scholarly journals Audits of emergency trolleys’ contents in selected hospitals in Botswana

2012 ◽  
Vol 17 (1) ◽  
Author(s):  
Lakshmi Rajeswaran ◽  
Valerie J. Ehlers
Keyword(s):  
Cardiac Arrest ◽  
Emergency Situation ◽  
Hospital Ward ◽  
Equipment And Supplies ◽  
Staff Members ◽  
Cardio Pulmonary Resuscitation ◽  
Government Hospitals ◽  
Life Threatening ◽  
Hospital Wards

Cardiac arrest is a life-threatening emergency situation. The outcome depends on timely and effective cardio-pulmonary resuscitation (CPR). Successful CPR attempts in hospitals require well-equipped emergency trolleys and properly functioning equipment, as well as staff members skilled in performing CPR. The study aimed to determine whether the emergency trolleys in Botswana’s hospitals’ wards or units met the expected standards. The contents of the emergency trolleys in 20 wards or units of two referral government hospitals in Botswana were audited by using a standardised checklist. No hospital ward or unit had all the expected equipment or drugs on its emergency trolley, some units failed to check their emergency trolleys’ contents daily. All 20 hospital wards or units that participated in this study, needed to improve the contents and maintenance of their emergency trolleys, otherwise in-hospital CPR efforts in Botswana might be doomed to failure, losing lives that could have been saved if emergency trolleys’ equipment and supplies had been up to standard.OpsommingHartarres is ‘n lewensbedreigende noodsituasie. Die uitkoms word bepaal deur tydige en effektiewe kardio-pulmonale resussitasie (KPR). Suksesvolle KPR pogings in hospitale vereis goed toegeruste noodtrollies en toerusting wat behoorlik funksioneer, asook personeellede wat bedrewe is in die uitvoering van KPR. Die studie het gepoog om te bepaal of die noodtrollies in Botswana se hospitaalsale of eenhede aan die verwagte standaarde voldoen. Die inhoud van die noodtrollies in 20 sale of enhede van twee van Botswana se hospitale is ge-ouditeer deur ‘n gestandardiseerde kontrolelys te benut. Geen hospitaalsaal of eenheid het al die verwagte toerusting of drogerye op sy noodtrollie gehad nie, sommige eenhede het nie hulle noodtrollies se inhoud gereeld gekontroleer nie. Al 20 hospitaalsale of eenhede wat aan die studie deelgeneem het, moet die inhoud en instandhouding van hulle noodtrollies verbeter, anders kan in-hospitaal KPR pogings in Botswana tot mislukkings gedoem wees, waardeur lewens verloor word wat gered kon gewees het, indien die noodtrollies se inhoud op standaard was.

scholarly journals Considerations on Liver Injuries Caused by CPR Case Presentation

2015 ◽  
Vol 20 (2) ◽  
pp. 104-108
Author(s):  
Beatrice Ioan ◽  
Bianca Hanganu ◽  
Marius Neagu
Keyword(s):  
Cardiac Arrest ◽  
Cardiac Activity ◽  
Cardiac Massage ◽  
Injury Death ◽  
Emergency Team ◽  
Cardio Pulmonary Resuscitation ◽  
Life Saving ◽  
Threatening Condition ◽  
Life Threatening ◽  
Intraperitoneal Bleeding

Cardiac arrest is a life-threatening condition which requires fast maneuvers for saving the victim’s life. Cardio-pulmonary resuscitation (CPR) is one of the easiest and handiest maneuver which proved many times to be savior even though sometimes it could worsen the victim’s prognosis. In this paper the authors present the case of a 75-year old male, with a significant medical history and long term thrombolytic treatment who suffered a witnessed cardiac arrest. The emergency team who arrived at the victim’s home initiated the CPR and transported him to the hospital. The electrocardiogram showed inferior-lateral acute myocardial infarction and the cardiologist in the emergency room decided to transfer him to another hospital for specialized treatment. Despite the fact that the CPR was continued in the ambulance in order to maintain the cardiac activity, the blood pressure decreased gradually and he died couple of hours later. Internal examination at the autospy revealed multiple injuries caused by the cardiac massage: rib and sternum fractures, massive intraperitoneal bleeding, liver laceration and contusion. This paper brings to the attention of the physicians the issue of the iatrogenic injuries following the CPR and the possibility for these injuries to contribute to thanatogenesis. The authors also analyze the factors influencing the quality of the life-saving procedures and the role of the pathologist in establishing the correct cause of death taking into the gravity of the CPR related injuries.Keywords: CPR, liver injury, death

scholarly journals Extracorporeal cardiopulmonary resuscitation for severe chloroquine intoxication in a child – a case report

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Thomas Ferry ◽  
Vivianne Amiet ◽  
Julia Natterer ◽  
Marie-Hélène Perez ◽  
Raymond Pfister ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Cardiac Toxicity ◽  
Experimental Treatment ◽  
Neurological Impairment ◽  
The Novel ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Cardio Pulmonary Resuscitation ◽  
Life Threatening ◽  
Novel Coronavirus

Abstract Background Chloroquine use has increased worldwide recently in the setting of experimental treatment for the novel coronavirus disease (Covid-19). Nevertheless, in case of chloroquine intoxication, it can be life threatening, with cardiac arrest, due to its cardiac toxicity. Case presentation This case study reports on a 14-years-old girl who presented in cardiac arrest after an uncommon suicide attempt by ingesting 3 g of chloroquine. After 66 min of cardio-pulmonary resuscitation (CPR), extracorporeal cardiopulmonary resuscitation (ECPR) was initiated, allowing cardiac function to recover. Conclusions Chloroquine intoxication is a rare but serious condition due to its cardiac toxicity. Use of ECPR in this case of transient toxicity allowed a favorable evolution with little neurological impairment.

scholarly journals Effective control of an acute gastroenteritis outbreak due to norovirus infection in a hospital ward in Athens, Greece, April 2011

2011 ◽  
Vol 16 (28) ◽  
Author(s):  
S P Georgiadou ◽  
D Loukeris ◽  
S Smilakou ◽  
G L Daikos ◽  
N V Sipsas
Keyword(s):  
Infection Control ◽  
Acute Gastroenteritis ◽  
Clinical Symptoms ◽  
Hospital Ward ◽  
Control Measures ◽  
Effective Control ◽  
Gastroenteritis Outbreak ◽  
Staff Members ◽  
Infection Control Measures ◽  
Hospital Wards

In April 2011, an acute gastroenteritis outbreak due to norovirus infection occurred in a hospital ward in Athens, Greece, affecting 28 people: 16 staff members, 10 inpatients and two relatives of symptomatic inpatients. The attack rate among the patients and staff was 16.4% (10/61) and 31.4% (16/51), respectively. The outbreak lasted eight days and the clinical symptoms were mild. Effective infection control measures prevented the spread of the virus to other hospital wards.

viewpoint TIME TO RESTART: PROTOCOL OF RESUMPTION OF ACTIVITIES OF A DERMATOLOGICAL CLINIC OF A LEVEL II HOSPITAL IN THE COVID-19 ERA. (Preprint)

2020 ◽  
Author(s):  
Federico Diotallevi ◽  
Anna Campanati ◽  
Giulia Radi ◽  
Oriana Simonetti ◽  
Emanuela Martina ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
World Health ◽  
New Wave ◽  
Staff Members ◽  
Level Ii ◽  
The World ◽  
Health Organization ◽  
Spread Of Infection ◽  
Hospital Wards ◽  
Medical And Healthcare

UNSTRUCTURED Two months have passed since the World Health Organization (WHO) declared the pandemic of the Coronavirus Disease 19 (COVID-19), caused by the SARS CoV-2 virus, on March 11, 2020. Medical and healthcare workers have continued to be on the frontline to defeat this disease, however, continual changes are being made to their working habits which are proving to be difficult. Since the beginning of the pandemic, a major reorganisation of all hospital wards, including dermatological wards, has been carried out in order to make medical and nursing staff available in COVID wards and to prevent the spread of infection. These strategies, which were also adopted in our clinic, proved to be effective, as no staff members or patients were infected by the virus. Now, thanks to the global decrease in SARS-CovV2 infections, it is necessary to make dermatological wards accessible to patients again, but it is also essential to adopt specific protocols to avoid a new wave of infections.

scholarly journals Profound Hypokalaemia Resulting in Maternal Cardiac Arrest: A Catastrophic Complication of Hyperemesis Gravidarum?

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Anna Walch ◽  
Madeline Duke ◽  
Travis Auty ◽  
Audris Wong
Keyword(s):  
Cardiac Arrest ◽  
Hyperemesis Gravidarum ◽  
Extracellular Fluid ◽  
Nutritional Deficiencies ◽  
Normal Limits ◽  
Life Threatening ◽  
Total Body ◽  
Anuric Renal Failure ◽  
Hospital Cardiac Arrest ◽  
In Pregnancy

We present a case of a 39-year-old G8P6 Pacific Islander woman who at 15+5 weeks’ gestation had an out-of-hospital cardiac arrest secondary to profound hypokalaemia which was associated with severe hyperemesis gravidarum (HG). Her clinical course after arrest was complicated by a second 5-minute cardiac arrest in the Intensive Care Unit (ICU) (pre-arrest potassium 1.8), anuric renal failure requiring dialysis, ischaemic hepatitis, and encephalopathy and unfortunately fetal demise and a spontaneous miscarriage on day 2 of admission. Despite these complications, she was discharged home 4 weeks later with a full recovery. Following a plethora of inpatient and outpatient investigations, the cause of her cardiac arrest was determined to be profound hypokalaemia. The hypokalaemia was presumed second to a perfect storm of HG with subsequent nutritional deficiencies causing electrolyte wasting, extracellular fluid (ECF) volume reduction, and activation of the renin-angiotensin-aldosterone axis (RAAS). This combined with the physiological changes that promote potassium wasting in pregnancy including volume expansion, increased renal blood flow, increased glomerular filtration rate, and increase in cortisol contributed to the patient having a profoundly low total body potassium level. This diagnosis is further strengthened by the fact that her pre- and post-pregnancy potassium levels were within normal limits in the absence of supplementary potassium. This case highlights the potentially life-threatening electrolyte imbalances that can occur with HG and the importance of recognising the disease, comprehensive electrolyte monitoring, and aggressive management in pregnancy.

Effectiveness of a Dispatcher-Assisted Cardiopulmonary Resuscitation Program Developed by the Thailand National Institute of Emergency Medicine (NIEMS)

2021 ◽  
pp. 1-6
Author(s):  
Chuenruthai Angkoontassaneeyarat ◽  
Chaiyaporn Yuksen ◽  
Chetsadakon Jenpanitpong ◽  
Pemika Rukthai ◽  
Marisa Seanpan ◽  
...  
Keyword(s):  
Health Care ◽  
Emergency Medicine ◽  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Health Care Providers ◽  
Care Providers ◽  
Chest Compressions ◽  
Threatening Condition ◽  
Life Threatening

Abstract Background: Out-of-hospital cardiac arrest (OHCA) is a life-threatening condition with an overall survival rate that generally does not exceed 10%. Several factors play essential roles in increasing survival among patients experiencing cardiac arrest outside the hospital. Previous studies have reported that implementing a dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) program increases bystander CPR, quality of chest compressions, and patient survival. This study aimed to assess the effectiveness of a DA-CPR program developed by the Thailand National Institute for Emergency Medicine (NIEMS). Methods: This was an experimental study using a manikin model. The participants comprised both health care providers and non-health care providers aged 18 to 60 years. They were randomly assigned to either the DA-CPR group or the uninstructed CPR (U-CPR) group and performed chest compressions on a manikin model for two minutes. The sequentially numbered, opaque, sealed envelope method was used for randomization in blocks of four with a ratio of 1:1. Results: There were 100 participants in this study (49 in the DA-CPR group and 51 in the U-CPR group). Time to initiate chest compressions was statistically significantly longer in the DA-CPR group than in the U-CPR group (85.82 [SD = 32.54] seconds versus 23.94 [SD = 16.70] seconds; P <.001). However, the CPR instruction did not translate into better performance or quality of chest compressions for the overall sample or for health care or non-health care providers. Conclusion: Those in the CPR-trained group applied chest compressions (initiated CPR) more quickly than those who initiated CPR based upon dispatch-based CPR instructions.

scholarly journals Cardio-pulmonary resuscitation challenges in selected Botswana hospitals: Nurse managers’ views

2013 ◽  
Vol 18 (1) ◽  
Author(s):  
Lakshmi Rajeswaran ◽  
Valerie J. Ehlers
Keyword(s):  
Traffic Accident ◽  
Qualitative Data ◽  
Nurse Managers ◽  
Road Traffic ◽  
Public Hospitals ◽  
Staff Members ◽  
Nursing Experience ◽  
Hospital Units ◽  
Cardio Pulmonary Resuscitation ◽  
Medical Emergencies

Road traffic accident victims, as well as persons experiencing cardiac and other medical emergencies, might lose their lives due to the non-availability of trained personnel to provide effective cardio-pulmonary resuscitation (CPR) with functional equipment and adequate resources. The objectives of the study were to identify unit managers’ perceptions about challenges encountered when performing CPR interventions in the two referral public hospitals in Botswana. These results could be used to recommend more effective CPR strategies for Botswana’s hospitals. Interviews, comprising two quantitative sections with closed ended questions and one qualitative section with semi-structured questions, were conducted with 22 unit managers. The quantitative data indicated that all unit managers had at least eight years’ nursing experience, and could identify CPR shortcomings in their hospitals. Only one interviewee had never performed CPR. The qualitative data analysis revealed that the hospital units sometimes had too few staff members and did not have fully equipped emergency trolleys and/or equipment. No CPR teams and no CPR policies and guidelines existed. Nurses and doctors reportedly lacked CPR knowledge and skills. No debriefing services were provided after CPR encounters. The participating hospitals should address the following challenges that might affect CPR outcomes: shortages of staff, overpopulation of hospital units, shortcomings of the emergency trolleys and CPR equipment, absence of CPR policies and guidelines, absence of CPR teams, limited CPR competencies of doctors and nurses and the lack of debriefing sessions after CPR attempts.Die slagoffers van padongelukke, asook persone wat hart- en ander mediese noodtoestande ervaar, kan hulle lewens verloor omdat daar nie opgeleide personeel met funksionele toerusting en voldoende hulpbronne beskikbaar is om effektiewe kardiopulmonale resussitasie (KPR) te doen nie. Die studie het ten doel gehad om eenheidsbestuurders se persepsies te bepaal oor uitdagings wat hulle in die gesig staan wanneer KPR-tussentredes plaasvind in die twee openbare hospitale in Botswana wat as verwysingshospitale dien. Die bevindings kan gebruik word om effektiewer KPR-strategieë vir Botswana se hospitale aan te beveel. Onderhoude bestaande uit twee kwantitatiewe afdelings met geslote vrae en een kwalitatiewe afdeling met semi-gestruktureerde vrae is met 22 eenheidsbestuurders gevoer. Die kwantitatiewe data het aangedui dat alle eenheidsbestuurders minstens agt jaar se verpleegervaring het en dat hulle die tekortkomings sover dit KPR in hulle hospitale aangaan, kon identifiseer. Slegs een persoon het nog nooit KPR toegepas nie. Die ontleding van die kwalitatiewe data dui daarop dat hospitaaleenhede soms te min personeel het en dat hulle nie ten volle toegeruste noodtrollies en/of toerusting het nie. Geen KPR-spanne en geen KPR-beleid of -riglyne bestaan nie. Verpleegkundiges en dokters het volgens die onderhoude ‘n gebrek aan KPR-kennis en -vaardighede. Geen ontlontingsdienste is na KPR-voorvalle vir die personeel beskikbaar nie. Die deelnemende hospitale behoort die uitdagings aan te spreek wat KPR-uitkomste kan beinvloed. Hierdie uitdagings sluit in personeeltekorte, oorbesetting in hospitaaleenhede, tekortkomings in die noodtrollies en toerusting, die gebrek aan KPR-beleid en -riglyne, die afwesigheid van KPR-spanne, dokters en verpleegsters se beperkte KPR-vaardighede en die feit dat ontlontingsdienste nie na KPR-pogings vir personeellede beskikbaar is nie.

scholarly journals Head-down tilt position successfully prevent severe brain air embolism

2018 ◽  
Vol 6 ◽  
pp. 2050313X1880926 ◽  
Author(s):  
Gaku Yamaguchi ◽  
Hiroyuki Miura ◽  
Eiji Nakajima ◽  
Norihiko Ikeda
Keyword(s):  
Cardiac Arrest ◽  
Low Temperature ◽  
Brain Damage ◽  
Air Embolism ◽  
Cardiac Massage ◽  
Open Chest ◽  
Successful Recovery ◽  
Life Threatening ◽  
Margin Detection ◽  
Air Embolus

Air embolisms are rare life-threatening complications that develop under various conditions, including surgery. During segmentectomy for thoracic surgery, air is blown into the selected bronchus for segment margin detection. This may result in the formation of an air embolus. Herein, we report a case of successful recovery from sudden intraoperative cardiac arrest due to an air embolism in a patient undergoing left superior division segmentectomy via open thoracotomy. Intraoperatively, the patient was positioned head-down. Upon blowing air into the bronchus, the patient suddenly developed cardiac arrest. Open-chest cardiac massage and low-temperature therapy were commenced and the patient recovered. The head-down position prevents the air embolus from reaching the brain and thus prevents severe brain damage, whereas continuous open-chest massage and low temperature prevents severe body damage from anticipated cardiac air embolism. Thus, operation in the head-down position is useful in preventing severe brain damage from brain air embolisms.

scholarly journals Cardiac Arrest Secondary to Bilateral Pulmonary Emboli following Arteriovenous Fistula Thrombectomy: A Case Report with Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Avni Shah ◽  
Naheed Ansari ◽  
Zaher Hamadeh
Keyword(s):  
Cardiac Arrest ◽  
Arteriovenous Fistula ◽  
Pulmonary Emboli ◽  
Hemodialysis Access ◽  
Number Of Patients ◽  
Life Threatening ◽  
Timely Fashion ◽  
Pulmonary Embolization ◽  
Stage Renal Disease ◽  
End Stage

Number of patients with End Stage Renal Disease (ESRD) is growing worldwide. Hemodialysis remains the main modality of renal replacement therapy for ESRD patients. A patent hemodialysis access (arteriovenous fistula or arteriovenous graft) plays a key role in successful delivery of hemodialysis. Common vascular access issues encountered by patients and nephrologists are thrombosis and infection. The thrombosed access is declotted by various percutaneous techniques these days by multiple outpatient access centers in a timely fashion. Thrombolysis can give rise to various complications, a few of which can be life threatening. A young hemodialysis patient underwent percutaneous thrombolysis of his clotted arteriovenous fistula. Outpatient access thrombectomy was complicated immediately afterwards with cardiac arrest requiring cardiac resuscitation in the recovery room. The patient was admitted to intensive care unit after life sustaining care. Work up revealed multiple pulmonary emboli to both lung fields on CT scan of the chest. Patient was anticoagulated and discharged from the hospital. Thrombolysis of clotted hemodialysis access is associated commonly with occurrences of pulmonary embolic which are usually asymptomatic. Massive pulmonary embolization due to access thrombolysis is rare. Nephrologists and radiologists should be aware of this dangerous complication particularly in patients with preexisting cardiopulmonary disease.

History and experience of a volunteer ambulance first responder scheme in London

2021 ◽  
Vol 13 (8) ◽  
pp. 344-348
Author(s):  
Saman Al-Sahab ◽  
Aditi Nijhawan ◽  
Tim Kirkby ◽  
Shadman Aziz
Keyword(s):  
Cardiac Arrest ◽  
Blue Light ◽  
Response Times ◽  
Ambulance Service ◽  
First Responder ◽  
Emergency Responders ◽  
Life Saving ◽  
Wide Range ◽  
Life Threatening ◽  
Set Up

Emergency responders (ERs) are volunteers who attend category 1 (immediately life-threatening) and category 2 (emergency) 999 calls on behalf of the London Ambulance Service NHS Trust (LAS). ERs aim to arrive first on scene to these incidents to provide essential life-saving interventions prior to the arrival of further ambulance resources. ERs come from a wide range of backgrounds and undergo a thorough selection, training and mentorship process before advancing to working in a two-person ER crew. Compared to most traditional volunteer first responder schemes, the LAS ER scheme, which was set up in 2008, involves an enhanced skillset, dispatch to medical and traumatic emergencies in addition to cardiac arrest, and the use of blue-light vehicles to reduce response times. Over a period of 13 years, the scheme has grown in scope and size, and now operates with more than 120 volunteers based at seven ambulance stations across London.

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