Early recognition and management of maternal sepsis in Pakistan

2021 ◽  
Author(s):  
Sheikh Irfan Ahmed ◽  
David Lissaeur ◽  
Lumaan Sheikh ◽  
Raheel Sikandar
Keyword(s):  
Early Recognition ◽  
Maternal Sepsis

scholarly journals Maternal sepsis- an audit in a tertiary care center in South India

2020 ◽  
Vol 9 (11) ◽  
pp. 4543
Author(s):  
Roopa P. Shivananda ◽  
Gurram Bhanuteja ◽  
Shubha Rao ◽  
Nivedita Hegde ◽  
Sangamithra Paladugu ◽  
...  
Keyword(s):  
Preterm Delivery ◽  
Early Recognition ◽  
Tertiary Care ◽  
Common Source ◽  
Intrauterine Death ◽  
Fetal Outcomes ◽  
Live Births ◽  
High Dependency ◽  
Maternal Sepsis ◽  
Culture Positive

Background: Objective of this study was to audit the cases of maternal sepsis and analyze their maternal and fetal outcomes.Methods: A retrospective analysis of cases of maternal sepsis was undertaken for one year. Cases were taken as infection with fever, tachycardia, tachypnea, low oxygen saturation, high or low white blood counts and clinical or laboratory evidence of organ dysfunction and were analyzed. Demographic profile, gestational age at the time of diagnosis, organisms & their sources of infection was noted. Maternal outcomes of abortion, preterm delivery, need for intensive care unit (ICU) / high dependency unit (HDU) stay, blood and blood products, surgical interventions for the control of infection, culture-positive rate, source of organism, antibiotic usage and maternal mortality were analyzed. Fetal outcomes of early fetal demise, preterm birth, intrauterine death, stillbirth and term birth were studied.  Results: There were a total of 2327 deliveries, with 2333 live births during the study period. Twenty-two cases were diagnosed with sepsis, of which 17 survived, and five died. The incidence of maternal sepsis was 9.4/1000 live births & maternal deaths were 22.7%. Ninety percent were in the age group of 21-39 years, 68% were referred, 59% were post-delivery. Fifty nine percent of women who survived, and none of the women who died had medical co-morbidities. Respiratory tract followed by genitourinary tract were the most common source of infection, though culture was negative in 54.5% of the cases. The organisms grown were varied, with Escherichia coli (3/10) contributing to 30% of the culture positive cases. Spontaneous abortion and preterm delivery were 18% each, 36% required surgical intervention, 81% required ICU and 64.7 HDU stay. Seventy-seven had live birth.Conclusions: Maternal sepsis is an evolving preventable health burden. Early recognition requires a high index of clinical suspicion, even in the absence of risk factors. Mortality to morbidity ratio is very high in maternal sepsis. The timing of sepsis determines the fetal outcomes.

Early Recognition and Management of Maternal Sepsis

2016 ◽  
Vol 20 (2) ◽  
pp. 182-196 ◽  
Author(s):  
Lori Olvera ◽  
Danette Dutra
Keyword(s):  
Early Recognition ◽  
Maternal Sepsis

Review of Flap Monitoring Technology in 2020

2020 ◽  
Vol 36 (06) ◽  
pp. 722-726
Author(s):  
Adam Jacobson ◽  
Oriana Cohen
Keyword(s):  
Head And Neck ◽  
Free Flap ◽  
Loss Rate ◽  
Early Recognition ◽  
Postoperative Patient ◽  
Free Flap Monitoring ◽  
Improved Outcomes ◽  
Vascular Compromise ◽  
Flap Monitoring ◽  
Multiple Levels

AbstractAdvances in free flap reconstruction of complex head and neck defects have allowed for improved outcomes in the management of head and neck cancer. Technical refinements have decreased flap loss rate to less than 4%. However, the potential for flap failure exists at multiple levels, ranging from flap harvest and inset to pedicle lay and postoperative patient and positioning factors. While conventional methods of free flap monitoring (reliant on physical examination) remain the most frequently used, additional adjunctive methods have been developed. Herein we describe the various modalities of both invasive and noninvasive free flap monitoring available to date. Still, further prospective studies are needed to compare the various invasive and noninvasive technologies and to propel innovations to support the early recognition of vascular compromise with the goal of even greater rates of flap salvage.

Cardiogenic Shock – Developments and Treatment Strategies

2009 ◽  
Vol 5 (2) ◽  
pp. 48 ◽  
Author(s):  
Ricardo Seabra-Gomes ◽  
Jorge Ferreira ◽  
◽  
Keyword(s):  
Cardiogenic Shock ◽  
Early Recognition ◽  
Treatment Strategies ◽  
Left Ventricular ◽  
Ventricular Assist Devices ◽  
Left Ventricular Assist Devices ◽  
Significant Treatment ◽  
Ventricular Assist ◽  
Hard Data ◽  
Oxide Synthase

Cardiogenic shock remains one of the most serious and challenging conditions in cardiology and is responsible for the highest in-hospital mortality associated with ST-elevation myocardial infarction. The only significant treatment strategy that has been shown to reduce its incidence and inherent mortality is emergent coronary revascularisation. Prevention should aim at early recognition of symptoms, appropriate pre-hospital emergency medical care and prompt primary revascularisation. Once established, cardiogenic shock still has an unacceptably high mortality rate. Approaches that include new pharmacological therapies and other forms of mechanical haemodynamic support are under investigation. The possible role of systemic inflammatory response has led to the investigation of nitric oxide synthase inhibition, although initial results with tilarginine were disappointing. The use of percutaneous left ventricular assist devices looks promising, but hard data regarding mortality benefit are still missing. Cardiogenic shock remains a perplexing and often fatal condition. The future may require more basic, translational and clinical research.

In situ deteriorating patient simulation in general practice

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711425
Author(s):  
Joanna Lawrence ◽  
Petronelle Eastwick-Field ◽  
Anne Maloney ◽  
Helen Higham
Keyword(s):  
Life Support ◽  
Early Recognition ◽  
Phase 1 ◽  
Patient Simulation ◽  
Medical Emergency ◽  
Phase 2 ◽  
Action Plans ◽  
Integrated Simulation ◽  
Deteriorating Patient

BackgroundGP practices have limited access to medical emergency training and basic life support is often taught out of context as a skills-based event.AimTo develop and evaluate a whole team integrated simulation-based education, to enhance learning, change behaviours and provide safer care.MethodPhase 1: 10 practices piloted a 3-hour programme delivering 40 minutes BLS and AED skills and 2-hour deteriorating patient simulation. Three scenarios where developed: adult chest pain, child anaphylaxis and baby bronchiolitis. An adult simulation patient and relative were used and a child and baby manikin. Two facilitators trained in coaching and debriefing used the 3D debriefing model. Phase 2: 12 new practices undertook identical training derived from Phase 1, with pre- and post-course questionnaires. Teams were scored on: team working, communication, early recognition and systematic approach. The team developed action plans derived from their learning to inform future response. Ten of the 12 practices from Phase 2 received an emergency drill within 6 months of the original session. Three to four members of the whole team integrated training, attended the drill, but were unaware of the nature of the scenario before. Scoring was repeated and action plans were revisited to determine behaviour changes.ResultsEvery emergency drill demonstrated improved scoring in skills and behaviour.ConclusionA combination of: in situ GP simulation, appropriately qualified facilitators in simulation and debriefing, and action plans developed by the whole team suggests safer care for patients experiencing a medical emergency.

Terson sign:

2020 ◽  
Vol 2 (1) ◽  
pp. 38-43
Author(s):  
Luiz Severo Bem Junior ◽  
Gustavo De Souza Andrade ◽  
Joao Ribeiro Memória Júnior ◽  
Hildo Rocha Cirne de Azevedo Filho
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Early Recognition ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Case Reports ◽  
Clinical Status ◽  
Vitreous Hemorrhage ◽  
Anterior Communicating Artery ◽  
Inclusion Criteria ◽  
Relationship Of ◽  
The Relationship

Terson's sign (TS) is classically defined as vitreous hemorrhage associated with subarachnoid hemorrhage of aneurysmal origin, being an important predictor of severity, indicating greater morbidity and mortality when compared to patients without the sign. The objective of this study is to review the relationship of Terson syndrome/Terson sign with the prognosis of aneurysmal subarachnoid hemorrhage. A search for original articles, research and case reports was performed on the PubMed, Scielo, Cochrane and ScienceDirect platform, with the following descriptors: Terson sign and subarachnoid hemorrhage. Retrospective, prospective articles and case reports published in the last 5 years and which were in accordance with the established objective and inclusion criteria were selected. Ten (10) articles were selected, in which the available results show an unfavorable prognostic relationship of TS and subarachnoid hemorrhage, because these patients had a worse clinical status assessed on the Glasgow scales ≤ 8, Hunt & Hess > III, Fisher > 3, in addition to intracranial hypertension and location of the aneurysm in the anterior communicating artery complex. The early recognition of this condition described by Albert Terson in 1900 brought an important contribution to neurosurgery, being recognized until nowadays.

Sign in / Sign up

Export Citation Format

Share Document