ethical and legal issues in trauma and critical care
Báo cáo y học: " Year in review 2009: Critical Care – cardiac arrest, trauma and disasters" docx
... 2.1 In contrast, when the creatinine declined by 0.2 mg/dl, the relative risk was 0.46 In summary, this article demonstrated a strong link between an initial decline in serum creatinine level and ... creatinine levels and neurologic outcomes Utilizing the Acute Kidney Injury Network guidelines for acute kidney injury, the researchers not only determined that this complication is very common in ... 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...
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Tài liệu Clinical presentation and outcome of patients diagnosed with active pulmonary tuberculosis in a large critical care unit docx
... National Guard soldiers and their extended families It has one of the largest critical care units in the Kingdom serve 40 beds and runs by qualified pulmonary and critical care board certified consultants ... our intensive care unit in a period over six years and to examine the characteristics, presentation, underlying risk factors, outcome of patients and to highlight the possible causes of delaying ... pulmonary tuberculosis Conclusion In emerging nations infections such as tuberculosis requiring intensive care are not uncommon Clinician awareness of the symptomatology and contributory factors of...
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Báo cáo y học: " Ethics and critical care in the new millennium" pps
... to think critically about our ability to reconcile the interests of society, patients, their families, and critical care practitioners, using logic and reaching agreement on common goals In the ... resolve these ethical dilemmas We must discard the notion that the skills to approach and resolve ethical dilemmas are innate in all intensivists, and instead strive to create and develop our ... Critical Care February 2002 Vol No Hawryluck and Crippen involved in the design and/ or funding of a project, then what are the responsibilities and obligations of the investigator...
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Báo cáo khoa học: " Year in review in Critical Care, 2003 and 2004: respirology and critical care" potx
... during and after liberation from mechanical ventilation using pressure support, CPAP, and T-piece (n = 20 each) During weaning, plasma insulin and glucose as well as urinary vanilmandelic acid increased ... acute hypoxia Although plasma renin activity and angiotensin II immunoreactivity increased during hypoxia, angiotensin-converting enzyme inhibition and type angiotensin II receptor blockade did not ... in pediatric patients when uncuffed ETTs are used, effective VT is inaccurate and VT is most accurately estimated at the airway opening Conditioning inspired gases with heat and moisture in invasively...
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Báo cáo y học: "Year in review 2005: Critical Care — Respirology: mechanical ventilation, infection, monitoring, and education" ppsx
... significantly influenced resting short-term breathing patterns by selectively affecting the duration of expiration A reduction in PEEP was paralleled by an increase in respiratory rate and in minute ... Roch A, Gainnier M, Sainty JM, Auffray JP, Papazian L: Correction: Influence of support on intra-abdominal pressure, hepatic kinetics of indocyanine green and extravascular lung water during prone ... during SARS to train health care workers in managing cardiac arrest while wearing unfamiliar equipment and following a modified advanced cardiac life support protocol Simulation provided insights...
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Báo cáo khoa học: "Year in review 2006: Critical Care – multiple organ failure, sepsis, and shock" doc
... markedly increased ERK1 and ERK2 expression and attenuated reperfusion lung injury and apoptosis, thus presenting a promising approach for moderating lung injury and supporting recovery after clinical ... represents another challenging circumstance in intensive care medicine Interestingly, selective activation of A3 adenosine receptor (AR) subtype attenuated I/R-induced lung injury and associated apoptosis ... the c-Jun amino-terminal protein kinases (JNKs), and p38 kinases Notably, whereas ERK1 and ERK2 exert a cytoprotective effect and are involved in cell proliferation, transformation, and differentiation,...
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Core Topics in Operating Department Practice Anaesthesia and Critical Care – Part 3 pdf
... pressure using a part task trainer Continuing Education in Anaesthesia, Critical Care & Pain, 5(2), 45À8 Sinclair, R C F & Luxton, M C (2005) Rapid sequence induction Continuing Education in Anaesthesia, ... cuff by inserting a syringe into the valve housing and removing the air until a definite vacuum is noted in the syringe and the pilot balloon is collapsed 10 Extubate the patient, following currently ... carried out in Australia and Scandinavia over a number of years Myles et al (2004) published findings from a large randomised controlled trial using Bispectral Index (BIS) monitoring as a potential...
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Core Topics in Operating Department Practice Anaesthesia and Critical Care – Part 6 doc
... anaesthesia are intravenous and inhalational Intravenous is more frequently used than inhalational induction in adults whereas in paediatric anaesthesia both intravenous and inhalational induction ... inhalational induction Intravenous and inhalational methods of inducing anaesthesia are both widely used techniques in paediatrics Intravenous induction has become less traumatic for a child since the ... for injury and pain especially during placement into the lithotomy position if hip rotation and over abduction occur Intubation difficulties can be increased due to shortening and thickening...
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Core Topics in Operating Department Practice Anaesthesia and Critical Care – Part 7 pot
... administered via a single shot, intended to bring about uterine contraction as the foetus is being delivered, or as an infusion if the surgeon indicates that the uterus is flaccid and lacking ... three in common use: syntocinon, ergometrine and syntometrine, which is a combined preparation of the other two They have the action of contracting the myometrium, although in differing manners and ... of causing nausea and vomiting and can induce a general vasoconstriction leading to a rise in blood pressure, an effect unwanted if the mother is already hypertensive Interestingly, according to...
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Core Topics in Operating Department Practice Anaesthesia and Critical Care – Part 8 ppt
... including staffing and training issues are addressed Basic good practice guidelines about consent and treatment have now been issued and ECT clinics are now being inspected and audited both internally ... internally and externally by health and government bodies including the Mental Health Act Commission and ECTAS This inevitably will bring about higher and better maintained standards for the care of ... of avoiding intubation either temporarily, or if successful can be instrumental in eliminating the need for intubation altogether Non-invasive ventilation is used in the clinical setting when...
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Core Topics in Operating Department Practice Anaesthesia and Critical Care – Part 9 doc
... relevance to monitoring and therapy of ventilator induced lung injury Current Opinion in Critical Care, 5, 17À20 Shelly, M & Nightingale, P (1999) ABC of Intensive Care M Singer & I Grant, eds ... relevant information and evidence can be collected and stored centrally For some, portfolio building will have begun at an early stage in their career and will mainly include the education and training ... store of information This portfolio needs careful recording and sorting of information to help establish and build a picture of the individual’s development Organising the information into chronological...
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Core Topics in Operating Department Practice Anaesthesia and Critical Care – Part 10 pps
... practitioners and remaining professional tensions seem increasingly less important in the face of NHS reform and modernisation Broad principles surrounding legal, 199 200 S Wordsworth professional and ... 94, 95 intubation by 32 (see also difficult intubation; intubation) legal rights of 192, 198 (see also laws and legal issues) malpractice by 194, 197 (see also laws and legal issues) minimum ... history of intestinal 34 intracranial 40, 46, 71 (see also brain; intracranial pressure) intracranial surgery 71 (see also intracranial pressure) justified risk taking during 54 obstetric and gynaecological...
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Báo cáo y học: " Year in review 2007: Critical Care – multiple organ failure and sepsi" pdf
... group-box protein 1, lipopolysaccharide-binding protein and procalcitonin levels were higher in patients than in healthy control individuals None of the biomarkers of interest discriminated between ... E: A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care Transfusion Requirements in Critical Care Investigators, Canadian Critical Care Trials Group ... through increased expression of heat shock protein 70 with glutamine administration [40] Heat shock proteins are a group of proteins that are induced by a wide range of stimuli and serve to maintain...
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Báo cáo y học: " The Simple Triage Scoring System (STSS) successfully predicts mortality and critical care resource utilization in H1N1 pandemic flu: a retrospective analysis" doc
... the Ontario Ministry of Health This system was proposed to guide critical care resource allocation issues during the initial days and weeks of an overwhelming influenza pandemic and to prioritize ... Society of Intensive Care Medicine’s Task Force for intensive care unit triage during an influenza epidemic or mass disaster Intensive Care Med 2010, 36:428-443 Hick J, Rubinson L, O’Laughlin D, Farmer ... confidence interval Adeniji and Cusack Critical Care 2011, 15:R39 http://ccforum.com/content/15/1/R39 Page of Table Discrimination of initial SOFA score groupings in predicting mortality in our...
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Textbook of Neuroanaesthesia and Critical Care - part 1 potx
... sufficiently to avulse the bridging veins, provoking brisk venous bleeding from multiple points in the sinus when the clot is evacuated Tearing of bridging veins may also occur during or early after neurosurgical ... margin and result in ischaemia or infarction of the prolapsing tissue Preservation of the draining veins is another factor which should be considered when planning the approach in order to minimize ... neurokinin A (NKA) and calcitonin gene-related peptide (CGRP), are contained within vesicles in the naked nerve endings All three are vasodilators, whilst SP and NKA promote plasma protein extravasation...
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Textbook of Neuroanaesthesia and Critical Care - part 2 ppsx
... pulsation, with breathing and during coughing and straining Each of the intracranial constituents occupies a certain volume and, being essentially liquid, is incompressible In the closed box of ... Pathology of brain damage in brain injury In: Tindall G, Cooper R, Barrow D (eds) The practice of neurosurgery Williams and Wilkins, Baltimore, 1996, pp 1385–1400 Andrew K Head injuries In: Andrews K ... haemorrhage and vessel disruption with subsequent infarction These injuries are typically followed by brain swelling, leading to an increase in intracranial volume and intracranial pressure and a consequent...
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Textbook of Neuroanaesthesia and Critical Care - part 3 doc
... (MMN) in oddball paradigms of AEP recording The relationship of MMN to outcome was examined in a group of head-injured patients82 and is summarized in Table 5.6 The other interesting finding in ... which are seen on the EEG in acute brain injury This knowledge may allow EEG to be even more widely applied in determining the severity of brain injury and predicting clinical outcome Conclusion ... Ti and Tm are the temperature of blood, indicator and mixture of blood and indicator respectively, Vb and Vi the volumes (ml) of blood and indicator, λb and λi the specific heat of blood and indicator,...
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Textbook of Neuroanaesthesia and Critical Care - part 6 pps
... paid to maintaining body temperature Induction may be intravenous or inhalational with the aim of maintaining oxygenation and haemodynamic stability and preventing an acute rise in intracranial ... Management of Spinal Injuries and Surgery to the Cervical Spine Karen J Heath & Richard E Erskine Introduction 241 Clinical Anatomy and Biomechanics 241 Aetiology and Incidence of Spinal Injuries 242 ... problems include positioning, blood loss and spinal cord monitoring The patients are prone and care must be taken to prevent abdominal compression as an increase in intraabdominal pressure may divert...
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Textbook of Neuroanaesthesia and Critical Care - part 7 pptx
... thickening GH plays a pivotal role in intermediate metabolism It acts with insulin to encourage protein production and, in insulin-depleted states, as a fat-mobilizing agent It increases amino acid ... posterior fossa is being exposed Entrainment can occur at pin sites, veins in muscle, diploic veins, emissary veins and intracranial venous sinuses The cited incidence varies depending on the sensitivity ... respiratory tract, carcinomas originating in these regions can readily invade the posterior fossa In recent years, combined surgical approaches involving neurosurgery, ear, nose and throat and plastic surgery...
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Textbook of Neuroanaesthesia and Critical Care - part 8 pptx
... of traumatic brain injury: relationship to neurochemical and biomechanical mechanisms Lab Invest 1996; 74: 315–342 25 McKeating EG, Andrews PJD Cytokines and adhesion molecules in acute brain injury ... mediators have been postulated including oxyhaemoglobin, serotonin, histamine, catecholamines, prostaglandins, endothelin, angiotensin and lipid peroxidase.53–55 In the patient with SAH, the appearance ... in the choice of therapy in such a setting The first of these is to use a standard protocol in all patients and introduce more intensive therapies in a sequence based either on intensity of intervention...
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