
Mothers' perceptions of their neonates' in-hospital transfers from a
neonatal intensive-care unit.
AUTHOR NAMES
Kolotylo C.J.
Parker N.I.
Chapman J.S.
AUTHOR ADDRESSES
(Kolotylo C.J.; Parker N.I.; Chapman J.S.) McMaster University, Hamilton,
Ontario, Canada.
CORRESPONDENCE ADDRESS
C.J. Kolotylo, McMaster University, Hamilton, Ontario, Canada.
SOURCE
Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG
(1991) 20:2 (146-153). Date of Publication: 1991 Mar-Apr
ISSN
0884-2175
ABSTRACT
This study explored mothers' perceptions of their neonates' in-hospital
transfers from a neonatal intensive-care unit. A convenience sample of 15
mothers was selected, and the researchers interviewed each mother once
within a week after her neonate's transfer. Three themes emerged from the
data: (1) the mothers expressed feelings of relief accompanied by concern,
fear of the unknown, and feelings of alienation; (2) the mothers depended on
familiar things and people; and (3) the mothers experienced feelings of
helplessness. The mothers' perceptions of their preparation for transfer and
continuity of care were mainly negative.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
attitude to health
mental stress (etiology)
mother
newborn intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
control
fear
female
human
interview
male
newborn
nursing
psychological aspect
LANGUAGE OF ARTICLE
English
MEDLINE PMID
2030452 (http://www.ncbi.nlm.nih.gov/pubmed/2030452)
PUI
L21826059
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1084
TITLE
Critical care transportation medicine: New concepts in pretransport
stabilization of the critically ill patient
AUTHOR NAMES
Crippen D.
AUTHOR ADDRESSES
(Crippen D.) Department of Critical Care, St Francis Medical Center,
Pittsburgh, PA 15201
CORRESPONDENCE ADDRESS
Department of Critical Care, St Francis Medical Center, Pittsburgh, PA 15201
SOURCE
American Journal of Emergency Medicine (1990) 8:6 (551-554). Date of
Publication: 1990
ISSN
0735-6757
BOOK PUBLISHER
W.B. Saunders, Independence Square West, Philadelphia, United States.
ABSTRACT
Regionalization of health care for trauma has become commonplace, and the
same concept for critically ill medical/surgical patients is developing.
Recent evidence suggests that current stabilization measures used by
transport teams can be inadequate for this critically ill patient
population. In trauma, speed has been considered a necessity to get the
patient to a facility which cannot be carried out to the field, eg, an
operating room. For acute medical illnesses, critical care transport teams
can bring intensive care technology to the patient. Accumulating evidence
supports the premise that speed of transport is not as important as
stabilization before transport, knowledge of hemodynamics during transport,
and early use of critical care monitoring systems. Other reports identify
the need for initial evaluation and stabilization of critically ill patients
by physicians at the critical care level of expertise. Accordingly, critical
care transportation teams have evolved, creating new notions of pretransport
stabilization not applicable to previous transport systems.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency ward
hemodynamics
patient transport
EMTREE MEDICAL INDEX TERMS
human
risk factor
short survey
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1991016340
MEDLINE PMID
2222604 (http://www.ncbi.nlm.nih.gov/pubmed/2222604)
PUI
L21016340
DOI
10.1016/0735-6757(90)90163-T
FULL TEXT LINK
http://dx.doi.org/10.1016/0735-6757(90)90163-T
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1085
TITLE
Critical care transport
AUTHOR NAMES
Fromm Jr. R.E.
AUTHOR ADDRESSES
(Fromm Jr. R.E.) Section of Cardiology, Department of Medicine, Baylor
College of Medicine, Houston, TX
CORRESPONDENCE ADDRESS
Section of Cardiology, Department of Medicine, Baylor College of Medicine,
Houston, TX
SOURCE
Problems in Critical Care (1990) 4:4 (ix). Date of Publication: 1990
ISSN
0889-4701
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
editorial
nonhuman
priority journal
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1991003243
PUI
L21003243
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1086
TITLE
Issues in critical care transport
AUTHOR NAMES
Fromm Jr. R.E.
Cronin L.A.
AUTHOR ADDRESSES
(Fromm Jr. R.E.; Cronin L.A.) MS B101, Methodist Hospital, 6565 Fannin,
Houston, TX 77030, United States.
CORRESPONDENCE ADDRESS
R.E. Fromm Jr., MS B101, Methodist Hospital, 6565 Fannin, Houston, TX 77030,
United States.
SOURCE
Problems in Critical Care (1990) 4:4 (439-446). Date of Publication: 1990
ISSN
0889-4701
ABSTRACT
Hospital closures, changes in reimbursement, and advances in diagnostics and
therapeutics have led to an increase in the number of critically ill
patients transported. Despite years of evolution in transport systems, many
issues remain. The importance of medical direction and control is generally
recognized but issues of appropriate use and reimbursement persist. Although
data from ground transport systems is limited, safety remains a paramount
issue in both ground and air transport activities.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
devices
female
human
male
priority journal
review
risk factor
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1991003244
PUI
L21003244
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1087
TITLE
Intrahospital transport of critically ill patients
AUTHOR NAMES
Link J.
Krause H.
Wagner W.
Papadopoulos G.
AUTHOR ADDRESSES
(Link J.; Krause H.; Wagner W.; Papadopoulos G.) FU Klinikum Steglitz,
Klinik fur Anaesthesiologie, Operative Intensivmedizin, Hindenburgdamm 30,
D-1000 Berlin 45, Germany.
CORRESPONDENCE ADDRESS
J. Link, FU Klinikum Steglitz, Klinik fur Anaesthesiologie, Operative
Intensivmedizin, Hindenburgdamm 30, D-1000 Berlin 45, Germany.
SOURCE
Critical Care Medicine (1990) 18:12 (1427-1429). Date of Publication: 1990
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
ABSTRACT
Severe complications sometimes occur in critically ill patients during
intrahospital transport. Possible causes may be inadequate ventilation,
insufficient monitoring, interrupted application of vasoactive drugs, or
disconnections and accidental extubation. We constructed a transport unit
equipped with a respiratory; capnometer; monitor to measure ECG, arterial
and intracranial pressures, and temperature; and two syringe pumps that can
be connected easily to the patient's bed. Gas is supplied by cylinders with
oxygen and air. Electrical power is supplied by two accumulators connected
to recharger and transformer devices that deliver 220 V (110 V). Since this
transfer unit was introduced, we have had no unanticipated problems during
intrahospital ICU patient transport.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hemodynamic monitoring
intensive care
patient transport
vasodilatation
EMTREE MEDICAL INDEX TERMS
article
extubation
human
priority journal
risk factor
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1991028000
MEDLINE PMID
2245620 (http://www.ncbi.nlm.nih.gov/pubmed/2245620)
PUI
L21028000
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1088
TITLE
The practicability of a transportable haemoglobin measuring system in
routine operative and intensive medical care
ORIGINAL (NON-ENGLISH) TITLE
ZUR ANWENDBARKEIT EINES TRANSPORTABLEN HAMOGLOBINMESSSYSTEMS IM OPERATIVEN
UND INTENSIVMEDIZINISCHEN ROUTINEBETRIEB
AUTHOR NAMES
Polasek J.
Taeger K.
AUTHOR ADDRESSES
(Polasek J.; Taeger K.) Institut fur Anasthesiologie,
Ludwig-Maximilians-Universitat, Innenstadt-Kliniken, Nussbaumstrasse 20,
D-8000 Munchen
CORRESPONDENCE ADDRESS
Institut fur Anasthesiologie, Ludwig-Maximilians-Universitat,
Innenstadt-Kliniken, Nussbaumstrasse 20, D-8000 Munchen
SOURCE
Anasthesiologie und Intensivmedizin (1990) 31:9 (268-270). Date of
Publication: 1990
ISSN
0170-5334
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
hemoglobin
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
oximeter
EMTREE MEDICAL INDEX TERMS
article
methodology
nonhuman
CAS REGISTRY NUMBERS
hemoglobin (9008-02-0)
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
German
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1990316445
PUI
L20310534
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1089
TITLE
Effect of in-house transport on murine plasma corticosterone concentration
and blood lymphocyte populations.
AUTHOR NAMES
Drozdowicz C.K.
Bowman T.A.
Webb M.L.
Lang C.M.
AUTHOR ADDRESSES
(Drozdowicz C.K.; Bowman T.A.; Webb M.L.; Lang C.M.) Department of
Comparative Medicine, College of Medicine, Milton S. Hershey Medical Center,
Pennsylvania State University, Hershey 17033.
CORRESPONDENCE ADDRESS
C.K. Drozdowicz, Department of Comparative Medicine, College of Medicine,
Milton S. Hershey Medical Center, Pennsylvania State University, Hershey
17033.
SOURCE
American journal of veterinary research (1990) 51:11 (1841-1846). Date of
Publication: Nov 1990
ISSN
0002-9645
ABSTRACT
The effect of in-house transport on plasma corticosterone concentration and
blood lymphocyte populations of laboratory mice was investigated. Mice were
transported within a research facility at 0900 hours in a pattern designed
to simulate that commonly used by investigators prior to experimental
manipulation. Plasma corticosterone concentration and WBC count were
determined at 0.25, 2, 4, 8, 12, and 24 hours after transport. A significant
(P less than 0.05) increase in plasma corticosterone concentration was seen
in mice immediately after transport. The normal circadian rhythm of plasma
corticosterone concentration was altered for the subsequent 24-hour period.
Corresponding significant (P less than 0.05) decreases in total WBC numbers,
lymphocyte count, and thymus gland weight were observed. The decrease in
total blood lymphocyte numbers at 4 hours was reflected in B- and
T-lymphocyte populations. The subsequent acute increase in plasma
corticosterone concentration was associated with alterations in the cellular
components of the immune system. Results of the study indicated that routine
in-house transport of laboratory mice should be considered a stressful
stimulus.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
corticosterone
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
laboratory diagnosis
lymphocyte
EMTREE MEDICAL INDEX TERMS
animal
animal disease
article
Bagg albino mouse
blood
circadian rhythm
histology
leukocyte count
male
methodology
mouse
organ size
thymus
traffic and transport
CAS REGISTRY NUMBERS
corticosterone (50-22-6)
LANGUAGE OF ARTICLE
English
MEDLINE PMID
2240810 (http://www.ncbi.nlm.nih.gov/pubmed/2240810)
PUI
L20886144
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1090
TITLE
A dedicated helicopter-based ITU has all the advantages
AUTHOR NAMES
Bristow A.
Evans I.
AUTHOR ADDRESSES
(Bristow A.; Evans I.) St Bartholomew's Hospital, London EC1A 7BE
CORRESPONDENCE ADDRESS
St Bartholomew's Hospital, London EC1A 7BE
SOURCE
British Journal of Hospital Medicine (1990) 44:2 (91). Date of Publication:
1990
ISSN
0007-1064
BOOK PUBLISHER
MA Healthcare Ltd, Dulwich Road, London, United Kingdom.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
human
letter
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1990281548
MEDLINE PMID
2207488 (http://www.ncbi.nlm.nih.gov/pubmed/2207488)
PUI
L20275654
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1091
TITLE
Early 'step-down' transfer of low-risk patients with chest pain. A
controlled interventional trial
AUTHOR NAMES
Weingarten S.
Ermann B.
Bolus R.
Riedinger M.S.
Rubin H.
Green A.
Karns K.
Ellrodt A.G.
AUTHOR ADDRESSES
(Weingarten S.; Ermann B.; Bolus R.; Riedinger M.S.; Rubin H.; Green A.;
Karns K.; Ellrodt A.G.) Southern California, Permanente Medical Group, Dept.
of Internal Medicine, 5601 De Soto Avenue, Woodland Hills, CA 91365-4084,
United States.
CORRESPONDENCE ADDRESS
S. Weingarten, Southern California, Permanente Medical Group, Dept. of
Internal Medicine, 5601 De Soto Avenue, Woodland Hills, CA 91365-4084,
United States.
SOURCE
Annals of Internal Medicine (1990) 113:4 (283-289). Date of Publication:
1990
ISSN
0003-4819
BOOK PUBLISHER
American College of Physicians, 190 N. Indenpence Mall West, Philadelphia,
United States.
ABSTRACT
Objective: To determine whether providing private practitioners with triage
criteria for their low-risk chest pain patients would safely enhance bed
utilization efficiency in coronary and intermediate care units. Design:
Prospective, controlled, interventional trial using an alternate month study
design. Setting: A large teaching community hospital. Patients: Cohort of
404 low-risk patients with chest pain for whom a diagnosis of myocardial
infarction has been excluded and who have not sustained complications,
required interventions, or developed unstable comorbidity. Interventions:
During intervention months, private practitioners caring for low-risk
patients in the coronary and intermediate care units were contacted 24 hours
after admission. Physicians were informed that the transfer of low-risk
patients to nonmonitored beds could probably be done safely, based on the
results of a pilot study. The practitioner had the option of agreeing to or
deferring patient transfer. During control months, physicians were not
contacted in this way. Measurements and Main Results: Use of the triage
criteria by private practitioners reduced lengths of stay of the
intermediate and coronary care units by 36% and 53%, respectively. Bed
availability increased by 744 intermediate and 372 coronary care unit
bed-days per year. Charges decreased by $2.6 million per year and profits
improved by $390000 per year. There were no significant differences in
complications between control and intervention patients and in no case (95%
CI, 0% to 1.6%) did the triage criteria adversely affect quality of care.
Conclusions: The early transfer triage criteria may be a safe and
efficacious decision aid for improving bed utilization in intermediate and
coronary care units. In addition, this study shows the feasibility of and
potential benefits from applying practice guidelines at a community
hospital.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
coronary care unit
thorax pain
EMTREE MEDICAL INDEX TERMS
article
clinical trial
controlled clinical trial
controlled study
cost
economic aspect
education
general practitioner
hospital bed utilization
human
medical education
priority journal
prospective study
EMBASE CLASSIFICATIONS
Internal Medicine (6)
Cardiovascular Diseases and Cardiovascular Surgery (18)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1990260221
MEDLINE PMID
2115754 (http://www.ncbi.nlm.nih.gov/pubmed/2115754)
PUI
L20254355
COPYRIGHT
Copyright 2010 Elsevier B.V., All rights reserved.
RECORD 1092
TITLE
Three or more rib fractures as an indicator for transfer to a Level I trauma
center: A population-based study
AUTHOR NAMES
Lee R.B.
Bass S.M.
Morris Jr. J.A.
MacKenzie E.J.
AUTHOR ADDRESSES
(Lee R.B.; Bass S.M.; Morris Jr. J.A.; MacKenzie E.J.) Division of Trauma,
Vanderbilt University, School of Medicine, Nashville, TN 37232-3755, United
States.
CORRESPONDENCE ADDRESS
J.A. Morris Jr., Division of Trauma, Vanderbilt University, School of
Medicine, Nashville, TN 37232-3755, United States.
SOURCE
Journal of Trauma (1990) 30:6 (689-694). Date of Publication: 1990
ISSN
0022-5282
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
ABSTRACT
The presence of major chest wall injury is an indication for transfer to a
Level I trauma center. We hypothesized that the presence of three or more
rib fractures on initial chest X-ray would identify a small subgroup of
patients with a high probability of requiring trauma center care. All trauma
discharges in Maryland between 1984 and 1986 (N = 105,683) were reviewed.
Patients were divided by the presence of rib fractures (no rib fractures,
1-2 fractures, 3+ fractures) and age in years (0-13, 14-64, 65+). Results:
The presence of three or more rib fractures in the pediatric age group was
rare and precluded further evaluation. When comparing patients with 1-2 rib
fractures versus 3 or more rib fractures, significant differences were found
in mortality, mean Injury Severity Score, mean hospital stay and mean number
of ICU days (p < 0.001). The significant differences occurred in all age
groups 14 years old and older. The presence of three of more rib fractures
increased the relative risk of splenic injury (6.2) and liver injury (3.6)
but did not predict the presence of aortic injury. Conclusion: The presence
of 3 or more rib fractures identifies a small subgroup of patients (2.4%)
likely to require tertiary care. This triage tool is useful in all patients
over the age of 14 years.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
age
hospital bed utilization
intensive care unit
length of stay
liver injury
rib fracture
spleen injury
thorax injury (therapy)
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
child
conference paper
economic aspect
fatality
female
human
infant
major clinical study
male
organization and management
priority journal
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1990198340
MEDLINE PMID
2352298 (http://www.ncbi.nlm.nih.gov/pubmed/2352298)
PUI
L20197982
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1093
TITLE
Mishaps during transport from the intensive care unit
AUTHOR NAMES
Smith I.
Fleming S.
Cernaianu A.
AUTHOR ADDRESSES
(Smith I.; Fleming S.; Cernaianu A.) Div. of Critical Care Med., Department
of Anesthesia, Cooper Hosp./Univ. Med. Cent., Three Cooper Plaza, Camden, NJ
08103, United States.
CORRESPONDENCE ADDRESS
I. Smith, Div. of Critical Care Med., Department of Anesthesia, Cooper
Hosp./Univ. Med. Cent., Three Cooper Plaza, Camden, NJ 08103, United States.
SOURCE
Critical Care Medicine (1990) 18:3 (278-281). Date of Publication: 1990
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
ABSTRACT
We undertook a prospective study of 125 intrahospital patient transports
from the ICU in an attempt to identify any factors that could influence the
occurrence of mishaps. One third of the transports sustained at least one
mishap. Therapeutic intervention scoring system class IV transports had the
highest rate of mishaps (35%). We found no relationship of occurrence of
mishaps to severity of illness (Acute Physiology and Chronic Health
Evaluation, APACHE II), number of lines, monitoring and support modalities,
and time out of the ICU. Transports for elective procedures had more mishaps
(60%) than occurred for emergencies (40%). Most mishaps occurred either
during the procedure, on transports to CT scan, or while waiting at the
destination. The numbers and types of escorts as defined by our ICU policy
and physician attendance on transport did not clearly reduce mishap risk.
Morbidity and mortality were not affected by mishaps. Although certain
trends did emerge, no clearly defined predictive factor could be identified.
Further study into transport mishaps is warranted.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
diagnostic error
intensive care unit
patient transport
risk factor
EMTREE MEDICAL INDEX TERMS
article
catheterization
education
electrocardiogram
human
major clinical study
priority journal
tracheostomy
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1990087199
MEDLINE PMID
2302952 (http://www.ncbi.nlm.nih.gov/pubmed/2302952)
PUI
L20086855
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1094
TITLE
Critical care transport: A trauma perspective
AUTHOR NAMES
Grande C.M.
AUTHOR ADDRESSES
(Grande C.M.) Department of Anesthesiology, Maryland Institute for Emergency
Medical Services Systems, 22 South Greene Street, Baltimore, MD 21201-1595
CORRESPONDENCE ADDRESS
Department of Anesthesiology, Maryland Institute for Emergency Medical
Services Systems, 22 South Greene Street, Baltimore, MD 21201-1595
SOURCE
Critical Care Clinics (1990) 6:1 (165-183). Date of Publication: 1990
ISSN
0749-0704
BOOK PUBLISHER
W.B. Saunders, Independence Square West, Philadelphia, United States.
ABSTRACT
The realm of CCT is a challenging one, an arena open to advances in skills
and technology that will improve the patient's ultimate outcome as well as
provide that patient with the best possible conditions for transfer.
Considering the background of skills and knowledge and anesthesiologist
possesses, he or she is a 'natural' for this subspecialty.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
burn
heart disease
injury
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
anemia
conference paper
helicopter
human
hypoxia
methodology
organization and management
physiology
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
Forensic Science Abstracts (49)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1990084148
MEDLINE PMID
2404546 (http://www.ncbi.nlm.nih.gov/pubmed/2404546)
PUI
L20083804
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1095
TITLE
From ICU to rehabilitation: a checklist to ease the transition for the
spinal cord injured.
AUTHOR NAMES
Swarczinski C.
Graham P.
AUTHOR ADDRESSES
(Swarczinski C.; Graham P.) Southeastern Michigan Spinal Cord Injury System,
Rehabilitation Institute, Detroit 48201.
CORRESPONDENCE ADDRESS
C. Swarczinski, Southeastern Michigan Spinal Cord Injury System,
Rehabilitation Institute, Detroit 48201.
SOURCE
The Journal of neuroscience nursing : journal of the American Association of
Neuroscience Nurses (1990) 22:2 (89-91). Date of Publication: Apr 1990
ISSN
0888-0395
ABSTRACT
Spinal cord injuries are devastating. The injured person faces many unknowns
including surgical procedures, hospitalization and rehabilitation.
Frequently, the transition from acute care to rehabilitation is frightening.
In the intensive care unit (ICU), the patient receives one-to-one nursing
care and develops trust, but then may feel abandoned when faced with
rehabilitation. In order to facilitate readiness for rehabilitation,
coordinators of the Southeastern Michigan Spinal Cord Injury System proposed
a checklist of activities designed to meet individual patient and family
needs. Coordinators assess the patient within 24 hours of admission to the
spinal ICU. The physiatrist is notified of the admission and recommends
initial therapies as appropriate. The patient is followed through the acute
phase and preparations are made for rehabilitation. A checklist format has
been developed to coordinate the transfer. This article describes the
checklist and its use at our institution.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
medical record
patient care
patient transport
primary health care
spinal cord injury (rehabilitation)
EMTREE MEDICAL INDEX TERMS
adaptive behavior
article
human
intensive care
nursing
nursing assessment
patient education
psychological aspect
LANGUAGE OF ARTICLE
English
MEDLINE PMID
2139687 (http://www.ncbi.nlm.nih.gov/pubmed/2139687)
PUI
L20824614
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1096
TITLE
Critical care air transportation of the severely injured: Does long distance
transport adversely affect survival?
AUTHOR NAMES
Valenzuela T.D.
Criss E.A.
Copass M.K.
Luna G.K.
Rice C.L.
AUTHOR ADDRESSES
(Valenzuela T.D.; Criss E.A.; Copass M.K.; Luna G.K.; Rice C.L.) Section of
Emergency Medicine, Arizona Health Science Center, 1501 North Campbell
Avenue, Tucson, AZ 85724, United States.
CORRESPONDENCE ADDRESS
T.D. Valenzuela, Section of Emergency Medicine, Arizona Health Science
Center, 1501 North Campbell Avenue, Tucson, AZ 85724, United States.
SOURCE
Annals of Emergency Medicine (1990) 19:2 (169-172). Date of Publication:
1990
ISSN
0196-0644
BOOK PUBLISHER
Mosby Inc., 11830 Westline Industrial Drive, St. Louis, United States.
ABSTRACT
Civilian aeromedical transportation systems, both fixed and rotary wing,
have proliferated since the middle 1970s. However, outcome data
substantiating the benefit of these services have been slow in coming. From
February 22, 1982, through March 5, 1984, Airlift Northwest transported 118
trauma patients (aged 15 years and older) an average distance of 340 miles
(range, 100 to 800 miles) with fixed-wing aircraft. The in-hospital
mortality for this group was 19% compared with 18% for a comparable group of
trauma patients who were ground-transported from within the city limits of
Seattle, Washington. The two groups did not differ significantly in age,
Injury Severity Score, or Glasgow Coma Score. These results suggest that
some part of the clinical benefit of a regional trauma center may be
extended up to 800 miles with no increase in transport-related mortality.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air transportation
coma
resuscitation
EMTREE MEDICAL INDEX TERMS
aircraft
article
fatality
human
injury
methodology
organization and management
priority journal
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1990058186
MEDLINE PMID
2301795 (http://www.ncbi.nlm.nih.gov/pubmed/2301795)
PUI
L20057842
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1097
TITLE
Secondary insults during intrahospital transport of head-injured patients
AUTHOR NAMES
Andrews P.J.D.
Piper I.R.
Dearden N.M.
Miller J.D.
AUTHOR ADDRESSES
(Andrews P.J.D.; Piper I.R.; Dearden N.M.; Miller J.D.) Dept. Clinical
Neurosciences, University of Edinburgh, Western General Hospital, Edinburgh
EH4 2UX, United Kingdom.
CORRESPONDENCE ADDRESS
P.J.D. Andrews, Dept. Clinical Neurosciences, University of Edinburgh,
Western General Hospital, Edinburgh EH4 2UX, United Kingdom.
SOURCE
Lancet (1990) 335:8685 (327-330). Date of Publication: 1990
ISSN
0140-6736
BOOK PUBLISHER
Elsevier Limited, 32 Jamestown Road, London, United Kingdom.
ABSTRACT
Secondary pathophysiological insults occurring after injury have been
prospectively assessed in 50 head-injured patients who required
intrahospital transfer. 35 patients were transported from the intensive care
unit (ICU) and 15 from the accident and emergency department. Physiological
variables were recorded every minute in the four hours before transfer (ICU
group only), during the move, and for four hours afterwards. Pretransfer
insults were predictive of further insults during and after transport. There
was significant correlation between increased frequency of insults
post-transfer (compared with pre-transfer) and high injury severity score. A
greater proportion of the patients transported from the emergency department
had secondary injuries post-transfer. Adequate resuscitation before moving
the patient, especially in patients with multiple injury, is important.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
brain ischemia
coma
head injury
patient transport
EMTREE MEDICAL INDEX TERMS
article
clinical article
human
priority journal
EMBASE CLASSIFICATIONS
Neurology and Neurosurgery (8)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1990051611
MEDLINE PMID
1967776 (http://www.ncbi.nlm.nih.gov/pubmed/1967776)
PUI
L20051267
DOI
10.1016/0140-6736(90)90614-B
FULL TEXT LINK
http://dx.doi.org/10.1016/0140-6736(90)90614-B
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1098
TITLE
Secondary transportation of intensive care patients in Switzerland
ORIGINAL (NON-ENGLISH) TITLE
SEKUNDARTRANSPORTE VON INTENSIVPATIENTEN IN DER SCHWEIZ
AUTHOR NAMES
Frutiger A.
AUTHOR ADDRESSES
(Frutiger A.) Interdisziplinare Intensivst., Kantonsspital Chur, CH-7000
Chur, Switzerland.
CORRESPONDENCE ADDRESS
A. Frutiger, Interdisziplinare Intensivst., Kantonsspital Chur, CH-7000
Chur, Switzerland.
SOURCE
Schweizerische Medizinische Wochenschrift (1990) 120:6 (159-163). Date of
Publication: 1990
ISSN
0036-7672
BOOK PUBLISHER
Schwabe A.G. Verlag, Steinentorstrasse 13, Basel, Switzerland.
ABSTRACT
This study addresses the frequency and circumstances of secondary
transportation of intensive care patients in Switzerland by evaluation of a
questionnaire sent to all recognized intensive care units. Surprisingly many
critically ill (roughly speaking two full ICUs with 8 patients) are
transferred daily between Swiss hospitals, which amounts of about 6000
transfers per year. Pediatric cases make up 1/4 of the transfers and follow
a rather common pattern, since pediatric units prefer to pick up their
patients in the primary hospital with their own personnel and also to
transfer them later in the same way. For adult patients no common pattern is
recognizable except as regards admissions, which are usually performed by
the primary hospital's facilities. We suspect a considerable degree of
improvisation around secondary transfers of adults. Well trained personnel,
suitable ambulances, good communication and a reasonable degree of
monitoring are desirable. Non invasive monitoring techniques are considered
mandatory or at least helpful by most of the answering units, whereas
invasive monitoring was generally judged superfluous. The large number of
secondary patient transfers and their only moderately standardized
organization patterns make further research desirable.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
conference paper
organization and management
patient monitoring
priority journal
Switzerland
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Anesthesiology (24)
LANGUAGE OF ARTICLE
German
LANGUAGE OF SUMMARY
French, English
EMBASE ACCESSION NUMBER
1990048434
MEDLINE PMID
2305226 (http://www.ncbi.nlm.nih.gov/pubmed/2305226)
PUI
L20048090
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 1099
TITLE
Intrahospital transport of critically ill patients
ORIGINAL (NON-ENGLISH) TITLE
DER SPITALINTERNE TRANSPORT IM GROSSEN SPITAL
AUTHOR NAMES
Roth F.
AUTHOR ADDRESSES
(Roth F.) Abteilung fur Intensivbehandl., Inselspital, CH-3010 Bern,
Switzerland.
CORRESPONDENCE ADDRESS
F. Roth, Abteilung fur Intensivbehandl., Inselspital, CH-3010 Bern,
Switzerland.
SOURCE
Schweizerische Medizinische Wochenschrift (1990) 120:6 (164-169). Date of
Publication: 1990
ISSN
0036-7672
BOOK PUBLISHER
Schwabe A.G. Verlag, Steinentorstrasse 13, Basel, Switzerland.
ABSTRACT
In July 1989 an enquiry was conducted among all intensive care units with
more than 6 beds regarding their experience of intrahospital transport of
critically ill patients. The results are presented and commented on. The
study then deals with some of the specific problems which arise when
critically ill patients have to be moved within the hospital. Recent
publications and our own experience concerning transport of
ventilator-dependent patients suggest that there should at least be
monitoring of expiratory volumes. Ventilation of the patient by portable
mechanical ventilator has proven superior to manual ventilation since
mechanical ventilation is more consistent and therefore fewer hemodynamic
complications are to be expected. A simple device is described involving
suction (by means of an injector run on oxygen) and an oxygen delivery
system including an outlet into which the respirator can be plugged direct.
A small shelf which can be easily attached to the bed has proven helpful
during transport.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
artificial ventilation
intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
conference paper
organization and management
patient monitoring
priority journal
Switzerland
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
German
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1990048435
MEDLINE PMID
2305227 (http://www.ncbi.nlm.nih.gov/pubmed/2305227)
PUI
L20048091
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1100
TITLE
Rapid transfer to the coronary unit of patients with acute myocardial
infarct. Justification of the necessity and action measures
ORIGINAL (NON-ENGLISH) TITLE
El traslado rápido a la unidad coronaria de los enfermos con infarto agudo
de miocardio. Justificación de su necesidad y medidas de actuación.
AUTHOR NAMES
Gausí Gené C.
AUTHOR ADDRESSES
(Gausí Gené C.) Servicio de Cardiología, Hospital de Bellvitge, L'Hospitalet
de Llobregat, Barcelona.
CORRESPONDENCE ADDRESS
C. Gausí Gené, Servicio de Cardiología, Hospital de Bellvitge, L'Hospitalet
de Llobregat, Barcelona.
SOURCE
Medicina clínica (1990) 94:7 (259-261). Date of Publication: 24 Feb 1990
ISSN
0025-7753
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
heart infarction (therapy)
patient transport
EMTREE MEDICAL INDEX TERMS
coronary care unit
human
note
time
LANGUAGE OF ARTICLE
Spanish
MEDLINE PMID
2325488 (http://www.ncbi.nlm.nih.gov/pubmed/2325488)
PUI
L20753384
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1101
TITLE
Law and the emergency nurse. Orders on admitted patients held in the
emergency department.
AUTHOR NAMES
George J.E.
Quattrone M.S.
AUTHOR ADDRESSES
(George J.E.; Quattrone M.S.)
CORRESPONDENCE ADDRESS
J.E. George,
SOURCE
Journal of emergency nursing: JEN : official publication of the Emergency
Department Nurses Association (1990) 16:1 (43). Date of Publication: 1990
Jan-Feb
ISSN
0099-1767
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
clinical protocol
coronary care unit
emergency health service
patient transport
EMTREE MEDICAL INDEX TERMS
article
hospital bed utilization
human
legal aspect
nursing care
standard
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
2406495 (http://www.ncbi.nlm.nih.gov/pubmed/2406495)
PUI
L20811408
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1102
TITLE
Intrahospital transport of seriously ill or injured children.
AUTHOR NAMES
Tompkins J.M.
AUTHOR ADDRESSES
(Tompkins J.M.)
CORRESPONDENCE ADDRESS
J.M. Tompkins,
SOURCE
Pediatric nursing (1990) 16:1 (51-53). Date of Publication: 1990 Jan-Feb
ISSN
0097-9805
ABSTRACT
Critically ill children are frequently subject to transfer between hospitals
or even between units in hospitals. Safety is an important concern for the
ensuing transport in order to minimize risk and maximize efficiency. Nurses
should give careful consideration to many aspects of the intrahospital
transport when planning the move. Principles outlined in this article can be
included in critical care educational programs.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
clinical protocol
patient transport
pediatric nursing
EMTREE MEDICAL INDEX TERMS
article
child
human
organization and management
patient care
LANGUAGE OF ARTICLE
English
MEDLINE PMID
2359624 (http://www.ncbi.nlm.nih.gov/pubmed/2359624)
PUI
L20839805
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1103
TITLE
Effect of opposite changes in cardiac output and arterial PO(2) on the
relationship between mixed venous PO(2) and oxygen transport
AUTHOR NAMES
Carlile P.V.
Gray B.A.
AUTHOR ADDRESSES
(Carlile P.V.; Gray B.A.) Pulmonary Disease and Critical Care Medicine
Section, Veterans Administration Medical Center, Oklahoma City, OK
CORRESPONDENCE ADDRESS
Pulmonary Disease and Critical Care Medicine Section, Veterans
Administration Medical Center, Oklahoma City, OK
SOURCE
American Review of Respiratory Disease (1989) 140:4 (891-898). Date of
Publication: 1989
ISSN
0003-0805
BOOK PUBLISHER
American Lung Association, 16 Broadway Fl 4, New York, United States.
ABSTRACT
We examined the relationship between changes in systemic oxygen transport
(SO(2)T) and mixed venous PO(2) (Pv̄(O2)) in nine critically ill patients
with acute respiratory failure and analyzed the effect of like and opposite
changes in cardiac output (CO) and arterial PO(2) (Pa(O2)) on this
relationship. Paired measurements of oxygen consumption (V̇O(2)), SO(2)T,
and Pv̄(O2) were obtained before and after changes in the level of positive
end-expiratory pressure (PEEP) equal to or more than 5 cm H(2)O. V̇O(2) was
measured with a rebreathing circuit adapted to a volume ventilator, and
SO(2)T was calculated from thermodilution CO, Pa(O2), Sa(O2), and
hemoglobin. In eight studies, CO and Pa(O2) changed in the same direction,
and the absolute change in SO(2)T averaged 48 ± 38 ml/min/m(2). In 12
studies, CO and Pa(O2) changed in opposite directions, and the absolute
change in SO(2)T averaged 78 ± 69 ml/min/m(2). When Pa(O2) and CO changed in
the same direction, Pv̄(O2) increased on the higher level of SO(2)T (average
difference 3.0 ± 3.7 mm Hg, p < 0.05) and there was a strong positive
correlation between the difference in SO(2)T on lower and higher levels of
PEEP and the difference in Pv̄(O2) (r = 0.83). When Pa(O2) and CO changed in
opposite directions, Pv̄(O2) was unchanged on the higher level of SO(2)T,
and there was no correlation between the difference in SO(2)T on lower and
higher levels of PEEP and the difference in Pv̄(O2) (r = -0.45). V̇O(2) was
not different at the lower and higher levels of PEEP and the difference in
Pv̄O(2) (r = -0.45). V̇O(2) was not different at the lower and higher levels
of SO(2)T in both groups, indicating that V̇O(2) was not transport-limited
in these patients. We conclude that unidirectional changes in CO and Pa(O2)
produced like changes in Pv̄(O2), whereas the relationship between SO(2)T
and Pv̄(O2) is inconsistent when opposite changes in CO and Pa(O2) occur.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
acute respiratory failure
arterial oxygen tension
heart output
oxygen transport
EMTREE MEDICAL INDEX TERMS
artificial ventilation
human
hypoxemia
intensive care unit
oxygen consumption
positive end expiratory pressure
priority journal
venous oxygen tension
EMBASE CLASSIFICATIONS
Physiology (2)
Internal Medicine (6)
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Cardiovascular Diseases and Cardiovascular Surgery (18)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1989259529
MEDLINE PMID
2508523 (http://www.ncbi.nlm.nih.gov/pubmed/2508523)
PUI
L19259483
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1104
TITLE
Maintaining continuity of care: transferring patients from the CCU.
AUTHOR NAMES
Appel-Hardin S.J.
AUTHOR ADDRESSES
(Appel-Hardin S.J.)
CORRESPONDENCE ADDRESS
S.J. Appel-Hardin,
SOURCE
Critical care nurse (1989) 9:9 (92-94). Date of Publication: Oct 1989
ISSN
0279-5442
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
medical record
patient care
patient transport
primary health care
EMTREE MEDICAL INDEX TERMS
article
human
interpersonal communication
LANGUAGE OF ARTICLE
English
MEDLINE PMID
2805770 (http://www.ncbi.nlm.nih.gov/pubmed/2805770)
PUI
L19512422
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1105
TITLE
Front-page coverage.
AUTHOR NAMES
Stephens B.
AUTHOR ADDRESSES
(Stephens B.)
CORRESPONDENCE ADDRESS
B. Stephens,
SOURCE
Profiles in healthcare marketing (1989) :36 (46-49). Date of Publication:
Oct 1989
ISSN
1040-7480
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient transport
public relations
publication
EMTREE MEDICAL INDEX TERMS
article
hospital bed capacity
intensive care unit
United States
utilization review
LANGUAGE OF ARTICLE
English
MEDLINE PMID
10295710 (http://www.ncbi.nlm.nih.gov/pubmed/10295710)
PUI
L19493550
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1106
TITLE
Transportation of very low birthweight infants in 1986
AUTHOR NAMES
Cull A.B.
Darlow B.A.
Knight D.B.
AUTHOR ADDRESSES
(Cull A.B.; Darlow B.A.; Knight D.B.) Christchurch School of Medicine,
Christchurch
CORRESPONDENCE ADDRESS
Christchurch School of Medicine, Christchurch
SOURCE
New Zealand Medical Journal (1989) 102:869 (275-277). Date of Publication:
1989
ISSN
0028-8446
BOOK PUBLISHER
New Zealand Medical Association, 26 The Terrace, P.O. Box 156, Wellington,
New Zealand.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
low birth weight
patient transport
EMTREE MEDICAL INDEX TERMS
clinical article
human
infant
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1989221921
MEDLINE PMID
2733902 (http://www.ncbi.nlm.nih.gov/pubmed/2733902)
PUI
L19221879
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1107
TITLE
Role of the oncology nurse when the patient with cancer is transferred to
the critical care unit.
AUTHOR NAMES
Griffin J.P.
Comley C.
AUTHOR ADDRESSES
(Griffin J.P.; Comley C.)
CORRESPONDENCE ADDRESS
J.P. Griffin,
SOURCE
Oncology nursing forum (1989) 16:5 (703-707). Date of Publication: 1989
Sep-Oct
ISSN
0190-535X
ABSTRACT
Patients with cancer can become critically ill from treatment-related
complications or from progressive disease. The oncology nurse can positively
influence the care of the patient and family during and after transfer to
the Intensive Care Unit (ICU) by maintaining a strong advocacy role. Patient
and family education can prevent or alleviate many of the psychological
discomforts precipitated by critical illness. Open communication between the
oncology and critical care staff can ease discussion about ethical issues.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
oncology nursing
patient transport
EMTREE MEDICAL INDEX TERMS
article
family
human
mental stress
nursing
patient advocacy
patient education
LANGUAGE OF ARTICLE
English
MEDLINE PMID
2780406 (http://www.ncbi.nlm.nih.gov/pubmed/2780406)
PUI
L19483684
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1108
TITLE
Criteria predicting bad outcome before transfer to a critical care unit
AUTHOR NAMES
Badlissi A.
Baigelman W.
Beiser A.
Gannon D.
Goldiron J.
AUTHOR ADDRESSES
(Badlissi A.; Baigelman W.; Beiser A.; Gannon D.; Goldiron J.) Pulmonary
Medicine Unit, Waterbury Hospital, Waterbury, CT
CORRESPONDENCE ADDRESS
Pulmonary Medicine Unit, Waterbury Hospital, Waterbury, CT
SOURCE
Journal of Critical Care (1989) 4:2 (78-82). Date of Publication: 1989
ISSN
0883-9441
ABSTRACT
The charts of 225 hospitalized patients who were transferred into a critical
care unit were reviewed to variables that might be useful for identifying a
bad outcome by the time of discharge of 6-month follow-up. An age of more
than 65 years, the pre-hospital admission function status, the presence of
hypotension, and respiratory decompensation individually correlated well
with a bad outcome. Combinations of these variables were capable of
identifying individuals who were almost certain to have a bad outcome. We
conclude that charts and nomograms can be created applying simple and
readily available objective data that will permit physicians with triage
responsibility for critical care units to limit access for some patients.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hemodynamic monitoring
intensive care unit
risk factor
EMTREE MEDICAL INDEX TERMS
age
human
hypotension
major clinical study
mortality
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1989146463
PUI
L19146421
DOI
10.1016/0883-9441(89)90121-4
FULL TEXT LINK
http://dx.doi.org/10.1016/0883-9441(89)90121-4
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1109
TITLE
Comparison of neonatal mortality rates between transports to tertiary and
intermediate neonatal intensive care units.
AUTHOR NAMES
Chan L.S.
Vogt J.F.
Winters L.
AUTHOR ADDRESSES
(Chan L.S.; Vogt J.F.; Winters L.) Department of Pediatrics, School of
Medicine, University of Southern California, Los Angeles 90033.
CORRESPONDENCE ADDRESS
L.S. Chan, Department of Pediatrics, School of Medicine, University of
Southern California, Los Angeles 90033.
SOURCE
Journal of perinatology : official journal of the California Perinatal
Association (1989) 9:2 (141-146). Date of Publication: Jun 1989
ISSN
0743-8346
ABSTRACT
The differential of neonatal mortality rates between infant transports to
tertiary and to intermediate neonatal intensive care units (NICUs) was
examined based on 8,391 one-time infant transports from community hospitals
to tertiary or intermediate NICUs in Southern California in the three-year
period 1981-1983. Among the demographic, birth and delivery, and diagnostic
characteristics studied, nine were identified to be related significantly to
the higher neonatal mortality rate among transports to tertiary NICUs:
birthweight, gestational age, necessity of intubation, multiple clinical
conditions, presence of cardiac, neurologic, and genitourinary problems,
anomalies, and syndromes. Adjusting for differences in the number of cases
with necessity of intubation and the presence of the five clinical problems
reduced the neonatal mortality ratio of tertiary to intermediate NICUs from
1:56 to 1:01, while adjustment for birthweight and gestational age
differences reduced the ratio from 1.56 to 1.54. This analysis indicates
that the difference of neonatal mortality between the two levels of NICUs
can be explained to a larger extent by the higher proportion of infants
requiring intubation with serious clinical problems. Birthweight and
gestational age played only a minor role in this respect.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
infant mortality
newborn intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
Apgar score
article
birth weight
classification
comparative study
congenital malformation
gestational age
heart disease (complication)
human
intubation
neurologic disease (complication)
newborn
syndrome
urogenital system
LANGUAGE OF ARTICLE
English
MEDLINE PMID
2738723 (http://www.ncbi.nlm.nih.gov/pubmed/2738723)
PUI
L19443397
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1110
TITLE
A turnaround tale.
AUTHOR NAMES
Murphy B.
AUTHOR ADDRESSES
(Murphy B.)
CORRESPONDENCE ADDRESS
B. Murphy,
SOURCE
The American journal of nursing (1989) 89:6 (810). Date of Publication: Jun
1989
ISSN
0002-936X
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospice
intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
letter
organization and management
LANGUAGE OF ARTICLE
English
MEDLINE PMID
2729365 (http://www.ncbi.nlm.nih.gov/pubmed/2729365)
PUI
L19437139
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1111
TITLE
Need for ICU transfer questioned.
AUTHOR NAMES
Alexander B.
AUTHOR ADDRESSES
(Alexander B.)
CORRESPONDENCE ADDRESS
B. Alexander,
SOURCE
Oncology nursing forum (1989) 16:3 (316). Date of Publication: 1989 May-Jun
ISSN
0190-535X
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
oncology nursing
patient transport
EMTREE MEDICAL INDEX TERMS
education
human
note
psychological aspect
LANGUAGE OF ARTICLE
English
MEDLINE PMID
2734212 (http://www.ncbi.nlm.nih.gov/pubmed/2734212)
PUI
L19438165
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1112
TITLE
Training and development of the ICU nurse for critical care transport.
AUTHOR NAMES
Dyer L.L.
AUTHOR ADDRESSES
(Dyer L.L.)
CORRESPONDENCE ADDRESS
L.L. Dyer,
SOURCE
Critical care nurse (1989) 9:4 (74-80). Date of Publication: Apr 1989
ISSN
0279-5442
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
in service training
intensive care
nursing staff
patient transport
EMTREE MEDICAL INDEX TERMS
article
education
human
United States
university hospital
LANGUAGE OF ARTICLE
English
MEDLINE PMID
2582812 (http://www.ncbi.nlm.nih.gov/pubmed/2582812)
PUI
L19515878
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1113
TITLE
Changes in homeostatic parameters during transportation of patients from the
operating room to the resuscitation and intensive care unit
ORIGINAL (NON-ENGLISH) TITLE
Izmenenie nekotorykh pokazateleǐ gomeostaza v period transportirovki
bol'nykh iz operatsionnoǐ v otdelenie reanimatsii i intensivnoǐ terapii.
AUTHOR NAMES
Gochashvili N.D.
Grishchenko M.N.
AUTHOR ADDRESSES
(Gochashvili N.D.; Grishchenko M.N.)
CORRESPONDENCE ADDRESS
N.D. Gochashvili,
SOURCE
Anesteziologiia i reanimatologiia (1989) :2 (19-21). Date of Publication:
1989 Mar-Apr
ISSN
0201-7563
ABSTRACT
Oxygen balance, acid-base balance, systolic and diastolic blood pressure,
heart rate, central and peripheral temperature have been investigated in
patients after abdominal, thoracic and vascular surgery during
transportation from the operation room into an intensive care unit, using
different respiratory techniques and inhaled mixture composition. It has
been shown that spontaneous respiration leads to the onset of arterial
hypoxemia, which is more pronounced in patients after thoracic surgery.
Inhalation of vapourized O2 through nasal catheters during transportation
reduces the incidence and degree of arterial hypoxemia. Assisted lung
ventilation with O2 prevents the onset of arterial hypoxemia during
transportation.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
homeostasis
intensive care unit
operating room
patient transport
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
article
female
human
male
middle aged
LANGUAGE OF ARTICLE
Russian
MEDLINE PMID
2742180 (http://www.ncbi.nlm.nih.gov/pubmed/2742180)
PUI
L19450871
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1114
TITLE
Nursing frontiers. Critical care in the air.
AUTHOR NAMES
Guest J.L.
AUTHOR ADDRESSES
(Guest J.L.)
CORRESPONDENCE ADDRESS
J.L. Guest,
SOURCE
Journal of Christian nursing : a quarterly publication of Nurses Christian
Fellowship (1989) 6:2 (17-21). Date of Publication: 1989 Spring
ISSN
0743-2550
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
aerospace medicine
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
aircraft
article
human
LANGUAGE OF ARTICLE
English
MEDLINE PMID
2926644 (http://www.ncbi.nlm.nih.gov/pubmed/2926644)
PUI
L19392315
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1115
TITLE
Use of mobile coronary care unit by patients with myocardial infarction
AUTHOR NAMES
Galimidi J.
Tamir A.
Egoz N.
AUTHOR ADDRESSES
(Galimidi J.; Tamir A.; Egoz N.)
CORRESPONDENCE ADDRESS
J. Galimidi,
SOURCE
Harefuah (1989) 116:4 (199-202). Date of Publication: 15 Feb 1989
ISSN
0017-7768
ABSTRACT
140 consecutive patients with MI, all those admitted during 1 month to 3
general hospitals in Haifa, were interviewed and their records reviewed.
Only 17.3% had been transferred by a mobile coronary care unit (MCCU). The
rates of utilization were lower among residents of the Mount Carmel area and
among those hospitalized in Carmel Hospital. Those of European origin used
MCCU less than those of Asian-African origin. The rate of usage was
inversely related to the level of education. Multivariate analysis showed
that the continent of origin explained the largest proportion of the
variance. Age of patient and day of week were not of significance. Patients
who had had a previous coronary event used the MCCU more than those had not.
Only 13% referred to hospitals by physicians in the community were
transferred by MCCU, in contrast to 33% of those referred by Magen David
Adom stations. 67% of the patients had prior knowledge of the MCCU, but this
was not associated with rate of usage. We conclude that the use of the MCCU
in the Haifa area is not consistent with its original objectives. The
reasons are both patient- and service-related.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
coronary care unit
heart infarction
patient transport
preventive health service
EMTREE MEDICAL INDEX TERMS
Africa
article
Asia
ethnology
Europe
hospitalization
human
Israel
socioeconomics
utilization review
LANGUAGE OF ARTICLE
Hebrew
MEDLINE PMID
2731787 (http://www.ncbi.nlm.nih.gov/pubmed/2731787)
PUI
L19448717
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1116
TITLE
Intraclinical transport of intensive care patients
ORIGINAL (NON-ENGLISH) TITLE
INNERKLINISCHER TRANSPORT VON INTENSIVPATIENTEN: ERSTE ERFAHRUNGEN
AUTHOR NAMES
Pehl S.
Claus S.
Brost F.
Jantzen J.-P.
Dick W.
AUTHOR ADDRESSES
(Pehl S.; Claus S.; Brost F.; Jantzen J.-P.; Dick W.) Klinik fur
Anasthesiologie der Johannes-Gutenberg-Universitat, D-6500 Mainz
CORRESPONDENCE ADDRESS
Klinik fur Anasthesiologie der Johannes-Gutenberg-Universitat, D-6500 Mainz
SOURCE
Notfall Medizin (1988) 14:11 (949-954). Date of Publication: 1988
ISSN
0341-2903
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
high risk patient
human
organization
organization and management
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
German
EMBASE ACCESSION NUMBER
1988276863
PUI
L18276859
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1117
TITLE
Risk, cost, and benefit of transporting ICU patients for special studies
AUTHOR NAMES
Indeck M.
Peterson S.
Smith J.
Brotman S.
AUTHOR ADDRESSES
(Indeck M.; Peterson S.; Smith J.; Brotman S.) Department of Trauma Surgery,
Geisinger Medical Center, Danville, PA 17822
CORRESPONDENCE ADDRESS
Department of Trauma Surgery, Geisinger Medical Center, Danville, PA 17822
SOURCE
Journal of Trauma (1988) 28:7 (1020-1025). Date of Publication: 1988
ISSN
0022-5282
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
ABSTRACT
Prospective evaluation of 103 consecutive transports for diagnostic studies
of 56 patients out of the Shock Trauma Unit over a 3-month period was done
to document physiologic changes, the cost of each transport, and to assess
whether the information gained was utilized to change patient management. Of
the 56 patients, 36 (65%) were males and 20 (35%) were females with an age
range of 14-82 years (mean, 48 years). The Apache II score ranged from 3-49
(mean, 19.4). There were seven types of diagnostic studies: CT of the head
(28), CT of abdomen (35), CT of chest (four), angiography (nine),
ventilation/perfusion scan (three), tomography (seven) and miscellaneous
studies (15). The average trip time was 81 minutes, a range of 15-210,
requiring an average of 3.3 personnel per trip. Ninety-four transported
patients had ventilatory support, 26 had PA lines, and 26 transports
required three or more IV infusion pumps. Sixty-eight per cent of all
transports experienced serious physiologic changes of 5 minutes' duration
defined as BP systolic or diastolic ± 20 mm Hg (40%), pulse ± 20
beats/minute (21%), ventilatory rate ± 5/minute (20%), O(2) saturation
decrease by 5% or more (17%). There was a total of 113 serious changes
requiring an increase in support of the patient during the transport. There
were no significant differences when comparing diagnosis of patient or types
of studies to the number of changes in the physiologic parameters, nor were
there significant differences within a physiologic parameter when comparing
patient types or diagnostic studies. Twenty-five of the transports resulted
in a change in patient management within 48 hours. However, no diagnostic
study produced a significantly greater number of management changes. The
average transport cost per patient was $465.00. Transportation of patients
from the ICU resulted in a large number of physiologic changes, each
requiring changes in support, therefore suggesting a need for the
preservation of equally intensive monitoring and care of these patients
during transports. The indications for diagnostic studies must be weighed
against a 76% chance that the result will not alter the patient's
management.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cardiopulmonary hemodynamics
computer assisted tomography
cost
hospital
intensive care
lung ventilation
nuclear magnetic resonance
patient transport
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
complication
computer analysis
diagnosis
economic aspect
female
human
major clinical study
male
organization and management
priority journal
EMBASE CLASSIFICATIONS
Surgery (9)
Health Policy, Economics and Management (36)
Forensic Science Abstracts (49)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1988204540
MEDLINE PMID
3135417 (http://www.ncbi.nlm.nih.gov/pubmed/3135417)
PUI
L18204540
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1118
TITLE
The child requiring critical care transport.
AUTHOR NAMES
McCloskey K.A.
AUTHOR ADDRESSES
(McCloskey K.A.)
CORRESPONDENCE ADDRESS
K.A. McCloskey,
SOURCE
Pediatric emergency care (1988) 4:3 (230-231). Date of Publication: Sep 1988
ISSN
0749-5161
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
aircraft
child
human
letter
organization and management
patient care planning
LANGUAGE OF ARTICLE
English
MEDLINE PMID
3186534 (http://www.ncbi.nlm.nih.gov/pubmed/3186534)
PUI
L18819097
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1119
TITLE
Physician-accompanied transport of surgical intensive care patients
AUTHOR NAMES
Girotti M.J.
Pagliarello G.
Todd T.R.
Demajo W.
Cain J.
Walker P.
Patterson A.
AUTHOR ADDRESSES
(Girotti M.J.; Pagliarello G.; Todd T.R.; Demajo W.; Cain J.; Walker P.;
Patterson A.) Surgical Intensive Care Research Group, Department of Surgery,
Toronto General Hospital, Toronto, Ont. M5G 2C4
CORRESPONDENCE ADDRESS
Surgical Intensive Care Research Group, Department of Surgery, Toronto
General Hospital, Toronto, Ont. M5G 2C4
SOURCE
Canadian Journal of Anaesthesia (1988) 35:3 I (303-308). Date of
Publication: 1988
ISSN
0832-610X
BOOK PUBLISHER
Canadian Anaesthetists' Society, 1 Eglinton Avenue East, Suite 208, Toronto,
Canada.
ABSTRACT
During a one-year period, 107 critically ill adult patients were transferred
by a physician-accompanied transport system (PATS). Most patients required
both tracheal intubation (82 per cent) and mechanical ventilation (71 per
cent), while continuous vasopressor support was required in 27 per cent of
transfers. Patients were classified as either potential organ donors (n =
21) or nondonor patients (n = 86). Nondonor patients had a mean time of
patient transfer documented from the initial telephone contact to final
arrival of the patient in the ICU of 345 ± 221 min (range 65-1350 min); the
mean time the patients were out-of-hospital was 73 ± 58 min (range 5-330
min); the average distance travelled by the patient and PATS was 342 ± 692
km (range 1-4000 km). Ultimate nonsurvivors of ICU admission (36 per cent)
had shorter out-of-hospital times, shorter travel distances, and increased
interventional support, as assessed by the Therapeutic Intervention Scoring
System applied over the telephone and prior to departure at the referring
hospital. Significant interventions were undertaken by PATS in 23 per cent
of the nondonor patients prior to departure. During the transport process,
there was at least a seven per cent morbidity (arrhythmia, hypotension, and
vehicular difficulties) and a 0.9 mortality rate. We conclude that PATS
offered significant advantages to this patient population through its
ability to maintain acceptable morbidity and mortality rates while
transferring patients over long distances and for prolonged periods of time.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
organ donor
survival
EMTREE MEDICAL INDEX TERMS
blunt trauma
fatality
human
mortality
organization and management
review
sepsis
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
French, English
EMBASE ACCESSION NUMBER
1988132062
MEDLINE PMID
3383322 (http://www.ncbi.nlm.nih.gov/pubmed/3383322)
PUI
L18132062
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1120
TITLE
Nursing interventions: caring for parents of a newborn transferred to a
regional intensive care nursery--a challenge for low risk obstetric
specialists.
AUTHOR NAMES
Weingarten C.T.
AUTHOR ADDRESSES
(Weingarten C.T.) College of Nursing, Villanova University, PA 19085-1690.
CORRESPONDENCE ADDRESS
C.T. Weingarten, College of Nursing, Villanova University, PA 19085-1690.
SOURCE
Journal of perinatology : official journal of the California Perinatal
Association (1988) 8:3 (271-275). Date of Publication: 1988 Summer
ISSN
0743-8346
ABSTRACT
Parents of infants transferred to a regional NICU have unique needs for
support when the mother remains in the hospital of birth. Suddenly in a high
risk situation and faced with family separation, these parents may display
intense grief and crisis reactions related to their infant's status and
transfer. The high risk interventions they require are frequently
incongruent with the wellness orientation of staff specializing in care of
the low risk clients. Nevertheless, low risk specialists have a critical
role in assisting parents through this difficult transition to parenthood.
Effective strategies are based upon: understanding that at some point
infants requiring transfer to a regional NICU will be born; advance planning
to prepare staff to assist parents during this type of crisis; establishing
an ongoing relationship with staff from the regional NICU; and
identification of crisis support networks available to parents and to staff
within the low risk setting.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
mother
newborn intensive care
obstetrical nursing
EMTREE MEDICAL INDEX TERMS
article
crisis intervention
female
grief
human
methodology
mother child relation
newborn
patient care planning
patient transport
psychological aspect
LANGUAGE OF ARTICLE
English
MEDLINE PMID
3225670 (http://www.ncbi.nlm.nih.gov/pubmed/3225670)
PUI
L19375639
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1121
TITLE
Medical directors of critical care air transport services.
AUTHOR NAMES
White J.D.
AUTHOR ADDRESSES
(White J.D.)
CORRESPONDENCE ADDRESS
J.D. White,
SOURCE
Critical care medicine (1988) 16:5 (570-571). Date of Publication: May 1988
ISSN
0090-3493
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
aircraft
letter
organization and management
LANGUAGE OF ARTICLE
English
MEDLINE PMID
3359799 (http://www.ncbi.nlm.nih.gov/pubmed/3359799)
PUI
L18747261
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1122
TITLE
Critical care helicopter service: evaluation of prehospital utilization in
trauma care.
AUTHOR NAMES
Kazarian K.K.
AUTHOR ADDRESSES
(Kazarian K.K.)
CORRESPONDENCE ADDRESS
K.K. Kazarian,
SOURCE
Connecticut medicine (1988) 52:5 (317). Date of Publication: May 1988
ISSN
0010-6178
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
aircraft
emergency health service
patient transport
EMTREE MEDICAL INDEX TERMS
human
letter
utilization review
LANGUAGE OF ARTICLE
English
MEDLINE PMID
3402215 (http://www.ncbi.nlm.nih.gov/pubmed/3402215)
PUI
L18779435
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1123
TITLE
Critical care helicopter service. Evaluation of prehospital utilization in
trauma care.
AUTHOR NAMES
Schwartz R.J.
Jacobs L.M.
AUTHOR ADDRESSES
(Schwartz R.J.; Jacobs L.M.)
CORRESPONDENCE ADDRESS
R.J. Schwartz,
SOURCE
Connecticut medicine (1988) 52:4 (203-208). Date of Publication: Apr 1988
ISSN
0010-6178
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
aircraft
emergency health service
patient transport
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
article
child
female
human
male
middle aged
traffic accident
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
3370977 (http://www.ncbi.nlm.nih.gov/pubmed/3370977)
PUI
L18760938
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1124
TITLE
Risks in intrahospital transport.
AUTHOR NAMES
Wright I.
Rogers P.N.
Ridley S.
AUTHOR ADDRESSES
(Wright I.; Rogers P.N.; Ridley S.)
CORRESPONDENCE ADDRESS
I. Wright,
SOURCE
Annals of internal medicine (1988) 108:4 (638). Date of Publication: Apr
1988
ISSN
0003-4819
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient transport
EMTREE MEDICAL INDEX TERMS
human
intensive care
letter
methodology
LANGUAGE OF ARTICLE
English
MEDLINE PMID
3348578 (http://www.ncbi.nlm.nih.gov/pubmed/3348578)
PUI
L18731248
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1125
TITLE
Written policy and patient transport from the intensive care unit.
AUTHOR NAMES
Smith I.U.
Fleming S.
Bekes C.E.
AUTHOR ADDRESSES
(Smith I.U.; Fleming S.; Bekes C.E.)
CORRESPONDENCE ADDRESS
I.U. Smith,
SOURCE
Critical care medicine (1987) 15:12 (1162). Date of Publication: Dec 1987
ISSN
0090-3493
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
management
patient transport
EMTREE MEDICAL INDEX TERMS
accident prevention
human
letter
organization and management
standard
LANGUAGE OF ARTICLE
English
MEDLINE PMID
3677771 (http://www.ncbi.nlm.nih.gov/pubmed/3677771)
PUI
L18672002
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1126
TITLE
Medical directors of critical care air transport services
AUTHOR NAMES
Poulton T.J.
Kisicki P.A.
AUTHOR ADDRESSES
(Poulton T.J.; Kisicki P.A.) Department of Anesthesiology, Creighton
University School of Medicine, Omaha, NE 68131
CORRESPONDENCE ADDRESS
Department of Anesthesiology, Creighton University School of Medicine,
Omaha, NE 68131
SOURCE
Critical Care Medicine (1987) 15:8 (784-785). Date of Publication: 1987
ISSN
0090-3493
BOOK PUBLISHER
Lippincott Williams and Wilkins, 351 West Camden Street, Baltimore, United
States.
ABSTRACT
Since 1975, the number of hospital-based, air medical transport services in
the United States has increased from under ten to over 100. Since
approximately 70% of flights in the typical flight program transport a
critical patient between hospitals, we expected critical care specialists to
be involved in the medical direction of many flight programs. To determine
how many are directing such programs, we designed a survey of the
qualifications, specialties, and aeromedical and critical care training of
those medical directors.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
air transportation
critical illness
organization
patient transport
EMTREE MEDICAL INDEX TERMS
clinical article
human
organization and management
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1988055669
MEDLINE PMID
3608535 (http://www.ncbi.nlm.nih.gov/pubmed/3608535)
PUI
L18055669
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1127
TITLE
Complications of intrahospital transport in critically ill patients
AUTHOR NAMES
Braman S.S.
Dunn S.M.
Amico C.A.
Millman R.P.
AUTHOR ADDRESSES
(Braman S.S.; Dunn S.M.; Amico C.A.; Millman R.P.) Rhode Island Hospital,
Division of Pulmonary and Critical Care Medicine, Providence, RI 02903
CORRESPONDENCE ADDRESS
Rhode Island Hospital, Division of Pulmonary and Critical Care Medicine,
Providence, RI 02903
SOURCE
Annals of Internal Medicine (1987) 107:4 (469-473). Date of Publication:
1987
ISSN
0003-4819
BOOK PUBLISHER
American College of Physicians, 190 N. Indenpence Mall West, Philadelphia,
United States.
ABSTRACT
To determine the frequency of hemodynamic and respiratory complications
during movement within the hospital, we conducted a prospective study
involving 36 critically ill, ventilator-dependent patients who needed
procedures done outside the intensive care unit. During the first 20
transports, patients received ventilation through a manual resuscitation
bag. Arterial blood gas measurements showed frequent changes from baseline
with alterations in P(CO(2)) (> 10 torr) or pH (> 0.05) occurring on 14
occasions. In a subsequent study, 16 patients received ventilation during
transit with the aid of a portable mechanical ventilator. Although 6
patients showed changes in arterial blood gas values, mean changes in
P(CO(2)) and pH were significantly less than in the group that received
manual ventilatory support (p < 0.01). Hemodynamic complications of
hypotension and cardiac arrhythmia showed a significant correlation with
disturbances in arterial blood gases (p < 0.05). Although limited by the
lack of a control period, this study shows that the transport of critically
ill patients may result in severe hemodynamic complications; it also
suggests that these complications might be prevented by more careful
monitoring of ventilation.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital transport system
ventilator
EMTREE MEDICAL INDEX TERMS
cardiovascular system
clinical article
human
intensive care
therapy
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1987217260
MEDLINE PMID
3477105 (http://www.ncbi.nlm.nih.gov/pubmed/3477105)
PUI
L17149760
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1128
TITLE
An organizational system for critical care transport
AUTHOR NAMES
Hackel A.
AUTHOR ADDRESSES
(Hackel A.) Department of Anesthesia, Stanford University School of
Medicine, Stanford, CA
CORRESPONDENCE ADDRESS
Department of Anesthesia, Stanford University School of Medicine, Stanford,
CA
SOURCE
International Anesthesiology Clinics (1987) 25:2 (1-13). Date of
Publication: 1987
ISSN
0020-5907
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
human
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1987178501
MEDLINE PMID
3610342 (http://www.ncbi.nlm.nih.gov/pubmed/3610342)
PUI
L17111001
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1129
TITLE
Reducing in-house transfers improves cost effectiveness.
AUTHOR NAMES
Deines E.
Stevens B.
AUTHOR ADDRESSES
(Deines E.; Stevens B.)
CORRESPONDENCE ADDRESS
E. Deines,
SOURCE
Nursing management (1987) 18:9 (54-57). Date of Publication: Sep 1987
ISSN
0744-6314
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient transport
EMTREE MEDICAL INDEX TERMS
article
cost
cost benefit analysis
economics
human
productivity
task performance
time
LANGUAGE OF ARTICLE
English
MEDLINE PMID
3114689 (http://www.ncbi.nlm.nih.gov/pubmed/3114689)
PUI
L17784567
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1130
TITLE
Early recanalization in acute myocardial infarction: the role of the
community hospital
AUTHOR NAMES
Aziz D.A.
Landau E.
Gotsman M.
Reisin L.H.
AUTHOR ADDRESSES
(Aziz D.A.; Landau E.; Gotsman M.; Reisin L.H.)
CORRESPONDENCE ADDRESS
D.A. Aziz,
SOURCE
Harefuah (1987) 112:12 (592-593). Date of Publication: 15 Jun 1987
ISSN
0017-7768
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
streptokinase (drug administration)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
community hospital
coronary care unit
heart infarction (therapy)
hospital
patient transport
EMTREE MEDICAL INDEX TERMS
article
heart catheterization
human
percutaneous transluminal angioplasty
time
CAS REGISTRY NUMBERS
streptokinase (9002-01-1)
LANGUAGE OF ARTICLE
Hebrew
MEDLINE PMID
2962913 (http://www.ncbi.nlm.nih.gov/pubmed/2962913)
PUI
L18694239
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1131
TITLE
Critical care transport.
AUTHOR ADDRESSES
SOURCE
International anesthesiology clinics (1987) 25:2 (1-173). Date of
Publication: 1987 Summer
ISSN
0020-5907
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
article
human
LANGUAGE OF ARTICLE
English
MEDLINE PMID
3610343 (http://www.ncbi.nlm.nih.gov/pubmed/3610343)
PUI
L17780018
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1132
TITLE
A pressure-limited critical care ventilator
AUTHOR NAMES
Morris A.H.
Myers L.
AUTHOR ADDRESSES
(Morris A.H.; Myers L.) Pulmonary Division, LDS Hospital, Salt Lake City, UT
84143
CORRESPONDENCE ADDRESS
Pulmonary Division, LDS Hospital, Salt Lake City, UT 84143
SOURCE
Respiratory Care (1987) 32:3 (172-177). Date of Publication: 1987
ISSN
0020-1324
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
artificial ventilation
patient transport
ventilator
EMTREE MEDICAL INDEX TERMS
devices
nonhuman
peak expiratory flow
preliminary communication
pressure
respiratory system
therapy
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1987097228
MEDLINE PMID
10315728 (http://www.ncbi.nlm.nih.gov/pubmed/10315728)
PUI
L17029728
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1133
TITLE
Easing the transfer from CCU.
AUTHOR NAMES
Craney J.M.
Greck D.L.
AUTHOR ADDRESSES
(Craney J.M.; Greck D.L.)
CORRESPONDENCE ADDRESS
J.M. Craney,
SOURCE
The American journal of nursing (1987) 87:5 (618-619). Date of Publication:
May 1987
ISSN
0002-936X
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
information processing
medical record
nursing
patient transport
EMTREE MEDICAL INDEX TERMS
article
coronary care unit
human
organization and management
progressive patient care
LANGUAGE OF ARTICLE
English
MEDLINE PMID
3646837 (http://www.ncbi.nlm.nih.gov/pubmed/3646837)
PUI
L17730337
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1134
TITLE
Transfer stress in patients after myocardial infarction.
AUTHOR NAMES
Schactman M.
AUTHOR ADDRESSES
(Schactman M.)
CORRESPONDENCE ADDRESS
M. Schactman,
SOURCE
Focus on critical care / American Association of Critical-Care Nurses (1987)
14:2 (34-37). Date of Publication: Apr 1987
ISSN
0736-3605
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
heart infarction
mental stress
patient transport
EMTREE MEDICAL INDEX TERMS
article
coronary care unit
human
progressive patient care
psychological aspect
LANGUAGE OF ARTICLE
English
MEDLINE PMID
3646146 (http://www.ncbi.nlm.nih.gov/pubmed/3646146)
PUI
L17733767
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1135
TITLE
Genetic and biochemical study of allelic variants of hypoxanthine
phosphoribosyl transferase in house mice
AUTHOR NAMES
Bochkarev M.N.
Kulbakina N.A.
Zakiyan S.M.
AUTHOR ADDRESSES
(Bochkarev M.N.; Kulbakina N.A.; Zakiyan S.M.) Institute of Cytology and
Genetics, Academy of Sciences of the USSR, Siberian Branch, Novosibirsk
CORRESPONDENCE ADDRESS
Institute of Cytology and Genetics, Academy of Sciences of the USSR,
Siberian Branch, Novosibirsk
SOURCE
Doklady Biological Sciences (1986) 288:1-6 (304-306). Date of Publication:
1986
ISSN
0012-4966
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
hypoxanthine phosphoribosyltransferase
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
allele
genetic polymorphism
EMTREE MEDICAL INDEX TERMS
animal cell
heredity
mouse
nonhuman
CAS REGISTRY NUMBERS
hypoxanthine phosphoribosyltransferase (9016-12-0)
EMBASE CLASSIFICATIONS
Human Genetics (22)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1987050650
PUI
L17218795
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1136
TITLE
Conditions for transportation to specialized burn units
ORIGINAL (NON-ENGLISH) TITLE
Podmínky transportu na specializované popáleninové pracoviste.
AUTHOR NAMES
Königová R.
Klimes J.
AUTHOR ADDRESSES
(Königová R.; Klimes J.)
CORRESPONDENCE ADDRESS
R. Königová,
SOURCE
Rozhledy v chirurgii : mesícník Ceskoslovenské chirurgické spolecnosti
(1986) 65:12 (797-801). Date of Publication: Dec 1986
ISSN
0035-9351
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
burn (diagnosis, therapy)
intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
article
human
LANGUAGE OF ARTICLE
Czech
MEDLINE PMID
3810320 (http://www.ncbi.nlm.nih.gov/pubmed/3810320)
PUI
L17688094
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1137
TITLE
Emergency Nurses Association/National Flight Nurses Association joint
position paper: staffing of critical care air medical transport services.
AUTHOR ADDRESSES
SOURCE
Journal of emergency nursing: JEN : official publication of the Emergency
Department Nurses Association (1986) 12:6 (16A-19A). Date of Publication:
1986 Nov-Dec
ISSN
0099-1767
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
patient transport
personnel management
EMTREE MEDICAL INDEX TERMS
article
human
manpower
nursing organization
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
3540400 (http://www.ncbi.nlm.nih.gov/pubmed/3540400)
PUI
L17671213
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1138
TITLE
Transfer to a public hospital. A prospective study of 467 patients
AUTHOR NAMES
Schiff R.L.
Ansell D.A.
Schlosser J.E.
AUTHOR ADDRESSES
(Schiff R.L.; Ansell D.A.; Schlosser J.E.) Division of General Medicine,
Department of Medicine, Cook County Hospital, Chicago, IL 60612
CORRESPONDENCE ADDRESS
Division of General Medicine, Department of Medicine, Cook County Hospital,
Chicago, IL 60612
SOURCE
New England Journal of Medicine (1986) 314:9 (552-557). Date of Publication:
1986
ISSN
0028-4793
ABSTRACT
In recent years there has been a dramatic increase in the number of patients
transferred to public hospitals in the United States. We prospectively
studied 467 medical and surgical patients who were transferred from the
emergency departments of other hospitals in the Chicago area to Cook County
Hospital and subsequently admitted. Eighty-nine percent of the transferred
patients were black or Hispanic, and 81 percent were unemployed. Most (87
percent) were transferred because they lacked adequate medical insurance.
Only 6 percent of the patients had given written informed consent for
transfer. Twenty-two percent required admission to an intensive care unit,
usually within 24 hours of arrival. Twenty-four percent were in an unstable
clinical condition at the transferring hospital. The proportion of
transferred medical-service patients who died was 9.4 percent, which was
significantly higher than the proportion of medical-service patients who
were not transferred (3.8 percent, P < 0.01). There was no significant
difference in the proportion of deaths on the surgical service between
patients who were transferred and those who were not (1.5 vs. 2.4 percent).
We conclude that patients are transferred to public hospitals predominantly
for economic reasons, in spite of the fact that many of them are in an
unstable condition at the time of transfer.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
admission
ethics
health insurance
health status
intensive care unit
patient referral
public hospital
EMTREE MEDICAL INDEX TERMS
economic aspect
ethnic group
human
organization and management
priority journal
prospective study
psychological aspect
social aspect
social structure
therapy
United States
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1986117124
MEDLINE PMID
3945293 (http://www.ncbi.nlm.nih.gov/pubmed/3945293)
PUI
L16128063
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 1139
TITLE
Monitoring of serum pseudocholinesterase and transferrin in intensive care
patients
ORIGINAL (NON-ENGLISH) TITLE
Monitoraggio della pseudo-colinesterasi serica e della transferrina in
pazienti di rianimazione.
AUTHOR NAMES
Cantoni A.
Pizzola A.
AUTHOR ADDRESSES
(Cantoni A.; Pizzola A.)
CORRESPONDENCE ADDRESS
A. Cantoni,
SOURCE
Minerva anestesiologica (1986) 52:1-2 (51-57). Date of Publication: 1986
Jan-Feb
ISSN
0375-9393
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
cholinesterase
transferrin
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
EMTREE MEDICAL INDEX TERMS
adolescent
adult
aged
article
blood
female
human
male
metabolism
middle aged
monitoring
prognosis
retrospective study
CAS REGISTRY NUMBERS
cholinesterase (9001-08-5)
transferrin (82030-93-1)
LANGUAGE OF ARTICLE
Italian
MEDLINE PMID
3736913 (http://www.ncbi.nlm.nih.gov/pubmed/3736913)
PUI
L16737201
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1140
TITLE
Transfer anxiety and the MI patient.
AUTHOR NAMES
Miracle V.A.
AUTHOR ADDRESSES
(Miracle V.A.)
CORRESPONDENCE ADDRESS
V.A. Miracle,
SOURCE
Kentucky nurse (1986) 34:1 (15-16). Date of Publication: 1986 Jan-Feb
ISSN
0742-8367
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
anxiety
heart infarction
progressive patient care
EMTREE MEDICAL INDEX TERMS
article
coronary care unit
human
nurse patient relationship
nursing
psychological aspect
LANGUAGE OF ARTICLE
English
MEDLINE PMID
3633006 (http://www.ncbi.nlm.nih.gov/pubmed/3633006)
PUI
L16670572
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1141
TITLE
Oxygen lung transfer under respirator during anaesthesia and intensive care
ORIGINAL (NON-ENGLISH) TITLE
TRANSFERT PULMONAIRE DE L'OXYGENE SOUS RESPIRATEUR EN ANESTHESIE ET EN
REANIMATION
AUTHOR NAMES
Gay R.
Horellou M.F.
Gobeaux R.
AUTHOR ADDRESSES
(Gay R.; Horellou M.F.; Gobeaux R.) Service de Reanimation Medicale, Hopital
Universitaire Dupuytren, 87042 Limoges Cedex
CORRESPONDENCE ADDRESS
Service de Reanimation Medicale, Hopital Universitaire Dupuytren, 87042
Limoges Cedex
SOURCE
Clinical Respiratory Physiology (1985) 21:3 (257-261). Date of Publication:
1985
ISSN
0272-7587
ABSTRACT
The resistance of the passage of oxygen from air to blood is estimated in
measuring P(A - a)O(2). This index varies with FIO(2). P(a/A)O(2), the index
proposed by GILBERT and KEIGHLEY [18], expresses PaO(2) as a percentage of
PAO(2). This index would be independent of FIO(2). Two groups are studied.
Patients of the first group (n = 22) are artificially ventilated in
intensive care for severe parenchymal lesion. Those of the second group (n =
25) have no notable history of pulmonary disease and are anaesthetized and
hooked up to a respirator for surgery. Blood gases are measured and the
transfer indices calculated for increasing FIO(2) (0.4, 0.6, 0.8 and 1).
Under conditions of anaesthesia, the effect of thermic decrease on PaCO(2)
is dampened by maintaining a constant PACO(2) during measurement. P(a/A)O(2)
does not vary significantly as a function of FIO(2) in the intensive care
group, whereas the results observed in the anaesthetized patients are
substantially dispersed. Factors which are susceptible to affect oxygen
transfer as well as the effects of FIO(2) increase are discussed. P(a/A)O(2)
stability observed in intensive care is probably related to the predominant
effect of venous admixture, which is hardly affected by variations in
FIO(2). In anaesthesia, resistance to the transfer of oxygen appears to be
linked mainly to changes in the distribution of the ventilation/perfusion
ratio (reduction in CRF; pharmacological effect of oxygen on pulmonary
vascular reactivity). These phenomena lead to alveolar instability and a
variable shunt effect. It appears that P(a/A)O(2) is a useful index for
determining oxygen transfer at different concentrations of oxygen in the
case of parenchymal injury, if ever the haemodynamic state is relatively
stable. On the other hand, the use of this index in functional pulmonary
affection is much more delicate.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
alfadolone acetate
alfaxalone
althesin
pancuronium bromide
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
anesthesia
artificial ventilation
drug therapy
gas exchange
lung ventilation perfusion ratio
oxygen transport
EMTREE MEDICAL INDEX TERMS
blood and hemopoietic system
blood gas
central nervous system
clinical article
human
priority journal
respiratory system
therapy
DRUG TRADE NAMES
althesin
CAS REGISTRY NUMBERS
alfadolone acetate (23930-37-2)
alfaxalone (23930-19-0)
althesin (8067-82-1)
pancuronium bromide (15500-66-0)
EMBASE CLASSIFICATIONS
Chest Diseases, Thoracic Surgery and Tuberculosis (15)
Anesthesiology (24)
Clinical and Experimental Pharmacology (30)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
French
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1985144809
PUI
L15094809
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1142
TITLE
Immediate problems met in intensive care and transportation of neonates
under 1500 g born outside of a maternity hospital. Study of results over
four years
ORIGINAL (NON-ENGLISH) TITLE
PROBLEMES IMMEDIATS POSES PAR LA RENAIMATION ET LE TRANSPORT DESENFANTS DE
MOINS DE 1500 GRAMMES NES HORS MATERNITE. ETUDE DES RESULTATS SUR UNE
PERIODE DE QUATRE ANS
AUTHOR NAMES
Herve C.
Gaillard M.
Huguenard P.
AUTHOR ADDRESSES
(Herve C.; Gaillard M.; Huguenard P.) Service d'Aide Medicale Urgente du
Val-de Marne (SAMU 94), Hopital Henri Mondor, 94010 Creteil
CORRESPONDENCE ADDRESS
Service d'Aide Medicale Urgente du Val-de Marne (SAMU 94), Hopital Henri
Mondor, 94010 Creteil
SOURCE
Annales de Pediatrie (1985) 32:3 BIS (257-261). Date of Publication: 1985
ISSN
0066-2097
ABSTRACT
Analysis of 12 unexpected deliveries of infants under 1500 g at birth which
occurred over four years in the Val-de-Marne district exemplifies the
significance of emergency medical care. Mortality rate is 30% and is
significantly higher (with an up to three-fold increase) in deliveries of
infants under 1250 g. Furthermore, six children had residual neurologic
impairment, severe in three, with a follow up ranging from six months to
four years. Comparison with studies on small-for-dates or premature infants
confirms the importance of the first moments of life for these hypotrophic,
high risk neonates in whom the chief secondary disorders are enterocolitis
and patent ductus arteriosus, more prevalent in our series. These problems
seem to be related, mainly, to hypothermia and non-optimal conditions at
delivery and explain the discrepancies in mortality rates between these
different series. However, improvement in the prognosis for these infants
should not rely on optimization of management which is already very thorough
and very rapid on the spot, but rather on information of mothers and routine
monitoring of pregnancies, which will avoid increasing the risk in these
already high-risk infants.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
newborn intensive care
transport
EMTREE MEDICAL INDEX TERMS
case report
epidemiology
geographic distribution
human
hypothermia
low birth weight
mortality
newborn
organization and management
pregnancy
prevention
risk factor
therapy
EMBASE CLASSIFICATIONS
Obstetrics and Gynecology (10)
Public Health, Social Medicine and Epidemiology (17)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
French
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1985109254
PUI
L15109254
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1143
TITLE
Transferring the terminally ill
AUTHOR NAMES
Vernon M.S.
Klectner H.
Vinciguerra V.
AUTHOR ADDRESSES
(Vernon M.S.; Klectner H.; Vinciguerra V.) East Carolina University, School
of Medicine, Greenville, NC 27835-1846
CORRESPONDENCE ADDRESS
East Carolina University, School of Medicine, Greenville, NC 27835-1846
SOURCE
New England Journal of Medicine (1985) 312:7 (440-442). Date of Publication:
1985
ISSN
0028-4793
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
terminal care
EMTREE MEDICAL INDEX TERMS
editorial
human
intensive care unit
patient transport
priority journal
psychological aspect
therapy
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Health Policy, Economics and Management (36)
Public Health, Social Medicine and Epidemiology (17)
Gerontology and Geriatrics (20)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1985080148
MEDLINE PMID
3969099 (http://www.ncbi.nlm.nih.gov/pubmed/3969099)
PUI
L15130148
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1144
TITLE
Unconvinced of value of antenatal transfer to level 3 intensive care units.
AUTHOR NAMES
Sepkowitz S.
AUTHOR ADDRESSES
(Sepkowitz S.)
CORRESPONDENCE ADDRESS
S. Sepkowitz,
SOURCE
Pediatrics (1985) 75:4 (801-802). Date of Publication: Apr 1985
ISSN
0031-4005
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
infant mortality
newborn intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
human
letter
newborn
statistics
LANGUAGE OF ARTICLE
English
MEDLINE PMID
3982913 (http://www.ncbi.nlm.nih.gov/pubmed/3982913)
PUI
L15654989
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1145
TITLE
Immediate problems posed in the intensive care and transportation of
children weighing less than 1,500 grams born outside of a maternity center.
Study of results over a period of 4 years
ORIGINAL (NON-ENGLISH) TITLE
Problèmes immédiats posés par la réanimation et le transport des enfants de
moins de 1 500 grammes nés hors maternité. Etude des résultats sur une
période de quatre ans.
AUTHOR NAMES
Hervé C.
Gaillard M.
Huguenard P.
AUTHOR ADDRESSES
(Hervé C.; Gaillard M.; Huguenard P.)
CORRESPONDENCE ADDRESS
C. Hervé,
SOURCE
Annales de pédiatrie (1985) 32:3 Pt 2 (257-261). Date of Publication: 25 Mar
1985
ISSN
0066-2097
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
home delivery
intensive care
low birth weight
obstetric delivery
patient transport
EMTREE MEDICAL INDEX TERMS
article
birth weight
comparative study
female
France
human
infant mortality
male
mortality
newborn
prematurity (prevention)
small for date infant
LANGUAGE OF ARTICLE
French
MEDLINE PMID
4004034 (http://www.ncbi.nlm.nih.gov/pubmed/4004034)
PUI
L15681475
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1146
TITLE
Military neonatal transport and intensive care - Effective and cost
effective
AUTHOR NAMES
Bell R.E.
Yoder B.A.
Ackerman Jr. N.B.
AUTHOR ADDRESSES
(Bell R.E.; Yoder B.A.; Ackerman Jr. N.B.) Neonatology Service, Division of
Maternal Child Care, Wilford Hall USAF Medical Center, Lackland AF Base, San
Antonio, TX 78236
CORRESPONDENCE ADDRESS
Neonatology Service, Division of Maternal Child Care, Wilford Hall USAF
Medical Center, Lackland AF Base, San Antonio, TX 78236
SOURCE
Military Medicine (1984) 149:3 (143-145). Date of Publication: 1984
ISSN
0026-4075
ABSTRACT
Medical support of dependents of active duty military members is a major
priority in the Military Health Care System. There are two important
questions to be considered in evaluating the military health care delivery
system for premature infants: Is the mortality and morbidity of preterm
newborns similar to that in major civilian centers; and is the expense of
military transport and neonatal care cost effective when compared with
civilian transport and care. To answer these two questions, we reviewed the
medical records of all preterm newborns cared for at Wilford Hall USAF
Medical Center (WHMC) from July 1979 thru July 1982. Costs of newborn care
and transport were determined for both WHMC and civilian Newborn Intensive
Care Units (NICU) in our referral area. Our results show: that mortality of
preterm newborns at WHMC compares favorably with that reported in other
series; and the duration of hospitalization beyond which it is cost
effective to transport these infants to WHMC is 18 days.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cost
intensive care
military medicine
newborn care
patient transport
EMTREE MEDICAL INDEX TERMS
economic aspect
human
organization and management
short survey
therapy
EMBASE CLASSIFICATIONS
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1985072839
MEDLINE PMID
6425731 (http://www.ncbi.nlm.nih.gov/pubmed/6425731)
PUI
L15172839
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1147
TITLE
When should a child with febrile purpura be transferred to an intensive care
unit?
ORIGINAL (NON-ENGLISH) TITLE
QUAND FAUT-IL TRANSFERER EN REANIMATION UN ENFANT PRESENTANT UN PURPURA
FEBRILE?
AUTHOR NAMES
Devictor D.
AUTHOR ADDRESSES
(Devictor D.) Unite de Reanimation Pediatrique, Hopital de Bicetre, 94270 Le
Kremlin Bicetre
CORRESPONDENCE ADDRESS
Unite de Reanimation Pediatrique, Hopital de Bicetre, 94270 Le Kremlin
Bicetre
SOURCE
Revue de Pediatrie (1984) 20:8 (383-387). Date of Publication: 1984
ISSN
0035-1644
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child health care
fulminating purpura
intensive care
EMTREE MEDICAL INDEX TERMS
cardiovascular system
child
human
infection
priority journal
purpura
septic shock
short survey
therapy
EMBASE CLASSIFICATIONS
Dermatology and Venereology (13)
Anesthesiology (24)
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
French
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1985239744
PUI
L15240194
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1148
TITLE
Implementation of exempt status for an inpatient psychiatric unit
AUTHOR NAMES
Hutzler N.P.
AUTHOR ADDRESSES
(Hutzler N.P.) Medical Records at St. Joseph's Hospital, Parkersburg, WV
CORRESPONDENCE ADDRESS
Medical Records at St. Joseph's Hospital, Parkersburg, WV
SOURCE
Journal of the American Medical Record Association (1984) 55:7 (29-31). Date
of Publication: 1984
ISSN
0273-9976
ABSTRACT
PPS regulations are redefining the way that intrahospital transfers are
handled when those transfers involve 'exempt' units. The author describes
procedures which proved to be successful in meeting criteria for exempt
psychiatric units.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
medical record
prospective pricing
psychiatric department
EMTREE MEDICAL INDEX TERMS
economic aspect
methodology
nonhuman
organization and management
short survey
EMBASE CLASSIFICATIONS
Health Policy, Economics and Management (36)
Psychiatry (32)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1984207433
MEDLINE PMID
10310702 (http://www.ncbi.nlm.nih.gov/pubmed/10310702)
PUI
L14032486
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1149
TITLE
Implementing an ICU transfer tool.
AUTHOR NAMES
Coleman B.
AUTHOR ADDRESSES
(Coleman B.)
CORRESPONDENCE ADDRESS
B. Coleman,
SOURCE
Dimensions of critical care nursing : DCCN (1984) 3:6 (352-361). Date of
Publication: 1984 Nov-Dec
ISSN
0730-4625
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital discharge
intensive care unit
medical record
EMTREE MEDICAL INDEX TERMS
aged
article
case report
female
human
male
patient care
preschool child
LANGUAGE OF ARTICLE
English
MEDLINE PMID
6568156 (http://www.ncbi.nlm.nih.gov/pubmed/6568156)
PUI
L14810386
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1150
TITLE
Organization and delivery of medical care in group and mass thermal injuries
ORIGINAL (NON-ENGLISH) TITLE
Organizatsiia i provedenie meditsinskoi pomoshchi pri gruppovykh i massovykh
termicheskikh porazheniiakh.
AUTHOR NAMES
Povstianoi N.E.
Polishchuk S.A.
AUTHOR ADDRESSES
(Povstianoi N.E.; Polishchuk S.A.)
CORRESPONDENCE ADDRESS
N.E. Povstianoi,
SOURCE
Klinicheskaia khirurgiia (1983) :3 (36-40). Date of Publication: Mar 1983
ISSN
0023-2130
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
burn
intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
article
human
organization and management
Ukraine
LANGUAGE OF ARTICLE
Russian
MEDLINE PMID
6855082 (http://www.ncbi.nlm.nih.gov/pubmed/6855082)
PUI
L13678502
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1151
TITLE
Minimizing stress-of-transfer responses.
AUTHOR NAMES
Poe C.M.
AUTHOR ADDRESSES
(Poe C.M.)
CORRESPONDENCE ADDRESS
C.M. Poe,
SOURCE
Dimensions of critical care nursing : DCCN (1982) 1:6 (364, 366-373). Date
of Publication: 1982 Nov-Dec
ISSN
0730-4625
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
heart infarction
mental stress (prevention)
patient education
progressive patient care
EMTREE MEDICAL INDEX TERMS
article
coronary care unit
fear
human
psychological aspect
LANGUAGE OF ARTICLE
English
MEDLINE PMID
6923818 (http://www.ncbi.nlm.nih.gov/pubmed/6923818)
PUI
L13620114
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1152
TITLE
The responsibilities of first aid at the scene of an accident and during
transport. Viewpoints on intensive care
AUTHOR NAMES
Wickstrom I.
AUTHOR ADDRESSES
(Wickstrom I.) Anestesiklin., Sahlgrenska Sjukhuset, 413 45 Goteborg
CORRESPONDENCE ADDRESS
Anestesiklin., Sahlgrenska Sjukhuset, 413 45 Goteborg
SOURCE
Opuscula Medica, Supplement (1982) 26:58 (17-19). Date of Publication: 1982
ISSN
0473-1018
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
first aid
injury
intensive care
EMTREE MEDICAL INDEX TERMS
therapy
EMBASE CLASSIFICATIONS
Rehabilitation and Physical Medicine (19)
Neurology and Neurosurgery (8)
LANGUAGE OF ARTICLE
Swedish
EMBASE ACCESSION NUMBER
1982180611
PUI
L12094705
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1153
TITLE
The physiological basis of critical care nursing. Diffusion and
transportation of respiratory gases
AUTHOR NAMES
Kim Y.Y.
AUTHOR ADDRESSES
(Kim Y.Y.)
CORRESPONDENCE ADDRESS
Y.Y. Kim,
SOURCE
Taehan kanho. The Korean nurse (1981) 20:5 (51-54). Date of Publication: 31
Dec 1981
ISSN
0047-3618
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
carbon dioxide
oxygen
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
breathing
EMTREE MEDICAL INDEX TERMS
article
blood
human
intensive care
pressure
CAS REGISTRY NUMBERS
carbon dioxide (124-38-9, 58561-67-4)
oxygen (7782-44-7)
LANGUAGE OF ARTICLE
Korean
MEDLINE PMID
6798300 (http://www.ncbi.nlm.nih.gov/pubmed/6798300)
PUI
L12596872
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1154
TITLE
Newborn transport in metropolitan Sydney: Experience with a newborn
intensive care unit based regional transport service
AUTHOR NAMES
Barr P.A.
Suthers J.A.
Leslie G.I.
AUTHOR ADDRESSES
(Barr P.A.; Suthers J.A.; Leslie G.I.) Newborn Intens. Care Unit, Roy. North
Shore Hosp., St Leonards, NSW 2065
CORRESPONDENCE ADDRESS
Newborn Intens. Care Unit, Roy. North Shore Hosp., St Leonards, NSW 2065
SOURCE
Australian Paediatric Journal (1981) 17:2 (95-99). Date of Publication: 1981
ISSN
0004-993X
ABSTRACT
The effect of skilled transport on the condition of 100 infants referred for
intensive care and the factors affecting their survival were analysed.
Infants with respiratory failure who were not moribound showed significant
increases in pH (P < 0.01) and arterial/alveolar PO(2) ratio (P < 0.001)
with assisted ventilation. Less severely ill infants were transported
without significant change in pH and blood gas status. Hypoxaemia (17%),
hyperoxaemia (24%) and hyperglycaemia (14%) were not uncommon on admission
to the newborn intensive care unit. Survival rate did not decrease
significantly with decreasing birth weight or gestation. Factors
significantly more common in infants who died were one minute Apgar score
0-3 (P < 0.05), and pH < 7.25 (P < 0.05) and PaCO(2) > 60 mmHg (P < 0.005)
on admission to the NICU. Infants mechanically ventilated before transport
did not have a significantly higher mortality rate than those ventilated
after admission, though moribound infants and those with untreated early
onset bacterial pneumonia had high mortality rates. Pre-transfer events were
responsible for the death of 8 (38%) of the 21 infants who died and perhaps
contributed to the death from intraventricular haemorrhage of a further 5
infants (24%).
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
artificial ventilation
brain ventricle hemorrhage
newborn intensive care
patient transport
respiratory failure
EMTREE MEDICAL INDEX TERMS
central nervous system
diagnosis
geographic distribution
methodology
newborn
respiratory system
short survey
therapy
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Forensic Science Abstracts (49)
Public Health, Social Medicine and Epidemiology (17)
Surgery (9)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1981235068
MEDLINE PMID
7305777 (http://www.ncbi.nlm.nih.gov/pubmed/7305777)
PUI
L11011068
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1155
TITLE
Transporting the critically burned patient.
AUTHOR NAMES
Trunkey D.D.
AUTHOR ADDRESSES
(Trunkey D.D.)
CORRESPONDENCE ADDRESS
D.D. Trunkey,
SOURCE
Topics in emergency medicine (1981) 3:3 (21-24). Date of Publication: Oct
1981
ISSN
0164-2340
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
burn (therapy)
intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
article
classification
human
organization
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
10253308 (http://www.ncbi.nlm.nih.gov/pubmed/10253308)
PUI
L11648820
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1156
TITLE
Airborne intensive care.
AUTHOR NAMES
Griffin M.
AUTHOR ADDRESSES
(Griffin M.)
CORRESPONDENCE ADDRESS
M. Griffin,
SOURCE
Nursing times (1981) 77:38 (1022-1023). Date of Publication: 1981 Sep 16-22
ISSN
0954-7762
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
aerospace medicine
article
case report
female
France
human
Ireland
traffic accident
LANGUAGE OF ARTICLE
English
MEDLINE PMID
6912511 (http://www.ncbi.nlm.nih.gov/pubmed/6912511)
PUI
L11636447
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1157
TITLE
A comparison of inborn versus transferred neonates admitted to a special
care unit.
AUTHOR NAMES
Easa D.
Ash K.
Boychuk R.B.
Light M.J.
LaBarre M.
AUTHOR ADDRESSES
(Easa D.; Ash K.; Boychuk R.B.; Light M.J.; LaBarre M.)
CORRESPONDENCE ADDRESS
D. Easa,
SOURCE
Hawaii medical journal (1981) 40:7 (175-177). Date of Publication: Jul 1981
ISSN
0017-8594
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child care
infant mortality
intensive care unit
newborn disease (complication)
EMTREE MEDICAL INDEX TERMS
article
birth weight
comparative study
human
lung disease (epidemiology)
newborn
retrospective study
standard
United States
utilization review
LANGUAGE OF ARTICLE
English
MEDLINE PMID
7263214 (http://www.ncbi.nlm.nih.gov/pubmed/7263214)
PUI
L11634203
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1158
TITLE
Neonatal intensive care in Sweden
AUTHOR NAMES
Tunell R.
Palme C.
Sandberg K.
AUTHOR ADDRESSES
(Tunell R.; Palme C.; Sandberg K.) Barnmed. Klin., Huddinge Sjukh., S-141 86
Huddinge
CORRESPONDENCE ADDRESS
Barnmed. Klin., Huddinge Sjukh., S-141 86 Huddinge
SOURCE
Lakartidningen (1981) 78:5 (331-342). Date of Publication: 1981
ISSN
0023-7205
ABSTRACT
Results of a retrospective survey of transports from a neonatal ward to a
neonatal intensive care unit are presented. The authors see a need for
centralisation of neonatal intensive care. The structure of the portable
incubator should be improved, while the child must be in optimal condition
at the time of transport. A comparison was executed between the results of
intensive care transports from a ward located 10 km from a neonatal
intensive care unit, and from a department in the same hospital as the
intensive care unit. Short transport within one and the same hospital seems
to be as hazardous as a journey of many miles by ambulance. The survival
rate and rate of complications in a population of 89 very low birth weight
infants below 1,000 g were studied. Meticulous control of vital functions
during transportation is necessary to avoid complications in transit. A
portable incubator suitable for Swedish ambulances and specially designed
for transport of neonatal intensive care cases is presented. Experience of
this device hitherto indicates that it is feasible to transport babies with
very severe respiratory insufficiency under controlled conditions without
hazard to the quality of care in transit. A review is presented of the modes
of long distance air transport of sick neonates. The article describes the
problems which arise both when the arrangements are made and during the
actual journeys.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
newborn intensive care
patient transport
EMTREE MEDICAL INDEX TERMS
geographic distribution
newborn
Sweden
therapy
EMBASE CLASSIFICATIONS
Health Policy, Economics and Management (36)
Pediatrics and Pediatric Surgery (7)
Obstetrics and Gynecology (10)
LANGUAGE OF ARTICLE
Swedish
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1981112621
MEDLINE PMID
6937726 (http://www.ncbi.nlm.nih.gov/pubmed/6937726)
PUI
L11144408
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 1159
TITLE
The transfer summary--an essential link.
AUTHOR NAMES
DiCiancia P.
AUTHOR ADDRESSES
(DiCiancia P.)
CORRESPONDENCE ADDRESS
P. DiCiancia,
SOURCE
Supervisor nurse (1981) 12:4 (36-37). Date of Publication: Apr 1981
ISSN
0039-5870
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
medical record
progressive patient care
EMTREE MEDICAL INDEX TERMS
article
coronary care unit
interpersonal communication
organization and management
LANGUAGE OF ARTICLE
English
MEDLINE PMID
6908179 (http://www.ncbi.nlm.nih.gov/pubmed/6908179)
PUI
L11572341
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1160
TITLE
NICU: intensive education and infant transport capabilities optimize service
of Boise's St. Luke's Hospital neonatal IC unit.
AUTHOR NAMES
Graalman N.M.
AUTHOR ADDRESSES
(Graalman N.M.)
CORRESPONDENCE ADDRESS
N.M. Graalman,
SOURCE
Hospital forum (1981) 24:2 (55-56). Date of Publication: 1981 Mar-Apr
ISSN
0018-5663
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health care planning
intensive care unit
nursery
perinatology
EMTREE MEDICAL INDEX TERMS
article
hospital bed capacity
human
newborn
newborn disease
organization and management
progressive patient care
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
10250100 (http://www.ncbi.nlm.nih.gov/pubmed/10250100)
PUI
L11554651
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1161
TITLE
Oxygenation for the transport of newborn infants with respiratory disorders
ORIGINAL (NON-ENGLISH) TITLE
Oxigeniációs rendszer légzési zavarban szenvedö újszülöttek szállítására.
AUTHOR NAMES
Rubecz I.
Tóth G.
Varga P.
Vincellér M.
Farbaky I.
AUTHOR ADDRESSES
(Rubecz I.; Tóth G.; Varga P.; Vincellér M.; Farbaky I.)
CORRESPONDENCE ADDRESS
I. Rubecz,
SOURCE
Orvosi hetilap (1980) 121:50 (3065-3067). Date of Publication: 14 Dec 1980
ISSN
0030-6002
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
neonatal respiratory distress syndrome (therapy)
oxygen therapy
EMTREE MEDICAL INDEX TERMS
article
devices
human
incubator
intensive care unit
newborn
patient transport
LANGUAGE OF ARTICLE
Hungarian
MEDLINE PMID
7220024 (http://www.ncbi.nlm.nih.gov/pubmed/7220024)
PUI
L11580719
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1162
TITLE
Regional integration of intensive care and transport of severely ill
newborns
AUTHOR NAMES
Hager-Malecka B.
Grzywna W.
Norska-Borowka I.
AUTHOR ADDRESSES
(Hager-Malecka B.; Grzywna W.; Norska-Borowka I.) Klin. Ped. IP SLAM Zabrze
CORRESPONDENCE ADDRESS
Klin. Ped. IP SLAM Zabrze
SOURCE
Pediatria Polska (1980) 55:8 (979-985). Date of Publication: 1980
ISSN
0031-3939
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency medicine
newborn intensive care
transport
EMTREE MEDICAL INDEX TERMS
geographic distribution
newborn
short survey
therapy
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
Polish
LANGUAGE OF SUMMARY
English, Russian
EMBASE ACCESSION NUMBER
1981009243
MEDLINE PMID
7432833 (http://www.ncbi.nlm.nih.gov/pubmed/7432833)
PUI
L11233024
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 1163
TITLE
The course of patients with suspected myocardial infarction. The
identification of low-risk patients for early transfer from intensive care
AUTHOR NAMES
Mulley A.G.
Thibault G.E.
Hughes R.A.
AUTHOR ADDRESSES
(Mulley A.G.; Thibault G.E.; Hughes R.A.) Med. Practices Eval. Unit,
Massachusetts Gen. Hosp., Boston, Mass. 02114
CORRESPONDENCE ADDRESS
Med. Practices Eval. Unit, Massachusetts Gen. Hosp., Boston, Mass. 02114
SOURCE
New England Journal of Medicine (1980) 302:17 (943-948). Date of
Publication: 1980
ISSN
0028-4793
ABSTRACT
The hospital course of all patients admitted to a medical intensive-care
unit (ICU) with suspected myocardial infarction was reviewed to test the
feasibility of identifying patients suitable for earlier transfer from the
ICU. Three hundred sixty patients admitted after presentation with
uncomplicated chest pain could be stratified into 3 risk groups within 24 hr
of admission to the ICU. One hundred sixty-eight patients (47%), who were
without major complications, elevation of total serum creatine
phosphokinase, or electrocardiographic evidence of transmural infarction
during the first day, could be designated 'low-risk' patients. Three per
cent of the low-risk patients subsequently met clinical criteria for
infarction, 2% had late complications in the ICU, and none died. Rates of
infarction, late complications in the ICU, and mortality in the hospital
were significantly higher for patients at intermediate and high risk.
Identification of low-risk patients for whom early transfer may be routinely
indicated is feasible and could reduce by 55% the total number of days that
such patients spend in the ICU.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
coronary care unit
heart infarction
EMTREE MEDICAL INDEX TERMS
heart
major clinical study
methodology
therapy
EMBASE CLASSIFICATIONS
Cardiovascular Diseases and Cardiovascular Surgery (18)
Internal Medicine (6)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1980129002
MEDLINE PMID
7360201 (http://www.ncbi.nlm.nih.gov/pubmed/7360201)
PUI
L10096599
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1164
TITLE
Coronary emergencies. II. Transport to an intensive care unit
ORIGINAL (NON-ENGLISH) TITLE
II-LE TRANSPORT DES URGENCES CORONARIENNES DANS LES UNITES DE SOINS
INTENSIFS
AUTHOR NAMES
Cara M.
Poisvert M.
Galinski R.
AUTHOR ADDRESSES
(Cara M.; Poisvert M.; Galinski R.)
SOURCE
Concours Medical (1980) 102:3 (241-242). Date of Publication: 1980
ISSN
0010-5309
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency medicine
heart infarction
intensive care
ischemic heart disease
EMTREE MEDICAL INDEX TERMS
diagnosis
heart
short survey
EMBASE CLASSIFICATIONS
Cardiovascular Diseases and Cardiovascular Surgery (18)
LANGUAGE OF ARTICLE
French
EMBASE ACCESSION NUMBER
1980097246
PUI
L10128026
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1165
TITLE
Referral of mothers and infants for intensive care
AUTHOR NAMES
Blake A.M.
Pollitzer M.J.
Reynolds E.O.R.
AUTHOR ADDRESSES
(Blake A.M.; Pollitzer M.J.; Reynolds E.O.R.) Dept. Paed., Univ. Coll.
Hosp., London WC1E 6BT
CORRESPONDENCE ADDRESS
Dept. Paed., Univ. Coll. Hosp., London WC1E 6BT
SOURCE
British Medical Journal (1979) 2:6187 (414-416). Date of Publication: 1979
ISSN
0959-8146
ABSTRACT
During 1975-7, 96 monthers were referred to University College Hospital for
delivery from 39 other hospitals other hispitals because their pregnancies
were considered to be at very high risk. One hundred of the 111 infants born
to the 96 mothers weighed 2500 g or less and 60 weighed 1500 g or less. A
high proportion of the infants developed serious illnesses necessitating
intensive care. The birth-weight-specific neonatal mortality rates of the
infants were much lower than those of infants born in England and Wales as a
whole and were also lower than those of the 370 infants transported to this
hospital for intensive care after delivery elsewhere. Whenever possible
mothers with very high-risk pregnancies should be referred for delivery to
centres with full facilities for the intensive care of the mother, fetus,
and newborn infant.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
high risk pregnancy
intensive care
obstetrics
patient transport
EMTREE MEDICAL INDEX TERMS
fetus
major clinical study
newborn
normal human
pregnancy
prevention
therapy
EMBASE CLASSIFICATIONS
Obstetrics and Gynecology (10)
Pediatrics and Pediatric Surgery (7)
Anesthesiology (24)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1979243072
MEDLINE PMID
486967 (http://www.ncbi.nlm.nih.gov/pubmed/486967)
PUI
L9241655
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1166
TITLE
Critical care unit transfer: Reducing patient stress through nursing
interventions
AUTHOR NAMES
Schwartz L.P.
Brenner Z.R.
AUTHOR ADDRESSES
(Schwartz L.P.; Brenner Z.R.) Sch. Nurs., Univ. Rochester, N.Y.
CORRESPONDENCE ADDRESS
Sch. Nurs., Univ. Rochester, N.Y.
SOURCE
Heart and Lung: Journal of Acute and Critical Care (1979) 8:3 (540-546).
Date of Publication: 1979
ISSN
0147-9563
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
coronary care unit
intensive care
nursing
patient care
stress
EMTREE MEDICAL INDEX TERMS
cardiovascular system
psychological aspect
short survey
therapy
EMBASE CLASSIFICATIONS
Cardiovascular Diseases and Cardiovascular Surgery (18)
Public Health, Social Medicine and Epidemiology (17)
Neurology and Neurosurgery (8)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1980221284
MEDLINE PMID
254678 (http://www.ncbi.nlm.nih.gov/pubmed/254678)
PUI
L10000084
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1167
TITLE
Who pays the bill for neonatal intensive care?
AUTHOR NAMES
McCarthy J.T.
Koops B.L.
Honeyfield P.R.
Butterfield L.J.
AUTHOR ADDRESSES
(McCarthy J.T.; Koops B.L.; Honeyfield P.R.; Butterfield L.J.) Dept.
Perinatol., Child. Hosp., Denver, Colo. 80218
CORRESPONDENCE ADDRESS
Dept. Perinatol., Child. Hosp., Denver, Colo. 80218
SOURCE
Journal of Pediatrics (1979) 95:5 I (755-762). Date of Publication: 1979
ISSN
0022-3476
ABSTRACT
The Children's Hospital Newborn Emergency Service conducted 174 transports
to the Newborn Center during a four-month period in 1976. The transport
charge directly related to the distance between the referring hospital and
the NBC. Two years after the NBC discharged the last study infant, 150 of
174 accounts had been paid in full. Insurance paid 85%, families paid 4%,
and the hospital wrote off 11% of all hospital charges. The Children's
Hospital referred 2% of all hospital charges to a bill collection agency.
One hundred-forty-four infants (84%) survived and 27 (16%) died. The mean
charge per day for survivors was $338; the mean charge per day for
nonsurvivors was $607.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
cost
intensive care
newborn mortality
patient transport
EMTREE MEDICAL INDEX TERMS
economic aspect
geographic distribution
newborn
therapy
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Health Policy, Economics and Management (36)
Public Health, Social Medicine and Epidemiology (17)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1980009019
MEDLINE PMID
490247 (http://www.ncbi.nlm.nih.gov/pubmed/490247)
PUI
L10228540
DOI
10.1016/S0022-3476(79)80731-3
FULL TEXT LINK
http://dx.doi.org/10.1016/S0022-3476(79)80731-3
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1168
TITLE
Manually transferred contamination and its prevention in surgical intensive
care
ORIGINAL (NON-ENGLISH) TITLE
LA CONTAMINATION MANUPORTEE ET SA PREVENTION EN REANIMATION CHIRURGICALE
RESUME
AUTHOR NAMES
Picard J.M.
Hartemann Ph.
Blech M.F.
Jacob F.
AUTHOR ADDRESSES
(Picard J.M.; Hartemann Ph.; Blech M.F.; Jacob F.)
SOURCE
Annales de l'Anesthesiologie Francaise (1979) 20:6-7 (517). Date of
Publication: 1979
ISSN
0003-4061
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hand washing
infection
intensive care
EMTREE MEDICAL INDEX TERMS
prevention
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Microbiology: Bacteriology, Mycology, Parasitology and Virology (4)
LANGUAGE OF ARTICLE
French
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1980083696
MEDLINE PMID
44964 (http://www.ncbi.nlm.nih.gov/pubmed/44964)
PUI
L10177495
COPYRIGHT
Copyright 2012 Elsevier B.V., All rights reserved.
RECORD 1169
TITLE
Transport problems of intensive care patients
ORIGINAL (NON-ENGLISH) TITLE
TRANSPORTPROBLEME BEI KRITISCHEN INTENSIVBEHANDLUNGSPATIENTEN
AUTHOR NAMES
Hess F.A.
Roth F.
AUTHOR ADDRESSES
(Hess F.A.; Roth F.) Abt. Reanimat. Intensivbehandl., Univ. Bern
CORRESPONDENCE ADDRESS
Abt. Reanimat. Intensivbehandl., Univ. Bern
SOURCE
Intensivbehandlung (1979) 4:1 (1-7). Date of Publication: 1979
ISSN
0341-3063
ABSTRACT
The transport of an intensive care patient brings up several special
problems: First of all those of ventilation, then those of monitoring and
eventually supporting circulation. A nonbreathing valve combined with a
controllable flow of fresh gas allows a satisfactory constancy of
respiratory minutevolume. Also pressure-operated respirators are suitable
for such transports. The administration of an adequate air-oxygen mixture is
discussed. With an Ambu-PEEP-valve, PEEP may be maintained satisfactorily.
During an operation, patients with serious respiratory problems should be
ventilated on the same respirator as before. Thoracic drainage needs a
maintenance of suction during transport only in special situations. For sure
suction is not necessary in patients on IPPV. Transportable ECG-monitors are
available already for years, also battery-operated pacemakers and
defibrillators. A direct monitoring of blood pressure is possible without
any special expense. Modern compact monitors, which can be driven on
batteries, bring the great advantage of monitoring a patient through
operation, transport and postoperative follow-up by the same apparatus. An
inverter delivering 220 V AC keeps infusion pumps working during transport,
but there are also battery-operated pumps available today.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
patient transport
EMBASE CLASSIFICATIONS
Anesthesiology (24)
LANGUAGE OF ARTICLE
German
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1979232154
PUI
L9230876
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1170
TITLE
Myocardial infarct stress-of-transfer inventory: Development of a research
tool
AUTHOR NAMES
Minckley B.B.
Burrows D.
Ehrat K.
AUTHOR ADDRESSES
(Minckley B.B.; Burrows D.; Ehrat K.) Stanford Univ. Sch. Nurs., Palo Alto,
Calif.
CORRESPONDENCE ADDRESS
Stanford Univ. Sch. Nurs., Palo Alto, Calif.
SOURCE
Nursing Research (1979) 28:1 (4-10). Date of Publication: 1979
ISSN
0029-6562
ABSTRACT
The Myocardial Infarct Stress-of-Transfer Inventory is a set of measures
composed of grouped variables related to patients' perceptions of external
support, perceived attitudes and behaviors, and physiological
(cardiovascular and autonomic) responses commonly assessed by nurses in
typical hospital settings. These measures were designed to evaluate changes
in patients' status as a result of transfer from the coronary care unit to a
general care ward at the time the patient is presumably out of danger.
Direction of change of all parameters is a measure of patient response to
transfer as well as a measure of effectiveness of nursing care. The tool
consists of observational and nurse questionnaire data collected and
averaged for pre- and posttransfer items. Of 48 total items of the tool, 20
are designated 'change scores'. Interrater reliability was obtained for 20
percent of the tests with 80 percent agreement. A score of less than 22 is
associated with poor transfer outcome; a score of more than 25 is associated
with better-than-expected transfer outcome. Midrange from 22 to 25 is the
average total score expectation for change as a result of transfer. The
instrument was tested on 177 transfers of patients in six hospital settings
in five western states (Arizona, Montana, Nevada, Utah and Washington). The
six hospital populations were found to be homogeneous as to patient age,
sex, race, diagnosis, and patterns of nursing care. Individual total scores
for the tool ranged from 18 to 27 with a mean of 23.175 and S.D. of 1.754.
Change scores were adjusted to accommodate the influence of prescores on
postscores for the behavioral variables. Factor analysis indicated 17
factors in the tool with eigen values greater than 1.00. Significant
findings were: 1) Cardiovascular signs and symptoms are unstable and
arrhythmias are likely to occur in the two-hour period following transfer.
Nursing care needs to accommodate this finding. 2) Nurses equated patient
acceptance of disconnection of the Cardiac monitor with patient 'readiness
for transfer'. 3) Because family visits had significant effect on patients,
sometimes negative, sometimes positive families should be taught how to
visit the patient in order to avoid negative effects. 4) Nursing care plans
are associated with patients who are out of danger and are usually not
available or not written for patients who are critically ill. 5) The tool
proved easy to use. It may lend itself to evaluation of other transfer
situations such as transfer from hospital to nursing home.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
coronary care unit
heart infarction
nursing
EMTREE MEDICAL INDEX TERMS
heart
methodology
psychological aspect
therapy
EMBASE CLASSIFICATIONS
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1979108551
MEDLINE PMID
252703 (http://www.ncbi.nlm.nih.gov/pubmed/252703)
PUI
L9108284
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1171
TITLE
Effectiveness of neonatal transport
AUTHOR NAMES
Modanlou H.D.
Dorchester W.L.
AUTHOR ADDRESSES
(Modanlou H.D.; Dorchester W.L.) UCIMiller Children's Hospital, Long Beach,
United States.
SOURCE
Journal of Pediatrics (1979) 94:4 (682-683). Date of Publication: 1 Apr 1979
ISSN
1097-6833 (electronic)
0022-3476
BOOK PUBLISHER
Mosby Inc., customerservice@mosby.com
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
newborn care
patient transport
EMTREE MEDICAL INDEX TERMS
birth weight
human
length of stay
letter
morbidity
mortality rate
neonatal intensive care unit
newborn
newborn mortality
priority journal
EMBASE CLASSIFICATIONS
Anesthesiology (24)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20170624364
MEDLINE PMID
430326 (http://www.ncbi.nlm.nih.gov/pubmed/430326)
PUI
L618126701
DOI
10.1016/S0022-3476(79)80064-5
FULL TEXT LINK
http://dx.doi.org/10.1016/S0022-3476(79)80064-5
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 1172
TITLE
Reply
AUTHOR NAMES
Chance G.W.
Cunningham K.
AUTHOR ADDRESSES
(Chance G.W.) Division of NeonatologyThe Hospital for Sick Children,
Toronto, Canada.
(Cunningham K.) Division of Bio-Statistics The Hospital for Sick Children,
Toronto, Canada.
SOURCE
Journal of Pediatrics (1979) 94:4 (683-684). Date of Publication: 1 Apr 1979
ISSN
1097-6833 (electronic)
0022-3476
BOOK PUBLISHER
Mosby Inc., customerservice@mosby.com
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
low birth weight
patient transport
perinatal care
EMTREE MEDICAL INDEX TERMS
gestational age
hospitalization
human
length of stay
letter
neonatal intensive care unit
patient referral
priority journal
probability
prognosis
rectal temperature
small for date infant
statistical analysis
EMBASE CLASSIFICATIONS
Obstetrics and Gynecology (10)
Public Health, Social Medicine and Epidemiology (17)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
20170624128
PUI
L618126276
DOI
10.1016/S0022-3476(79)80066-9
FULL TEXT LINK
http://dx.doi.org/10.1016/S0022-3476(79)80066-9
COPYRIGHT
Copyright 2017 Elsevier B.V., All rights reserved.
RECORD 1173
TITLE
Transfer of the newborn at risk to a neonatal intensive care unit.
ORIGINAL (NON-ENGLISH) TITLE
TRASPORTO DEL NEONATO A RISCHIO AD UNA UNITA NEONATALE DI TERAPIA INTENSIVA
AUTHOR NAMES
Minoli I.
Calciolari G.
Cherubini P.
AUTHOR ADDRESSES
(Minoli I.; Calciolari G.; Cherubini P.) Unita Neonatale Ter. Intens., Ist.
Osp. Prov. Matern., Milano
CORRESPONDENCE ADDRESS
Unita Neonatale Ter. Intens., Ist. Osp. Prov. Matern., Milano
SOURCE
Minerva Pediatrica (1978) 30:14 (1131-1136). Date of Publication: 1978
ISSN
0026-4946
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
high risk newborn
intensive care
perinatal morbidity
transport
EMTREE MEDICAL INDEX TERMS
methodology
newborn
pregnancy
therapy
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Public Health, Social Medicine and Epidemiology (17)
Obstetrics and Gynecology (10)
LANGUAGE OF ARTICLE
Italian
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1978403463
MEDLINE PMID
672855 (http://www.ncbi.nlm.nih.gov/pubmed/672855)
PUI
L8397852
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1174
TITLE
Endogenous inhibitors of glutathione S-transferases in house flies
AUTHOR NAMES
Motoyama N.
Kulkarni A.P.
Hodgson E.
Dauterman W.C.
AUTHOR ADDRESSES
(Motoyama N.; Kulkarni A.P.; Hodgson E.; Dauterman W.C.) Toxicol. Progr.,
Dept. Entomol., North Carolina State Univ., Raleigh, N.C. 27607
CORRESPONDENCE ADDRESS
Toxicol. Progr., Dept. Entomol., North Carolina State Univ., Raleigh, N.C.
27607
SOURCE
Pesticide Biochemistry and Physiology (1978) 9:3 (255-262). Date of
Publication: 1978
ISSN
0048-3575
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
1,2 dichloro 4 nitrobenzene
1,4 benzoquinone
1,4 dimethoxybenzene
2,5 dihydroxybenzoquinone
anthracene derivative
aromatic compound
catechol
epinephrine
glutathione
glutathione transferase
hydroquinone
mequinol
monophenol monooxygenase
naphthalene derivative
para cresol
pentachlorophenol
phenol
pyrogallol
resorcinol
tetroquinone
ubiquinone
EMTREE DRUG INDEX TERMS
unclassified drug
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
enzyme inhibition
EMTREE MEDICAL INDEX TERMS
animal experiment
arthropod
drug comparison
house fly
in vitro study
DRUG MANUFACTURERS
(United States)Aldrich
(United States)Baker
(United States)chem. procurement lab.
(United States)eastman organic chem
(United States)Fisher
(United States)Valeant
(United States)Sigma
CAS REGISTRY NUMBERS
1,2 dichloro 4 nitrobenzene (99-54-7)
1,4 benzoquinone (106-51-4)
1,4 dimethoxybenzene (150-78-7)
2,5 dihydroxybenzoquinone (615-94-1)
adrenalin (51-43-4, 55-31-2, 6912-68-1)
catechol (120-80-9)
glutathione transferase (50812-37-8)
glutathione (70-18-8)
hydroquinone (123-31-9)
mequinol (150-76-5)
monophenol monooxygenase (9002-10-2)
para cresol (106-44-5)
pentachlorophenol (87-86-5)
phenol (108-95-2, 3229-70-7)
pyrogallol (87-66-1)
resorcinol (108-46-3)
tetroquinone (319-89-1)
ubiquinone (1339-63-5)
EMBASE CLASSIFICATIONS
Clinical and Experimental Pharmacology (30)
Drug Literature Index (37)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1979075696
PUI
L9075507
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1175
TITLE
Transportation of severely ill neonates to an intensive care unit
(experience with 55 cases)
ORIGINAL (NON-ENGLISH) TITLE
TRANSPORTE DE RECEM-NASCIDOS GRAVES: EXPERIENCIA DE 55 CASOS
AUTHOR NAMES
Grajwer L.A.
Ruffier J.
Genes L.
Ruffier C.
AUTHOR ADDRESSES
(Grajwer L.A.; Ruffier J.; Genes L.; Ruffier C.) Serv. Pediat., Policlin.
Botafogo, Rio de Janeiro
CORRESPONDENCE ADDRESS
Serv. Pediat., Policlin. Botafogo, Rio de Janeiro
SOURCE
Jornal de Pediatria (1978) 45:3 (187-190). Date of Publication: 1978
ISSN
0021-7557
ABSTRACT
During a six-month period, 55 newborns were transported to an intensive care
unit. 56% had respiratory problems such as hyaline membrane disease and
transient tachypnea of the newborn. About half of the newborns were hypo or
hyperthermic at the referring hospitals. There was an improvement of the
thermal balance during transport. The viability of the transport system and
the lack of equipment in the referring hospitals are discussed in the paper.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
newborn
EMTREE MEDICAL INDEX TERMS
case report
therapy
EMBASE CLASSIFICATIONS
Obstetrics and Gynecology (10)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
Portuguese
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
1979075971
PUI
L9075782
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1176
TITLE
Mobile critical care unit safeguards lives during transfers
AUTHOR NAMES
Tinker A.J.
Birnbaum M.L.
Burns L.A.
AUTHOR ADDRESSES
(Tinker A.J.; Birnbaum M.L.; Burns L.A.) Univ. Hosp., Madison, Wis.
CORRESPONDENCE ADDRESS
Univ. Hosp., Madison, Wis.
SOURCE
Hospitals (1978) 52:18 (79-85). Date of Publication: 1978
ISSN
0018-5973
ABSTRACT
Providing access to high-quality critical care services for patients in
small or remote hospitals is an important problem faced by many hospitals in
this country. In an effort to meet the needs of critically ill patients who
might be saved if they could be safely transported from their community
hospitals to a large medical center with more specialized care capabilities,
the University of Wisconsin Hospitals, Madison, designed a Mobile Critical
Care Unit. The details of the unit's construction and of the program's
operation are presented herein.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
mobile clinic
transport
EMTREE MEDICAL INDEX TERMS
economic aspect
therapy
United States
EMBASE CLASSIFICATIONS
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1979045021
MEDLINE PMID
680670 (http://www.ncbi.nlm.nih.gov/pubmed/680670)
PUI
L9044839
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1177
TITLE
Transport of neonates for intensive care
AUTHOR NAMES
Ryan M.E.
AUTHOR ADDRESSES
(Ryan M.E.) Dept. Ped., Geisinger Med. Cent., Danville, Pa. 17821
CORRESPONDENCE ADDRESS
Dept. Ped., Geisinger Med. Cent., Danville, Pa. 17821
SOURCE
Journal of the American Osteopathic Association (1978) 78:2 (103-109). Date
of Publication: 1978
ISSN
0098-6151
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1979091323
MEDLINE PMID
711521 (http://www.ncbi.nlm.nih.gov/pubmed/711521)
PUI
L9091102
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1178
TITLE
Control of heart rate during movement in acute myocardial infarction
AUTHOR NAMES
Devlin J.E.
Mulholland H.C.
Kelly M.J.H.
AUTHOR ADDRESSES
(Devlin J.E.; Mulholland H.C.; Kelly M.J.H.) Card. Dept., Roy. Victoria
Hosp., Belfast
CORRESPONDENCE ADDRESS
Card. Dept., Roy. Victoria Hosp., Belfast
SOURCE
European Journal of Cardiology (1978) 7:2-3 (147-156). Date of Publication:
1978
ISSN
0301-4711
ABSTRACT
Among patients with acute myocardial infarction and a normal heart rate and
blood pressure, a high incidence of sympathetic overactivity was recorded
during transport. The combined administration of atropine and sotalol had no
significant effect on the mean maximum heart rate on movement. However, this
drug combination prevented excessive slowing of the heart rate. Sotalol
caused a significant reduction in the mean maximum heart rate on movement.
The side-effects were minimal. 10% of patients who received sotalol required
atropine for the correction of bradyarrhythmia.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
atropine
sotalol
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
adrenergic system
blood pressure
coronary care unit
drug mixture
drug therapy
heart infarction
heart rate
patient transport
transport
EMTREE MEDICAL INDEX TERMS
cardiovascular system
heart
major clinical study
therapy
CAS REGISTRY NUMBERS
atropine (51-55-8, 55-48-1)
sotalol (3930-20-9, 80456-07-1, 959-24-0)
EMBASE CLASSIFICATIONS
Drug Literature Index (37)
Cardiovascular Diseases and Cardiovascular Surgery (18)
Internal Medicine (6)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1978370914
MEDLINE PMID
352700 (http://www.ncbi.nlm.nih.gov/pubmed/352700)
PUI
L8366842
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1179
TITLE
Utilizing the nurse-patient relationship to reduce stress on transfer out of
the coronary care unit
AUTHOR NAMES
Brenner Z.R.
AUTHOR ADDRESSES
(Brenner Z.R.) Univ. Rochester, N.Y.
CORRESPONDENCE ADDRESS
Univ. Rochester, N.Y.
SOURCE
Abstracts of Hospital Management Studies (1978) 14:3 (18507 SC). Date of
Publication: 1978
ABSTRACT
This study investigated what effect the establishment of a relationship
between a general medical nurse and a myocardial infarction patient might
have on the stress experienced on transfer out of the coronary care unit. A
post-test only control group was used. Twenty English-speaking patients who
had been directly admitted to the coronary care unit, had confirmed
myocardial infarctions, had family members available, and had no previous
history of psychiatric therapy were randomly assigned to either the control
or experimental group. The level of the patient's psychosocial stress the
evening of transfer was evaluated by means of a questionnaire administered
to the patient, a family member and the nurse caring for the patient. The
patient questionnaire also included items for reporting physiological
symptoms. The patient's chart was examined for information on physiological
complications and documentation by the professional staff of behavioral
manifestations of stress and physiological status during recuperation. The
responses of the patient, family and nurse supported the hypothesis that
patients in the experimental group would be less stressed on transfer out of
the coronary care unit. Patient-reported levels of physical symptoms the
evening of transfer were identical for both groups, but experimental
patients experienced fewer physiological symptoms within 24 hours of
transfer and from that time until discharge. The experimental patients also
exhibited fewer behavioral manifestations of stress and had shorter hospital
stays with fewer physiological complications.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
coronary care unit
nurse patient relationship
EMTREE MEDICAL INDEX TERMS
clinical trial
controlled study
human
psychological aspect
randomized controlled trial
EMBASE CLASSIFICATIONS
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1978324308
PUI
L8320744
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1180
TITLE
Nurse-family interaction to reduce patient stress during transfer from the
coronary care unit
AUTHOR NAMES
Schwartz L.P.
AUTHOR ADDRESSES
(Schwartz L.P.) Univ. Rochester, N.Y.
CORRESPONDENCE ADDRESS
Univ. Rochester, N.Y.
SOURCE
Abstracts of Hospital Management Studies (1978) 14:3 (18532 SC). Date of
Publication: 1978
ABSTRACT
Twenty patients hospitalized with acute myocardial infarction were studied
to determine the effects of a family-centered nursing approach on reducing
patient stress associated with CCU transfer and the incidence of
cardiovascular complications. Three nurse-family interactions provided the
family with information about CCU transfer and encouraged family members to
offer emotional support to the patient. A comparison group was also used.
Six dependent variables measured the effect of the nurse-family
intervention. The instrument used was equally divided between psychosocial
and physiological measures of patient stress. The psychosocial portion
consisted of questionnaires administered to the patient, a family member,
and a staff nurse. The physiological portion consisted of 1) cardiovasuclar
complaints as reported on the patient questionnaire, 2) cardiovascular
complications as recorded in the hospital record within 24 hours of
transfer, and 3) cardiovascular complications as recorded in the patient's
chart for the remainder of the hospitalization. Findings indicated that,
overall, experimental patients scored lower than control patients on 1) self
reported patient stress, 2) family reported patient stress, 3)
cardiovascular complications with 24 hours of transfer and 4) cardiovasuclar
complications during the remainder of the hospitalization. Of these, only
the difference in the family evaluated patient stress was statistically
significant. There was no difference found between experimental and control
patients for 1) patient reported cardiovascular complaints and 2) patient
stress as reported by the staff nurse. Additional findings revealed no
alteration in feelings of anger, but anxiety, depression, and fear were
reduced in patients who received the experimental intervention. These
patients were also more likely to comply with physicians' orders, had fewer
readmissions to CCU, spent fewer days hospitalized on the general medical
unit, and had fewer acute cardiovasuclar readmissions during the first three
months.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
coronary care unit
nurse
patient attitude
stress
EMTREE MEDICAL INDEX TERMS
psychological aspect
EMBASE CLASSIFICATIONS
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1978324310
PUI
L8320746
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1181
TITLE
The effects of telemetry in reducing anxiety for myocardial infarction
patients after coronary care unit transfer
AUTHOR NAMES
Van De Zande G.A.
AUTHOR ADDRESSES
(Van De Zande G.A.) Univ. Rochester, N.Y.
CORRESPONDENCE ADDRESS
Univ. Rochester, N.Y.
SOURCE
Abstracts of Hospital Management Studies (1978) 14:3 (18534 SC). Date of
Publication: 1978
ABSTRACT
The purpose of this study was to test the theoretical hypothesis that
telemetry reduces anxiety for myocardial infarction patients after transfer
from the coronary care unit. The sample consisted of 45 myocardial
infarction patients at two city hospitals. Twenty patients were transferred
on telemetry and 25 patients were transferred not on telemetry. The
dependent variables utilized to test the study hypothesis were the scores on
the Multiple Affect Adjective Check List the day after transfer, scores on
the anxiety about care questionnaire, difficulty in sleeping scores, the
amount of sleeping medication, tranquilizers, and analygesics for chest
pain, and the number of complaints of chest pain. It was hypothesized that
patients on telemetry would have lower scores on each of these variables.
Statistically significant results in the predicted direction were obtained
for the anxiety about care scores, the difficulty in sleeping scores, and
the amount of tranquilizers received. An exploratory analysis of the
quantitative data showed that patients over 60 years of age tended to have
more difficulty in sleeping than patients under 60, and that female patients
tended to report higher anxiety levels than males. Telemetry patients, as
compared to non-telemetry patients, were more likely to see transfer as a
positive step in their recovery. Patients transferred to a small cardiac
telemetry unit were more likely to feel secure in their environment.
Qualitative data, separated into six categories of concerns, showed that the
majority of the patients reacted positively to the coronary care unit and to
the nursing care, but expressed indifference to the presence of the
monitors.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
anxiety
coronary care unit
nursing
patient attitude
telemetry
EMTREE MEDICAL INDEX TERMS
psychological aspect
therapy
EMBASE CLASSIFICATIONS
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1978324311
PUI
L8320747
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1182
TITLE
Does a photograph of a newborn about to be transferred to an intensive care
center promote mother-infant bonding?
AUTHOR NAMES
Kopelman A.E.
Simeonsson R.J.
Smaldone A.
Gilbert L.
AUTHOR ADDRESSES
(Kopelman A.E.; Simeonsson R.J.; Smaldone A.; Gilbert L.) Dept. Ped., Univ.
Rochester Sch. Med. Dent., Rochester, N.Y. 14642
CORRESPONDENCE ADDRESS
Dept. Ped., Univ. Rochester Sch. Med. Dent., Rochester, N.Y. 14642
SOURCE
Clinical Pediatrics (1978) 17:1 (15-16). Date of Publication: 1978
ISSN
0009-9228
ABSTRACT
The first days following birth are now looked upon as a 'sensitive period'
in which mother-infant bonding most readily occurs. Separation of a mother
from her infant at that time may interfere with this process, so that the
mother-infant attachment may subsequently be achieved imperfectly or even
not at all. This preliminary communication describes the experiences with
the use of an infant photograph, presented to the mother at the time of
neonatal transfer, as a simple measure to help her deal with the psychologic
process of bonding during a time of crisis.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
mother child relation
newborn
EMTREE MEDICAL INDEX TERMS
major clinical study
methodology
therapy
EMBASE CLASSIFICATIONS
Psychiatry (32)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1978275871
MEDLINE PMID
618695 (http://www.ncbi.nlm.nih.gov/pubmed/618695)
PUI
L8273117
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1183
TITLE
Neonatal transport, 1976.
AUTHOR NAMES
McCaffree M.A.
AUTHOR ADDRESSES
(McCaffree M.A.)
CORRESPONDENCE ADDRESS
M.A. McCaffree,
SOURCE
The Journal of the Oklahoma State Medical Association (1978) 71:1 (10-14).
Date of Publication: Jan 1978
ISSN
0030-1876
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
newborn disease (therapy)
patient transport
EMTREE MEDICAL INDEX TERMS
aircraft
article
car
human
intensive care unit
newborn
patient care
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
621596 (http://www.ncbi.nlm.nih.gov/pubmed/621596)
PUI
L8663673
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1184
TITLE
The Maryland State Intensive Care Neonatal Program (MSICNP), part 2: role of
the Maryland State police Aviation Division.
AUTHOR NAMES
Mazzi E.
Gutberlet R.
Phillips J.A.
AUTHOR ADDRESSES
(Mazzi E.; Gutberlet R.; Phillips J.A.)
CORRESPONDENCE ADDRESS
E. Mazzi,
SOURCE
Maryland state medical journal (1977) 26:12 (48-50). Date of Publication:
Dec 1977
ISSN
0025-4363
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
aircraft
intensive care unit
newborn disease (therapy)
patient transport
EMTREE MEDICAL INDEX TERMS
article
health care planning
human
methodology
newborn
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
926862 (http://www.ncbi.nlm.nih.gov/pubmed/926862)
PUI
L8642663
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1185
TITLE
Intra hospital transfer: effects on chronically ill psychogeriatric patients
AUTHOR NAMES
Raasoch J.
Willmuth R.
Thomson L.
Hyde R.
AUTHOR ADDRESSES
(Raasoch J.; Willmuth R.; Thomson L.; Hyde R.) Vermont State Hosp.,
Waterbury, Vt.
CORRESPONDENCE ADDRESS
Vermont State Hosp., Waterbury, Vt.
SOURCE
Journal of the American Geriatrics Society (1977) 25:6 (281-284). Date of
Publication: 1977
ISSN
0002-8614
ABSTRACT
Since the Vermont State Hospital was approaching a major transition period,
it was decided to study systematically the effects of intraunit and
interunit transfer on its psychogeriatric patients. Ten patients were
assessed by means of 4 standardized measures in the intraunit study,
specifically investigating the effects of integrating wards previously
devoted either to chronic or to acute psychiatric illness. Twenty five
patients from a specialized geriatric unit were evaluated, by separate
investigators, with respect to changes occurring as a result of their
transfer to regional mixed units. The critical incident log, the problem
classification form, and the clinical global impression showed some changes,
for which there were several possible explanations. None of the changes was
as dramatic as predicted by staff members holding divergent views prior to
the study. The optimists predicted a 'blossoming' of the psychogeriatric
patients in the mixed, regional units, whereas the pessimists prophesied
dire consequences. The group of patients studied was not completely
homogeneous with respect to the effect of transfer. Clinical assessment
after transfer could be relied on to detect improvement in some of these
psychogeriatric patients and deterioration in others. Some understanding of
the complexity of the multifactor determinants of change developed along
with increased cooperation among the investigators and the nursing staff. A
middle ground of mutual respect for fresh ideas and an appreciation for
years of experience was reached.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
chronic disease
gerontopsychiatry
hospital patient
transfer
EMTREE MEDICAL INDEX TERMS
age
diagnosis
major clinical study
EMBASE CLASSIFICATIONS
Gerontology and Geriatrics (20)
Public Health, Social Medicine and Epidemiology (17)
Health Policy, Economics and Management (36)
Psychiatry (32)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1978104287
MEDLINE PMID
864175 (http://www.ncbi.nlm.nih.gov/pubmed/864175)
PUI
L8103720
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1186
TITLE
Transfer of the cardiac patient
ORIGINAL (NON-ENGLISH) TITLE
Le transfert du malade cardiaque.
AUTHOR NAMES
Lethbridge B.
Somboon O.
Shea H.L.
AUTHOR ADDRESSES
(Lethbridge B.; Somboon O.; Shea H.L.)
CORRESPONDENCE ADDRESS
B. Lethbridge,
SOURCE
L' Infirmière canadienne (1977) 19:7 (16-18). Date of Publication: Jul 1977
ISSN
0019-9605
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
adaptive behavior
heart disease
progressive patient care
EMTREE MEDICAL INDEX TERMS
article
hospital subdivisions and components
human
intensive care unit
nursing
LANGUAGE OF ARTICLE
French
MEDLINE PMID
586204 (http://www.ncbi.nlm.nih.gov/pubmed/586204)
PUI
L7547879
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1187
TITLE
The transfer of patients from the I.C.U.
AUTHOR NAMES
Sombun O.
AUTHOR ADDRESSES
(Sombun O.)
CORRESPONDENCE ADDRESS
O. Sombun,
SOURCE
Thai journal of nursing (1977) 26:3 (225-231). Date of Publication: Jul 1977
ISSN
0125-0078
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
coronary care unit
heart infarction
patient transport
progressive patient care
EMTREE MEDICAL INDEX TERMS
article
human
nursing
LANGUAGE OF ARTICLE
Thai
MEDLINE PMID
252825 (http://www.ncbi.nlm.nih.gov/pubmed/252825)
PUI
L9505864
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1188
TITLE
Where is the borderline between the work of physicians and nurses? Questions
of responsibility, salary and education often unsolved in transfer of duties
ORIGINAL (NON-ENGLISH) TITLE
Ansvars-, löne- och utbildningsfrågor ofta olösta vid överföring av
uppgifter
AUTHOR NAMES
Karlsson Y.
AUTHOR ADDRESSES
(Karlsson Y.)
CORRESPONDENCE ADDRESS
Y. Karlsson,
SOURCE
Nordisk medicin (1977) 92:5 (136-138). Date of Publication: May 1977
ISSN
0029-1420
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
health economics
nurse
nursing education
EMTREE MEDICAL INDEX TERMS
article
diabetes mellitus
human
human relation
hypertension
injection
intensive care unit
nurse anesthetist
nursing
prescription
Sweden
utilization review
vaccination
LANGUAGE OF ARTICLE
Swedish
MEDLINE PMID
866099 (http://www.ncbi.nlm.nih.gov/pubmed/866099)
PUI
L7528665
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1189
TITLE
Transport of high risk neonates. Part II: Short term intensive care and
stabilization of the sick infant.
AUTHOR NAMES
Ramamurthy R.S.
Yeh T.F.
Pildes R.S.
AUTHOR ADDRESSES
(Ramamurthy R.S.; Yeh T.F.; Pildes R.S.)
CORRESPONDENCE ADDRESS
R.S. Ramamurthy,
SOURCE
IMJ. Illinois medical journal (1976) 150:6 (601-604). Date of Publication:
Dec 1976
ISSN
0019-2120
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
newborn disease (therapy)
patient transport
EMTREE MEDICAL INDEX TERMS
article
human
infant
intensive care unit
newborn
time
LANGUAGE OF ARTICLE
English
MEDLINE PMID
12098 (http://www.ncbi.nlm.nih.gov/pubmed/12098)
PUI
L7472022
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1190
TITLE
The ecology of adaptation to a new environment
AUTHOR NAMES
Lawton M.P.
Patnaik B.
Kleban M.H.
AUTHOR ADDRESSES
(Lawton M.P.; Patnaik B.; Kleban M.H.) Philadelphia Geriat. Cent.,
Philadelphia, Pa. 19141
CORRESPONDENCE ADDRESS
Philadelphia Geriat. Cent., Philadelphia, Pa. 19141
SOURCE
International Journal of Aging and Human Development (1976) 7:1 (15-26).
Date of Publication: 1976
ISSN
0091-4150
ABSTRACT
The intrainstitutional room transfer of 48 elderly residents was studied by
direct behavior mapping techniques. Data were obtained on the physical
location, body position, and behavior of both residents and staff on a large
number of tours of residential floors preceding and following the move.
About half of the hypotheses suggesting that greater passivity and
restriction in social space would occur following the move were supported.
These responses were seen as adaptive in allowing the individual to
comprehend the new environment prior to moving out more actively.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
adaptation
institutionalization
EMTREE MEDICAL INDEX TERMS
age
classification
EMBASE CLASSIFICATIONS
Gerontology and Geriatrics (20)
Anatomy, Anthropology, Embryology and Histology (1)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1977117336
MEDLINE PMID
1279029 (http://www.ncbi.nlm.nih.gov/pubmed/1279029)
PUI
L7117284
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1191
TITLE
The present state of the regionalization of intensive care and the transport
system for high risk newborn babies in Japan (Japanese)
AUTHOR NAMES
Ishizuka Y.
Hashimoto T.
Fujii T.
AUTHOR ADDRESSES
(Ishizuka Y.; Hashimoto T.; Fujii T.) Dept. Ped., II Tokyo Nat. Hosp., Tokyo
CORRESPONDENCE ADDRESS
Dept. Ped., II Tokyo Nat. Hosp., Tokyo
SOURCE
Acta Neonatologica Japonica (1976) 12:4 (451-458). Date of Publication: 1976
ISSN
0029-0386
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
EMTREE MEDICAL INDEX TERMS
history
statistics
therapy
EMBASE CLASSIFICATIONS
Public Health, Social Medicine and Epidemiology (17)
Health Policy, Economics and Management (36)
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
Japanese
EMBASE ACCESSION NUMBER
1978020068
PUI
L8019729
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1192
TITLE
A new transparent insulating gown for the surgical neonate
AUTHOR NAMES
Hobbs J.F.
Eidelman A.I.
MacKuanying N.
AUTHOR ADDRESSES
(Hobbs J.F.; Eidelman A.I.; MacKuanying N.) Div. Neonatol., Dept. Ped.,
Hosp. Albert Einstein Coll. Med., Bronx, N.Y. 10461
CORRESPONDENCE ADDRESS
Div. Neonatol., Dept. Ped., Hosp. Albert Einstein Coll. Med., Bronx, N.Y.
10461
SOURCE
Journal of Pediatric Surgery (1976) 11:3 (455-460). Date of Publication:
1976
ISSN
0022-3468
ABSTRACT
A single layer infant gown of transparent polyethylene was designed to
provide insulation with accessability. Initial testing was done in the
delivery room, a hazardous environment for the unprotected infant.
Subsequently, additional infants were studied during intra hospital
transport, diagnostic radiologic testing, and operative procedures.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
homeostasis
newborn
EMTREE MEDICAL INDEX TERMS
methodology
therapy
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
Surgery (9)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1977116513
MEDLINE PMID
957071 (http://www.ncbi.nlm.nih.gov/pubmed/957071)
PUI
L7116461
DOI
10.1016/S0022-3468(76)80203-5
FULL TEXT LINK
http://dx.doi.org/10.1016/S0022-3468(76)80203-5
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1193
TITLE
Intensive care in obstetrics and gynecology; indications for the transfer to
the intensive care unit
ORIGINAL (NON-ENGLISH) TITLE
INTENSIV THERAPIE IN GEBURTSHILFE UND GYNAKOLOGIE; INDIKATIONEN ZUR
VERLEGUNG AUF INTENSIV STATIONEN
AUTHOR NAMES
Grumbrecht C.
Hohlweg Majert P.
Klose R.
Wochele E.
AUTHOR ADDRESSES
(Grumbrecht C.; Hohlweg Majert P.; Klose R.; Wochele E.) Frauenklin., Fak.
Klin. Med., Univ. Heidelberg, Mannheim
CORRESPONDENCE ADDRESS
Frauenklin., Fak. Klin. Med., Univ. Heidelberg, Mannheim
SOURCE
Fortschritte der Medizin (1976) 94:27 (1447-1450). Date of Publication: 1976
ISSN
0015-8178
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
gynecology
intensive care
obstetrics
EMTREE MEDICAL INDEX TERMS
diagnosis
major clinical study
therapy
EMBASE CLASSIFICATIONS
Obstetrics and Gynecology (10)
LANGUAGE OF ARTICLE
German
EMBASE ACCESSION NUMBER
1977152807
MEDLINE PMID
971890 (http://www.ncbi.nlm.nih.gov/pubmed/971890)
PUI
L7152668
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1194
TITLE
The effects of patient preparation on reducing anxiety in patients
transferred from a coronary care unit
AUTHOR NAMES
Sicard J.
AUTHOR ADDRESSES
(Sicard J.) Univ. Rochester, N.Y. 14627
CORRESPONDENCE ADDRESS
Univ. Rochester, N.Y. 14627
SOURCE
Abstracts of Hospital Management Studies (1976) 13:2 (16052 NU:103p). Date
of Publication: 1976
ABSTRACT
Study investigated the effect of patient preparation on level of anxiety and
use of pain and sleeping medications and tranquilizers in a sample of
coronary care patients transferred from an acute care setting to a
convalescent unit. Fourteen patients meeting study criteria were randomly
assigned to either an experimental group or control group. The experimental
group received daily teaching sessions regarding their illness while the
control group received only routine preparations for transfer. Anxiety
scores were determined and compared from questionnaires administered before
and after the transfer. Results show a significant relationship between
preparation of the patient and decreased anxiety and use of tranquilizers at
0.05 level of significance using the one tail t test. Findings also show
relationship between frequency of sleeping disturbances and patient
preparation was in direction predicted, although not statistically
significant.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
coronary care unit
patient care
EMTREE MEDICAL INDEX TERMS
clinical trial
controlled study
human
major clinical study
methodology
randomized controlled trial
therapy
EMBASE CLASSIFICATIONS
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1978011616
PUI
L8011511
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1195
TITLE
Indicators and periods of transfer of sick newborn infants and premature
infants from maternity homes into specialized wards of pediatric hospitals
ORIGINAL (NON-ENGLISH) TITLE
Pokazaniia i sroki perevoda iz rodil'nykh domov zabolevshikh novorozhdennykh
i nedonoshennykh detei v spetsializirovannye otdeleniia (palaty) detskikh
bol'nits
AUTHOR NAMES
Balashova V.G.
AUTHOR ADDRESSES
(Balashova V.G.)
CORRESPONDENCE ADDRESS
V.G. Balashova,
SOURCE
Feldsher i akusherka (1976) 41:9 (5-6). Date of Publication: Sep 1976
ISSN
0014-9772
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
newborn disease
nursery
patient transport
prematurity
EMTREE MEDICAL INDEX TERMS
article
hospital
human
intensive care unit
newborn
USSR
LANGUAGE OF ARTICLE
Russian
MEDLINE PMID
1050297 (http://www.ncbi.nlm.nih.gov/pubmed/1050297)
PUI
L7471482
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1196
TITLE
Retransfer of convalescent infants from newborn intensive care to community
intermediate care nurseries.
AUTHOR NAMES
Leake R.D.
Loew A.D.
Oh W.
AUTHOR ADDRESSES
(Leake R.D.; Loew A.D.; Oh W.)
CORRESPONDENCE ADDRESS
R.D. Leake,
SOURCE
Clinical pediatrics (1976) 15:3 (293-294). Date of Publication: Mar 1976
ISSN
0009-9228
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child health care
patient transport
EMTREE MEDICAL INDEX TERMS
article
community hospital
convalescence
cross infection (therapy)
human
intensive care unit
newborn
newborn disease (therapy)
nursery
nursing
salmonellosis (therapy)
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
1253510 (http://www.ncbi.nlm.nih.gov/pubmed/1253510)
PUI
L6527543
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1197
TITLE
Organization, transport, admission and permanent control of the severely
sick child
ORIGINAL (NON-ENGLISH) TITLE
Organizacija transporta, prijema i stalne kontrole tesko obolelog deteta.
AUTHOR NAMES
Pavlović P.
Ugoci S.
Janković S.
AUTHOR ADDRESSES
(Pavlović P.; Ugoci S.; Janković S.)
CORRESPONDENCE ADDRESS
P. Pavlović,
SOURCE
Narodno zdravlje (1976) 32:3-4 (186-190). Date of Publication: 1976 Mar-Apr
ISSN
0027-8025
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child hospitalization
monitoring
patient transport
EMTREE MEDICAL INDEX TERMS
age
article
child
hemorrhagic shock (therapy)
human
injury (therapy)
intensive care unit
organization and management
respiratory failure (therapy)
Yugoslavia
LANGUAGE OF ARTICLE
Serbian
MEDLINE PMID
1029787 (http://www.ncbi.nlm.nih.gov/pubmed/1029787)
PUI
L7557406
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1198
TITLE
Neonatal ICU transport--a life-saver.
AUTHOR ADDRESSES
SOURCE
RN (1975) 38:12 (ICU14-15). Date of Publication: Dec 1975
ISSN
0033-7021
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
newborn disease (therapy)
patient transport
EMTREE MEDICAL INDEX TERMS
article
human
newborn
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
1043113 (http://www.ncbi.nlm.nih.gov/pubmed/1043113)
PUI
L6483088
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1199
TITLE
Practical experience in the transport of newborn infants at risk by means of
a mobile intensive care unit
ORIGINAL (NON-ENGLISH) TITLE
PRAKTISCHE ERFAHRUNGEN MIT DEM INTENSIVPFLEGE TRANSPORT VON FRUH- UND
NEUGEBORENEN BEI VITALER GEFAHRDUNG
AUTHOR NAMES
Lemburg P.
Enayat U.
Renner K.
Volberg B.
AUTHOR ADDRESSES
(Lemburg P.; Enayat U.; Renner K.; Volberg B.) Abt. Pad. Intensivmed., Univ.
Kinderklin., Dusseldorf
CORRESPONDENCE ADDRESS
Abt. Pad. Intensivmed., Univ. Kinderklin., Dusseldorf
SOURCE
Wiener Klinische Wochenschrift (1975) 87:15 (468-474). Date of Publication:
1975
ISSN
0043-5325
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
German
EMBASE ACCESSION NUMBER
1976113918
MEDLINE PMID
1226753 (http://www.ncbi.nlm.nih.gov/pubmed/1226753)
PUI
L6113857
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1200
TITLE
Transport of "high-risk" newborn infants. (Apropos of 159 emergency calls by
the SAMU 94-Service d'Aide Médicale Urgente-Emergency Health Service)
ORIGINAL (NON-ENGLISH) TITLE
Transport des nouveau-nes "a haut risque" (a propos de 159 interventions
médicales urgentes régulée par le SAMU 94)
AUTHOR NAMES
Scheyer M.
Iannascoli F.
Brioude R.
Canet J.
AUTHOR ADDRESSES
(Scheyer M.; Iannascoli F.; Brioude R.; Canet J.)
CORRESPONDENCE ADDRESS
M. Scheyer,
SOURCE
Annales de l'anesthésiologie française (1975) 16 Spec No 1 (130-134). Date
of Publication: 1975
ISSN
0003-4061
ABSTRACT
Analysis of our experience confirms in the domain of the newborn the
fundamental notion of the Emergency medical call. The EMC has two
objectives: 1--Emergency treatment before the patient is moved, and the
correction of failing vital functions by a medical team skilled in problems
of neonates. 2--Transportation of the neonate in a stable condition, to the
Intensive Care unit. The quality of such transportation depends closely upon
the quality of the medical care given and upon organisation. It can only be
carried out in the context of a system coordinated by a "coordinating
physician" (e.g. SAMU 94). This coordinating physician has responsibility
for logistics, telephone coordination, and application of the call procedure
as rapidly as possible. From a logistical point of view, only coordination
between:--SAMU-SMUR;--Medical team of the Intensive care unit;--Requesting
service make possible the provision and quality of continuous supplies of
oxygen, warmth, sugar - all under aseptic conditions, indispensable to the
quality of survival of the neonate. In addition, we feel it essential--that
the delay before the call is answered be as brief as possible;--that the
call should be dealt with by a mixed team, including at least one physician
experienced in neonatal problems;--that the choice of vehicle used for
transportation should be better adapted to the situation. This choice is the
responsibility of the coordinating physician, who should base his decisions
on two fundamental requirements:--rapidity of dealing with the
call;--personal safety of those involved. This without losing sight
of--Prevention of perinatal problems lies part with the detection of high
risk pregnancies, with the aim of arranging delivery in specialised "mother
and baby" centres where close collaboration between obstetrician and
paediatrician is assured.--The development of transportation of the
"high-risk" neonate, which is so costly in manpower and equipment, depends
closely upon general concepts of health care in France, which should be
aimed at:--the prevention of prematury;--the detection of high risk
pregnancies;--the development of mother and baby centres.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency health service
newborn disease (therapy)
patient transport
EMTREE MEDICAL INDEX TERMS
article
child health care
emergency
female
France
human
intensive care unit
newborn
nursery
pregnancy
pregnancy complication (therapy)
LANGUAGE OF ARTICLE
French
MEDLINE PMID
2070 (http://www.ncbi.nlm.nih.gov/pubmed/2070)
PUI
L6498679
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1201
TITLE
Letter: Transport of infants for intensive care.
AUTHOR ADDRESSES
SOURCE
British medical journal (1975) 4:5993 (408). Date of Publication: 15 Nov
1975
ISSN
0007-1447
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child health care
intensive care unit
EMTREE MEDICAL INDEX TERMS
article
human
newborn
newborn disease (therapy)
LANGUAGE OF ARTICLE
English
MEDLINE PMID
1192098 (http://www.ncbi.nlm.nih.gov/pubmed/1192098)
PUI
L6474580
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1202
TITLE
Movement of criticall ill patients within hospital.
AUTHOR NAMES
Waddell G.
AUTHOR ADDRESSES
(Waddell G.)
CORRESPONDENCE ADDRESS
G. Waddell,
SOURCE
British medical journal (1975) 2:5968 (417-419). Date of Publication: 24 May
1975
ISSN
0007-1447
ABSTRACT
Critically ill patients were observed during routine movement inside the
hospital to and from the intensive therapy unit. One patient a month
suffered major cardiorespiratory collapse or death as a direct result of
movement. Renewed bleeding of a pelvic fracture, cardiac arrhythmia, cardiac
embarrassment due to a haemothorax, and cardiovascular decompensation were
seen. It was difficult to continue treatment during movement, especially
maintaining an airway or providing adequate intermittent positive pressure
ventilation. Seventy postoperative patients suffered few ill effects on
being moved. Greater awareness of the dangers of moving critically ill
patients within hospital is needed. Thorough preparation for the move and
adequate maintenance of treatment during movement requires the skill of
experienced medical staff.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital
intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
acute disease
aged
airway obstruction (epidemiology)
article
bleeding (epidemiology)
child
female
heart arrest (etiology)
heart arrhythmia (etiology)
human
intermittent positive pressure ventilation
male
middle aged
mortality
traction therapy
wound drainage
LANGUAGE OF ARTICLE
English
MEDLINE PMID
1092402 (http://www.ncbi.nlm.nih.gov/pubmed/1092402)
PUI
L5508288
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1203
TITLE
Neonatal Intensive Care Center, Maine Medical Center: who and how to
transfer
AUTHOR NAMES
Hallett G.W.
AUTHOR ADDRESSES
(Hallett G.W.) 22 Bramhall St., Portland, Me. 04102
CORRESPONDENCE ADDRESS
22 Bramhall St., Portland, Me. 04102
SOURCE
Journal of the Maine Medical Association (1974) 65:8 (183). Date of
Publication: 1974
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care
newborn
EMBASE CLASSIFICATIONS
Pediatrics and Pediatric Surgery (7)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1975111081
PUI
L5111002
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1204
TITLE
Organization for patient movement at Fitzsimons General Hospital, Denver,
Colorado
AUTHOR NAMES
Soriano Jr F.M.
AUTHOR ADDRESSES
(Soriano Jr F.M.) Baylor Univ., Waco, Tex.
CORRESPONDENCE ADDRESS
Baylor Univ., Waco, Tex.
SOURCE
Abstracts of Hospital Management Studies (1974) 10:3 (11291:101p.). Date of
Publication: 1974
ABSTRACT
The purpose of this study was to define the air evacuation problem at
Fitzsimons General Hospital and develop the best system of organization for
patient movement. Data was collected through unstructured interviews of air
evacuation personnel and others in various position levels in the hospital.
Review of the literature revealed significant lack of material in the area
of organization for patient movement. Time study of the patient movement
activity for air evacuation was conducted. Work load and performance data
were analyzed. The premise was that an organization with a sound
organizational structure and centralized control of its resources would
facilitate coordination, cooperation, and communication among its members,
and would result in a more efficient and effective enterprise. Emphasis was
on the concept that patient movement is a part of total patient care and a
medical function that should be performed and supervised by medically
trained personnel. It was recommended that: (1) the Air Evacuation Section
and the Ambulance Section be consolidated into a centralized 'Patient
Movement Activity' under the organizaion and operational control of the
Nursing Department; (2) there be continuing medical training and cross
training of all personnel of the activity including the ambulance drivers
and the registrar trained air evacuation enlisted personnel; (3)
consideration be given to the future addition of a centralized intrahospital
patient transport service organized under the proposed Patient Movement
Activity because of its nurse timesaving feature and more efficient
utilization of orderlies and porters.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
economic aspect
EMTREE MEDICAL INDEX TERMS
outpatient care
EMBASE CLASSIFICATIONS
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1974206159
PUI
L4206048
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1205
TITLE
The observed and expressed nursing needs of fifteen myocardial infarction
patients following transfer from a coronary care unit
AUTHOR NAMES
McNeely E.R.
AUTHOR ADDRESSES
(McNeely E.R.) Univ. Toronto
CORRESPONDENCE ADDRESS
Univ. Toronto
SOURCE
Abstracts of Hospital Management Studies (1973) 10:2 (10686 NU: 94p). Date
of Publication: 1973
ABSTRACT
A study was made of the observed and expressed nursing needs of 15
myocardial infarction patients following their transfer from a coronary care
unit to a general care unit in 2 metropolitan general hospitals. Data were
collected from medical records, direct observation, and interviews with
patients and their families. Study findings showed the 7 most frequently
observed and expressed physical needs, the 7 most frequently occurring
psychological needs, and the needs most frequently expressed by the
families.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
coronary care unit
economic aspect
heart infarction
hospital patient
nursing
psychology
EMTREE MEDICAL INDEX TERMS
general hospital
hospital
teaching hospital
university hospital
EMBASE CLASSIFICATIONS
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1974131929
PUI
L4131846
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1206
TITLE
Prehospital care and transport in acute myocardial infarction
AUTHOR NAMES
Grace W.J.
AUTHOR ADDRESSES
(Grace W.J.) Dept. Med., St Vincent's Hosp., New York, N.Y.
CORRESPONDENCE ADDRESS
Dept. Med., St Vincent's Hosp., New York, N.Y.
SOURCE
CHEST (1973) 63:4 (469-472). Date of Publication: 1973
ISSN
0012-3692
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
coronary care unit
heart infarction
EMTREE MEDICAL INDEX TERMS
therapy
EMBASE CLASSIFICATIONS
Cardiovascular Diseases and Cardiovascular Surgery (18)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1974143446
MEDLINE PMID
4695341 (http://www.ncbi.nlm.nih.gov/pubmed/4695341)
PUI
L4143362
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1207
TITLE
The effects of ward change on patients' psychopathology and behaviour: a
failure to replicate
AUTHOR NAMES
Hoffmann H.
Nickles L.A.
AUTHOR ADDRESSES
(Hoffmann H.; Nickles L.A.) Willmar State Hosp., Willmar, Minn.
CORRESPONDENCE ADDRESS
Willmar State Hosp., Willmar, Minn.
SOURCE
Journal of Clinical Psychology (1973) 29:1 (97). Date of Publication: 1973
ISSN
0021-9762
ABSTRACT
33 psychiatric patients were rated by three nursing staff members on
psychiatric symptoms and ward behavior 1 mth prior to and 6 mth after a
transfer from a general assignment type ward to a geographic unit system.
Changes in psychopathology as noted by other researchers in retests after 3
mth could not be found in this study, which used retests completed 6 mth
after patients' transfers. This indicates that immediate or shortterm
effects from intrahospital transfer tend not to be maintained over a longer
period of time.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
behavior
nursing staff
psychiatry
EMTREE MEDICAL INDEX TERMS
methodology
EMBASE CLASSIFICATIONS
Psychiatry (32)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1974109309
MEDLINE PMID
4683403 (http://www.ncbi.nlm.nih.gov/pubmed/4683403)
PUI
L4109233
COPYRIGHT
Copyright 2009 Elsevier B.V., All rights reserved.
RECORD 1208
TITLE
Transport of pregnant patients with severe forms of late toxicosis to
specialized resuscitation departments
ORIGINAL (NON-ENGLISH) TITLE
Transportirovka bol'nykh s tiazhelymi formami poznego toksikoza beremennykh
v spetsializirovannye reanimatsionnye otdeleniia
AUTHOR NAMES
Manevich L.E.
Kaverina K.P.
Khlestova R.A.
Blinkin A.I.
AUTHOR ADDRESSES
(Manevich L.E.; Kaverina K.P.; Khlestova R.A.; Blinkin A.I.)
CORRESPONDENCE ADDRESS
L.E. Manevich,
SOURCE
Voprosy okhrany materinstva i detstva (1973) 18:4 (85-89). Date of
Publication: 1973
ISSN
0042-8825
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency
patient transport
preeclampsia (therapy)
resuscitation
EMTREE MEDICAL INDEX TERMS
acute disease
article
female
human
intensive care unit
pregnancy
Russian Federation
LANGUAGE OF ARTICLE
Russian
MEDLINE PMID
4802937 (http://www.ncbi.nlm.nih.gov/pubmed/4802937)
PUI
L5450806
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1209
TITLE
Materials transportation
AUTHOR NAMES
Jones R.
Pisinski E.
AUTHOR ADDRESSES
(Jones R.; Pisinski E.) Commun. Syst. Found., Ltd., Ann Arbor, Mich. 48105
CORRESPONDENCE ADDRESS
Commun. Syst. Found., Ltd., Ann Arbor, Mich. 48105
SOURCE
Abstracts of Hospital Management Studies (1973) 10:2 (10488 PU:34p). Date of
Publication: 1973
ABSTRACT
This study analyzed the intrahospital transportation system (delivery of
items such as linen and pharmaceuticals), projected cart requirements, and
defined routes carts should follow during material delivery in a hospital
that was expanding from 207 to 315 beds. The study also examined ways to
adapt the transportation system to team nursing.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
hospital linen
EMTREE DRUG INDEX TERMS
unclassified drug
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
economic aspect
hospital management
materials handling
nurse
teamwork
transport
EMTREE MEDICAL INDEX TERMS
general hospital
home for the aged
hospital
mental health center
mental hospital
nursing home
public hospital
teaching hospital
university hospital
EMBASE CLASSIFICATIONS
Health Policy, Economics and Management (36)
LANGUAGE OF ARTICLE
English
EMBASE ACCESSION NUMBER
1974132053
PUI
L4131970
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1210
TITLE
Diagnostic criteria for admission to or transfer from the intensive care
unit--description of patients treatment in the ICU
AUTHOR NAMES
Urukami H.
AUTHOR ADDRESSES
(Urukami H.)
CORRESPONDENCE ADDRESS
H. Urukami,
SOURCE
[Kango gijutsu] : [Nursing technique] (1973) 19:8 (132-137). Date of
Publication: Aug 1973
ISSN
0449-752X
EMTREE MEDICAL INDEX TERMS
article
diagnosis
intensive care unit
prognosis
progressive patient care
LANGUAGE OF ARTICLE
Japanese
MEDLINE PMID
4489950 (http://www.ncbi.nlm.nih.gov/pubmed/4489950)
PUI
L93411193
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1211
TITLE
Early transportable combination-apparatus for oxygen supply and suction
device
ORIGINAL (NON-ENGLISH) TITLE
Ein leicht transportables Kombinationsgerät für Sauerstoffzufuhr und
Absaugevorrichtung.
AUTHOR NAMES
Wietelmann H.
Klaucke D.
AUTHOR ADDRESSES
(Wietelmann H.; Klaucke D.)
CORRESPONDENCE ADDRESS
H. Wietelmann,
SOURCE
Zeitschrift für praktische Anästhesie, Wiederbelebung und Intensivtherapie
(1973) 8:3 (186-187). Date of Publication: Jun 1973
ISSN
0300-8789
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
artificial ventilation
catheterization
oxygen therapy
EMTREE MEDICAL INDEX TERMS
article
bronchus
devices
human
intensive care unit
intubation
secretion (process)
ventilator
LANGUAGE OF ARTICLE
German
MEDLINE PMID
4520415 (http://www.ncbi.nlm.nih.gov/pubmed/4520415)
PUI
L4445796
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1212
TITLE
The transfer process: an area of concern for the CCU nurse.
AUTHOR NAMES
Shannon V.J.
AUTHOR ADDRESSES
(Shannon V.J.)
CORRESPONDENCE ADDRESS
V.J. Shannon,
SOURCE
Heart & lung : the journal of critical care (1973) 2:3 (364-367). Date of
Publication: 1973 May-Jun
ISSN
0147-9563
EMTREE MEDICAL INDEX TERMS
adaptive behavior
article
coronary care unit
nurse patient relationship
progressive patient care
LANGUAGE OF ARTICLE
English
MEDLINE PMID
4488728 (http://www.ncbi.nlm.nih.gov/pubmed/4488728)
PUI
L93367696
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1213
TITLE
Transferable resistance to gentamycin. II. Transmission and linkage of the
resistance character
ORIGINAL (NON-ENGLISH) TITLE
Resistance transferable a la gentamicine. II. Transmission et liaisons du
caractere de resistance
AUTHOR NAMES
Witchitz J.L.
Chabbert Y.A.
AUTHOR ADDRESSES
(Witchitz J.L.; Chabbert Y.A.) Lab. Cent., Hop. Claude Bernard, Paris.
CORRESPONDENCE ADDRESS
Lab. Cent., Hop. Claude Bernard, Paris.
SOURCE
Annales de l'Institut Pasteur (1972) 122:3 (367-378). Date of Publication:
1972
ISSN
0020-2444
ABSTRACT
Transferable gentamycin resistance (Gk) was studied in 26 strains belonging
to 7 bacterial species: E. coli, Enterobacter aerogenes, K. pneumoniae,
Citrobacter, P. mirabilis, Providencia and Pseudomonas aeruginosa, isolated
in an intensive care unit between November 1969 and December 1970. All these
strains were also resistant to ampicillin (A), chloramphenicol (C),
sulfonamides (Su) and in some cases other agents as well. The strains
transferred at least the resistance pattern ACSuGk to E. coli K12. Phage
P1Kc transduces the complete pattern ACSuGk from K12 to suitable K12
recipients. The resistance marker Gk was first observed in November 1969 and
ACSu R factors seem to be rare in previous studies. These observations may
be explained by in vivo transfer of a single R factor between different
bacterial species. Such transfer may have occurred in the liquid of a
peritoneal dialysis performed in one of the first patients. Transferable
resistance to gentamycin may thus have become widely distributed as the
result of in vivo transfer of a single R factor between different bacterial
species.
EMTREE DRUG INDEX TERMS (MAJOR FOCUS)
gentamicin
EMTREE DRUG INDEX TERMS
ampicillin
chloramphenicol
kanamycin
marker
sulfonamide
EMTREE MEDICAL INDEX TERMS
bacteriophage
Citrobacter
disinfection
Enterobacter aerogenes
Escherichia coli
Gram negative bacterium
hospital infection
in vitro study
intensive care unit
Klebsiella pneumoniae
liquid
Mirabilis
patient
peritoneal dialysis
Providencia
Pseudomonas aeruginosa
R factor
recipient
species
LANGUAGE OF ARTICLE
French
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2008442639
PUI
L292053558
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1214
TITLE
Transfer of newborns with respiratory distress syndrome from obstetrical to
paediatric wards for intensive care
ORIGINAL (NON-ENGLISH) TITLE
Beitrag zum Problem der Uberführung deprimierter Neugeborener aus
geburtshilflicher Sofortreanaimation in preanimation in pädiatrische
Langzeitreanimation.
AUTHOR NAMES
Koenen F.W.
Schnell U.C.
AUTHOR ADDRESSES
(Koenen F.W.; Schnell U.C.)
CORRESPONDENCE ADDRESS
F.W. Koenen,
SOURCE
Zeitschrift für praktische Anästhesie, Wiederbelebung und Intensivtherapie
(1972) 7:6 (378-382). Date of Publication: Dec 1972
ISSN
0300-8789
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
hospital department
intensive care unit
neonatal respiratory distress syndrome (therapy)
patient transport
EMTREE MEDICAL INDEX TERMS
article
emergency health service
German Federal Republic
human
incubator
long term care
newborn
procedures
resuscitation
ventilator
LANGUAGE OF ARTICLE
German
MEDLINE PMID
4631278 (http://www.ncbi.nlm.nih.gov/pubmed/4631278)
PUI
L93304767
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1215
TITLE
Value of helicopter evacuations in pediatric practice in the region of
Lyons. Analysis of 40 cases in emergency and intensive care units of
Desgenettes army instruction hospital
ORIGINAL (NON-ENGLISH) TITLE
Interêt des évacuations par hélicoptere en pratique pédiatrique dans la
région Lyonnaise. Analyse de 40 observations réunies ar le service d'Urgence
et de Soins Intensifs de l'Hôpital d'Instruction des Armées Desgenettes.
AUTHOR NAMES
Giroud M.
Morlat C.
Buffat J.J.
Calamai M.
AUTHOR ADDRESSES
(Giroud M.; Morlat C.; Buffat J.J.; Calamai M.)
CORRESPONDENCE ADDRESS
M. Giroud,
SOURCE
Pédiatrie (1972) 27:7 (783-788). Date of Publication: 1972 Oct-Nov
ISSN
0031-4021
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
aircraft
patient transport
pediatrics
EMTREE MEDICAL INDEX TERMS
article
child
emergency health service
France
human
infant
intensive care unit
military medicine
newborn
preschool child
teaching hospital
LANGUAGE OF ARTICLE
French
MEDLINE PMID
4659978 (http://www.ncbi.nlm.nih.gov/pubmed/4659978)
PUI
L93350873
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1216
TITLE
The recently burned patient. (Appraisal of the seriousness. 1st therapeutic
measures. Transport)
ORIGINAL (NON-ENGLISH) TITLE
Le brulé récent. (Appréciation de la gravité. Premiers gestes
thérapeutiques. Transport.
AUTHOR NAMES
Aubert P.
Aubert M.
Saizy R.
Stern A.
Apoil A.
Gaudy J.H.
Coloigner M.
AUTHOR ADDRESSES
(Aubert P.; Aubert M.; Saizy R.; Stern A.; Apoil A.; Gaudy J.H.; Coloigner
M.)
CORRESPONDENCE ADDRESS
P. Aubert,
SOURCE
Anesthésie, analgésie, réanimation (1971) 28:6 (1109-1125). Date of
Publication: 1971 Nov-Dec
ISSN
0003-3014
EMTREE DRUG INDEX TERMS
dextran (drug therapy)
glucose (drug therapy)
plasma substitute (drug therapy)
sodium chloride (drug therapy)
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
burn (therapy)
first aid
patient transport
EMTREE MEDICAL INDEX TERMS
age
article
blood pressure measurement
catheterization
diuresis
electrolyte balance
human
infusion
intensive care unit
metabolism
nursing
resuscitation
CAS REGISTRY NUMBERS
dextran (87915-38-6, 9014-78-2)
glucose (50-99-7, 84778-64-3)
sodium chloride (7647-14-5)
LANGUAGE OF ARTICLE
French
MEDLINE PMID
5154085 (http://www.ncbi.nlm.nih.gov/pubmed/5154085)
PUI
L92516057
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1217
TITLE
Emergency care and evacuation of the severely burned
ORIGINAL (NON-ENGLISH) TITLE
Soins d'urgence et évacuation des brûlés graves.
AUTHOR NAMES
Monteil R.
AUTHOR ADDRESSES
(Monteil R.)
CORRESPONDENCE ADDRESS
R. Monteil,
SOURCE
Thérapie (1971) 26:2 (291-298). Date of Publication: 1971 Mar-Apr
ISSN
0040-5957
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
burn (therapy)
emergency health service
patient transport
EMTREE MEDICAL INDEX TERMS
acute disease
article
human
infusion
intensive care unit
resuscitation
LANGUAGE OF ARTICLE
French
MEDLINE PMID
5574553 (http://www.ncbi.nlm.nih.gov/pubmed/5574553)
PUI
L91383788
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1218
TITLE
So-called transportable thoracic radiography and its importance in the
intensive therapy
ORIGINAL (NON-ENGLISH) TITLE
Die sogenannte transportable Thoraxaufnahme und ihre Bedeutung in der
Intensivtherapie.
AUTHOR NAMES
Birzle H.
Meroth O.
Zix R.
AUTHOR ADDRESSES
(Birzle H.; Meroth O.; Zix R.)
CORRESPONDENCE ADDRESS
H. Birzle,
SOURCE
Zeitschrift für praktische Anästhesie und Wiederbelebung (1971) 6:1 (7-12).
Date of Publication: Feb 1971
ISSN
0044-3387
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
intensive care unit
thorax radiography
EMTREE MEDICAL INDEX TERMS
accident
article
devices
human
injury
lung embolism (diagnosis)
radiography
radiology
time
LANGUAGE OF ARTICLE
German
MEDLINE PMID
4255683 (http://www.ncbi.nlm.nih.gov/pubmed/4255683)
PUI
L91475347
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1219
TITLE
Air transportation of high-risk infants utilizing a flying intensive-care
nursery.
AUTHOR NAMES
Shepard K.S.
AUTHOR ADDRESSES
(Shepard K.S.)
CORRESPONDENCE ADDRESS
K.S. Shepard,
SOURCE
The Journal of pediatrics (1970) 77:1 (148-149). Date of Publication: Jul
1970
ISSN
0022-3476
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
child care
emergency health service
intensive care unit
patient transport
EMTREE MEDICAL INDEX TERMS
article
human
infant
LANGUAGE OF ARTICLE
English
MEDLINE PMID
5450278 (http://www.ncbi.nlm.nih.gov/pubmed/5450278)
PUI
L90438027
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1220
TITLE
The induction process. A method of choice in intrainstitutional transfer.
AUTHOR NAMES
Muzekari L.H.
AUTHOR ADDRESSES
(Muzekari L.H.)
CORRESPONDENCE ADDRESS
L.H. Muzekari,
SOURCE
The Journal of nervous and mental disease (1970) 150:6 (419-422). Date of
Publication: Jun 1970
ISSN
0022-3018
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
group therapy
mental hospital
therapeutic community
EMTREE MEDICAL INDEX TERMS
article
human
United States
LANGUAGE OF ARTICLE
English
MEDLINE PMID
5444882 (http://www.ncbi.nlm.nih.gov/pubmed/5444882)
PUI
L90379971
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1221
TITLE
Respiratory distress syndrome. an emergency air ground transport system for
newborn infants
AUTHOR NAMES
Arp L.J.
Dillon R.E.
Long M.T.
Boatwright C.X.
AUTHOR ADDRESSES
(Arp L.J.; Dillon R.E.; Long M.T.; Boatwright C.X.) Div. of Engin.
Fundament, Virginia Polytechn. Lnst, Blacksburg, VA, United States.
CORRESPONDENCE ADDRESS
L.J. Arp, Div. of Engin. Fundament, Virginia Polytechn. Lnst, Blacksburg,
VA, United States.
SOURCE
Ohio St.Med.J. (1969) 65:7 (703-706). Date of Publication: 1969
ABSTRACT
Described is an emergency air ground transport system which has been used
successfully to transport newborn infants with respiratory distress syndrome
to the Roanoke Memorial Hospitals at Roanoke, Virginia. The special
equipment which has been developed for ventilating the distressed newborn
will not be available commercially for about one year. In an effort to make
this equipment available immediately to physicians and the distressed
infants, the Virginia Polytechnic Institute at Blacksburg, Virginia, has
established an emergency air ground transport system. A twin engine airplane
equipped with special respiratory support equipment will be available to
physicians who may wish to transfer respiratory distress cases to the
Intensive Care Nursery at the Roanoke Memorial Hospitals.
EMTREE DRUG INDEX TERMS
hyalin
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
emergency
newborn
respiratory distress syndrome
EMTREE MEDICAL INDEX TERMS
aircraft
assisted ventilation
emergency medicine
hospital
hyaline membrane disease
infant
intensive care
intensive care unit
membrane
newborn intensive care
nursery
physician
respiratory distress
twins
United States
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2008464068
PUI
L290061167
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1222
TITLE
Transfer from a coronary care unit. Some adverse responses
AUTHOR NAMES
Klein R.F.
Kliner V.
Zipes D.P.
AUTHOR ADDRESSES
(Klein R.F.; Kliner V.; Zipes D.P.) Dept. of Med., Duke Univ. Med. Cent.,
Durham, NC, United States.
()
CORRESPONDENCE ADDRESS
R.F. Klein, Dept. of Med., Duke Univ. Med. Cent., Durham, NC, United States.
SOURCE
Archives of Internal Medicine (1968) 122:2 (104-108). Date of Publication:
1968
ISSN
0003-9926
ABSTRACT
A series of 14 patients with myocardial infarction hospitalized on a
Coronary Care Unit and then transferred to a general medical ward were
studied by clinical observation and measurement of urinary catecholamine
excretion. Emotional changes were frequent and correlated temporally with
urinary catecholamine changes at the time of transfer. The incidence of
cardiovascular complications was reduced in patients prepared for transfer
and followed by a nurse and physician throughout their hospitalization. The
findings reaffirm the importance of continuity of care in the treatment of
patients with myocardial infarction.
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
coronary care unit
EMTREE MEDICAL INDEX TERMS
cardiovascular disease
catecholamine excretion
catecholamine urine level
clinical observation
heart arrhythmia
heart infarction
hospitalization
nurse
patient
patient care
physician
ward
LANGUAGE OF ARTICLE
English
LANGUAGE OF SUMMARY
English
EMBASE ACCESSION NUMBER
2008926616
PUI
L289109467
COPYRIGHT
Copyright 2007 Elsevier B.V., All rights reserved.
RECORD 1223
TITLE
Transferring cardiac patients stirs communications problems.
AUTHOR NAMES
Mary George Sister
AUTHOR ADDRESSES
(Mary George Sister)
CORRESPONDENCE ADDRESS
Mary George Sister,
SOURCE
Chart (1967) 64:10 (309-312). Date of Publication: Dec 1967
ISSN
0069-2778
EMTREE MEDICAL INDEX TERMS
article
human relation
intensive care unit
interpersonal communication
nursing
LANGUAGE OF ARTICLE
English
MEDLINE PMID
5183742 (http://www.ncbi.nlm.nih.gov/pubmed/5183742)
PUI
L88036815
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1224
TITLE
The transferring phenomena influences on nurse and patient.
AUTHOR NAMES
Mary George Sister
AUTHOR ADDRESSES
(Mary George Sister)
CORRESPONDENCE ADDRESS
Mary George Sister,
SOURCE
Hospital management (1967) 104:4 (92 passim). Date of Publication: Oct 1967
ISSN
0018-5744
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
nurse patient relationship
nursing
EMTREE MEDICAL INDEX TERMS
article
human relation
intensive care unit
LANGUAGE OF ARTICLE
English
MEDLINE PMID
6082626 (http://www.ncbi.nlm.nih.gov/pubmed/6082626)
PUI
L88035263
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.
RECORD 1225
TITLE
Mechanization of intrahospital transport of stretcher patients in field
condition.
AUTHOR NAMES
Turovskii B.I.
AUTHOR ADDRESSES
(Turovskii B.I.)
CORRESPONDENCE ADDRESS
B.I. Turovskii,
SOURCE
Voenno-meditsinskiǐ zhurnal (1960) 3 (23-24). Date of Publication: Mar 1960
ISSN
0026-9050
EMTREE MEDICAL INDEX TERMS (MAJOR FOCUS)
patient transport
TRANSPORT OF WOUNDED
EMTREE MEDICAL INDEX TERMS
article
LANGUAGE OF ARTICLE
Russian
MEDLINE PMID
13778763 (http://www.ncbi.nlm.nih.gov/pubmed/13778763)
PUI
L80397171
COPYRIGHT
MEDLINE® is the source for the citation and abstract of this record.