scholarly journals A COVID-19 Young Girl Patient with Developing Pneumonia and Septic Shock Passing the Death

2020 ◽  
pp. 1-6
Keyword(s):  
Septic Shock ◽  
Critical Care ◽  
Critical Care Unit ◽  
Strong Relationship ◽  
Young Girl ◽  
Arterial Blood Gas ◽  
Reactive Protein ◽  
Arterial Blood ◽  
Venous Catheterization

Rationale: Coronavirus disease is a current worldwide pandemic serious infection. Septic shock is a very common cause of death due to COVID-19 infection. There is a strong relationship between the severity of COVID-19 infection and death. COVID-19 infection is a well-known trigger for severe inflammatory changes and sepsis. Up till now, there is no well-known treatment for COVID-19. Patient concerns: A young girl COVID-19 patient admitted to the critical care unit with severe shock and developing pneumonia. Diagnosis: COVID-19 patient admitted to the critical care unit with COVID-19 young girl patient with septic shock and developing pneumonia. Interventions: Electrocardiography, arterial blood gas test, chest CT scan, central venous catheterization, and intravenous vasopressors infusion. Outcomes: Progressive dramatic clinical electrocardiography and radiological improvement had happened. Lessons: It denotes the role of anticoagulants, vasopressors, steroids, and antibiotics in the management of COVID-19 pneumonic infection and septic shock. C- reactive protein, lymphocytic count, liver enzymes, and CT chest may be used as a good laboratory guide for follow up for the inflammatory activity of COVID-19 patient. Blood pressure, respiratory rate, and O2 saturation are another strong guide for clinical for follow up in COVID-19 patients.

Does Implementing Pulse Oximetry in a Critical Care Unit Result in Substantial Arterial Blood Gas Savings?

CHEST Journal ◽  
1993 ◽  
Vol 104 (2) ◽  
pp. 542-546 ◽  
Author(s):  
Kevin J. Inman ◽  
William J. Sibbald ◽  
Frank S. Rutledge ◽  
Mark Speechley ◽  
Claudio M. Martin ◽  
...  
Keyword(s):  
Critical Care ◽  
Pulse Oximetry ◽  
Critical Care Unit ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood

scholarly journals THE EFFECT OF STRUCTURED TEACHING PROGRAM ON KNOWLEDGE ABOUT ARTERIAL BLOOD GAS ANALYSIS AMONG THE STAFF NURSES WORKING IN CRITICAL CARE UNIT

2021 ◽  
Vol 9 (5) ◽  
pp. 1355-1361
Author(s):  
Priya Sachan ◽  
Swastika Das
Keyword(s):  
Critical Care ◽  
Critical Care Unit ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Staff Nurses ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Arterial Blood Gas Analysis ◽  
Structured Teaching

Statement:A STUDY TO ASSESS THE EFFECT OF STRUCTURED TEACHING PROGRAM ON KNOWLEDGE ABOUT ARTERIAL BLOOD GAS ANALYSIS AMONG THE STAFF NURSES WORKING IN CRITICAL CARE UNIT OF SELECTED HOSPITAL, LUCKNOW Introduction: Arterial blood gas analysis is a basic and useful laboratory test for the critically ill patients. It is an essential investigation for assessing ventilation, oxygenation and acid base status among critically ill patients. These three are closely interrelated physiological parameters which maintain pH homeostasis. Measurement of arterial blood gas involves analysis of components: pH, partial pressure (PP), Base excess (BE), Bicarbonate (HCO3), Electrolytes, Haemoglobin (Hb) and Glucose.Interpreting an arterial blood gas (ABG) is a crucial skill for physicians, nurses, respiratory therapists, and other health care personnel. Any deviation from a normal value will indicate that the client is experiencing an acid base imbalance. Disorders of acid-base balance can lead to severe complications and occasionally the abnormality may be so severe that it can lead to life threatening condition. Objectives Of The Study: 1. Assess the level of knowledge about Arterial Blood Gas analysis among the staff nurses working in the Critical Care Unit at selected Hospital. 2. Evaluate the effect of Structure Teaching Programme on level of knowledge about Arterial Blood Gas Analysis among the staff nurses working in the Critical Care Unit at selected Hospital. 3. Association between level of knowledge about Arterial Blood Gas analysis among the staff nurses working in the Critical Care Unit with selected demographic variables. Research Methodology:This study was conducted using Quantitative approach at Integral Hospital, Lucknow. Pre-experimental one group pre-test-post-test design was used in the study. The conceptual framework used in this study was Modified Kings Goal Attainment theory. The total sample size was 30 selected by convenience sampling technique. The data was collected by administering Structured Knowledge Questionnaire followed by Structured Teaching Programme about Arterial Blood Gas analysis. After 7 days, post-test was done to assess the effectiveness of STP. Reults:The data obtained are tabulated and analysed using descriptive and inferential statistics. The statistical analysis of the data shows that 86.7% of the staff nurses had moderate knowledge and 13.3% of the staff nurses had inadequate knowledge. The mean pretest knowledge score regarding Arterial Blood Gas analysis was 13.96 with a standard deviation of 3.39. After giving STP the mean score was increased to 23.00 with a standard deviation of 2.36. The Structured Teaching Programme was effective in improving the knowledge as the t value is -12.54 which was highly significant with the degree of freedom 29 p< 0.05. Conclusion: The findings revealed that there was a significant improvement in knowledge of staff nurses in post-test after structured teaching programme. It also showed that there was an association with pre-test knowledge and selected demographic variables like age and association of post-test knowledge and selected demographic variable like qualification.

scholarly journals Dark brown serum and plasma samples

2020 ◽  
Vol 30 (2) ◽  
pp. 320-324
Author(s):  
Lora Dukic ◽  
Nikolina Maric ◽  
Ana-Maria Simundic
Keyword(s):  
Blood Count ◽  
Complete Blood Count ◽  
Reference Interval ◽  
Serum Samples ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Reflex Testing ◽  
Colicky Pain ◽  
Hb Concentration

This case report describes occurrence of unusual, dark brown coloration of citrate plasma and serum samples in a female 68 years old patient admitted into Emergency department (ED). Patient complained of nausea and vomiting, fever up to 38.9°C, colicky pain in abdomen, diminished urinary output and yellowish skin tone. Her medical history included arterial hypertension, hypothyroidism and facial squamous cell carcinoma. For previous two years, she was treated with tuberculostatic therapy for Mycobacterium avium positive interstitial lung disease. Regular follow-up showed no signs of active disease. Upon admission to ED, complete blood count (CBC) analysis showed low red blood count (RBC) (3.76 x1012/L (reference interval (RI) 3.86 – 5.08 x1012/L)), low haemoglobin (Hb) concentration (111 g/L (RI 119 - 157 g/L)) and low haematocrit (Hct) (0.310 L/L (RI 0.360 – 0.470 L/L)). Biochemistry analytes were high, with foremost lactate dehydrogenase (LD) activity (2900 U/L, RI < 240 U/L). After communication with the clinician, methaemoglobin measured in arterial blood gas sample was reported. Patient was admitted to the Intensive care unit and upon reflex testing of haptoglobin, intravascular haemolysis was confirmed. This case indicates that every case of brown coloration of the serum must be promptly communicated to the clinician. Reflex testing assured timely diagnosis and favourable patient outcome.

scholarly journals Is pulse oximeter a reliable tool for non-critically ill patients with COVID-19?

2021 ◽  
Author(s):  
Aslıhan Gürün Kaya ◽  
Miraç Öz ◽  
İREM AKDEMİR KALKAN ◽  
Ezgi Gülten ◽  
güle AYDIN ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Pulse Oximeter ◽  
Lymphocyte Count ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen ◽  
Arterial Blood Gas ◽  
Reactive Protein ◽  
Arterial Blood ◽  
The Difference ◽  
Clinical Conditions

Introduction: Guidelines recommend using a pulse oximeter rather than arterial blood gas (ABG) for COVID-19 patients. However, significant differences can be observed between oxygen saturation measured by pulse oximetry (SpO2) and arterial oxygen saturation (SaO2) in some clinical conditions. We aimed to assess the reliability of pulse oximeter in patients with COVID-19 Methods: We retrospectively reviewed ABG analyses and SpO2 levels measured simultaneously with ABG in patients hospitalized in COVID-19 wards. Results: We categorized total 117 patients into two groups; in whom the difference between SpO2 and SaO2 was 4% (acceptable difference) and >4% (large difference). Large difference group exhibited higher neutrophil count, C-reactive protein, ferritin, fibrinogen, D-dimer and lower lymphocyte count. Multivariate analyses revealed that increased fibrinogen, increased ferritin and decreased lymphocyte count were independent risk factors for large difference between SpO2 and SaO2. The total study group demonstrated the negative bias of 4.02% with the limits of agreement of −9.22% to 1.17%. The bias became significantly higher in patients with higher ferritin, fibrinogen levels and lower lymphocyte count. Conclusion: Pulse oximeters may not be sufficient to assess actual oxygen saturation especially in COVID-19 patients with high ferritin and fibrinogen levels and low lymphocyte count low SpO2 measurements.

An easy method for interpreting the results of arterial blood gas analysis

2001 ◽  
Vol 21 (5) ◽  
pp. 49-54 ◽  
Author(s):  
KM Kirksey ◽  
M Holt-Ashley ◽  
BK Goodroad
Keyword(s):  
Critical Care ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Critical Care Nurses ◽  
Blood Gas ◽  
Easy Method ◽  
Arterial Blood Gas ◽  
Confidence Levels ◽  
Arterial Blood ◽  
Arterial Blood Gas Analysis

Interpretation of acid-base disturbances is an essential skill for critical care nurses. Using the H model makes this process easy. When students and novice critical care nurses feel competent with certain skills, their confidence levels are greatly enhanced. One of us (K.M.K.) has been using the H model for many years to teach students how to interpret the results of arterial blood gas analysis. The students are often amazed at how easy and fun the model makes learning a subject many perceive as complex.

scholarly journals APACHE II score, C-reactive protein and Marshall score in acute pancreatitis. Association with admission at critical care unit. A cohort study

HPB ◽  
2016 ◽  
Vol 18 ◽  
pp. e321-e322
Author(s):  
H. Losada Morales ◽  
A. Troncoso Trujillo ◽  
L. Burgos San Juan ◽  
J. Silva Abarca ◽  
L. Acencio Barrientos ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Critical Care ◽  
Cohort Study ◽  
Critical Care Unit ◽  
Apache Ii ◽  
Apache Ii Score ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Marshall Score

scholarly journals Acidose Tubular Renal Distal: Expressão Clínica Variável na Mesma Família

2019 ◽  
Vol 32 (7-8) ◽  
pp. 542
Author(s):  
Daniela Ramos ◽  
Sofia Reis ◽  
Carolina Cordinhã ◽  
Carmen Do Carmo ◽  
Clara Gomes ◽  
...  
Keyword(s):  
Renal Tubular Acidosis ◽  
Chronic Renal Disease ◽  
Genetic Disorder ◽  
Distal Renal Tubular Acidosis ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
First Case ◽  
Hyperchloremic Metabolic Acidosis ◽  
Renal Tubular

Primary distal renal tubular acidosis is a genetic disorder characterized by the inability in acidification of urine. Symptoms are usually non-specific and highly variable. We described six cases in a family with four generations affected. The first case was diagnosed in a 3-year-old child presenting with hematuria and urolithiasis. Later, his sister, sons and two nephews were studied. Although asymptomatic, they all had nephrocalcinosis and hyperchloremic metabolic acidosis with normal anionic gap, except one case with normal arterial blood gas test but with nephrocalcinosis and inability of urinary acidification. At follow-up, they all maintained nephrocalcinosis, the index case had acute renal damage and developed hypertension, but none developed chronic renal disease. The diagnosis of autosomal dominant distal renal tubular acidosis is generally made later and patients tend to present with milder disease. But the condition may manifest early and have a variable phenotypic severity spectrum. Carrying out screening through assessment of family history enables an earlier diagnosis while also allowing treatment to start sooner.

scholarly journals Clinical profile and short-term outcomes in neonates with septic shock

2019 ◽  
Vol 6 (4) ◽  
pp. 1456
Author(s):  
C. Sai Sujana ◽  
R. J. Meshram ◽  
B. B. Lakhkar
Keyword(s):  
Septic Shock ◽  
Blood Culture ◽  
Early Identification ◽  
Neonatal Intensive Care ◽  
Clinical Profile ◽  
Normal Vaginal Delivery ◽  
High Morbidity ◽  
Short Term ◽  
Arterial Blood Gas ◽  
Arterial Blood

Background: Neonatal sepsis is a syndrome causing severe organ dysfunction triggered by a dysregulated host in response to an infection, affecting millions of neonates. In such situations, early identification and management in the initial hours dramatically improves the outcome. Hence, it was taken up to study the incidence, clinical profile and short-term outcomes of neonates with septic shock.Methods: Hospital based prospective observational study on 95 neonates admitted to neonatal intensive care unit in the department of Paediatrics at Acharya Vinobha Bhave rural hospital, Sawangi, Wardha from 1st August 2016 to 31st July 2018.Neonates diagnosed with septic refractory shock were enrolled after taking IEC approval and assent form and those with non-septic aetiology shock were excluded. Statistical analysis was done to establish correlation between neonatal variables and outcome.Results: 95 neonates fulfilled the inclusion criteria and were recruited. Out of these, 37 and 53 were outborn and inborn respectively. Maximum neonates were preterm and males. Neonates with birth weight 1000-1499 grams to those less than 1000 was 4.2:1. Normal vaginal delivery was more common as compared to lower segment caesarean section (LSCS). Blood culture positivity was in 44.2%. Age of presentation with shock ranged from 1 to 20 days and duration of shock ranged from 2 hours to 192 hours. Most infants were ventilated (84%) and it was more among those who died.Conclusions: Septic shock is the most common type, carrying high morbidity and mortality (more than 60%). Laboratory and clinical parameters (TLC, Platelet count, CRP, Blood culture, duration of shock, HR, RR, BP or arterial blood gas) (p>0.05) did not carry a prognostic value in predicting the outcome of such neonates. Early identification and intervention remains the key in managing such a challenging neonatal condition.

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