scholarly journals WHO cares? Safety checklists in echocardiography

2015 ◽  
Vol 2 (4) ◽  
pp. E9-E12 ◽  
Author(s):  
Clare Quarterman ◽  
Nick Fletcher ◽  
Vishal Sharma

The number of potentially preventable medical errors that occur has been steadily increasing. These are a significant cause of patient morbidity, can lead to life-threatening complications and may result in a significant financial burden on health care. Effective communication and team working reduce errors and serious incidents. In particular the implementation of the World Health Organisation (WHO) Safe Surgery Checklist has been shown to reduce in-hospital mortality, postoperative complications and the incidence of surgical site infection. However an increasing number of complex medical procedures and interventions are being performed outside of the theatre environment. The lessons learnt from the surgical setting are relevant to other procedures performed in other areas. For the echocardiographer, transoesophageal echocardiography (TOE) is one such procedure in which there is the potential for medical errors that may result in patient harm. This risk is increased if patient sedation is being administered. The British Society of Echocardiography and the Association of Cardiothoracic Anaesthetists have developed a procedure specific checklist to facilitate the use of checklists into routine practice. In this article we discuss the evolution of the WHO safety checklist and explore its relevance to TOE.

2015 ◽  
Vol 2 (4) ◽  
pp. G25-G27 ◽  
Author(s):  
Vishal Sharma ◽  
Susan Alderton ◽  
Helen McNamara ◽  
Richard Steeds ◽  
Will Bradlow ◽  
...  

The World Health Organisation (WHO) launched the Surgical Safety Checklist in 2008. The introduction of this checklist resulted in a significant reduction in the incidence of complications and death in patients undergoing surgery. Consequently, the WHO Surgical Safety checklist is recommended for use by the National Patient Safety Agency for all patients undergoing surgery. However, many invasive or interventional procedures occur outside the theatre setting and there are increasing requirements for a safety checklist to be used prior to such procedures. Transoesophageal echocardiography (TOE) is an invasive procedure and although generally considered to be safe, it carries the risk of serious and potentially life-threatening complications. Strict adherence to a safety checklist may reduce the rate of significant complications during TOE. However, the standard WHO Surgical Safety Checklist is not designed for procedures outside the theatre environment and therefore this document is designed to be a procedure-specific safety checklist for TOE. It has been endorsed for use by the British Society of Echocardiography and the Association of Cardiothoracic Anaesthetists.


2020 ◽  
Vol 49 (9) ◽  
pp. 661-668
Author(s):  
Alvin HY Lo ◽  
Adrian CL Kee ◽  
Andrew Li ◽  
Francesca Rubulotta

Sepsis is life-threatening and might potentially progress from dysregulation to severe organ dysfunction. It is recognised by the World Health Organisation as a global health priority. The mortality rate for sepsis has decreased in many countries, and this is credited to the earlier recognition and treatment of this complex syndrome. In 2002, the Surviving Sepsis Campaign was launched, and there have been several revisions to the sepsis recommendations therefrom. The latest sepsis guidelines focus on viral as well as bacterial infections, and advise that initiating resuscitation and management should take place within one hour from when sepsis is initially suspected. Numerous studies and guidelines pertaining to sepsis management have been published over the past 2 decades. The use of novel therapies and alternative adjunctive therapies has tremendous potential in sepsis management. Debates amongst intensivists exist with the creation of updated sepsis guidelines and advances in treatment. The present review article provides both a summary and recommendations based on the latest clinical evidence and controversies around sepsis management. Key words: Critical Care Medicine, Intensive Care Medicine, Respiratory Medicine, Sepsis, Sepsis Bundles, Sepsis Management


2018 ◽  
Vol 31 (2) ◽  
pp. 65-68
Author(s):  
Justyna Pasternak ◽  
Ewa Kliszczewska ◽  
Malgorzata Polz-Dacewicz

Abstract Polyomavirus (PyV) was discovered by accident in 1950 in the course of describing an infectious factor causing multiple tumours in rodents. The term is derived from two Greek words: poly (many) and oma (tumour). At present the family of human polyomaviruses (HPyV) consists of 10 members. One of the first members was BK virus, isolated in 1971 from the urine of a renal transplant patient. Serological examinations have shown that due to its ability to cause latent infection, about 90% of the general population can have specific antibodies attesting infection. In the case of infected persons with normal immunity, this virus is not dangerous. In the impaired immunity, however, loss of immunity results in virus reactivation and development of many life-threatening illnesses. Serological examinations have also reveal that BK polyomavirus considerably affects the development of cancers in humans. Hence, in 2012 a group of 26 researchers from 11 countries associated with the International Agency for Research on Cancer (a part of the World Health Organisation) classified BK polyomavirus within group 2B - “potentially carcinogenic to humans”


2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Ashar Dhana

Despite access to antiretroviral therapy, mortality from cryptococcal meningitis (CM) is high among persons with advanced HIV infection in sub-Saharan Africa. Cryptococcal antigen (CrAg) is present several weeks to months before the onset of symptoms of meningitis and can be screened to prevent life threatening meningitis. Recently, the World Health Organisation recommended that a new rapid CrAg lateral flow ‘‘dipstick’’ assay (LFA) is to be used to screen HIV-infected persons with CD4 counts of less than 100 cells/µL. In this paper, we describe two cases of cryptococcosis with differing outcomes. In the first case, the new CrAg LFA was used as part of a screen and preemptive treatment strategy to prevent CM. In the second case, our patient had no access to the CrAg LFA and subsequently developed life threatening meningitis. To the best of our knowledge, this is the first case report of cryptococcosis diagnosed using this novel assay.


2010 ◽  
Vol 21 (4) ◽  
pp. 323-345 ◽  
Author(s):  
R GUNDRY ◽  
D SIASSAKOS ◽  
JF CROFTS ◽  
TJ DRAYCOTT

The World Health Organisation (WHO) has estimated that 1500 women die every day from preventable complications of pregnancy and childbirth. While barriers to accessing healthcare are undoubtedly multi-factorial, studies have repeatedly shown that providing skilled healthcare workers can result in untold benefits for women and babies in developing countries. The phenomenon of preventable maternal and fetal morbidity and mortality is not limited to the developing world. The Confidential Enquiries into Maternal Deaths (CEMD) and Stillbirths and Infant Deaths (CESDI) in the UK have repeatedly identified substandard care as a major contributor to maternal and neonatal mortality. In 2008 The King's Fund publishedSafe Births: Everybody's business,an independent enquiry into the safety of maternity services in England. This recommended that simulation-based training to assess clinical, communication and team skills should be available to all maternity staff, and that training should form a core activity. Many hospitals in the UK have been running in-house courses for staff for over a decade with measurable improvements in neonatal outcomes. The value of these training schemes is recognised and rewarded through reduced insurance premiums for participating hospital trusts as part of clinical negligence schemes. Gaining competence in managing obstetric emergencies presents particular challenges for trainees. Most emergencies are, thankfully, uncommon but some constitute life-threatening events where management naturally falls to the most experienced available clinician. The skills required are often particular to emergencies and therefore novel to trainees. Utilising emergencies as training opportunities is further complicated by the presence of a conscious patient.


2020 ◽  
Vol 13 (1) ◽  
pp. 1-6
Author(s):  
Ndatenda Shamiso Mutaurwa ◽  
Ellen Munemo ◽  
Garikai Malunga ◽  
Danai Tavonga Zhou

Background: Typhoid is a life-threatening infectious disease requiring the administration of antibiotics for treatment. Ciprofloxacin is the antibiotic of choice for diarrheal cases in Zimbabwe, adopted by the Ministry of Health and Child Care, from current World Health Organisation (WHO) guidelines. However, there has been an increase in the emergence and spread of multidrug resistance against ciprofloxacin and conventional drugs antibiotics for the treatment of typhoid. Objective: This cross-sectional study aimed to determine the prevalence of ciprofloxacin-resistant Salmonella Typhi (S. Typhi) isolated in Harare for the first quarter of 2016. Methods: This study was carried out at the National Microbiology Reference Laboratory (NMRL), located at Harare Central Hospital, in Zimbabwe. The NMRL carries out confirmatory tests and molecular typing of pathogens isolated at different national laboratories. The current study retrieved demographics, clinical data, and isolates for confirmed typhoid cases out of 402 suspected specimens. The isolates from Harare, confirmed as S. Typhi, between January and April 2016, were evaluated for ciprofloxacin resistance. Results: A total of 35 S. Typhi isolates were recovered for the period from January to April 2016. When the 35 isolates were characterised, nine (25.7%) were resistant to ciprofloxacin. The area with the highest recorded cases of typhoid fever was Budiriro High-Density Suburb in Harare. This area has been hit by other diarrheal outbreaks in the past, most likely due to the intermittent supply of safe water. Conclusion: Most high-density areas, where S. Typhi positive specimens originated, are overpopulated and have regular water cuts, resulting in a decrease in hygiene. More than a quarter of isolates are resistant to ciprofloxacin, agreeing with other reports from Zimbabwe. The misuse of antibiotics could be associated with resistance, necessitating education on the correct use of antibiotics in the community and other preventive measures. Additionally, molecular research on geographic and phylogenetic relatedness of isolates and other holistic approaches for studying the development of antimicrobial resistance mutations, using whole-genome sequencing, in this setting, are warranted.


2020 ◽  
Vol 11 (1) ◽  
pp. 65-72
Author(s):  
Elena V. Pshenichnaya ◽  
Alexandra P. Dudchak ◽  
Nadezhda A. Usenko ◽  
Viktoriya V. Sosna

Acute myocarditis by the World Health Organization is an inflammatory disease of the heart muscle, confirmed by histologically, immunologically and immunohistochemically. The diagnosis of acute myocarditis in children remains open due to the presence of a number of reasons. First of all, it is difficult to diagnose myocarditis in children due to the variety of clinical manifestations and the presence of nonspecific symptoms of the disease. What matters is the lack of accessibility in the routine practice of a doctor of certain research methods and a sharp limitation in the use of endomyocardial biopsy. The search for differential diagnostic algorithms of the disease continues. According to modern literature, much attention is paid to non-invasive methods for the diagnosis of acute myocarditis in children. The course of acute myocarditis can be complicated by life-threatening cardiac arrhythmias: ventricular extrasystole, lengthening of the corrected QT interval, atrioventricular block. The appearance of cardiac arrhythmias increases the risk of sudden cardiac death. Recommendations for the treatment of myocardium in children often undergo changes due to the small number of multicenter and controlled studies in the pediatric population. The article provides an overview of modern approaches to the treatment of acute myocarditis in children: the use of antiviral drugs, intravenous immunoglobulin, immunosuppressive therapy, especially the treatment of heart failure in acute myocarditis in children.


2020 ◽  
pp. 661-668
Author(s):  
Alvin HY Lo ◽  
Adrian CL Kee ◽  
Andrew Li ◽  
Francesca Rubulotta

Sepsis is life-threatening and might potentially progress from dysregulation to severe organ dysfunction. It is recognised by the World Health Organisation as a global health priority. The mortality rate for sepsis has decreased in many countries, and this is credited to the earlier recognition and treatment of this complex syndrome. In 2002, the Surviving Sepsis Campaign was launched, and there have been several revisions to the sepsis recommendations therefrom. The latest sepsis guidelines focus on viral as well as bacterial infections, and advise that initiating resuscitation and management should take place within one hour from when sepsis is initially suspected. Numerous studies and guidelines pertaining to sepsis management have been published over the past 2 decades. The use of novel therapies and alternative adjunctive therapies has tremendous potential in sepsis management. Debates amongst intensivists exist with the creation of updated sepsis guidelines and advances in treatment. The present review article provides both a summary and recommendations based on the latest clinical evidence and controversies around sepsis management. Key words: Critical Care Medicine, Intensive Care Medicine, Respiratory Medicine, Sepsis, Sepsis Bundles, Sepsis Management


2021 ◽  
Vol 6 (6) ◽  
pp. 200-206
Author(s):  
N. O. Iakovenko ◽  
◽  
M. V. Ogloblina ◽  
O. K. Nuzhna

COVID-19 is a life-threatening disease that can be asymptomatic in the form of a common ARVI, or in extremely severe forms, with serious long-term consequences. Vaccination against COVID-19 is critically important to restrain the pandemic. The purpose of the study was to analyze and systematize the data of pharmacological supervision of the use of vaccines against COVID-19. For this, methods of analysis, systematization and generalization of information were used using the databases of the State Expert Center of the Ministry of Health of Ukraine, Food and Drug Administration, World Health Organisation in the period from February 24, 2021 to October 31, 2021. Currently, such vaccines are registered and approved for use in Ukraine as AstraZeneca (Covishield, SKBio), Comirnaty / Pfizer-BioNTech, Moderna, CoronaVac / Sinovac Biotech. According to official data, the effectiveness of all these vaccines is quite high. They are especially effective in preventing severe course of disease, hospitalization, and death. Sometimes the vaccination process can be with the development of a number of side effects. Responsibility for the risks associated with the production and use of vaccines dictates the need for constant monitoring of these side effects. That is why we analyzed the data of the State Expert Center of the Ministry of Health of Ukraine about adverse events after immunization from COVID-19 in Ukraine. Thus, the analysis of adverse events reported showed that they took place in 0.018% cases of the total number of vaccine doses that were administered. In the context, for each vaccine separately, the number of adverse events reported were: Covishield – 1128 cases (0.23%), CoronaVac – 419 (0.008%), Comirnaty – 854 (0.02%), AstraZeneca – 540 (0.02%), Moderna – 393 (0.02%), respectively. It should be noted that most of the reported cases of adverse events reported in Ukraine during vaccination against COVID-19 are mild predictable reactions (88.72 – 93.38%). This result allows us to speak of a fairly high predictability of the adverse events reported after COVID-19 vaccination. This is confirmed by the data of world literature. After analyzing the presented data of the State Expert Center of the Ministry of Health of Ukraine, we found that the most of adverse events reported after COVID-19 vaccination are so-called general disorders and disorders at the injection site (fever, fatigue, chills, redness, pain and swelling at the injection site). Neurological disorders ranked second in terms of the number of adverse events reported, and musculoskeletal disorders ranked third. Adverse events reported manifestations from other organs and systems had isolated cases. After using all of the above vaccines, the percentage of adverse events reported was significantly higher in women than in men, which coincides with the data of the world literature. Conclusion. Thus, the analysis of the safety of vaccines against COVID-19, registered and authorized for use in Ukraine, shows that the risks of adverse events reported after COVID-19 vaccination are rare; the most of them are mild and predictable. At the same time, these manifestations of adverse events reported cannot be compared with the health and life risks associated with the COVID-19 disease itself. Ensuring continuous monitoring of the safety of vaccine use and identifying potential side effects will further reduce and manage the risks associated with vaccine use


Author(s):  
Bhakti Sarang ◽  
Geetu Bhandoria ◽  
Priti Patil ◽  
Anita Gadgil ◽  
Lovenish Bains ◽  
...  

Abstract Background Cancellations of elective surgeries on the day of surgery (DOS) can lead to added financial burden and wastage of resources for healthcare facilities; as well as social and emotional problems to patients. These cancellations act as barriers to delivering efficient surgical services. Optimal utilisation of the available resources is necessary for resource-constrained low-and-middle-income countries (LMIC). This study investigates the rate and causes of cancellations of elective surgeries on the DOS in various surgical departments across ten hospitals in India. Methods A research consortium ‘IndSurg’ led by World Health Organisation Collaboration Centre (WHOCC) for Research in Surgical Care Delivery in LMICs, India conducted this multicentre retrospective cross-sectional study to analyse the cancellations of elective/planned surgical operations on DOS across urban secondary and tertiary level hospitals. We audited surgical records of a pre-decided period of six weeks for cancellations, documented relevant demographic information and reasons for cancellations. Results We analysed records from the participating hospitals, with an overall cancellation rate of 9.7% (508/5231) on the DOS for elective surgical operations. Of these, 74% were avoidable cancellations. A majority (30%) of these 508 cancellations were attributed to insufficient resources, 28% due to patient's refusal or failure to show-up, and 22% due to change in patient's medical status. Conclusion We saw a preponderance of avoidable reasons for elective surgery cancellations. A multidisciplinary approach with adequate preoperative patient counselling, timely communication between the patients and caregivers, adequate preoperative anaesthetic assessment, and planning by the surgical team may help reduce the cancellation rate.


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