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Research and Reviews in the Fastlane 099
This study took a sample from healthy pregnant patients (n=760) at different stages of gestation. They found, unsurprisingly, that d-dimer increases with gestational age, congruent with limited prior literature. They propose a continuous increasing d-dimer in pregnancy. With PE experts such as Dr. Kline proposing gestation adjusted d-dimer, this is a research space to watch. Recommended by: Lauren Westafer Systems and administration Del Portal DA, et al. Impact of an Opioid Prescribing Guideline in the Acute Care Setting. J Emerg Med 2015. PMID: 26281819 As many EDs implement voluntary opioid prescribing guidelines, this...
Source: Life in the Fast Lane - September 9, 2015 Category: Emergency Medicine Authors: Nudrat Rashid Tags: Anaesthetics Cardiology Education Emergency Medicine Haematology Intensive Care critical care literature R&R in the FASTLANE recommendations research and reviews Source Type: blogs

Transitioning HIV-Infected Youth Into Adult Health Care
With advances in antiretroviral therapy, most HIV-infected children survive into adulthood. Optimal health care for these youth includes a formal plan for the transition of care from primary and/or subspecialty pediatric/adolescent/family medicine health care providers (medical home) to adult health care provider(s). Successful transition involves the early engagement and participation of the youth and his or her family with the pediatric medical home and adult health care teams in developing a formal plan. Referring providers should have a written policy for the transfer of HIV-infected youth to adult care, which will gui...
Source: PEDIATRICS - July 1, 2013 Category: Pediatrics Authors: COMMITTEE ON PEDIATRIC AIDS Tags: From the American Academy of Pediatrics Source Type: research

The Initial Approach to the Multisystem Pediatric Trauma Patient
Trauma remains the leading cause of morbidity and mortality in children and youth 1 to 19 years old in the United States. Providing timely care with a systematic approach is essential for emergently addressing life-threatening injuries and ongoing assessment. The primary survey is focused on identifying and managing life-threatening injuries. The secondary survey is focused on identifying and managing other important injuries. Over the past decade, there have been important advances in the evidence supporting the management of multisystem trauma in the pediatric patient by the emergency medicine clinician. In addition, the...
Source: Pediatric Emergency Care - June 1, 2022 Category: Emergency Medicine Tags: CME Review Article Source Type: research

A critical ethnographic look at paediatric intensive care nurses and the determinants of nurses’ job satisfaction
This study illuminates the role both formal and informal education plays in breaking the power barrier for nurses in the PICU. This level of expertise and mutual respect between professions aids in retaining nurses in the PICU. The lack of autonomy and/or respect shown to nurses by administrators appears to be one of the major stressors in nurses’ working lives and can lead to attrition from the PICU.Family Centred Care (FCC) is practiced in paediatrics and certainly accentuated in the PICU as there is usually only one patient assigned per nurse, who thus afforded the time to provide comprehensive care to both the child ...
Source: Intensive and Critical Care Nursing - December 3, 2013 Category: Nursing Authors: Paula R. Mahon Tags: Original Articles Source Type: research

The Mischief and the Good In Precision Medicine
By MERCEDITAS VILLANUEVA, MD When The White House announced their Precision Medicine Initiative last year, they referred to precision medicine as “a new era of medicine,” signaling a shift in focus from a “one-size-fits-all-approach” to individualized care based on the specific characteristics that distinguish one patient from another. While there continues to be immense excitement about its game-changing impact in terms of early diagnoses and targeting specific treatment options, the advancements in technology, which underlie this approach, may not always yield the best medical results. In some cases, low cost ap...
Source: The Health Care Blog - June 22, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Gene Expert Precision Medicine Initiative tuberculosis Source Type: blogs

Use of cognitive aids in pediatric emergency care : Interdisciplinary consensus statement.
Abstract Preclinical pediatric emergencies are rare events and are therefore often associated with stress and uncertainty for emergency medical service personnel. To ensure adequate treatment of pediatric patients a variety of different cognitive aids exist (e.g. books, apps, rulers, weight-adapted bag systems). Especially the size specifications of the medical equipment and the dosage of emergency medication are individually very different in children and are dependent on parameters, such as body height and weight. Therefore, cognitive aids often enable length measurement whereby it is possible to draw conclusi...
Source: Der Anaesthesist - April 28, 2017 Category: Anesthesiology Authors: Wirtz S, Eich C, Becke K, Brenner S, Callies A, Harding U, Höhne C, Hoffmann F, Kaufmann J, Landsleitner B, Marung H, Nicolai T, Reifferscheid F, Trappe U, Jung P Tags: Anaesthesist Source Type: research

NQP Playbook Released on Shared Decision Making in Health Care Settings
In March 2018,  the National Quality Forum (NQF) released a guide for healthcare providers, the National Quality Partners PlaybookTM: Shared Decision Making in Healthcare. This recently-released Playbook offers vital guidance for the process of making shared decision making a standard of care for all patients, across settings and conditions. The National Quality Partners (NQP) Playbook: Shared Decision Making in Healthcare was developed with input from the NQP Shared Decision Making Action Team, including twenty public and private sector experts and stakeholders, holding a variety of positions including patients, cl...
Source: Policy and Medicine - April 30, 2018 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

U.S. Primary Care Doctors Face Challenges in Coordinating Care
Substantial proportion of U.S. doctors do not get timely notifications, information needed from specialists
Source: Pulmonary Medicine News - Doctors Lounge - November 11, 2014 Category: Respiratory Medicine Tags: Cardiology, Dermatology, Endocrinology, Family Medicine, Geriatrics, Gastroenterology, Gynecology, Infections, AIDS, Internal Medicine, Allergy, Critical Care, Emergency Medicine, Nephrology, Neurology, Nursing, Oncology, Ophthalmology, Orthopedics, ENT, Source Type: news

Management of HIV-infected patients in the intensive care unit
AbstractThe widespread use of combination antiretroviral therapies (cART) has converted the prognosis of HIV infection from a rapidly progressive and ultimately fatal disease to a chronic condition with limited impact on life expectancy. Yet, HIV-infected patients remain at high risk for critical illness due to the occurrence of severe opportunistic infections in those with advanced immunosuppression (i.e., inaugural admissions or limited access to cART), a pronounced susceptibility to bacterial sepsis and tuberculosis at every stage of HIV infection, and a rising prevalence of underlying comorbidities such as chronic obst...
Source: Intensive Care Medicine - February 2, 2020 Category: Intensive Care Source Type: research

Where Have All the "AIDS Babies" Gone? A Historical Memoir of the Pediatric AIDS Epidemic in New Haven and its Eventual Eradication.
Authors: Andiman WA Abstract S.L. was one of our first HIV-positive babies. He was born at Yale-New Haven Hospital (YNHH) in 1982. His mother was a sex worker who also injected drugs. He died at 3½ years following multiple episodes of opportunistic infection and metastatic lymphoma. In the years between 1986 and 1990, 163 HIV-positive mothers gave birth at YNHH. The mother-to-child transmission (MTCT) rate was 20 percent. Women represented 8 percent of all HIV cases in the US compared with 29 percent in New Haven. We had a six times greater proportion of children living with HIV. The mean number of HIV-exposed bab...
Source: The Yale Journal of Biology and Medicine - October 3, 2020 Category: Universities & Medical Training Tags: Yale J Biol Med Source Type: research

All Health Care, Long - Term Care Workers in California Must Get COVID - 19 Shots
Order issued as the most populous state in the country struggles to slow infections caused by the highly contagious delta variant
Source: Pulmonary Medicine News - Doctors Lounge - August 7, 2021 Category: Respiratory Medicine Tags: Cardiology, Dermatology, Endocrinology, Family Medicine, Geriatrics, Gastroenterology, Gynecology, Infections, AIDS, Internal Medicine, Allergy, Critical Care, Emergency Medicine, Nephrology, Neurology, Nursing, Oncology, Ophthalmology, Orthopedics, ENT, Source Type: news

Pediatric Prehospital Medication Dosing Errors: A Mixed-Methods Study.
Authors: Hoyle JD, Sleight D, Henry R, Chassee T, Fales B, Mavis B Abstract Prehospital dosing errors affect approximately 56,000 US children yearly. To decrease these errors, barriers, enablers and solutions from the paramedic (EMT-P) and medical director (MD) standpoint need to be understood. We conducted a mixed-methods study of EMT-P and MDs in Michigan utilizing focus groups (FG). FGs were held at EMS agencies and state EMS conferences. Questions focused on the drug dose delivery process, barriers and enablers to correct dosing and possible solutions to decrease errors. Responses were coded by the research tea...
Source: Prehospital Emergency Care - February 14, 2016 Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research

Variation in Occupational Influenza Vaccination Coverage
Wide variation by state in vaccination coverage among tier 1 and health care personnel groups
Source: Pulmonary Medicine News - Doctors Lounge - April 4, 2017 Category: Respiratory Medicine Tags: Endocrinology, Family Medicine, Geriatrics, Gastroenterology, Gynecology, Infections, AIDS, Internal Medicine, Allergy, Critical Care, Emergency Medicine, Nursing, Oncology, ENT, Pathology, Pediatrics, Pharmacy, Pulmonology, Journal, Source Type: news

Most Health Care Providers Can Offer Cost Estimate
Although 75 percent of provider organizations can offer estimate, only 25 % of patients request one
Source: Pulmonary Medicine News - Doctors Lounge - March 7, 2017 Category: Respiratory Medicine Tags: Cardiology, Dermatology, Endocrinology, Family Medicine, Geriatrics, Gastroenterology, Gynecology, Infections, AIDS, Internal Medicine, Allergy, Critical Care, Emergency Medicine, Nephrology, Neurology, Oncology, Ophthalmology, Orthopedics, ENT, Pathology Source Type: news

Health Information Theft a Pressing Concern for U.S. Patients
44 percent of U.S. adults are worried about having their personal health care information stolen
Source: Pulmonary Medicine News - Doctors Lounge - February 23, 2017 Category: Respiratory Medicine Tags: Cardiology, Dermatology, Endocrinology, Family Medicine, Geriatrics, Gastroenterology, Gynecology, Infections, AIDS, Internal Medicine, Allergy, Critical Care, Emergency Medicine, Nephrology, Neurology, Nursing, Oncology, Ophthalmology, Orthopedics, ENT, Source Type: news