scholarly journals Sudden cardiac death in excited delirium, and how to prevent it

2021 ◽  
Keyword(s):  
Medical Emergency Team ◽  
Panic Attacks ◽  
Medical Emergency ◽  
Physical Restraints ◽  
Police Intervention ◽  
Emergency Team ◽  
Excited Delirium ◽  
Threatening Condition ◽  
Life Threatening ◽  
The Individual

The purpose of this study was to review data on restraint related deaths in persons in a state of excited delirium (ExDS) and to propose guidelines for treatment. We analysed three unexpected deaths in persons in a state of ExDS shortly after police restraint. Death which occurs during a police intervention, using physical restraints, may be related to placing the individual in a prone position, the use of neck holds, expert grips, and handcuffs or pepper spray. ExDS results in an altered mental state with agitation, aggression, paranoia, and panic attacks, and is a life-threatening condition. Therefore, before police intervention is initiated, a medical emergency team should be present. In patients with ExDS, physical restraints used by the police should be brief, effective, and include rapid tranquilization (sedation) using benzodiazepines, and antipsychotics.

scholarly journals Myelodysplastic Syndrome Clinically Presenting with the “Classic TTP Pentad”

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Santiago Fabián Moscoso Martínez ◽  
Evelyn Carolina Polanco Jácome ◽  
Elizabeth Guevara ◽  
Vijay Mattoo
Keyword(s):  
Myelodysplastic Syndrome ◽  
Clinical Presentation ◽  
Renal Involvement ◽  
Medical Emergency ◽  
Complete Blood Cell Count ◽  
Blood Cell Count ◽  
Thrombocytopenic Purpura ◽  
Life Saving ◽  
Threatening Condition ◽  
Life Threatening

The clinical presentation of myelodysplastic syndrome (MDS) is not specific. Many patients can be asymptomatic and can be detected only due to an abnormal complete blood cell count (CBC) on routine exam or for other reasons while others can be symptomatic as a consequence of underlying cytopenias. Thrombotic thrombocytopenic purpura (TTP) usually is suspected under the evidence of microangiopathic hemolytic anemia (MAHA) and thrombocytopenia and because it is a life-threatening condition (medical emergency) immediate initiation of plasmapheresis could be life-saving. The following case illustrates an unusual presentation of MDS in a patient who came in to the emergency room with the classic TTP “pentad” of fever, renal involvement, MAHA, mental status changes, and thrombocytopenia. We will focus our discussion in the clinical presentation of this case.

Comparison of policies for recognising and responding to clinical deterioration across five Victorian health services

2018 ◽  
Vol 42 (4) ◽  
pp. 412 ◽  
Author(s):  
Julie Considine ◽  
Anastasia F. Hutchison ◽  
Helen Rawson ◽  
Alison M. Hutchinson ◽  
Tracey Bucknall ◽  
...  
Keyword(s):  
Patient Safety ◽  
Health Services ◽  
Medical Emergency Team ◽  
National Standards ◽  
Clinical Deterioration ◽  
Medical Emergency ◽  
Emergency Team ◽  
Subacute Care ◽  
Guidance Documents ◽  
Activation Criteria

Objectives The aim of the present study was to describe and compare organisational guidance documents related to recognising and responding to clinical deterioration across five health services in Victoria, Australia. Methods Guidance documents were obtained from five health services, comprising 13 acute care hospitals, eight subacute care hospitals and approximately 5500 beds. Analysis was guided by a specific policy analysis framework and a priori themes. Results In all, 22 guidance documents and five graphic observation and response charts were reviewed. Variation was observed in terminology, content and recommendations between the health services. Most health services’ definitions of physiological observations fulfilled national standards in terms of minimum parameters and frequency of assessment. All health services had three-tier rapid response systems (RRS) in place at both acute and subacute care sites, consisting of activation criteria and an expected response. RRS activation criteria varied between sites, with all sites requiring modifications to RRS activation criteria to be made by medical staff. All sites had processes for patient and family escalation of care. Conclusions Current guidance documents related to the frequency of observations and escalation of care omit the vital role of nurses in these processes. Inconsistencies between health services may lead to confusion in a mobile workforce and may reduce system dependability. What is known about the topic? Recognising and responding to clinical deterioration is a major patient safety priority. To comply with national standards, health services must have systems in place for recognising and responding to clinical deterioration. What does this paper add? There is some variability in terminology, definitions and specifications of physiological observations and medical emergency team (MET) activation criteria between health services. Although nurses are largely responsible for physiological observations and escalation of care, they have little authority to direct frequency of observations and triggers for care escalation or tailor assessment to individual patient needs. Failure to identify nurses’ role in policy is concerning and contrary to the evidence regarding nurses and MET activations in practice. What are the implications for practitioners? Inconsistencies in recommendations regarding physiological observations and escalation of care criteria may create patient safety issues when students and staff work across organisations or move from one organisation to another. The validity of other parameters, such as appearance, pain, skin colour and cognition, warrant further consideration as early indicators of deterioration that may be used by nurses to identify clinical deterioration earlier. A better understanding of the relationship between the sensitivity, specificity and frequency of monitoring of particular physiological observations and patient outcomes is needed to improve the predictive validity for identification of clinical deterioration.

Features of an Intensive Care based Medical Emergency Team nurse training program in a University Teaching Hospital

2016 ◽  
Vol 29 (1) ◽  
pp. 46-49 ◽  
Author(s):  
Michelle Topple ◽  
Brooke Ryan ◽  
Richard McKay ◽  
Damien Blythe ◽  
John Rogan ◽  
...  
Keyword(s):  
Intensive Care ◽  
Training Program ◽  
Teaching Hospital ◽  
Medical Emergency Team ◽  
University Teaching ◽  
Medical Emergency ◽  
Nurse Training ◽  
Emergency Team

"To evaluate efficacy of Gruta in Grabhashaymukhgata Vrana with special reference to Cervical Erosion."

2020 ◽  
Vol 8 (06) ◽  
Author(s):  
Pravin Ashok Mali
Keyword(s):  
Vaginal Discharge ◽  
Benign Lesion ◽  
Modern Science ◽  
Routine Activity ◽  
Major Life ◽  
Causative Factors ◽  
Threatening Condition ◽  
Life Threatening ◽  
The Individual ◽  
Gynaecological Disease

Cervical erosion is one of the causative factors for vaginal discharge. Cervical erosion, a benign lesion is sometimes much troublesome due to its chronic nature and recurrence. Cauterization and cryosurgery are most common treatment for cervical erosion in modern science. Certain diseases may not be life threatening but may be troublesome and irritating to the individual in her routine activity. When neglected may lead to serious complications or turn into major life threatening condition. Cervical erosion is one among them, increasingly prevalent nowadays, demanding great concern over it. Cervical erosion is a common gynaecological disease and seen in about 80-85% of women. As per Ayurveda classics Garbhashaya grivamukhagatavrana can be correlated with cervical erosion. Various research has been done in ayurveda on its treatment. One such compound Ghrut can be used incorporation with other treatment. This article is to enlighten on the same.

scholarly journals Timing and Location of Medical Emergency Team Activation Is Associated with Seriousness of Outcome: An Observational Study in a Tertiary Care Hospital

PLoS ONE ◽  
2016 ◽  
Vol 11 (12) ◽  
pp. e0168729 ◽  
Author(s):  
Takeo Kurita ◽  
Taka-aki Nakada ◽  
Rui Kawaguchi ◽  
Koichiro Shinozaki ◽  
Ryuzo Abe ◽  
...  
Keyword(s):  
Observational Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Medical Emergency Team ◽  
Medical Emergency ◽  
Care Hospital ◽  
Emergency Team
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