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Systematic review and meta-analysis of the correlation between bispectral index (BIS) and clinical sedation scales: Toward defining the role of BIS in critically ill patients.
Get PDFINTRODUCTION: The bispectral index (BIS) is an attractive approach for monitoring level of consciousness in critically ill patients, particularly during paralysis, when commonly used sedation scales cannot be used.
OBJECTIVES: As a first step toward establishing the utility of BIS during paralysis, this review examines the strength of correlation between BIS and clinical sedation scales in a broad population of non-paralyzed, critically ill adults.
METHODS: We included studies evaluating the strength of correlation between concurrent assessments of BIS and Richmond Agitation Sedation Scale (RASS), Ramsay Sedation Scale (RSS), or Sedation Agitation Scale (SAS) in critically ill adult patients. Studies involving assessment of depth sedation periperative or procedural time periods, and those reporting BIS and sedation scale assessments conducted \u3e5 min apart or while neuromuscular blocking agents (NMBA) were administered, were excluded. Data were abstracted on sedation scale, correlation coefficients, setting, patient characteristics, and BIS assessment characteristics that could impact the quality of the studies.
RESULTS: Twenty-four studies which enrolled 1235 patients met inclusion criteria. The correlation between BIS and RASS, RSS, and SAS overall was 0.68 (95% confidence interval, 0.61-0.74, Ƭ
CONCLUSIONS: BIS demonstrated moderate to strong correlation with clinical sedation scales in adult ICU patients, providing preliminary evidence for the validity of BIS as a measure of sedation intensity when clinical scales cannot be used. Future studies should determine whether BIS monitoring is safe and effective in improving outcomes in patients receiving NMBA treatment
2022 Student Research Fellowship Program: SERF ABSTRACT Booklet
Get PDF2022 Abstracts Featured
Assessing the Impact of Physician Pain on Motivation to Provide Longitudinal Osteopathic Manipulative Therapy to Patients and its Correlation to Opioid Prescribing: A Cohort Study
Predicting Cognitive Decline in Long-COVID Patients: A Demographic and Comorbid Analysis Using BrainCheck Cognitive Assessment
The Use of Anticoagulants in COVID-19 Positive Patients on Extracorporeal Membrane Oxygenation
A Mineralized Allograft in Lumbar Interbody Fusion – A Retrospective Chart Review Study
Creating a Patient Registry for the Parkview Vein Clinic
Traumatic Brain Injury in a Level II Trauma Center Network Serving Rural Northeastern Indiana: A Cross-Sectional Study
Peripheral Neuropathy in Long-COVID Patients: Demographic Distribution and Medical Risk Factors
Complications in Burn Patients Following Fluid Over-Resuscitation
Lutheran Children’s Hospital Neonatal Follow-Up Clinic: Risk of Developmental Delay of Preterm Neonates as a Function of Gestational Birth Age
The Effects of the COVID-19 Pandemic on IVC Filter Placement
The Impact of Improving Nutrition Status, Pre-habilitation, Optimization of Cardiac Hemodynamics Including use of Temporary Mechanical Support When Indicated on the Reduction of Frailty in Patients Evaluated for Advanced Heart Failure Therapies
Associations Between Psychiatric Symptoms and Cognitive Impairment in Post-Acute Sequelae of COVID
Therapeutic Effects of Benzoylacetonitrile on Microglia Activation in Multiple Sclerosi
Systemic Amyloidosis Presenting as Adrenal Insufficiency and Multi-nodular Goiter
Get PDFPoster Presented at ACP Indiana Chapter 2022 Annual Scientific Meeting, October 2022.
Case Presentation: A 69-year-old male presented to the Endocrinology clinic after multiple hospital admissions for severe orthostatic hypotension, weight loss, edema and generalized weakness. On physical exam, he was found to have orthostatic hypotension and large goiter
Papillary Thyroid Cancer in a Patient with Germline TTN Mutation
Get PDFPoster Presented at the ACP Indiana Chapter 2022 Annual Scientific Meeting, October 2022.
Case Presentation:
• A 60-year-old male presented with new onset atrial fibrillation and hyperthyroidism.
• His past medical history was significant for germline TTN mutation and recurrent ventricular tachycardia status post implantable cardiac defibrillator placement.
• He had been treated with amiodarone for two and a half years and had stopped the medication eight months prior to presentation.
• Laboratory workup was done (table 1) and an ultrasound of the thyroid gland showed a multinodular goiter with subcentimeter cysts and a right lower lobe nodule.
• A follow-up thyroid ultrasound twelve months later showed a new 11 mm nodule in the left lower lobe and a stable 5 mm nodule in the right lower lobe.
• Fine needle aspiration of the left nodule was suspicious for follicular neoplasm with suspicious Afirma Genome Sequence Classifier testing (corresponding to ~ 50% risk of malignancy)
Evaluation of Therapies for Treatment of Hyponatremia
Get PDFPoster presentation completed at ASHP Midyear Clinical Conference & Exhibition.
Objective: Characterize the use and assess the efficacy of tolvaptan and urea in the treatment of patients who were admitted to the hospital with chronic hyponatremia
The Roles and Contributions of Certified Transport Registered Nurses in Critical Care Ground Transport Today.
Get PDFRegistered nurses are core members of critical care ground transport teams because of their education, experience, and scope of practice. Advances in medicine, technology, and equipment, combined with regionalization of specialized care and, most recently, the coronavirus disease 2019 pandemic, necessitate that transport nurses possess specialized knowledge, skills, and abilities. National specialty certification in ground transport nursing via the Certified Transport Registered Nurse (CTRN) offers registered nurses a process to validate their expertise. The most recent transport nursing role delineation study, which was conducted by the Board of Certification for Emergency Nursingin 2019, provided the foundation for the revised CTRN examination content outline, which is now separate from the Certified Flight Registered Nurse (CFRN) content outline. In this article, we provide a brief history of the specialty of ground transport nursing; details on the CTRN examination blueprint; and a composite patient case report to illustrate the ground-specific role, expertise, and contributions of the CTRN in delivering the highest level of patient care during ground transport
Self-Regulation as a Protective Factor for Diabetes Distress and Adherence in Youth with Type 1 Diabetes During the COVID-19 Pandemic.
Get PDFOBJECTIVE: The COVID-19 pandemic increased economic, social, and health stressors for families, yet its impacts on families of youth with chronic conditions, such as type 1 diabetes (T1D), are not well understood. Self-regulation (SR)-or the capacities to control emotions, cognition, and behavior in response to challenge-is known to support T1D management and coping in the face of stress. Strong SR may have protected youth with T1D from the impacts of pandemic-related stressors. This study compared youth and parent emotional functioning and T1D management before and after the pandemic\u27s onset in relation to family pandemic-related stress and youth SR.
METHODS: Parents of youth with T1D (N = 88) and a subset of these youth (N = 43; Mean age 15.3 years [SD 2.2]) completed surveys regarding SR, stress, emotional functioning, and T1D-related functioning prior to and after March 2020. Outcomes were compared using mixed effects models adjusting for covariates. Family pandemic-related stress experiences and youth SR were tested as moderators of change.
RESULTS: Parents\u27 responsibility for T1D management increased across pandemic onset and their diabetes-related distress decreased. Family pandemic-related stress was associated with decreased emotional functioning over time. Youth SR, particularly emotional and behavioral aspects, predicted better emotional and T1D-related functioning.
DISCUSSION: While youth with T1D whose families experienced higher pandemic-related stress had poorer adjustment, strong emotional and behavioral SR appeared to protect against worsening youth mood and adherence across pandemic onset. Both social-contextual and individual factors are important to consider when working with families managing T1D
Unpacking Invisible Work Practices, Constraints, and Latent Power Relationships in Child Welfare through Casenote Analysis
No full textCHI \u2722: Proceedings of the 2022 CHI Conference on Human Factors in Computing Systems
Caseworkers are trained to write detailed narratives about families in Child-Welfare (CW) which informs collaborative high-stakes decision-making. Unlike other administrative data, these narratives offer a more credible source of information with respect to workers’ interactions with families as well as underscore the role of systemic factors in decision-making. SIGCHI researchers have emphasized the need to understand human discretion at the street-level to be able to design human-centered algorithms for the public sector. In this study, we conducted computational text analysis of casenotes at a child-welfare agency in the midwestern United States and highlight patterns of invisible street-level discretionary work and latent power structures that have direct implications for algorithm design. Casenotes offer a unique lens for policymakers and CW leadership towards understanding the experiences of on-the-ground caseworkers. As a result of this study, we highlight how street-level discretionary work needs to be supported by sociotechnical systems developed through worker-centered design. This study offers the first computational inspection of casenotes and introduces them to the SIGCHI community as a critical data source for studying complex sociotechnical systems
Patient efficacy in telehealth is moderated by distress among patients with cancer: a cross-sectional survey study
Get PDFLow emotional distress and high confidence with tech impacts cancer patients’ choice of in person or telehealth visits
Designing Displays of Cardiac Implantable Electronic Device Sensor Data with Patients who have Heart Failure with Reduced Ejection Fraction
Get PDFBackground: Cardiac implantable electronic devices (CIEDs) are important life-saving and therapeutic devices for patients with heart failure with reduced ejection fraction (HFrEF). These devices capture a multitude of data, including factors that have potential to indicate worsening heart failure. Patients may be interested to monitor sensor data from their device as part of heart failure self-care, and are key stakeholders in designing visualizations and displays for interpretation of the data.
Objectives: The objective of this study was to explore the presentation of HF-related CIED sensor data in a small participatory design session with people who have HFrEF and CIEDs.
Methods: The 3-hour participatory design session took place at a mid-size, not-for-profit health system in the Midwestern United States. Participants were five adults who had HFrEF and cardiac synchronization therapy (CRT) devices. Activities included presentation and discussion of HF-sensor data across four levels of detail (“birds-eye view”, mini trend graph, detailed, and supporting information).
Results: Five themes emerged regarding information needs (3), benefits (1), and concerns (1) for displaying and monitoring CIED sensor data, as well as recommendations for displaying data at the various levels of detail.
Conclusions: The session revealed that there are information gaps to fill to transform raw CIED sensor data into displays that provide meaningful, contextual, and actionable information. Future work should be aimed toward closing these gaps in design sessions with patients and their health care providers to create displays that cultivate a shared understanding of CIED data