scholarly journals Perioperative considerations for COVID-19 patients: lessons learned from the pandemic -a case series-

2020 ◽  
Vol 73 (6) ◽  
pp. 557-561 ◽  
Author(s):  
Jia Lin Jacklyn Yek ◽  
Sheng Chuu Anne Kiew ◽  
James Chi-Yong Ngu ◽  
Jimmy Guan Cheng Lim
Keyword(s):  
Case Series ◽  
Face Mask ◽  
Supplemental Oxygen ◽  
Lessons Learned ◽  
Rapid Sequence Intubation ◽  
Travel History ◽  
Airborne Infection ◽  
Rapid Sequence ◽  
Chest X Ray ◽  
Septic Condition

Background: As the coronavirus disease 2019 (COVID-19) pandemic spreads globally, hospitals are rushing to adapt their facilities, which were not designed to deal with infections adequately. Here, we present the management of a suspected COVID-19 patient. Case: A 66-year-old man with a recent travel history, infective symptoms, and chest X-ray was presented to our hospital. Considering his septic condition, we decided to perform an emergency surgery. The patient was given supplemental oxygen through a face mask and transported to an operating theatre on a plastic-covered trolley. An experienced anesthetist performed rapid sequence intubation using a video laryngoscope. Due to the initial presentation of respiratory distress, the patient remained intubated after surgery to avoid re-intubation. Precautions against droplet, contact, and airborne infection were instituted. Conclusions: Our objective was to facilitate surgical management of patients with known or suspected COVID-19 while minimizing the risk of nosocomial transmission to healthcare workers and other patients.

scholarly journals Push-Dose Pressors During Peri-intubation Hypotension in the Emergency Department: A Case Series

2021 ◽  
Vol 5 (4) ◽  
pp. 390-393
Author(s):  
Abdullah Bakhsh ◽  
Leena Alotaibi
Keyword(s):  
Blood Pressure ◽  
Emergency Department ◽  
Mean Arterial Pressure ◽  
Side Effects ◽  
Case Series ◽  
Rapid Sequence Intubation ◽  
Emergency Physicians ◽  
Rapid Sequence ◽  
Lethal Complications ◽  
The Mean

Introduction: Emergency physicians frequently encounter critically ill patients in circulatory shock requiring definitive airway procedures. Performing rapid sequence intubation in these patients without blood pressure correction has lethal complications. Questioning the efficacy and fearing side effects of push-dose pressors (PDP) has created an obstacle for their use in the emergency department (ED) setting. In this case series we describe the efficacy and side effects of PDP use during peri-intubation hypotension in the ED. Case series: We included 11 patients receiving PDPs in this case series. The mean increase in systolic blood pressure was 41.3%, in diastolic blood pressure 44.3%, and in mean arterial pressure 35.1%. No adverse events were documented in this case series. Conclusion: The use of push-dose pressors during peri-intubation hypotension may potentially improve hemodynamic status when used carefully in the ED.

scholarly journals ENDOTRACHEAL INTUBATION PROCEDURES

2015 ◽  
Vol 22 (11) ◽  
pp. 1509-1513
Author(s):  
Shua Nasir ◽  
Lal Shehbaz ◽  
Hamid Raza ◽  
Saqib Basar
Keyword(s):  
Endotracheal Intubation ◽  
Incomplete Data ◽  
Case Series ◽  
Rapid Sequence Intubation ◽  
Short Term ◽  
Accident And Emergency ◽  
Rapid Sequence ◽  
Study Population ◽  
The Common ◽  
Head And Neck Injury

Objective: The objective of the study is to study the procedure of endotrachealintubation; its methods between Rapid sequence intubation and crash intubation its successrates and the associated short term complications at the accident and emergency departmentof a government run hospital in Karachi, Pakistan. Study Design: Case series. Setting: Accidentand Emergency Department of Civil Hospital Karachi. Period: 2010 to 2012. Methods: Thesample size taken is of 260 patients, all of whom must be above the age of 14 years, andundergo the procedure of emergency endotracheal intubation. Rapid sequence intubation isanalyzed against crash intubation using descriptive type of statistical analysis. The significancelevel was p<0.05. Results: From the 260 Endotracheal intubations performed, 45 (17.30%)had to be discarded on account of incomplete data. The remaining study population was 215patients (123 males, 92 females) Rapid sequence intubation was the commonest type (n=138,64.18%). Head and neck injury, pulmonary edema was the common complication. Crashintubation was the second type (n= 77, 35.8%) Primary attempt success was found to be 97%(n=134) in rapid sequence intubation and 80% (n = 62) in crash Endotracheal intubations. Atotal of 13 complications (6.04 %) were observed. Conclusion: In light of the results obtainedour study shows a satisfactory success rate on using either mentioned types of intubationprocedures that is either RSI or Crash Intubation.

Implementing a REBOA program outside of the ivory tower: initial case series and lessons learned at a community trauma center.

2018 ◽  
Vol 2 (3) ◽  
Author(s):  
Jacob J Glaser ◽  
Adam Czerwinski ◽  
Ashley Alley ◽  
Michael Keyes ◽  
Valentino Piacentino ◽  
...  
Keyword(s):  
Acute Care ◽  
Trauma Center ◽  
Systolic Pressure ◽  
Case Series ◽  
Lessons Learned ◽  
Hospital Environment ◽  
Open Approach ◽  
Improvement Program ◽  
Clinical Series ◽  
Community Trauma

Background: REBOA has become an established adjunct to hemorrhage control. Prospective data sets are being collected, primarily from large, high volume trauma centers. There are limited data, and guidelines, to guide implementation and use outside of highly resourced environments. Smaller centers interested in adopting a REBOA program could benefit from closing this knowledge gap. Methods: A clinical series of cases utilizing REBOA from Grand Strand Medical Center, Myrtle Beach, South Carolina were reviewed. This represents early data from a busy community trauma center (ACS Level 2), from January 2017 to May 2018. Seven cases are identified and reported on, including outcomes. Considerations and ‘lessons learned’ from this early institutional experience are commented on.   Results: REBOA was performed by trauma and acute care surgeons for hemorrhage and shock (blunt trauma n=3, penetrating trauma n=2, no- trauma n=2). All were placed in Zone 1 (one initially was placed in zone 3 then advanced). Mean (SD) systolic pressure (mmHg) before REBOA was 43 (30); post REBOA pressure was 104 (19). N=4 were placed via an open approach, n=3 percutaneous (n=2 with ultrasound). All with arrest before placement expired (n=3) and all others survived. Complications are described.   Conclusions: REBOA can be a feasible adjunct for shock treatment in the community hospital environment, with outcomes comparable to large centers, and can be implemented by acute care and trauma surgeons. A rigorous process improvement program and critical appraisal process are critical in maximizing benefit in these centers.

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