scholarly journals An automated electronic screening tool (DETECT) for the detection of potentially irreversible loss of brain function

Author(s):  
Anne Trabitzsch ◽  
Konrad Pleul ◽  
Kristian Barlinn ◽  
Volkmar Franz ◽  
Markus Dengl ◽  
...  
2020 ◽  
Vol 41 (S1) ◽  
pp. s84-s84
Author(s):  
Lorinda Sheeler ◽  
Mary Kukla ◽  
Oluchi Abosi ◽  
Holly Meacham ◽  
Stephanie Holley ◽  
...  

Background: In December of 2019, the World Health Organization reported a novel coronavirus (severe acute respiratory coronavirus virus 2 [SARS-CoV-2)]) causing severe respiratory illness originating in Wuhan, China. Since then, an increasing number of cases and the confirmation of human-to-human transmission has led to the need to develop a communication campaign at our institution. We describe the impact of the communication campaign on the number of calls received and describe patterns of calls during the early stages of our response to this emerging infection. Methods: The University of Iowa Hospitals & Clinics is an 811-bed academic medical center with >200 outpatient clinics. In response to the coronavirus disease 2019 (COVID-19) outbreak, we launched a communications campaign on January 17, 2020. Initial communications included email updates to staff and a dedicated COVID-19 webpage with up-to-date information. Subsequently, we developed an electronic screening tool to guide a risk assessment during patient check in. The screening tool identifies travel to China in the past 14 days and the presence of symptoms defined as fever >37.7°C plus cough or difficulty breathing. The screening tool was activated on January 24, 2020. In addition, university staff contacted each student whose primary residence record included Hubei Province, China. Students were provided with medical contact information, signs and symptoms to monitor for, and a thermometer. Results: During the first 5 days of the campaign, 3 calls were related to COVID-19. The number of calls increased to 18 in the 5 days following the implementation of the electronic screening tool. Of the 21 calls received to date, 8 calls (38%) were generated due to the electronic travel screen, 4 calls (19%) were due to a positive coronavirus result in a multiplex respiratory panel, 4 calls (19%) were related to provider assessment only (without an electronic screening trigger), and 2 calls (10%) sought additional information following the viewing of the web-based communication campaign. Moreover, 3 calls (14%) were for people without travel history but with respiratory symptoms and contact with a person with recent travel to China. Among those reporting symptoms after travel to China, mean time since arrival to the United States was 2.7 days (range, 0–11 days). Conclusion: The COVID-19 outbreak is evolving, and providing up to date information is challenging. Implementing an electronic screening tool helped providers assess patients and direct questions to infection prevention professionals. Analyzing the types of calls received helped tailor messaging to frontline staff.Funding: NoneDisclosures: None


1969 ◽  
pp. 209-212 ◽  
Author(s):  
A. A. Hadjidimos ◽  
M. Brock ◽  
P. Baum ◽  
K. Schürmann

2013 ◽  
Vol 173 (8) ◽  
pp. 699 ◽  
Author(s):  
Nathan C. Dean ◽  
Barbara E. Jones ◽  
Jeffrey P. Ferraro ◽  
Caroline G. Vines ◽  
Peter J. Haug

Heart ◽  
2016 ◽  
Vol 102 (11) ◽  
pp. 855-861 ◽  
Author(s):  
Lakkhina Troeung ◽  
Diane Arnold-Reed ◽  
Wendy Chan She Ping-Delfos ◽  
Gerald F Watts ◽  
Jing Pang ◽  
...  

Author(s):  
Barbara E. Jones ◽  
Jeffrey P. Ferraro ◽  
Peter Haug ◽  
Kumar Mynam ◽  
Herman Post ◽  
...  

1958 ◽  
Vol 36 (1) ◽  
pp. 721-730
Author(s):  
K. A. C. Elliott ◽  
M. Rosenfeld

If brain slices are deprived of oxygen and glucose while they are incubated in saline medium at 38 °C. the respiratory activity, subsequently determined in the presence of oxygen and glucose, is slowly decreased; the anaerobic glycolytic activity, determined after adding glucose, is very rapidly lost. These effects are prevented if the deprivation occurs at 0 °C.Loss of glycolytic activity does not occur rapidly if the brain is kept in the head at 38° after decapitation nor if slices are kept humid but without suspending medium at 38° in the absence of oxygen.The glycolytic activity of slices which have been deprived of oxygen and glucose in saline medium at 38° can be largely restored by a period of aerobiosis or by merely replacing the medium with fresh oxygenated medium.Addition of pyruvate to the medium stimulates glycolysis by normal slices but not that by deprived slices. The stimulatory effect of pyruvate reappears if the deprived slices are given a period of aerobiosis.It is concluded that the drastic irreversible effects of brief cerebral anemia on brain function cannot be ascribed to irreversible loss of aerobic or anaerobic metabolic activity.


2018 ◽  
Vol 3 (2) ◽  
pp. e058
Author(s):  
Hannah R. Stinson ◽  
Erica Stevens ◽  
Paige Koetter ◽  
Jennifer Setlik ◽  
Shirley Viteri ◽  
...  

2020 ◽  
pp. 147775092098357
Author(s):  
Ahmeneh Ghavam

Declaration of cardiorespiratory death, as defined by the Uniform Determination of Death Act (UDDA), requires irreversible cessation of circulatory and respiratory function. A physician’s ability to confidently declare death is paramount because death is both a biological and social construct, and can afford a dying patient the opportunity to be an organ donor via donation after circulatory death (DCD). Inconsistencies related to cardiorespiratory death and DCD include the specific language used in the UDDA, specifically the use of the word “irreversible”. Additionally, in DCD there is a large focus on the auto-resuscitative capacity of the heart, however recently some have argued that instead the focus should shift to the brain and a determination of how long it needs to be without circulation to cease functioning prior to declaring death. In this paper, I discuss inconsistencies with cardiorespiratory death as they pertain to organ donation and posit several possible solutions to mitigate these inconsistencies.


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