cardiac catheterization in the pediatric critical care setting

... working in the ICU in the event of a staffing shortage Finally, leaders from the ICU community were appointed to deal directly with the Ministry of Health to bring forward (in one voice) critical ... coordinated data collection for the purposes of better understanding the critical care aspects of the illness [4,5] As a result, thrice weekly teleconference calls involving critical care clinicians, ... ongoing communication initiatives within the Toronto critical care community Education and training staff in the use of appropriate protective equipment continues Efforts related to debriefing...

Ngày tải lên: 12/08/2014, 20:20

... dramatic, in terms of both life-saving and ICU resources In summary, the use of AEDs by the average person may be considered one of the greatest advances in critical care medicine during the past ... research efforts [8] In addition to evaluating the concept of markedly abbreviating the time taken to provide effective training for the masses [13], recent investigations using sophisticated (but ... life-saving critical care Considering that sudden cardiac death due to ventricular fibrillation is one of the greatest causes of premature mortality in many societies, the magnitude of the public...

Ngày tải lên: 12/08/2014, 23:21

... From Insulin Therapy • The Joint Commission considers insulin to be of the highest-risk medicines in the inpatient setting – Consequences of errors with insulin therapy can be catastrophic • In ... therapies reduce insulin needs? 19 Calculating the SC Insulin Dose • Establish the 24-hour insulin requirement by extrapolating from the average intravenous insulin dose required over the previous ... • Initiate prandial doses of rapid-acting analogue with the first dietary trays, even if patient is receiving IV insulin infusion Find a 6- to 8-h interval during IV insulin infusion when the...

Ngày tải lên: 23/07/2015, 21:12

... between the causes of cardiac arrest in the prehospital setting For standard use of this difference in the PetCO2 in the prehospital setting we suggest additional clinical research Competing interests ... results in continued oxygen consumption and CO2 production The high pressure of CO2 in the alveolar compartment is reflected in the high PetCO2 during the initial phase of CPR The fast decline of the ... (VT) cardiac arrest model In the asphyxial cardiac arrest model there should also be no difference in patients with and without ROSC regarding the initial PetCO2, since the initial PetCO2 in this...

Ngày tải lên: 12/08/2014, 19:22

... recognized by leaders in paediatric intensive care and incorporated into the daily routines of the PICU Caring for children in the PICU also involves responding to the needs of dying patients It is ... death and care of the dying in various clinical settings [17] Although the authors’ slant relates more to adults, the principles they espouse are equally relevant to the dying child The authors ... cognizant in attending to the psychological needs as well as some medical aspects of care such as pain management in children than in the past Being aware of our shortcomings and striving toward their...

Ngày tải lên: 12/08/2014, 22:21

... demonstrating the usefulness of CRP as a cardiac biomarker in the intensive care setting BNP is also a promising biomarker for use in the ICU, but its application is confined mainly to screening purposes ... circulatory level [37] Other uses of CK-MB include estimating the infarct time, the infarct size and expansion, and reinfarction [38] Troponins Troponin T and troponin I are part of the contractile apparatus ... elevated in patients with unstable angina but not in those with variant angina caused by vasospasm, indicating that CRP is associated with inflammation in the coronary artery rather than in the ischemic...

Ngày tải lên: 13/08/2014, 10:20

... sepsis occurring in the first 24 hrs in intensive care units in England, Wales, and Northern Ireland Crit Care Med 2003, 31:2332-2338 Irish Critical Care Trials Group: Acute lung injury and the acute ... relatively contentious border linking the Irish Republic with the United Kingdom is scientifically encouraging Competing interests The authors declare that they have no competing interests Page of (page ... The value of the present data will be more fully realised when the Irish Critical Care Trials Group produces further, hypothesis-testing studies Having taken advice from the ANZICS Critical Care...

Ngày tải lên: 13/08/2014, 11:22

... start an intravenous line and the patient is given intravenous fluids to maintain their hydration while waiting for the catheterization, particularly if there is a delay in the start of the catheterization ... leading to the cardiac catheterization, including the “informed consent” forms, are completed and verified of the catheterization and the catheterization is urgent, the patient’s hemoglobin/hematocrit ... the job training) working in the catheterization laboratory under the supervision of the already experienced personnel in the laboratory To work in a pediatric/ 15 CHAPTER Organization of catheterization...

Ngày tải lên: 13/08/2014, 12:20

... veins is dependent more on actual feeling and seeing the vein The veins in the arms not have the fixed relationships to the artery and other landmarks in the brachial area as they in the inguinal ... direction results in the catheter digging into the opposite wall of the vein or entering small side branches, which arise at the curve in the vein just as the catheter exits the tip of the sheath As ... skin between the skin puncture and the puncture into the vein This supports the wire beneath the skin and prevents the wire from bending or kinking in addition to preventing subcutaneous bleeding...

Ngày tải lên: 13/08/2014, 12:20

... artery The tip of the catheter is maintained pointing laterally in the right atrium (toward the patient’s right) when forming the atrial loop By continuing to advance the catheter in the right ... to the desired course and direction of the catheter within the body The stiff, preformed wire is introduced into the catheter with the purpose of deforming (deflecting) the tip of the catheter into ... further advancing the catheter, a large 180+° loop is formed within the right atrium until the tip of the catheter is pointing cephalad (Figure 5.22a) By rotating the whole 180+° loop in the catheter...

Ngày tải lên: 13/08/2014, 12:20

... elusive, “hiding” and clinging within the catheter, the plastic connecting tubing, in the junctions and stopcocks between the segments of tubing or even in the transducers themselves The only valid ... within the constantly flowing fluid, the rate of total flow is determined by measuring the difference in the concentrations of the indicator between the in ow and outflow samples The change in concentration ... content of the blood, is the principal indicator used in the determination of flow and the calculation of the magnitude of shunts in the cardiac catheterization laboratory; exogenous indicators...

Ngày tải lên: 13/08/2014, 12:20

... entrance into the vein, centrally through the vein, and to the fixation point in the heart The cut-down for the lead extraction is usually on the anterior chest wall in the area of the subclavian vein ... during its initial positioning and entire in ation The final positioning, the in ation of the balloon in the left atrium, and the withdrawal of the balloon are the times when the adjunct use of the ... “ballooning” that is used in the catheterization laboratory is used in the echo-guided procedure in the ICU Once the balloon pulls through the septum, the hole in the septum and the adequacy of the...

Ngày tải lên: 13/08/2014, 12:20

... through the sheath and into the left ventricle During the introduction and the entire time the balloon catheter is being advanced within the sheath, both the sheath and the catheter are maintained ... catheter The stretching tube is advanced into and locked to the Lure™ lock hub of the inner tube of the catheter The inner tube with the contained metal stretching tube is advanced into the catheter, ... and the locking pin on the hub of the inner tube is locked into the slot on the central hub of the balloon catheter The fully inserted and locked inner and stretching tube elongates the otherwise...

Ngày tải lên: 13/08/2014, 12:20

... withdrawing the balloon very carefully further into the stent until it is centered within the stent This balloon/stent is then in ated in the lesion, in order to secure the stent within the lesion ... fluoroscopy, the balloon catheter with the mounted stent is advanced over the wire within the sheath to the involved narrowing in the vessel As long as the wire and sheath are maintained securely in place, ... and increase the curvature of the sheath, the distance along the wire from the skin entry site to the lesion lengthens If the increasing circumference of this curve in the sheath/wire and, in...

Ngày tải lên: 13/08/2014, 12:20

... Both the material of the catheter and the internal diameter of the catheter are critically important in order to prevent the coil from “binding” within the lumen of the catheter during the delivery ... expansion of the stent(s), the wire is removed from the catheter and the catheter withdrawn The infant is maintained off the prostaglandin infusion Depending upon the status of the pulmonary ... catching in one of the side holes of the catheter and preventing the delivery of the coil out of the distal end of the catheter Both the material and the internal diameter of the catheter are critically...

Ngày tải lên: 13/08/2014, 12:20

... is introduced into the tiny sleeve While maintaining the ball on the device within the sleeve, the ball on the delivery/release wire is withdrawn into the sleeve by withdrawing the tumbler at the ... of the catheter The ball on the device will be locked into the tiny sleeve when the protuberance on the tumbler snaps into the small hole on the plastic latch The attached wires of the two tiny ... within a thick transparent Lucite casing This Lucite casing only serves to reinforce the thinner tubing of the Quick loader™ during the loading A single, long loading suture passes through the...

Ngày tải lên: 13/08/2014, 12:20

... just within the distal tip of the catheter The purpose of the Mullins™ wire is to redirect and maintain the guiding catheter in its position against, and pointing directly at, the center of the atretic ... each individual patient The angle at the tip of the particular guiding catheter, which is positioned in the RVOT, should point the tip of the catheter directly at the other catheter in the pulmonary ... the tip of the catheter parallel to the long axis of the two discontinuous segments of the obstructed vessel Changing the guiding catheter, changing the curve of the guiding catheter and/or the...

Ngày tải lên: 13/08/2014, 12:20

Ngày tải lên: 13/08/2014, 20:21

... affected more frequently In reviewing the results, one parameter that might be useful in determining outcome in patients after cardiac arrest is the change in serum creatinine over the first 24 hours ... pigs and left the ILA device open in the other six They then performed manual chest compressions on the animals for 30 minutes In the end, the researchers found no differences in the mean arterial ... depending on their size, but, cognitively, they still can learn the skills and also begin early psycho-motor training, making them much more prepared as they grow Will mild therapeutic hypothermia...

Ngày tải lên: 13/08/2014, 21:21

Ngày tải lên: 13/03/2016, 13:51