Moderate Adverse Events

2018 ◽  
pp. 146-149
Author(s):  
Corrie E. Chumpitazi
Keyword(s):  
Adverse Events ◽  
Airway Obstruction ◽  
Psychological Factors ◽  
Medical Condition ◽  
Patient Harm ◽  
Patient Factors ◽  
Physiologic Change ◽  
Significant Harm ◽  
And Training

The incidence of sedation-related adverse events depends on (1) the medications used; (2) the type, duration, invasiveness, and location of the procedure; and (3) patient factors (e.g., age, medical condition, psychological factors). For the purposes of this chapter, moderate adverse sedation-related events represent physiologic change that is extremely likely to lead to significant patient harm if unnoticed or responded to ineffectively by the sedationist. Apnea, airway obstruction, and laryngospasm are examples. The relative likelihood of events of this type (1 of every 400 sedation episodes) provides significant impetus for effective preparation and training so that sedationists can effectively respond to these adverse events or preempt them. Even though they are categorized as “moderate” and may not be associated with harm in and of themselves, these events may certainly progress to produce significant harm.

Minor Adverse Events

2018 ◽  
pp. 141-145
Author(s):  
Corrie E. Chumpitazi
Keyword(s):  
Adverse Events ◽  
Timely Manner ◽  
Patient Factors ◽  
Relative Likelihood ◽  
Significant Harm ◽  
Recovery Times ◽  
Psychological Harm ◽  
Prolonged Recovery ◽  
And Training

The incidence of sedation-related adverse events depends on the medications administered, the characteristics of the procedure, and preexisting patient factors. Minor adverse sedation-related events may present inconvenience or transient discomfort to the patient and, if recognized and supported in a timely manner by the sedationist, will not usually result in physiologic or psychological harm to the patient. Postprocedure vomiting, transient hypoxemia, mild hypotension, emergence reactions, and prolonged recovery times are examples of minor events. The relative likelihood of events of this type (1 of every 200 sedation episodes) provides significant impetus for effective preparation and training for sedationists to effectively respond to or preempt them. These “minor” events can still progress to more significant harm.

Major Adverse Events

2018 ◽  
pp. 150-153
Author(s):  
Corrie E. Chumpitazi
Keyword(s):  
Respiratory Failure ◽  
Adverse Events ◽  
Cardiovascular Collapse ◽  
Patient Harm ◽  
Psychological Conditions ◽  
Physiologic Change ◽  
Safety Studies ◽  
Pediatric Sedation ◽  
And Training ◽  
Major Adverse Events

The incidence of sedation-related adverse events depends on medication characteristics, procedure conditions, and preexisting patient physiologic and psychological conditions. Major adverse sedation-related events represent extreme physiologic change causing significant patient harm that may be long-lasting or permanent, particularly if responded to ineffectively by the sedationist. Large safety studies of pediatric sedation events suggest that events of this type occur very rarely when well-organized, equipped, and trained sedation teams are present. However, sporadic reports of death during pediatric sedation continue to surface, providing significant impetus for effective preparation and training for sedationists. Major adverse sedation-related events discussed here are aspiration, cardiovascular collapse, respiratory failure, and death.

817-P: Financial Stress Factors, Psychological Factors, and Self-Management Outcomes in Emerging Adults with Type 1 Diabetes

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 817-P
Author(s):  
JULIA E. BLANCHETTE ◽  
VALERIE B. TOLY ◽  
JAMIE R. WOOD ◽  
CAROL M. MUSIL ◽  
DIANA L. MORRIS ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Emerging Adults ◽  
Psychological Factors ◽  
Financial Stress ◽  
Stress Factors ◽  
Self Management

scholarly journals Stereotactic radiosurgery for treating meningiomas eligible for complete resection

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Maximilian I. Ruge ◽  
Juman Tutunji ◽  
Daniel Rueß ◽  
Eren Celik ◽  
Christian Baues ◽  
...  
Keyword(s):  
Adverse Events ◽  
Stereotactic Radiosurgery ◽  
Medical Condition ◽  
Local Tumor Control ◽  
Complete Resection ◽  
Neurological Deficits ◽  
Tumor Control ◽  
Recurrence Rates ◽  
Treatment Volume

Abstract Background For meningiomas, complete resection is recommended as first-line treatment while stereotactic radiosurgery (SRS) is established for meningiomas of smaller size considered inoperable. If the patient´s medical condition or preference excludes surgery, SRS remains a treatment option. We evaluated the efficacy and safety of SRS in a cohort comprising these cases. Methods In this retrospective single-centre analysis we included patients receiving single fraction SRS either by modified LINAC or robotic guidance by Cyberknife for potentially resectable intracranial meningiomas. Treatment-related adverse events as well as local and regional control rates were determined from follow-up imaging and estimated by the Kaplan–Meier method. Results We analyzed 188 patients with 218 meningiomas. The median radiological, and clinical follow-up periods were 51.4 (6.2–289.6) and 55.8 (6.2–300.9) months. The median tumor volume was 4.2 ml (0.1–22), and the mean marginal radiation dose was 13.0 ± 3.1 Gy, with reference to the 80.0 ± 11.2% isodose level. Local recurrence was observed in one case (0.5%) after 239 months. The estimated 2-, 5-, 10- and 15-year regional recurrence rates were 1.5%, 3.0%, 6.6% and 6.6%, respectively. Early adverse events (≤ 6 months after SRS) occurred in 11.2% (CTCEA grade 1–2) and resolved during follow-up in 7.4% of patients, while late adverse events were documented in 14.4% (grade 1–2; one case grade 3). Adverse effects (early and late) were associated with the presence of symptoms or neurological deficits prior to SRS (p < 0.03) and correlated with the treatment volume (p < 0.02). Conclusion In this analysis SRS appears to be an effective treatment for patients with meningiomas eligible for complete resection and provides reliable long-term local tumor control with low rates of mild morbidity.

The Prevalence and Nature of Medication Errors and Adverse Events Related to Preadmission Medications When Patients Are Admitted to an Orthopedic Inpatient Unit: An Observational Study

2018 ◽  
Vol 53 (3) ◽  
pp. 252-260 ◽  
Author(s):  
Tim Tran ◽  
Simone E. Taylor ◽  
Andrew Hardidge ◽  
Elise Mitri ◽  
Parnaz Aminian ◽  
...  
Keyword(s):  
Adverse Events ◽  
Observational Study ◽  
Medication Errors ◽  
Medication Reconciliation ◽  
Median Number ◽  
Patient Harm ◽  
Prescribing Error ◽  
Delayed Treatment ◽  
Metropolitan Hospital ◽  
Orthopedic Patients

Background: Medication errors commonly occur when patients move from the community into hospital. Whereas medication reconciliation by pharmacists can detect errors, delays in undertaking this can increase the risk that patients receive incorrect admission medication regimens. Orthopedic patients are an at-risk group because they are often elderly and use multiple medications. Objective: To evaluate the prevalence and nature of medication errors when patients are admitted to an orthopedic unit where pharmacists routinely undertake postprescribing medication reconciliation. Methods: A 10-week retrospective observational study was conducted at a major metropolitan hospital in Australia. Medication records of orthopedic inpatients were evaluated to determine the number of prescribing and administration errors associated with patients’ preadmission medications and the number of related adverse events that occurred within 72 hours of admission. Results: Preadmission, 198 patients were taking at least 1 regular medication, of whom 176 (88.9%) experienced at least 1 medication error. The median number of errors per patient was 6 (interquartile range 3-10). Unintended omission of a preadmission medication was the most common prescribing error (87.4%). There were 17 adverse events involving 24 medications in 16 (8.1%) patients that were potentially related to medication errors; 6 events were deemed moderate consequence (moderate injury or harm, increased length of stay, or cancelled/delayed treatment), and the remainder were minor. Conclusion and Relevance: Medication errors were common when orthopedic patients were admitted to hospital, despite postprescribing pharmacist medication reconciliation. Some of these errors led to patient harm. Interventions that ensure that medications are prescribed correctly at admission are required.

The Role of Protective Psychological Factors, Self‐Care Behaviours and HbA1c in Young Adults with Type 1 Diabetes

2021 ◽  
Author(s):  
Philippa Loseby ◽  
Kiralee Schache ◽  
Alana Cavadino ◽  
Simon Young ◽  
Paul L. Hofman ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Young Adults ◽  
Psychological Factors ◽  
Self Care

Diabeloop DBLG1 Closed-Loop System Enables Patients With Type 1 Diabetes to Significantly Improve Their Glycemic Control in Real-Life Situations Without Serious Adverse Events: 6-Month Follow-up

2021 ◽  
Author(s):  
Coralie Amadou ◽  
Sylvia Franc ◽  
Pierre-Yves Benhamou ◽  
Sandrine Lablanche ◽  
Erik Huneker ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Adverse Events ◽  
Closed Loop ◽  
Artificial Pancreas ◽  
Real Life ◽  
Serious Adverse Events ◽  
Life Conditions ◽  
Time In Range

<b>OBJECTIVE </b> <p>To analyze safety and efficacy of the DBLG1 hybrid closed-loop artificial pancreas system in patients with Type 1 Diabetes in real life conditions. </p> <p> </p> <p><b>METHODS</b></p> <p>Following a one-week run-in period with usual pump, 25 patients were provided with the commercial DBLG1 system. We present the results of Time-in-Range and HbA1c over a 6-month period.</p> <p><b> </b></p> <p><b>RESULTS</b></p> <p>The mean (SD;range) age of patients was 43 years (13.8; 25-72). At baseline, mean HbA1c and TIR 70-180mg/dL were respectively 7.9% (0.93; 5.6- 8.5) [63mmol/mol (10; 38-69)] and 53% (16.4;21-85). One patient stopped using the system after 2 months. At 6-month, mean HbA1c decreased to 7.1% [54mmol/mol] (p<0.001) and TIR 70-180mg/dL increased to 69.7% (p<0.0001). TIR<70mg/dL decreased from 2.4 to 1.3% (p=0.03). TIR<54mg/dL decreased from 0.32 to 0.24% (p=0.42). No serious adverse event was reported during the study. </p> <p> </p> <p><b>CONCLUSION</b></p> <p>The DBLG1 System confirms its ability to significantly improve glycemic control in real life conditions, without serious adverse events. </p>

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