#ISICEM23: Effects of Therapeutic-Dose Heparin in Hospitalised Patients With COVID-19
2023 21 Mar
At the #ISICEM23 this week in Brussels, the benefits and harms of therapeutic-dose heparin varied by hospitalised COVID-19 patient characteristics were discussed, and the importance of considering the heterogeneity of treatment effect (HTE) in the design and analysis of randomised clinical trials was highlighted. To date, RCTs that have tested...Read more
Prehospital Physician Presence During Paediatric OHCA
2023 22 Feb
A study was conducted to investigate whether the presence of prehospital physicians affected the neurological outcomes of paediatric patients who experienced an out-of-hospital cardiac arrest (OHCA). The study included paediatric patients who were 17 years old or younger and were registered in a database between June 2014 and December 2019. The...Read more
Antibiotic Review Kit for Hospitals
2022 11 Oct
Antibiotic overuse is a growing problem in healthcare. Antimicrobial resistance has a significant impact on global public health, and its effects are similar to that of malaria and HIV. Antimicrobial resistance caused nearly 4.95 million deaths in 2019. In addition, antimicrobial resistance has significant economic consequences on healthcare systems. ...Read more
Prehospital Lyophilised Plasma Transfusion for Trauma-Induced Coagulopathy
2022 02 Aug
Trauma-induced coagulopathy affects approximately 20 to 50% of patients with severe trauma. Its occurrence increases transfusion requirements, multi-visceral failure, and mortality. Blood transfusion is the primary therapy for trauma-induced coagulopathy. However, optimal modalities for plasma transfusion in a prehospital setting remain undefined....Read more
Prehospital Time and In-Hospital Trauma Mortality
2022 12 Jul
Time has always been considered an essential determinant of outcome in the early care of trauma patients, and the concept of trauma as a time-sensitive condition has been part of education and policy for decades. However, data on system performance from physician-staffed EMS are far less abundant than data from EMS systems. Physician-staffed EMS is...Read more
Long COVID and Recovery Following Hospitalisation
2022 10 May
More than 500 million cases of COVID-19 have been reported worldwide. Patients infected with COVID-19 are at a higher risk of persisting health impairments six months after hospital discharge associated with reduced physical function and health and quality of life. It is thus important to understand the long-term trajectory of recovery from COVID-19....Read more
Passive Leg Raising in Out-of-Hospital Cardiac Arrest
2021 08 Jun
Survival among patients with out-of-hospital cardiac arrest (OHCA) is typically quite low. Survival in OHCA is dependent on several factors, including the performance of early bystander cardiopulmonary resuscitation (CPR), the use of public automatic external defibrillators (AEDs), and the performance of high-quality CPR or the post-resuscitation...Read more
In-Hospital Cardiac Arrests in Patients With COVID-19
2021 25 May
Clinical manifestation and outcomes of patients with COVID-19 vary significantly. Most patients experience mild disease, but among those who are critically ill, there can be respiratory and cardiac complications. These can cause malignant arrhythmias and hypoxia and could lead to cardiac arrest and death. In case of in-hospital cardiac arrest,...Read more
RECOVERY Trial: Tocilizumab in Hospitalised COVID-19 Patients
2021 16 Feb
A large majority of COVID-19 infections are mild or asymptomatic. However, there is a significant portion of individuals who develop severe respiratory illness that requires hospital care, and that could progress to critical illness with hypoxic respiratory failure requiring prolonged ventilatory support. This hypoxic respiratory failure is associated...Read more
Solidarity Trial Interim Results: Antiviral Drugs in Hospitalised COVID-19 Patients
2021 16 Feb
Mortality trials of four antiviral drugs - remdesivir, hydroxychloroquine, lopinavir and interferon beta-1a were recommended by the World Health Organization (WHO) to evaluate their effect in patients hospitalised with COVID-19. In March 2020, the WHO began a large international trial that included hospital inpatients to evaluate the effects...Read more
Cardiopulmonary Resuscitation in COVID-19 Patients Experiencing In-Hospital Cardiac Arrest
2021 25 Jan
COVID-19 continues to infect people across the globe, and the United States continues to be one of the most affected regions in the world. Coronavirus primarily affects the respiratory system through angiotensin-converting enzyme (ACE) 2 receptor on host cells. It also affects other systems because ACE2 is present in the heart, GI tract and kidneys. Infection...Read more
Life After COVID-19 Hospitalisation
2020 14 Nov
Findings from a new study show that surviving a case of COVID-19 that is severe enough to require hospitalisation can be quite challenging, but life after the ICU stay is also not a bed of roses. The study includes data from 1250 patients treated in 38 hospitals. The average age of the participants is 62 years, and 83% of the patients lived at...Read more
Hospital Preparedness During COVID-19
2020 08 Jul
One of the biggest challenges of the COVID-19 pandemic has been the delivery of mass critical care. SARS-CoV-2 has put a significant strain on intensive care in most countries across the globe. This has become even more of a challenge because of a lack of staff and essential supplies. It is evident that in order to better cope with such a challenging...Read more
Imaging in Neurological Disease of Hospitalised COVID-19 Patients
2020 13 Jun
Originating in Wuhan, China, COVID-19 soon spread throughout the world and has been declared a pandemic by the World Health Organization. Italy was the second country to be hit as hard as China, with a total of 222,104 cases and 31,106 deaths (at time of publication). A study was conducted to understand the characteristics of neurological symptoms...Read more
COVID-19: Universal Masking in Hospitals
2020 27 May
The SARS-Cov-2 pandemic has all healthcare institutions scrambling for protocols to prevent virus transmission. The name of the game is to protect both patients and healthcare providers from the virus. However, every hospital has its protocol with respect to precautionary measures that have been undertaken to prevent transmission. While some hospitals...Read more
Association Between Hydroxychloroquine or Azithromycin and In-Hospital Mortality
2020 18 May
As of May 2020, at least a quarter of a million people worldwide have died from COVID-19. Over the past four months, many treatments have been suggested for this disease but none have worked so far. Hydroxychloroquine has been too much in the news, in particular. Laboratory evidence has indicated that the use of hydroxychloroquine can inhibit the...Read more
Adaptable Approach to Hospital Preparedness for Acute Surge Events
2020 30 Apr
Smooth clinical operations of a facility are based on the adequate and consistent availability of staff, space, equipment, and a coordination mechanism. However, under acute surge events such as local epidemics or pandemics like the ongoing COVID-19, healthcare facilities may consider a viable preparedness plan. Staff capacity, both clinical and...Read more
In-hospital mortality and misdiagnosis of site of infection
2019 11 Jun
Sepsis is one of the most dangerous and life-threatening conditions encountered in the intensive care unit. Sepsis is considered to be an emergent disease similar to trauma, heart attack, and stroke. But sepsis is characterised by various aetiologies and pathophysiological conditions, and that is why it is very complicated to treat compared to...Read more
Diagnostic approaches for hospital-acquired pneumonia
2019 27 Feb
A new study suggests that a comprehensive approach might be undertaken for microbiological diagnosis in critically ill non-ventilated hospital-acquired pneumonia (HAP). Sputum sampling determined one third of microbiological diagnosis in HAP patients who were not subsequently intubated. In contrast, invasive methods were associated with higher rates...Read more
How preventable are in-hospital sepsis-associated deaths?
2019 20 Feb
In a cohort study reviewing the medical records of 568 patients who were admitted to six U.S. hospitals, sepsis was found to be the most common immediate cause of death. However, most underlying causes of death were related to severe chronic comorbidities and most sepsis-associated deaths were unlikely to be preventable through better hospital-based...Read more
Noise pollution in hospitals a growing problem
2018 19 Nov
Noise levels in hospitals regularly exceed international recommendations, and the problem is getting worse, according to an editorial in the BMJ by a research team from King's College London and the University of the Arts London (UAL). You might also like : Music room soundproofing to reduce hospital noise Excessive noise can impact patients'...Read more
Study: Use of therapeutic hypothermia in out-of-hospital cardiac arrest dipped after TTM trial
2018 09 Nov
A U.S. registry study on use of therapeutic hypothermia for out-of-hospital cardiac arrest patients found that use dipped immediately after publication of the Targeted Temperature Management (TTM) trial , which provided evidence for more lenient temperature management. The study, by Steven M. Bradley, MD, MPH, Minneapolis Heart Institute and colleagues,...Read more
Improving antibiotic initiation for sepsis, pre-hospital
2018 13 Sep
Sepsis is a common and costly condition encountered by pre-hospital and emergency department (ED) clinicians. Early antibiotics improve outcomes for septic patients. Researchers from Intermountain Medical Center in Utah led a study to investigate the relationship between septic patients’ pre-hospital level of care and ED door-to-antibiotic time. ...Read more
PAMPer trial: plasma transfusion effective in prehospital setting
2018 02 Aug
In injured patients with severe bleeding, prehospital administration of plasma may help reduce the risk of downstream complications due to haemorrhage and shock. However, high-level evidence is lacking to show the efficacy of plasma transfusion in the prehospital setting. A new clinical trial (PAMPer) shows that two units of plasma given in a medical...Read more
Pre-hospital ECPR: challenges and benefits
2018 10 Apr
Survival from out-of-hospital cardiac arrest (OHCA) has remained low despite advances in resuscitation science. Hospital-based extracorporeal cardiopulmonary resuscitation (ECPR) is a novel use of an established technology that provides greater blood flow and oxygen delivery during cardiac arrest than closed chest compressions. Pre-hospital delivery...Read more
Does prehospital cooling help achieve target temperature after OHCA?
2017 05 Dec
Researchers conducted a pragmatic randomised controlled trial (ICEPACS RCT) in a large metropolitan area to compare prehospital cooling by paramedics of patients resuscitated after out-of-hospital cardiac arrest (OHCA), to usual care with no targeted temperature management (TTM) applied until hospital. Results show that prehospital cooling initiated...Read more
Hospital factors may influence NIV outcomes even in low-evidence use
2017 07 Nov
Strong evidence supports use of noninvasive ventilation (NIV) for patients with respiratory distress from chronic obstructive pulmonary disease and heart failure – i.e., strong evidence conditions (SECs). A new study of patients hospitalised in California shows that most patients who received NIV did not have conditions with strong supporting evidence...Read more
Driving pressure and hospital mortality in non-ARDS patients
2017 24 Oct
According to researchers in Canada, driving pressure was not associated with hospital mortality in a cohort of mechanically ventilated, critically ill patients without Acute Respiratory Distress Syndrome (ARDS), in whom compliance was also not associated with mortality. They say their findings published in the journal CHEST need to be replicated in...Read more
In-hospital cardiac arrest and extracorporeal CPR
2017 17 Oct
A new analysis has identified the predictors of survival to discharge in adults resuscitated with extracorporeal cardiopulmonary resuscitation (ECPR) following in-hospital cardiac arrest (IHCA). The study findings show that, in adult IHCA treated with ECPR, a shockable initial rhythm, a lower low-flow time, lower blood lactate levels before ECPR start...Read more
LUCAS-2 in Out-of-Hospital Cardiac Arrest: Cost Analysis
2017 17 Jul
The use of the mechanical chest compression device LUCAS-2 represents poor value for money when compared to standard manual chest compression in out-of-hospital cardiac arrest, according to a new study published in the journal Resuscitation. A critical step of the resuscitation process is early cardiopulmonary resuscitation (CPR) – i.e., the combination...Read more
