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  1. Article ; Online: It Is Time to Rethink the Role of the Sequential Organ Failure Assessment Score in Triage Protocols.

    Christian, Michael D

    Critical care medicine

    2021  Volume 49, Issue 2, Page(s) 365–368

    MeSH term(s) Hospital Mortality ; Humans ; Multiple Organ Failure/diagnosis ; Organ Dysfunction Scores ; Triage
    Language English
    Publishing date 2021-01-27
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 197890-1
    ISSN 1530-0293 ; 0090-3493
    ISSN (online) 1530-0293
    ISSN 0090-3493
    DOI 10.1097/CCM.0000000000004796
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  2. Article ; Online: Triage.

    Christian, Michael D

    Critical care clinics

    2019  Volume 35, Issue 4, Page(s) 575–589

    Abstract: This review provides an overview of triaging critically ill or injured patients during mass casualty incidents due to events such as disasters, pandemics, or terrorist incidents. Questions clinicians commonly have, including "what is triage?," "when to ... ...

    Abstract This review provides an overview of triaging critically ill or injured patients during mass casualty incidents due to events such as disasters, pandemics, or terrorist incidents. Questions clinicians commonly have, including "what is triage?," "when to triage?," "what are the types of disaster triage?," "how to triage?," "what are the ethics of triage?," "how to govern triage?," and "what research is required on triage?," are addressed.
    MeSH term(s) Disaster Planning/methods ; Disaster Planning/organization & administration ; Disasters ; Humans ; Mass Casualty Incidents ; Triage/methods ; Triage/organization & administration
    Keywords covid19
    Language English
    Publishing date 2019-07-27
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1006423-0
    ISSN 1557-8232 ; 0749-0704
    ISSN (online) 1557-8232
    ISSN 0749-0704
    DOI 10.1016/j.ccc.2019.06.009
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Patient Outcomes in Helicopter Emergency Medical Service Documentaries and on Air Ambulance Websites.

    McMunn, Finlay W / Buckland, Rosalyn / Watts, Rosanna E / Roberts, Jake / Christian, Michael D

    Cureus

    2024  Volume 16, Issue 2, Page(s) e53414

    Abstract: Background Helicopter emergency medical service (HEMS) documentaries attract millions of viewers, and publicly available patient stories on Air Ambulance websites are vital to raise awareness and funding for Air Ambulance charities in the United Kingdom ( ...

    Abstract Background Helicopter emergency medical service (HEMS) documentaries attract millions of viewers, and publicly available patient stories on Air Ambulance websites are vital to raise awareness and funding for Air Ambulance charities in the United Kingdom (UK). Despite abundant research investigating how fictional programs and news outlets present patient health outcomes, there are no comprehensive studies that investigate how non-fictional HEMS documentaries or Air Ambulance websites present patient outcomes. The aim of this study is to capture the frequency of poor outcomes (mortality) in patients broadcasted on documentaries focusing on HEMS and the patient stories section of UK Air Ambulance websites. Methods A retrospective cohort study reviewed five HEMS documentaries between January 2016 and October 2019 and 20 Air Ambulance websites that had patient stories published until October 2020. In all, 628 patients identified fit the eligibility criteria: 311 from HEMS documentaries and 317 patients from Air Ambulance websites.  Results In all, 0.64% (4/628) of patients died before the hospital, including 0.96% (3/311) of patients on HEMS documentaries and 0.32% (1/317) of patients on Air Ambulance websites. In addition, 2.23% (14/628) of patients died according to their final mention in the data source, including 1.93% (6/311) of patients on HEMS documentaries and 2.52% (8/317) of patients on Air Ambulance websites. Conclusions This study suggests under-reporting of poor patient outcomes in HEMS documentaries and on UK Air Ambulance websites. This could be attributed to the logistical and ethical implications of capturing and presenting poor outcomes but likely impacts upon public perception. Medical professionals should recognize this in order to proactively address potential misconceptions when communicating with patients and their families.
    Language English
    Publishing date 2024-02-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.53414
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Practical recommendations for critical care and anesthesiology teams caring for novel coronavirus (2019-nCoV) patients.

    Wax, Randy S / Christian, Michael D

    Canadian journal of anaesthesia = Journal canadien d'anesthesie

    2020  Volume 67, Issue 5, Page(s) 568–576

    Abstract: A global health emergency has been declared by the World Health Organization as the 2019-nCoV outbreak spreads across the world, with confirmed patients in Canada. Patients infected with 2019-nCoV are at risk for developing respiratory failure and ... ...

    Title translation Directives concrètes à l’intention des équipes de soins intensifs et d’anesthésiologie prenant soin de patients atteints du coronavirus 2019-nCoV.
    Abstract A global health emergency has been declared by the World Health Organization as the 2019-nCoV outbreak spreads across the world, with confirmed patients in Canada. Patients infected with 2019-nCoV are at risk for developing respiratory failure and requiring admission to critical care units. While providing optimal treatment for these patients, careful execution of infection control measures is necessary to prevent nosocomial transmission to other patients and to healthcare workers providing care. Although the exact mechanisms of transmission are currently unclear, human-to-human transmission can occur, and the risk of airborne spread during aerosol-generating medical procedures remains a concern in specific circumstances. This paper summarizes important considerations regarding patient screening, environmental controls, personal protective equipment, resuscitation measures (including intubation), and critical care unit operations planning as we prepare for the possibility of new imported cases or local outbreaks of 2019-nCoV. Although understanding of the 2019-nCoV virus is evolving, lessons learned from prior infectious disease challenges such as Severe Acute Respiratory Syndrome will hopefully improve our state of readiness regardless of the number of cases we eventually manage in Canada.
    MeSH term(s) Anesthesiology ; Betacoronavirus ; COVID-19 ; Canada ; Coronavirus Infections/diagnosis ; Coronavirus Infections/prevention & control ; Coronavirus Infections/therapy ; Critical Care/methods ; Cross Infection/prevention & control ; Cross Infection/virology ; Diagnostic Screening Programs ; Humans ; Infection Control/methods ; Intubation ; Pandemics/prevention & control ; Personal Protective Equipment ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/prevention & control ; Pneumonia, Viral/therapy ; Resuscitation ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-02-12
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 91002-8
    ISSN 1496-8975 ; 0832-610X
    ISSN (online) 1496-8975
    ISSN 0832-610X
    DOI 10.1007/s12630-020-01591-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 109: Show issues Location:
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  5. Article ; Online: COVID-19 and the global OHCA crisis: An urgent need for system level solutions.

    Christian, Michael D / Couper, Keith

    Resuscitation

    2020  Volume 157, Page(s) 274–276

    MeSH term(s) COVID-19 ; Humans ; Out-of-Hospital Cardiac Arrest/epidemiology ; Pandemics ; Registries ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-11-09
    Publishing country Ireland
    Document type Editorial ; Comment
    ZDB-ID 189901-6
    ISSN 1873-1570 ; 0300-9572
    ISSN (online) 1873-1570
    ISSN 0300-9572
    DOI 10.1016/j.resuscitation.2020.11.004
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    Zs.A 1048: Show issues Location:
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  6. Article: Caring for Critically Ill Adults in PICUs Is Not "Child's Play".

    Christian, Michael D / Kissoon, Niranjan

    Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

    2020  Volume 21, Issue 7, Page(s) 679–681

    MeSH term(s) Adult ; Betacoronavirus ; COVID-19 ; Child ; Coronavirus ; Coronavirus Infections ; Critical Illness ; Humans ; Intensive Care Units, Pediatric ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-05-14
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 2052349-X
    ISSN 1947-3893 ; 1529-7535
    ISSN (online) 1947-3893
    ISSN 1529-7535
    DOI 10.1097/PCC.0000000000002430
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  7. Article ; Online: Mental health care for medical staff and affiliated healthcare workers during the COVID-19 pandemic.

    Walton, Matthew / Murray, Esther / Christian, Michael D

    European heart journal. Acute cardiovascular care

    2020  Volume 9, Issue 3, Page(s) 241–247

    Abstract: The COVID-19 pandemic is an unprecedented challenge for society. Supporting the mental health of medical staff and affiliated healthcare workers (staff) is a critical part of the public health response. This paper details the effects on staff and ... ...

    Abstract The COVID-19 pandemic is an unprecedented challenge for society. Supporting the mental health of medical staff and affiliated healthcare workers (staff) is a critical part of the public health response. This paper details the effects on staff and addresses some of the organisational, team and individual considerations for supporting staff (pragmatically) during this pandemic. Leaders at all levels of health care organisations will find this a valuable resource.
    MeSH term(s) Betacoronavirus/isolation & purification ; COVID-19 ; Communication ; Coronavirus Infections/epidemiology ; Coronavirus Infections/psychology ; Crisis Intervention/organization & administration ; Critical Care/psychology ; Critical Care/statistics & numerical data ; Delivery of Health Care/organization & administration ; Empowerment ; Health Personnel/psychology ; Health Personnel/statistics & numerical data ; Humanism ; Humans ; Infection Control/methods ; Interpersonal Relations ; Leadership ; Medical Staff/psychology ; Medical Staff/statistics & numerical data ; Mental Health/standards ; Pandemics ; Physicians/psychology ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/psychology ; SARS-CoV-2 ; Stress Disorders, Post-Traumatic/psychology ; Stress Disorders, Traumatic, Acute/epidemiology ; Stress Disorders, Traumatic, Acute/psychology
    Keywords covid19
    Language English
    Publishing date 2020-04-28
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2663340-1
    ISSN 2048-8734 ; 2048-8726
    ISSN (online) 2048-8734
    ISSN 2048-8726
    DOI 10.1177/2048872620922795
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Biowarfare and bioterrorism.

    Christian, Michael D

    Critical care clinics

    2013  Volume 29, Issue 3, Page(s) 717–756

    Abstract: Bioterrorism is not only a reality of the times in which we live but bioweapons have been used for centuries. Critical care physicians play a major role in the recognition of and response to a bioterrorism attack. Critical care clinicians must be ... ...

    Abstract Bioterrorism is not only a reality of the times in which we live but bioweapons have been used for centuries. Critical care physicians play a major role in the recognition of and response to a bioterrorism attack. Critical care clinicians must be familiar with the diagnosis and management of the most likely bioterrorism agents, and also be adequately prepared to manage a mass casualty situation. This article reviews the epidemiology, diagnosis, and treatment of the most likely agents of biowarfare and bioterrorism.
    MeSH term(s) Animals ; Anthrax/diagnosis ; Anthrax/therapy ; Anthrax/transmission ; Biological Warfare Agents ; Bioterrorism ; Coccidioidomycosis/diagnosis ; Coccidioidomycosis/therapy ; Coccidioidomycosis/transmission ; Critical Care ; Disease Outbreaks ; Hemorrhagic Fevers, Viral/diagnosis ; Hemorrhagic Fevers, Viral/therapy ; Hemorrhagic Fevers, Viral/transmission ; Humans ; Insecta/pathogenicity ; Mass Casualty Incidents ; Noxae/analysis ; Noxae/poisoning ; Plague/diagnosis ; Plague/therapy ; Plague/transmission ; Q Fever/diagnosis ; Q Fever/therapy ; Q Fever/transmission ; Smallpox/diagnosis ; Smallpox/therapy ; Smallpox/transmission ; Toxins, Biological/analysis ; Toxins, Biological/poisoning ; Tularemia/diagnosis ; Tularemia/therapy ; Tularemia/transmission
    Chemical Substances Biological Warfare Agents ; Noxae ; Toxins, Biological
    Keywords covid19
    Language English
    Publishing date 2013-07-04
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1006423-0
    ISSN 1557-8232 ; 0749-0704
    ISSN (online) 1557-8232
    ISSN 0749-0704
    DOI 10.1016/j.ccc.2013.03.015
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Emergency scalpel cricothyroidotomy use in a prehospital trauma service: a 20-year review.

    Aziz, Shadman / Foster, Elizabeth / Lockey, David J / Christian, Michael D

    Emergency medicine journal : EMJ

    2021  Volume 38, Issue 5, Page(s) 349–354

    Abstract: Background: This study aimed to determine the rate of scalpel cricothyroidotomy conducted by a physician-paramedic prehospital trauma service over 20 years and to identify indications for, and factors associated with the intervention.: Methods: A ... ...

    Abstract Background: This study aimed to determine the rate of scalpel cricothyroidotomy conducted by a physician-paramedic prehospital trauma service over 20 years and to identify indications for, and factors associated with the intervention.
    Methods: A retrospective observational study was conducted from 1 January 2000 to 31 December 2019 using clinical database records. This study was conducted in a physician-paramedic prehospital trauma service, serving a predominantly urban population of approximately 10 million in an area of approximately 2500 km
    Results: Over 20 years, 37 725 patients were attended by the service, and 72 patients received a scalpel cricothyroidotomy. An immediate 'primary' cricothyroidotomy was performed in 17 patients (23.6%), and 'rescue' cricothyroidotomies were performed in 55 patients (76.4%). Forty-one patients (56.9%) were already in traumatic cardiac arrest during cricothyroidotomy. Thirty-two patients (44.4%) died on scene, and 32 (44.4%) subsequently died in hospital. Five patients (6.9%) survived to hospital discharge, and three patients (4.2%) were lost to follow-up. The most common indication for primary cricothyroidotomy was mechanical entrapment of patients (n=5, 29.4%). Difficult laryngoscopy, predominantly due to airway soiling with blood (n=15, 27.3%) was the most common indication for rescue cricothyroidotomy. The procedure was successful in 97% of cases. During the study period, 6570 prehospital emergency anaesthetics were conducted, of which 30 underwent rescue cricothyroidotomy after failed tracheal intubation (0.46%, 95% CI 0.31% to 0.65%).
    Conclusions: This study identifies a number of indications leading to scalpel cricothyroidotomy both as a primary procedure or after failed intubation. The main indication for scalpel cricothyroidotomy in our service was as a rescue airway for failed laryngoscopy due to a large volume of blood in the airway. Despite high levels of procedural success, 56.9% of patients were already in traumatic cardiac arrest during cricothyroidotomy, and overall mortality in patients with trauma receiving this procedure was 88.9% in our service.
    MeSH term(s) Adult ; Aged ; Emergency Medical Services/organization & administration ; Emergency Medical Technicians/organization & administration ; Female ; Humans ; Intubation, Intratracheal/methods ; Laryngeal Muscles/surgery ; Male ; Middle Aged ; Physicians/organization & administration ; Retrospective Studies ; Urban Population
    Language English
    Publishing date 2021-02-17
    Publishing country England
    Document type Journal Article ; Observational Study
    ZDB-ID 2040124-3
    ISSN 1472-0213 ; 1472-0205
    ISSN (online) 1472-0213
    ISSN 1472-0205
    DOI 10.1136/emermed-2020-210305
    Database MEDical Literature Analysis and Retrieval System OnLINE

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