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Emergency anaesthesia

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https://www.readbyqxmd.com/read/29666130/does-dexmedetomidine-given-as-a-premedication-or-intraoperatively-reduce-post-hospitalisation-behaviour-change-in-children-a-study-protocol-for-a-randomised-controlled-trial-in-a-tertiary-paediatric-hospital
#1
Paul Lee-Archer, Craig McBride, Rebecca Paterson, Michael Reade, Britta Regli-von Ungern-Sternberg, Deborah Long
INTRODUCTION: It has been reported that post-hospitalisation behaviour change (PHBC) occurs in over 50% of children undergoing a general anaesthetic and manifests as behaviours such as sleep and eating disorders, defiance of authority, nightmares, enuresis and temper tantrums. The effect is usually short-lived (2-4 weeks); however, in 5-10% of children, these behaviours can last up to 12 months. The risk factors for developing PHBC include underlying anxiety in the child or parent, a previous bad hospital experience, emergence delirium and preschool age...
April 17, 2018: BMJ Open
https://www.readbyqxmd.com/read/29663461/the-legal-frameworks-that-govern-fetal-surgery-in-the-united-kingdom-european-union-and-the-united-states
#2
REVIEW
Kevin X Cao, Alice Booth, Sebastien Ourselin, Anna L David, Richard Ashcroft
The specialty of fetal surgery or fetal intervention is one of the most exciting emerging fields of modern medicine. It is made possible by decades of major developments in antenatal imaging, obstetric anaesthesia, fetal medicine, paediatric surgery and of course by the bold and novel practitioners willing to take new steps to advance the field. Beginning in the 1970s it has now reached a stage of maturity where there are several established in-utero procedures and countless clinical trials and studies to develop more...
April 16, 2018: Prenatal Diagnosis
https://www.readbyqxmd.com/read/29661406/pre-hospital-anaesthesia-no-longer-the-poor-relative-of-high-quality-in-hospital-emergency-airway-management
#3
EDITORIAL
D J Lockey, K Crewdson
No abstract text is available yet for this article.
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29656528/the-role-of-scalpel-bougie-cricothyroidotomy-in-managing-emergency-front-of-neck-airway-access-a-review-and-technical-update-for-ent-surgeons
#4
N D McNiven, J P Pracy, B A McGrath, A K Robson
In October 2016 an editorial was published jointly in Clinical Otolaryngology and the British Journal of Anaesthesia concerning the appropriate management of the difficult airway in a situation of 'Can't Intubate Can't Oxygenate' (CICO).1 It highlighted the importance of joint working between surgeons and anaesthetists and also made a case for the wider use of the scalpel-bougie cricothyroidotomy technique in securing a Front of Neck Airway (FONA), especially in an emergency. This article is protected by copyright...
April 15, 2018: Clinical Otolaryngology
https://www.readbyqxmd.com/read/29644304/trans-triquetral-perilunate-fracture-dislocation
#5
John-Henry Rhind, Abhinav Gulihar, Andrew Smith
Perilunate dislocations and perilunate fracture dislocations are rare and serious injuries. Perilunate dislocations represent less than 10% of all carpal injuries of which 61% represent transcaphoid fractures. Because of their rarity, up to 25% of perilunate dislocations are initially missed on first assessment. We present the case of a 66-year-old-gentleman who sustained an isolated trans-triquetral perilunate fracture dislocation while walking his dog. This was diagnosed in the emergency department and he underwent open reduction internal fixation after failed attempts at closed reduction in the ED and in theatre under general anaesthesia...
April 2018: Trauma Case Reports
https://www.readbyqxmd.com/read/29644037/obstructive-hydrocephalus-secondary-to-odontoid-pannus-case-report-and-review-of-literature
#6
Wai Cheong Soon, Gopiga Thanabalasundaram, Kyaw Zayar Thant, Ebere Sunny Ogbonnaya, Stuart Edward Harrisson
Odontoid pannus or periodontoid pseudotumour is associated with a variety of rheumatological conditions. We report a case of an 80-year old man who presented with acute hydrocephalus following an emergency operation to amputate his infected left big toe. Imaging revealed a large tissue mass causing severe compression at the cervico-medullary junction and obstruction of CSF flow. The acute hydrocephalus was presumed to be related to neck manoeuvring during general anaesthesia. Following an initial emergency CSF diversion through external ventricular drainage catheter insertion, the patient subsequently underwent ventriculo-peritoneal insertion and posterior spinal decompression and fixation...
April 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29643163/effect-of-intratracheal-dexmedetomidine-administration-on-recovery-from-general-anaesthesia-after-gynaecological-laparoscopic-surgery-a-randomised-double-blinded-study
#7
Fei Wang, Haoxiang Zhong, Xiaoyan Xie, Weiping Sha, Caili Li, Zhenping Li, Zhuomei Huang, Chaojin Chen
OBJECTIVES: To examine the efficacy of intratracheal dexmedetomidine (Dex) injection for the prevention of the laryngeal response on emergence from general anaesthesia following gynaecological laparoscopic surgery. DESIGN: Prospective, randomised, double-blinded, controlled trial. SETTING: A general hospital, Guangdong Province, China. PARTICIPANTS: All patients who underwent elective laparoscopic gynaecological surgery, aged 18-60 years old, 40-80 kg in weight, American Society of Anesthesiologists class I-II were eligible...
April 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29615125/in-office-laryngeal-procedures-iolp-in-canada-current-safety-practices-and-procedural-care
#8
Yael Bensoussan, Jennifer Anderson
BACKGROUND: The advent of chip tip technology combined with advanced endoscopy has revolutionized the field of laryngology in the past decade. Procedures such as transnasal esophagoscopy, site-specific steroid injections, injection laryngoplasty and laryngeal laser treatment can now be performed in the office setting under local anaesthesia. Although In-Office Laryngeal Procedures (IOLPs) have become standard-of-care in many American and several Canadian centers, there are no guidelines regulating the practice of these procedures...
April 3, 2018: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29592987/seizure-induced-unilateral-posterior-dislocation-of-the-shoulder-a-diagnosis-not-to-be-missed
#9
Andrew Roy McKean, Shankar Kumar, Greg Michael McKean, Demitrios Tzias
A man in his mid-50s with a history of bladder carcinoma presented to the Emergency Department (ED) following a witnessed tonic-clonic seizure. Computed Tomography (CT) scanning of his brain revealed an indeterminate mass lesion in the left parietal region. The patient described bilateral shoulder pain prompting plain film radiographs with axial views, but no obvious abnormality was identified by the ED staff. Staging CT scanning did not reveal any evidence of underlying malignancy but revealed dislocation of the left humeral head with a large reverse Hill-Sachs lesion and posteriorly displaced reverse Bankart lesion...
March 28, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29577091/early-administration-of-venovenous-extracorporeal-life-support-for-status-asthmaticus-during-anaesthetic-induction-case-report-and-literature-review
#10
Won Ho Chang
Here we report a case of a 40-year-old man who visited the emergency room with severe chest pain. He showed a Stanford type B aortic dissection on chest-computed tomography. Despite medical treatment and malperfusion of lower extremities, acute renal failure developed; hence thoracic endovascular aortic repair (TEVAR) was considered under general anaesthesia. After endotracheal intubation, ventilation with low tidal volume required high inspiratory airway pressure. An arterial blood gas analysis showed PaCO2 of 61...
2018: Open Medicine (Warsaw, Poland)
https://www.readbyqxmd.com/read/29572099/a-ten-year-analysis-of-the-reasons-for-death-following-ambulatory-surgery-nine-closed-claims-declared-to-sham-insurance
#11
A Theissen, F Fuz, M Bouregba, M Autran, M Beaussier
INTRODUCTION: The constant development of ambulatory surgery (AS) raises the problem of monitoring patients after discharge and the risk of death in the case of delays in the management of a serious complication. PATIENTS AND METHODS: The aim of this retrospective study was to describe the deaths observed within the 30-day period following AS declared to the SHAM insurance (Société Hospitalière d'Assurance Mutuelle) over the last 10 years. RESULTS: During the study period 33,962 claims were surgery-related and 11 were for deaths after AS...
March 20, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29564214/use-of-ketamine-sedation-for-the-management-of-displaced-paediatric-forearm-fractures
#12
Anatole Vilhelm Wiik, Poonam Patel, Joanna Bovis, Adele Cowper, Philip Socrates Pastides, Alison Hulme, Stuart Evans, Charles Stewart
AIM: To determine if ketamine sedation is a safe and cost effective way of treating displaced paediatric radial and ulna fractures in the emergency department. METHODS: Following an agreed interdepartmental protocol, fractures of the radius and ulna (moderately to severely displaced) in children between the age of 2 and 16 years old, presenting within a specified 4 mo period, were manipulated in our paediatric emergency department. Verbal and written consent was obtained prior to procedural sedation to ensure parents were informed and satisfied to have ketamine...
March 18, 2018: World Journal of Orthopedics
https://www.readbyqxmd.com/read/29559211/tracheotomy-in-the-intensive-care-unit-guidelines-from-a-french-expert-panel-the-french-intensive-care-society-and-the-french-society-of-anaesthesia-and-intensive-care-medicine
#13
Jean-Louis Trouillet, Olivier Collange, Fouad Belafia, François Blot, Gilles Capellier, Eric Cesareo, Jean-Michel Constantin, Alexandre Demoule, Jean-Luc Diehl, Pierre-Grégoire Guinot, Franck Jegoux, Erwan L'Her, Charles-Edouard Luyt, Yazine Mahjoub, Julien Mayaux, Hervé Quintard, François Ravat, Sébastien Vergez, Julien Amour, Max Guillot
Tracheotomy is widely used in intensive care units, albeit with great disparities between medical teams in terms of frequency and modality. Indications and techniques are, however, associated with variable levels of evidence based on inhomogeneous or even contradictory literature. Our aim was to conduct a systematic analysis of the published data in order to provide guidelines. We present herein recommendations for the use of tracheotomy in adult critically ill patients developed using the grading of recommendations assessment, development and evaluation (GRADE) method...
March 17, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29557527/the-college-of-anaesthetists-of-ireland-simulation-training-programme-a-descriptive-report-and-analysis-of-course-participants-feedback
#14
Aine Cafferkey, Elizabeth Coyle, David Greaney, Sinead Harte, Niamh Hayes, Miriam Langdon, Birgitt Straub, Crina Burlacu
BACKGROUND: Simulation-based education is a modern training modality that allows healthcare professionals to develop knowledge and practice skills in a safe learning environment. The College of Anaesthetists of Ireland (CAI) was the first Irish postgraduate medical training body to introduce mandatory simulation training into its curriculum. Extensive quality assurance and improvement data has been collected on all simulation courses to date. AIMS: Describe The College of Anaesthetists of Ireland Simulation Training (CAST) programme and report the analysis of course participants' feedback...
March 20, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29549606/gonococcal-cellulitis-an-un-friendly-bite
#15
Amos Lal, Alwyn Rapose
BACKGROUND: Gonococcal infection can present with wide spectrum of symptoms, most commonly involving the genitals. This case highlights a rare presentation of Neisseria gonorrhoeae infection primarily with skin involvement without uro-genital disease. CASE: A 33-year-old male was admitted to the hospital with complaints of painful swelling of his penis. In the emergency room, he underwent incision and drainage of the abscess under local anaesthesia. After microbiological evaluation, he was found to have skin abscess caused by N...
March 16, 2018: Infection
https://www.readbyqxmd.com/read/29519218/recent-advances-and-anaesthetic-considerations-in-corneal-transplantation
#16
Awy Chua, M J Chua, Pca Kam
Significant surgical advances have been made recently in corneal transplantation. Penetrating keratoplasty was the dominant method from 1905, until selective lamellar keratoplasty emerged as the preferred technique over the last 20 years. Advanced techniques such as corneal limbal stem cell transplant and keratoprosthesis are also available. The major surgical complications of corneal transplantation are extrusion of ocular content and expulsive choroidal haemorrhage. It is essential for an ophthalmic anaesthetist to have a good understanding of these new surgical procedures so as to provide optimal surgical conditions...
March 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29516705/comparison-of-the-effects-of-low-doses-of-dexmedetomidine-and-remifentanil-on-the-maternal-haemodynamic-changes-during-caesarean-delivery-in-patients-with-severe-preeclampsia-a-randomised-trial
#17
Mohamed R El-Tahan, Samah El Kenany, Ehsan M Abdelaty, Eiad A Ramzy
BACKGROUND: Preoperative remifentanil administration blunts haemodynamic responses to tracheal intubation in parturients with severe preeclampsia. We hypothesised that the preoperative administration of low doses of remifentanil or dexmedetomidine would lead to comparable maternal neurohormonal responses and neonatal outcomes in patients with severe preeclampsia. METHODS: Parturients diagnosed with severe preeclampsia undergoing caesarean delivery were randomly allocated to receive remifentanil (0...
March 7, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29499365/frontalis-suspension-using-autogenous-temporal-fascia-by-fox-technique
#18
Hamama Jalal, Khalfi Lahcen, Sabani Hicham, El Khatib Karim
INTRODUCTION: Severe ptosis of more than 4mm with poor levator function of less than 4mm is treated via the frontalis muscle suspension technique using autogenous temporal fascia. TECHNICAL NOTE: The surgery was performed under general anaesthesia. The eyelid crease was incised and the tarsus exposed. An incision centered on the mid-pupillary level was then made just above the eyebrow with exposure of the frontalis muscle. The temporal fascia strip was sutured to the tarsus at three points...
February 27, 2018: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29497826/comparison-of-propofol-and-desflurane-for-postanaesthetic-morbidity-in-patients-undergoing-surgery-for-aneurysmal-sah-a-randomized-clinical-trial
#19
Avanish Bhardwaj, Hemant Bhagat, Vinod Kumar Grover, Nidhi Bidyut Panda, Kiran Jangra, Seelora Sahu, Navneet Singla
PURPOSE: Surgery for aneurysmal clipping after subarachnoid haemorrhage (SAH) poses a unique anaesthetic challenge. However, data on the influence of anaesthetic agents in these patients are lacking. The study aims to evaluate the superiority of propofol over desflurane for postanaesthetic morbidity in patients undergoing surgery following aneurysmal SAH. METHODS: Seventy World Federation of Neurosurgeons Grade I and II patients were randomized into propofol (n = 35) and desflurane groups (n = 35)...
March 1, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29477995/postoperative-epidural-abscess-after-spinal-anaesthesia-for-a-circumcision-necessitated-by-phimosis
#20
Sjaak Pouwels, Darryl M Coll, Alexander G J van Marle
A 70-year-old man was admitted to our hospital for a penile circumcision due to phimosis using continuous dose spinal anaesthesia. On postoperative day 10 he came to the emergency department with a superficial abscess localised at the injection site of the spinal catheter. He was treated with intravenous antibiotics for 10 days, and the superficial abscess was incised and drained. Ten days later, the patient was readmitted to the emergency department with complaints of back pain and fever. A repeat MRI scan of his lumbar sacral area was done and showed epidural abscesses without any compression of the medulla or the myelum...
February 23, 2018: BMJ Case Reports
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