scholarly journals Paliperidone Inducing Concomitantly Syndrome of Inappropriate Antidiuretic Hormone, Neuroleptic Malignant Syndrome, and Rhabdomyolysis

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Jaspinder Kaur ◽  
Dileep Kumar ◽  
Mostafa Alfishawy ◽  
Ricardo Lopez ◽  
Issac Sachmechi
Keyword(s):  
Neuroleptic Malignant Syndrome ◽  
Antidiuretic Hormone ◽  
Health Care Providers ◽  
Creatine Phosphokinase ◽  
Liver Enzymes ◽  
Antipsychotic Agent ◽  
Muscle Rigidity ◽  
Care Providers ◽  
High Grade Fever ◽  
Life Threatening

Paliperidone, an active metabolite of risperidone, is a new atypical antipsychotic agent. Syndrome of inappropriate antidiuretic hormone (SIADH), neuroleptic malignant syndrome (NMS), and rhabdomyolysis are the uncommon side effects of psychotropic drugs.We report a case of 35-year-old male with schizoaffective disorder who was admitted for acute-on-chronic exacerbation of his psychotic disorder for which intramuscular paliperidone 234 mg injection was given. Two days later, the patient developed hyponatremic seizures secondary to SIADH which was treated with hypertonic saline. On the third day, he developed high grade fever and severe muscle rigidity with raised creatine phosphokinase (CPK) and liver enzymes levels. He was treated with dantrolene 100 mg, bromocriptine 2.5 mg, and lorazepam 2 mg. Our patient required management of the three rare conditions following treatment with paliperidone. This case highlights the need for health care providers to be aware of the rare, potentially life threatening but preventable hyponatremia, NMS, and rhabdomyolysis as a possible adverse effect of paliperidone.

Effectiveness of a Dispatcher-Assisted Cardiopulmonary Resuscitation Program Developed by the Thailand National Institute of Emergency Medicine (NIEMS)

2021 ◽  
pp. 1-6
Author(s):  
Chuenruthai Angkoontassaneeyarat ◽  
Chaiyaporn Yuksen ◽  
Chetsadakon Jenpanitpong ◽  
Pemika Rukthai ◽  
Marisa Seanpan ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Medicine ◽  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Health Care Providers ◽  
Care Providers ◽  
Chest Compressions ◽  
Threatening Condition ◽  
Life Threatening

Abstract Background: Out-of-hospital cardiac arrest (OHCA) is a life-threatening condition with an overall survival rate that generally does not exceed 10%. Several factors play essential roles in increasing survival among patients experiencing cardiac arrest outside the hospital. Previous studies have reported that implementing a dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) program increases bystander CPR, quality of chest compressions, and patient survival. This study aimed to assess the effectiveness of a DA-CPR program developed by the Thailand National Institute for Emergency Medicine (NIEMS). Methods: This was an experimental study using a manikin model. The participants comprised both health care providers and non-health care providers aged 18 to 60 years. They were randomly assigned to either the DA-CPR group or the uninstructed CPR (U-CPR) group and performed chest compressions on a manikin model for two minutes. The sequentially numbered, opaque, sealed envelope method was used for randomization in blocks of four with a ratio of 1:1. Results: There were 100 participants in this study (49 in the DA-CPR group and 51 in the U-CPR group). Time to initiate chest compressions was statistically significantly longer in the DA-CPR group than in the U-CPR group (85.82 [SD = 32.54] seconds versus 23.94 [SD = 16.70] seconds; P <.001). However, the CPR instruction did not translate into better performance or quality of chest compressions for the overall sample or for health care or non-health care providers. Conclusion: Those in the CPR-trained group applied chest compressions (initiated CPR) more quickly than those who initiated CPR based upon dispatch-based CPR instructions.

Holding Secrets While Living With Life-Threatening Illness: Normalizing Patients’ Decisions to Reveal or Conceal

2019 ◽  
Vol 30 (5) ◽  
pp. 655-665 ◽  
Author(s):  
Anne Bruce ◽  
Rosanne Beuthin ◽  
Laurene Sheilds ◽  
Anita Molzahn ◽  
Kara Schick-Makaroff
Keyword(s):  
Health Care Providers ◽  
Narrative Analysis ◽  
Social Practice ◽  
Narrative Approach ◽  
Care Providers ◽  
Life Threatening Illness ◽  
Health And Illness ◽  
Life Threatening ◽  
Normative Practice

Communicating openly and directly about illness comes easily for some patients, whereas for others fear of disclosure keeps them silent. In this article, we discuss findings about the role of keeping secrets regarding health and illness. These findings were part of a larger project on how people with life-threatening illnesses re-story their lives. A narrative approach drawing on Frank’s dialogical narrative analysis and Riesman’s inductive approach was used. Interviews were conducted with 32 participants from three populations: chronic kidney disease, HIV/AIDS, and cancer. Findings include case exemplars which suggest keeping secrets is a social practice that acts along continuums of connecting–isolating, protecting–harming, and empowering–imprisoning. Keeping secrets about illness is a normative practice that is negotiated with each encounter. Findings call health-care providers to rethink the role of secrets for patients by considering patient privilege, a person’s right to take the lead in revealing or concealing their health and illness experience.

Chemotherapy Acute Infusion Reactions: A Qualitative Report of the Perspectives of Patients With Cancer

2018 ◽  
Vol 35 (11) ◽  
pp. 1384-1389
Author(s):  
David J. Bartlett ◽  
Daniel S. Childs ◽  
Carmen Radecki Breitkopf ◽  
Megan E. Grudem ◽  
Jessica L. Mitchell ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Antineoplastic Agents ◽  
Qualitative Methodology ◽  
Infusion Reaction ◽  
Care Providers ◽  
Patients With Cancer ◽  
Life Threatening ◽  
Infusion Reactions

Objective: A growing number of cancer antineoplastic agents can cause life-threatening acute infusion reactions. Because previous studies have not studied these reactions from the perspective of patients, this study was undertaken with that objective in mind. Methods: Patients who had an acute infusion reaction were interviewed based on the Leventhal model. Once saturation of content was achieved, interviews were transcribed and analyzed with qualitative methodology. Results: Twenty-one patients were enrolled. Most were women (n = 15); the median age was 58 years, and paclitaxel was the most common inciting agent. Three themes emerged. First, these reactions are frightening; patients made remarks such as “I was just thinking oh my God, I am dying.” Second, prior education about these reactions seemed to mitigate this fear, “Basically everything the nurses told me potentially could happen, like happened. So, I was prepared.” Third, when health-care providers were prompt and attentive during the reaction, patients described less fear with future chemotherapy, “So no, I’m really not fearful about going in tomorrow because I know they’ll be there and they’ll be watching me.” Conclusion: These reactions evoke fear which can be mitigated with education prior to and with prompt responsiveness during the acute infusion reaction.

Central Venous Catheter Securement: Using the Healthcare and Technology Synergy Model to Take a Closer Look

2015 ◽  
Vol 20 (1) ◽  
pp. 45-50 ◽  
Author(s):  
Denise Macklin ◽  
Paul L. Blackburn
Keyword(s):  
Central Venous Catheter ◽  
Health Care Providers ◽  
Venous Catheter ◽  
Clinical Settings ◽  
Care Providers ◽  
Central Venous ◽  
Bacterial Migration ◽  
Life Threatening ◽  
Delay Of Treatment ◽  
Catheter Replacement

Abstract Proper securement provides a safe vascular access device environment for both patients and health care providers. Successful securement protects central venous catheters from several sources of failure until the end of therapy by preventing central venous catheter movement during all phases of care. Movement causes vein trauma, bacterial migration, distal tip location variation, loss of dressing integrity, and even total dislodgement. Any of these events can have serious consequences, including catheter-related bloodstream infection, thrombosis, delay of treatment, catheter replacement, and potential hemorrhage, all of which can be life-threatening events, and increase costs. We review patient issues, practice issues, and the types of securement currently used in clinical settings.

scholarly journals A Case of Neuroleptic Malignant Syndrome in a Profoundly Intellectually Disabled Patient with Successful Reintroduction of Antipsychotic Therapy with Quetiapine

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Kamal Patel ◽  
Brandon Lilly ◽  
Oluwadamilare Ajayi ◽  
Kelly Melvin
Keyword(s):  
Neuroleptic Malignant Syndrome ◽  
First Generation ◽  
Early Recognition ◽  
Rare Condition ◽  
Signs And Symptoms ◽  
Antipsychotic Agent ◽  
Muscle Rigidity ◽  
Status Change ◽  
Antipsychotic Therapy ◽  
Autonomic Instability

Neuroleptic Malignant Syndrome (NMS) is a rare condition clinically characterized by muscle rigidity, hyperthermia, autonomic instability, and acute mental status change. NMS is most often associated with use of high-potency first-generation antipsychotic medications; though, other neuroleptics have been implicated as well. NMS can be fatal with estimated mortality rates as high as 20%. Patients experiencing certain severe complications, including renal failure, have been associated with mortality as high as 50%, stressing the need for early recognition and treatment. Here we present the case of a 54-year-old male that initially presented with symptoms suspicious for sepsis, but who eventually developed a clinical picture consistent with NMS. We describe the diagnostic and treatment process leading to symptom remission. We then discuss our decision to reintroduce an atypical antipsychotic agent, quetiapine. This case illustrates the importance of early recognition of the signs and symptoms of NMS and the need to initiate treatment promptly in order to prevent complications, including death. This case also highlights the decision to resume antipsychotic pharmacotherapy after adequate resolution of NMS, demonstrating that it can be done so safely if started at low doses coupled with intensive monitoring of the patient.

scholarly journals Watson’s Human Caring Theory-Based Palliative Care: A Discussion Paper

2020 ◽  
Vol 13 (6) ◽  
Author(s):  
Mir Hossein Aghaei ◽  
Zohreh Vanaki ◽  
Eesa Mohammadi
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Health Care Providers ◽  
Care Provision ◽  
Care Providers ◽  
Discussion Paper ◽  
Basic Care ◽  
Life Threatening ◽  
Human Caring ◽  
Different Cultures

: Palliative care is one of the most basic care approaches for providing care to patients with life-threatening illnesses. Applying theories in palliative care provision results in such cares’ development and organization and guides health care providers in this direction. One of the caring theories that can be focused on palliative care is Watson’s human caring theory, which despite its applicability in palliative care, has not been studied much. Thus, this study aimed at assessing how to use this theory in palliative care that can be applied to health care providers in all clinical specialties and societies with different cultures.

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.

Neurobiology of Female Homicide Perpetrators

2019 ◽  
pp. 088626051986007 ◽  
Author(s):  
Kathleen Brewer-Smyth ◽  
Ann Wolbert Burgess
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Access ◽  
Brain Injuries ◽  
Care Providers ◽  
Crime Severity ◽  
Care Access ◽  
Frontal Lobe Damage ◽  
Prevention Interventions ◽  
Life Threatening

Neurobiology of female homicide perpetrators is not well understood. Data from private interviews and examinations of females were re-analyzed comparing those who committed homicide ( n = 9); other violent crimes, no known homicide ( n = 51); nonviolent crimes, no known violent convictions ( n = 49); and noncriminals ( n = 12). Homicide perpetrators suffered the most childhood sexual abuse (CSA); most recent abuse; had the most neurological histories, mainly traumatic brain injuries (TBIs); most health care access for abuse-related injuries; lowest AM and PM salivary cortisol; and greatest proportion who committed crime under the influence of alcohol. Only CSA, years since last abuse, TBI, neurological histories, and health care access for abuse-related injuries were significant. Those who committed homicide under the influence of alcohol suffered the most recent abuse and had the lowest AM cortisol and flattest diurnal cortisol slope (DCS) compared with others; though the n precludes determining significance. Amount of time since last abuse, AM cortisol and DCS progressively decreased as crime severity increased; other variables progressively increased as crime severity increased. These preliminary findings suggest that low AM cortisol, flat DCS, greater CSA frequency and severity, recent abuse, TBIs, and health care access for abuse-related injuries could be risk factors for females committing homicide. Further study is needed due to the small n of homicide perpetrators. Abuse victims may be at greater risk for alcohol use and cortisol dysregulation associated with perpetrating violence, especially homicide. Frontal lobe damage from TBIs may decrease ability to control behaviors associated with emotions from the limbic system. Health care providers released these women when their abuse-related injuries were not life-threatening; yet, they were life-threatening for victims of their subsequent homicides. Females accessing health care for abuse-related injuries present a critical opportunity for violent crime prevention interventions.

The Role of Children and Adolescents in Decision Making About Life-Threatening Illness

2021 ◽  
pp. 104-117
Author(s):  
Victoria A. Miller ◽  
Melissa K. Cousino
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Children And Adolescents ◽  
Health Care Providers ◽  
Control Treatment ◽  
Future Research ◽  
Care Providers ◽  
Life Threatening Illness ◽  
Life Threatening ◽  
And Control

The concept of decision-making involvement (DMI) recognizes that children and adolescents can be involved in decision making in numerous ways and that parents and health care providers have an important role in supporting and guiding youth. Facilitating DMI may enhance youth decision-making skills, self-efficacy and control, treatment adherence, and satisfaction with care. Given the loss of control children and adolescents typically feel when diagnosed with a serious, life-threatening illness, DMI may be especially important. Parents and health care providers can facilitate child and adolescent involvement by seeking their opinions and concerns, soliciting questions, asking for information, and checking for understanding. Additional tools are available for facilitating youth involvement in decision making at the end of life. Future research is needed to develop and evaluate strategies to enhance different aspects of DMI in multiple settings and contexts across development.

Malignant catatonia and neuroleptic malignant syndrome: How different/similar are they?

2016 ◽  
Vol 33 (S1) ◽  
pp. S640-S640 ◽  
Author(s):  
P. Sales ◽  
M. Bernardo ◽  
A. Lopes ◽  
E. Trigo
Keyword(s):  
Supportive Care ◽  
Neuroleptic Malignant Syndrome ◽  
Specific Treatment ◽  
Hemodynamic Instability ◽  
Psychotic Symptoms ◽  
Muscle Rigidity ◽  
Life Threatening ◽  
History Of ◽  
Competing Interest ◽  
Malignant Catatonia

IntroductionCatatonia is a neuropsychiatric syndrome that appears in medical, neurological or psychiatric conditions. There are presentation variants: “malignant catatonia” (MC) subtype shares many characteristics with the neuroleptic malignant syndrome (NMS), possibly reflecting common pathophysiology.Objectives/methodsWe present a clinical vignette and review the literature available on online databases about MC/NMS.ResultsWe present a man, 41-years-old, black ethnicity, with no relevant medical history. He had two previous episodes compatible with brief psychosis, the last one in 2013, and a history of adverse reactions to low doses of antipsychotics. Since the last episode he was asymptomatic on olanzapine 2.5 mg id. He acutely presented to the Emergency Room with mutism, negativism, immobility and delusional speech, similar to the previous episodes mentioned and was admitted to a psychiatric infirmary, where his clinical condition worsened, showing muscle rigidity, hemodynamic instability, leukocytosis, rhabdomyolysis and fever. Supportive care was provided, olanzapine was suspended and electroconvulsive therapy (ECT) was initiated. After two months, he was discharged with no psychotic symptoms. He is still under ECT and no antipsychotic medication was reintroduced.Discussion/conclusionMany studies suggest that clinical or laboratory tests do not distinguish MC from NMS and that they are the same entity. These two conditions are life-threatening and key to treatment is a high suspicion level. There is no specific treatment; supportive care and stopping involved medications are the most widely used measures. ECT is a useful alternative to medication.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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