Articles Tagged With:
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Does Maternal BMI Influence the Success of Trial of Labor After Cesarean?
In this retrospective cohort study between May 2007 and April 2016, women undergoing a trial of labor after cesarean (TOLAC) were analyzed to determine if pre-pregnancy or delivery obesity status made an impact on TOLAC success. Overall, maternal body mass index did not have a significant effect on TOLAC success rates.
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Tranexamic Acid for the Prevention of Obstetric Hemorrhage
In this prospective, cohort, pharmacokinetic-pharmacodynamic (PKPD) dose-finding study by Ahmadzia and colleagues, 30 pregnant women (10 women in each study arm) received 5 mg/kg, 10 mg/kg, or 15 mg/kg doses of tranexamic acid for the prevention of postpartum hemorrhage. Advanced PKPD modeling demonstrated that 600 mg of tranexamic acid was the optimal dose to use in the prevention of postpartum hemorrhage.
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Effective Remote Communication Improves End-of-Life Care
Even in the post-COVID-19 era, the remote communication techniques that were an invention of necessity during the pandemic likely will remain.
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Poor Agreement Between ED Patients and Physicians on Goals of Care
Ideally, goals of care discussions do not happen for the first time when the patient presents to the ED. When goals of care conversations are held earlier in a patient’s disease course, advance care planning is possible. This can alleviate the use of aggressive interventions in the event the patient decompensates or does not make a meaningful recovery.
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Evolving Efforts to Integrate Critical Care and Palliative Care
Palliative care should be integrated into serious illness care at any point following diagnosis. This can happen in conjunction with curative treatment, or as a standalone intervention focused on comfort at the end of life.
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Controversy Developing Over Vaccine Passports
Concerns are emerging about individual rights, equal access, and how anyone would enforce mandates.
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New Data on Pediatric Clinical Ethics Consults
Pediatric cases involve, at a minimum, three stakeholders: The patient, the parents, and the healthcare team. This decision-making triad can lead to a multitude of ethical quandaries.
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Ethicists Challenged to Respond to Physicians’ Inappropriate Behavior
If a physician yells at a nurse or patient because of a disagreement over the treatment plan, involvement by human resources or another department is needed. But if a physician’s belligerence or disrespect affects someone’s decision-making, that is an ethical problem.
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Clinicians Reveal Why They Never Request Ethics Consults
Some clinicians request an ethics consult once, but never again. Others never call ethics a single time in their entire careers. Ethicists are left to wonder why.
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Pediatric Procedural Sedation and Analgesia in the Emergency Department
Children in the acute care setting may require nonpharmacologic and pharmacologic adjuncts for anxiety, pain, or to successfully complete diagnostic testing or therapeutic interventions. The authors review the requirements and pharmacologic agents necessary to complete a successful pediatric procedural sedation and analgesia.