Faculty of 1000 evaluation for Hypothermia for neuroprotection in children after cardiopulmonary arrest.

Acidentes e fatalidades podem acontecer desde simples contusões até as mais urgentes hemorragias e parada cardiorrespiratória. Os primeiros socorros realizados de forma adequada podem minimizar os agravos e até mesmo salvar vidas. No âmbito escolar, situações de emergência fazem parte do cotidiano e é essencial que Professores de Educação Física tenham um conhecimento básico para atender as necessidades escolares. O presente estudo teve como objetivo verificar o conhecimento dos Professores de Educação Física (EF) da rede pública de Ensino da Cidade de Santa Cecilia-SC com relação aos Primeiros Socorros (PS). Caracterizou-se em natureza descritiva, transversal, com análise quanti-qualitativa dos dados. Participaram do estudo 11 Professores de EF. Para a coleta de dados, foi desenvolvido um questionário abordando aspectos conceituais, procedimentos e atitudes referentes ao cotidiano profissional. Do total, apenas um professor não teve a disciplina de PS na graduação. Os professores na sua minoria se sentem aptos a prestar os PS e inclusive assumir as situações, demonstrando conhecimento satisfatório na teoria, mas na prática sentem-se inseguros para agir diante de situações mais graves. Destaca-se que mais de 80% sabem como agir em atendimentos menos agravantes. Já nas situações de parada cardiorrespiratória (RCP) e hemorragias, os mesmos relataram que necessitam de um treinamento mais atualizado. Em crianças principalmente eles não sentem muito seguros em prover o auxílio. Foi possível concluir que os professores de EF apresentaram um nível de conhecimento satisfatório na teoria, mas sugerem atualizações periódicas em forma de cursos.Palavras-chave: Primeiros Socorros. Docentes. Educação Física e Treinamento.<h3>ABSTRACT</h3>Accidents and fatalities can occur from simple bruises to the most urgent hemorrhages and cardiopulmonary arrest. First aid performed properly can minimize the aggravations and even save lives. In the school context, emergency situations are part of the daily life and it is essential that Physical Education Teachers have a basic knowledge to carry out the school needs. This study verified the Physical Education (PE) Teachers knowledge from Santa Cecilia-SC public teaching related to first aid. It featured in descriptive nature, transversal, with quantitative and qualitative analysis of the data. Eleven PE teachers participated of the study. For the data collection, it was developed a questionnaire addressing conceptual aspects, procedures and attitudes concerning professional daily life. From the total, only one teacher did not have the first aid subject at the college. Teachers in their minority feel able to provide the first aid and even take on the situations, showing satisfactory theory knowledge, however in real life they feel insecure to act on before serious situations. It points out that more than 80% know how to act before less aggravating calls. Nonetheless, during cardiopulmonary arrest (CPR) and hemorrhages, they reported the need of an updated training. Mainly in children, they do not feel safe to provide the aid. It was possible to conclude that Physical Education Teachers showed a satisfactory level of knowledge in theory, however it suggest courses periodic updates.Keywords: First Aid. Faculty. Physical Education and Training.

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Faculty Opinions recommendation of Survival and neurologic outcome after traumatic out-of-hospital cardiopulmonary arrest in a pediatric and adult population: a systematic review.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717953730.793459344 ◽

2012 ◽

Author(s):

Mark Wainwright

Keyword(s):

Systematic Review ◽

Cardiopulmonary Arrest ◽

Adult Population ◽

Neurologic Outcome

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Post-Tonsillectomy Hemorrhage Diagnosis and Management

Otolaryngology ◽

10.1016/j.otohns.2008.05.113 ◽

2008 ◽

Vol 139 (2_suppl) ◽

pp. P34-P35 ◽

Cited By ~ 2

Author(s):

Michael S Morris

Keyword(s):

Ct Angiography ◽

Early Stage ◽

Cardiopulmonary Arrest ◽

Vascular Trauma ◽

Post Mortem ◽

Direct Examination ◽

Operative Field ◽

Different Types ◽

Vascular Physiology ◽

Vascular Spasm

Objective 1) Better recognize pathophysiology of postoperative tonsillectomy hemorrhage. 2) Be able to better differentiate the different types of post-tonsillectomy hemorrhage based upon understanding the vascular physiology and adjust management accordingly. Methods Post-tonsillectomy complications in children and adults were reviewed. 7 cases of hemorrhage, including 5 deaths, were carefully reviewed. Patients ranged between 2–40 years of age. This represents the largest series of post-tonsillectomy deaths reported to date. All postoperative deaths were due to bleeding and cardiopulmonary arrest. Post-mortem analysis was undertaken on those patients. CT angiography was reviewed in one surviving patient and the utility of this type of scanning is discussed. Results Post-tonsillectomy bleeding is one of the most worrisome otolaryngology concerns. Patients with bleeding on postoperative days 2–3 reported episodic bleeding stopping spontaneously. In these patients, the episode of unobserved bleeding signaled a vascular spasm with a likehood of recurrence. When the bleeding recurred it was massive and occured in a uncontrolled setting, leading to a poor outcome. Vascular trauma and spasm is likely. Conclusions Postoperative tonsillectomy bleeding is better managed by differentiating those patients with early stage bleeding on postoperative days 2–3. Direct examination of the operative field is imperative. Ancillary testing including CT angiograpy is helpful in the evaluation.

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Sudden cardiac arrest of a 16-year-old boy with left main coronary artery atresia: a case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytaa125 ◽

2020 ◽

Vol 4 (4) ◽

pp. 1-5

Author(s):

Nobunari Tomura ◽

Takuo Nakagami ◽

Shinichiro Yamaguchi ◽

Hitoshi Yaku ◽

Peysh A Patel

Keyword(s):

Heart Failure ◽

Coronary Artery ◽

Rare Disease ◽

Left Main Coronary Artery ◽

Cardiopulmonary Arrest ◽

Artery Bypass ◽

False Negative ◽

Congenital Defect ◽

Left Main ◽

Exercise Induced

Abstract Background In many cases, the cause of exercise-induced cardiopulmonary arrest in young persons is thought to be fatal arrhythmia, and one of the causes is ischaemic heart disease. Left main coronary artery atresia (LMCAA) is an extremely rare disease in which there is a congenital defect of the left main coronary artery, causing heart failure and exercise-induced angina attacks at a young age. Thus, it is disease that should be differentiated when examining young persons with chest pain. Case summary A 16-year-old boy experienced sudden cardiopulmonary arrest during soccer practice, was brought to our hospital for emergency treatment after return of spontaneous circulation. Elective coronary angiography revealed findings indicating an osmium defect in the left coronary artery (LCA) and blood flow via collateral circulation from the right coronary artery. Contrast-enhanced coronary computed tomography (CT) angiography showed a defect in the LCA ostium and LMCAA was diagnosed in the patient. After coronary artery bypass grafting was performed, but the patient was discharged in an ambulatory state with a wearable cardiac defibrillator. Postoperative course has been favourable. Discussion Left main coronary artery atresia is an extremely rare disease in which there is a congenital defect of the left main trunk of the coronary artery and should be differentiated when encountering cases of heart failure or exercise-induced angina/arrhythmia attacks in young persons who are not at risk for atherosclerosis. Exercise electrocardiogram may show a false negative result, and therefore coronary CT is useful for diagnosis.

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Clinical prediction of bacteremia and early antibiotics therapy in patients with solid tumors

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2021.314 ◽

2021 ◽

pp. 1-7

Author(s):

Jonathan M. Hyak ◽

Mayar Al Mohajer ◽

Daniel M. Musher ◽

Benjamin L. Musher

Keyword(s):

Solid Tumors ◽

Solid Tumor ◽

Cardiopulmonary Arrest ◽

Tertiary Care ◽

Organ Transplant ◽

Antibiotic Use ◽

Care Hospital ◽

Tumor Patients ◽

Binomial Regression ◽

Sirs Criteria

Abstract Objective: To investigate the relationship between the systemic inflammatory response syndrome (SIRS), early antibiotic use, and bacteremia in solid-tumor patients. Design, setting, and participants: We conducted a retrospective observational study of adults with solid tumors admitted to a tertiary-care hospital through the emergency department over a 2-year period. Patients with neutropenic fever, organ transplant, trauma, or cardiopulmonary arrest were excluded. Methods: Rates of SIRS, bacteremia, and early antibiotics (initiation within 8 hours of presentation) were compared using the χ2 and Student t tests. Binomial regression and receiver operator curves were analyzed to assess predictors of bacteremia and early antibiotics. Results: Early antibiotics were administered in 507 (37%) of 1,344 SIRS-positive cases and 492 (22%) of 2,236 SIRS-negative cases (P < .0001). Of SIRS-positive cases, 70% had blood cultures drawn within 48 hours and 19% were positive; among SIRS negative cases, 35% had cultures and 13% were positive (19% vs 13%; P = .003). Bacteremic cases were more often SIRS positive than nonbacteremic cases (60% vs 50%; P =.003), but they received early antibiotics at similar rates (50% vs 49%, P = .72). Three SIRS components predicted early antibiotics: temperature (OR, 1.7; 95% CI, 1.31–2.29; P = .0001), tachycardia (OR, 1.4; 95% CI, 1.10–1.69; P < .0001), and white blood-cell count (OR, 1.8; 95% CI, 1.56–2.14; P < .0001). Only temperature (OR, 1.6; 95% CI, 1.09–2.41; P = .01) and tachycardia (OR, 1.5; 95% CI, 1.09–2.06; P = .01) predicted bacteremia. SIRS criteria as a composite were poorly predictive of bacteremia (AUC, 0.57). Conclusions: SIRS criteria are frequently used to determine the need for early antibiotics, but they are poor predictors of bacteremia in solid-tumor patients. More reliable models are needed to guide judicious use of antibiotics in this population.

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Severe infection including disseminated herpes zoster triggered by subclinical Cushing’s disease: a case report

BMC Endocrine Disorders ◽

10.1186/s12902-021-00757-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yuki Yamauchi ◽

Hiraku Kameda ◽

Kazuno Omori ◽

Michio Tani ◽

Kyu Yong Cho ◽

...

Keyword(s):

Herpes Zoster ◽

Cushing’S Disease ◽

Cardiopulmonary Arrest ◽

Severe Infection ◽

Japanese Woman ◽

The Body ◽

Cushing's Disease ◽

Old Japanese ◽

Subclinical Cushing’S Disease ◽

Physical Features

Abstract Background Subclinical Cushing’s disease (SCD) is defined by corticotroph adenoma-induced mild hypercortisolism without typical physical features of Cushing’s disease. Infection is an important complication associated with mortality in Cushing’s disease, while no reports on infection in SCD are available. To make clinicians aware of the risk of infection in SCD, we report a case of SCD with disseminated herpes zoster (DHZ) with the mortal outcome. Case presentation An 83-year-old Japanese woman was diagnosed with SCD, treated with cabergoline in the outpatient. She was hospitalized for acute pyelonephritis, and her fever gradually resolved with antibiotics. However, herpes zoster appeared on her chest, and the eruptions rapidly spread over the body. She suddenly went into cardiopulmonary arrest and died. Autopsy demonstrated adrenocorticotropic hormone-positive pituitary adenoma, renal abscess, and DHZ. Conclusions As immunosuppression caused by SCD may be one of the triggers of severe infection, the patients with SCD should be assessed not only for the metabolic but also for the immunodeficient status.

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Effect of fluid administration on scene to traffic accident patients by EMS personnel: a propensity score-matched study using population-based ambulance records and nationwide trauma registry in Japan

European Journal of Trauma and Emergency Surgery ◽

10.1007/s00068-020-01590-z ◽

2021 ◽

Author(s):

Yusuke Katayama ◽

Tetsuhisa Kitamura ◽

Kosuke Kiyohara ◽

Kenichiro Ishida ◽

Tomoya Hirose ◽

...

Keyword(s):

Logistic Regression ◽

Propensity Score ◽

Hospital Mortality ◽

Regression Model ◽

Traffic Accident ◽

Logistic Regression Model ◽

Cardiopulmonary Arrest ◽

Population Based ◽

Fluid Administration ◽

Secondary Outcome

Abstract Purpose The aim of this study was to assess the effect of fluid administration by emergency life-saving technicians (ELST) on the prognosis of traffic accident patients by using a propensity score (PS)-matching method. Methods The study included traffic accident patients registered in the JTDB database from January 2016 to December 2017. The main outcome was hospital mortality, and the secondary outcome was cardiopulmonary arrest on hospital arrival (CPAOA). To reduce potential confounding effects in the comparisons between two groups, we estimated a propensity score (PS) by fitting a logistic regression model that was adjusted for 17 variables before the implementation of fluid administration by ELST at the scene. Results During the study period, 10,908 traffic accident patients were registered in the JTDB database, and we included 3502 patients in this study. Of these patients, 142 were administered fluid by ELST and 3360 were not administered fluid by ELST. After PS matching, 141 patients were selected from each group. In the PS-matched model, fluid administration by ELST at the scene was not associated with discharge to death (crude OR: 0.859 [95% CI, 0.500–1.475]; p = 0.582). However, the fluid group showed statistically better outcome for CPAOA than the no fluid group in the multiple logistic regression model (adjusted OR: 0.231 [95% CI, 0.055–0.967]; p = 0.045). Conclusion In this study, fluid administration to traffic accident patients by ELST was associated not with hospital mortality but with a lower proportion of CPAOA.

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