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Emergancy Anaesthesia

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https://www.readbyqxmd.com/read/28327497/the-mapping-competences-of-the-nurse-case-care-manager-in-the-context-of-intensive-care
#1
Emanuela Alfieri, Anna Chiara Ferrini, Francesca Gianfrancesco, Gianluca Lise, Giovanni Messana, Lorenzo Tirelli, Ana Lorenzo, Leopoldo Sarli
BACKGROUND AND AIMS: Since the recent introduction of the Case/Care Manager's professional figure, it is quite difficult to identify properly his/her own particular features, which could be mainly be found revising mainly in American studies. Therefore, the present study intended to identify the Case/Care Manager's skills and professional profile in an Intensive Care Unit experience, taking into consideration the staff's activities, perception and expectations towards the Case/Care Manager...
March 15, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28320917/predictors-of-massive-blood-transfusion-a-delphi-study-to-examine-the-views-of-experts
#2
Jacqueline V Mclennan, K C Mackway-Jones, S T Horne, R Body
BACKGROUND: Trauma patients requiring massive blood transfusion (MBT) have high morbidity and mortality: early and aggressive use of blood products during immediate resuscitation may improve survival. There is currently a lack of evidence to guide initial identification of these patients which is especially important in areas where plasma may need to be thawed. In the absence of this evidence, this study aimed to robustly evaluate expert opinion by using a Delphi process to identify predictors of massive transfusion...
March 20, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28320312/the-effect-of-an-electronic-cognitive-aid-on-the-management-of-st-elevation-myocardial-infarction-during-caesarean-section-a-prospective-randomised-simulation-study
#3
Michael St Pierre, Bjoern Luetcke, Dieter Strembski, Christopher Schmitt, Georg Breuer
BACKGROUND: Cognitive aids have come to be viewed as promising tools in the management of perioperative critical events. The majority of published simulation studies have focussed on perioperative crises that are characterised by time pressure, rare occurrence, or complex management steps (e.g., cardiac arrest emergencies, management of the difficult airway). At present, there is limited information on the usefulness of cognitive aids in critical situations with moderate time pressure and complexity...
March 20, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28298792/comparison-of-king-vision-and-truview-laryngoscope-for-postextubation-visualization-of-vocal-cord-mobility-in-patients-undergoing-thyroid-and-major-neck-surgeries-a-randomized-clinical-trial
#4
Anto Sahaya Priyanka, Kusha Nag, V R Hemanth Kumar, Dewan Roshan Singh, Senthil Kumar, T Sivashanmugam
BACKGROUND: Visualization of vocal cords following extubation after thyroid and major neck surgeries is highly desirable for the surgeon as well as the anaesthesiologist to rule out vocal cord palsy or oedema. As the patient is emerging from general anaesthesia, it may be challenging for the anaesthesiologist to optimally visualise and grade vocal cord movement following extubation. SETTING: Randomized clinical trial at a tertiary care centre. METHODOLOGY: After obtaining institutional ethics committee approval, 60 patients posted for thyroid and major neck surgeries under American Society of Anesthesiologists (ASA) grade I and II were recruited for the study...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298758/comparison-of-analgesic-efficacy-of-dexmedetomidine-and-midazolam-as-adjuncts-to-lignocaine-for-intravenous-regional-anesthesia
#5
Bharti Gupta, Ravinder Kumar Verma, Sudershan Kumar, Geeta Chaudhary
BACKGROUND: Intravenous regional anesthesia (IVRA) is safe, technically simple, and cost-effective technique compared to general anesthesia with success rates of 94-98% for upper and lower limb surgeries. The main disadvantage of this procedure is its limited duration for surgery, lack of postoperative analgesia, and tourniquet pain. To overcome this disadvantage, various adjuvants to lignocaine have been studied from time to time. AIM: To compare the analgesic efficacy of dexmedetomidine and midazolam as adjuncts to lignocaine for IVRA for forearm and hand surgeries...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28292390/penile-incarceration-by-metallic-ring
#6
Muhammad Mansoor
Application of constricting objects over penis for auto-erotic purpose can lead to dangerous results. A variety of metallic and non-metallic objects are used. The removal of these objects is a great challenge. We report a case of a young man who placed a hard metallic ring around his penis for sexual pleasure. A 22-year old man presented in emergency department with complain of painful swelling of his penis since 4 hours. Physical examination revealed part of penis distal to ring as congested and markedly tender with decreased sensation...
February 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28277383/the-use-of-vasopressors-during-spinal-anaesthesia-for-caesarean-section
#7
Warwick D Ngan Kee
PURPOSE OF REVIEW: Hypotension remains one of the most researched subjects in obstetric anaesthesia. The purpose of this study is to review the most recent published articles on the use of vasopressors during spinal anaesthesia for caesarean section. RECENT FINDINGS: Despite continued research indicating advantages of phenylephrine over ephedrine, practitioners in some countries continue to favour ephedrine. Recent research has continued to compare the two drugs with some work emerging on high-risk patients...
March 8, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28275833/survey-of-emergency-and-essential-surgical-obstetric-and-anaesthetic-services-available-in-bangladeshi-government-health-facilities
#8
Jonathan Loveday, Sonal P Sachdev, Meena N Cherian, Francisco Katayama, A K M Akhtaruzzaman, Joe Thomas, N Huda, E Brian Faragher, Walter D Johnson
OBJECTIVE: Evaluate the capacity of government-run hospitals in Bangladesh to provide emergency and essential surgical, obstetric and anaesthetic services. METHODS: Cross-sectional survey of 240 Bangladeshi Government healthcare facilities using the World Health Organisation Situational Analysis Tool to Assess Emergency and Essential Surgical Care (SAT). This tool evaluates the ability of a healthcare facility to provide basic surgical, obstetric and anaesthetic care based on 108 queries that detail the infrastructure and population demographics, human resources, surgical interventions and reason for referral, and available surgical equipment and supplies...
March 8, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28274051/effectiveness-of-two-topical-anaesthetic-agents-used-along-with-audio-visual-aids-in-paediatric-dental-patients
#9
Nidhi Agarwal, Jayata Dhawan, Dipanshu Kumar, Ashish Anand, Karan Tangri
INTRODUCTION: Topical anaesthetic agents enable pain free intraoral procedures, symptomatic pain relief for toothache, superficial mucosal lesions and pain related to post extraction time. Most common anxiety provoking and fearful experience for children in dental operatory is administration of local anaesthesia because on seeing the needle, children usually become uncooperative. One of recent trend of behaviour management technique is using non-aversive techniques out of which audiovisual distraction has emerged as a very successful technique for managing children in dental settings...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28274022/use-of-dexmedetomidine-in-patients-undergoing-craniotomies
#10
Nalini Jadhav, Nilesh Wasekar, Vinayak Wagaskar, Bharati Kondwilkar, Rajesh Patil
INTRODUCTION: The neuroanaesthesia ensures stable perioperative cerebral haemodynamics, avoids sudden rise in intracranial pressure and prevents acute brain swelling. The clinical characteristics of dexmeditomidine make this intravenous agent a potentially attractive adjunct for neuroanaesthesia and in the neurological intensive care unit. AIM: This study aimed to assess the effect of dexmedetomidine on intraoperative haemodynamic stability and to assess the intraoperative requirements of analgesic and other anaesthetic agents, and also to assess postoperative sedation, respiratory depression and any other side effects of dexmedetomidine as compared to placebo...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28250481/comparison-of-oral-dexmedetomidine-versus-oral-midazolam-as-premedication-to-prevent-emergence-agitation-after-sevoflurane-anaesthesia-in-paediatric-patients
#11
M Kavya Prabhu, Sripada G Mehandale
BACKGROUND AND AIMS: Sevoflurane is the most often used inhalational agent in paediatric anaesthesia, but emergence agitation (EA) remains a major concern. Oral midazolam and parenteral dexmedetomidine are known to be effective in controlling EA. We attempted to elucidate whether oral dexmedetomidine is better than midazolam in controlling EA. METHODS: Prospective double-blinded study involving ninety patients aged 1-10 years, undergoing elective surgeries of <2 h of expected duration under sevoflurane general anaesthesia, randomised to receive either midazolam (Group A) or dexmedetomidine (Group B) as oral premedication was carried out to record level of sedation before induction, haemodynamic parameters and recovery time...
February 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28235512/transient-global-amnesia-in-immediate-postoperative-period-a-diagnostic-dilemma
#12
Anudeep Jafra, Tanvir Samra, Vasudha Gupta, M Seran Kumar Reddy
INTRODUCTION: Transient Global Amnesia (TGA) is short-term inability to form new memories despite otherwise normal neurological function. There is associated anterograde and retrograde amnesia. The memory loss is often accompanied by repetitive questioning and temporal disorientation while higher cognitive functions are preserved. The symptoms usually resolve by 24h. CASE REPORT: We present an interesting case of 31year old female who was planned for robotically assisted right sided pyeloplasty...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28235495/use-of-sugammadex-in-an-octagenerian-with-myaesthenia-gravis-undergoing-emergency-laporotomy
#13
Deep Shah, Aynkaran Dharmarajah
BACKGROUND: Myaesthenia Gravis is an autoimmune disorder that results in increased sensitivity to neuromuscular blockers. Anaesthesia and surgery in patients with Myaesthenia Gravis is associated with an increased incidence of complications, including post operative ventilation. We report the successful use of intra-operative train of four ratio monitoring and Sugammadex to reverse rocuronium induced neuromuscular blockade in an elderly octagenarian with Myaesthenia Gravis undergoing an emergency laporotomy...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28230439/developing-an-e-learning-resource-for-nurse-airway-assistants-in-the-emergency-department
#14
Peter Hersey, Sean McAleer
The aims of this project were to determine the required competencies for a nurse in the emergency department assisting with a rapid sequence induction of anaesthesia (RSI), and to produce a relevant e-learning resource. A three-round multidisciplinary Delphi process produced the following competencies: ability to describe the steps and sequence of events of an RSI, familiarity with the equipment used during an RSI, ability to recognise and help manage problems occurring during an RSI, ability to prepare for an RSI, ability to apply cricoid pressure, and understanding the modification of an RSI in special circumstances...
February 23, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28221204/frequency-and-risk-factors-for-malnutrition-in-children-undergoing-general-anaesthesia-in-a-french-university-hospital
#15
Louis Gerbaud-Morlaes, Eric Frison, Florence Babre, Arnaud De Luca, Anne Didier, Maryline Borde, Brigitte Zaghet, Hélène Batoz, François Semjen, Karine Nouette-Gaulain, Raphael Enaud, Régis Hankard, Thierry Lamireau
BACKGROUND: Malnutrition is often underdiagnosed in hospitalised children, although it is associated with postoperative complications, longer hospital lengths of stay and increased healthcare-related costs. OBJECTIVE: We aimed to estimate the frequency of, and identify factors associated with, malnutrition in children undergoing anaesthesia. DESIGN: Cross-sectional observational study. SETTING: Paediatric anaesthesia department at the University Children's Hospital, Bordeaux, France...
February 17, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28216710/anaesthesia-for-emergency-caesarean-section-in-a-morbidly-obese-achondroplastic-patient-with-pih-feasibility-of-neuraxial-anaesthesia
#16
Ridhima Sharma, Rohan Magoon, Ripon Choudhary, Punit Khanna
No abstract text is available yet for this article.
January 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28213758/influence-of-a-combined-ct-c-arm-system-on-periprocedural-workflow-and-procedure-times-in-mechanical-thrombectomy
#17
Johannes Pfaff, Silvia Schönenberger, Christian Herweh, Mirko Pham, Simon Nagel, Peter Arthur Ringleb, Sabine Heiland, Martin Bendszus, Markus Alfred Möhlenbruch
OBJECTIVE: To achieve the fastest possible workflow in ischaemic stroke, we developed a CT/C-arm system, which allows imaging and endovascular treatment on the same patient table. METHODS: This prospective, monocentric trial was conducted between October 2014 and August 2016. Patients received stroke imaging and mechanical thrombectomy under general anaesthesia (GA) or conscious sedation (CS) using our combined setup comprising a CT-scanner and a mobile C-arm X-ray device...
February 17, 2017: European Radiology
https://www.readbyqxmd.com/read/28208976/dexamethasone-as-an-adjuvant-to-bupivacaine-in-supraclavicular-brachial-plexus-block-in-paediatrics-for-post-operative-analgesia
#18
Karl Sa Ribeiro, Anjali Ollapally, Julie Misquith
INTRODUCTION: Sensory blockade of the brachial plexus with local anaesthetics for perioperative analgesia leads to stable haemodynamics intraoperatively, smoother emergence from general anaesthesia and decreased need for supplemental analgesics or suppositories in the Post-operative period. However, increasing the duration of local anaesthetic action is often desirable because it prolongs surgical anaesthesia and analgesia. Various studies in adults prove that steroids increase the duration of action of local anaesthetics when used as adjuncts...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28205213/haemodynamic-changes-to-a-midazolam-fentanyl-rocuronium-protocol-for-pre-hospital-anaesthesia-following-return-of-spontaneous-circulation-after-cardiac-arrest
#19
M Miller, C Groombridge, R Lyon
Following the return of spontaneous circulation after out-of-hospital cardiac arrest, neurological dysfunction, airway or ventilatory compromise can impede transport to early percutaneous coronary intervention, necessitating pre-hospital or emergency department anaesthesia to facilitate this procedure. There are no published reports of the ideal induction agents in these patients. We sought to describe haemodynamic changes associated with induction of anaesthesia using a midazolam (0.1 mg.kg(-1) ), fentanyl (2 μg...
February 15, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28203439/evolutional-trends-in-the-management-of-tracheal-and-bronchial-injuries
#20
REVIEW
Brendan Patrick Madden
Tracheal and Bronchial injuries are potentially life threatening complications which require urgent diagnosis and therapeutic intervention. They typically occur in association with blunt and penetrating chest trauma although they are increasingly being encountered in patients following endobronchial intervention and percutaneous tracheostomy insertion. Their precise incidence is unknown. Presenting features include dyspnoea, stridor, respiratory and haemodynamic compromise, haemoptysis, surgical emphysema, pneumothorax and persistent significant airleak...
January 2017: Journal of Thoracic Disease
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