Relation of body position at the time of discovery with suspected aspiration pneumonia in poisoned comatose patients

Adnet, Frédéric; Borron, Stephen W.; Finot, Marie‐Agnès; Minadeo, John; Baud, Frédéric J.

doi:10.1097/00003246-199904000-00028

Cited by 45 publications

(38 citation statements)

References 15 publications

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“…• Very-low-quality evidence (downgraded for imprecision) from 1 observational study 98 with 26 subjects showing no difference in plasma volume change (%) at 3 hours after hydration with CE solution; 1 observational study of very-low-quality evidence 99 (downgraded for imprecision) with 26 subjects showing a benefit with CE solution with increased plasma volume change (%) at 4 hours (MD,11; 95% CI,).…”

Section: % To 8% Ce Solution (I) Compared With Water (C)mentioning

confidence: 99%

“…For the critical outcome of the incidence of aspiration, we identified very-low-quality evidence (downgraded for imprecision) from 1 observational study with a total of 142 patients 11 found in the left lateral decubitus or supine position demonstrating no benefit to being in the left lateral position (relative risk [RR], 0.93; 95% confidence interval [CI], 0.55-1.58). The same observational study had a total of 132 patients found in the right lateral decubitus or supine position and demonstrated no benefit to being in the right lateral position (RR, 1.15; 95% CI, 0.67-1.96).…”

Section: Lateral Side-lying Recovery Position Compared With Supine Pmentioning

confidence: 99%

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Part 9: First Aid

Em¹,

Da²,

Buck³

et al. 2015

Circulation

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and curriculum development, and a specialist in first aid evidence evaluation methodology and guideline development.The task force convened in June 2013 to review the topics and questions that were evaluated in 2005 and 2010, past research questions formulated in the PICO style (population, intervention, comparator, outcomes) that were never completed, and the new questions that had been submitted since 2010 to the task force, and a priority list created. Topics were reviewed for areas of controversy, known additional new science, and subject matter not previously evaluated. Task force members created a priority list for review, and the top 10 priority-ranked PICO questions were assigned. After the successful commencement of the workflow, the task force co-chairs added a further 12 PICO questions, including 5 new questions, 1 derived question, and 6 that had been previously reviewed. Selected PICO questions that had been previously reviewed were, in some cases, reworded to facilitate literature searches, and outcomes were decided upon by group consensus.Evidence reviewers were recruited through a call for volunteers distributed by ILCOR to stakeholder organizations around the world. More than 30 individual reviewers were assigned to topics, usually by preference or expertise, but avoiding any direct conflicts of interest. In general, 2 evidence reviewers were assigned to each PICO, supervised by a member of the task force designated as the task force question owner. Evidence reviewers included physicians with diverse specialties including emergency medicine, EMS, wilderness medicine, critical care, cardiology, occupational medicine, toxicology, anesthesia, pediatric emergency medicine, public health, and epidemiology, as well as paramedics, nurse practitioners and first aid education specialists with experience in guideline and curriculum development, and professional evidence evaluation and methodology experts. The Evidence Evaluation ProcessFor the 2015 international evidence evaluation process, the AHA developed a new Web-based information and documentation platform, the Systematic Evidence Evaluation and Review System (SEERS), to support the ILCOR systematic reviews and to capture the data in reusable formats. This Webbased system facilitated structured reviews in a consistent format that would support the ultimate development of science summaries and evidence-based treatment recommendations.Each task force performed a detailed systematic review based on the recommendations of the Institute of Medicine of the National Academies, 1 using the methodological approach proposed by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Working Group.2 After identifying and prioritizing the PICO questions to be addressed, 3 and with the assistance of information specialists, a detailed search for relevant articles was performed in each of 3 online databases (PubMed, Embase, and the Cochrane Library).By using detailed inclusion and exclusion criteria, articles were screened for further evalu...

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Section: % To 8% Ce Solution (I) Compared With Water (C)mentioning

confidence: 99%

Section: Lateral Side-lying Recovery Position Compared With Supine Pmentioning

confidence: 99%

Part 9: First Aid

Em¹,

Da²,

Buck³

et al. 2015

Circulation

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“…Etliche verschiedene Seitenlagenpositionen sind verglichen worden, aber insgesamt konnten keine signifikanten Unterschiede zwischen ihnen identifiziert werden [812][813][814]. Lagern Sie bewusstlose Personen mit erhaltener Spontanatmung in stabiler Seitenlage und lassen Sie sie nicht in Rücken-lage liegen.…”

Section: Lagerung Einer Bewusstlosen Person Mit Erhaltener Atmungunclassified

Kurzdarstellung

Monsieurs

Nolan

Bossaert

et al. 2015

Notfall Rettungsmed

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“…Four LOE 5 studies 46 -49 supported the lateral recumbent recovery position because it was easier for the rescuer and more comfortable for the victim. One LOE 4 50 and 1 LOE 5 51 study compared the supine to a lateral position and concluded that there was no difference in heart rate variability or in risk for aspiration pneumonia.…”

Section: Treatment Recommendationmentioning

confidence: 99%

Part 13: First Aid

Markenson¹,

Ferguson²,

Chameides³

et al. 2010

Circulation

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The International First Aid Science Advisory Board identified 38 questions in first aid practice that had not been subjected to an evidence review process or that needed to be updated since the 2005 process. Two or more members of the International First Aid Science Advisory Board volunteered to independently review the scientific literature and complete an evidence-based review worksheet summarizing the literature (see Part 2 of this supplement for additional information). After the evidence was presented to the full board, a draft consensus summary of the scientific evidence and a draft consensus treatment recommendation were developed and represented at a subsequent meeting. Thus, each question, evidence-based review, draft summary of science, and draft treatment recommendation was presented and discussed on 2 separate occasions, and a Consensus on Science and Treatment Recommendation was reached by the Board. This document is a report of the group's consensus.As in 2005, the worksheets revealed the continuing paucity of scientific evidence to support specific first aid interventions. Very little research is being conducted in first aid, and most of the recommendations are extrapolations from research and experience in other medical venues, animal studies, and case series. It is hoped that this document will be a stimulus to future research in first aid. First Aid for Medical Emergencies SummaryThe medical questions addressed include poisoning, anaphylaxis, oxygen administration, and aspirin administration for a suspected coronary event.No changes were recommended for first aid management of acute poisoning.In reviewing epinephrine administration for anaphylaxis, evidence was found that laypeople and some medical and prehospital professionals are unable to recognize the signs and symptoms of anaphylaxis and therefore cannot, without training, make an independent decision to administer epinephrine with an auto-injector or to administer a second dose if the first is not effective. This issue takes on added importance in view of legislation in some jurisdictions that permits these actions.No evidence was found, except in decompression injuries, to support the routine administration of oxygen by first aid providers.The administration of aspirin to a victim experiencing chest discomfort is problematic. The literature is clear on the benefit of early administration of aspirin in an acute coronary event, except when there is a clear contraindication, such as aspirin allergy or a bleeding disorder. Less clear, however, is whether first aid providers can recognize the signs and symptoms of an acute Consensus on ScienceThere are no human studies on the effect of treating oral caustic exposure with dilution therapy. One in vitro LOE 5 chemistry study 2 demonstrated no benefit from the addition of large volumes of diluent to either a strong base or a strong acid. Five LOE 5 animal studies 3-7 demonstrated histological benefit to the esophagus when a diluent was administered following exposure to an alkali or acid. Treat...

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Relation of body position at the time of discovery with suspected aspiration pneumonia in poisoned comatose patients

Abstract: The prone position appears to be associated with a lower incidence of SAP than the lateral decubitus position in comatose poisoned patients.

Cited by 45 publications

References 15 publications

Part 9: First Aid

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