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Occlusive Dressing

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181. Out-of-Hospital Cardiac Arrest Resuscitation Systems of Care: A Scientific Statement From the American Heart Association

temperature between 32°C and 36°C for at least 24 hours for comatose patients with ROSC after cardiac arrest. , Access to PCI Up to 70% of patients with OHCA have coronary artery disease. Although 50% have acute coronary occlusion, only a minority of patients with OHCA with ROSC who were transported to hospital have an ST-segment elevation on a 12-lead ECG. , Mortality after emergent angiography for STEMI patients in the setting of post-ROSC OHCA is greater than that in the setting of STEMI alone (...) . However, these devices may have a role in reducing risks to EMS providers associated with performing manual compressions in a moving vehicle or in facilitating emergent coronary angiography in a patient with ongoing cardiac arrest and a high likelihood of acute coronary occlusion. Although the acceptance of regionalized approaches to systems of care and designated centers has increased, some EMS systems remain challenged by local concerns related to bypassing closer hospitals and the resultant loss

2018 American Heart Association

182. Spontaneous Coronary Artery Dissection: Current State of the Science: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

intramural hematoma (dotted arrow) compressing the true lumen (asterisk). Despite the importance of intracoronary imaging for the diagnosis of SCAD, these tools have potential risks, including extending the coronary dissection with wire or imaging catheter, guide-catheter iatrogenic dissection, catheter-induced occlusion of true lumen, and hydraulic extension with contrast injection for optical coherence tomography. With weighing of the risks and benefits, intracoronary imaging should be pursued only (...) of ACS advocate an early invasive strategy with revascularization of culprit lesions over conservative therapy alone. , This stent-based lesion pacification reduces the risk of recurrent occlusion at the lesion site and associated adverse events in atherosclerotic MI, but there have been no randomized studies or subgroup analyses of treatment outcomes or comparisons between acute revascularization strategies for ACS caused by SCAD. These studies are critical because the mechanism of vessel

2018 American Heart Association

183. ASPEN Guidelines for the Selection and Care of Central Venous Access Devices for Adult Home Parenteral Nutrition Administration Full Text available with Trip Pro

remains intact; requires no local site care when device is not accessed. PN may increase risk for CLABSI and occlusion in children with cancer. Adapted with permission from the American Society for Parenteral and Enteral Nutrition. CLABSI, central line–associated blood stream infection; CVAD, central venous access device; HPN, home parenteral nutrition; PICC, peripherally inserted central catheter; PN, parenteral nutrition; VAD, venous access device. The expansive duration of HPN (ranging from months (...) et al Retrospective cohort Compared complication rates of tunneled CVADs and PICCs in 1 Danish Center 136 adult HPN patients Total of 295 CVADs; 169 tunneled CVADs and 126 PICCs If removal was due to a mechanical cause (CVAD fell out, pulled out by mistake, occlusion, broken or other defects) PICC removal was higher (1.5 compared with 0.6/1000 CVAD days) PICCs were inserted when patient not able to care for the CVAD. Patients who had an acute condition, metabolically unstable requiring IV

2018 American Society for Parenteral and Enteral Nutrition

185. Atrial Fibrillation Burden: Moving Beyond Atrial Fibrillation as a Binary Entity: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

(rivaroxaban vs warfarin, P for interaction=0.6). Efficacy end point models were adjusted for the following: age, sex, BMI, region, DM, prior stroke/TIA, vascular disease, myocardial infarction, peripheral artery disease, carotid occlusive disease, CHF, hypertension, chronic obstructive pulmonary disease, DBP, creatinine clearance, heart rate, and abstinence from alcohol.Safety end point models were adjusted for the following: prior stroke/TIA; anemia; prior gastrointestinal bleed; chronic obstructive

2018 American Heart Association

186. Evaluation and Management of Right-Sided Heart Failure: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

and acute RV dilation. A smaller proportion of patients have RVMI resulting from circumflex coronary artery occlusion in a left-dominant coronary system and rarely in association with left anterior descending coronary artery occlusion, in which this artery supplies collaterals to an otherwise underperfused anterior portion of the RV free wall. RVMI is associated with hemodynamic compromise in 25% to 50% of patients presenting with this infarct pattern. Early mortality is highest among patients (...) lead to acute RV strain as a result of pressure overload within minutes of occlusion of a major PA segment and is a common cause of ARHF. , Physical presentation often includes initial syncope or right-sided atrial arrhythmias. The prevalence of ARHF in the setting of acute PE ranges from 25% to 60%. , Predictors of RVD include >50% of the PA tree occluded by thrombus. Patients with evidence of RVD have a 2.4- to 3.5-fold increase in mortality compared with those without RVD. , Given the poor

2018 American Heart Association

187. 2018 IDSA Clinical Practice Guideline for the Management of Outpatient Parenteral Antimicrobial Therapy

infusion without home nursing offers another model of self-administered OPAT (S-OPAT). Here, a physician’s office provides training and supervision, either in private practice or in a clinic setting. Typically, patients make weekly visits to the office to collect supplies and undergo assessment and catheter dressing changes. Critical to the success of home-based OPAT is the presence of a competent and adherent patient and/or caregiver. Minimal features required for safe home infusion include adequate (...) antimicrobials at home. In the United States, once the patient has established infusion competency, the home care model generally includes a once-weekly visit by a nurse who performs clinical assessment, changes the VAD dressings, and draws blood for monitoring tests, with the option to visit patients’ homes more frequently if needed. In time, other models of care have evolved, including the use of various office or infusion center settings. However, the majority of OPAT in the United States continues

2018 Infectious Diseases Society of America

188. Management of acute (fulminant) liver failure

) required,despiteprofoundabnormalitiesinbloodtestsandphys- iology. In the majority of cases LTx will not alter the outcome. Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a very rare presentation and should always be con- sidered in those with fever, eosinophilia, marked cutaneous rash and lymphadenopathy. Sulphur containing compounds, some anticonvulsants and antimicrobials are more often associated withDRESS.Highdosesteroidtherapyshouldbeconsideredprior

2017 European Association for the Study of the Liver

189. Management of Diabetic Foot

of Treatment Appendix 10. Types of Wound Dressings 55 in Diabetic Foot List of Abbreviations 57 Acknowledgement 58 Disclosure Statement 58 Source of Funding 59Management of Diabetic Foot (Second Edition) i LEVELS OF EVIDENCE SOURCE: US / CANADIAN PREVENTIVE SERVICES TASK FORCE 2001 FORMULATION OF RECOMMENDATION In line with new development in CPG methodology, the CPG Unit of MaHTAS is adapting Grading Recommendations, Assessment, Development and Evaluation (GRADE) in its work process. The quality of each (...) of Diabetic Foot (Second Edition) d. Treatment • Appropriate analgesia should be considered in painful diabetic foot. • Antibiotics should be used as an adjunct to surgical debridement in infected diabetic foot. • Advanced wound dressings may be offered in diabetic foot ulcer. • Adjuvant therapy may be offered in delayed wound healing in diabetic foot with good vascularity. • Revascularisation should be offered in diabetic patients with peripheral arterial disease. • Surgical debridement by trained

2018 Ministry of Health, Malaysia

190. Short Term Effectiveness Study of Juxta-Fit Versus Trico Bandages in the Treatment of Leg Lymphedema

Short Term Effectiveness Study of Juxta-Fit Versus Trico Bandages in the Treatment of Leg Lymphedema Short Term Effectiveness Study of Juxta-Fit Versus Trico Bandages in the Treatment of Leg Lymphedema - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please (...) remove one or more studies before adding more. Short Term Effectiveness Study of Juxta-Fit Versus Trico Bandages in the Treatment of Leg Lymphedema The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT01068431 Recruitment Status : Completed First Posted : February 15, 2010 Last Update Posted : December 5

2010 Clinical Trials

191. Randomized clinical trial of different bandage regimens after foam sclerotherapy for varicose veins. (Abstract)

to 5 days of bandaging. Target vein occlusion rates at 6-week duplex imaging were 90 and 89 per cent respectively (P = 0.842). There was no significant difference in phlebitis after 2 weeks (P = 0.445) or skin discoloration after 6 weeks (46 versus 40 per cent; P = 0.546). There was no significant difference in the change in AVVSS from baseline to 2 weeks (-0.29 versus -0.80; P = 0.717) or to 6 weeks (-5.89 versus -5.14; 95 per cent confidence interval (c.i.) for the difference -3.29 to 1.80; P (...) Randomized clinical trial of different bandage regimens after foam sclerotherapy for varicose veins. This trial compared outcomes after foam sclerotherapy in patients wearing compression bandaging for 24 h or 5 days after treatment.Consecutive patients with primary uncomplicated varicose veins were randomized after foam sclerotherapy treatment. The primary endpoint was 6-week Aberdeen Varicose Vein Severity Score (AVVSS) and Burford pain score.Some 124 legs were randomized, 61 to 24 h and 63

2010 British Journal of Surgery Controlled trial quality: predicted high

192. Fractures (complex): assessment and management

. 1.1.9 Consider a saline-soaked dressing covered with an occlusive layer for open fractures in pre-hospital settings. 1.1.10 In the pre-hospital setting, consider administering prophylactic intravenous antibiotics as soon as possible and preferably within 1 hour of injury to people with open fractures without delaying transport to hospital. Splinting long bone fr Splinting long bone fractures of the leg in the pre-hospital setting actures of the leg in the pre-hospital setting 1.1.11 In the pre (...) . 1.2.21 Consider a saline-soaked dressing covered with an occlusive layer (if not already applied) for open fractures in the emergency department before debridement. 1.2.22 In the emergency department, administer prophylactic intravenous antibiotics immediately to people with open fractures if not already given. Limb salv Limb salvage in people with open fr age in people with open fractur actures es 1.2.23 Do not base the decision whether to perform limb salvage or amputation on an injury severity

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines

193. Major trauma: assessment and initial management

. 1.3.7 In patients with an open pneumothorax: cover the open pneumothorax with a simple occlusive dressing and and observe for the development of a tension pneumothorax. © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 6 of 231.4 Management of chest trauma in hospital settings Chest decompression of tension pneumothor Chest decompression of tension pneumothorax ax 1.4.1 In patients with tension pneumothorax, perform (...) X-ray and/or ultrasound for first-line imaging to assess chest trauma in children (under 16s). 1.4.7 Do not routinely use CT for first-line imaging to assess chest trauma in children (under 16s). 1.5 Management of haemorrhage in pre-hospital and hospital settings Dressings and tourniquets in pre-hospital and hospital settings Dressings and tourniquets in pre-hospital and hospital settings 1.5.1 Use simple dressings with direct pressure to control external haemorrhage. 1.5.2 In patients

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines

194. Implantation of a corneal graft-keratoprosthesis for severe corneal opacity in wet blinking eyes

by the titanium ring. The central portion of the patient's opaque cornea is removed and if the natural lens is in place, it is also removed. The corneal graft–keratoprosthesis is then transferred to the patient's corneal opening and secured with multiple interrupted sutures. Finally, a soft bandage contact lens is placed on the surface of the eye. 3.4 Postoperatively, patients wear a soft contact lens and use prophylactic antibiotic drops for the rest of their lives. In addition, topical steroids are usually (...) opacity in wet blinking eyes (IPG534) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 6 of 10device was extruded and therapeutic penetrating keratoplasties were performed, but vision deteriorated. In 2 eyes with wound rupture, suturing of the wound was done. Vision improved in 1 eye and in the other it was stable. 5.13 Occlusive vasculopathy (peripheral occlusive vasculitis and ischaemia of the entire retina

2015 National Institute for Health and Clinical Excellence - Interventional Procedures

195. Use of Vital Pulp Therapies in Primary Teeth with Deep Caries Lesions

to maintain the highest standard of care and to ensure patient safety. 41 It is also important that clinicians select the best post- operative restoration using their clinical expertise and individual patient preferences. Either intra-coronal restoration or a stainless steel crown (SSC) may be adequate to achieve a good marginal seal for single surface (occlusal) restorations on a primary tooth with a life span of two years of less; whereas for multi-surface restorations, stainless steel crowns

2017 American Academy of Pediatric Dentistry

196. Endovenous mechanochemical ablation (MOCA) (ClariVein infusion catheter, nonthermal vein ablation system Vascular Insights LLC) for treatment of varicose veins

is confirmed ultrasonically. Sclerosis of the vein activates the clotting system, resulting in formation of a thrombus and occlusion of the vessel. Patient Population: MOCA with the ClariVein Infusion Catheter is intended for the infusion of physician-specified agents in the peripheral vasculature. It is used in patients with varicose veins of the lower extremities. Clinical Alternatives: Alternative treatments for varicose veins are lifestyle changes (weight loss, exercise, and elevation of the limb (...) ), compression therapy with bandaging or other products, surgical vein stripping, sclerotherapy, RFA, EVLA, steam ablation, and n-butyl cyanoacrylate glue. Final publication URL The report may be purchased from: Indexing Status Subject indexing assigned by CRD MeSH Catheter Ablation; Humans; Methylenebis (chloroaniline); Varicose Veins; Veins Language Published English Country of organisation United States English summary An English language summary is available. Address for correspondence HAYES, Inc., 157 S

2017 Health Technology Assessment (HTA) Database.

197. Infantile haemangioma: topical timolol

. Emollients, non-adherent dressings, pain relief and antibiotics may also be required. Infantile haemangioma: topical timolol (ESUOM47) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 21In April 2014, an oral propranolol product, Hemangiol 3.75 mg/ml oral solution, received a Europe-wide marketing authorisation for the treatment of proliferating infantile haemangioma requiring systemic therapy. Hemangiol has not been (...) areas where resolution may be incomplete such as around the nose, lips or ears. If the haemangioma is ulcerating. If the haemangioma is interfering with important functions or development of the senses, such as feeding, breathing, hearing or vision. Treatments, which are generally off-label, can include topical, oral, intravenous or intralesional corticosteroids, topical timolol, oral propranolol, laser treatment or surgery. Emollients, non-adherent dressings, pain relief and antibiotics may also

2015 National Institute for Health and Clinical Excellence - Advice

198. CRACKCast E063 – Thermal Burns

’ manner Topical antimicrobials (e.g. neomycin, mupirocin, silver sulfadiazine) Nonadherent dressing Daily dressing exchange and gentle cleansing with water and soap The second method for burn management is with occlusive dressings Support a moist wound-healing environment Less pain as dressings are not exchanged daily Most appropriate for superficial partial-thickness burns with no signs of infection Dressing such as Mepilex or a nano-crystaline silver-containing occlusive dressing should be applied (...) sensitive areas (e.g. face, ears, joints, perineum, hands, feet) Escharotomy required [8] Describe basic burn dressing management ABC’s Analgesia, analgesia, analgesia Prevent hypothermia! Assume burns are contaminated: clean and debride gently Tetanus toxoid booster if eligible (>5 years since last) If the patient did not complete primary series, TIG Leave blisters intact, debride ruptured blisters Dressings for partial-thickness burns Clearly infected, purulent wounds should be managed in an ‘open

2017 CandiEM

199. Superficial Bacterial Skin Infections - Guidelines for Prescribing Topical Antibiotics for impetigo and folliculitis

to the area and helps the pustule to rupture and drain Do not squeeze the sores as this may cause the infection to spread Wash hands often and after touching affected area Avoid tight fitting clothing Shave in the direction of hair growth; avoid shaving affected area Sores may be covered with non-stick gauze dressings Try to minimize friction on affected areas 2) OTC drug options for superficial bacterial skin infections: These products have little evidence of efficacy for impetigo or folliculitis (...) bacteria. ( Level 1 [likely reliable] evidence ) Each gram of product contains 20mg mupirocin. The ointment is a water-soluble base which contains polyethylene glycol. The cream is an oil and water based emulsion Mupirocin penetrates outer layers of skin with minimal systemic absorption. Ointment provides a more occlusive treatment. If necessary, area can be covered with gauze Dosage: Apply sparingly to infected area, 2-3 times a day for 5 days. If no significant healing occurs after 48 hours refer

2017 medSask

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