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John S. Geddes - One of the best experts on this subject based on the ideXlab platform.

  • The Revolution and Evolution of Prehospital Cardiac Care
    Archives of internal medicine, 1996
    Co-Authors: Mickey S. Eisenberg, J. Frank Pantridge, Leonard A. Cobb, John S. Geddes
    Abstract:

    Prehospital Cardiac Care, first established in Belfast, Northern Ireland, in 1966, may be called revolutionary in that it was a radical break from existing practices. The Belfast program "moved" the coronary Care unit into the community by treating the early complications of acute myocardial infarcation. The program staffed a mobile coronary Care unit with a physician and nurse and demonstrated that patients with out-of-hospital sudden Cardiac arrest could be resuscitated. The idea of prehospital Cardiac Care spread to other countries after publication of the Belfast experience in the Lancet . The first program in the United States, stationed at St Vincent's Hospital in New York, NY, began in 1968 and was modeled after the Belfast program. The physician-staffed model, however, was not widely imitated in the United States. Rather, beginning in 1969, programs using specially trained personnel, know as paramedics, began in Miami, Fla, Seattle, Wash, Columbus, Ohio, Los Angeles, Calif, Portland, Ore, and Nassau County, New York. Paramedic-staffed programs were designed not only to treat early complications of acute myocardial infarction, but also to attempt resuscitation for primary Cardiac arrest. Most of the early paramedic programs were based in fire departments. Other programs used private ambulance or police personnel. Prehospital Cardiac Care has evolved significantly in the past 3 decades. Some notable developments include the tiered response system, training of the general public in cardiopulmonary resuscitation, low-energy defibrillators, automatic external defibrillators, and 12-lead electrocardiographic telemetry. The basic lesson of prehospital Cardiac Care is that the timely provision of cardiopulmonary resuscitation and defibrillation saves lives. Arch Intern Med. 1996;156:1611-1619

Yonathan Hasin - One of the best experts on this subject based on the ideXlab platform.

  • Recommendations for the structure, organization, and operation of intensive Cardiac Care units
    Oxford Medicine Online, 2015
    Co-Authors: Menachem Nahir, Doron Zahger, Yonathan Hasin
    Abstract:

    Care for the critically ill cardiovascular patients and their families requires a unique environment that is structurally different from other clinical units. Coronary Care units were introduced in the 1960s for the main purpose of prevention and prompt treatment of life-threatening Cardiac arrhythmias related to acute myocardial infarction. Since then, major progress in cardiology in general and acute Cardiac Care, in particular, dictated a major change in the structure and organization of these units, symbolically expressed in the new title of ‘intensive Cardiac Care unit’. Contemporary intensive Cardiac Care units receive older and more complex patients, often with multiple comorbidities and diverse diagnoses. The modern intensive Cardiac Care unit incorporates sophisticated monitoring and up-to-date equipment to meet the changing needs of the patient with cardiovascular disease requiring critical Care. The intensive Cardiac Care unit operates in the centre of the hospital’s cardiology service, receiving patients from the mobile Care unit (directly or via an ST elevation myocardial infarction network), the emergency department, and other wards, including coronary, structural, and electrophysiology intervention laboratories and operating rooms. Patients are usually unstable and require immediate full attention by highly trained medical and nursing staff. The 2005 recommendations for the structure, organization, and operations of the intensive Cardiac Care unit were issued by Hasin et al. for the Working Group of Acute Cardiac Care of the European Society of Cardiology, which serves as basis for this chapter. The chapter will focus on the requirements for staffing, training, and accreditation, as well as the structure organization and equipment of the intensive and intermediate Cardiac Care units.

  • recommendations for the use of natriuretic peptides in acute Cardiac Care a position statement from the study group on biomarkers in cardiology of the esc working group on acute Cardiac Care
    European Heart Journal, 2012
    Co-Authors: Kristian Thygesen, Yonathan Hasin, Johannes Mair, Christian Mueller, Kurt Huber, Michael Weber, Mario Plebani, Luigi M Biasucci, E Giannitsis, Bertil Lindahl
    Abstract:

    Recommendations for the use of natriuretic peptides in acute Cardiac Care : A position statement from the Study Group on Biomarkers in Cardiology of the ESC Working Group on Acute Cardiac Care

  • Recommendations for the use of Cardiac troponin measurement in acute Cardiac Care
    European heart journal, 2010
    Co-Authors: Kristian Thygesen, Yonathan Hasin, Johannes Mair, Mario Plebani, Bertil Lindahl, Hugo A. Katus, Per Venge, Paul Collinson, Evangelos Giannitsis, Marcello Galvani
    Abstract:

    The release of cardiomyocyte components, i.e. biomarkers, into the bloodstream in higher than usual quantities indicates an ongoing pathological process. Thus, detection of elevated concentrations of Cardiac biomarkers in blood is a sign of Cardiac injury which could be due to supply-demand imbalance, toxic effects, or haemodynamic stress. It is up to the clinician to determine the most probable aetiology, the proper therapeutic measures, and the subsequent risk implied by the process. For this reason, the measurement of biomarkers always must be applied in relation to the clinical context and never in isolation. There are a large number of Cardiac biomarkers, but they can be subdivided into four broad categories, those related to necrosis, inflammation, haemodynamic stress, and/or thrombosis. Their usefulness is dependent on the accuracy and reproducibility of the measurements, the discriminatory limits separating pathology from physiology, and their sensitivity and specificity for specific organ damage and/or disease processes. In recent years, Cardiac biomarkers have become important adjuncts to the delivery of acute Cardiac Care. Therefore, the Working Group on Acute Cardiac Care of the European Society of Cardiology established a committee to deal with ongoing and newly developing issues related to Cardiac biomarkers. The intention of the group is to outline the principles for the application of various biomarkers by clinicians in the setting of acute Cardiac Care in a series of expert consensus documents. The first of these will focus on Cardiac troponin, a pivotal marker of Cardiac injury/necrosis.

  • recommendations for the structure organization and operation of intensive Cardiac Care units
    European Heart Journal, 2005
    Co-Authors: Yonathan Hasin, Gerasimos Filippatos, Magda Heras, Menachem Nahir, Nicolas Danchin, Kristian Thygesen, Uwe Janssens, Jonathan Leor, Alexander Parkhomenko, Marco Tubaro
    Abstract:

    Two major changes in patient characteristics and management occurred recently that demand distinctive alterations in the function of the intensive Cardiac Care unit (ICCU). These changes include the introduction of an early invasive strategy for the treatment of acute coronary syndromes, enabling early recuperation and shorter need for intensive Care on the one hand, while the number of older and sicker patients requiring prolonged and more complex intensive Care is steadily increasing. A task force of the European Society of Cardiology Working Group on Acute Cardiac Care was set to give a modern updated comprehensive recommendations concerning the structure, organization, and function of the modern ICCUs and intermediate Cardiac units. These include the statement that specially trained cardiologists and Cardiac nurses who can manage patients with acute Cardiac conditions should staff the ICCUs. The optimum number of physicians, nurses, and other personal working in the unit is included. The document indicates the desired architecture and structure of the units and the intermediate Cardiac unit and their relations to the other facilities in the hospital. Specific recommendations are also included for the minimal number of beds, monitoring system, respirators, pacemaker/defibrillators, and necessary additional equipment. The desired function is discussed, namely, the patients to be admitted, the length of stay, and the relocation policy. A uniformed electronic chart for ICCUs is advised, anticipating a common European database.

Mickey S. Eisenberg - One of the best experts on this subject based on the ideXlab platform.

  • The Revolution and Evolution of Prehospital Cardiac Care
    Archives of internal medicine, 1996
    Co-Authors: Mickey S. Eisenberg, J. Frank Pantridge, Leonard A. Cobb, John S. Geddes
    Abstract:

    Prehospital Cardiac Care, first established in Belfast, Northern Ireland, in 1966, may be called revolutionary in that it was a radical break from existing practices. The Belfast program "moved" the coronary Care unit into the community by treating the early complications of acute myocardial infarcation. The program staffed a mobile coronary Care unit with a physician and nurse and demonstrated that patients with out-of-hospital sudden Cardiac arrest could be resuscitated. The idea of prehospital Cardiac Care spread to other countries after publication of the Belfast experience in the Lancet . The first program in the United States, stationed at St Vincent's Hospital in New York, NY, began in 1968 and was modeled after the Belfast program. The physician-staffed model, however, was not widely imitated in the United States. Rather, beginning in 1969, programs using specially trained personnel, know as paramedics, began in Miami, Fla, Seattle, Wash, Columbus, Ohio, Los Angeles, Calif, Portland, Ore, and Nassau County, New York. Paramedic-staffed programs were designed not only to treat early complications of acute myocardial infarction, but also to attempt resuscitation for primary Cardiac arrest. Most of the early paramedic programs were based in fire departments. Other programs used private ambulance or police personnel. Prehospital Cardiac Care has evolved significantly in the past 3 decades. Some notable developments include the tiered response system, training of the general public in cardiopulmonary resuscitation, low-energy defibrillators, automatic external defibrillators, and 12-lead electrocardiographic telemetry. The basic lesson of prehospital Cardiac Care is that the timely provision of cardiopulmonary resuscitation and defibrillation saves lives. Arch Intern Med. 1996;156:1611-1619

Marco Tubaro - One of the best experts on this subject based on the ideXlab platform.

  • The Esc Textbook Of Intensive And Acute Cardiac Care
    2011
    Co-Authors: Doron Zahger, Gerasimos Filippatos, Pascal Vranckx, Patrick Goldstein, Nicolas Danchin, Marco Tubaro
    Abstract:

    The Esc Textbook Of Intensive And Acute Cardiac Care - Libros de Medicina - Medicina intensiva - 246,17

  • Clinical competence in intensive Cardiac Care units: from practical needs to training programs
    Giornale italiano di cardiologia (2006), 2010
    Co-Authors: Giuseppe Fradella, Marco Tubaro, De Luca L, Maddalena Lettino, Maria Rosa Conte, Giovanna Geraci, Gianni Casella
    Abstract:

    Since the early 1970s, intensive Cardiac Care is applied in coronary Care units (CCUs), initially developed to treat lethal arrhythmias in patients with acute myocardial infarction. In the last decades, treatments offered within the CCUs have greatly expanded. Thus, these units have been called intensive Cardiac Care units (ICCUs) to reflect such evolution of Care and the different epidemiology of patients admitted (subjects with acute coronary syndromes, acute and advanced heart failure, rhythm disturbances or severe valve dysfunction). At the same time, new drugs have become available but also different diagnostic, interventional and therapeutic procedures have been developed, resulting in better patient treatment and improved outcomes. These new devices require a high degree of specialization and specific skills that not every cardiologist is always used to. Consequently, specific training programs on intensive Cardiac Care for cardiologists working in ICCUs are clearly warranted. The present paper describes the advanced training programs on intensive Cardiac Care endorsed by the European Society of Cardiology and the Italian Association of Hospital Cardiologists (ANMCO). Both projects aim at improving current knowledge and skills of intensive cardiologists on specific pharmacologic and technical procedures, extending the competence of trained cardiologists to the management of critically ill Cardiac patients, and uniforming the quality of Care in any ICCU.

  • recommendations for the structure organization and operation of intensive Cardiac Care units
    European Heart Journal, 2005
    Co-Authors: Yonathan Hasin, Gerasimos Filippatos, Magda Heras, Menachem Nahir, Nicolas Danchin, Kristian Thygesen, Uwe Janssens, Jonathan Leor, Alexander Parkhomenko, Marco Tubaro
    Abstract:

    Two major changes in patient characteristics and management occurred recently that demand distinctive alterations in the function of the intensive Cardiac Care unit (ICCU). These changes include the introduction of an early invasive strategy for the treatment of acute coronary syndromes, enabling early recuperation and shorter need for intensive Care on the one hand, while the number of older and sicker patients requiring prolonged and more complex intensive Care is steadily increasing. A task force of the European Society of Cardiology Working Group on Acute Cardiac Care was set to give a modern updated comprehensive recommendations concerning the structure, organization, and function of the modern ICCUs and intermediate Cardiac units. These include the statement that specially trained cardiologists and Cardiac nurses who can manage patients with acute Cardiac conditions should staff the ICCUs. The optimum number of physicians, nurses, and other personal working in the unit is included. The document indicates the desired architecture and structure of the units and the intermediate Cardiac unit and their relations to the other facilities in the hospital. Specific recommendations are also included for the minimal number of beds, monitoring system, respirators, pacemaker/defibrillators, and necessary additional equipment. The desired function is discussed, namely, the patients to be admitted, the length of stay, and the relocation policy. A uniformed electronic chart for ICCUs is advised, anticipating a common European database.

M Koutouzis - One of the best experts on this subject based on the ideXlab platform.