Relationship Between Resuscitation Team Members' Self-Efficacy and Team Competence During In-Hospital Cardiac Arrest.

Objectives: Inadequate self-efficacy of resuscitation team members may impair team performance, but high self-efficacy does not guarantee competence. We evaluated the relationship between individual self-efficacy and resuscitation team competence.

Design: Secondary analysis of a randomized controlled trial.

Telemedical Intensivist Consultation During In-Hospital Cardiac Arrest Resuscitation: A Simulation-Based, Randomized Controlled Trial.

Background: High-quality leadership improves resuscitation for in-hospital cardiac arrest (IHCA), but experienced resuscitation leaders are unavailable in many settings.

Research Question: Does real-time telemedical intensivist consultation improve resuscitation quality for IHCA?

Study Design And Methods: In this multicenter randomized controlled trial, standardized high-fidelity simulations of IHCA conducted between February 2017 and September 2018 on inpatient medicine and surgery units at seven hospitals were assigned randomly to consultation (intervention) or simulated observation (control) by a critical care physician via telemedicine. The primary outcome was the fraction of time without chest compressions (ie, no-flow fraction) during an approximately 4- to 6-min analysis window beginning with telemedicine activation.

Automatic detection of hand hygiene using computer vision technology.

Objective: Hand hygiene is essential for preventing hospital-acquired infections but is difficult to accurately track. The gold-standard (human auditors) is insufficient for assessing true overall compliance. Computer vision technology has the ability to perform more accurate appraisals.

Acceptability and Perceived Utility of Telemedical Consultation during Cardiac Arrest Resuscitation. A Multicenter Survey.

Many clinicians who participate in or lead in-hospital cardiac arrest (IHCA) resuscitations lack confidence for this task or worry about errors. Well-led IHCA resuscitation teams deliver better care, but expert resuscitation leaders are often unavailable. To determine the acceptability and perceived utility of using telemedicine technology to enable remote IHCA resuscitation participation by a critical care physician.

Describing advanced practice provider roles within critical care teams with Tele-ICUs: Exemplars from seven US health systems.

Telehealth is an acknowledged strategy to meet patient healthcare needs. In critical care settings, Tele-ICU's are expanding to deliver clinical services across a diverse spectrum of critically ill patients. The expansion of telehealth provides increased opportunities for advanced practice providers including advanced practice nurses and physician assistants; however, limited information on roles and models of care for advanced practice providers in telehealth exist.

A computer vision system for deep learning-based detection of patient mobilization activities in the ICU.

Early and frequent patient mobilization substantially mitigates risk for post-intensive care syndrome and long-term functional impairment. We developed and tested computer vision algorithms to detect patient mobilization activities occurring in an adult ICU. Mobility activities were defined as moving the patient into and out of bed, and moving the patient into and out of a chair.

Clinician Perspectives Regarding In-Hospital Cardiac Arrest Resuscitation: A Multicenter Survey.

Objectives: Evaluate clinicians' sentiments about participating in cardiac arrest resuscitations and identify factors associated with confidence in resuscitation of cardiac arrest.

Design: Electronic survey.

Setting: Twenty-one hospitals in Utah and Idaho.

Incidence, risk factors, and mortality associated with acute respiratory distress syndrome in combat casualty care.

Background: The overall incidence and mortality of acute respiratory distress syndrome (ARDS) in civilian trauma settings have decreased over the past four decades; however, the epidemiology and impact of ARDS on modern combat casualty care are unknown. We sought to determine the incidence, risk factors, resource utilization, and mortality associated with ARDS in current combat casualty care.

Methods: This was a retrospective review of mechanically ventilated US combat casualties within the Department of Defense Trauma Registry (formerly the Joint Theater Trauma Registry) during Operation Iraqi Freedom/Enduring Freedom (October 2001 to August 2008) for ARDS development, resource utilization, and mortality.

Evacuation of the ICU: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement.

Background: Despite the high risk for patient harm during unanticipated ICU evacuations, critical care providers receive little to no training on how to perform safe and effective ICU evacuations. We reviewed the pertinent published literature and offer suggestions for the critical care provider regarding ICU evacuation. The suggestions in this article are important for all who are involved in pandemics or disasters with multiple critically ill or injured patients, including front-line clinicians, hospital administrators, and public health or government officials.

Early detection of hospitalized patients with previously diagnosed obstructive sleep apnea using computer decision support alerts.

Obstructive sleep apnea (OSA) is a worldwide problem affecting 2-14% of the general population and most patients remain undiagnosed. OSA patients are at elevated risk for hypoxemia, cardiac arrhythmias, cardiorespiratory arrest, hypoxic encephalopathy, stroke and death during hospitalization. Clinical screening questionnaires are used to identify hospitalized patients with OSA; especially before surgery.

Transfusion strategies and development of acute respiratory distress syndrome in combat casualty care.

Background: Damage-control resuscitation (DCR) has been advocated to reduce mortality in military and civilian settings. However, DCR and excessive crystalloid resuscitation may be associated with a higher incidence of acute respiratory distress syndrome (ARDS). We sought to examine the impact of resuscitation strategies on ARDS development in combat casualty care.

Short-term outcomes of US Air Force Critical Care Air Transport Team (CCATT) patients evacuated from a combat setting.

Purpose: The purpose of this study is to describe the short-term outcomes (during air transport) of patients managed by the United States Air Force Critical Care Air Transport Teams (CCATT).

Methods: This is a retrospective chart review of patients who were transported by CCATT between March 1, 2007 and June 30, 2008. A standardized abstraction form was used.

The critical care air transport program.

Background: The critical care air transport team program is a component of the U.S. Air Force Aeromedical Evacuation system.

Clinical review: critical care transport and austere critical care.

The development of modern intensive care units (ICUs) has allowed the survival of patients with advanced illness and injury, although at a cost of substantial infrastructure. Natural disasters and military operations are two common situations that can create critically ill patients in an environment that is austere or has been rendered austere. This has driven the development of two related strategies to care for these casualties.

Optimal continuous positive airway pressure for the treatment of obstructive sleep apnea/hypopnea.

The obstructive sleep apnea/hypopnea syndrome (OSA/H) is characterised by repetitive obstruction of the upper airway during sleep. The consequences of OSA/H include excessive daytime sleepiness, reduced perceived health quality and an increased risk of driving accidents. There is evidence that treatment with nasal continuous positive airway pressure (CPAP) is effective in eliminating these consequences.

Mechanical ventilation during long-range air transport.

Mechanical ventilation during long-range aeromedical transport presents significant challenges. Patient, crew member, and equipment are placed in an environment with reduced barometric pressure, noise, vibration, and limited space, oxygen, electrical power, and access to imaging technology. It is the transport team's responsibility to provide care in this environment, which approximates that given in the ICU as closely as possible.

The effect of snoring and obstructive sleep apnea on the sleep quality of bed partners.

Objective: To measure the effect of snoring and obstructive sleep apnea (OSA) on the sleep of snorers' bed partners and to determine whether a bed partner's sleep improves when snoring and OSA are treated.

Materials And Methods: We studied 10 married couples in which 1 member was undergoing polysomnography to evaluate suspected OSA. The patients and their spouses underwent simultaneous polysomnography.

High-frequency oscillatory ventilation for adult respiratory distress syndrome--a pilot study.

Objective: To evaluate the safety and effectiveness of high-frequency oscillatory ventilation using a protocol designed to recruit and maintain optimal lung volume in patients with severe adult respiratory distress syndrome (ARDS).

Setting: Surgical and medical intensive care units in a tertiary care, military teaching hospital.

Design: A prospective, clinical study.

V beta-specific immunotoxin selectively kills acetylcholine receptor-reactive T lymphocytes from mice with experimental autoimmune myasthenia gravis.

Immunization of C57BL/6 mice with purified acetylcholine receptor (AChR) is known to induce a T cell-dependent antibody response that results in experimental autoimmune myasthenia gravis (EAMG). Since past observations link V beta 6+ T cells with a prominent AChR epitope specificity, a V beta 6-specific immunotoxin (VIT6) was tested in vitro for its ability to selectively kill monoclonal and polyclonal T cells that demonstrate reactivity against AChR. Results described below clearly demonstrate the ability to selectively kill AChR-reactive T cells based on their expression of a particular V beta-associated antigen receptor.

Pulmonary eosinophils express HLA-DR in chronic eosinophilic pneumonia.

Background: Chronic eosinophilic pneumonia is a rare idiopathic disorder. role the eosinophil plays in the pathogenesis of this disease is unknown. The recent finding that nature eosinophils can express the class II major histocompatibility complex molecule HLA-DR suggests an immunologic role, perhaps through antigen presentation.

Air travel in patients with chronic obstructive pulmonary disease.

Air travel exposes patients with chronic obstructive pulmonary disease to the risk of severe hypoxemia. We sought to determine the frequency and outcome of airline travel in patients with chronic obstructive pulmonary disease. A cohort of 100 patients (76 men and 24 women; age 67 +/- 7 years [mean +/- SD]) with severe chronic pulmonary obstructive disease examined by means of spirometry (forced expiratory volume in the first second, 0.