Who is a candidate for TTM?

A candidate for Targeted Temperature Management (TTM) is typically an adult who is comatose after cardiac arrest (ROSC), regardless of the initial heart rhythm, to protect the brain from injury, with specific criteria including a Glasgow Coma Scale (GCS) of ≤8 and not following commands, and may include those with shockable (VF/pulseless VT) or non-shockable rhythms after in-hospital or out-of-hospital arrest. Key factors are being unresponsive (comatose) post-ROSC and needing protection from hypoxic-ischemic damage, though contraindications like pregnancy or severe underlying illness exist.

Who is a candidate for targeted temperature management?

Any survivor of cardiac arrest who is comatose should be considered as a candidate for targeted temperature management (TTM). TTM requires a multidisciplinary team and multiple clinical decisions.

What is the purpose of TTM?

[3] Today, the term targeted temperature management (TTM) is used instead of therapeutic hypothermia. TTM can be used to prevent fever, maintain normothermia, or induce hypothermia.

What medical conditions use TTM?

TTM is effective in five primary categories of medical events:

• Neonatal encephalopathy.
• Cardiac arrest.
• Ischemic stroke.
• Traumatic brain or spinal cord injury without a fever.
• Neurogenic fever following brain trauma.

When to start TTM?

TTM should be initiated as soon as possible after cardiac arrest in comatose patients.

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How long does TTM last?

Duration of TTM and rewarming

TTM should be induced and maintained at the selected target temperature for 24 hours, and rewarmed gradually at a rate not faster than 0.5°C per hour. Every hour of delay in TTM after ROSC increases mortality by 20%. Thus, TTM should be initiated as soon as possible after ROSC.

How to perform TTM?

SUGGESTED TTM PROTOCOL

1. Completely expose the patient.
2. Lower the ambient temperature.
3. If failing to achieve normothermia, use an active cooling device such as: An endovascular cooling device with a closed-loop system. A surface cooling device with a closed-loop system.

What is the first line treatment for trichotillomania?

Cognitive behavioral approaches are the first-line treatment for trichotillomania and have consistently demonstrated efficacy in research trials. Specifically, Habit Reversal Therapy (HRT) in tandem with stimulus control is utilized.

What are the 4 phases of TTM?

Overview of the stages of change or transtheoretical model (TTM) in a health promotion setting: precontemplation, contemplation, preparation, action, and maintenance.

What are the risks of TTM?

Risk and complications

TTM may lead to fluid and electrolyte imbalances, arrhythmias, insulin resistance, shivering, coagulation problems, pancreatitis, infection, skin breakdown and other adverse effects.

What is TTM full form?

TTM (“Trailing Twelve Months”)—often used interchangeably with the term LTM (“Last Twelve Months”)—is used by practitioners to analyze a company's recent financial performance. Conceptually, the trailing twelve months (TTM) is a measure of a company's financial performance in the most recent 12-month period.

What are the five stages of TTM?

TTM stages include[1][2][3][4][5]:

• Precontemplation.
• Contemplation.
• Preparation.
• Action.
• Maintenance.

When is therapeutic hypothermia recommended?

Therapeutic hypothermia can help only some people who have had cardiac arrest. Some people regain consciousness right after cardiac arrest. These people often don't need this procedure. It's helpful only for people whose heartbeat returns after a sudden cardiac arrest.

Does TTM improve neurological outcomes?

Early initiation of in-hospital TTM (within 2 hours after admission) has been shown to be generally safe and associated with improved survival, but not with better neurological outcome.

What is the absolute contraindication for TTM?

Contraindications: the only absolute contraindication for TTM is an advanced directive prohibiting invasive interventions.

Is TTM used for stroke patients?

TTM is a recommended neuroprotective intervention for all comatose/unresponsive survivors of cardiac arrest, regardless of the initial rhythm or arrest location (19). Several studies have reported that early initiation of TTM within a few hours of ischemic stroke is associated with favorable outcomes (9).

What are the principles of TTM?

There are four key constructs of TTM, 1) five stages of change, 2) 10 processes of change, 3) decisional balance, and 4) self-efficacy. Central to TTM are the stages of change: 1) precontemplation, 2) contemplation, 3) preparation, 4) action, and 5) maintenance.

What are the 4 phases of risk management?

The four key steps of the risk management process are Risk Identification, Risk Assessment, Risk Treatment (or Response), and Risk Monitoring & Reporting, forming a continuous cycle to understand, analyze, manage, and track potential threats and opportunities to achieve objectives. This systematic approach helps organizations proactively address uncertainties, building resilience by turning potential problems into manageable situations. 

What are the 10 processes of change in the TTM model?

The ten processes of change are consciousness raising, counterconditioning, dramatic relief,environmental reevaluation, helping relationships, reinforcement management, self-liberation,self-reevaluation, social-liberation, and stimulus control.

What vitamin deficiency causes trichotillomania?

Trichotillomania Triggered by Vitamin D Deficiency and Resolving Dramatically With Vitamin D Therapy. Clin Neuropharmacol.

What famous person has trichotillomania?

Actress Olivia Munn recently shared her struggles with trichotillomania, a mental health condition that causes people to pull out their own hair. Opening up about the disorder has sparked conversation about how common trichotillomania is and what treatments are available.

What type of doctor treats trichotillomania?

A trichologist is a specialist who focuses on the study of hair and scalp health. The term “trichology” comes from the Greek word “trikhos,” which means hair. Unlike dermatologists, who handle a broad range of skin issues, trichologists are specifically trained to deal with problems related to the hair and scalp.

How long does TTM treatment last?

Targeted Temperature Management means "manipulating body temperature for a given therapeutic goal." TTM therapy intentionally lower's a patient's body temperature for 24 hours to around 91°F, or in other cases 97°F (normal body temperature is about 98.6°F).

What should be avoided in TTM?

Avoid fever following targeted temperature management (TTM), as any elevated temperature is associated with worse neurologic outcome. Avoid hypoxia, with administration of oxygen saturation above 94%. However, hyperoxia is also harmful.

What are the alternatives to TTM?

TTM's top competitors include Nucleon Security, Crossword Cybersecurity, and BroadBand Security. Nucleon Security is a cybersecurity company that focuses on endpoint protection and vulnerability management. The company's main offering is the Nucleon Smart Endpoint …