Ventilatory management of critically ill children.in the emergency setting, during transport and retrieval

2021 ◽  
Author(s):  
Shelley Riphagen ◽  
Ruth Bird
2013 ◽  
Vol 15 (3) ◽  
pp. 175-188 ◽  
Author(s):  
Kate Murphy ◽  
Angie Hibbert

Aim: Detailed information regarding the causes and treatment of acute collapse in the cat can be difficult to locate in a single published source. This two-part review aims to provide a logical approach to the clinical assessment and stabilisation of the critically ill collapsed cat. Practical relevance: Cats are particularly challenging when presented as emergency patients, often in the later stages of an illness or with a vague history and non-specific signs. The nuances of the critically ill cat are considered, especially for shock and its management. Clinical challenges: Shocked cats do not present in the classic stages typically seen in dogs, and the signs are more subtle. Therefore, the clinician must consider whether physical parameters are appropriate for the state and environment of the patient; for example, a normal heart rate in a shocked cat would be considered inappropriate. Audience: This review is directed at any veterinarian working with feline patients, and particularly those dealing with emergencies on a regular basis. Evidence base: There is an extensive body of published literature, both original studies and textbook chapters, pertaining to the causes and treatment of collapse in the cat. In this article the authors draw on information from original publications, reviews and their clinical experience to provide practical guidance to assist in the emergency setting.


Author(s):  
Quah Wy Jin ◽  
Jeffrey Jeswant Dillon ◽  
Lee Tjen Jhung ◽  
Beni Isman Rusani

Abstract Background  Sinus of Valsalva aneurysm (SoVA) is a rare anomaly and can be divided into acquired and congenital forms, the latter being commonly associated with ventricular septal defects (VSDs). Rupture is a catastrophic complication with high mortality without urgent surgical intervention. We would like to highlight the use of echocardiography in an emergency setting for diagnosis and surgical intervention in a critically ill patient. Case summary  We report a 27-year-old female with history of conservatively managed VSD known since childhood. She presented with acute decompensated cardiac failure requiring intubation and inotropic support. Bedside echocardiography performed in the emergency department suggested a ruptured SoVA at the right coronary cusp with underlying supracristal VSD. Despite the patient being critically ill with multi-organ failure, surgery was performed as it was the patient’s best chance for survival. Intraoperative findings tallied with the early echocardiographic results. She recovered gradually and was eventually discharged despite a stormy post-operative period. Discussion  This case report highlights the importance of prompt recognition of SoVA rupture by using bedside echocardiography. Surgical intervention needs to be early despite ongoing sepsis in view of acute mechanical failure. This case was unique as it illustrates a successful management of an acutely ill patient with multi-organ failure through early diagnosis, intensive perioperative stabilization, and surgical intervention.


2001 ◽  
Vol 5 (1) ◽  
pp. A5-A5
Author(s):  
Keith Y.C. Goh ◽  
Wendy Teoh ◽  
Chumpon Chan

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