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https://www.readbyqxmd.com/read/27896148/plasma-lyte-148-a-clinical-review
#1
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/27887758/blind-nasal-intubation-revisited-no-longer-a-blind-technique
#2
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/27871580/c1-esterase-inhibitor-for-short-term-prophylaxis-in-a-patient-with-hereditary-angioedema-with-normal-c1-inhibitor-function
#3
Savio K H Yu, Jeannie Callum, Asim Alam
Hereditary angioedema with normal C1-esterase inhibitor (HAE-nC1INH) perioperative is a rare condition which could have potential disastrous ramifications for the anesthesiologist in the perioperative period. However, there is limited evidence and/or guidelines on the optimal way to manage these patients. We present the case of a patient with HAE-nC1INH who was successfully managed in the perioperative period with plasma derived C1-esterase inhibitor (pdC1INH). A 29-year-old woman with a diagnosis of HAE-nC1INH presented to the preoperative consultation in preparation for an upcoming total thyroidectomy...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27848018/supraglottic-jet-oxygenation-and-ventilation-saved-a-patient-with-cannot-intubate-and-cannot-ventilate-emergency-difficult-airway
#4
Qiaoyun Li, Ping Xie, Benjun Zha, ZhiYun Wu, Huafeng Wei
The emergency difficult airway with the 'cannot intubate and cannot ventilate' (CICV) situation contributes to a high percentage of anesthesia- and emergency medicine-related morbidity and mortality. A new technique of supraglottic jet oxygenation and ventilation (SJOV) via the nasal approach was successfully used in an emergency to save a patient with a CICV difficult airway from a catastrophic outcome.
November 15, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27830713/efficacy-and-acceptability-of-different-auxiliary-drugs-in-pediatric-sevoflurane-anesthesia-a-network-meta-analysis-of-mixed-treatment-comparisons
#5
Wuchao Wang, Panchuan Huang, Weiwei Gao, Fangli Cao, Mingling Yi, Liyong Chen, Xiaoli Guo
Emergence agitation preventive medicine should be combined with pediatric anesthesia because of the high frequency of emergence agitation. However, it is challenging to determine the most appropriate medication that can be introduced into pediatric anesthesia for the sake of emergence agitation prevention. We reviewed and retrieved the data from PubMed and Embase. Various medications were assessed based on several endpoints including Emergence agitation outcomes (EA), postoperative nausea and vomiting (PONV), the number of patients who required analgesic (RA), pediatric anesthesia emergence delirium (PAED), the extubation time, the emergency time and the duration of post-anesthesia care unit (PACU) stay...
November 10, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27727041/oculocardiac-reflex-as-a-result-of-intraorbital-trauma
#6
Joel M Fahling, L Kendall McKenzie
BACKGROUND: The oculocardiac reflex is a decrease in heart rate caused by ocular compression or traction upon the extraocular musculature. Multiple instances of this phenomenon have been described in anesthesia, trauma, craniofacial, and ophthalmology literature, but there is a sparsity of documentation in the emergency medicine literature. CASE REPORT: We describe the observation and management of the oculocardiac reflex in a 26-year-old man with retrobulbar hematoma and intraocular trauma caused by a self-inflicted gunshot wound...
October 8, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27682659/-current-status-of-work-related-musculoskeletal-disorders-in-nurses-in-xinjiang-china
#7
P Yan, F Y Li, Y Yang, Y N Wang, A M Huang, H Yao
Objective: To investigate the prevalence of work-related musculoskeletal disorders (WMSDs) in nurses in Xinjiang, China, to analyze the influencing factors for the development of WMSDs, and to provide a reference for the prevention and treatment of WMSDs in nurses. Methods: Stratified cluster sampling was used to randomly select 8 422 nurses in 8 tertiary hospitals and 4 secondary hospitals in Xinjiang from January to October, 2015. A questionnaire survey was performed to investigate the prevalence of WMSDs in nurses from departments of internal medicine, surgery, gynecology, pediatrics, emergency, and intensive care and operating rooms and analyze related influencing factors...
August 20, 2016: Chinese Journal of Industrial Hygiene and Occupational Diseases
https://www.readbyqxmd.com/read/27648689/hyperoxia-induces-inflammation-and-cytotoxicity-in-human-adult-cardiac-myocytes
#8
Christina Hafner, Jing Wu, Akos Tiboldi, Moritz Hess, Goran Mitulovic, Christoph Kaun, Konstantin Alexander Krychtiuk, Johann Wojta, Roman Ullrich, Eva Verena Tretter, Klaus Markstaller, Klaus Ulrich Klein
Supplemental oxygen (O2) is used as adjunct therapy in anesthesia, emergency and intensive care medicine. We hypothesized that excessive O2 levels (hyperoxia) can directly injure human adult cardiac myocytes (HACMs). HACMs obtained from the explanted hearts of transplantation patients were exposed to constant hyperoxia (95% O2), intermittent hyperoxia (alternating 10 min exposures to 5% and 95% O2), constant normoxia (21% O2), or constant mild hypoxia (5% O2) using a bioreactor. Changes in cell morphology, viability as assessed by lactate dehydrogenase (LDH) release and trypan blue (TB) staining, and secretion of vascular endothelial growth factor (VEGF), macrophage migration inhibitory factor (MIF), and various pro-inflammatory cytokines (interleukin, IL; chemokine C-X-C motif ligand, CXC; granulocyte-colony stimulating factor, G-CSF; intercellular adhesion molecule, ICAM; chemokine C-C motif ligand, CCL) were compared among treatment groups at baseline (0 h) and after 8 h, 24 h, and 72 h of treatment...
September 19, 2016: Shock
https://www.readbyqxmd.com/read/27563588/developing-competency-in-interns-for-endotracheal-intubation-an-educational-article
#9
Harsha Dhirubhai Makwana, Nilay N Suthar, Mehul P Gajjar, Advait V Thakor
BACKGROUND: Our existing undergraduate curriculum lacks developing competency for endotracheal intubation. Even though it is a lifesaving procedure, interns are exposed only during their posting in anesthesia or emergency medicine and so, when need arises, they fail to perform endotracheal intubation and it leads to catastrophes. AIMS AND OBJECTIVES: The aim of this study was to develop competency in interns for endotracheal intubation. MATERIALS AND METHODS: A study was conducted on fifty interns of medical college...
July 2016: International Journal of Applied and Basic Medical Research
https://www.readbyqxmd.com/read/27516413/pediatric-procedural-sedation-using-dexmedetomidine-a-report-from-the-pediatric-sedation-research-consortium
#10
Carmen Sulton, Courtney McCracken, Harold K Simon, Kiran Hebbar, Jason Reynolds, Joseph Cravero, Michael Mallory, Pradip Kamat
OBJECTIVES: Dexmedetomidine (DEX) is widely used in pediatric procedural sedation (PPS) by a variety of pediatric subspecialists. The objective of our study was to describe the overall rates of adverse events and serious adverse events (SAEs) when DEX is used by various pediatric subspecialists. METHODS: Patients from the Pediatric Sedation Research Consortium (PSRC) database were retrospectively reviewed and children that received DEX as their primary sedation agent for elective PPS were identified...
September 2016: Hospital Pediatrics
https://www.readbyqxmd.com/read/27464942/airway-management-and-definitive-care-of-a-toddler-following-impalement-injury-by-a-metal-straw
#11
Laura V Duggan, Ronelle Theron, Alyssa L Hodgson, Frederick K Kozak
Although pediatric trauma benefits from specialized pediatric care, at times, nonpediatric centers are required to provide initial management. In this unusual airway impalement injury, the combination of smooth coordination between emergency medicine and anesthesia, an articulated airway strategy, parental involvement, and clear, calm teamwork maximized patient safety during airway securement and transfer for definitive care. The airway strategy included the anticipation that the first attempt at endotracheal intubation may not be successful and the need to keep the "auditory space" clear...
October 1, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27429939/oral-surgery-under-local-anesthesia-with-dexmedetomidine-sedation-in-a-morbidly-obese-patient-with-aortic-dissection
#12
Mika Seto, Michitaka Matsuda, Kyoichi Narihira, Toshihiro Kikuta
We report a case of a morbidly obese man with an aortic aneurysm, in whom dental surgery was performed before elective cardiac surgery. His aortic aneurysm required emergency surgery. However, because of his morbid obesity, elective cardiac surgery was planned. Considering the high risk of infective endocarditis, dental surgery was required. Our patient was at a high risk of aortic rupture caused by hypertension and breathing difficulty in the supine position. Dexmedetomidine (DEX) is an anti-anxiety, sedative, and analgesic medicine that can stabilize circulatory dynamics and minimize blood pressure fluctuations...
June 2016: Journal of the Korean Association of Oral and Maxillofacial Surgeons
https://www.readbyqxmd.com/read/27359234/-hyperoxia-in-anesthesia-and-intensive-care-medicine-too-much-of-a-good-thing
#13
Marc Moritz Berger, Franziska Macholz, Peter Schmidt, Ragnar Huhn
For decades the administration of oxygen has been a corner stone in the treatment of various medical emergencies, e.g. acute myocardial infarction. Several arguments support the perioperative use of high oxygen concentrations (>80%) for the prevention of surgical site infections. However, effects of oxygen include an increase in systemic vascular resistance, a reduction in heart rate and stroke volume and thus an impairment of the microcirculation, e.g. in the coronary and cerebral vasculature. Adequately powered, prospective, randomized, blinded outcome studies on the effects of hyperoxia in anesthesia and intensive care medicine are scarce...
June 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/27330672/introducing-a-fresh-cadaver-model-for-ultrasound-guided-central-venous-access-training-in-undergraduate-medical-education
#14
Ryan Miller, Hang Ho, Vivienne Ng, Melissa Tran, Douglas Rappaport, William J A Rappaport, Stewart J Dandorf, James Dunleavy, Rebecca Viscusi, Richard Amini
INTRODUCTION: Over the past decade, medical students have witnessed a decline in the opportunities to perform technical skills during their clinical years. Ultrasound-guided central venous access (USG-CVA) is a critical procedure commonly performed by emergency medicine, anesthesia, and general surgery residents, often during their first month of residency. However, the acquisition of skills required to safely perform this procedure is often deficient upon graduation from medical school...
May 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27244785/ovarian-cystadenoma-in-a-trafficked-patient
#15
Kanani E Titchen, Douglas Katz, Kidian Martinez, Krishna White
The topic of child sex trafficking is receiving increased attention both in the lay press and in research articles. Recently, a number of physician organizations have issued policy statements calling for the education and involvement of physicians in combating this form of "modern-day slavery." Primary care and emergency medicine physicians have led these efforts, but a number of these victims may present to surgeons. Surgeons are in a unique position to identify trafficked patients; during the process of undraping, intubation, and surgical preparation, signs of trafficking such as tattoos, scars, dental injuries, and bruising may be evident...
May 2016: Pediatrics
https://www.readbyqxmd.com/read/27232771/procedural-ultrasound-in-pediatric-patients-techniques-and-tips-for-accuracy-and-safety
#16
REVIEW
Sophia Lin
Point-of-care ultrasound is becoming more prevalent in pediatric emergency departments as a critical adjunct to both diagnosis and procedure guidance. It is cost-effective, safe for unstable patients, and easily repeatable as a patient's clinical status changes. Point-of-care ultrasound does not expose the patient to ionizing radiation and may care ultrasound in pediatric emergency medicine is relatively new, the body of literature evaluating its utility is small, but growing. Data from adult emergency medicine, radiology, critical care, and anesthesia evaluating the utility of ultrasound guidance must be extrapolated to pediatric emergency medicine...
June 2016: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/27216301/national-orthopedic-residency-attrition-who-is-at-risk
#17
Jennifer M Bauer, Ginger E Holt
BACKGROUND: National U.S. orthopedic resident attrition rates have been historically low, but no literature exists as to the characteristics of those who leave nor the circumstance of the departure. We aimed to determine factors that may place a resident at higher risk for attrition. Additionally, we planned to determine whether the 2003-work hour restriction affected attrition rate. MATERIALS AND METHODS: All orthopedic surgery residency program directors in the United States were surveyed on demographic data for their current resident class, the number of residents who left the program, as well as demographic description for each of the residents who left their program from 1998 to 2013...
September 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/27162294/-the-evolution-of-the-emergency-medical-services-system-from-ancient-to-modern-times
#18
Mariusz Goniewicz, Krzysztof Goniewicz
The paper discusses the historical perspective - from ancient to modern times - on the evolution of military medicine and its support during the wars and battles as well as its impact on the development of civilian health care and emergency medical services. Indicated breakthroughs related to conducting military operations and pointed to the visionaries who have developed new paradigms of medical care, including programs designed to assess the health status of patients, treatment in the battlefield, medical transport, anesthesia, surgery and emergency procedures...
2016: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/27159073/a-comparison-of-web-based-with-traditional-classroom-based-training-of-lung-ultrasound-for-the-exclusion-of-pneumothorax
#19
Thomas Edrich, Matthias Stopfkuchen-Evans, Patrick Scheiermann, Markus Heim, Wilma Chan, Michael B Stone, Daniel Dankl, Jonathan Aichner, Dominik Hinzmann, Pingping Song, Ashley L Szabo, Gyorgy Frendl, Kamen Vlassakov, Dirk Varelmann
BACKGROUND: Lung ultrasound (LUS) is a well-established method that can exclude pneumothorax by demonstration of pleural sliding and the associated ultrasound artifacts. The positive diagnosis of pneumothorax is more difficult to obtain and relies on detection of the edge of a pneumothorax, called the "lung point." Yet, anesthesiologists are not widely taught these techniques, even though their patients are susceptible to pneumothorax either through trauma or as a result of central line placement or regional anesthesia techniques performed near the thorax...
July 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27142362/-pharmacogenetics-in-anesthesia-and-intensive-care-medicine-clinical-and-legal-challenges-exemplified-by-malignant-hyperthermia
#20
W Klingler, E Pfenninger
Pharmacotherapy is a key component of anesthesiology and intensive care medicine. The individual genetic profile influences not only the effect of pharmaceuticals but can also completely alter the mode of action. New technologies for genetic screening (e.g. next generation sequencing) and increasing knowledge of molecular pathways foster the disclosure of pharmacogenetic syndromes, which are classified as rare diseases. Taking into account the high genetic variability in humans and over 8000 known rare diseases, up to 20 % of the population may be affected...
May 2016: Der Anaesthesist
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