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Exam Code: CCRN Practice exam 2022 by Killexams.com team
CCRN Critical Care Register Nurse

A criterion-referenced standard setting process, known as the modified Angoff, is used to establish the passing point/cut score for the exam. Each candidates performance on the exam is measured against a predetermined standard.
The passing point/cut score for the exam is established using a panel of subject matter experts, an exam development committee (EDC), who carefully reviews each exam question to determine the basic level of knowledge or skill that is expected. The passing point/cut score is based on the panels established difficulty ratings for each exam question.
Under the guidance of a psychometrician, the panel develops and recommends the passing point/cut score, which is reviewed and approved by AACN Certification Corporation. The passing point/cut score for the exam is established to identify individuals with an acceptable level of knowledge and skill. All individuals who pass the exam, regardless of their score, have demonstrated an acceptable level of knowledge.

I. CLINICAL JUDGMENT (80%)
A. Cardiovascular (17%)
1. Acute coronary syndrome:
a. NSTEMI
b. STEMI
c. Unstable angina
2. Acute peripheral vascular insufficiency:
a. Arterial/venous occlusion
b. Carotid artery stenosis
c. Endarterectomy
d. Fem-Pop bypass
3. Acute pulmonary edema
4. Aortic aneurysm
5. Aortic dissection
6. Aortic rupture
7. Cardiac surgery:
a. CABG
b. Valve replacement or repair
8. Cardiac tamponade
9. Cardiac trauma
10. Cardiac/vascular catheterization
11. Cardiogenic shock
12. Cardiomyopathies:
a. Dilated
b. Hypertrophic
c. Idiopathic
d. Restrictive
13. Dysrhythmias
14. Heart failure
15. Hypertensive crisis
16. Myocardial conduction system abnormalities
(e.g., prolonged QT interval, Wolff-ParkinsonWhite)
17. Papillary muscle rupture
18. Structural heart defects (acquired and congenital, including valvular disease)
19. TAVR

B. Respiratory (15%)
1. Acute pulmonary embolus
2. ARDS
3. Acute respiratory failure
4. Acute respiratory infection (e.g., pneumonia)
5. Aspiration
6. Chronic conditions (e.g., COPD, asthma, bronchitis, emphysema)
7. Failure to wean from mechanical ventilation
8. Pleural space abnormalities (e.g., pneumothorax, hemothorax, empyema, pleural effusions)
9. Pulmonary fibrosis
10. Pulmonary hypertension
11. Status asthmaticus
12. Thoracic surgery
13. Thoracic trauma (e.g., fractured rib, lung contusion, tracheal perforation)
14. Transfusion-related acute lung injury (TRALI)

C. Endocrine/Hematology/Gastrointestinal/Renal/Integumentary (20%)
1. Endocrine
a. Adrenal insufficiency
b. Diabetes insipidus (DI)
c. Diabetes mellitus, types 1 and 2
d. Diabetic ketoacidosis (DKA)
e. Hyperglycemia
f. Hyperosmolar hyperglycemic state (HHS)
g. Hyperthyroidism
h. Hypoglycemia (acute)
i. Hypothyroidism
j. SIADH
2. Hematology and Immunology
a. Anemia
b. Coagulopathies (e.g., ITP, DIC, HIT)
c. Immune deficiencies
d. Leukopenia
e. Oncologic complications (e.g., tumor lysis syndrome, pericardial effusion)
f. Thrombocytopenia
g. Transfusion reactions
3. Gastrointestinal
a. Abdominal compartment syndrome
b. Acute abdominal trauma
c. Acute GI hemorrhage
d. Bowel infarction, obstruction, perforation (e.g., mesenteric ischemia, adhesions)
e. GI surgeries (e.g., Whipple, esophagectomy, resections)
f. Hepatic failure/coma (e.g., portal hypertension, cirrhosis, esophageal varices, fulminant hepatitis, biliary atresia, drug-induced)
g. Malnutrition and malabsorption
h. Pancreatitis
4. Renal and Genitourinary
a. Acute genitourinary trauma
b. Acute kidney injury (AKI)
c. Chronic kidney disease (CKD)
d. Infections (e.g., kidney, urosepsis)
e. Life-threatening electrolyte imbalances
5. Integumentary
a. Cellulitis
b. IV infiltration
c. Necrotizing fasciitis
d. Pressure injury
e. Wounds:
i. infectious
ii. surgical
iii. trauma
D. Musculoskeletal/Neurological/

Psychosocial (14%)
1. Musculoskeletal
a. Compartment syndrome
b. Fractures (e.g., femur, pelvic)
c. Functional issues (e.g., immobility, falls, gait disorders)
d. Osteomyelitis
e. Rhabdomyolysis
2. Neurological
a. Acute spinal cord injury
b. Brain death
c. Delirium (e.g., hyperactive, hypoactive, mixed)
d. Dementia
e. Encephalopathy
f. Hemorrhage:
i. intracranial (ICH)
ii. intraventricular (IVH)
iii. subarachnoid (traumatic or aneurysmal)
g. Increased intracranial pressure (e.g., hydrocephalus)
h. Neurologic infectious disease (e.g., viral, bacterial, fungal)
i. Neuromuscular disorders (e.g., muscular dystrophy, CP, Guillain-Barré, myasthenia)
j. Neurosurgery (e.g., craniotomy, Burr holes)
k. Seizure disorders
l. Space-occupying lesions (e.g., brain tumors)
m. Stroke:
i. hemorrhagic
ii. ischemic (embolic)
iii. TIA
n. Traumatic brain injury (TBI): epidural, subdural, concussion
3. Behavioral and Psychosocial
a. Abuse/neglect
b. Aggression
c. Agitation
d. Anxiety
e. Suicidal ideation and/or behaviors
f. Depression
g. Medical non-adherence
h. PTSD
i. Risk-taking behavior
j. Substance use disorders (e.g., withdrawal, chronic alcohol or drug dependence)
E. Multisystem (14%)
1. Acid-base imbalance
2. Bariatric complications
3. Comorbidity in patients with transplant history
4. End-of-life care
5. Healthcare-associated conditions (e.g., VAE, CAUTI, CLABSI)
6. Hypotension
7. Infectious diseases:
a. Influenza (e.g., pandemic or epidemic)
b. Multi-drug resistant organisms (e.g., MRSA, VRE, CRE)
8. Life-threatening maternal/fetal complications (e.g., eclampsia, HELLP syndrome, postpartum hemorrhage, amniotic embolism)
9. Multiple organ dysfunction syndrome (MODS)
10. Multisystem trauma
11. Pain: acute, chronic
12. Post-intensive care syndrome (PICS)
13. Sepsis
14. Septic shock
15. Shock states:
a. Distributive (e.g., anaphylactic, neurogenic)
b. Hypovolemic
16. Sleep disruption (including sensory overload)
17. Thermoregulation
18. Toxic ingestion/inhalations (e.g., drug/alcohol overdose)
19. Toxin/drug exposure (including allergies)

II. PROFESSIONAL CARING 7 ETHICAL PRACTICE (20%)
A. Advocacy/Moral Agency
B. Caring Practices
C. Response to Diversity
D. Facilitation of Learning
E. Collaboration
F. Systems Thinking
G. Clinical Inquiry

CLINICAL JUDGMENT
General
• Recognize normal and abnormal:
o developmental assessment findings and provide developmentally appropriate care
o physical assessment findings
o psychosocial assessment findings
• Recognize signs and symptoms of emergencies, initiate interventions, and seek assistance as needed
• Recognize indications for, and manage patients requiring:
o capnography (EtCO2)
o central venous access
o medication reversal agents
o palliative care
o SvO2 monitoring
• Manage patients receiving:
o complementary/alternative medicine and/or nonpharmacologic interventions
o medications (e.g., safe administration, monitoring, polypharmacy)
• Monitor patients and follow protocols for pre- and postoperative care
• Assess pain
• Evaluate patients response to interventions
• Identify and monitor normal and abnormal diagnostic test results
• Manage fluid and electrolyte balance
• Manage monitor alarms based on protocols and changes in patient condition Cardiovascular
• Apply leads for cardiac monitoring
• Identify, interpret and monitor cardiac rhythms
• Recognize indications for, and manage patients requiring:
o 12-lead ECG
o arterial catheter
o cardiac catheterization
o cardioversion central venous pressure monitoring
o defibrillation
o IABP
o invasive hemodynamic monitoring
o pacing: epicardial, transcutaneous, transvenous
o pericardiocentesis
o QT interval monitoring
o ST segment monitoring
• Manage patients requiring:
o endovascular stenting
o PCI Respiratory
• Interpret blood gas results
• Recognize indications for, and manage patients requiring:
o modes of mechanical ventilation
o noninvasive positive pressure ventilation (e.g., BiPAP, CPAP, high-flow nasal cannula)
o oxygen therapy delivery devices
o prevention of complications related to mechanical ventilation (ventilator bundle)
o prone positioning
o pulmonary therapeutic interventions related to mechanical ventilation: airway clearance, extubation, intubation, weaning
o therapeutic gases (e.g., oxygen, nitric oxide, heliox, CO2 )
o thoracentesis
o tracheostomy Hematology and Immunology
• Manage patients receiving transfusion of blood products
• Monitor patients and follow protocols:
o pre-, intra-, post-intervention (e.g., plasmapheresis, exchange transfusion, leukocyte depletion)
o related to blood conservation Neurological
• Recognize indications for, and manage patients requiring neurologic monitoring devices and drains (e.g., ICP, ventricular or lumbar drain)
• Use a swallow evaluation tool to assess dysphagia
• Manage patients requiring:
o neuroendovascular interventions (e.g., coiling, thrombectomy)
o neurosurgical procedures (e.g., pre-, intra-, post-procedure)
o spinal immobilization Integumentary
• Recognize indications for, and manage patients requiring, therapeutic interventions (e.g. wound VACs, pressure reduction surfaces, fecal management devices, IV infiltrate treatment) Gastrointestinal
• Monitor patients and follow protocols for procedures pre-, intra-, post-procedure (e.g., EGD, PEG placement)
• Intervene to address barriers to nutritional/fluid adequacy (e.g., chewing/swallowing difficulties, alterations in hunger and thirst, inability to self-feed)
• Recognize indications for, and manage patients requiring:
o abdominal pressure monitoring
o GI drains
o enteral and parenteral nutrition Renal and Genitourinary
• Identify nephrotoxic agents
• Monitor patients and follow protocols pre-, intra-, and post-procedure (e.g., renal biopsy, ultrasound)
• Recognize indications for, and manage patients requiring, renal therapeutic intervention (e.g., hemodialysis, CRRT, peritoneal dialysis)
Musculoskeletal
• Manage patients requiring progressive mobility
• Recognize indications for, and manage patients requiring, compartment syndrome monitoring
Multisystem
• Manage continuous temperature monitoring
• Provide end-of-life and palliative care
• Recognize risk factors and manage malignant hyperthermia
• Recognize indications for, and manage patients undergoing:
o continuous sedation
o intermittent sedation
o neuromuscular blockade agents
o procedural sedation - minimal
o procedural sedation - moderate
o targeted temperature management (previously known as therapeutic hypothermia)
Behavioral and Psychosocial
• Respond to behavioral emergencies (e.g., nonviolent crisis intervention, de-escalation techniques)
• Use behavioral assessment tools (e.g., delirium, alcohol withdrawal, cognitive impairment)
• Recognize indications for, and manage patients requiring:
o behavioral therapeutic interventions
o medication management for agitation
o physical restraints

I. CLINICAL JUDGMENT (80%)
A. Cardiovascular (14%)
1. Cardiac infection and inflammatory diseases
2. Cardiac malformations
3. Cardiac surgery
4. Cardiogenic shock
5. Cardiomyopathies
6. Cardiovascular catheterization
7. Dysrhythmias
8. Heart failure
9. Hypertensive crisis
10. Myocardial conduction system defects
11. Obstructive shock
12. Vascular occlusion
B. Respiratory (18%)
1. Acute pulmonary edema
2. Acute pulmonary embolus
3. Acute respiratory distress syndrome (ARDS)
4. Acute respiratory failure
5. Acute respiratory infection
6. Air-leak syndromes
7. Apnea of prematurity
8. Aspiration
9. Chronic pulmonary conditions
10. Congenital airway malformations
11. Failure to wean from mechanical ventilation
12. Pulmonary hypertension
13. Status asthmaticus
14. Thoracic and airway trauma
15. Thoracic surgery

C. Endocrine/Hematology/Gastrointestinal/Renal/Integumentary (20%)
1. Endocrine
a. Adrenal insufficiency
b. Diabetes insipidus (DI)
c. Diabetic ketoacidosis (DKA)
d. Diabetes mellitus, types 1 and 2
e. Hyperglycemia
f. Hypoglycemia
g. Inborn errors of metabolism
h. Syndrome of inappropriate secretion of antidiuretic hormone (SIADH)
2. Hematology and Immunology
a. Anemia
b. Coagulopathies (e.g., ITP, DIC)
c. Immune deficiencies
d. Myelosuppression (e.g., thrombocytopenia, neutropenia)
e. Oncologic complications
f. Sickle cell crisis
g. Transfusion reactions
3. Gastrointestinal
a. Abdominal compartment syndrome
b. Abdominal trauma
c. Bowel infarction, obstruction and perforation
d. Gastroesophageal reflux
e. GI hemorrhage
f. GI surgery
g. Liver disease and failure
h. Malnutrition and malabsorption
i. Necrotizing enterocolitis (NEC)
j. Peritonitis
4. Renal and Genitourinary
a. AKI
b. Chronic kidney disease (CKD)
c. Hemolytic uremic syndrome (HUS)
d. Kidney transplant
e. Life-threatening electrolyte imbalances
f. Renal and genitourinary infections
g. Renal and genitourinary surgery
5. Integumentary
a. IV infiltration
b. Pressure injury
c. Skin failure (e.g., hypoperfusion)
d. Wounds

D. Musculoskeletal/Neurological/Psychosocial (15%)
1. Musculoskeletal
a. Compartment syndrome
b. Musculoskeletal surgery
c. Musculoskeletal trauma
d. Rhabdomyolysis
2. Neurological
a. Acute spinal cord injury
b. Agitation
c. Brain death
d. Congenital neurological abnormalities
e. Delirium
f. Encephalopathy
g. Head trauma
h. Hydrocephalus
i. Intracranial hemorrhage
j. Neurogenic shock
k. Neurologic infectious disease
l. Neuromuscular disorders
m. Neurosurgery
n. Pain: acute, chronic
o. Seizure disorders
p. Space-occupying lesions
q. Spinal fusion
r. Stroke
s. Traumatic brain injury (TBI)
3. Behavioral and Psychosocial
a. Abuse and neglect
b. Post-traumatic stress disorder (PTSD)
c. Post-intensive care syndrome (PICS)
d. Self-harm
e. Suicidal ideation and behavior

E. Multisystem (13%)
1. Acid-base imbalance
2. Anaphylactic shock
3. Death and dying
4. Healthcare-associated conditions (e.g., VAE, CAUTI, CLABSI)
5. Hypovolemic shock
6. Post-transplant complications
7. Sepsis
8. Submersion injuries (i.e. near drowning)
9. Hyperthermia and hypothermia
10. Toxin and drug exposure

II. Professional Caring & Ethical Practice (20%)
A. Advocacy/Moral Agency
B. Caring Practices
C. Response to Diversity
D. Facilitation of Learning
E. Collaboration
F. Systems Thinking
G. Clinical Inquiry

CLINICAL JUDGMENT
General
• Manage patients receiving:
o continuous sedation
o extracorporeal membrane oxygenation (ECMO)
o nonpharmacologic interventions
o pharmacologic interventions
o intra-procedural and post-procedural care
o post-operative care
o vascular access
• Conduct physical assessment of critically ill or injured patients
• Conduct psychosocial assessment of critically ill or injured patients
• Evaluate diagnostic test results and laboratory values
• Manage patients during intrahospital transport
• Manage patients undergoing procedural sedation
• Manage patients with temperature monitoring and regulation devices
• Provide family-centered care Cardiovascular
• Manage patients requiring:
o arterial catheterization (e.g., arterial line)
o cardiac catheterization
o cardioversion
o CVP monitoring
o defibrillation
o epicardial pacing
o near-infrared spectroscopy (NIRS)
o umbilical catheterization (e.g., UVC, UAC)
• Manage patients with:
• cardiac dysrhythmias
• hemodynamic instability Respiratory
• Manage patients requiring:
o artificial airways (e.g., endotracheal tubes, tracheotomy)
o assistance with airway clearance chest tubes
o high-frequency oscillatory ventilation (HFOV)
o mechanical ventilation
o noninvasive positive-pressure ventilation (e.g., CPAP, nasal IMV, high-flow nasal cannula)
o prone positioning
o respiratory monitoring devices (e.g., SpO2, SVO2, EtCO2)
o therapeutic gases (e.g., oxygen, nitric oxide, heliox, CO2)
o thoracentesis
Hematology and Immunology
• Manage patients receiving:
o plasmapheresis, exchange transfusion or leukocyte depletion
o transfusion
Neurological
• Conduct pain assessment of critically ill or injured patients
• Manage patients with seizure activity
• Provide end-of-life and palliative care
• Manage patients requiring:
o neurologic monitoring devices and drains (e.g., ICP, ventricular drains, grids)
o spinal immobilization Integumentary
• Manage patients requiring wound prevention and/or treatment (e.g., wound VACs, pressure reduction surfaces, fecal management devices, IV infiltrate treatment)
Gastrointestinal
• Manage patients with inadequate nutrition and fluid intake (e.g., chewing and swallowing difficulties, alterations in hunger and thirst, inability to self-feed)
• Manage patients receiving:
o enteral and parenteral nutrition
o GI drains
o intra-abdominal pressure monitoring Renal and Genitourinary
• Manage patients requiring:
o electrolyte replacement
o renal replacement therapies (e.g., hemodialysis, CRRT, peritoneal dialysis)
Multisystem
• Manage patients requiring progressive mobility
Behavioral and Psychosocial
• Conduct behavioral assessment of critically ill or injured patients (e.g., delirium, withdrawal)
• Manage patients requiring behavioral and mental health interventions
• Respond to behavioral emergencies (e.g., nonviolent crisis intervention, de-escalation techniques)

I. CLINICAL JUDGMENT (80%)
A. Cardiovascular (5%)
1. Acute pulmonary edema
2. Cardiac surgery (e.g., congenital defects, patent ductus arteriosus)
3. Dysrhythmias
4. Heart failure
5. Hypovolemic shock
6. Structural heart defects (acquired and congenital, including valvular disease)

B. Respiratory (21%)
1. Acute respiratory distress syndrome (ARDS)
2. Acute respiratory failure
3. Acute respiratory infection (e.g., pneumonia)
4. Air-leak syndromes
5. Apnea of prematurity
6. Aspiration
7. Chronic conditions (e.g., chronic lung disease/bronchopulmonary dysplasia)
8. Congenital anomalies (e.g., diaphragmatic hernia, tracheoesophageal fistula, choanal atresia, tracheomalacia, tracheal stenosis)
9. Failure to wean from mechanical ventilation
10. Meconium aspiration syndrome
11. Persistent pulmonary hypertension of the newborn (PPHN)
12. Pulmonary hemorrhage
13. Pulmonary hypertension
14. Respiratory distress (RDS)
15. Thoracic surgery
16. Transient tachypnea of the newborn

C. Endocrine/Hematology/Gastrointestinal/Renal/Integumentary (27%)
1. Endocrine
a. Adrenal insufficiency
b. Hyperbilirubinemia
c. Hyperglycemia
d. Hypoglycemia
e. Inborn errors of metabolism
2. Hematology and Immunology
a. Anemia
b. Coagulopathies (e.g., ITP, DIC)
c. Immune deficiencies
d. Leukopenia
e. Polycythemia
f. Rh incompatibilities, ABO incompatibilities, hydrops fetalis
g. Thrombocytopenia
3. Gastrointestinal
a. Bowel infarction/obstruction/perforation (e.g., mesenteric ischemia, adhesions)
b. Feeding intolerance
c. Gastroesophageal reflux
d. GI abnormalities (e.g., omphalocele, gastroschisis, volvulus, imperforate anus, Hirshsprung disease, malrotation, intussusception, hernias)
e. GI surgeries
f. Hepatic failure (e.g., biliary atresia, portal hypertension, esophageal varices)
g. Malnutrition and malabsorption
h. Necrotizing enterocolitis (NEC)
i. Pyloric stenosis
4. Renal and Genitourinary
a. Acute kidney injury (AKI)
b. Chronic kidney disease
c. Congenital genitourinary conditions (e.g., hypospadias, polycystic kidney disease, hydronephrosis, bladder exstrophy)
d. Genitourinary surgery
e. Infections
f. Life-threatening electrolyte imbalances
5. Integumentary
a. Congenital abnormalities (e.g., epidermolysis bullosa, skin tags)
b. IV infiltration
c. Pressure injury/ulcer (e.g., device, incontinence, immobility)
d. Wounds:
i. non-surgical
ii. surgical

D. Musculoskeletal/Neurological/Psychosocial (13%)
1. Musculoskeletal
a. Congenital or acquired musculoskeletal conditions
b. Osteopenia
2. Neurological
a. Agitation
b. Congenital neurological abnormalities (e.g., AV malformation, myelomeningocele, encephalocele)
c. Encephalopathy
d. Head trauma (e.g., forceps and/or vacuum injury)
e. Hemorrhage:
i. intracranial (ICH)
ii. intraventricular (IVH)
f. Hydrocephalus
g. Ischemic insult (e.g., stroke, periventricular leukomalacia)
h. Neurologic infectious disease (e.g., viral, bacterial, fungal)
i. Neuromuscular disorders (e.g., spinal muscular atrophy)
j. Neurosurgery
k. Pain (acute, chronic)
l. Seizure disorders
m. Sensory impairment (e.g., retinopathy of prematurity, hearing impairment, visual impairment)
n. Stress (e.g., noise, overstimulation, sleep disturbances)
o. Traumatic brain injury (e.g., epidural, subdural, concussion, physical abuse)
3. Behavioral and Psychosocial
a. Abuse and neglect
b. Families in crisis (e.g., stress, grief, lack of coping)

E. Multisystem (14%)
1. Birth injuries (e.g., hypoxic-ischemic encephalopathy, brachial plexus injury, lacerations)
2. Developmental delays
3. Failure to thrive
4. Healthcare-associated conditions (e.g., VAE, CAUTI, CLABSI)
5. Hypotension
6. Infectious diseases (e.g., influenza, respiratory syncytial virus, multidrugresistant organisms)
7. Life-threatening maternal/fetal complications (e.g., eclampsia, HELLP syndrome, maternal-fetal transfusion, placental
abruption, placenta previa) 8. Low birth weight/prematurity
9. Sepsis
10. Terminal conditions (e.g., end-of-life, palliative care)
11. Thermoregulation
12. Toxin/drug exposure (e.g., neonatal abstinence syndrome, fetal alcohol syndrome, maternal or iatrogenic).

II. Professional Caring & Ethical Practice (20%)
A. Advocacy/Moral Agency
B. Caring Practices
C. Response to Diversity
D. Facilitation of Learning
E. Collaboration
F. Systems Thinking
G. Clinical Inquiry

CLINICAL JUDGMENT
General
• Assess pain considering patients gestational age
• Follow protocol for newborn car seat testing, hearing and congenital heart disease screening
• Follow protocol for feeding and supplementation
• Identify and monitor normal and abnormal diagnostic test results
• Implement interventions to keep neonates safe (e.g., transponder use, safe sleep)
• Manage monitor alarms based on protocol and change in patient condition
• Manage patients receiving complementary alternative medicine and/or nonpharmacologic interventions
• Manage patients receiving medications (e.g., safe administration, monitoring, polypharmacy)
• Monitor patients and follow protocols for pre- and postoperative care
• Recognize indications for, and manage patients requiring, central venous access
• Recognize normal and abnormal:
o developmental assessment findings and provide developmentally appropriate care
o family psychosocial assessment findings
o physical assessment findings
• Recognize signs and symptoms of emergencies, initiate interventions, and seek assistance as needed
Cardiovascular
• Apply leads for cardiac monitoring
• Identify, interpret and monitor cardiac rhythms
• Monitor hemodynamic status and recognize signs and symptoms of hemodynamic instability
• Recognize early signs of decreased cardiac output
• Recognize normal fetal circulation and transition to extra-uterine life
Recognize indications for, and manage patients requiring:
o 12-lead ECG
o arterial catheter
o cardioversion
o invasive hemodynamic monitoring Respiratory
• Interpret blood gas results
• Manage medications and monitor patients requiring rapid sequence intubation (RSI)
• Recognize indications for, and manage patients with, tracheostomy
• Recognize indications for, and manage patients requiring:
o assisted ventilation
o bronchoscopy
o chest tubes
o endotracheal tubes
o non-invasive positive pressure ventilation (e.g., bilevel positive airway pressure, CPAP, high-flow nasal cannula)
o oxygen therapy delivery device
o prone positioning (lateral rotation therapy)
o rescue airways (e.g., laryngeal mask airway [LMA])
o respiratory monitoring devices (e.g., SpO2, EtCO2) and report values
o therapeutic gases (e.g., oxygen, nitric oxide, heliox, CO2)
o thoracentesis
Hematology and Immunology
• Manage patients receiving transfusion of blood products
• Monitor and manage patients with bleeding disorders
• Monitor patients and follow protocols:
o pre-, intra-, post-intervention (e.g., exchange transfusion)
o related to blood conservation
Neurological
• Manage patients with congenital neurological abnormalities
Critical Care Register Nurse
Medical Critical test
Killexams : Medical Critical test - BingNews https://killexams.com/pass4sure/exam-detail/CCRN Search results Killexams : Medical Critical test - BingNews https://killexams.com/pass4sure/exam-detail/CCRN https://killexams.com/exam_list/Medical Killexams : New Mexico doing away with some COVID-19 PCR test sites, but community health advocates pushing state to keep them

This story was first published by Source New Mexico.

New Mexico is preparing to no longer provide easily available, community-wide, free diagnostic testing for COVID, worrying community health advocates that it could affect New Mexicans’ ability to get treatment.

KUNM reports Curative PCR test sites around the state and the country will close by the end of December, ending reliable access to fast and accurate test results and treatment options.

Six days later, state officials announced on Thursday “the state will only provide free, at-home testing going forward,” and will work with local governments to hand out 1 million free at-home tests from the Centers for Disease Control and Prevention.

Free PCR testing going away means many New Mexicans having to resort to using free at-home tests and will delay care simply waiting. They’re waiting to get an accurate result, waiting to get a prescription, and then waiting to get that prescription filled.

Experts have pointed out a PCR test is the best way to find out if you have COVID in the event you are experiencing symptoms or you have been exposed to someone who tested positive.

A PCR test takes the molecules of the cells inside the SARS-CoV-2 virus and multiplies the sample to a point where a technician can tell what was in the sample, said Rafael Rubio, president of Albuquerque-based medical technology company NetMedical.

“So if you have a teeny tiny bit of virus. It can amplify to the point where it’s like, ‘Hey, that thing that’s growing inside you right now, that’s SARS-CoV-2,’” Rubio said.

That process is where the test gets its name: reverse transcription-polymerase chain reaction (PCR).

PCR tests detect it earlier in the course of infection after exposure than the less sensitive rapid antigen test, Dr. Albert Ko, the Raj and Indra Nooyi Professor of Public Health at the Yale School of Public Health, told CNN.

But on Thursday, New Mexico’s Acting Health Secretary Dr. David Scrase said he does not see PCR testing as a necessary tool.

Scrase presented data showing you have to take two or three at-home tests in order to get the most accurate result, and those at-home tests are the most accurate at three days after the onset of symptoms.

The FDA recommends spacing out rapid tests at least 48 hours apart.

Paxlovid must be taken within five days of developing symptoms for it to reduce your risk of getting hospitalized with COVID, and to reduce your risk of developing Long COVID.

“You’re talking about a five-day window for doing the job of what PCR could have done in a single test,” Rael said. “If the FDA is saying that you’ve got three tests across five days, then you really might miss your window for the Paxlovid prescription.”

But Scrase said this will not impact New Mexicans’ ability to get Paxlovid treatment on time. Having a test that’s 10% more accurate but 10 times harder to reach is not better than a less accurate test that gives results in 15 minutes, he said.

Scrase said most of his patients go through the entire process “in one or two days at the most.”

“I don’t think we’re unnecessarily introducing a huge delay that’s gonna delay care,” Scrase said. “I actually think we’re setting ourselves up for success, because of the wide ability and access of home testing to virtually everyone, as opposed to having to get a ride and transportation, or to have someone help you get to a place to get a PCR test.”

Curative was offering two-hour PCRs and one-day PCRs, said Roberta Rael, director and founder of Generation Justice.

“The folks I work with keep saying that they keep on taking the antigen test, and it’s not coming through, but they’re super sick, they have all of the symptoms,” Rael said. “They’re not getting the Paxlovid if they do need it.”

There is also concern about people not knowing how to get a good sample using a home test. If you don’t get a good sample, you’re not going to get a good test result, Rael said.

An example of a free at-home COVID-19 test. © CHRIS LANDSBERGER/THE OKLAHOMAN An example of a free at-home COVID-19 test.

“There’s less and less education, and all of the different tests that I have at home, and that I buy for folks, all have different instructions,” Rael said.

Scrase said people should carefully read the instructions to determine if a test requires you to swab one nostril or two, and how far to put the swab into your nose. To get an adequate sample with an at-home test, “you have to be uncomfortable,” Scrase said.

Petition to keep PCR going

After northern New Mexico resident Luis Peña started asking around about where to get his children tested for COVID, he started a petition to state health officials, as a request to extend safety measures to an underserved area.

He said this is absolutely the worst time to be taking away a layer of testing.

“Don’t take this away in the middle of the flu season,” he said. “I know they’re gonna take it away eventually, it’s just a matter of time, but it’s like, don’t do it now, and don’t do it under the cloak of the holidays when everyone’s getting into vacation mode and their guard is down.”

Rael asked Scrase if there is another option for PCR tests the public should be aware of and can send their loved ones to as they need them.

Scrase said most hospitals in New Mexico offer PCR testing, and told the public to ask local laboratories like TriCore Reference Labs, Southwest Laboratories, or SED Medical Laboratories.

Peña acknowledged he could still get a PCR test at an urgent care or a hospital, but the difference is there is social distancing at the Curative sites, and in some cases they are outdoors.

A man swabs his nose in anticipation of a polymerase chain reaction (PCR) test for the COVID-19 virus Wednesday, Feb. 2, 2022, at the Field of Dreams. The west parking lot of Field of Dreams, 2501 Tashiro Drive in Las Cruces, will be a COVID-19 testing site Monday through Saturday, through Feb. 21, 2022. © Nathan J. Fish/Sun-News A man swabs his nose in anticipation of a polymerase chain reaction (PCR) test for the COVID-19 virus Wednesday, Feb. 2, 2022, at the Field of Dreams. The west parking lot of Field of Dreams, 2501 Tashiro Drive in Las Cruces, will be a COVID-19 testing site Monday through Saturday, through Feb. 21, 2022.

“Versus, you know, I got to go to the emergency room, or urgent care, and there’s tons of people there, man, I could get COVID just going to get the dang test,” he said.

Marquel Musgrave (Nambé) is the COVID Technical Assistance Specialist for the National Indigenous Women’s Resource Center. They heavily rely on data to support and communicate with tribal communities across the U.S. about the impacts and reality of COVID.

“When we remove testing tools, it not only impacts rates of COVID, but it removes the data, which is critical in order for us to assess risk, and to communicate to the public the level of risk,” they said.

Musgrave urges New Mexicans to support the petition, advocate for tools of access like PCR testing in New Mexico, and support the collective health of their communities right now, especially when the entire state other than one county is experiencing high transmission.

Let’s use the tools we have

Everybody either knows somebody, or has somebody in their home who has been sick with either the flu, COVID, or RSV, or multiple ones at one time, Musgrave said.

“We still don’t have a mask mandate, even though the CDC has recommended masking with this level of transmission, and we’re impacted by incredibly severe cases of RSV,” they said.

Young people did so much to protect elderly folks at the beginning of the pandemic, they said, and now they are the ones being most impacted.

“They really did so much for their grandparents, and for who they were around, and right now, we need to support them, because they’re the most impacted right now,” Musgrave said. “How are we protecting our children? What policies do we have to reduce transmission? What tools do we have? Let’s put those to use.”

More health news:

Austin Fisher is a reporter for Source New Mexico.

This article originally appeared on Las Cruces Sun-News: New Mexico doing away with some COVID-19 PCR test sites, but community health advocates pushing state to keep them

Fri, 09 Dec 2022 04:42:54 -0600 en-US text/html https://www.msn.com/en-us/health/medical/new-mexico-doing-away-with-some-covid-19-pcr-test-sites-but-community-health-advocates-pushing-state-to-keep-them/ar-AA156gu9
Killexams : FDA Is Letting Harmful Lab-Developed Tests Fall Through the Cracks

Imagine nearly ending a pregnancy because a lab test was wrong. In January 2022, a story in the New York Times recounted one pregnant woman's experience with an inaccurate genetic non-invasive prenatal screening (NIPS) test. These blood tests analyze small pieces of fetal DNA that cross the placenta into the mother's circulation to assess the risk for genetic abnormalities in the fetus. Though NIPS tests for more common conditions like Down syndrome are very useful clinically, tests for serious but rare conditions like Prader-Willi syndrome -- a condition associated with distinctive facial features, poor muscle tone, weight gain, and behavioral disturbances -- are prone to false-positives. Because Prader-Willi is so rare, it is actually more likely that a positive test is false than true.

And that is exactly what happened in this case. After her test came back positive for fetal Prader-Willi syndrome, the woman contemplated terminating her pregnancy. Luckily, she underwent a follow-up invasive procedure and learned that the initial result was indeed a false-positive. She went through with the pregnancy and delivered a baby with no indication of Prader-Willi syndrome. But it was a close call and the psychological toll was immense.

NIPS tests are a type of medical device called laboratory-developed tests (LDTs). Unlike conventionally manufactured medical devices, LDTs are developed and used in one laboratory and providers send their tests to that facility. At first, LDTs were largely confined to isolated academic laboratories, but with time the number and complexity of such tests has burgeoned as companies are increasingly offering them for more common conditions.

The FDA has the uncontested authority to review all medical devices -- including LDTs -- for safety and efficacy under the Federal Food, Drug, and Cosmetic Act. However, the agency has chosen not to use its authority to regulate LDTs to date. As a result, the FDA does not know how many of these tests are on the market, let alone whether they are safe or effective.

Defenders of the status quo love to point out that regulation of LDTs currently falls under the CMS Clinical Laboratory Improvement Amendments, thus rendering FDA regulation unnecessary in their view. But CMS regulates labs themselves rather than the safety and effectiveness of tests. CMS also only requires labs to have documentation of their tests' "analytical validity" but does not require "clinical validity" data. This means that, for example, CMS would only assess whether a pancreatic cancer test accurately detects cancer proteins, not whether the detection of the proteins is a reliable way to diagnose pancreatic cancer. Or CMS regulation would determine whether a test detects Prader-Willi in fetal DNA, not establish the likelihood that the fetus actually has the condition -- as FDA regulation would. Consequently, regulation under FDA would be much more comprehensive, include communication to doctors and patients, and would allow the agency to track the tests on the market. In sum, it would close critical gaps that allow the marketing of inaccurate LDTs.

The issues arising from the lack of LDT regulation can be seen as similar to the challenges in the early fumbled approach to COVID. Early COVID-19 diagnostic tests were in effect regulated like LDTs in that FDA, anxious to get new tests into the market, allowed them to be marketed without review until the agency had a chance to review their applications for emergency use authorization. Once the agency was able to review the applications, it found validation or design issues in over 65% of a sample of 125 tests submitted for authorization. False-positive COVID-19 tests may have led to unnecessary quarantining and false-negative tests may have led to additional spread of the virus.

By establishing a risk-based framework for FDA regulation of all in vitro clinical tests, regardless of where they are produced and used, the Verifying Accurate Leading-edge IVCT Development Act of 2021 (VALID) sets forth a potential solution to the problem of inaccurate LDTs. The bill creates a tiered system whereby tests that carry risks of serious harm if inaccurate undergo full premarket review, those that pose less-serious risks of harm submit less-detailed documentation of their analytical and clinical validity, and those that are likely to result in minimal harm are exempt from review. The bill also authorizes FDA to require test developers to conduct surveillance of higher-risk tests once they are on the market and mandates adverse event reporting by developers. These processes are standard for drugs. While not a perfect solution, VALID would help ensure the highest-risk tests are properly vetted by the FDA for their safety and effectiveness.

In May 2022, VALID was incorporated into the Senate version of the user fee reauthorization bill, a piece of legislation that must pass every 5 years because it funds a large portion of FDA activities. Unfortunately, Congress instead passed a stripped-down continuing resolution that left out all LDT provisions.

Now that the midterms are behind us, Congress gets a second bite at the apple when the continuing resolution expires on December 16. FDA's current commissioner, Robert Califf, MD, and device chief, Jeffrey Shuren, MD, JD -- and even former Trump-era FDA commissioner Scott Gottlieb, MD -- have supported Congressional action on LDTs. The window of opportunity for LDT reform appears to be closing; let's pass consumer-protective legislation before it slams securely shut.

Stephanie Rogus, PhD, RDN, is a research scientist and campaign manager for scientific integrity at the Center for Science in the Public Interest. Peter G. Lurie, MD, MPH, is president of the Center for Science in the Public Interest, and a former associate commissioner of the FDA.

Fri, 09 Dec 2022 02:02:00 -0600 en text/html https://www.medpagetoday.com/opinion/second-opinions/102161
Killexams : ‘Entire life gone in minutes.’ Kennewick 21-year-old still critical after dramatic fire rescue

Dec. 7—Gavin Conatser dreamed of becoming an Army Ranger.

Now the Kennewick 21-year-old is in the intensive care unit at Harborview Medical Center in Seattle fighting to recover from severe burns and lung damage.

An early morning house fire last week left him with second- and third-degree burns before his girlfriend, Jenae Gallegos, could pull him to safety.

The recovery from the burns could take four to six weeks and his lungs may take much longer or may never recover at all, his sister, Kyleigh Conatser, told the Tri-City Herald this week.

Gallegos and his family are asking for help with medical bills and living expenses as he faces an uncertain future.

They have organized a GoFundMe campaign (bit.ly/ConatserFundraiser) for donations.

"The fire consumed all of Gavin's and Jenae's personal belongings. Their entire life gone in minutes," says the GoFundMe description. "Gavin has a lengthy recovery ahead — physically and mentally."

Dec. 2 fire

Gavin Conatser was sleeping on Dec. 2 when a fire broke out on the main floor of the Quincy Street home that he shares with Gallegos. She wasn't home when he woke up to smoke and flames.

He managed to make it through most of the house before the thick smoke overcame him just a few feet from the front door.

Gallegos arrived home to discover the house on fire and their landlady, who lived in the daylight basement, outside. Her boyfriend was nowhere to be seen.

She raced up to the door and forced it open, and could see Gavin. She grabbed him and, with the help of her landlord, they pulled him to safety.

Kennewick Fire Chief Chad Michael credited Gallegos' quick action for giving her boyfriend a chance to live.

An ambulance rushed him to a local hospital and then he was flown to the burn unit at Harborview.

Michael said the cause of the fire is still under investigation.

Road to recovery

Before the fire, Gavin Conatser was considering enlisting in the U.S. Army with the goal of becoming a Ranger.

He loves to spend time with friends laughing and joking playing games and learning more about military history," Kyleigh Conatser said. "He loves Hondas and all things fast cars. He is a great mechanic and can talk about cars for hours."

His recovery will be lengthy.

Burns cover about 20% to 30% of his body including his head, face, neck arms and hands. Even after leaving the hospital, it's unclear how long treatment will be after his release.

A medical test found his lungs were very damaged from inhaling smoke and, while his condition is stable, he remains critical, according to the GoFundMe.

His family, as well as his girlfriend of eight years, are at the hospital with him.

"Our prayer is that his body responds quickly with no complications and miraculous healing," the GoFundMe says. "He has been blessed with an amazing team of healthcare professionals on the burn unit. We are so thankful for all of the compassion and support he has and is receiving at Harborview Medical Center."

This story was originally published December 7, 2022 12:50 PM.

(c)2022 Tri-City Herald (Kennewick, Wash.) Distributed by Tribune Content Agency, LLC.

Wed, 07 Dec 2022 12:35:00 -0600 en-US text/html https://www.msn.com/en-us/news/us/entire-life-gone-in-minutes-kennewick-21-year-old-still-critical-after-dramatic-fire-rescue/ar-AA151OVf
Killexams : The Army's Fitness Test Might Be Revamped Yet Again for Gender-Neutral and Job-Specific Standards

The Army will likely have to implement further changes to its embattled fitness test, just months after the long-in-development Army Combat Fitness Test, or ACFT, was finally rolled out, as Congress pushes for gender-neutral and potentially job-specific standards.

The must-pass National Defense Authorization Act, or NDAA, which sets funding and policy priorities for the Pentagon, would require Army Secretary Christine Wormuth to revamp the ACFT within 180 days of the bill's passing, establishing the same fitness standards for men and women "that ensure soldiers can perform the duties of their respective" jobs. The language of the bill was unveiled late Tuesday and is expected to become law in the coming weeks.

The requirement would largely take the ACFT back to what Army planners were hoping for, though widespread skepticism from Capitol Hill and Wormuth effectively forced the service to have gender-specific standards shortly after a Military.com report on early test data showed that half of women could not pass the planned test.

Read Next: Military's COVID Vaccine Mandate to Be Repealed by Annual Defense Bill

The poor pass rate for women was partly attributed to the leg tuck, an exercise in which soldiers would touch their knees to their elbows on a pull-up bar. That exercise was eliminated in favor of the plank, which is generally seen as a better measurement of core strength. However, the two-mile run is still the most failed event.

The service was also aiming for job-specific scoring, the idea being an infantryman needs to be held to a higher standard of physical fitness than a soldier who works in an admin job.

Army officials interviewed by Military.com said that differentiating based on jobs quickly gets complicated and test developers who had tried to create such standards before the ACFT was put into use couldn't figure out critical logistics, including whether to grade a soldier based on their job title on paper or responsibilities within a unit. For example, someone in combat arms might be in a recruiting position or a non-combat arms soldier might be assigned to a cavalry unit.

Army planners are already in the early phases of developing separate job standards, but only for combat arms troops, while the rest of the force would likely keep the existing scoring standards. Military.com was first to report in October that the service is testing a completely separate gender-neutral fitness test, but exclusively for expert soldier, infantryman and field medical badges.

The ACFT went live for active-duty soldiers in October and is set to be the test that determines career advancement and potential separation for part-time soldiers in the National Guard and reserve in April. Soldiers have been taking the test in a beta period, during which there are no consequences for results, since 2019.

The ACFT took more than a decade to develop, replacing the decades-old Army Physical Fitness Test, or APFT, which was widely seen as a poor measurement of fitness, grading soldiers only on push-ups, sit-ups and a two-mile run. Soldiers now are evaluated on deadlifts, a plank, hand-release push-ups, a two-mile run, and throwing a 10-lb. ball behind them as far as possible, among other fitness tests.

-- Steve Beynon can be reached at Steve.Beynon@military.com. Follow him on Twitter @StevenBeynon.

Related: The Army's New Fitness Test Is Here. For Real This Time. No, Seriously. But Its Future Is Uncertain.

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Thu, 08 Dec 2022 06:47:00 -0600 en text/html https://www.military.com/daily-news/2022/12/07/armys-fitness-test-might-be-revamped-yet-again-gender-neutral-and-job-specific-standards.html
Killexams : This Low-Cost Test for Hearing Loss Lives on a Smartphone

Inside the snug confines of the human ear lies a bony structure, curly and shaped like a seashell. This structure, called the cochlea, contains little hairy cells that vibrate when sounds pass through. These slight vibrations emerge as faint sounds—hard to detect, but still traceable—and they are different in healthy ears compared to those with hearing loss. 

Detecting these faint sounds, known as otoacoustic emissions, could be the key to screening for hearing loss among children in low-resource countries, where audiology equipment can be hard to come by. Traditional devices can cost thousands of dollars. Now, in Nature Biomedical Engineering, a team at the University of Washington writes that they have developed a test sensitive enough to detect hearing loss that relies only on a conventional smartphone, earbuds, and microphone.

“Growing up in India, we never had any kind of universal hearing screening,” says Shyamnath Gollakota, a computer scientist at the University of Washington who led the study. “Using these devices, we actually have an opportunity to enable universal hearing screening across the world—it’s pretty exciting.”

Measuring otoacoustic emissions is a boon for testing very young patients because it requires no behavioral response. “If you’re an adult, you can go to the doctor, the doctor can play different frequencies in your ear and ask you to raise your hand if you can hear the sound,” says Gollakota. “You can’t do that with a newborn baby.”

And screening in newborns is critical. Without early identification, children can be put at an “enormous developmental disadvantage,” wrote Carolyn Jenks, a pediatric otolaryngologist at Johns Hopkins University, in an email. While testing right after birth is standard in the United States, it is often unavailable in economically developing nations or rural areas with few resources. 

Excluding the smartphone, the team estimates that the rest of their setup costs about $10: $5 for the earbuds, about $2 for the microphone, and the rest for tubing and sealing materials. By using off-the-shelf products, Gollakota says,“We’re leveraging the exponential pace of innovation in computing and mobile devices that has happened in the last 20 years.”

The team tested their homebrew setup’s sensitivity and accuracy on 201 people who ranged from one week to 20 years old at Seattle Children’s Hospital and the Center on Human Development and Disability at the University of Washington. The scientists recruited the patients by simply asking those who came for regular appointments—many of whom had hearing loss of different types—if they would be interested in joining the study. 

To conduct the test, the scientists would insert the earbuds, seal them snugly, and send a pair of sound tones into the ear. If the ear’s hair cells are healthy, “the cochlea will respond in an automatic and involuntary way—producing another tone at another independent frequency,” says Justin Chan, one of the study’s coauthors.

These response emissions are picked up by the external microphone that passes the tones to a phone app the scientists designed, which uses signal processing algorithms to measure the emissions. The app checks four frequencies commonly used for hearing tests. Each one indicates that at that particular frequency, the hair cells are vibrating properly, and the cochlea is passing back the correct sound.

Mon, 05 Dec 2022 23:00:00 -0600 en-US text/html https://www.wired.com/story/this-low-cost-test-for-hearing-loss-lives-on-a-smartphone/
Killexams : 2022 Commonwealth Games: New Medical Test Helps Athletes

The 2022 Commonwealth Games drew about 6,500 athletes and officials from 72 nations and territories for the biggest multi-sport event held in the United Kingdom since the 2012 London Olympics. But behind the scenes of the 11-day event, which took place earlier this month in Birmingham, England, some of the most advanced sports medicine tech and other medical devices were hard at work.

One such medical technology on the sidelines at the 2022 Commonwealth Games was a portable, rapid diagnostic system, developed by London-based ProtonDx, called the Dragonfly. According to the company, Team Scotland requested to use the Dragonfly as a direct result of having used the system earlier this year at the 2022 Olympic Winter Games in Beijing, China.

Testing at the 2022 Commonwealth Games provided insight into respiratory infections that might have affected individual performance and helped identify any impact on other athletes who might have potentially been exposed, ProtonDx noted. It helped provide ‘peace of mind’ to athletes and coaches in the run-up to, and during, the Games. Team Scotland’s request to use the system was a direct result of the highly positive experience, earlier this year, of Dragonfly’s use by Team GB at the 2022 Olympic Winter Games held in Beijing, China.

Using ultra-fast nucleic acid extraction, and isothermal colorimetric detection, the system achieves PCR-equivalent sensitivity and specificity in less than 30 minutes from sample to result. The 5-in-1 respiratory test panel detects severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2), influenza A, influenza B, respiratory syncytial virus, and human rhinovirus in a single test.

"It has taken years of intense training and focused preparation for Scotland’s best athletes to compete in the 2022 Commonwealth Games, the largest games ever held," said Niall Elliott, MD, chief medical officer for Team Scotland. "It was of the utmost importance that my team and I were able to ensure our athletes were in top condition and free of several critical respiratory viruses. The exact COVID-19 pandemic has made us more attuned to how vital it is to be able to quickly assess athletes’ health using a system that is highly portable and can test for multiple viruses in parallel. With the successful use of Dragonfly in Beijing, we approached ProtonDx about using this diagnostic tool during the 2022 Commonwealth Games. We appreciate our strong relationships and coordinated efforts with Team GB and ProtonDx, and value the innovative Dragonfly technology.”

In June, ProtonDx, reported that it had received a CE‑IVD mark for its Dragonfly multi-pathogen detection diagnostic system. The company says the system is poised to help revolutionize rapid infectious disease diagnosis and tracking worldwide. ProtonDx is a heath technology spin-out from Imperial College London UK.

"Dragonfly's successful deployment in elite sports is a testament to the reliability, ease-of-use, and portability of the system that we saw during its use by Team GB at the Olympic Winter Games," said Bob Enck, chairman and president at ProtonDx. “Team Scotland wanted to access the independent infectious disease detection and testing capability that Dragonfly offers. Dragonfly is a potential game changer in the diagnostics industry –  providing quick, cost-effective, and confident results, irrespective of location. With its demonstrated value at major international sporting events, the interest in Dragonfly throughout the sporting world and other key industries is rapidly expanding across Europe.”

Medical imaging at 2022 Commonwealth Games

Imaging systems provided by Canon Medical Systems UK also played a prominent role in the 2022 Commonwealth Games. The company provided advanced diagnostic imaging services at three specialist sports medicine polyclinics during the event.

Canon said it installed diagnostic ultrasound, digital radiography X-ray, and two artificial intelligence-assisted relocatable MRI scanners with full healthcare IT connectivity. These imaging systems helped clinicians quickly and digitally assess common musculoskeletal sports related issues such as bone, muscle, tendon or joint injury, without the need to be transferred to local hospitals, the company noted.

The 2022 Commonwealth Games were the first UK multi-sports event to offer all competing athletes access to advanced diagnostic healthcare imaging featuring AI, Canon said. The two Vantage Orian 1.5T MRI scanners housed in modular units feature Canon Medical UK’s pioneering Advanced Intelligent Clear-IQ Engine (AiCE), a deep learning reconstruction technology. This technology uses training data from thousands of images/ data sets to intelligently remove the noise, allowing anatomy and pathology to be clearly visualized. AiCE is an algorithm that can be used to shorten scan time, Improve resolution, or a combination of the two, offering greater efficiency and patient comfort.

Diagnostic ultrasound support at the 2022 Commonwealth Games was provided by the Canon Medical Aplio i800 Prism Edition. This is cart-based system with touch screen controls or can be operated by a wireless tablet. According to Canon, the system produces crystal-clear images to diagnose ligament tears or muscle strains. It also includes Canon’s micro-vascular imaging technology, which visualizes blood flow in color of very low-velocity and small diameter blood vessels in the evaluation of musculoskeletal disorders.

Tue, 29 Nov 2022 10:00:00 -0600 en text/html https://www.mddionline.com/ivd/2022-commonwealth-games-new-medical-test-helps-athletes
Killexams : Column: Critical need for lawsuit reforms in Florida No result found, try new keyword!Lawmakers should tackle legal reform when they convene during the upcoming special session and the 2023 regular session, the author writes. Thu, 08 Dec 2022 19:00:00 -0600 text/html https://www.bizjournals.com/tampabay/news/2022/12/09/critical-need-for-lawsuit-reforms-in-florida.html Killexams : Cepheid's Multi-Target Test Design Enables Detection of Influenza Variants

SUNNYVALE, Calif., Dec. 8, 2022 /PRNewswire/ -- Currently circulating mutant strains of influenza highlight the need for multi-target diagnostic tests. Two recently identified mutations in the matrix genes of the Human Influenza A virus have been reported to cause matrix gene target failure (MGTF) for several commercial diagnostic tests1. Cepheid's respiratory test design enables detection of these new variants, and with similar symptoms across various illnesses such as the flu, respiratory syncytial virus (RSV) disease, and COVID-19, an accurate and fast diagnosis is critical to patient care.

Variants of the (H1N1)pdm09 and A(H3N2) viruses containing matrix gene mutations are currently circulating around the world1. Recombination and other mutations of the viruses impact the performance of molecular diagnostic tests – which may lead to an increase in false negative test results. The greatest impact occurs in tests that detect only one genetic target of the influenza genome.2, 3

"In developing our portfolio of respiratory tests, we include multiple conserved gene targets to account for genetic drift within the influenza genome," said David Persing, M.D., Ph.D., EVP and Chief Scientific Officer of Cepheid. "The resulting target redundancy mitigates the impact of mutational drift. Our three-gene target design for detection of influenza A reduces the risk of false-negative test results, even in the event of an MGTF."

Cepheid's respiratory tests all utilize a multi-target approach for the detection of influenza, providing target redundancy to mitigate the potential impact of genetic shift and drift on strain detection:

  • Xpert Xpress Flu/RSV
  • Xpert Xpress SARS-CoV-2/Flu/RSV^
  • Xpert Xpress CoV-2/Flu/RSV plus^

Table 1. Influenza genes targeted by Cepheid tests

Influenza virus type
A B
3-Gene Target Detection 2-Gene Target Detection

"The Medicines and Healthcare Products Regulatory Agency (MHRA), United Kingdom (UK) has asked all influenza test manufacturers in the UK to analyze their tests for any impact to diagnostic performance against the H1N1pdm09 strain. Our Scientific Affairs team performed in silico testing of the performance of our portfolio of influenza tests against the new H1N1pdm09 strain," said Mike Loeffelholz, Ph.D., D(ABMM) and Senior Director, Scientific Affairs. "Our analysis shows 100% predicted coverage for this strain."

Visit www.cepheid.com for more information.

References

  • Jørgensen RL, et al. Emergence of circulating influenza A H3N2 viruses with genetic drift in the matrix gene: be alert of false-negative test results. 2022. APMIS. 130(10): 612–617.
  • Overmeire Y et al. Severe sensitivity loss in an influenza A molecular assay due to antigenic drift variants during the 2014/15 influenza season. 2016. Diagnostic Microbiology and Infectious Disease. 85(1):42-46.
  • Binnicker MJ, et al. Identification of an Influenza A H1N1/2009 Virus with Mutations in the Matrix Gene Causing a Negative Result by a Commercial Molecular Assay.  2013. J Clinical Microbiology. 51(6):2006-2007.
  • About Cepheid

    Based in Sunnyvale, Calif., Cepheid is a leading molecular diagnostics company. Cepheid is dedicated to improving healthcare by developing, manufacturing, and marketing accurate yet easy-to-use molecular systems and tests. By automating highly complex and time-consuming manual procedures, the company's solutions deliver a better way for institutions of any size to perform sophisticated molecular diagnostic testing for organisms and genetic-based diseases. Through its strong molecular biology capabilities, the company is focusing on those applications where accurate, rapid, and actionable test results are needed most, such as managing infectious diseases and cancer. For more information, visit https://www.cepheid.com.

    US-IVD and CE-IVD. In Vitro Diagnostic Medical Device.
    ^ For use under an Emergency Use Authorization in the United States.

    For Cepheid Media Inquiries: 
    Darwa Peterson
    darwa.peterson@cepheid.com 

    Cision View original content:https://www.prnewswire.com/news-releases/cepheids-multi-target-test-design-enables-detection-of-influenza-variants-301698045.html

    SOURCE Cepheid

Wed, 07 Dec 2022 22:21:00 -0600 en text/html https://markets.businessinsider.com/news/stocks/cepheid-s-multi-target-test-design-enables-detection-of-influenza-variants-1031960075
Killexams : Report finds young Australians play critical role in youth mental health support

Western Sydney University researchers, youth mental health charity batyr, and clinical researcher Dr. Erin Dolan have released a new report that examines the help young people are providing each other, to better understand the care young people need when facing mental health challenges.

The findings reveal that 94% of those surveyed had direct experience helping a through mental ill-health, with young people spending an average of 3.5 hours per week supporting friends. In addition, almost 70% reported that during , they felt most supported from friends, more so than parents or mental health practitioners.

The report, "Being there: Young people supporting their friends through tough times," draws on findings from a and focus groups exploring how young people their friends through challenging times, amplifying the voices and experiences of young people around Australia.

The study highlights the critical work being undertaken by Australian youth and provides insight into the unique expertise of young people, that could foster the development of resources that not only include friendships but build on existing tools to better address services that support youth and address the fundamental issues such as poverty, discrimination, uncertainty that lead to those tough times.

Lead researcher Dr. Benjamin Hanckel, Senior Research Fellow from Western Sydney University's Institute for Culture and Society and Vice-Chancellor's fellow at Young and Resilient Research Center, said the findings were significant as they highlight the role young Australians can play in unlocking better support for youth challenges.

"For the first time, our research shows the ways young people across the nation provide critical support for their peers when they are struggling or going through tough times. Importantly, highlighting how through providing personalized support to their friends, young people are well placed to notice changes in behavior or mood while having a unique understanding of their friends' individual needs and circumstances," said Dr. Hanckel.

"By simply 'being there' for their friends in their toughest moments, young people create spaces for their friends to be vulnerable. By understanding the benefits of peer-to-peer support, we can better address the challenges our youth face and build on this knowledge to foster useful support resources."

Findings of the report also include improved understanding of the level of support young people provide to one another. Significantly, they are assisting during tough health and finance difficulties, exam stress and other mental health stressors.

"Young people are going above and beyond by providing , temporary housing, and being strategic in asking specific questions that make it easier for their friends to open up. This is happening in both an online and in-person setting. We need to think about how we best resource young people in acceptable ways, so they have the tools to continue to support friends and manage feelings of responsibility," said Dr. Hanckel.

CEO of batyr, Nic Brown said young people care about their peers and communities particularly given the disruptions and uncertainty they experienced in the last few years.

"Friendships are playing a central role in , with around 70% of this cohort more likely to turn to their peers and friends before their parents or teachers," he said.

"Not only are young people providing ongoing support when friends are dealing with mental ill-health, but they are recognizing when friends need professional help too, connecting friends to more formal pathways of care. They are working really hard to support their friends when their access to professional help is limited."

In terms of professional help, the results have significant implications for clinicians. With clinicians under pressure from increased demand on services due to COVID-19, this study has the potential to support the ways clinicians help young people who are taking on critical roles supporting their friends.

Co-author of the report Clinical psychologist Dr. Erin Dolan, recognizes the important role friendships play in day to day support changes that need to happen to better support youth.

"Young people often feel adults are inexperienced or minimizing their issues. The best thing clinicians, parents and other adults can do is to listen without judgment and offer validation and support. Learning to see the world from their point of view is essential to help them navigate their support journey," said Dr. Dolan.

The report makes recommendations developed from discussions with young people and consultations within the sector. This includes that mental health support provision should look to solve youth challenges through youth-led approaches and should factor in the expertise of and the critical support they are already providing to their friends.

Citation: Report finds young Australians play critical role in youth mental health support (2022, November 30) retrieved 9 December 2022 from https://medicalxpress.com/news/2022-11-young-australians-play-critical-role.html

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Wed, 30 Nov 2022 03:46:00 -0600 en text/html https://medicalxpress.com/news/2022-11-young-australians-play-critical-role.html
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