Patients with aortic dissection who have syncope are at high risk for life-threatening complications

2003 ◽  
Keyword(s):  
High Risk ◽  
Aortic Dissection ◽  
Life Threatening

Behavioral Emergencies and Crises

2010 ◽  
pp. 739-762
Author(s):  
Phillip M. Kleespies ◽  
Justin M. Hill
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
High Risk ◽  
Work Environment ◽  
Emotional Impact ◽  
High Risk Patients ◽  
Risk Patients ◽  
Life Threatening ◽  
Behavioral Emergencies ◽  
And Training

This chapter illustrates the mental health clinician’s relationship with behavioral emergencies. The chapter begins by distinguishing the terms behavioral emergency and behavioral crisis, and underlying themes among all behavioral emergencies are identified. Given that most clinicians will face a behavioral emergency in their careers, the importance of enhancing the process of educating and training practitioners for such situations far beyond the minimal training that currently exists is highlighted. The chapter continues by exploring various aspects of evaluating and managing high-risk patients (i.e., those who exhibit violent tendencies toward themselves or others, and those at risk for victimization). It includes a discussion of the benefits and limitations to estimating life-threatening risk factors and specific protective factors. The chapter concludes by discussing the emotional impact that working with high-risk patients has on clinicians, and an emphasis is placed on the importance of creating a supportive work environment.

Ultrasound diagnosis of dissecting thoracic aortic aneurysms: procedure with a handheld device and a video-illustrated case

2021 ◽  
Vol 51 (1) ◽  
pp. 10-15
Author(s):  
Kenneth V Iserson ◽  
Sri Devi Jagjit ◽  
Balram Doodnauth
Keyword(s):  
Aortic Dissection ◽  
Correct Diagnosis ◽  
Signs And Symptoms ◽  
Aortic Aneurysms ◽  
Thoracic Aortic Aneurysms ◽  
Handheld Device ◽  
Thoracic Aortic Dissection ◽  
Threatening Condition ◽  
Life Threatening ◽  
Handheld Ultrasound

Acute thoracic aortic dissection is an uncommon, although not rare, life-threatening condition. With protean signs and symptoms that often suggest more common cardiac or pulmonary conditions, it can be difficult to diagnose. Ultrasound has proven useful in making the correct diagnosis. This case demonstrates that training gained using standard ultrasound machines can be easily and successfully adapted to newer handheld ultrasound devices. The examination technique using the handheld device is illustrated with photos and a video.

scholarly journals Acute pulmonary embolism in COVID-19 patient: a case report of free-floating right heart thrombus successfully treated with fibrinolysis

2020 ◽  
Author(s):  
Fernando Scudiero ◽  
Antonino Pitì ◽  
Roberto Keim ◽  
Guido Parodi
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
Retrospective Studies ◽  
Right Heart ◽  
Clinical Issue ◽  
Systemic Thrombolysis ◽  
Case Summary ◽  
High Prevalence ◽  
Life Threatening ◽  
Complex Scenario

Abstract Background Despite the fast-growing understanding of the coronavirus disease 2019 (COVID-19), patient management remains largely empirical or based on retrospective studies. In this complex scenario, an important clinical issue appears to be represented by the high prevalence of thromboembolic events, but the data regarding high-risk pulmonary embolism (PE) is still not available. Case summary A patient with COVID-19 developed sudden shortness of breath and hypoxia. Early echocardiographic diagnosis of high-risk PE related to right heart thrombus was performed. Systemic thrombolysis was administered with excellent clinical and haemodynamic response. Discussion Pulmonary thromboembolism is a common occurrence in severe COVID-19 infection. In our experience, systemic thrombolysis proved to be effective and for this reason may be considered for life-threatening PE in COVID-19 patients.

scholarly journals 10-Year Outcomes After Endovascular Repair of Acute Complicated and High-Risk Type B Aortic Dissection

2021 ◽  
Vol 74 (3) ◽  
pp. e232-e233
Author(s):  
Andrew M. Vekstein ◽  
E. Hope Weissler ◽  
Julie W. Doberne ◽  
Adam Williams ◽  
Ryan P. Plichta ◽  
...  
Keyword(s):  
High Risk ◽  
Aortic Dissection ◽  
Endovascular Repair ◽  
Type B ◽  
Type B Aortic Dissection ◽  
High Risk Type

Efficacy of Zoster Immune Globulin

PEDIATRICS ◽  
1974 ◽  
Vol 53 (4) ◽  
pp. 476-480
Author(s):  
Richard G. Judelsohn ◽  
Joel D. Meyers ◽  
Robert J. Ellis ◽  
Elaine K. Thomas
Keyword(s):  
High Risk ◽  
Disease Control ◽  
Immune Globulin ◽  
Immune Status ◽  
Clinical Symptoms ◽  
Normal Children ◽  
Therapeutic Modalities ◽  
Immunosuppressive Medications ◽  
Life Threatening ◽  
High Risk Children

Varicella may be a life-threatening infection in children who have immunodeficiency diseases or who are taking immunosuppressive medications. It was previously demonstrated that zoster immune globulin (ZIG) can prevent varicella in normal children if given within 72 hours of exposure, and its possible efficacy has been reported in high-risk immunodeficient children as well. A program for the distribution of ZIG to high-risk susceptibles was established at the Center for Disease Control in 1971. In 1972, 56 high-risk children were treated with ZIG after exposure. Forty-nine recipients had no clinical symptoms of varicella; at least 34 of these 49 had undetectable CF antibody before treatment, though their immune status by other serologic techniques was unknown. In the seven recipients who developed varicella, the disease was not life-threatening. ZIG may be preferable to other available therapeutic modalities in the prevention or modification of varicella.

Latex Hypersensitivity in Children: Clinical Presentation and Detection of Latex-Specific Immunoglobulin E

PEDIATRICS ◽  
1995 ◽  
Vol 95 (5) ◽  
pp. 693-699
Author(s):  
Pamela L. Kwittken ◽  
Sharon K. Sweinberg ◽  
Donald E. Campbell ◽  
Nicholas A. Pawlowski
Keyword(s):  
High Risk ◽  
Immunoglobulin E ◽  
High Risk Patient ◽  
Latex Allergy ◽  
Patient Profile ◽  
Specific Immunoglobulin E ◽  
Specific Immunoglobulin ◽  
Life Threatening ◽  
History Of

Objective. To better understand the clinical characteristics, diagnosis, and possible prevention of immediate hypersensitivity reactions to latex in a hospitalized, pediatric patient population. Methods. We performed a retrospective case analysis of the first 35 patients with latex allergy evaluated by our service over a 2-year period at our institution. Characteristics of patients and clinical reactions were analyzed and the presence of latex-specific immunoglobulin E was assessed using in vitro methods. In a limited group of Objective. To better understand the clinical premedication with steroids and antihistamines was evaluated for the prevention of latex allergic reactions. Results. The majority of our patients had life-threatening reactions. In previous reports, most pediatric patients underwent reactions in the perioperative period and belonged to two well-recognized "high-risk" patient groups (spina bifida and genitourinary malformations). In our series, 21 patients (60%) had reactions outside of the operating room setting, and 14 patients (40%) had primary diagnoses outside of the previously recognized "high-risk" groups. Many patients had a history of multiple surgical procedures, and a history of a surgical procedure in the first year of life was very common. A pre-existing clinical history of latex allergy was present in only 18 of the 35 patients, and a severe or life-threatening allergic reaction was the presenting feature of latex allergy in 11 of the 35 patients. Using in vitro assays, we were able to detect latex-specific immunoglobulin E in the sera of all but two of our patients. Latex gloves and latex-containing intravenous sets were common triggers for reactions. When exposure to latex occurs systemically, as through an intravenous line, premedication with steroids and antihistamines may fail to protect against anaphylaxis. Conclusions. Our experience indicates that the incidence of latex hypersensitivity in children is increasing, that the circumstances (patient profile, hospital location, route of exposure) in which life-threatening reactions may occur are more broad than previously reported, and that a better understanding of both environmental sources of latex antigens and host responses to latex exposure are needed for improved prevention of serious reactions.

Anaesthetic considerations for emergency laparotomy

Nowa Medycyna ◽  
2020 ◽  
Vol 27 (3) ◽  
Author(s):  
Jacek Wadełek
Keyword(s):  
Risk Assessment ◽  
Decision Making ◽  
High Risk ◽  
Adverse Outcomes ◽  
Emergency Laparotomy ◽  
Life Threatening ◽  
The Right ◽  
Level Of Experience ◽  
Time Frames ◽  
Reduced Time

The majority of patients undergoing emergency laparotomy have potentially life?threatening conditions that require prompt intervention. The reduced time?frames available due to surgical urgency necessitate prompt and senior decision?making to minimise delays. The time taken to correct any anomalies needs to be balanced against the need for prompt surgery, particularly in time?sensitive situations involving sepsis or hypovolaemia. Therefore, corrective measures may be performed in parallel with surgery. Patients undergoing emergency laparotomy are at a high risk of adverse outcomes. Key elements of care for these patients include repeated risk assessment, early antibiotic therapy, as well as fluid resuscitation and appropriate timely interventions provided by clinicians with the right level of experience.

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