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21. Covid-19: Guidance review for emergency medical dispatch centres

of the present review is to identify, classify and summarise international guidance on this particular topic in order to inform the development of guidance by the National Ambulance Service. The focus of this review is on guidance published by national-level health and emergency services authorities and professional associations, and lessons learned from the operation of emergency medical dispatch centres, in the midst of COVID-19 or other recent respiratory virus epidemics or pandemics. Methods

2020 Health Information and Quality Authority

22. Rapid review - public health guidance for residential care facilities

) In addition to testing for COVID-19, the CDC recommends that clinicians should consider testing symptomatic residents for other causes of respiratory illness, such as influenza. The CDC, as part of their guidance, have published a number of core practices that should remain in place as RCFs resume normal activities. (8) These core practices are: assign one or more individuals with training in infection control to on-site management of the IPC Program; report cases, facility staffing and information (...) the specific risks for them and others should be undertaken for the person’s care, and this same risk assessment should be applied for people visiting the resident. If visors or clear face coverings are available, they can be considered as part of the risk assessment. It is strongly stated that this assessment should not be applied to a whole care setting. All visitors should be screened for symptoms of acute respiratory infection before entering: no one who is currently experiencing, or first experienced

2020 Health Information and Quality Authority

23. Covid-19: Rapid review of protective measures for vulnerable people

immunotherapy or other continuing antibody treatments for cancer o people having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors o people who have had bone marrow or stem cell transplants in the last six months, or who are still taking immunosuppression drugs. ? People with severe respiratory conditions including cystic fibrosis, severe asthma, pulmonary fibrosis or lung fibrosis or interstitial lung disease and severe COPD ? People (...) kinase inhibitors or PARP inhibitors o people who have had bone marrow or stem cell transplants in the last six months, or who are still taking immunosuppression drugs. ? People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe Chronic Obstructive Pulmonary Disease (COPD), severe bronchiectasis and pulmonary hypertension. People in this group include: o people with cystic fibrosis o people on home oxygen for a lung condition. o people with severe asthma

2020 Health Information and Quality Authority

24. Evidence summary for airborne transmission of SARS-CoV-2 via aerosols

of respiratory viruses is typically through three modes: contact, droplet (typically >5µm diameter) and or aerosol (typically = 5µm diameter). This review concentrates on the potential airborne transmission of SARS-CoV-2 via aerosols. ? Each mode of transmission, and the degree to which it contributes to the overall spread of SARS-CoV-2, has important connotations for public health guidance. This is particularly true with regards to healthcare precautions and personal protective equipment use. ? This review (...) Expert Advisory Group (EAG) in supporting the National Public Health Emergency Team (NPHET) in their response to COVID-19. These summaries are based on specific research questions. This review was developed to address the following research question: Does airborne transmission via aerosols contribute to the spread of SARS-CoV-2? Background Transmission of respiratory viruses is typically through three modes: contact, droplet and or aerosol. (1-3) Contact transmission can be direct

2020 Health Information and Quality Authority

25. NZSHS Syphilis in Pregnancy Guideline

in decreasing frequency of occurrences are: Features of early congenital syphilis Hepatomegaly with or without splenomegaly Radiographic bone changes (periostitis; osteochondritis); pseudoparalysis of Parrot Lymphadenopathy Jaundice Rash Hepatitis (elevated transaminase concentrations) Anemia and/or thrombocytopenia Respiratory distress (pneumonia) Fever Syphilis in Pregnancy Sept 2020 V1 10 Features of early congenital syphilis Small for gestational age; Birth weight 20 weeks of pregnancy • It is important (...) Chest X-Ray (cardiomegaly) o Neuroimaging o Ophthalmologic (interstitial keratitis) o Formal audiology examination (sensorineural (8 th ) nerve deafness) • Infection control of neonate Gloves should be worn for handling babies with suspected congenital syphilis as moist open lesions of skin and mucous membranes, secretions and possibly blood are contagious until 24hrs of penicillin treatment has been completed. Released 2020 11.1 Infant assessment and management summary (infants 4 weeks before

2020 New Zealand Sexual Health Society

26. Implantable cardiac monitors to detect atrial fibrillation after cryptogenic stroke

atrial fibrillation after cryptogenic stroke (DG41) © NICE 2020. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 6 of 50people are diagnosed with atrial fibrillation, they can then be offered anticoagulant therapy to reduce the risk of having another stroke or TIA. 2.4 The monitors are implanted under the skin of the person's chest using a small incision under local anaesthetic. They can continuously monitor heart rhythm

2020 National Institute for Health and Clinical Excellence - Diagnostics Guidance

27. High-sensitivity troponin tests for the early rule out of NSTEMI

high-sensitivity troponin tests are recommended as options for the early rule out of non-ST-segment elevation myocardial infarction (NSTEMI) in people presenting to an emergency department with chest pain and suspected acute coronary syndrome: • Access High-Sensitivity Troponin I Assay • ADVIA Centaur High-Sensitivity Cardiac Troponin-I Assay • Alinity High Sensitive Troponin-I assay • ARCHITECT STAT High Sensitive Troponin-I assay • Atellica IM High-Sensitivity Cardiac Troponin I Assay • Dimension (...) of 99th percentile thresholds or thresholds at or near the limit of detection of the assay. Healthcare professionals should consider the likely time since the onset of symptoms when interpreting test results. 1.3 When NSTEMI is not ruled out using early rule-out test strategies, use NICE's guideline on recent-onset chest pain of suspected cardiac origin to help diagnose myocardial infarction, and consider using sex-specific thresholds at the 99th percentile (see section 4.7 and section 5.2). 1.4

2020 National Institute for Health and Clinical Excellence - Diagnostics Guidance

28. COVID-19 Risks and Precautions for Choirs Full Text available with Trip Pro

produces a higher concentration of particles than breathing. 22 Respiratory particles released by vocalization are generated by a combination of mechanisms in the bronchioles, larynx, and oral cavity. As air is exhaled from the bronchioles, the mucosal layer on the collapsed surfaces forms a continuous film. During inhalation, this continuous film is torn apart by incoming air, forming small particles (fluid-film burst) that are inhaled into the lungs, and subsequently exhaled. In the larynx (...) breathing and talking. Indoor Air. 2010;20(1):31-9. Available from: . Kang J, Scholp A, Jiang JJ. A review of the physiological effects and mechanisms of singing. J Voice. 2018 Jul;32(4):390-5. Available from: . Johnson GR, Morawska L. The mechanism of breath aerosol formation. J Aerosol Med Pulmon Drug Del. 2009 2009;22(3):229-37. Available from: . Irzaldy A, Wiyasihati SI, Purwanto B. Lung vital capacity of choir singers and nonsingers: a comparative study. J Voice. 2016 Nov;30(6):717-20. Available

2020 National Collaborating Centre for Environmental Health

29. 2020 Adult Congenital Heart Disease (previously Grown-Up Congenital Heart Disease) (Management of) Guidelines

coronary artery from the pulmonary artery; AS = aortic stenosis; ASD = atrial septal defect; AV = atrioventricular; AVSD = atrioventricular septal defect; BNP = B-type natriuretic peptide; ccTGA = congenitally corrected transposition of the great arteries; CHD = congenital heart disease; CMR = cardiovascular magnetic resonance; EF = ejection fraction; HTAD = heritable thoracic aortic disease; IART = intraatrial reentrant tachycardia; ICD = implantable cardioverter defibrillator; L–R = left-to-right; LV (...) with a functionally single ventricle) Truncus arteriosus Other complex abnormalities of AV and ventriculoarterial connection (i.e. crisscross heart, heterotaxy syndromes, ventricular inversion). ASD = atrial septal defect; AV = atrioventricular; AVSD = atrioventricular septal defect; CHD = congenital heart disease; HTAD = heritable thoracic aortic disease; LV = left ventricle/ventricular; PA = pulmonary artery; PAP = pulmonary artery pressure; PDA = patent ductus arteriosus; VSD = ventricular septal defect. Table

2020 European Society of Cardiology

30. Nutrition screening and use of oral nutrition support for adults in the acute care setting

effects of undernutrition is presented in Table 5 below. Malnutrition effects Physical and psychosocial impact Impaired immune response Impaired ability to fight infection. Reduced muscle strength and fatigue Inactivity and reduced ability to work, shop, cook and self-care. Poor muscle function may result in falls, and poor respiratory muscle function may result in poor cough pressure - delaying expectoration and recovery from chest infection. Inactivity In bed-bound patients this may result (...) temperature spikes - Wet voice quality - Tongue fasciculation (may be indicative of motor neurone disease) - Xerostomia - Heartburn - Change in eating habits - for example, eating slowly or avoiding social occasions - Frequent throat clearing - Recurrent chest infections - Atypical chest pain6 | Nutrition screening and use of oral nutrition support for adults in the acute care setting | National Clinical Guideline Recommendation 12 Healthcare professionals should recognise that people with acute

2020 National Clinical Guidelines (Ireland)

31. Covid-19: Remdesivir (trade name: Veklury) and Favipiravir (trade name: Avigan Tablet)

showed tendency to improve symptoms in both groups although the difference was not significant. However, it is not consistent with the rate of discontinuation due to severe respiratory adverse events and viral elimination. Adverse events tended to occur more frequently in the remdesivir group with 11.6% than in the placebo group 5.1% in the placebo group (p=0.12). Especially, the number of patients who discontinued due to acute lung Page 42 · MED CHECK August 2020/ Vol.6 No.18 injury/acute (...) respiratory distress syndrome (ARDS) was higher in the remdesivir group (7 patients, 4.5%) than in the placebo group (1 patient, 1.3%) (p=0.20). Acute lung injury and ARDS are the most important conditions that indicate severe COVID-19. While symptoms, including respiratory symptoms, improved, more severe respiratory symptoms were observed as adverse events in the remdesivir group. We cannot explain such contradicting results. (Supplementary slides 15,16) Moreover, since remdesivir is an antiviral agent

2020 Med Check - The Informed Prescriber

32. A Clinical Prediction Rule to Identify Febrile Infants 60 Days and Younger at Low Risk for Serious Bacterial Infections

procalcitonin which would include CRP and ESR as well as bandemia which may indicate infection in the acute setting. Authors state that PCT has demonstrated superior accuracy over CRP as reason for excluding. Other causes of serious viral (non-bacterial) infections in this age group, which could include a respiratory viral panel (RSV, enterovirus, influenza) and viral CSF panel/cultures for HSV. Age group based on gestational age taking into account pre- mature infants were excluded. 2b. Were all important (...) this prediction rule does remove much of the subjective bias from prior prediction rules such as that contained in the “step by step” with the use of the pediatric assessment triangle (appearance, work of breathing, circulation) there still is some subjective bias as only “non-toxic” patients were included in this study which may lead to some (albeit likely mild) variation in interpretation among clinicians. 2. Patients were enrolled based on the convenience research coordinator availability. 3. Biomarkers

2020 Emergency Medicine Journal Club

33. Masks for Prevention of COVID-19 in Community and Healthcare Settings: A Living Rapid Review

use is possibly associated with decreased risk versus less consistent use. No new evidence No change in conclusions Healthcare settings: N95 respirators are possibly associated with decreased risk versus surgical masks. No new evidence No change in conclusions KQ 1. Effectiveness – influenza, influenzalike illness, and other viral respiratory illness (excluding pandemic coronaviruses) Community settings: Possibly no difference between an N95 respirator or equivalent versus surgical mask. No new (...) controlled trials. • Discomfort, breathing difficulty, and skin issues common with N95 respirators and masks. No new evidence No change in conclusions KQ 2. Extended or reuse of N95 respirators No evidence No new evidence No evidence Evidence Summary No study in the original review evaluated effects of mask use in the community and risk of SARS-CoV-2 infection. One new observational study 1 on mask use and risk of SARS-CoV-2 infection in community settings was identified for this surveillance report

2020 Effective Health Care Program (AHRQ)

34. The Evidence Base for Telehealth: Reassurance in the Face of Rapid Expansion During the COVID-19 Pandemic Full Text available with Trip Pro

of telehealth for: Remote, home monitoring for patients with chronic conditions, such as chronic obstructive pulmonary disease and congestive heart failure Communicating and counseling patients with chronic conditions Providing psychotherapy as part of behavioral health Our second report, , built on the evidence map and synthesized evidence from research published between 1996 and May 2018 on the use of technology to facilitate collaboration among clinicians across time and/or distance. Based on findings (...) . Systems that allowed images or data (e.g., electrocardiogram [EKG], electroencephalogram [EEG]) to be quickly shared and interpreted produced positive results. Fewer heart attack patients died when consultations based on transmitted data were provided to EMS personnel in the field or during transport, and it is plausible this could be generalizable to emergency care of patients in respiratory distress, given that measures of respiration and oxygenation are the first step in current trauma triage

2020 Effective Health Care Program (AHRQ)

35. Rapid review of the effectiveness and safety of treatments for COVID-19 and other coronaviruses that cause serious respiratory tract infections

Rapid review of the effectiveness and safety of treatments for COVID-19 and other coronaviruses that cause serious respiratory tract infections DSEN Abstract: Effectiveness and safety of treatments for COVID-19 and other coronaviruses: A rapid scoping review - CIHR Language selection Search and menus Search Search website Search Topics menu You are here: DSEN Abstract Effectiveness and safety of treatments for COVID-19 and other coronaviruses: A rapid scoping review *This research was funded

2020 Drug Safety and Effectiveness Network

36. Practice guidelines for Canadian neurophysiology laboratories during the COVID-19 pandemic

are based on expert opinion and review of relevant published guidelines. 141 These guidelines are not intended to replace institutional, regional, or provincial protocols. 142 143 Background: 144 Named ‘SARS-CoV-2’ by the Coronaviridae Study Group, the coronavirus causing the current 145 pandemic is responsible for the third outbreak of acute respiratory syndrome in the last two 146 decades after the SARS in 2003 and the MERS in 2012 20 . The disease caused by this coronavirus 147 is known as ‘COVID-19 (...) ’ and the full spectrum of its symptomatology and pathophysiology is 148 yet to be defined. As its name implies the respiratory symptoms (cough, fever, and dyspnea) are 149 present in more than 60% of hospitalized patients and is the main cause of death 21 . It is clear that 150 staff in the neurophysiology laboratory will be exposed to COVID-19 due to the nature of this 151 disease. The reported neurological manifestations include a wide range of symptoms and signs 152 such as headaches, anosmia and ageusia

2020 CPG Infobase

37. Clinical management of patients with COVID-19: second interim guidance

of pneumonia can be made on clinical grounds; chest imaging (radiograph, CT scan, ultrasound) may assist in diagnosis and identify or exclude pulmonary complications. Severe pneumonia Adolescent or adult : fever or suspected respiratory infection, plus one of the following: respiratory rate > 30 breaths/min; severe respiratory distress; or SpO 2 < 90% on room air (adapted). Child with cough and/or difficulty in breathing, plus at least one of the following: central cyanosis or SpO 2 < 90%; severe (...) respiratory distress (for example, grunting, marked chest indrawing); signs of pneumonia with: inability to breastfeed or drink, lethargy or unconsciousness, or convulsions. Other signs of pneumonia may be present: fast breathing (in breaths/min) < 2 months: ≥ 60; 2 to 11 months: ≥ 50; 1 to 5 years: ≥ 40. Chest imaging may identify some pulmonary complications. Acute respiratory distress syndrome (ARDS) Onset : within 1 week of a known clinical insult or new or worsening respiratory symptoms. Chest

2020 Public Health Agency of Canada

38. Adrenocortical carcinomas and malignant phaeochromocytomas: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up Full Text available with Trip Pro

phaeochromocytoma Evidence of thoracic metastases? Chest CT (or PET/CT including full-dose CT) All PPGL patients with a ‘high risk of metastases’ a Evidence of cerebral metastases? Cerebral MRT Only if cerebral metastases are suspected Evidence of bone metastases FDG-PET/CT, DOTATATE-PET/CT, bone scan, bone CT or bone MRI Only if skeletal metastases are suspected b Additional functional imaging? At least one functional whole-body imaging (i.e. FDG-PET, DOTATATE-PET, MIBG scintigraphy) In all PPGL patients (...) and steroid precursors excess? – DHEA-S – 17-OH-progesterone – Androstenedione – Testosterone (only in women) – 17-beta-estradiol (only in men and postmenopausal women) – 11-deoxycortisol (if available) Any adrenal mass suspected to be an ACC Mineralocorticoid excess? – Potassium – Aldosterone/renin ratio Any adrenal masses with hypertension and/or hypokalaemia Extension of the adrenal tumour and evidence for metastases? CT or MRI of abdomen, pelvis and chest (or FDG-PET/CT including full-dose CT) All

2020 European Society for Medical Oncology

39. Imlifidase (Idefirix) - kidney transplants

transplantation. A total of 16 patients had a functioning kidney 6 months after transplantation. Additional data on the benefits of Idefirix came from three supportive studies. Analyses of the data from all four studies showed that 43 out of a total of 46 patients had a functioning kidney 6 months after transplantation. What are the risks associated with Idefirix? The most common side effects with Idefirix (which may affect more than 1 in 10 people) are infections, including pneumonia (infection of the lungs

2020 European Medicines Agency - EPARs

40. Ivacaftor / tezacaftor / elexacaftor (Kaftrio) - cystic fibrosis

to make lung mucus and digestive juices less thick, thereby helping to relieve symptoms of the disease. What benefits of Kaftrio have been shown in studies? Kaftrio taken together with ivacaftor was effective at improving lung function in two main studies in patients with cystic fibrosis aged 12 years and above. The main measure of effectiveness was ppFEV1, which is the maximum amount of air a person can breathe out in one second compared with values from an average person with similar characteristics (...) / elexacaftor) An overview of Kaftrio and why it is authorised in the EU What is Kaftrio and what is it used for? Kaftrio is a medicine used to treat patients aged 12 years and above who have cystic fibrosis, an inherited disease that has severe effects on the lungs, the digestive system and other organs. Cystic fibrosis can be caused by various mutations (changes) in the gene for a protein called ‘cystic fibrosis transmembrane conductance regulator’ (CFTR). People have 2 copies of this gene, one inherited

2020 European Medicines Agency - EPARs

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