analgesia and sedation for trauma and critical care
Textbook of Neuroanaesthesia and Critical Care - part 1 potx
... Neuroanaesthesia and Critical Care Page ii DEDICATION To our patients Page iii Textbook of Neuroanaesthesia and Critical Care Edited by Basil F Matta MB BCh BA BOA DA FRCA Consultant in Anaesthesia and Neuro -Critical ... constitutive form of enzyme nitric oxide synthase (NOS) This form of the enzyme is calmodulin dependent and requires Ca++ and tetrahydrobiopterin for its activity and differs from the inducible form ... flow: 70 and 20 ml/100g/min for grey and white matter respectively Regional CBF (rCBF) and glucose consumption decline with age, along with marked reductions in brain neurotransmitter content and...
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Textbook of Neuroanaesthesia and Critical Care - part 2 ppsx
... neuroanaesthesia and intensive care, it is important to remember that the primary cause for a high ICP must be sought and treated Outcome studies for any treatment are necessary to improve standards of ... classified as traumatic, ischaemic or hypoxic Traumatic brain injury may be due to the trauma associated with accidents or personal violence Alternatively, the trauma may be iatrogenic and accompany ... including Na+K+, Na+–Ca++, and Ca++–H+, as well as Cl– and HCO3– leakage fluxes, maintain electrical and concentration gradients for various ions across the cell membrane and hence generate the resting...
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Textbook of Neuroanaesthesia and Critical Care - part 3 doc
... blood and indicator, λb and λi the specific heat of blood and indicator, and ρb and ρi the density of blood and indicator If time is brought into the equation, the volumes become flows and: Figure ... assumptions for calculating CBF and hence are indirect or open to criticism This chapter will outline the methods most commonly employed for the measurement of CBF in theatre and intensive care Kety–Schmidt ... CBF and portable units are available The technique is relatively simple and is reliable and reproducible Patient and operator radiation exposure is low, enabling repeated studies on a patient, and...
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Textbook of Neuroanaesthesia and Critical Care - part 6 pps
... careful history and thorough examination, noting the presence of angina and its severity, previous myocardial infarction and symptoms and signs of cardiac failure The ECG should be examined for ... infant and child physiology and pharmacology and paediatric neurophysiology and neuropharmacology is required for the practice of paediatric neurosurgical anaesthesia Furthermore, an understanding ... Codeine phosphate and paracetamol are usually all that is required for analgesia The Arnold–Chiari Malformation The Arnold–Chiari malformation is an abnormality of the brain and skull base, a...
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Textbook of Neuroanaesthesia and Critical Care - part 7 pptx
... thin and very fragile with loss of connective tissue Osteoporosis and bone fractures are common and care is needed when gaining vascular access and positioning the patient Wound healing is slow and ... synthesis and release of ACTH and other pro-opiomelanocortin (POMC)-derived peptides in the pituitary ACTH in turn induces secretion of cortisol and adrenal androgens by the adrenal gland with ... macroglossia and decreased mobility of the neck and temporomandibular joints Hypertrophy of pharyngeal and laryngeal soft tissue obscures the glottis Thyroid enlargement may distort the airway and cause...
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Textbook of Neuroanaesthesia and Critical Care - part 8 pptx
... between the second and fifth days posttrauma and vasogenic oedema then contributes to brain swelling Unfortunately, patients vary enormously and different mechanisms responsible for intracranial ... crystalloid, colloid and blood may be required for trauma patients For non -trauma patients intravenous isotonic crystalloid solutions are preferred to maintain normal intravascular volume and plasma osmolality ... to be much room for improvement in conventional clinical practice A series of telephone and postal surveys suggest that basic recommendations for monitoring and general intensive care in severe...
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Textbook of Neuroanaesthesia and Critical Care - part 9 ppt
... pneumonia and pulmonary embolism followed by dehydration and renal failure, UTI's and sepsis and other comorbidities for example, ischaemic heart disease and cancer Severe Strokes and Intensive Care ... practice, therefore, to maintain tight glycaemic control with insulin and fluids if necessary (to aim for a blood sugar of 4–8) and to perform regular monitoring using BM stix A randomized controlled ... critical illness polyneuropathy and the critical illness myopathies Critical investigations are a serum creatinine kinase and neurophysiological examination of the nerves, which in skilled hands...
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Textbook of Neuroanaesthesia and Critical Care - part 10 ppt
... central nervous system and the techniques of doing so and their applications continue to expand Anaesthetists are increasingly involved in both anaesthesia and sedation for adults and children in this ... Considerations for the Safe Conduct of Anaesthesia for MRI Anaesthesia for MRI requires modifications of anaesthetic techniques and equipment The same standards of care apply to patients requiring sedation ... performed under conscious sedation, it is first necessary to secure the airway and ventilation before the cause of the emergency can be actively treated Several techniques are described for sedation...
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Báo cáo y học: " Ethics and critical care in the new millennium" pps
... balance of supply and demand between health care providers and the public; a balance between the health care the public needs and that which its want; and a balance between what health care providers ... health care team, who must perform often invasive, painful procedures when the chances of survival are very poor; and to society are we all willing to accept? Moreover, the acuity and severity of critical ... 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 y học: "Eighth World Congress of Intensive and Critical Care Medicine, 28 October–1 November 2001, Sydney, Australia: Harm minimization and effective risk managemen" doc
... cutting edges of science and the wisdom of experts in all aspects of critical care. …’ The Congress provided a forum in which researchers and clinicians could come together and look at the questions ... pituitary failure in patients who are critically ill for protracted periods intensive care: that of harm minimisation and risk management Microcirculation and oxygen delivery Dr Can Ince of the ... Critical Care February 2002 Vol No Ramakrishnan of hyperglycaemia in critically ill patients A total of 1548 medical and surgical patients were randomised on admission...
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Báo cáo khoa học: "Clinical review: The Israeli experience: conventional terrorism and critical care" docx
... between October 2000 and September 2004 was performed Information was assembled from the medical center’s trauma registry and from GICU patient admission and discharge records The information we collected ... orthopedic surgery and anesthesiology/ critical care medicine and hospital administration As events evolve and more senior personnel arrive they will take charge A senior general surgeon performs triage ... from the ICU and recovery room Send on-call most experienced physicians to the trauma bay and emergency department Prepare trauma bay, two operating rooms and ICU beds (including PACU) for admission...
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Báo cáo khoa học: " Year in review in Critical Care, 2003 and 2004: respirology and critical care" potx
... monitor sedation levels Muellejans and coworkers [30] compared efficacy and safety of remifentanil and fentanyl for analgesia and sedation in 152 mechanically ventilated patients Both remifentanil and ... duration of MV and ICU stay Koksal and coworkers [17] compared plasma insulin, cortisol, glucose and urinary vanilmandelic acid in patients ventilated for more than 48 hours before, during and after ... Remifentanil versus fentanyl for analgesia based sedation to provide patient comfort in the intensive care unit: a randomized, double-blind controlled trial [ISRCTN43755713] Crit Care 2004, 8:R1-R11 31...
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Báo cáo khoa học: "Clinical review: Mass casualty triage – pandemic influenza and critical care" pps
... bombings Crit Care Med 2005, 33: S107-S112 37 Agency for Healthcare Research and Quality: Altered Standards of Care in Mass Casualty Events Rockville: Agency for Healthcare Research and Quality; ... demand for critical care services, not only for respiratory support through mechanical ventilation but also for a full range of care to manage multi-organ failure Assuming that the next pandemic ... strategy for reducing staff illness in critical care areas [28] Triage The evolution of a new pandemic strain of influenza will inevitably result in a major increase in demand for critical care services...
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Core Topics in Operating Department Practice Anaesthesia and Critical Care – Part 3 pdf
... incorrect hand placement and continuously shows the force being applied to the cricoid cartilage When using the task trainer, many healthcare providers are surprised by the force required and the ... 33 34 C Wayne-Conroy priority for health professionals is to standardise the use and technique of cricoid pressure and start training programmes for those who teach and practise this technique ... practitioners, and that each develops his or her own strategies and methods for practice Nevertheless, in areas where there is potential for causing harm, there is a need for at least a standardised...
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Core Topics in Operating Department Practice Anaesthesia and Critical Care – Part 6 doc
... event and are therefore vulnerable in supporting the child themselves and thus can cause greater distress for the child A smooth and perfect induction is rewarding for the anaesthesia team and ... dorsum of the hands or feet and is covered with an adhesive plastic dressing and sometimes bandaged The cream or gel needs to be covered to allow for the anaesthetic to be absorbed and effectively ... unpleasant smell and pungent odour and is not tolerated by children and therefore its use for inhalational induction is ineffective One other disadvantage in using this volatile agent for inhalational...
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Core Topics in Operating Department Practice Anaesthesia and Critical Care – Part 7 pot
... needle and consequent resistance to injection and flow Pudendal block is the only other commonly found regional technique and is used for episiotomy but may not provide adequate analgesia for forceps ... consumption associated with labour and the need for effective analgesia becomes apparent Therefore pain control can involve a pre-, interand post-operative role for the anaesthetist 127 128 T Williams ... anxiety or pain Adam, S K & Osborne, S (1997) Critical Care Nursing À Science and Practice Oxford: Oxford University Press Cooper, N (2004) Acute care: arterial blood gases Student BMJ, 12, 105À7...
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Core Topics in Operating Department Practice Anaesthesia and Critical Care – Part 8 ppt
... considerations for the patient • How to care for the patient having electro-convulsive therapy • Discuss current standards in electro-convulsive therapy and understand the proposed changes in patient care ... controversy and disagreement It is a dramatic and alarming form of therapy which is disturbing to watch and equivocal in its effects It has enthusiasts on both sides, for and against That it is performed ... anaesthetic and permitted uncontrolled grand mal seizures These were dangerous to the patients and traumatic to the staff Restraining patients often involved enough force to induce injuries and broken...
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Core Topics in Operating Department Practice Anaesthesia and Critical Care – Part 9 doc
... 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 ... grow and be amended, and will form a key support for other developments, which is why careful structuring and organisation is important It is also why this document should remain intact and that ... Guidelines for transfer of the critically ill patient London: Intensive Care Society Juniper, M (1999) Ventilator-associated pneumonia: risk factors, diagnosis and management Care of the Critically...
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Core Topics in Operating Department Practice Anaesthesia and Critical Care – Part 10 pps
... assessment for 157, 158 bilateral 155 consent for 154, 157–9 controversy surrounding 154 E.E.G monitoring and 158 grand mal seizures during 155, 156 guidelines for 159 history of 154–6 patient care ... induction and emergence from anaesthesia APs will also deputise for anaesthetists in various situations where their airway and venous cannulation skills will assist in patient care and where ... healthcare professionals In his summary Lord Denning stated that: ‘When hospital authorities undertake to treat a patient, and themselves select and appoint and employ the professional men and...
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