Time to Defibrillation After Onset of Ventricular Fibrillation and Ventricular Tachycardia Cardiac Arrest at Thomas Jefferson University Hospital and Jefferson Hospital for Neurosciences.

Aims for Improvement Improve average time to defibrillation after VFib/pVTach cardiac arrest to \u3c 2 minutes within an 8 month interval at TJUH and JHN. Improve the percent of VFib/pVTach cardiac arrests that are defibrillated within the recommended 2 minute interval by 30% at TJUH/JHN within an 8 month interva

The effect of environmental conditions on the physiological response during a stand-up paddle surfing session

Stand Up Paddleboard (SUP) surfing entails riding breaking waves and maneuvering the board on the wave face in a similar manner to traditional surfing. Despite some scientific investigations on SUP, little is known about SUP surfing. The aim of this study was to investigate the physiological response during SUP surfing sessions and to determine how various environmental conditions can influence this response. Heart rate (HR) of an experienced male SUP surfer aged 43 was recorded for 14.9 h during ten surfing sessions and synced with on board video footage to enable the examination of the effect of different surfing modes and weather conditions on exercise intensity. Results indicated that the SUP surfer’s HR was above 70% of HRmax during 85% of each session, with the greatest heart rates found during falls off the board (~85% HRmax) and while paddling back to the peak (~83% HRmax). Total time surfing a wave was less than 5%, with the majority of time spent paddling back into position. Wind speed positively correlated with HR (r = 0.75, p < 0.05) and wave height negatively correlated with wave caching frequency (r = 0.73, p < 0.05). The results highlight the aerobic fitness for SUP surfing, where wave riding, paddling back to the peak, and falls appear to be associated with the greatest cardiovascular demand and demonstrate that environmental conditions can have an effect on the physiological response during SUP surfing sessions

Use of EPIC EMR for Early Identification and Management of Patients at Risk of Cardiac Implantable Electronic Device (CIED) Infection

Objectives Aim of our project was early identification of 100% of patients with a CIED IMPLANT presenting with bacteremia Process involves use of EPIC EMR to automatically identify patients with positive blood cultures Traditionally, cardiologists are alerted by the care team using the CONSULT system for management of these patients EPIC EMR as an adjunct to the CONSULT syste

Investigating the Etiology of Non-Ischemic Cardiomyopathy; A Case Report of Cardiac Amyloidosis

Amyloidosis is the result of misfolded protein deposition in organs and tissues, including the heart also known as cardiac amyloidosis. We describe a case of a patient presenting with decompensated heart failure, which highlights the importance of identifying the etiology of the patient’s cardiomyopathy through a thorough history and physical. This led to a diagnosis of cardiac amyloidosis. The patient was subsequently initiated on tafamidis, a medication that is associated with reductions in all-cause mortality and cardiovascular-related hospitalizations, reduced decline in functional capacity, and improved quality of life of the patient

The echo of an unanswered ring: Improving the rate of reporting abnormal findings on echocardiography at TJUH

Aim: To improve the rate of reporting abnormal echo findings verbally to primary patient care teams. Goal: Increase the rate of attending reported abnormal echo findings to a patient\u27s primary team by 75% in 6 months

Improving Evaluation and Follow-up of Patients Diagnosed with Left Bundle Branch Block

Left bundle branch block (LBBB) is a pathologic finding on electrocardiogram (ECG). Most commonly present in patients with antecedent hypertension, cardiac enlargement, coronary artery disease or a combination of these Class 1B recommendation: Those with findings of LBBB on ECG should undergo transthoracic echocardiography for evaluation of underlying heart disease LBBB is prevalent (33%) in patients with heart failure Cardiac resynchronization therapy can improve left ventricular mechanical function in patients with LBBB (QRS \u3e150 msec) This study aims to understand how effectively we are evaluating and following up these patients at Thomas Jefferson University Hospital

Brain and Mind Integration: Childhood Sexual Abuse Survivors Experiencing Hyperbaric Oxygen Treatment and Psychotherapy Concurrently

Due to evidence that traumatic experience impacts the brain, the body (concerning sensory sensitivity), and the mind, a recent study that attempted to answer the question of whether the effects of CSA can be reversed by using a multidisciplinary approach consisting of dual treatments: hyperbaric & psychotherapy, was conducted. Its results showed that in addition to improvement of brain functionality, symptoms of distress were significantly reduced. The current paper aims to present the process as experienced by the 40 female childhood sexual abuse survivor participants. Data included participants' daily journals and drawings, and participants' summaries presented verbally and written, 6-months after the study ended. A phenomenological analysis was used. Results showed three phases, the initial phase—remembering the trauma from both physical and cognitive aspects, the second phase—physiological relaxation as well as positive memories emerge; and, the third phase—bouncing back to life. The results are discussed in light of the study theoretical model and Lev-Wiesel (2015) childhood sexual abuse conceptualization

Improving Safety of Direct Oral Anticoagulant (DOAC) Dosing in Patients with Severe Chronic and End-Stage Renal Disease

The significance of this study is to determine the degree of inconsistency in dosing practice of DOACs at a quaternary care institution such as Thomas Jefferson University Hospital. What is the primary indication for anticoagulation in out population? What percentage is dosed correctly? Are patients primarily over or underdosed

Delayed Effect of Acupuncture Treatment in OA of the Knee: A Blinded, Randomized, Controlled Trial

To assess the efficacy in providing improved function and pain relief by administering 8 weeks of acupuncture as adjunctive therapy to standard care in elderly patients with OA of the knee. This randomized, controlled, blinded trial was conducted on 55 patients with OA of the knee. Forty-one patients completed the study (26 females, 15 males, mean age ± SD 71.7 ± 8.6 years). Patients were randomly divided into an intervention group that received biweekly acupuncture treatment (n = 28) and a control group that received sham acupuncture (n = 27), both in addition to standard therapy, for example, NSAIDS, cyclooxygenase-2 inhibitors, acetaminophen, intra-articular hyaluronic acid and steroid injections. Primary outcomes measures were changes in the Knee Society Score (KSS) knee score and in KSS function and pain ratings at therapy onset, at 8 weeks (closure of study) and at 12 weeks (1 month after last treatment). Secondary outcomes were patient satisfaction and validity of sham acupuncture. There was significant improvement in all three scores in both groups after 8 and 12 weeks compared with baseline (P < .05). Significant differences between the intervention and control groups in the KSS knee score (P = .036) was apparent only after 12 weeks. Patient satisfaction was higher in the intervention group. Adjunctive acupuncture treatment seems to provide added improvement to standard care in elderly patients with OA of the knee. Future research should determine the optimal duration of acupuncture treatment in the context of OA