Midlevel practitioners can safely place intracranial pressure monitors

Young, Pamela J.; Bowling, William M.

doi:10.1097/ta.0b013e318262437b

Cited by 38 publications

(26 citation statements)

References 7 publications

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“…5,6 Currently there are no treatments that effectively deal with internal hemorrhage, which must be reduced within minutes of injury to improve patient survival. In addition, to be practical for use by a first responder, a drug cannot require excessive special handling such as refrigeration to ensure that it remains safe and effective until use.…”

Section: Resultsmentioning

confidence: 99%

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Hemostatic Nanoparticles Improve Survival Following Blunt Trauma Even after 1 Week Incubation at 50 °C

Lashof-Sullivan

Mark

Groynom

et al. 2016

ACS Biomater. Sci. Eng.

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According to the CDC, the leading cause of death for both men and women between the ages of 5 and 44 is traumatic injury. Blood loss is the primary cause of death at acute time points post trauma. Early intervention is critical to save lives, and yet there are no treatments to stop internal bleeding that can be deployed in the field. In this work, we developed hemostatic nanoparticles that are stable at high temperatures (50 °C for 7 days) and are still effective at stopping bleeding and improving survival over the one hour time period in a rat liver injury model. These particles are exceptionally simple: PLA-based nanospheres functionalized with PEG terminated with variants of the RGD motif. This simple system can be stored at temperatures up to 50°C and maintain size, shape, and efficacy. The particles lead to a reduction in bleeding and increased acute survival with significance compared to both control particles and saline. Overall, these hemostatic nanoparticles offer an important step towards an immediate intervention in the field to stop bleeding and improve survival.

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Section: Resultsmentioning

confidence: 99%

“…For external bleeding, treatments such as dressings, absorbent materials, and tourniquets have been very successful 5–6 . However, there has been a lack of successful treatments for internal bleeding.…”

Section: Introductionmentioning

confidence: 99%

Hemostatic Nanoparticles Improve Survival Following Blunt Trauma Even after 1 Week Incubation at 50 °C

Lashof-Sullivan

Mark

Groynom

et al. 2016

ACS Biomater. Sci. Eng.

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“…16,17 Bevis and colleagues 16 reviewed thoracostomy tube placement in trauma patients, comparing procedures performed by PEs to those performed by trauma surgeons.…”

Section: Methodsmentioning

confidence: 99%

Physician extenders on surgical services: a systematic review

Johal

Dodd

2017

CJS

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Background: With the introduction of resident duty hour restrictions and the resulting in-house trainee shortages, a long-term solution to ensure safe and efficient patient care is needed. One solution is the integration of nurse practitioners (NPs) and physician assistants (PAs) in a variety of health care settings. We sought to examine the use of NPs and PAs on surgical/trauma services and their effect on patient outcomes and resident workload. Methods:We performed a systematic review of EMBASE, Medline, CINAHL, and the Cochrane Central Register of Controlled Trials. We included studies (all designs) examining the use of NPs and PAs on adult surgical and trauma services that reported the following outcomes: complications, length of stay, readmission rates, patient satisfaction and perceived quality of care, resident workload, resident work hours, resident sleep hours, resident satisfaction, resident perceived quality of care, other health care worker satisfaction and perceived quality of care, and economic impact assessments. We excluded studies assessing nonsurgical/trauma services or pediatrics and review articles.Results: Twenty-nine articles met the inclusion criteria. With the addition of NPs and PAs, patient length of stay decreased, and morbidity and mortality were unchanged. In addition, resident workload decreased, sleep time increased, and operating time improved. Patient and health care worker satisfaction rates were high. Several studies reported cost savings after the addition of NPs/PAs. Conclusion:The addition of NPs and PAs to surgical/trauma services appears to be a safe, cost-effective method to manage some of the challenges arising because of resident duty hour restrictions. More high-quality research is needed to confirm these findings and to further assess the economic impact of adding NPs and PAs to the surgical team.Contexte : Compte tenu de la réduction du nombre d'heures de travail des médecins résidents et de la pénurie de stagiaires qui en a résulté, une solution à long terme s'impose pour assurer la sécurité et l'efficacité des soins aux patients. Une solution consiste à intégrer des infirmières praticiennes (IP) et des adjoints aux médecins (AM) dans divers contextes de soins de santé. Nous avons voulu examiner l'incidence du recours aux IP et aux AM dans des services de chirurgie et de traumatologie et son effet sur la santé des patients et sur la charge de travail des médecins résidents.

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“…They are appointed for both in hospital as well as outpatient clinic tasks, ranging from invasive diagnostic procedures to consultation. For instance, literature has reported that invasive procedures like the placement of intracranial pressure monitors, ultrasound-assisted percutaneous liver biopsy and dermatologic surgical procedures are both feasible and safe in the hands of trained NPCs [15,16,17]. In the field of CRC, training programs for flexible sigmoidoscopy in the context of screening have been set up and are currently being evaluated [18,19,20].…”

Section: Discussionmentioning

confidence: 99%

Nonphysician Clinicians in the Follow-Up of Resected Patients with Colorectal Cancer

Braak¹,

Lalmahomed²,

Büttner³

et al. 2017

Dig Dis

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Background/Aims: The 5-year postoperative follow-up for patients undergoing curative treatment for colorectal cancer (CRC) is labour intensive. We assessed the added value of a dedicated nonphysician clinician (NPC) in the follow-up of patients after resection for CRC. Methods: Patients were divided into 2 groups as defined by the number of follow-up visits in the first year, including intensive (≥3×) and minimal (≤2×). Involvement of an NPC, diagnosis of disease recurrence and the course of the disease were determined. Results: Of the 681 patients, 79.9% belonged to the “intensive” and 21.1% to the “minimal” group. Involvement of an NPC resulted in a higher adherence to follow-up (84.3 vs. 73.9%, p = 0.001). Overall, patients in regular follow-up less often had multifocal recurrence (47.1 vs. 73.7%, p = 0.04), and a better survival after recurrence (SAR; hazard ratio [HR] 3.604, p < 0.001). The “intensive” group had a significantly better overall survival compared to the “minimal” group (HR 1.71, p = 0.013). Conclusion: Adherence to surveillance programs after resection for CRC is better in hospitals with a dedicated NPC. Overall, patients' adherence to follow-up resulted in less multifocal disease recurrence at the time of diagnosis as compared to patients presenting with symptoms and a better 3-year SAR.

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Midlevel practitioners can safely place intracranial pressure monitors

Abstract: ICP monitors can be safely placed by midlevel practitioners with major complication rates not different from those of neurosurgeons.

Cited by 38 publications

References 7 publications

Hemostatic Nanoparticles Improve Survival Following Blunt Trauma Even after 1 Week Incubation at 50 °C

Hemostatic Nanoparticles Improve Survival Following Blunt Trauma Even after 1 Week Incubation at 50 °C

Physician extenders on surgical services: a systematic review

Nonphysician Clinicians in the Follow-Up of Resected Patients with Colorectal Cancer

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