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First use of new ablation catheter in US offers improved atrial fibrillation treatment

Dr. Daniel Melby, an investigator at the Minneapolis Heart Institute Foundation, performed the first atrial fibrillation ablation in the US using Biosense Webster's new THERMOCOOL SMARTTOUCH SF contact force sensing catheter as part of an FDA regulated safety trial. 'Contact force sensing combined with the more efficient irrigation design of this catheter may allow for a more effective ablation pattern while potentially reducing risk of thrombus formation and improving outcomes,' said Dr. Melby.  
eurekalert.org
almost 6 years ago
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Emergency Medicine Literature of Note: Early Goal-Directed Waste For Sepsis

Hey Ryan, As always great work and post. I did want to make sure something was clarified from your post.....Looking at the results, a significant portion of “usual” care patients still get arterial catheters (62.2%), CVCs (50.9%), and vasopressors (46.6%). What this tells me is that our “usual” care has components of the EGDT algorithm engrained in it. Sick patients need fluids, antibiotics, and supportive therapies (i.e. Early critical care and resuscitation), but they don’t need CVP and SCVO2 monitoring to dictate their care. So there are still components of EGDT that should continue to be used, it is the invasive monitoring that is not really needed. Hope all is well.Salim  
emlitofnote.com
almost 6 years ago
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Suction Assisted Laryngoscopy Airway Decontamination

Suction Assisted Laryngoscopy Airway Decontamination UW Madison Mar 2015 from AirwayNautics on Vimeo. Movie captures the important lessons of a simulation session based upon using a rigid suction catheter (Yankauer and other variant) to decontaminate the airway of a modified Laerdal Difficult Airway Simulator mannequin. The technique described in this simulation is known as the…  
prehospitalmed.com
almost 6 years ago
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ECMO - Avalon Cannula - Intensive Care Network

Intensivist Dr Roger Pye demonstrates the Avalon Cannula for ECMO. Presented at SMACCGold 2014.  
intensivecarenetwork.com
almost 6 years ago
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Antibiotic lock to prevent catheter infection in infants | Cochrane

Babies in the neonatal intensive care unit require medicines and fluids through their veins. To do this, a small tube (described as a central venous catheter, CVC) is inserted into the infant's vein through the umbilical cord or through the skin. This tube is placed just outside the heart. This tube is then used to give medicines and fluid without causing any discomfort. However, this tube does lead to an increased risk of infection, which can be life threatening. There are many measures taken to try to prevent this, but infection still occurs. This review looks at one way to prevent this infection by putting an antibiotic solution into the tube and leaving it to stay there for a certain length of time (called antibiotic lock) compared with a solution containing no antibiotic.  
cochrane.org
over 5 years ago
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Strategies used for the withdrawal of humidified high flow nasal cannulae (HHFNC) in preterm infants | Cochrane

Background: Humidified high flow nasal cannula (HHFNC) is a form of respiratory support used in the treatment of preterm infants. Potential risks of HHFNC include damage to the nose and leaking of air from the lungs. Infants on HHFNC require more nursing care and the use of extra equipment (when compared to not being on any support). However, potential complications of removing HHFNC from babies too early include increased episodes of forgetting to breathe, increased oxygen needs, increased effort of breathing, the need to restart HHFNC, and the need for a breathing tube with mechanical ventilation. Any of these complications can be seen as a "failure" and are potentially distressing to staff and family. The best way to withdraw HHFNC once it has been started is unknown. Options include simply stopping, weaning the flow, increasing the time off HHFNC each day, or combinations of both.  
cochrane.org
over 5 years ago
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WHAT THE HELL I AM DOING? I AM ENGORGING A VEIN IS WHAT I AM DOING!

I’m not sure where this fits in, in this age of ultrasounding everything, but there is an interesting short report in EMJ. It describes a simple technique to achieve IV access in patients where the periphery is shut down.  A typical scenario could be a patient in shock were all you can get in is a pathetic 22-24G cannula on the hand, when what you really want to do is a rapid infusion through a 14-16G in the cubital vein.  
scancrit.com
over 5 years ago
Sinaiem dark
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respiratory-failure

As we all know, NiPPV is a well established practice and therapy of choice in patients with COPD and CHF exacerbations.  It is typically used in patients with hypercarbic respiratory failure.  But for those patients who come to the ED with pure hypoxemic respiratory failure (in say, someone with pneumonia) is there a better way to oxygenate them when standard nasal cannula isn’t doing the trick and you want to avoid intubation?  According to 2 recent studies high flow nasal cannula may provide the answer.  In comparing NiPPV to standard oxygen delivery therapy to high flow nasal cannula the intubation rates did not differ significantly, but appear to be lower in the high flow NC group.  Additionally, the 90 day mortality rate was significantly lower and ventilator free days were increased in the the high flow NC group compared to the other two.  The other benefit is that there was less patient discomfort in the high flow NC group.  
sinaiem.org
over 5 years ago
Static.www.bmj
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Delivering thrombectomy for acute stroke using cardiology services

Evidence is mounting for the supplementary benefit over thrombolysis of endovascular therapy in selected patients with acute stroke. Mechanical percutaneous removal of intracerebral clot using an aspiration catheter ensures that the artery is recanalised. Like thrombolysis, the benefits are greater with early treatment, and we need to think about how to achieve this. Evidence on the benefits of rapid primary percutaneous coronary intervention in patients presenting with ST segment elevation myocardial infarction (STEMI) led to a network being set up in the United Kingdom to provide 24 hour care.1 Teams staffing these networks, skilled in opening arteries quickly, could also provide endovascular therapy to selected patients with acute stroke.  
feeds.bmj.com
over 5 years ago
Podcast art for itunes 600 600 2011 version
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does-central-line-position-matter-can.html

To avoid misplacement of the central line we used the very simple technic discribed by Bedel et al http://www.ncbi.nlm.nih.gov/pubmed/24052186Subclavian view show intracardiac positionning of the guidewire before insertion of the catheter. We believe this to be a better approch for your [b] point.  
pulmcrit.org
over 5 years ago
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Lab-on-a-Disc Device Detects Urinary Tract Infections in About an Hour |

UTIs are a common occurrence in hospitalized patients with catheters, but they're typically detected too late and can lead to sepsis. Currently, a diagnost  
medgadget.com
over 5 years ago