Management of Subarachnoid Hemorrhage

2019 ◽  
Vol 39 (5) ◽  
pp. 58-67 ◽  
Author(s):  
Bryan Boling ◽  
Tasha R. Groves
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Subarachnoid Hemorrhage ◽  
Health Care Team ◽  
Current Evidence ◽  
Small Community ◽  
Community Based ◽  
Acute Bleeding ◽  
Specialized Care ◽  
Arachnoid Hemorrhage

Subarachnoid hemorrhage is an often devastating intracranial hemorrhage resulting from acute bleeding into the subarachnoid space. Although its overall incidence is less than that of acute ischemic stroke, sub-arachnoid hemorrhage carries increased risks of both mortality and disability. Although many patients with subarachnoid hemorrhage are transferred to specialty centers, they might initially present to small community-based hospitals. Treatment for these patients is complex, requiring specialized care and knowledge, and various complications can occur quickly and without warning. Therefore, all members of the health care team who care for these patients must understand proper management. Nurses in the intensive care unit play an important role in influencing outcomes, as they are best positioned to recognize neurological decline and provide rapid intervention. This article discusses the anatomy relevant to, and the epidemiology and pathophysiology of, subarachnoid hemorrhage and provides an overview of current evidence and clinical guidelines for managing this brain injury.

Navigator-Based Intervention to Support Communication in the Pediatric Intensive Care Unit: A Pilot Study

2020 ◽  
Vol 29 (4) ◽  
pp. 271-282
Author(s):  
Kelly N. Michelson ◽  
Elizabeth Charleston ◽  
Danica Y. Aniciete ◽  
Lauren R. Sorce ◽  
Patricia Fragen ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Health Care Team ◽  
Care Team ◽  
Care Needs ◽  
Family Meetings ◽  
Family Perceptions

Background Communication in the pediatric intensive care unit (PICU) between families and the health care team affects the family experience, caregiver psychological morbidity, and patient outcomes. Objective To test the feasibility of studying and implementing a PICU communication intervention called PICU Supports, and to assess families’ and health care teams’ perceptions of the intervention. Methods This study involved patients requiring more than 24 hours of PICU care. An interventionist trained in PICU-focused health care navigation, a “navigator,” met with parents and the health care team to discuss communication, decision-making, emotional, informational, and discharge or end-of-life care needs; offered weekly family meetings; and checked in with parents after PICU discharge. The feasibility of implementing the intervention was assessed by tracking navigator activities. Health care team and family perceptions were assessed using surveys, interviews, and focus groups. Results Of 53 families approached about the study, 35 (66%) agreed to participate. The navigator met with parents on 71% and the health care team on 85% of possible weekdays, and completed 86% of the postdischarge check-ins. Family meetings were offered to 95% of eligible patients. The intervention was rated as helpful by 97% of parents, and comments during interviews were positive. Conclusions The PICU Supports intervention is feasible to implement and study and is viewed favorably by parents.

scholarly journals Reaction time of a health care team to monitoring alarms in the intensive care unit: implications for the safety of seriously ill patients

2014 ◽  
Vol 26 (1) ◽  
pp. 28-35 ◽  
Author(s):  
Adriana Carla Bridi ◽  
Roberto Carlos Lyra da Silva ◽  
Carolina Correa Pinto de Farias ◽  
Andrezza Serpa Franco ◽  
Viviane de Lima Quintas dos Santos
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Reaction Time ◽  
Health Care Team ◽  
Care Team ◽  
Seriously Ill Patients ◽  
Seriously Ill

St Joseph's Community Health Centre model of community-based interdisciplinary health care team education

2007 ◽  
Vol 3 (1) ◽  
pp. 33-42 ◽  
Author(s):  
Mary-Lou Horst ◽  
Irene Turpie ◽  
Nelson Wendy ◽  
Cole Beverley ◽  
Sammon Sheila ◽  
...  
Keyword(s):  
Health Care ◽  
Community Health ◽  
Health Centre ◽  
Health Care Team ◽  
Care Team ◽  
Community Health Centre ◽  
Community Based ◽  
Interdisciplinary Health Care

scholarly journals People with physical disabilities in Sri Lanka are in need for the service of community physiotherapists

2021 ◽  
Vol 8 (8) ◽  
pp. 3799
Author(s):  
Vindya Vimani Senadheera ◽  
Kavinda Tharani Malwanage ◽  
Sithravelayuthan Mayooran ◽  
Abdul Majeed Mohomad Rikas ◽  
Agampodi Liyanage Indrajith Prasanna
Keyword(s):  
Health Care ◽  
Sri Lanka ◽  
Physical Disabilities ◽  
Pediatric Population ◽  
Health Care Team ◽  
Rehabilitation Program ◽  
Health Care Practitioner ◽  
Community Based ◽  
Community Based Rehabilitation ◽  
People With Physical Disabilities

Background: Physiotherapists have long been recognized as important providers of services for people with disability. In Sri Lanka the concept of community physiotherapy has not emerged yet. The present study aimed to identify the need for ‘community physiotherapy service’ in Kandy district, Sri Lanka. Methods: A community service projection community based rehabilitation, of three years was conducted by the department of physiotherapy, faculty of allied health sciences, University of Peradeniya, Sri Lanka in 2017-2019 in collaboration with department of social service and social welfare of Kandy district secretariat, Sri Lanka.Results: One hundred and seventy participants with physical disabilities were included in the study 94 (55.29%) were males (mean age; 33.57 (SD ±23.17) and 76 (44.71%) were females (mean age; 33.14 (SD ±24.98). The pediatric population was 41.76% (N=71) followed by 38.82% of adults (N=66) and 19.41% of elderly patients (N=33) of the total population. The highest number of PWD had pediatric conditions (39.41%), followed by musculoskeletal (31.76%), neurological (15.88%), geriatric (8.82%) and cardio-respiratory (4.12%) conditions. The majority (55.88%) of all the people with disabilities who visited the clinics were in need for further physiotherapy consultation and follow up.Conclusions: In Kandy district of Sri Lanka alone, number of people with physical disabilities who are in need of continuous physiotherapy follow ups is high compared to services already available. Conducting a successful community-based rehabilitation program in Sri Lanka as a whole, require having a specialized health care practitioner to the primary health care team; ‘a community physiotherapist’.

scholarly journals A pilot survey of post-deployment health care needs in small community-based primary care clinics

2011 ◽  
Vol 12 (1) ◽  
Author(s):  
Polly H Noël ◽  
John E Zeber ◽  
Mary J Pugh ◽  
Erin P Finley ◽  
Michael L Parchman
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Needs ◽  
Small Community ◽  
Care Needs ◽  
Community Based ◽  
Primary Care Clinics ◽  
Pilot Survey

Cancer-related distress and unmet needs among members of a metastatic breast cancer registry.

2014 ◽  
Vol 32 (26_suppl) ◽  
pp. 118-118
Author(s):  
Joanne S. Buzaglo ◽  
Melissa F Miller ◽  
Anne Morris ◽  
Allison Harvey ◽  
Mitch Golant
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Metastatic Breast Cancer ◽  
Metastatic Breast ◽  
Health Care Team ◽  
Cost Of Care ◽  
Care Team ◽  
Comprehensive Cancer Center ◽  
Community Based ◽  
Cancer Support

118 Background: An estimated 155,000 people are living with metastatic breast cancer (MBC) in the US. Emotional distress among people living with MBC is common; yet, little is known about the patient experience and distress screening. Methods: Since March 2013, the Cancer Support Community has registered 909 people living with MBC to the Cancer Experience Registry, an online initiative that is designed to raise awareness about the psychosocial impact of cancer. 599 registrants responded to questions about cancer related distress. This sample was 99% female, 91% Caucasian, and 69% with a college degree and median age 56. Median time since MBC diagnosis was 3 years. Results: The top sources of distress (% rated seriously or very seriously concerned) were: (1) worry about the future (44%); (2) fatigue (39%); (3) health insurance or money worries (38%). 49% reported fatigue was ‘quite a bit’ or ‘very much’ disruptive in their life and 46% reported intrusive ideation about the financial cost of care. Factors that were independently associated with greater overall distress included younger age (p<0.001), higher comorbidity (p<0.001), lower income (p=0.001). 43% of respondents were never asked about distress by their health care team. Those who received all or part of their treatment in an academic or comprehensive cancer center were significantly more likely to be asked about distress versus those receiving treatment anywhere else (65% vs. 50%, p=0.002). Among those who were asked about distress (n=340), 62% received referrals to manage distress within their health care system, and 19% at a community-based organization; 47% reported their health care team helped coordinated distress-related care. 20% of those asked about distress never received referrals for managing it. Conclusions: These findings support the need for integrated supportive care services and better side-effect management. Disturbingly, 20% of patients who asked for referrals never received them and only 19% of patients were referred to community-based organizations for treating their distress where these services are often provided at low or no-cost. There is an on-going need for coordinated care that integrates programs and services across health care systems.

scholarly journals Home and Community-Based Physical Therapist Management of Adults With Post–Intensive Care Syndrome

2020 ◽  
Vol 100 (7) ◽  
pp. 1062-1073 ◽  
Author(s):  
James M Smith ◽  
Alan C Lee ◽  
Hallie Zeleznik ◽  
Jacqueline P Coffey Scott ◽  
Arooj Fatima ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Home Health Care ◽  
Mental Health Problems ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Health Care Team ◽  
Rehabilitation Service ◽  
Community Based ◽  
Post Intensive Care Syndrome

Abstract More than 4 million adults survive a stay in the intensive care unit each year, with many experiencing new or worsening physical disability, mental health problems, and/or cognitive impairments, known as post-intensive care syndrome (PICS). Given the prevalence and magnitude of physical impairments after critical illness, many survivors, including those recovering from COVID-19, could benefit from physical therapist services after hospital discharge. However, due to the relatively recent recognition and characterization of PICS, there may be limited awareness and understanding of PICS among physical therapists practicing in home health care and community-based settings. This lack of awareness may lead to inappropriate and/or inadequate rehabilitation service provision. While this perspective article provides information relevant to all physical therapists, it is aimed toward those providing rehabilitation services outside of the acute and postacute inpatient settings. This article reports the prevalence and clinical presentation of PICS and provides recommendations for physical examination and outcomes measures, plan of care, and intervention strategies. The importance of providing patient and family education, coordinating community resources including referring to other health care team members, and community-based rehabilitation service options is emphasized. Finally, this perspective article discusses current challenges for optimizing outcomes for people with PICS and suggests future directions for research and practice.

scholarly journals Professional Education in Multiple Sclerosis Care Through a Multidisciplinary Program for Health Care Practitioners

2007 ◽  
Vol 9 (4) ◽  
pp. 148-153
Author(s):  
Alexander Rae-Grant ◽  
Sharon R. Kimmel ◽  
Nancy Eckert ◽  
Richard Schall ◽  
Maureen Beilman ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Professional Education ◽  
Health Care Team ◽  
Community Based ◽  
End Of Life Decisions ◽  
Multidisciplinary Program ◽  
Health Care Practitioners ◽  
Demographic Questionnaire

Multiple sclerosis (MS) is a common and long-term condition. It requires the intervention of various health care practitioners over a spectrum of care ranging from first diagnosis to end-of-life decisions. We developed a multispecialty program of education and worked with groups from a multisite community-based teaching hospital and a comprehensive rehabilitation network. We used a demographic questionnaire and pre- and postintervention testing. Participants consistently scored higher on the postsession (89.70 ± 8.09%) than on the presession (76.50 ± 17.61%) questionnaire (P &lt; .001). No statistically significant differences were found in percentage points improved across level of education, previous training status, experience in caring for MS patients, or position classification. Ninety-five percent of participants responded that the information provided through the session related to their current role as part of a multidisciplinary health care team. In conclusion, this format was useful in providing key knowledge about the biological, psychological, and social care of patients with MS. A targeted educational program for health care practitioners should become part of the curriculum offered by MS centers to enhance the care provided to their patient population.

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