Search results for "emergencies"
showing 10 items of 122 documents
A New Evaluation of Emergency Methods for Artificial Ventilation
1968
SUMMARY The effect of artificial ventilation by the exhaled-air methods (mouth-to-nose and mouth-to-mouth) and chest-pressure-arm-lift methods (Ho-ward-Thomsen, Silvester-Brosch, Holger Nielsen) was investigated in 11 anaesthetised apnoeic volunteers. The efficiency of these methods was assessed by the changes in arterial PO2, O2 saturation, PCO2 and pH. It could be shown that the exhaled-air methods ensured normal PO2 and O2 saturation in all cases, while the ventilation by the manual methods was insufficient. Even though normal oxygenation was achieved by the manual methods in some cases, others were extremely hypoventilated, with critically low O2 tensions. pH and CO2 tensions did not ch…
A very rare cause of retroperitoneal bleeding in young patients: do not forget the occurrence of a ruptured left gastroepiploic artery aneurysm!
2019
Visceral artery aneurysms represent a very rare condition. The affected patients usually present as emergency secondary to the sudden rupture of the aneurysm or as an incidental finding on imaging. In this setting, gastric and gastroepiploic aneurysms account for only about 4% of all the splancnic aneurysms. Since ruptured visceral aneurysms present a high mortality, a prompt and adequate (surgical or radiological interventional) treatment is mandatory. Due to the difficulty in achieving an adequate transcatheter access in some cases the emergency laparotomy may represent the only chance for the recover of the affected patients. We report two cases of ruptured left gastroepiploic aneurysms …
Procalcitonin levels in candidemia versus bacteremia: a systematic review
2019
Background Procalcitonin (PCT) is a biomarker used to assess systemic inflammation, infection, and sepsis and to optimize antimicrobial therapies. Its role in the in the differential diagnosis between candidemia and bacteremia is unclear. The aim of this systematic review was to summarize the current evidence about PCT values for differentiating candidemia from bacteremia. Methods PubMed and EMBASE were searched for studies reporting data on the diagnostic performance of serum PCT levels in intensive care unit (ICU) or non-ICU adult patients with candidemia, in comparison to patients with bacteremia. Results We included 16 studies for a total of 45.079 patients and 785 cases of candidemia. …
Identifying associations between diabetes and acute respiratory distress syndrome in patients with acute hypoxemic respiratory failure: an analysis o…
2018
Background: Diabetes mellitus is a common co-existing disease in the critically ill. Diabetes mellitus may reduce the risk of acute respiratory distress syndrome (ARDS), but data from previous studies are conflicting. The objective of this study was to evaluate associations between pre-existing diabetes mellitus and ARDS in critically ill patients with acute hypoxemic respiratory failure (AHRF). Methods: An ancillary analysis of a global, multi-centre prospective observational study (LUNG SAFE) was undertaken. LUNG SAFE evaluated all patients admitted to an intensive care unit (ICU) over a 4-week period, that required mechanical ventilation and met AHRF criteria. Patients who had their AHRF…
Effects of Visually Induced Motion Sickness on Emergency Braking Reaction Times in a Driving Simulator
2019
Objective: The study explores associations of visually induced motion sickness (VIMS) with emergency braking reaction times (RTs) in driving simulator studies. It examines the effects over the progression of multiple simulated drives. Background: Driving simulator usage has many advantages for RT studies; however, if it induces VIMS, the observed driving behavior might deviate from real-world driving, potentially masking or skewing results. Possible effects of VIMS on RT have long been entertained, but the progression of VIMS across simulated drives has so far not been sufficiently considered. Method: Twenty-eight adults completed six drives on 2 days in a fixed-base driving simulator. At f…
Endoscopic Procedures through the Foramen Interventriculare of Monro under Stereotactical Conditions
1994
The foramen interventriculare of Monro is an anatomical narrowness for the endoscopic access to the third ventricle. The effective mechanical angle to pass the foramen interventriculare from a frontal bore hole depends on the diameter in the plane of entrance, the depth of the foramen, and the diameter of the endoscope. Under the pathological conditions of a hydrocephalus internus the foramen interventriculare is enlarged. By means of stereotactical guidance, it is possible to reach the third ventricle accurately without damaging anatomical structures around the foramen interventriculare. The endoscopic technique under stereotactical guidance using a rigid endoscope is sufficient and safe t…
Bowel wall thickening: inquire or not inquire? Our guidelines
2018
Introduction Bowel wall thickening is not an uncommon finding among patient undergoing abdomen CT scan. It may be caused by neoplastic, inflammatory, infectious or ischaemic conditions but also be a normal variant. Although specific radiologic patterns may direct to a precise diagnosis, occasionally misidentification may occur. Thus, in the absence of guidelines, further and not always needed diagnostic procedures (colonoscopy, esophagogastroduodenoscopy or capsule endoscopy) are performed. Patients and methods We conducted a retrospective study on data collected from May 2016 to June 2017. We selected 40 adult patients, admitted in Emergency Department with "abdominal pain" and undergone a…
Acute appendicitis: should the laparoscopic approach be proposed as the gold standard? Six-year experience in an Emergency Surgery Unit
2016
Acute appendicitis is common in an Emergency Surgery Unit. Although the laparoscopic approach is a method accepted for its treatment, no strong data are available for determining how many procedures must an experienced surgeon carry out for obtaining all the advantages of this technique and if this approach can become the gold standard in the activity of a general emergency unit with senior surgeons variously skilled on the basic laparoscopy. 142 patients that underwent appendectomy (90 laparoscopic, 52 conventional) for acute appendicitis were enrolled in this institutional retrospective cohort study. The surgeons were classified with a descriptor-based grading and divided in two groups re…
Checking the carotid pulse check: diagnostic accuracy of first responders in patients with and without a pulse.
1996
International guidelines for cardiopulmonary resuscitation (CPR) in adults advocate that cardiac arrest be recognized within 5-10 s, by the absence of a pulse in the carotid arteries. However, validation of first responders' assessment of the carotid pulse has begun only recently. We aimed (1) to develop a methodology to study diagnostic accuracy in detecting the presence or absence of the carotid pulse in unresponsive patients, and (2) to evaluate diagnostic accuracy and time required by first responders to assess the carotid pulse. In 16 patients undergoing coronary artery bypass grafting, four groups of first responders (EMT-1: 107 laypersons with basic life support (BLS) training; EMT-2…
Emergency toe-to-hand transfer for post-traumatic finger reconstruction: A multicenter case series
2019
Abstract Background The aim of this paper was to evaluate the outcomes of a homogenous series of emergency with a toe-to-hand transfer reconstructions with a different timing: immediate (same surgical step with the debridement), primary (in the first 24 h), early (24–72 h after the debridement) or delayed (72 h-7 days). Materials and methods Between 2001 and 2011, 31 patients received an immediate reconstruction with a toe-to-hand transfer. Data on indications, timing, type of surgery, complications and outcomes (sensory and motor recovery, patient satisfaction) were extrapolated and recorded. Results Most of the procedures in our series (71%) were performed in the first 24 h. Survival rate…