Challenges of implementation of the RCPCH paediatric stroke guidelines (acute management component) and how they can be overcome

2022 ◽  
pp. archdischild-2020-320906
Author(s):  
Susan Byrne ◽  
Dipak Ram
Keyword(s):  
Acute Management ◽  
Paediatric Stroke

Exploring the Differences in Macrocognition Between Experts and Non-CHD Experts Managing Congenital Heart Disease (CHD)

2021 ◽  
Vol 10 (1) ◽  
pp. 335-339
Author(s):  
Azadeh Assadi ◽  
Peter C. Laussen ◽  
Patricia Trbovich
Keyword(s):  
Decision Making ◽  
Emergency Medicine ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Pediatric Emergency ◽  
Acute Management ◽  
Naturalistic Decision Making ◽  
The Face

Background and aims: Children with congenital heart disease (CHD) are at risk of deterioration in the face of common childhood illnesses, and their resuscitation and acute management is often best achieved with the guidance of CHD experts. Access to such expertise may be limited outside specialty heart centers and the fragility of these patients is cause for discomfort among many emergency medicine physicians. An understanding of the differences in macrocognition of these clinicians could shed light on some of the causes of discomfort and facilitate the development of a sociotechnological solution to this problem. Methods: Cardiac intensivists (CHD experts) and pediatric emergency medicine physicians (non-CHD experts) in a major academic cardiac center were interviewed using the critical decision method. Interview transcripts were coded deductively based on Klein’s macrocognitive framework and inductively to allow for new or modified characterization of dimensions. Results: While both CHD-experts and non-CHD experts relied on the macrocognitive functions of sensemaking, naturalistic decision making and detecting problems, the specific data and mental models used to understand the patients and course of therapy differed between CHD-experts and non-CHD experts. Conclusion: Characterization of differences between the macrocognitive processes of CHD experts and non-CHD experts can inform development of sociotechnological solutions to augment decision making pertaining to the acute management of pediatric CHD patients.

Real‐world off‐label use of icatibant for acute management of non‐hereditary angioedema

2021 ◽  
Vol 51 (3) ◽  
pp. 419-423
Author(s):  
Thanh‐Thao (Adriana) Le ◽  
William Smith ◽  
Pravin Hissaria
Keyword(s):  
Real World ◽  
Hereditary Angioedema ◽  
Acute Management ◽  
Off Label Use ◽  
Off Label ◽  
Label Use

scholarly journals Endovascular options in the treatment of delayed ischemic neurological deficits due to cerebral vasospasm

2009 ◽  
Vol 26 (3) ◽  
pp. E6 ◽  
Author(s):  
Christopher S. Eddleman ◽  
Michael C. Hurley ◽  
Andrew M. Naidech ◽  
H. Hunt Batjer ◽  
Bernard R. Bendok
Keyword(s):  
Cerebral Vasospasm ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Delayed Cerebral Ischemia ◽  
Mortality Rates ◽  
Neurological Deficits ◽  
Acute Management ◽  
Treatment Algorithms ◽  
Angiographic Evidence ◽  
Intraarterial Therapy ◽  
Clinical Changes

The second leading cause of death and disability in patients with aneurysmal subarachnoid hemorrhage (SAH) is delayed cerebral ischemia due to vasospasm. Although up to 70% of patients have been shown to have angiographic evidence of vasospasm, only 20–30% will present with clinical changes, including mental status changes and neurological deficits that necessitate acute management. Endovascular capabilities have progressed to become viable options in the treatment of cerebral vasospasm. The rationale for intraarterial therapy includes the fact that morbidity and mortality rates have not changed in recent years despite optimized noninvasive medical care. In this report, the authors discuss the most common endovascular options—namely intraarterial vasodilators and transluminal balloon angioplasty—from the standpoint of mechanism, efficacy, limitations, and complications as well as the treatment algorithms for cerebral vasospasm used at our institution.

scholarly journals The acute management of myocardial infarction

2001 ◽  
Vol 59 (1) ◽  
pp. 89-112 ◽  
Author(s):  
A H Gershlick
Keyword(s):  
Myocardial Infarction ◽  
Acute Management

scholarly journals Acute management of pregnancy associated cardiomyopathy with cardiac resynchronisation therapy

2007 ◽  
Vol 9 (5) ◽  
pp. 542-544
Author(s):  
Dominic Kelly ◽  
Peter M. Hickey ◽  
Joan Davies ◽  
Leong L. Ng ◽  
Derek Chin
Keyword(s):  
Cardiac Resynchronisation Therapy ◽  
Acute Management ◽  
Cardiac Resynchronisation ◽  
Resynchronisation Therapy

Doctors’ knowledge of the acute management of Inborn Errors of Metabolism

2010 ◽  
Vol 100 (3) ◽  
pp. 461-463 ◽  
Author(s):  
Colin Patrick Hawkes ◽  
Aoibhinn Walsh ◽  
Siobhan O’Sullivan ◽  
Ellen Crushell
Keyword(s):  
Inborn Errors Of Metabolism ◽  
Acute Management ◽  
Inborn Errors

scholarly journals Therapeutic Strategies for the Treatment of Chronic Hyperuricemia: An Evidence-Based Update

Medicina ◽  
2021 ◽  
Vol 57 (1) ◽  
pp. 58
Author(s):  
Arrigo F. G. Cicero ◽  
Federica Fogacci ◽  
Masanari Kuwabara ◽  
Claudio Borghi
Keyword(s):  
Clinical Trials ◽  
Uric Acid ◽  
Clinical Research ◽  
Safety Profile ◽  
Therapeutic Strategies ◽  
Evidence Based ◽  
Acute Management ◽  
Efficacy And Safety ◽  
Uricosuric Agents ◽  
Xanthine Oxidase Inhibitors

This article aims to critically review the evidence on the available therapeutic strategies for the treatment of hyperuricemia. For this reason, several papers were reviewed. Xanthine oxidase inhibitors are the safest and most effective uric acid lowering drugs for the management of chronic hyperuricemia, while the efficacy of uricosuric agents is strongly modulated by pharmacogenetics. Emergent drugs (lesinurad, peglotidase) were found to be more effective for the acute management of refractory hyperuricemia, but their use is supported by a relatively small number of clinical trials so that further well-designed clinical research is needed to deepen their efficacy and safety profile.

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