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Intracerebral hemorrhage is defined as extravasation of blood into the brain parenchymal tissue or ventricles. This form of hemorrhage may be primary (as in hypertension or amyloid angiopathy) or it can be secondary to vascular lesions or coagulopathy, or trauma or tumor.
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In this study from the University of Vermont, Turki and colleagues sought to determine the tidal volumes delivered and peak airway pressures generated during manual ventilation (hand bagging). They recruited experienced, off-duty respiratory therapists who worked regularly in the ICU and thus frequently performed manual ventilation.
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Is Holding NSAIDs Prior to Surgery Rational?; Low-Dose Aspirin: Men vs Women; FDA Actions
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In the past few years, new strategies in the management of sepsis have shown significant mortality benefits. This article addresses aspects regarding the management of sepsis, including appropriate fluid administration, medications, and other evidence-based strategies necessary for the treatment of septic patients in the emergency department. With the incorporation of these new practice strategies in addition to the guidelines published by the Surviving Sepsis Campaign, emergency physicians can contribute to a significant decrease in sepsis mortality in the years to come.
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The widespread publicity surrounding the case of Terri Schiavo may have brought end-of-life issues to the forefront for the general public, but ED managers deal with these challenges on a daily basis. The proper way to treat these extremely ill patients in the ED whether or not they have a do-not-resuscitate (DNR) order is, like the Schiavo case, hardly cut and dried.
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While ED staff are well-versed in life-saving techniques, they are not as expert in making dying patients feel comfortable, asserts Tammie E. Quest, MD, assistant professor in the department of emergency medicine at Emory University in Atlanta.
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Its important for ED managers to remember that just because a patient has a do-not-resuscitate (DNR) order, that doesnt mean all of the patients wishes have been expressed in writing, says James Espinosa, MD, medical director of the ED at Overlook Hospital in Summit, NJ. A DNR is just one part of a continuum, Espinosa says.
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About one year ago, the ED at Doctors Hospital in Columbus, OH, was facing what Marci Conti, RN, MBA, vice president of operations and chief nursing officer, calls a perfect storm.
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Because concepts from other industries can sometimes seem a bit obscure to the health care professional, this real-life synopsis of the use of lean manufacturing techniques (eliminating waste, or extra steps, in a process) at Doctors Hospital in Columbus, OH, may help illustrate how the approach can be applied practically in the ED. It involves the process of sending an ED patient to radiology.
