scholarly journals Accidental Placement of Nasogastric Tube into the Brain: Case Report and Review of the Literature

2020 ◽  
Vol 6 (02) ◽  
pp. 74-76
Author(s):  
Khursheed Ansari ◽  
Rafique Umer Harvitkar ◽  
Saiprasad Shetty ◽  
Tushar P. Raut ◽  
Shabnam Qureshi
Keyword(s):  
Case Report ◽  
Health Care Providers ◽  
Nasogastric Tube ◽  
Simple Procedure ◽  
Vital Role ◽  
Care Providers ◽  
Novel Method ◽  
The Brain ◽  
Acceptable Outcome

AbstractThe nasogastric tube (NGT) plays a very vital role in the early resuscitation of head injury patients for various reasons. Though considered a simple procedure, it can be associated with multiple dreadful complications. Our patient was a 44-year-old male, referred from a peripheral health center for further management of severe head and faciomaxillary injuries following a motor vehicular accident. On arrival at the hospital, the endotracheal tube and NGT were in situ. A computed tomography scan of the brain revealed the NGT piercing through the cribriform plate of ethmoid and coiling into the cranial cavity with pneumocephalus. The NGT was retrieved under C-arm guidance and his injuries were managed respectively. The patient was discharged after prolong hospitalization with an acceptable outcome. With this case report, we want to remind emergency health care providers to avoid this catastrophic complication of NGT insertion in a faciomaxillary trauma patient by doing it transorally. We report a novel method of safely removing NGT which has not been reported in the past.

scholarly journals EP.FRI.828 Accidental Placement of Nasogastric Tube into the brain

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Rafique Harvitkar ◽  
Khursheed Ansari ◽  
Harish Peri
Keyword(s):  
Health Care Providers ◽  
Nasogastric Tube ◽  
Simple Procedure ◽  
Vital Role ◽  
Care Providers ◽  
Novel Method ◽  
The Brain ◽  
Tomography Scan ◽  
Acceptable Outcome

Abstract The nasogastric tube (NGT) plays a very vital role in the early resuscitation of head injury patients for various reasons. Though considered a simple procedure, it can be associated with multiple dreadful complications. Our patient was a 44-year-old male, referred from a peripheral health center for further management of severe head and faciomaxillary injuries following a motor vehicular accident. On arrival at the hospital, the endotracheal tube and NGT were in situ. A computed tomography scan of the brain revealed the NGT piercing through the cribriform plate of ethmoid and coiling into the cranial cavity with pneumocephalus. The NGT was retrieved under C-arm guidance and his injuries were managed respectively. The patient was discharged after prolong hospitalization with an acceptable outcome. With this case report, we want to remind emergency health care providers to avoid this catastrophic complication of NGT insertion in a faciomaxillary trauma patient by doing it transorally. We report a novel method of safely removing NGT which has not been reported in the past.

scholarly journals Caregiver Burden: Caregiving Workshops Have a Positive Impact on Those Caring for Individuals With Dementia in Arkansas

2021 ◽  
Vol 8 ◽  
pp. 237437352110180
Author(s):  
Robin E. McAtee ◽  
Laura Spradley ◽  
Leah Tobey ◽  
Whitney Thomasson ◽  
Gohar Azhar ◽  
...  
Keyword(s):  
Caregiver Burden ◽  
Health Care Providers ◽  
Positive Impact ◽  
Educational Programs ◽  
Vital Role ◽  
Complex Care ◽  
Care Providers ◽  
Dementia Caregivers ◽  
Before And After ◽  
Burden Scale

Millions of Americans live with dementia. Caregivers of this population provide countless hours of multifaceted, complex care that frequently cause unrelenting stress which can result in immense burden. However, it is not fully understood what efforts can be made to reduce the stress among caregivers of persons with dementia (PWD). Therefore, the aim of this pretest–posttest designed study was to evaluate changes in caregiver burden after providing an educational intervention to those caring for PWD in Arkansas. Forty-one participants completed the Zarit Caregiver Burden Scale before and after attending a 4-hour dementia-focused caregiving workshop. The analysis of the means, standard deviations, and paired t tests showed that there was an increase in the confidence and competence in caring for PWD 30 to 45 days after attending the workshop. Health care providers need to understand both the vital role caregivers provide in managing a PWD and the importance of the caregiver receiving education about their role as a caregiver. Utilizing caregiver educational programs is a first step.

“My Whole World Fell Apart”: Parents Discovering Their Child Has Anorexia Nervosa

2020 ◽  
Vol 30 (12) ◽  
pp. 1821-1832
Author(s):  
Emily P. Williams ◽  
Shelly Russell-Mayhew ◽  
Nancy J. Moules ◽  
Gina Dimitropoulos
Keyword(s):  
Health Care ◽  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Health Care Providers ◽  
Family Dynamics ◽  
Vital Role ◽  
Care Providers ◽  
Critical Gap ◽  
Hermeneutic Inquiry ◽  
Difficult Times

This was the first study to examine the experience of parents who discover their child was living with anorexia nervosa (AN), thus fulfilling a critical gap in the eating disorder literature. Gadamerian hermeneutic inquiry was the guiding philosophy and method used to investigate this topic. Dialogues with parents revealed the ambiguity inherent within discovery; the isolation, betrayal, and loss felt by parents; and the complicated family dynamics occurring during the process of discovering one’s child has AN. As such, when discoveries are made, parents play a vital role in the development and functioning of the family’s response to the situation. This research offers health care providers a better understanding of the difficult times parents and caregivers experience when discovering their child has AN.

scholarly journals Case report: Chlorpromazine and deep venous thrombosis

2019 ◽  
Vol 11 (2) ◽  
pp. 16-19 ◽  
Author(s):  
Matthew Joseph Reed ◽  
Sean Comeau ◽  
Todd R. Wojtanowicz ◽  
Bharat Reddy Sampathi ◽  
Sofia Penev ◽  
...  
Keyword(s):  
Case Report ◽  
Health Care Providers ◽  
Case Reports ◽  
Manic Episode ◽  
Venous Stasis ◽  
Poor Sleep ◽  
Care Providers ◽  
Content Type ◽  
Difficulty Breathing ◽  
Typical Antipsychotics

Purpose Since the development of antipsychotic drugs in the 1950s, a variety of studies and case reports have been published that suggest an association between exposure to typical antipsychotics and venous thromboembolisms (VTE). Therefore, when starting treatment with antipsychotics, especially low-potency typical antipsychotics and clozapine, health-care providers must account for the patient’s existing VTE risk factors. Design/methodology/approach In this case report, the authors describe the development of a pulmonary embolism associated with use of chlorpromazine in the treatment of an acute manic episode in a 51-year-old female patient with bipolar disorder type 1. Findings The patient was brought to the emergency room by the police on a legal hold for bizarre behaviors at a bus stop, which included incessantly yelling at bystanders. The patient was found to have disorganized thoughts, poor sleep, rapid speech, labile mood, distractibility, auditory hallucinations and grandiose delusions. During the course of her stay, the patient received extensive IM chlorpromazine for extreme agitation, in addition to chlorpromazine 200 mg IM Q8H, which was later decreased to chlorpromazine 100 mg chlorpromazine IM/PO Q8H. On day 4 of the treatment, the patient experienced difficulty breathing, hypoxia and tachycardia and was found to have bilateral expiratory wheezes. CT angiography showed sub-segmental pulmonary embolus and the patient was transferred to MICU service. The patient was then intubated and started on heparin by the medical team. Over the course of the next day, her respiratory distress resolved and the patient was extubated. Originality/value It is possible that chlorpromazine may indeed increase VTEs, and there are various physiological postulations regarding the mechanism of action. However, multiple confounding variables existed in the authors’ report, including venous stasis and the use of restraints, tobacco and valproic acid. Each of these variables has been shown to increase VTE occurrence. Further controlled studies are necessary to identify the true relationship between antipsychotics and VTEs.

scholarly journals Pharmacist’s Intervention Considering the Prognosis for a Terminal Cancer Patient: A Case Report

Pharmacy ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 212
Author(s):  
Masahiro Okada ◽  
Kazuko Okazaki ◽  
Keisuke Kimura ◽  
Hiroki Sugihara ◽  
Fumiyoshi Murakami ◽  
...  
Keyword(s):  
Case Report ◽  
Health Care Providers ◽  
Prognostic Index ◽  
Oral Intake ◽  
Sigmoid Colon Cancer ◽  
Care Providers ◽  
Abdominal Wall Metastasis ◽  
First Case ◽  
Prognostic Prediction ◽  
Loss Of Appetite

Prognostic prediction has been reported to affect the decision of doctors and non-physician health care providers such as nurses, social workers, pastors, and hospice volunteers on the selection of appropriate medical interventions. This was a case of a 65-year-old woman who presented with a poor oral intake. The patient had a history of sigmoid colon cancer with abdominal wall metastasis and peritoneal dissemination. On the day of admission, nausea, anorexia, and malaise were noted, requiring immediate intervention. The patient’s prognosis was predicted using the Palliative Prognostic Index. The pharmacist suggested the use of dexamethasone tablets in order to alleviate the patient’s symptoms. Indeed, the administration of dexamethasone alleviated the symptoms of nausea, loss of appetite, and malaise. To the best of our knowledge, this is the first case report to demonstrate that prognosis prediction is important not only for other medical staff but also for pharmacists when deciding the need to initiate a treatment and continue such treatment, and when providing pharmacist interventions.

scholarly journals Antenatal diagnosis of alobar holoprosencephaly: a case report

2019 ◽  
Vol 6 (5) ◽  
pp. 2198
Author(s):  
Manjushri Waikar ◽  
Anamika Singh
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Antenatal Diagnosis ◽  
Fetal Mri ◽  
Psychological Trauma ◽  
Vital Role ◽  
Outpatient Department ◽  
Fetal Anomalies ◽  
Medical Termination ◽  
The Brain

 Holoprosencephaly (HPE) is a structural malformation of the brain that results from the complete or incomplete noncleavage of the forebrain/ prosencephalon of the embryo into 2 hemispheres1. We present a case of twenty-five year-old primigravida presented to the Outpatient department of Obstetrics for routine checkup and diagnosed with Alobar holoprosencephaly on 2nd level USG. Fetal MRI was performed and the findings were confirmed. Even though ultrasonography is diagnostic in the detection of fetal anomalies, MRI plays a vital role due to its multiplanar capability and excellent soft tissue resolution. The purpose of publishing this case is to sensitize the clinicians to the classical features of holoprosencephaly on various imaging modalities and to stress the importance of its detection before 20 weeks of gestation so as to allow for legal medical termination and alleviate maternal psychological trauma of bearing a deformed fetus.

scholarly journals An integrative overview of the cannabinergic system and mental health

Salud Mental ◽  
2017 ◽  
Vol 40 (3) ◽  
pp. 119-128
Author(s):  
Oscar E Prospéro García ◽  
◽  
Pavel E Rueda Orozco ◽  
Octavio Amancio Belmont ◽  
Alejandra E Ruiz Contreras ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care Providers ◽  
Brain Function ◽  
Endocannabinoid System ◽  
Inhibitory Neurons ◽  
Synaptic Membranes ◽  
Care Providers ◽  
Area Of Interest ◽  
Nervous System Function ◽  
The Brain

Background. The endocannabinoid system (eCBs) is one of the modulatory systems widely expressed in the brain. It consists of receptors expressed in the cytoplasmic (CB1 and CB2), the mitochondrial membrane (CB1), and the endogenous ligands known as endocannabinoids, such as anandamide, 2AG and oleamide. CB1 has been found in excitatory and inhibitory neurons in the pre- and post-synaptic membranes. It is expressed in several brain areas such as the hippocampus, dorsal, and ventral striatum, amygdala and prefrontal cortex. The eCBs has been involved in the regulation of learning and memory, mood, energy balance, sleep, and drug addiction. Objective. Integrate existing information about the eCBs and its role in brain function and mental health. Method. Review of the information of basic and clinical relevance obtained from indexed scientific journals (PubMed/Medline, Scopus). Results. Basic and clinical research on eCBs related to central nervous system function is described. Discussion and conclusion. At present, the study of eCBs is of importance. The development of drugs that affect this system may be clinically useful to control different debilitating diseases. This is an area of interest to the scientific community and health care providers.

scholarly journals Home Management of the Device Detected Atrial Fibrillation during COVID-19 Pandemic: A Case Report

2021 ◽  
Vol 9 (C) ◽  
pp. 170-173
Author(s):  
Idaliya Rakhimova ◽  
Talgat Khaibullin ◽  
Yerbol Smail ◽  
Zhanar Urazalina ◽  
Vitalii Koval`chuk ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Case Report ◽  
Health Care Providers ◽  
Remote Monitoring ◽  
Beta Blockers ◽  
Oral Anticoagulants ◽  
Home Monitoring ◽  
Phone Call ◽  
Care Providers ◽  
Remote Monitoring System

BACKGROUND: Patients with heart failure (HF) and implanted heart devices constitute a vulnerable category during the coronavirus disease –2019 (COVID-19) pandemic. The remote monitoring function allows the physician to detect atrial fibrillation (AF) in these patients and to prevent thromboembolic complications by prescribing anticoagulants. Under quarantine conditions, such patients can receive fully remote consultation and treatment, which will protect them from the risk of infection, and also reduce the burden on medical institutions. CASE REPORT: A 56-year-old man presented to the clinic with shortness of breath when climbing the second floor, moderate non-specific fatigue, general weakness, and a decrease in exercise tolerance. The patient received standard treatment for HF for at least 3 months (ACEI, beta blockers, MR antagonists, and loop diuretics) in individually selected adequate doses. ECG on admission showed a QRS of 150 ms, left bundle branch block (LBBB). Echo showed dilatation of all heart chambers, diffuse hypokinesis of the walls with akinesis of the apical, middle anterior LV segments, as well as hypokinesis of the basal, middle apical, and anterior septal segment of the LV. The ejection fraction was reduced to 35%. RV function is reduced. After a detailed discussion with the team, it was decided to do implantation of a cardioverter-defibrillator with resynchronization function, equipped with remote monitoring (Biotronik, and Home monitoring). Date of implantation is June 19, 2014. Due to the fact that the patient was connected to the remote monitoring system, May 5, 2020, he was diagnosed with asymptomatic AF. The episode lasted 1 min 22 s. On the following days of monitoring, episodes of AF were also recorded. The duration of the episodes ranged from a few seconds to 12 h/day. The patient received a doctor’s consultation through phone call, his risk of stroke was four when assessed using the CHA2DS2VASc scale. In treatment, it was recommended to add antiarrhythmic drugs (amiodarone 600 mg a day) and oral anticoagulants (rivaroxaban 20 mg × 1 time/day). Later, periodic IEGM showed absence of AF. CONCLUSION: In the context of the COVID-19 pandemic, health-care providers should rethink their approach to managing patients with implanted heart devices. Modern cardiovascular implantable electronic devices allow the physician to monitor the status of patients and immediately respond to situations requiring a change in treatment. Consultations can be carried out completely online.

scholarly journals COVID-19: a case report

ANALES RANM ◽  
2020 ◽  
Vol 137 (137(02)) ◽  
pp. 147-149
Author(s):  
Jesús Mateos Nozal ◽  
Beatriz Montero Errasquín ◽  
Alfonso J. Cruz Jentoft
Keyword(s):  
Health Care ◽  
Case Report ◽  
Health Care Providers ◽  
Health Care Workers ◽  
Care Providers ◽  
Daily Work ◽  
Care Workers ◽  
High Incidence

COVID-19 pandemic is relentlessly spreading worldwide since it was described in Wuhan in december 2019. A high incidence in health care workers has been described in Spain. The number or articles discussing this condition is exponentially growing, but few published cases report on what physicians have faced in their daily work. It is key that health care providers learn how to convey the severity that COVID-19 can reach, in order to raise awareness on the importance of prevention.

Creating Coronary Care Units and Empowering Nurses

2015 ◽  
Author(s):  
W. Bruce Fye
Keyword(s):  
Cardiac Arrest ◽  
Health Care Providers ◽  
Vital Role ◽  
Care Providers ◽  
Vulnerable Patients ◽  
Life Saving ◽  
Life Threatening ◽  
Coronary Care ◽  
Infarction Heart ◽  
Coronary Care Units

The coronary care unit (CCU) concept was proposed in 1961 as a strategy to save the lives of patients hospitalized after an acute myocardial infarction (heart attack). The notion was to place vulnerable patients in an area where their heartbeats were monitored continuously and where specially trained nurses could initiate cardiopulmonary resuscitation (CPR) if a patient had a cardiac arrest. Cardiac defibrillators and temporary pacemakers, technologies developed in the 1950s to treat life-threatening heart rhythms, were combined with CPR in 1960 in an attempt save patients’ lives. Nurses played a vital role in CCUs, and the new care model transformed the traditional nurse-doctor relationship. Nurses were trained to initiate life-saving treatments without a physician being present. The resulting empowerment of nurses had significant implications for their status as health care providers. The CCU movement also contributed to the development of cardiac arrest teams and paramedic-staffed, defibrillator-equipped ambulances.

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