An unusual cause of hypotension and abnormal electrocardiogram (ECG) — scombroid poisoning

Open Medicine ◽  
2010 ◽  
Vol 5 (3) ◽  
pp. 292-297 ◽  
Author(s):  
Catalina Lionte
Keyword(s):  
Intensive Care ◽  
Allergic Reaction ◽  
Fish Consumption ◽  
Complete Resolution ◽  
Food Poisoning ◽  
Medical Personnel ◽  
Ecg Changes ◽  
Electrocardiogram Ecg

AbstractScombroid fish or histamine food poisoning is an illness typically associated with fish consumption, rarely encountered and reported in Europe. Symptoms develop quickly and resemble an allergic reaction. This paper reports three cases of severe scombroid poisoning in previously healthy patients, which presented diffuse macular erythema, hypotension, palpitations, and abnormal electrocardiogram (ECG). All patients required intensive care, with a complete resolution of symptoms and ECG changes within 24 hours. This is the first Romanian report of scombroid poisoning, emphasizing that medical personnel should be aware of this condition, because symptoms and ECG changes often lead to confusion with other diseases.

scholarly journals Time Course of ECG Depolarization and Repolarization Changes during Ischemia in PTCA Recordings

2004 ◽  
Vol 43 (01) ◽  
pp. 43-46 ◽  
Author(s):  
J. García ◽  
G. Wagner ◽  
R. Bailón ◽  
L. Sörnmo ◽  
P. Laguna ◽  
...  
Keyword(s):  
Time Course ◽  
Wave Amplitude ◽  
Temporal Evolution ◽  
Delayed Response ◽  
S Wave ◽  
Ecg Changes ◽  
T Complex ◽  
Karhunen Loeve Transform ◽  
Low Amplitude ◽  
Electrocardiogram Ecg

Summary Objectives: In this work we studied the temporal evolution of changes in the electrocardiogram (ECG) as a consequence of the induced ischemia during prolonged coronary angioplasty, comparing the time course of indexes reflecting depolarization and those reflecting repolarization. Methods: We considered both local (measured at specific points of the ECG) and global (obtained from the Karhunen-Loève transform) indexes. In particular, the evolution of Q, R and S wave amplitudes during ischemia was analyzed with respect to classical indexes such as ST level. As a measurement of sensitivity we used an Ischemic Changes Sensor (ICS), which reflects the capacity of an index to detect changes in the ECG. Results: The results showed that, in leads with low-amplitude ST-T complexes, the S wave amplitude was more sensitive in detecting ischemia than was the commonly used index ST60. It was found that in such leads the S wave amplitude initially exhibited a delayed response to ischemia when compared to ST60, but its performance was better from the second minute of occlusion. The global indexes describing the ST-T complex were, in terms of the ICS, superior to the S wave amplitude for ischemia detection. Conclusions: Ischemic ECG changes occur both at repolarization and depolarization, with alterations in the depolarization period appearing later in time. Local indexes are less sensitive to ischemia than global ones.

scholarly journals Postoperative ‘STEMI’ in Intracerebral Hemorrhage due to Arteriovenous Malformation: A Case Report and Review of Literature

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Ravinder Datt Bhanot ◽  
Jasleen Kaur ◽  
Shitiz Sriwastawa ◽  
Kendall Bell ◽  
Kushak Suchdev
Keyword(s):  
Myocardial Infarction ◽  
Intracerebral Hemorrhage ◽  
Arteriovenous Malformation ◽  
Cardiac Biomarkers ◽  
Review Of Literature ◽  
Fibrinolytic Agents ◽  
Intraparenchymal Hemorrhage ◽  
Ecg Changes ◽  
St Segment ◽  
Electrocardiogram Ecg

Electrocardiogram (ECG) changes suggestive of cardiac ischemia are frequently demonstrated in patients with ischemic stroke and subarachnoid hemorrhage. However, little is known of such changes particularly acute ST segment myocardial infarction (STEMI) in patients with intracerebral hemorrhage (ICH), especially after neurosurgery. We present a patient with intraparenchymal hemorrhage due to cerebral arteriovenous malformation (AVM) who exhibited acute STEMI after neurosurgery. Serial cardiac biomarkers and echocardiograms were performed which did not reveal any evidence of acute myocardial infarction. The patient was managed conservatively from cardiac stand point with no employment of anticoagulants, antiplatelet therapy, fibrinolytic agents, or angioplasty and recovered well with minimal neurological deficit. This case highlights that diffuse cardiac ischemic signs on the ECG can occur in the setting of an ICH after neurosurgery, potentially posing a difficult diagnostic and management conundrum.

scholarly journals Burnout Syndrome in UK Intensive Care Unit staff: Data from all three Burnout Syndrome domains and across professional groups, genders and ages

2019 ◽  
Vol 20 (4) ◽  
pp. 363-369 ◽  
Author(s):  
Laura Vincent ◽  
Peter G Brindley ◽  
Julie Highfield ◽  
Richard Innes ◽  
Paul Greig ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Emotional Exhaustion ◽  
Comprehensive Evaluation ◽  
Maslach Burnout Inventory ◽  
Medical Personnel ◽  
Personal Accomplishment ◽  
Burnout Syndrome ◽  
Age Group ◽  
The Uk

IntroductionThis is the first comprehensive evaluation of Burnout Syndrome across the UK Intensive Care Unit workforce and in all three Burnout Syndrome domains: Emotional Exhaustion, Depersonalisation and lack of Personal Accomplishment.MethodsA questionnaire was emailed to UK Intensive Care Society members, incorporating the 22-item Maslach Burnout Inventory Human Services Survey for medical personnel. Burnout Syndrome domain scores were stratified by ‘risk’. Associations with gender, profession and age-group were explored.ResultsIn total, 996 multi-disciplinary responses were analysed. For Emotional Exhaustion, females scored higher and nurses scored higher than doctors. For Depersonalisation, males and younger respondents scored higher.ConclusionApproximately one-third of Intensive Care Unit team-members are at ‘high-risk’ for Burnout Syndrome, though there are important differences according to domain, gender, age-group and profession. This data may encourage a more nuanced understanding of Burnout Syndrome and more personalised strategies for our heterogeneous workforce.

Disaster Reanimatology Potentials: A Structured Interview Study in Armenia I. Methodology and Preliminary Results

1989 ◽  
Vol 4 (2) ◽  
pp. 135-152 ◽  
Author(s):  
Miroslav Klain ◽  
Edmund Ricci ◽  
Peter Safar ◽  
Victor Semenov ◽  
Ernesto Pretto ◽  
...  
Keyword(s):  
Intensive Care ◽  
Life Support ◽  
Medical Personnel ◽  
The United States ◽  
Structured Interview ◽  
Advanced Trauma Life Support ◽  
Mass Casualties ◽  
Medical Systems ◽  
Preliminary Results ◽  
Medical Teams

AbstractIn general, preparations for disasters which result in mass casualties do not incorporate a modern resuscitation approach. We explored the life-saving potential of, and time limits for life-supporting first aid (LSFA), advanced trauma life support (ATLS), resuscitative surgery, and prolonged life support (PLS: intensive care) following the earthquake in Armenia on 7 December 1988. We used a structured, retrospective interview method applied previously to evaluation of emergency medical services (EMS) in the United States. A total of 120 survivors of, and participants in the earthquake in Armenia were interviewed on site (49 lay eyewitnesses, 20 search-rescue personnel, 39 medical personnel and records, and 12 administrators). Answers were verified by crosschecks. Preliminary results permit the following generalizations: 1) a significant number of victims died slowly as the result of injuries such as external hemorrhage, head injury with coma, shock, or crush syndrome; 2) early search and rescue was performed primarily by uninjured covictims using hand tools; 3) many lives potentially could have been saved by the use of LSFA and ATLS started during extrication of crushed victims. 4) medical teams from neighboring EMS systems started to arrive at the site at 2-3 hours and therefore, A TLS could have been provided in time to save lives and limbs; 5) some amputations had to be performed in the field to enable extrication; 6) the usefulness of other resuscitative surgery in the field needs to be clarified; 7) evacuations were rapid; 8) air evacuation proved essential; 9) hospital intensive care was well organized; and 10) international medical aid, which arrived after 48 hours, was too late to impact on resuscitation. Definitive analysis of data in the near future will lead to recommendations for local, regional, and National Disaster Medical Systems (NDMS).

scholarly journals Stress and burnout in a group of intensive care unit medical personnel – a preliminary study

2021 ◽  
Vol 29 (1) ◽  
pp. 22-25
Author(s):  
Jakub Lickiewicz ◽  
Barbara Salawa ◽  
Wojciech Serednicki ◽  
Patricia Hughes ◽  
Marta Makara
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Personnel ◽  
Preliminary Study

scholarly journals Low Incidence of Biphasic Allergic Reactions in Patients Admitted to Intensive Care after Anaphylaxis

2019 ◽  
Vol 130 (2) ◽  
pp. 284-291 ◽  
Author(s):  
Sofie Højlund ◽  
Peter Søe-Jensen ◽  
Anders Perner ◽  
Morten H. Bestle ◽  
Peder Carl ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Allergic Reaction ◽  
Respiratory Symptoms ◽  
Allergic Reactions ◽  
Total Incidence ◽  
Skin Symptoms ◽  
Initial Symptoms ◽  
Patient Groups ◽  
Low Incidence

Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background Biphasic allergic reactions—recurrence of allergy symptoms after a symptom-free period—are reported to occur in 1 to 23% of allergic reactions. Patients admitted to an intensive care unit after anaphylaxis potentially have more severe reactions and a higher risk of biphasic allergic reactions. The purpose of this study was to examine incidence, triggers, symptoms, and treatment of biphasic allergic reactions, in patients admitted to an intensive care unit. Methods Records of patients admitted to intensive care units with anaphylaxis from 2011 to 2014 were reviewed. Only patients with a reaction fulfilling internationally accepted criteria for anaphylaxis were included. Potential biphasic allergic reactions, defined as renewed allergy symptoms 1 to 72 h after initial symptoms had resolved, without further exposure to the trigger, were identified. Results A total of 83 cases of anaphylaxis were identified, and the most frequent triggers were medications (58 of 83 [70%]). Skin symptoms occurred in 69 (83%) cases, and circulatory and respiratory symptoms in 48 (58%) and 45 (54%) cases, respectively. In total, 82 (99%), 80 (96%), and 66 (80%) were treated with antihistamines, corticosteroids, and epinephrine, respectively. Only 10 patients presented with one or more relevant symptoms after the initial allergic reaction. Of these, three were possible, and one was a probable biphasic allergic reaction, giving a total incidence of 4 of 83 (4.8% [95% CI, 1.6 to 12.5]) or 1 of 83 (1.2% [95% CI, 0.1 to 7.46]), respectively. All cases were mild, presenting with skin symptoms only, occurring on average 14 h after initial reactions. Conclusions The authors observed a low incidence of biphasic reactions in patients admitted to an intensive care unit after anaphylaxis, at a rate equivalent to that reported in other patient groups.

scholarly journals Investigation of an Ultra Wideband Noise Sensor for Health Monitoring

Sensors ◽  
2020 ◽  
Vol 20 (4) ◽  
pp. 1034
Author(s):  
Xuezhi Zeng ◽  
Joakim Robakowski ◽  
Mikael Persson ◽  
Albert Monteith ◽  
Andreas Fhager
Keyword(s):  
Low Cost ◽  
Medical Personnel ◽  
Medical Diagnostics ◽  
Ultra Wideband ◽  
Trauma Patients ◽  
Wideband Noise ◽  
Heartbeat Rate ◽  
Additional Support ◽  
Electrocardiogram Ecg ◽  
Monitoring Devices

Quick on-scene assessment and early intervention is the key to reduce the mortality of stroke and trauma patients, and it is highly desirable to develop ambulance-based diagnostic and monitoring devices in order to provide additional support to the medical personnel. We developed a compact and low cost ultra wideband noise sensor for medical diagnostics and vital sign monitoring in pre-hospital settings. In this work, we demonstrated the functionality of the sensor for respiration and heartbeat monitoring. In the test, metronome was used to manipulate the breathing pattern and the heartbeat rate reference was obtained with a commercial electrocardiogram (ECG) device. With seventeen tests performed for respiration rate detection, sixteen of them were successfully detected. The results also show that it is possible to detect the heartbeat rate accurately with the developed sensor.

scholarly journals The utility of the prehospital electrocardiogram

CJEM ◽  
2011 ◽  
Vol 13 (06) ◽  
pp. 372-377 ◽  
Author(s):  
Matthew T. Davis ◽  
Adam Dukelow ◽  
Shelley McLeod ◽  
Severo Rodriguez ◽  
Michael Lewell
Keyword(s):  
Data Extraction ◽  
Tertiary Care ◽  
Medical Personnel ◽  
Data Extraction Tool ◽  
Patient Arrival ◽  
Handover Process ◽  
St Elevation ◽  
Record Review ◽  
Electrocardiogram Ecg ◽  
Retrospective Medical Record Review

ABSTRACTObjectives:The 12-lead electrocardiogram (ECG) can capture valuable information in the prehospital setting. By the time patients are assessed by an emergency department (ED) physician, their symptoms and any ECG changes may have resolved. We sought to determine whether the prehospital electrocardiogram (pECG) could influence ED management and how often the pECG was available to and reviewed by the ED physician.Methods:A retrospective medical record review was conducted on a random sample of patients ≥ 18 years who had a prehospital 12-lead ECG and were transported to one of two tertiary care centres. Data were recorded onto a standardized data extraction tool. Three investigators independently compared the pECG to the first ECG obtained in the ED after patient arrival at the hospital. Any abnormalities not present on the ED ECG were adjudicated to ascertain whether they had the potential to change ED management.Results:Of 115 ambulance runs selected, 47 had no pECG attached to the ambulance call record (ACR) and another 5 were excluded (one ST elevation myocardial infarction, one cardiac arrest, three ACR missing). Of the 63 pECGs reviewed, 16 (25%) showed changes not apparent on the initial ED ECG (κ = 0.83; 95% CI 0.74–0.93), of which 12 had differences that might influence ED management (κ = 0.76; 95% CI 0.72–0.82). Only one hospital record contained a copy of the pECG, despite the current protocol that paramedics print two copies of the pECG on arrival in the ED (one copy for the ACR and one to be handed to the medical personnel). None of 110 ED charts documented that the pECG was reviewed by the ED physician.Conclusion:The pECG has the potential to influence ED management. Improvement in paramedic and physician documentation and a formal pECG handover process appear necessary.

scholarly journals Intensive Care Unit Setup for COVID-19

2020 ◽  
Vol 04 (01) ◽  
pp. 05-11
Author(s):  
Shweta Panse ◽  
Muralidhar Kanchi ◽  
Jose Chacko ◽  
Srinath Kumar T. S. ◽  
Ranganatha Ramanjaneya ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Healthcare Workers ◽  
Medical Personnel ◽  
Healthcare Systems ◽  
Protective Equipment ◽  
Cross Contamination ◽  
Ventilator Management ◽  
Coronavirus Infection ◽  
The Ideal

AbstractThe coronavirus pandemic has become a challenge to all the healthcare systems in the world. Urgent creation of an intensive care unit (ICU) for the same is the need of the hour. The ideal ICU for COVID -19 should be isolated, fully equipped with invasive and noninvasive monitoring, with 24/7 trained medical personnel, nursing staff and laboratory support. As the coronavirus infection is transmitted by droplets and is highly contagious, protection of healthcare workers is crucial. Personnel working inside the ICU should get personal protective equipment (PPE). Strict guidelines for donning and doffing of PPE should be followed to prevent cross-contamination. Respiratory failure being the commonest complication of COVID-19, knowing the ventilator management for the same is essential. It is of great importance to meticulously manage all the resources to combat this contagion.

Sign in / Sign up

Export Citation Format

Share Document