Acute Asthma in Adults: Controversies and Best Practice

2009 ◽  
Vol 8 (1) ◽  
pp. 10-16
Author(s):  
Maren Schuhmann ◽  
◽  
Fraser Brims ◽  
Anoop J Chauhan ◽  
◽  
...  
Keyword(s):  
Emergency Care ◽  
Best Practice ◽  
Care Setting ◽  
Acute Asthma ◽  
British Thoracic Society ◽  
International Guidelines ◽  
Life Threatening

Asthma in the emergency care setting is common and may be life-threatening. Last year the British Thoracic Society updated their guidelines for the management of asthma, however some treatments remain controversial and there is variation in adherence to these and other national and international guidelines.

scholarly journals Which health-related reasons lead to prehospital emergency care and how does subjective emergency status connect to subsequent care?

2021 ◽  
Author(s):  
Silke Piedmont ◽  
Anna Katharina Reinhold ◽  
Jens-Oliver Bock ◽  
Enno Swart ◽  
Bernt-Peter Robra
Keyword(s):  
Health Insurance ◽  
Emergency Care ◽  
Third Party ◽  
Insurance Companies ◽  
Prehospital Emergency Care ◽  
Health Related ◽  
Life Threatening ◽  
Prehospital Emergency ◽  
Health Insurance Companies ◽  
Reported Data

Abstract Objectives/Background In many countries, the use of emergency medical services (EMS) increases steadily each year. At the same time, the percentage of life-threatening complaints decreases. To redesign the system, an assessment and consideration of the patients’ perspectives is helpful. Methods We conducted a paper-based survey of German EMS patients who had at least one case of prehospital emergency care in 2016. Four health insurance companies sent out the questionnaire to 1312 insured persons. We linked the self-reported data of 254 respondents to corresponding claims data provided by their health insurance companies. The analysis focuses a.) how strongly patients tend to call EMS for themselves and others given different health-related scenarios, b.) self-perceived health complaints in their own index case of prehospital emergency care and c.) subjective emergency status in combination with so-called “objective” characteristics of subsequent EMS and inpatient care. We report principal diagnoses of (1) respondents, (2) 57,240 EMS users who are not part of the survey and (3) all 20,063,689 inpatients in German hospitals. Diagnoses for group 1 and 2 only cover the inpatient stay that started on the day of the last EMS use in 2016. Results According to the survey, the threshold to call an ambulance is lower for someone else than for oneself. In 89% of all cases during their own EMS use, a third party called the ambulance. The most common, self-reported complaints were pain (38%), problems with heart and circulation (32%), and loss of consciousness (17%). The majority of respondents indicated that their EMS use was due to an emergency (89%). We could detect no or only weak associations between patients’ subjective urgency and different items for objective care. Conclusion Dispatchers can possibly optimize or reduce the disposition of EMS staff and vehicles if they spoke directly to the patients more often. Nonetheless, there is need for further research on how strongly the patients’ perceived urgency may affect the disposition, rapidness of the service and transport targets.

Mitigating Chronic Diseases during Archaeological Fieldwork

2021 ◽  
Vol 9 (1) ◽  
pp. 41-48 ◽  
Author(s):  
Carla Klehm ◽  
Elisabeth Hildebrand ◽  
Maureen S. Meyers
Keyword(s):  
Chronic Diseases ◽  
Best Practice ◽  
Cultural Norms ◽  
Group Leaders ◽  
Group Awareness ◽  
Team Members ◽  
Emergency Situations ◽  
Raising Awareness ◽  
Life Threatening ◽  
Preexisting Conditions

ABSTRACTChronic diseases and preexisting conditions shape daily life for many archaeologists both in and out of the field. Chronic issues, however, can be overlooked in safety planning, which more often focuses on emergency situations because they are considered mundane, or they are imperceptible to project directors and crews until a serious problem arises. This article focuses on asthma, diabetes, and depression as common medical conditions that impact otherwise healthy archaeologists during fieldwork, with the goal of raising awareness of these conditions in particular, and the need to be more attentive to chronic diseases in general. Archaeological fieldwork presents novel situations that put those with chronic diseases and preexisting conditions at risk: environmental hazards, remoteness from medical and social resources and networks, lack of group awareness, and varying cultural norms. As a result, if chronic diseases are not attended to properly in the field, they can lead to life-threatening situations. Managing the risk presented by these conditions requires a group culture where team members are aware of issues, as appropriate, and collaborate to mitigate them during fieldwork. Descriptions of how chronic diseases affect archaeologists in the field are followed by “best practice” recommendations for self-management and for group leaders.

scholarly journals Anaphylaxis in an emergency care setting: a one year prospective study in children and adults

2017 ◽  
Vol 25 (1) ◽  
Author(s):  
Athamaica Ruiz Oropeza ◽  
Annmarie Lassen ◽  
Susanne Halken ◽  
Carsten Bindslev-Jensen ◽  
Charlotte G Mortz
Keyword(s):  
Prospective Study ◽  
Emergency Care ◽  
Care Setting ◽  
One Year

scholarly journals Reversal of Ketamine Induced Acute Delirium with Continuous Midazolam Infusion in a Post Extubation Child with Refractory Bronchospasm: A Case Report

2020 ◽  
Vol 26 (2) ◽  
pp. 56-59
Author(s):  
Fahisham Taib ◽  
Laila Ab Mukmin
Keyword(s):  
Low Dose ◽  
Care Setting ◽  
Tertiary Hospital ◽  
Emergence Delirium ◽  
The Past ◽  
First Case ◽  
Midazolam Infusion ◽  
Standardized Treatment ◽  
Life Threatening ◽  
The Common

Continuous ketamine infusion has been used successfully to treat severe refractory bronchospasm in children requiring mechanical ventilation in the intensive care setting. One of the common side effects known is emergence delirium. There is no standardized treatment for the ketamine-induced emergence delirium although benzodiazepine, haloperidol and dexmedetomidine have been reported to be effective in the past. A 7-year-old girl admitted to a tertiary hospital for life-threatening asthma requiring immediate intubation and ventilation. Ketamine was used as sedative and bronchodilator in anticipation of her challenging ventilation strategy. She was successfully extubated on day 8 of admission, however, she developed symptoms associated with the delirium. Successful reversal of the symptoms was achieved after 48-hour use of low dose intravenous midazolam. This was the first case reported on the reversal of ketamine-induced emergence phenomenon using low dose intravenous midazolam infusion.

Recognising and managing an acute asthma attack

2021 ◽  
Vol 2 (1) ◽  
pp. 12-18
Author(s):  
Richard Elston
Keyword(s):  
Acute Asthma ◽  
Asthma Attack ◽  
Threatening Condition ◽  
Life Threatening ◽  
The Uk ◽  
Inhaled Salbutamol

Asthma is a potentially life-threatening condition, characterised by a reversible narrowing of the airways. It affects 1 in 10 children in the UK. During exacerbations, it is difficult for the child to breathe and get enough oxygen into their blood. There is a huge variance in the severity of an attack. Some can be managed in the community while others are potentially fatal and need urgent transfer to hospital. For that reason, criteria have been created to categorise attacks as mild, moderate, severe or life threatening. Initially, an asthma attack should be treated using inhaled salbutamol; however, if the patient does not respond or has severe or life-threatening asthma, they need urgent transfer to hospital.

Thoracics

2020 ◽  
pp. 215-246
Author(s):  
James Bennett ◽  
Gerard Gould
Keyword(s):  
Best Practice ◽  
Bronchopleural Fistula ◽  
Management Strategies ◽  
Lung Ventilation ◽  
Bronchial Obstruction ◽  
Dynamic Hyperinflation ◽  
One Lung Ventilation ◽  
Cardiac Herniation ◽  
Life Threatening ◽  
Practice Methods

In this chapter on life-threatening thoracic problems in anaesthesia, the authors offer their guidance and expertise on the best-practice methods of dealing with each of these. These problems include tracheal/bronchial obstruction, inhaled foreign body, tracheal injury or laceration, bronchopleural fistula, hypoxia/pneumothorax/high airway pressure during one-lung ventilation, dynamic hyperinflation, cardiac herniation postpneumonectomy, major airway bleeding, and bleeding during mediastinoscopy. In addition, the definitions, presentation, management strategies, investigations, risk factors, exclusions and causes, and any special considerations for each potential thoracically related situation are given and elaborated upon. Lists of up-to-date online resources and further reading are also provided here, offering invaluable know-how to encourage the reader to broaden their knowledge.

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