This study is being done to evaluate the impact that monitored anesthetic care (MAC) versus general endotracheal anesthesia (GETA) has on hospital length of stay, rate of ICU admission, or procedural mortality. Also, we hope to determine if the use of Transesophageal Echocardiography (TEE) during GETA impacts device success and durability. Adult patients undergoing transfemoral approach TAVR for aortic valve stenosis may be eligible candidates for this study.
This study seeks to identify the impact of structured communication between Registered nurses (RNs) and Unlicensed Assistive Personnel (UAP) to decrease the fall rate and number of injurious falls on a Medical-Surgical unit. A seven item tool addressing fall risks (pocket card) will be utilized to communicate fall risks on admission, at hand off of care, and every 4 hrs.
Pain control after tonsillectomy is imperative but often difficult. Current post-operative pain medication regimens include opioid analgesics and are often still inadequate. Though not standard of care, it is our practice to prescribe a single dose of oral steroid medication on the third day after surgery, when pain and swelling are at their peak, in order to assist with pain control and reduce opioid consumption. Though this practice has a rational theoretical basis, there is no prospective data supporting or discounting it. We aim to compare pain control, opioid consumption, and complication rates in children receiving post-operative steroids versus those who do not.
The purpose of this study is to test whether the study drug (QPI-1002) prevents Major Adverse Kidney Events (MAKE) after heart surgery in adult patients who are at high risk of developing Acute Kidney Injuries (AKI). This study is a one-time infusion of the study drug (QPI-1002) with follow-up visits lasting for one year.
Venous thromboembolism, which includes both deep vein thrombosis (DVT) and pulmonary embolism (PE), is a common complication after injury. PE carries a mortality rate of 11% and is the third leading cause of death after injury. Traditionally, PE has been thought to originate from a clot in the lower extremities or vena cava that migrates to the lungs. However, with the liberal use of computed tomography after injury, many small thrombi (pulmonary thrombi or PT) are being found in the pulmonary arteries that may be de novo clots that arise due to pulmonary injury or inflamation. This novel finding has major implications for both prophylaxis and treatment. The CLOTT study group that includes 17 investigators from 17 major trauma centers could not come to a consensus as to the treatment of asymptomatic PT. This prospective observational multicenter study will collect data from seriously injured patients who develope PE/PT admitted to any of our 17 trauma centers without altering the standard of care at any center allowing us to compare two treatment patterns: anticoagulation versus observation. If this study supports our hypothesis that occult PT do not need specific treatment, it would have a major impact on practice patterns and would prevent overtreatment in a large number of injured patients.
This study will focus on collecting coded patient data from pediatric traumas prospectively. Data will be collected to assess inclusion of patients that fit the inclusion criteria of <18 years old with an elevated shock index based on age (Form A). There will also be a post-resuscitation data collection to examine products given to pediatric patients with an elevated shock index (Form B).
These data collection forms will help us determine the impact on primary outcomes of crystalloid administration volume and timing prior to blood products in children presenting in shock following trauma.
We will assess patient factors that predict need for early transfusion of blood products and clotting factors in pediatric trauma patients presenting in shock. We will also relate primary outcomes to ratio of blood products in pediatric trauma patients in shock who are transfused. We will also evaluate the role of clotting factor administration on coagulation studies. This study will help define variability in pediatric trauma fluid and blood resuscitation practices between centers.
Transcranial direct current stimulation (tDCS) has shown the potential to improve symptoms in patients with motor deficits, however its effects have not been consistent in randomized studies to date, limiting widespread adoption of this technology. A critical gap in our knowledge is a detailed understanding of how tDCS affects motor areas in the brain. We propose using tDCS while recording directly from motor cortex using subdural electrocorticography (sECoG) in patients undergoing deep brain stimulation surgery. We expect this novel approach to broaden our understanding of tDCS application and possibly lead to therapeutic advances in this population.
The purpose of this research study is to find out if a nerve block named quadratus lumborum block (QL) can provide better pain relief than having no nerve block for patients having their surgery on their hip through several small incisions while the surgeon looks with a camera (hip arthroscopy).
The purpose of this study is to compare post operative pain control with the use of two nerve blocks, quadratus lumborum and transversus abdominis plane block, after elective laparoscopic abdominal surgery.
This study will compare the safety and effectiveness of a new facemask, the Tao mask, as compared to the standard mask for manual ventilation of patients with BMIs of 40 or greater who are undergoing elective surgery. The Tao mask and the standard mask will both be used for each patient but the order of evaluating the masks will be randomized.