Anesthesia Procedure of Emergency Operation for Patients with Suspected or Confirmed COVID-19

2020 ◽  
Vol 21 (3) ◽  
pp. 299-299 ◽  
Author(s):  
Xianjie Wen ◽  
Yiqun Li
Keyword(s):  
Emergency Operation ◽  
Anesthesia Procedure

Antibiotic Therapy Did Not Prevent the Rupture of Mycotic Aneurysm of the Superior Mesenteric Artery

2015 ◽  
Vol 18 (3) ◽  
pp. 088
Author(s):  
Ye-tao Li ◽  
Xiao-bin Liu ◽  
Tao Wang
Keyword(s):  
Abdominal Pain ◽  
Infective Endocarditis ◽  
Aortic Valve ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Mycotic Aneurysm ◽  
Acute Abdominal Pain ◽  
Rare Complication ◽  
Emergency Operation ◽  
History Of

<p class="p1"><span class="s1">Mycotic aneurysm of the superior mesenteric artery (SMA) is a rare complication of infective endocarditis. We report a case with infective endocarditis involving the aortic valve complicated by multiple septic embolisms. The patient was treated with antibiotics for 6 weeks. During preparation for surgical treatment, the patient developed acute abdominal pain and was diagnosed with a ruptured SMA aneurysm, which was successfully treated with an emergency operation of aneurysm ligation. The aortic valve was replaced 17 days later and the patient recovered uneventfully. In conclusion, we present a rare case with infective endocarditis (IE) complicated by SMA aneurysm. Antibiotic treatment did not prevent the rupture of SMA aneurysm. Abdominal pain in a patient with a recent history of IE should be excluded with ruptured aneurysm.</span></p>

scholarly journals An Approach to Analyze Diagnosis Errors in Advanced Main Control Room Operations Using the Cause-Based Decision Tree Method

Energies ◽  
2021 ◽  
Vol 14 (13) ◽  
pp. 3832
Author(s):  
Awwal Mohammed Arigi ◽  
Gayoung Park ◽  
Jonghyun Kim
Keyword(s):  
Decision Tree ◽  
Nuclear Power ◽  
Power Plants ◽  
Human Error ◽  
Cognitive Activity ◽  
Emergency Operation ◽  
Nuclear Industry ◽  
Working Environment ◽  
Control Rooms ◽  
Diagnosis Errors

Advancements in the nuclear industry have led to the development of fully digitized main control rooms (MCRs)—often termed advanced MCRs—for newly built nuclear power plants (NPPs). Diagnosis is a major part of the cognitive activity in NPP MCRs. Advanced MCRs are expected to improve the working environment and reduce human error, especially during the diagnosis of unexpected scenarios. However, with the introduction of new types of tasks and errors by digital MCRs, a new method to analyze the diagnosis errors in these new types of MCRs is required. Task analysis for operator diagnosis in an advanced MCR based on emergency operation was performed to determine the error modes. The cause-based decision tree (CBDT) method—originally developed for analog control rooms—was then revised to a modified CBDT (MCBDT) based on the error mode categorizations. This work examines the possible adoption of the MCBDT method for the evaluation of diagnosis errors in advanced MCRs. We have also provided examples of the application of the proposed method to some common human failure events in emergency operations. The results show that with some modifications of the CBDT method, the human reliability in advanced MCRs can be reasonably estimated.

scholarly journals Perforation of the atrial wall and aortic sinus after closure of an atrial septal defect with an Atriasept occluder: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Zai-Qiang Zhang ◽  
Jia-Wang Ding
Keyword(s):  
Case Report ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Emergency Operation ◽  
Atrial Wall ◽  
Aortic Sinus ◽  
Case Presentation ◽  
Lethal Complications ◽  
Life Threatening

Abstract Background While the perforation of the atrial wall and aortic sinus after closure of an atrial septal defect (ASD) is rare, it’s life-threatening, with rapid progress and high mortality. To the best of our knowledge, 21 similar cases have been reported since 1976. Case presentation We report a 16-year-old male whose atrial septal defect (ASD) was closed using a 12-mm Amplatzer septal occluder (ASO). Atrial wall and aortic sinus perforation occurred 3 months after transcatheter closure, and the patient was discharged after emergency operation. He was discharged on the 12th postoperative day in good overall condition. Conclusions With this case report, we want to illustrate that although percutaneous closure of ASD is regarded as a routine procedure, we should not forget the potentially lethal complications, especially cardiac erosion. Therefore, we should carefully evaluate the risk of erosion before surgery, and careful lifelong follow-up is needed.

scholarly journals Hepatic Inflammatory Myofibroblastic Tumor Detected in the Fetal Period That Caused an Oncologic Emergency

2020 ◽  
Vol 13 (3) ◽  
pp. 1513-1519
Author(s):  
Hirotaka Kato ◽  
Yasuyuki Mitani ◽  
Taro Goda ◽  
Masaki Ueno ◽  
Shinya Hayami ◽  
...  
Keyword(s):  
Inflammatory Myofibroblastic Tumor ◽  
Emergency Operation ◽  
Cystic Mass ◽  
Abdominal Distention ◽  
Tumor Biopsy ◽  
Emergency Cesarean ◽  
Subcutaneous Edema ◽  
Male Neonate ◽  
Circulation Dynamics ◽  
Inflammatory Effect

A huge abdominal cystic lesion with ascites was detected in a male neonate at 31 weeks of gestation. Increasing ascites and the appearance of subcutaneous edema were detected, which caused fetal hydrops. The patient was delivered by emergency cesarean section at 33 weeks of gestation. The birth weight was 2,407 g, and the Apgar score was 8/9 points (1-/5-min values). Breathing at birth was stable, but the patient presented with remarkable abdominal distention due to the ascites. Later, the patient presented with tachypnea, and breathing gradually worsened, so an emergency operation was performed. There were no intraoperative findings within the small intestine, but there was a large amount of ascites and a cystic mass arising from the liver. The patient’s breathing and circulation dynamics could only be stabilized by ascites removal, so only a tumor biopsy was performed. The pathological findings led to the diagnosis of an inflammatory myofibroblastic tumor, and steroids were administered early after surgery for the purpose of an anti-inflammatory effect and tumor shrinkage. The abdominal distention was alleviated, and blood examinations showed a reduced inflammatory response. There was no apparent shrinkage of the tumor, however; thus, radical surgical treatment was performed on day 24. The postoperative course was uneventful, so the patient was discharged on day 36. Seven years after the operation there has been no recurrence or distant metastasis.

Improving the Appropriateness of Advanced Life Support Teams’ Dispatch: A Before-After Study

2021 ◽  
pp. 1-7
Author(s):  
Lorenzo Gamberini ◽  
Cosimo Picoco ◽  
Donatella Del Giudice ◽  
Corrado Zenesini ◽  
Marco Tartaglione ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Life Support ◽  
Advanced Life Support ◽  
Emergency Operation ◽  
Support Teams ◽  
Global Sensitivity ◽  
Emergency Logistics ◽  
Prehospital Emergency ◽  
Task Time ◽  
Algorithm Implementation

Abstract Background and Importance: The dispatch of Advanced Life Support (ALS) teams in Emergency Medical Services (EMS) is still a hardly studied aspect of prehospital emergency logistics. In 2015, the dispatch algorithm of Emilia Est Emergency Operation Centre (EE-EOC) was implemented and the dispatch of ALS teams was changed from primary to secondary based on triage of dispatched vehicles for high-priority interventions when teams with Immediate Life Support (ILS) skills were dispatched. Objectives: This study aimed to evaluate the effects on the appropriateness of ALS teams’ intervention and their employment time, and to compare sensitivity and specificity of the algorithm implementation. Design: This was a retrospective before-after observational study. Settings and Participants: Primary dispatches managed by EE-EOC involving ambulances and/or ALS teams were included. Two groups were created on the basis of the years of intervention (2013-2014 versus 2017-2018). Intervention: A switch from primary to secondary dispatch of ALS teams in case of high-priority dispatches managed by ILS teams was implemented. Outcomes: Appropriateness of ALS team intervention, total task time of ALS vehicles, and sensitivity and specificity of the algorithm were reviewed. Results: The study included 242,501 emergency calls that generated 56,567 red code dispatches. The new algorithm significantly increased global sensitivity and specificity of the system in terms of recognition of potential need of ALS intervention and the specificity of primary ALS dispatch. The appropriateness of ALS intervention was significantly increased; total tasking time per day for ALS and the number of critical dispatches without ALS available were reduced. Conclusion: The revision of the dispatch criteria and the extension of the two-tiered dispatch for ALS teams significantly increased the appropriateness of ALS intervention and reduced both the global tasking time and the number of high-priority dispatches without ALS teams available.

scholarly journals Determinants of Success and Early Complications in Common Femoral Artery Endarterectomy: A Retrospective Study

Surgeries ◽  
2021 ◽  
Vol 2 (2) ◽  
pp. 180-189
Author(s):  
Marcel Libertus Johannes Quax ◽  
Daniël Eefting ◽  
Herman Joseph Smeets
Keyword(s):  
Retrospective Study ◽  
Femoral Artery ◽  
Clinical Success ◽  
Ankle Brachial Index ◽  
Emergency Operation ◽  
Common Femoral Artery ◽  
Walking Distance ◽  
Safe Procedure ◽  
Hybrid Procedures ◽  
Significant Difference

Introduction: Common femoral artery endarterectomy (CFE) is considered a relatively simple, successful and safe procedure in the literature, but major complications can occur. This retrospective study was performed in order to define characteristics contributing to success or failure after common femoral artery endarterectomy, either performed as a single or hybrid procedure. Methods: A total of 298 patients who underwent CFE in our hospital between 1 January 2011 and 1 January 2017 were included. After exclusion, 227 patients were analyzed. Patient characteristics and outcomes were derived from the patient records. Follow-up was 30 days postoperatively. Outcomes were analyzed by the chi-square test and regression analysis. Clinical success was defined as a combination of technical success, improvement in the ankle-brachial index, increased walking distance and “no complications.” Results: The procedure was clinically successful in 74.4% of the patients, and in 25.6%, a complication occurred. The Rutherford class improved in 65.1% of the patients with 1.6 (SD 1.3) class points. The ankle-brachial index improved in 44.8% of the cases, with an average of 116.6%. The most contributing factors for complications such as death, unplanned amputation, surgical site infection, thrombosis and longer hospital admission were emergency operation and a higher ASA classification. Significantly more complications also occurred in patients with renal failure, congestive heart disease, a high Rutherford classification and previous groin incision. A higher Rutherford class was the only factor correlating with an increase in the ankle-brachial index. When single CFE (48.9% of cases) and hybrid procedures (51.1%) were compared, no significant difference in success or failure was found. Conclusion: Limb ischemia requiring emergency operation and preoperative comorbidity were identified as the most important factors predictive for complications following femoral artery endarterectomy. Combining femoral endarterectomy with an endovascular intervention does not seem to increase the risk of a postoperative complication.

Control strategies for microgrids emergency operation

2005 ◽  
Author(s):  
J.A.P. Lopes ◽  
C.L. Moreira ◽  
A.G. Madureira ◽  
F.O. Resende ◽  
X. Wu ◽  
...  
Keyword(s):  
Control Strategies ◽  
Emergency Operation
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