Assessment and Treatment of Adult Acute Responses to Traumatic Stress Following Mass Traumatic Events

CNS Spectrums ◽  
2005 ◽  
Vol 10 (2) ◽  
pp. 123-131 ◽  
Author(s):  
Patricia J. Watson ◽  
Arieh Y. Shalev
Keyword(s):  
Traumatic Stress ◽  
Recovery Phase ◽  
Future Research ◽  
Trauma Systems ◽  
Early Recovery ◽  
Mass Trauma ◽  
Stress Theory ◽  
Acute Responses ◽  
Assessment And Treatment ◽  
Early Recovery Phase

ABSTRACTAssessment and treatment of acute responses to traumatic stress has received much attention since September 11, 2001. This article elucidates principles of early intervention with adults in the immediate (within 48 hours) and early recovery phase (within the first week). The principles have been drawn from research on risk and recover factors, stress and traumatic stress theory, and expert consensus recommendations. The debriefing model is discussed, and principle interventions of psychological first aid, pharmacology, and mass trauma systems are described. This article concludes with brief guidelines for longer-term interventions and recommendations for future research.

scholarly journals The role of precipitation losses in producing the rapid early recovery phase of the Great Magnetic Storm of February 1986

1998 ◽  
Vol 103 (A4) ◽  
pp. 6801-6814 ◽  
Author(s):  
J. U. Kozyra ◽  
M.-C. Fok ◽  
E. R. Sanchez ◽  
D. S. Evans ◽  
D. C. Hamilton ◽  
...  
Keyword(s):  
Magnetic Storm ◽  
Recovery Phase ◽  
Early Recovery ◽  
Early Recovery Phase

scholarly journals Tocilizumab use during Covid-19 should alert an orthopaedic surgeon for the surgical management of arthroplasty patients: A narrative review

2022 ◽  
Vol 7 (2) ◽  
pp. 65-70
Author(s):  
Gaurav Govil ◽  
Lavindra Tomar ◽  
Pawan Dhawan
Keyword(s):  
Side Effects ◽  
Perioperative Period ◽  
Recovery Phase ◽  
Narrative Review ◽  
Orthopaedic Surgeon ◽  
Surgical Patients ◽  
Future Research ◽  
Early Recovery ◽  
Considerable Uncertainty ◽  
Post Surgery

The crisis of Covid-19 has shaken the world healthcare systems. The intensive care resources to manage the medical conditions associated with Covid-19 are consistently found to be inadequate with exploration and implementation of newer treatment avenues for an early recovery. Presently, the use of Tocilizumab (TCZ) in severe to critical affection of Covid-19 is being practiced as an off-label therapy. A narrative review of present knowledge regarding TCZ pharmacology, indications of its use, and potential side effects with clinical implications for an orthopedic surgeon is presented. The article discusses the clinicopathological factors required to be monitored during the perioperative management of an orthopedic patient who may have received TCZ for Covid-19 related illness. The implications of its usage should alert the orthopaedic surgeons for future management of their arthritic surgical patients. The commonly associated side effects and complications in the post-operative phase following an arthroplasty or any orthopaedic surgery are an area of concern and considerable uncertainty. In the post-Covid-19 recovery phase, when surgeons need to plan a surgical intervention then a thorough evaluation of their Covid-19 medical management history may be warranted. Practical guidelines for the management of arthritic surgical patients have been postulated. With an unregulated increased usage of TCZ during Covid-19 management, an orthopaedic surgeon should worry and needs to be aware of the possible consequences in the perioperative period for the post-surgery management. Future research to gain more insights will confirm the implied concerns.

Abstract 17270: Prognostic Impact of Ventricular Ectopy During the Recovery Phase of Stress Testing: A Meta-Analysis

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_1) ◽  
Author(s):  
Muhammad T Ayub ◽  
Muhammad S Khan ◽  
Sagar Ranka ◽  
Muhammad Ishaq ◽  
Muhammad F Khalid ◽  
...  
Keyword(s):  
Stress Testing ◽  
Meta Analysis ◽  
Recovery Phase ◽  
Prognostic Impact ◽  
Ventricular Ectopy ◽  
Early Recovery ◽  
Premature Ventricular Contractions ◽  
Risk Of Death ◽  
All Cause Mortality ◽  
Early Recovery Phase

Introduction: Ventricular ectopy after exercise, due to parasympathetic activity, predicts an increased risk of death in population-based cohorts. We sought to examine the composite risk of all cause mortality in patients with premature ventricular contractions (PVCs) in the early recovery phase of stress testing. Methods: PubMed, Medline & EMBASE were queried for all English language articles from 1993 to 2017. The primary outcome was incidence of all cause mortality in patients with frequent PVCs during recovery phase (RPV) of stress testing. Frequent PVCs were defined as the presence of seven or more ventricular premature beats/min, frequent ventricular couplets, ventricular bigeminy or trigeminy, or any other form of ventricular tachycardia or ventricular fibrillation. Meta-analysis of the main outcome was performed using a weighted random effects model. Results: A total of four observational studies including 38765 patients were retrieved. Data for 2065 patients with RPV was pooled. A comparative analysis of PVC vs Infrequent/Non-PVC group showed a calculated risk ratio for all cause mortality of 1.8 (95% CI 1.36-2.38; p=0.001). I 2 statistic for heterogeneity testing was 82.8% (Fig.1). Conclusion: Frequent premature ventricular contractions during early recovery phase of stress testing are associated with increased all cause mortality as compared to patients with infrequent or no PVCs.

Abstract 2142: Diagnostic and Prognostic Value of Augmented ST-Segment Elevation at Exercise Testing in Patients with Brugada Syndrome

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Hisaki Makimoto ◽  
Eiichiro Nakagawa ◽  
Hiroshi Takaki ◽  
Kenichiro Yamagata ◽  
Hiro Kawata ◽  
...  
Keyword(s):  
Exercise Testing ◽  
Brugada Syndrome ◽  
Recovery Phase ◽  
Peak Exercise ◽  
Early Recovery ◽  
St Segment Elevation ◽  
St Segment ◽  
History Of ◽  
Diagnostic And Prognostic Value ◽  
Early Recovery Phase

Background : It has been reported that ST-segment elevation was augmented at early recovery phase or at peak exercise during exercise testing in some patients with Brugada syndrome (BrS), but its diagnostic and prognostic value has not fully been clarified. Methods : Treadmill exercise testing (TMT) was conducted in 93 patients (pts) with BrS (22 documented VF, 31 syncope alone, and 40 asymptomatic; 91 males, 46±14 years) and 22 healthy control subjects (20 males, 48±14 years, 11 with incomplete right bundle branch block (RBBB) and 4 with complete RBBB). Results : The augmentation of ST-segment elevation ≥0.05mV in V1-V3 leads compared with that before exercise was observed at early recovery phase (1– 4 minutes at recovery phase) in 32 BrS pts (34%, Group1), at peak exercise in 8 BrS pts (9%, Group 2), but not in either the remaining 53 BrS pts (57%, Group 3) or 22 control subjects. There were no significant differences among the 3 BrS groups in the baseline clinical (age, gender, family history of sudden death, SCN5A mutation), electrocardiographic (PR, QRS duration, QTc interval and ST amplitude), and electrophysiologic (AH, HV interval, and VF induction) variables except for the positive ratio of signal averaged ECG (87%, 48%, 63%; P= 0.001). No significant difference was observed in the proportion of previous cardiac events (VF/syncope/asymptomatic; 6/12/14, 0/3/5, 16/16/21, respectively for Group 1, 2, and 3). During 76.0, 74.8, and 52.0 months follow-up, VF occurred in 12/32 (38%) pts of Group1, 0/8 (0 %) pts of Group2, and 10/53 (19%) pts of Group3. Augmentation of ST-segment elevation at early recovery phase was a significant and an independent predictor for subsequent VF occurrence (12/32 (38%) in Group1 vs. 10/61 (16%) in Group2 and 3; hazard ratio [HR]= 1.68; P=0.014), especially in 31 pts with a history of syncope alone (6/12 (50%) in Group1 vs. 1/19 (5%) in Group2 and 3; HR=3.44; P=0.004). Conclusions : Our data suggest that augmentation of ST-segment elevation at early recovery phase during exercise testing can be a predictor of poor prognosis in patients with Brugada syndrome, especially in those with a history of syncope alone.

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