scholarly journals COVID-19 PANDEMIC AND CHALLENGES IT POSES TO OTORHINOLARYNGOLOGISTS

2020 ◽  
Vol 18 (Suppl.1) ◽  
pp. 247-250
Author(s):  
V. Stoyanov

As doctors, we all have a shared responsibility in terms of COVID-19. At first glance, ENT specialists are not classed as the so-called “front line” medical workers but have a key role to play and these needs to be addressed. In response to the pressures on the Health Care System, the medical care provided by otorhinolaryngologists has been limited. Irrespective of the imposed work limitations, patients will still need to be provided with the specific care, which requires us to find the best solutions for work stations and wards. In addition, measures should be put in place to avoid compromising surgical activity (especially emergency procedures), deriving from a combination of factors, including staff sickness, problems with the supply of medical equipment, the use of operating theaters, anesthesiological teams, etc. An increased number of performed tracheostomies are expected in positive COVID-19 patients who need artificial pulmonary ventilation. The purpose of this paper is to address all these issues, based on current and accessible information, and propose measures and procedures for otorhinolaryngologists in the context of the COVID-19 pandemic for different patient groups. Simultaneously, recommendations are made to protect the doctors and their teams, as well as to reconfigure the medical operations in the new conditions.

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Julia Becker ◽  
Gerald Huschak ◽  
Hannes-Caspar Petzold ◽  
Volker Thieme ◽  
Sebastian Stehr ◽  
...  

Abstract Background Operation room (OR) planning is a complex process, especially in large hospitals with high rates of unplanned emergency procedures. Postponing elective surgery in order to provide capacity for emergency operations is inevitable at times. Elderly patients, residents of nursing homes, women, patients with low socioeconomic status and ethnic minorities are at risk for undertreatment in other contexts, as suggested by reports in the medical literature. We hypothesized that specific patient groups could be at higher risk for having their elective surgery rescheduled for non-medical reasons. Methods In this single center, prospective observational trial, we analysed 2519 patients undergoing elective surgery from October 2018 to May 2019. A 14-item questionnaire was handed out to illicit patient details. Additional characteristics were collected using electronic patient records. Information on the timely performance of the scheduled surgery was obtained using the OR’s patient data management system. 6.45% of all planned procedures analysed were postponed. Association of specific variables with postponement rates were analysed using the Mann–Whitney U test and Fisher's exact test/χ2-test. Results Significantly higher rates of postponing elective surgery were found in elderly patients. No significant differences in postponing rates were found for the variables gender, nationality (Germany, EU, non-EU), native language, professional medical background and level of education. Significantly lower rescheduling rates were found in patients with ties to hospital staff and in patients with a private health insurer. Conclusions Elderly patients, retirees and nursing home residents seem to be at higher risk for having their elective surgery rescheduled. However, owing to the study design, causality could not be proven. Our findings raise concern about possible undertreatment of these patient groups and provide data on short-term postponement of elective surgery. Trial registration DRKS00015836. Retrospectively registered.


2005 ◽  
Vol 3 (1) ◽  
pp. 0-0
Author(s):  
Kristina Vostrugina ◽  
Daiva Gudavičienė ◽  
Rytis Rimdeika

Kristina Vostrugina, Daiva Gudavičienė, Rytis RimdeikaKauno medicinos universiteto klinikųPlastinės chirurgijos ir nudegimų skyrius,Eivenių g. 2, LT-50009 KaunasEl paštas: [email protected] Tikslas Ištirti 1999–2003 m. Kauno medicinos universiteto klinikų Plastinės chirurgijos ir nudegimų skyriaus ligonių, kuriems patvirtinta bakteriemija, gydymo aspektus. Ligoniai ir metodai Atlikta retrospektyvi 82 nudegusių ligonių, kuriems patvirtinta bakteriemija, ligos istorijų analizė. Vertintas pacientų amžius, nudegimą sukėlę veiksniai, nudegimo plotas, kvėpavimo takų nudegimas. Analizuota, kokiam skaičiui pacientų reikėjo kateterizuoti centrines venas, prireikė dirbtinės plaučių ventiliacijos, enterinio ar parenterinio maitinimo, kokių radosi komplikacijų, kokie mikroorganizmai išaugo žaizdų pasėliuose ir toks jų sutapimas su kraujo pasėlių duomenimis, nagrinėti antibiotikų terapijos aspektai. Rezultatai Pacientų, kuriems patvirtinta bakteriemija, vidutinis amžius buvo 50 metų, standartinis nuokrypis – 16. Vyravo nudegimai liepsna (82%) ir skysčiais (8,5%). Vidutinis nudegusio kūno paviršiaus plotas buvo 29%, standartinis nuokrypis – 19. Centrines venas reikėjo kateterizuoti 78% pacientų. Dirbtinės plaučių ventiliacijos prireikė 13% pacientų. Enterinis maitinimas skirtas 48% pacientų, parenteriniu būdu maitinta 90% ligonių. Pneumonija nustatyta 29% pacientų, kardiovaskulinis nepakankamumas – 15%, dauginis organų funkcijos nepakankamumas – 13%, inkstų funkcijos nepakankamumas – 7% ligonių. Visais atvejais sutapo žaizdos ir kraujo pasėlių duomenys, kai iš kraujo išaugo Pseudomonas aeruginosa, 87% – kai išaugo meticilinui atsparus Staphylococcus aureus ir 74% – kai išaugo meticilinui jautrus S. aureus. Antibiotikais gydyta 80 ligonių, dažniausiai penicilinu, gentamicinu ir vankomicinu. Išvados Bakteriemija dažnai nustatoma didelius plotus nudegusiems ligoniams, kuriems tenka kateterizuoti centrines venas, skirti parenterinį maitinimą. Dažniausiai iš kraujo mėginių išauga tie mikroorganizmai, kurie auga žaizdų pasėliuose. Reikšminiai žodžiai: nudegimai, bakteriemija, antibiotikų terapija Treatment of burned patients with diagnosed bacteremia Kristina Vostrugina, Daiva Gudavičienė, Rytis RimdeikaKaunas University of Medicine Hospital,Department of Plastic Surgery and Burns,Eivenių str. 2, LT-50009 Kaunas, LithuaniaE-mail: [email protected] Objective The aim of the study was to investigate the aspects of treatment of burned patients with confirmed bacteremia treated at Kaunas University of Medicine Hospital Department of Plastic Surgery and Burns during 1999–2003. Patients and methods A retrospective analysis of case histories of 82 burned patients with confirmed bacteremia was performed. The evaluated factors included the patients’ age, factors that caused the burns, the burned area, and burns of the airways. We also analyzed how many patients required catheterization of the central veins, artificial pulmonary ventilation, enteral or parenteral feeding, and complications, as well as what microorganisms grew in wound crops, how many cases corresponded to the blood crop findings, and the aspects of antibiotic therapy. Results Mean age of patients with confirmed bacteremia was 50 years, standard deviation (SD) – 16. Flame burns (82%) and scalds (8.5%) predominated. Mean burned body surface area was 29%, SD – 19. 78% of patients required catheterization of central veins, and 13% – artificial pulmonary ventilation. 48% of patients were fed enterally, and 90% – parenterally. 29% of patients had pneumonia, 15% – cardiovascular insufficiency, 13% – multiple organ failure, and 7% – renal failure. The coincidence of the findings of wound and blood crops was 100% in cases of Pseudomonas aueruginosa growth, 87% – in cases of methicillin-resistant Staphylococcus aureus growth, and 74% – in cases of methicillin-sensitive Staphylococcus aureus growth. 80 patients received antibiotics, mostly penicillin, gentamicin, and vancomycin. Conclusions Bacteremia was very common among extensively burned patients requiring catheterization of the central veins and parenteral feeding. In most cases, microorganisms that grew in wound crops also grew in blood samples. Key words: burns, bacteremia, antibiotic therapy


2017 ◽  
Vol 86 (1) ◽  
pp. 36-41
Author(s):  
V. S. Isachenko ◽  
◽  
D. M. Il’yasov ◽  
A. M. Mel’nik ◽  
V. Yu. Ovchinnikov ◽  
...  

1973 ◽  
Vol 7 (3) ◽  
pp. 166-168
Author(s):  
A. B. Gruzman ◽  
V. M. Yurevich

Sign in / Sign up

Export Citation Format

Share Document