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604 results on '"Tsai, Min-Shan"'

5. Improving Outcomes After Post–Cardiac Arrest Brain Injury: A Scientific Statement From the International Liaison Committee on Resuscitation

Author

Perkins, Gavin D., Neumar, Robert, Hsu, Cindy H., Hirsch, Karen G., Aneman, Anders, Becker, Lance B., Couper, Keith, Callaway, Clifton W., Hoedemaekers, Cornelia W.E., Lim, Shir Lynn, Meurer, William, Olasveengen, Theresa, Sekhon, Mypinder S., Skrifvars, Markus, Soar, Jasmeet, Tsai, Min-Shan, Vengamma, Bhuma, and Nolan, Jerry P.

Published
2024
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19. The Outcomes of the Initial Misclassification of Undifferentiated Hypotension in the Emergency Department: A Prospective Observational Study.

Author

Lin, Jr-Jiun, Chen, Wei-Ting, Ong, Hooi-Nee, Hung, Chi-Sheng, Chang, Wei-Tien, Huang, Chien-Hua, and Tsai, Min-Shan

Subjects
LOGISTIC regression analysis, HYPOVOLEMIC anemia, HOSPITAL emergency services, HOSPITAL mortality, ODDS ratio
Abstract

Background: Managing shock, a life-threatening emergency, is challenging. The influence of the initial misclassification of undifferentiated hypotension (UH) in the emergency department (ED) on patients' outcomes remains uninvestigated. The aim of this study was to investigate whether the initial misclassification of UH in the ED affects patients' clinical outcomes. Materials and Methods: This prospective observational study enrolled 270 non-traumatic adult patients with UH who had visited the ED of National Taiwan University Hospital between July 2020 and January 2022. The patients were divided into same-diagnosis and different-diagnosis groups, depending on the consistency between the initial and final classifications of shock. The outcome was survival to discharge. The clinical variables, management, and outcomes were compared between the groups. Results: A total of 39 of 270 patients (14.4%) were in the different-diagnosis group. Most misclassified patients were initially diagnosed as having hypovolemic shock (HS, n = 29) but finally diagnosed as having distributive shock (DS, n = 28) or cardiogenic shock (n = 1). When compared with the same-diagnosis group, the different-diagnosis group had higher hospitalization (94.9% vs. 81.4%, p = 0.023) but lower ED discharge (5.1% vs. 16.5%, p = 0.046) rates. Logistic regression analysis showed that the HS initially diagnosed was associated with an increased risk of misclassification (odds ratio [OR] = 14.731, 95% confidence interval [CI] = 3.572–60.749, p < 0.001). However, the survival to discharge did not differ between the two groups. DS, when finally diagnosed instead of the initial misclassification, was associated with in-hospital mortality (OR = 0.317, 95%CI = 0.124–0.810, p = 0.016). Conclusions: The misclassification of UH in the ED is not rare, particularly in patients with DS, who are likely to be initially misdiagnosed with HS. Although misclassification may increase hospitalization and decrease ED discharge, it does not affect survival to discharge. [ABSTRACT FROM AUTHOR]

Published
2024
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20. Using a telemedicine-assisted airway model to improve the communication and teamwork of tracheal intubation during the coronavirus disease 2019 pandemic.

Author

Lin, Chien-Hao, Lin, Hao-Yang, Wu, Shih-Ni, Tseng, Wen-Pin, Chen, Wei-Ting, Tien, Yu-Tzu, Wu, Cheng-Yi, Huang, Chien-Hua, and Tsai, Min-Shan

Subjects
COVID-19 pandemic, COVID-19, MEDICAL personnel, TRACHEA intubation, INTERSTELLAR communication
Abstract

Introduction: Isolated spaces impair communication and teamwork during tracheal intubation (TI) in suspected coronavirus disease 2019 patients. We thus aimed to evaluate the telemedicine-assisted airway model (TAM) to improve communication and teamwork during the pandemic. Methods: This two-stage prospective study included adult patients intubated in the emergency department of the National Taiwan University Hospital between 1 August 2020 and 31 July 2021. First, we randomised patients receiving TI in the standard setting into the conventional group (Con-G) and the isolation area into the isolation group (Iso-G). We evaluated the obstacles to communication and teamwork in an isolation scenario. Second, we developed the TAM to facilitate communication and teamwork between staff in separate spaces during TI and assigned patients to the TAM group (TAM-G). Communication and teamwork were evaluated using the Team Emergency Assessment Measure (TEAM). Subjective evaluations were conducted using a questionnaire administered to medical staff. Results: Eighty-nine patients were enrolled: 17, 34, and 38 in the Con-G, Iso-G, and TAM-G, respectively. The communication frequency (CF) of the Con-G and Iso-G was the highest and lowest, respectively. The CF of the TAM-G increased and approached that of the Con-G. The overall TEAM score was the highest in the Con-G and the lowest in the Iso-G, while the overall score in the TAM-G was comparable to that of the Con-G. Discussion: The TAM may improve communication and teamwork for TIs without compromising efficacy during the pandemic. This study was registered at ClinicalTrials.gov; registration numbers: NCT04479332 and NCT04591873. [ABSTRACT FROM AUTHOR]

Published
2024
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