Increasing the Effectiveness of Targeted Temperature Management

2021 ◽  
Vol 41 (5) ◽  
pp. 59-63
Author(s):  
Melissa Moreda ◽  
Pamela S. Beacham ◽  
Angela Reese ◽  
Malissa A. Mulkey
Keyword(s):  
Patient Outcomes ◽  
Targeted Temperature Management ◽  
Fine Tuning ◽  
Temperature Management ◽  
Multimodal Approach ◽  
High Quality ◽  
Effective Interventions ◽  
Essential Components ◽  
Underlying Pathophysiology ◽  
Improve Patient

Topic Targeted temperature management and therapeutic hypothermia are essential components of the multimodal approach to caring for compromised patients after cardiac arrest and severe traumatic brain injury. Clinical Relevance The continuously evolving science necessitates summation of individual facets and concepts to enhance knowledge and application for optimally delivering care. Targeted temperature management is a complex therapy that requires fine-tuning the most effective interventions to maintain high-quality targeted temperature management and maximize patient outcomes. Purpose To describe the underlying pathophysiology of fever and the importance of manipulating water temperature and of preventing and treating shivering during that process. Content Covered This article discusses nursing considerations regarding the care of patients requiring targeted temperature management that are necessary to improve patient outcomes.

Abstract 2019: Untrained Volunteers Perform High Quality CPR When using an Automatic External Defibrillator with a CPR Voice Prompting Algorithm

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Benjamin S Abella ◽  
Salem Kim ◽  
Alexandra Colombus ◽  
Cheryl L Shea ◽  
Lance B Becker
Keyword(s):  
Real Time ◽  
Patient Outcomes ◽  
Chest Compression ◽  
Automatic External Defibrillator ◽  
Chest Compressions ◽  
High Quality ◽  
Cpr Training ◽  
Adult Volunteers ◽  
Improve Patient ◽  
External Defibrillator

Background: Recent investigations have demonstrated that CPR performance among trained providers can be improved by audiovisual prompting and real-time feedback, and higher quality CPR before defibrillation can improve shock success and has the potential to improve patient outcomes. Objective: We hypothesized that simplified voice prompts incorporated into an automatic external defibrillator (AED) can lead to improvements in CPR performance by untrained lay rescuers. Methods: Adult volunteers with no prior CPR training were assessed in their use of an AED with chest compression voice instructions and metronome prompts on a CPR-recording manikin. Volunteers were given minimal instructions regarding use of the device and were given no instructions regarding CPR performance. The AED was designed to prompt five cycles of 30 chest compressions between defibrillatory attempts. Chest compression rates and depths were measured via review of videotape and manikin recording data, respectively. Results: A total of 60 adults were assessed in their use of the AED, with a mean age of 33.6±12.8; 36/63 (57%) were female. Mean chest compression rate was 103±12 and mean depth was 37±14 mm. Furthermore, minimal decay in chest compression rates occurred over 5 cycles of chest compressions, with mean rate of 101±19 during the first cycle and 104±10 during the 5 th cycle. No volunteers were unable to use the AED or complete 5 cycles of chest compressions. Conclusions: Our work demonstrates that with appropriate real-time prompts delivered even in the absence of training or human coaching, laypersons can perform CPR that has a quality often similar to trained providers. This finding has important implications for AED design especially in light of the renewed importance of both CPR and the interaction of quality chest compressions and defibrillatory success.

scholarly journals A Critical Approach to Clinical Practice Guidelines

2000 ◽  
Vol 14 (6) ◽  
pp. 505-509 ◽  
Author(s):  
John K Marshall
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Patient Outcomes ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Care Delivery ◽  
Critical Approach ◽  
High Quality ◽  
Number Of Publications ◽  
Improve Patient

The rate of publication of clinical practice guidelines for the management of common medical illnesses continues to accelerate. The appropriate dissemination and uptake of high quality practice guidelines can synthesize evidence, improve patient outcomes and enhance the efficiency of health care delivery. However, the methodological rigour and relevance of the growing number of publications labelled ’clinical practice guidelines’ vary widely. Health care payers, providers and advocates must learn to appraise and interpret guideline recommendations critically. A simple and practical nine-question approach to evaluating the quality, relevance and effectiveness of clinical practice guidelines is presented.

scholarly journals A Review of Adverse Effects of Targeted Temperature Management for Post-cardiac Arrest Patients

2020 ◽  
Vol 2 (5) ◽  
pp. 01-03
Author(s):  
Leonard Ranasinghe
Keyword(s):  
Cardiac Arrest ◽  
Adverse Effects ◽  
Standard Of Care ◽  
Targeted Temperature Management ◽  
Antiarrhythmic Therapy ◽  
Temperature Management ◽  
Future Research ◽  
High Quality

Targeted Temperature Management has been the standard of care in post cardiac arrest since 2005. Despite significant advancements since its infancy, and a multitude of studies, discrepancies still exist as to its efficacy. By understanding the associated adverse effects, we can begin to delineate incongruencies to guide future research in order to progress towards a more uniform “high-quality” Targeted Temperature Management. Both anticonvulsant and antiarrhythmic therapy may provide an avenue towards improving Targeted Temperature Management.

scholarly journals High Quality Targeted Temperature Management (TTM) After Cardiac Arrest

Critical Care ◽  
2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Fabio Silvio Taccone ◽  
Edoardo Picetti ◽  
Jean-Louis Vincent
Keyword(s):  
Cardiac Arrest ◽  
Complex Intervention ◽  
Neurological Outcome ◽  
Targeted Temperature Management ◽  
Temperature Management ◽  
Target Temperature ◽  
High Quality ◽  
Large Variability ◽  
Anoxic Injury

AbstractTargeted temperature management (TTM) is a complex intervention used with the aim of minimizing post-anoxic injury and improving neurological outcome after cardiac arrest. There is large variability in the devices used to achieve cooling and in protocols (e.g., for induction, target temperature, maintenance, rewarming, sedation, management of post-TTM fever). This variability can explain the limited benefits of TTM that have sometimes been reported. We therefore propose the concept of “high-quality TTM” as a way to increase the effectiveness of TTM and standardize its use in future interventional studies.

Traumatic Brain Injury Update

2021 ◽  
Vol 32 (1) ◽  
pp. 29-50
Author(s):  
Maureen Scarboro ◽  
Karen A. McQuillan
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Patient Outcomes ◽  
Temperature Management ◽  
Evidence Based ◽  
Secondary Injury ◽  
Essential Interventions ◽  
Tools And Techniques ◽  
Improve Patient ◽  
Potential Therapeutics

Traumatic brain injury is a devastating, life-changing event in most cases. After the primary brain insult, it is helpful to use evidence-based monitoring techniques to guide implementation of essential interventions to minimize secondary injury and thereby improve patient outcomes. An update on multimodal neuromonitoring is provided in this narrative review, with discussion of tools and techniques currently used in the treatment of patients with brain injury. Neuroprotective treatments, from the well-studied targeted temperature management to new potential therapeutics under investigation, such as glyburide, also are presented.

scholarly journals Applicability of Data Mining and Predictive Analysis for Tobacco Cessation: An Exploratory Study

2020 ◽  
Author(s):  
Kavita Rijhwani ◽  
Vikrant R Mohanty ◽  
Aswini YB ◽  
Vaibhav Singh ◽  
Sumbul Hashmi
Keyword(s):  
Data Mining ◽  
Patient Outcomes ◽  
Tobacco Cessation ◽  
Healthcare Professionals ◽  
Secondary Data ◽  
Analytical Models ◽  
Predictive Analysis ◽  
Effective Interventions ◽  
Mining Tool ◽  
Improve Patient

Objectives: Predictive analysis can be used to evaluate the enormous data generated by the healthcare industry to extract information and establish relationships amongst the variables. It uses artificial intelligence to reveal associations not suspected by the healthcare professionals. Tobacco cessation is clearly beneficial; however, many tobacco users respond differently as it is based on multitude of factors.  Our objectives were to assess the data mining techniques using the WEKA tool, evaluate its role in predictive analysis, and to predict the quit status of patients using prediction algorithms in tobacco cessation.  Materials and Methods: WEKA, a data mining tool, was used to classify the data and evaluate them using 10-fold cross-validations. The various algorithms used in this tool are Naïve Bayes, SMO, Random Forest, J-48, and Decision Stump to further analyze its role in determining the quit status of patients. For this, secondary data of 655 patients from a tobacco cessation clinic were utilized and described using 20 different attributes for prediction of quit status. Results: The Decision Stump and SMO were found to be having the best prediction and accuracy for prediction of the quit status. Out of 20 attributes, previous quitting attempt, type of intervention, and number of years since the habit was initiated were found to be associated with early quitting rate. Conclusion: This study concluded that data mining and predictive analytical models like WEKA tool will not only improve patient outcomes but identify variables or a combination of variables for effective interventions in tobacco cessation.

Combined Approaches to the Skull Base for Intracranial Extension of Tumors via Perineural Spread can Improve Patient Outcomes

2016 ◽  
Vol 77 (S 01) ◽  
Author(s):  
Sheri Palejwala ◽  
Jonnae Barry ◽  
Crystal Rodriguez ◽  
Chandni Parikh ◽  
Stephen Goldstein ◽  
...  
Keyword(s):  
Skull Base ◽  
Patient Outcomes ◽  
Intracranial Extension ◽  
Perineural Spread ◽  
Improve Patient

Microporous Polysaccharide Hemosphere Absorbable Hemostat (AristaAH®) in Re-Operative Cardiac Surgical Procedures

2012 ◽  
Vol 9 (2) ◽  
pp. 96-98
Author(s):  
Brian A Bruckner ◽  
Matthias Loebe
Keyword(s):  
Patient Outcomes ◽  
Surgical Procedures ◽  
Systematic Approach ◽  
Surgical Intervention ◽  
Transfusion Requirement ◽  
Cardiac Surgical Procedures ◽  
Platelet Inhibitors ◽  
Hemostatic Agents ◽  
Surgical Field ◽  
Improve Patient

Patients undergoing re-operative cardiac surgical procedures present a great challenge with regard to obtaining hemostasis in the surgical field. Adhesions are ever-present and these patients are often on oral anti-coagulants and platelet inhibitors. As part of a well-planned surgical intervention, a systematic approach to hemostasis should be employed to decrease blood transfusion requirement and improve patient outcomes. Topical hemostatic agents can be a great help to the surgeon in achieving surgical field hemostasis and are increasingly being employed. Our approach, to these difficult patients, includes the systematic and planned use of AristaAH, which is a novel hemostatic agent whose use has proven safe and efficacious in our patient population.

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