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Emergency anesthesia

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https://www.readbyqxmd.com/read/27924205/risperidone-in-a-child-with-untractable-emergency-delirium-a-case-report
#1
Young Hee Shin, Seung Hyeon Lee, Dae Yoon Kim
A 6-year-old boy was scheduled for thoracic magnetic resonance imaging under deep sedation with midazolam 1.8 mg and propofol 100 µg/kg/min via intravenous injection. He showed emergence delirium in the post-anesthesia care unit. The staff attempted to calm him by administering flumazenil as an antidote for midazolam, propofol for further sedation, and meperidine. However, this was not successful. A psychiatrist recommended the use of antipsychotics. Administration of risperidone led to immediate resolution of the boy's symptoms and relaxed him...
December 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27922569/mode-of-information-delivery-does-not-effect-anesthesia-trainee-performance-during-simulated-perioperative-pediatric-critical-events-a-trial-of-paper-versus-electronic-cognitive-aids
#2
Scott C Watkins, Shilo Anders, Anna Clebone, Elisabeth Hughes, Vikram Patel, Laura Zeigler, Yaping Shi, Matthew S Shotwell, Matthew D McEvoy, Matthew B Weinger
INTRODUCTION: Cognitive aids (CAs), including emergency manuals and checklists, have been recommended as a means to address the failure of healthcare providers to adhere to evidence-based standards of treatment during crisis situations. Unfortunately, users of CAs still commit errors, omit critical steps, fail to achieve perfect adherence to guidelines, and frequently choose to not use CA during both simulated and real crisis events. We sought to evaluate whether the mode in which a CA presents information (ie, paper vs...
December 2016: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/27917532/do-women-have-a-choice-care-providers-and-decision-makers-perspectives-on-barriers-to-access-of-health-services-for-birth-after-a-previous-cesarean
#3
Sarah Munro, Jude Kornelsen, Kitty Corbett, Elizabeth Wilcox, Nick Bansback, Patricia Janssen
BACKGROUND: Repeat cesarean delivery is the single largest contributor to the escalating cesarean rate worldwide. Approximately 80 percent of women with a past cesarean are candidates for vaginal birth after a cesarean (VBAC), but in Canada less than one-third plan VBAC. Emerging evidence suggests that these trends may be due in part to nonclinical factors, including care provider practice patterns and delays in access to surgical and anesthesia services. This study sought to explore maternity care providers' and decision makers' attitudes toward and experiences with providing and planning services for women with a previous cesarean...
December 5, 2016: Birth
https://www.readbyqxmd.com/read/27916664/experience-dependent-modulation-of-right-anterior-insula-and-sensorimotor-regions-as-a-function-of-noise-masked-auditory-feedback-in-singers-and-nonsingers
#4
Boris Kleber, Anders Friberg, Anthony Zeitouni, Robert Zatorre
Previous studies on vocal motor production in singing suggest that the right anterior insula (AI) plays a role in experience-dependent modulation of feedback integration. Specifically, when somatosensory input was reduced via anesthesia of the vocal fold mucosa, right AI activity was down regulated in trained singers. In the current fMRI study, we examined how masking of auditory feedback affects pitch-matching accuracy and corresponding brain activity in the same participants. We found that pitch-matching accuracy was unaffected by masking in trained singers yet declined in nonsingers...
December 1, 2016: NeuroImage
https://www.readbyqxmd.com/read/27903951/a-management-algorithm-for-retained-rectal-foreign-bodies
#5
Shamir O Cawich, Dexter A Thomas, Fawwaz Mohammed, Nahmorah J Bobb, Dorothy Williams, Vijay Naraynsingh
Few authors have proposed therapeutic protocols to manage retained rectal foreign bodies (RFBs). All patients with retained RFBs in hospitals across Trinidad and Tobago over 5 years were identified. Hospital records were retrieved and manually reviewed to extract the following data: demographics, history, foreign body retrieved, clinical signs at presentation, management strategy, duration of hospitalization, and morbidity and mortality. There were 10 patients with RFBs over the study period. The annual incidence of this phenomenon was 0...
November 29, 2016: American Journal of Men's Health
https://www.readbyqxmd.com/read/27903341/-the-application-of-conscious-sedation-with-a-small-dose-of-dexmedetomidine-and-sufentanil-in-elderly-patients-undergoing-multiple-intestinal-polyps-resection
#6
C M Shi, Y D Zhou, M Xu, X D Wang, L M Meng, X J Liu, X Y Guo
Objective: To explore the effectiveness and feasibility of conscious sedation with a low dose of dexmedetomidine and sufentanil during multiple intestinal polyps resection in elderly patients. Methods: Sixty elderly patients who underwent multiple intestinal polyps resection in Peking University Third Hospital from Janurary to May 2016 were randomly divided into dexmedetomidine group (D group, n=30) and propofol group (P group, n=30). There were 28 males and 32 females with a mean age of (70.4±4.5) years old (range: 65-80 years old)...
November 22, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27901329/comparing-incidence-of-emergence-delirium-between-sevoflurane-and-desflurane-in-children-following-routine-otolaryngology-procedures
#7
Jeremy N Driscoll, Brian M Bender, Carlos A Archilla, Carol M Klim, J Hossain, George Mychaskiw, Julie L Wei
BACKGROUND: Emergence delirium (ED) is a state of aggressive agitation that can occur temporarily in the process of emerging from anesthesia in children exposed to volatile or intravenous anesthetics. Emergence delirium is typically assessed using the published and validated pediatric emergence delirium (PAED) scale. Due to some variation in properties between sevoflurane and desflurane for maintenance of anesthesia after standard sevoflurane induction, we designed a prospective study to examine potential differences in emergence behavior and incidence of ED in children undergoing elective ear-nose-throat (ENT) surgery...
November 30, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27896148/plasma-lyte-148-a-clinical-review
#8
Laurence Weinberg, Neil Collins, Kiara Van Mourik, Chong Tan, Rinaldo Bellomo
AIM: To outline the physiochemical properties and specific clinical uses of Plasma-Lyte 148 as choice of solution for fluid intervention in critical illness, surgery and perioperative medicine. METHODS: We performed an electronic literature search from Medline and PubMed (via Ovid), anesthesia and pharmacology textbooks, and online sources including studies that compared Plasma-Lyte 148 to other crystalloid solutions. The following keywords were used: "surgery", "anaesthesia", "anesthesia", "anesthesiology", "anaesthesiology", "fluids", "fluid therapy", "crystalloid", "saline", "plasma-Lyte", "plasmalyte", "hartmann's", "ringers" "acetate", "gluconate", "malate", "lactate"...
November 4, 2016: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27895441/a-retrospective-analysis-of-postoperative-patients-admitted-to-the-intensive-care-unit
#9
S Uzman, Y Yilmaz, M Toptas, I Akkoc, Y G Gul, H Daskaya, Y Toptas
BACKGROUND: The aim of this retrospective study was to evaluate postoperative patients admitted to the intensive care unit (ICU) and to describe their characteristics and outcomes. METHODS: We performed a retrospective chart review of 1,756 postoperative patients admitted to the ICU of a tertiary referral hospital from January 2008 to December 2012. For each patient we recorded: demographic data, reason for admission to the ICU, duration of mechanical ventilation, elective versus emergency surgery, type of anaesthesia, American Society of Anesthesiologists (ASA) physical status, Acute Physiology and Chronic Health Evaluation (APACHE) II score, Glasgow Coma Score (GCS), and outcome...
January 2016: Hippokratia
https://www.readbyqxmd.com/read/27894430/anesthesia-for-common-pediatric-emergency-surgeries
#10
REVIEW
Matthew C Mitchell, Ibrahim Farid
Anesthesiologist must be prepared on a daily basis to care for children who need emergency surgery. An appropriate perioperative plan must be formulated and executed to ensure successful management of the child. This article outlines how to prepare and effectively manage common pediatric emergency surgeries.
February 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/27893667/abdominal-compartment-syndrome-after-endovascular-repair-for-ruptured-abdominal-aortic-aneurysm-leads-to-acute-intestinal-necrosis-case-report
#11
Xiyang Chen, Jichun Zhao, Bin Huang, Ding Yuan, Yi Yang, Yukui Ma
INTRODUCTION: Abdominal compartment syndrome (ACS) after endovascular repair (EVAR) of rupture abdominal aortic aneurysm (rAAA) is a rare emergency situation, which has a high mortality. However, the progression of ACS is rapid and the diagnosis is usually been delayed, which increase the difficulties in treatment and affect the prognosis. We describe a case of a sever complication (acute intestinal necrosis) resulting from ACS after endovascular repair of rAAA. CLINICAL FINDING: An elderly man, 81 years old, complained a sudden lower abdominal and back pain without any predisposing cause...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27893572/pain-management-in-pediatric-burn-patients-review-of-recent-literature-and-future-directions
#12
Omar Pardesi, Gennadiy Fuzaylov
Childhood burns are a profoundly traumatic and painful experience. Despite recognition of the prevalence of burn injuries in children and the severity of the associated pain, burn pain remains undertreated. At the same time, more evidence is emerging to suggest that undertreated pain has serious long-term medical and psychiatric consequences, many of which can be ameliorated with improved pain control. Pain in burn patients is, however, notoriously difficult to treat, perhaps because there is a chronic pain aspect underlying the acute pain that accompanies wound care and procedures...
November 17, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/27890467/use-of-hyperbaric-oxygen-therapy-and-pegylated-carboxyhemoglobin-bovine-in-a-jehovah-s-witness-with-life-threatening-anemia-following-postpartum-hemorrhage
#13
K Thenuwara, J Thomas, M Ibsen, U Ituk, K Choi, E Nickel, M J Goodheart
We present a case of a Jehovah's Witness patient who refused blood products, with the exception of albumin and clotting factors, and underwent cesarean section under spinal anesthesia complicated by postpartum hemorrhage. She was fluid resuscitated and treated with multiple uterotonics and internal iliac artery embolization. Because of agitation she required emergency tracheal intubation. Her hemoglobin concentration dropped from a preoperative value of 12mg/dL to 3mg/dL on postoperative day one. She was acidotic, requiring vasopressors for hemodynamic stability and remained ventilated and sedated...
October 24, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27887758/blind-nasal-intubation-revisited-no-longer-a-blind-technique
#14
Prakash K Dubey, Preksha Dubey, Niranjan Kumar, Gautam Bhardwaj, Neeraj Kumar
BACKGROUND: Advancements in airway management have made the practice of blind nasal intubation obsolete. We report on successful blind nasal intubation performed with the help of capnography and real-time ultrasonography in two patients with tempormandibular joint ankylosis. CASE REPORT: Blind nasal intubation was performed in a 12-year-old patient and a 17-year old patient under general anesthesia with spontaneous respiration. Capnography was used as an aid during insertion and dynamic ultrasonography was performed to guide and confirm proper tracheal tube placement...
November 22, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27886904/mastocytosis-and-anaphylaxis
#15
REVIEW
Anna Schuch, Knut Brockow
This article updates current knowledge on epidemiology, risk factors, triggers, and management of anaphylaxis in patients with mastocytosis. Hyperactive mast cells and higher number of effector mast cells are speculated to facilitate anaphylaxis in this condition. In children, increased risk is limited to those with extensive skin involvement and high tryptase. In adults, manifestations of anaphylaxis are severe with high frequency of cardiovascular symptoms. Hymenoptera stings are the most common triggers for these reactions; however, idiopathic anaphylaxis and reactions to food or drugs occur...
February 2017: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/27884665/airway-management-for-cesarean-delivery-performed-under-general-anesthesia
#16
S Rajagopalan, M Suresh, S L Clark, B Serratos, S Chandrasekhar
BACKGROUND: With the increasing popularity of neuraxial anesthesia, there has been a decline in the use of general anesthesia for cesarean delivery. We sought to examine the incidence, outcome and characteristics associated with a failed airway in patients undergoing cesarean delivery under general anesthesia. METHODS: A retrospective review of airway management in women undergoing cesarean delivery under general anesthesia over an eight-year period from 2006-2013 at an academic medical center was conducted...
October 27, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27884330/factors-associated-with-adverse-events-after-emergency-laparotomy-in-cape-town-south-africa-identifying-opportunities-for-quality-improvement
#17
Richard Trafford Spence, Mark Hampton, Kent Pluke, Miriam Kahn, Nkhabe Chinyepi, Mohamed Elmusbahi, Tirsa van Wyngaard, Eugenio Panieri
BACKGROUND: Surgical outcomes research is limited in areas of the world with the greatest unmet surgical need and likely greatest variation in outcomes. Measurement alone may improve outcomes-the so-called Hawthorne effect. The purpose of this multicenter cohort study was to identify factors that are both feasible to collect and are associated with a major adverse event following a targeted procedure in Cape Town, South Africa. METHODS: A collaborative of four acute care surgical units was formed to develop a data set with minimal data burden describing outcomes after an emergency exploratory laparotomy during a 3-mo period (February-April 2015)...
December 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27882039/pediatric-tooth-extractions-under-sedoanalgesia
#18
Ayse Hande Arpaci, Berrin Isik
OBJECTIVE: The present study aims to evaluate intravenous ketamine and inhalation sedation in children, their unwanted side-effects and surgeon satisfaction. METHODS: In this study, data of 922 children aged between 1-18 who underwent tooth extraction under sedoanalgesia in our department between September 2015-January 2016 were gathered and anesthesia approaches, unwanted side effects and surgical satisfaction was investigated. Postoperative recovery emergence agitation or delirium was evaluated with Watcha Behavior Scale (WBS)...
September 2016: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/27878131/extra-luminal-entrapment-of-guide-wire-a-rare-complication-of-central-venous-catheter-placement-in-right-internal-jugular-vein
#19
Md Abu Masud Ansari, Naveen Kumar, Shailesh Kumar, Sarita Kumari
Central venous Catheterization (CVC) is a commonly performed procedure for venous access. It is associated with several complications. We report a rare case of extra luminal entrapment of guide wire during CVC placement in right jugular vein. We report a case of 28 years old female patient presented in our emergency with history of entrapped guide wire in right side of neck during CVC. X-ray showed coiling of guide wire in neck. CT Angiography showed guide wire coursing in between common carotid artery and internal jugular vein (IJV), closely abutting the wall of both vessels...
October 2016: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/27877032/pulmonary-complications-after-abdominal-surgery-in-patients-with-mild-to-moderate-chronic-obstructive-pulmonary-disease
#20
Tae Hoon Kim, Jae Seung Lee, Sei Won Lee, Yeon-Mok Oh
Postoperative pulmonary complications (PPCs) are one of the most important causes of postoperative morbidity and mortality after abdominal surgery. Although chronic obstructive pulmonary disease (COPD) has been considered a risk factor for PPCs, it remains unclear whether mild-to-moderate COPD is a risk factor. This retrospective cohort study included 387 subjects who underwent abdominal surgery with general anesthesia in a tertiary referral hospital. PPCs included pneumonia, pulmonary edema, pulmonary thromboembolism, atelectasis, and acute exacerbation of COPD...
2016: International Journal of Chronic Obstructive Pulmonary Disease
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