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Signa Vitae

Journal of Intensive Care and Emergency Medicine

Month: March 2018 (Page 1 of 4)

Medical emergencies in dental offices in Slovenia and readiness of dentists to handle them

Abstract

Introduction. Dentists, and all other dental healthcare workers, can expect to face a medical emergency directly or indirectly related to dental treatment. This study evaluates the incidence of medical emergencies in dental offices in Slovenia, the readiness of dentists and possession of specific medical equipment.

Methods. An anonymous online based questionnaire was sent through the Medical Chamber of Slovenia via email to all 1503 active dentists in Slovenia. The questionnaire was pilot-tested on 25 dentists and improved accordingly. Thirty closed-ended questions were answered by 289 (19.2 %) dentists.

Results. 93.4 % (n=267) of dentists reported a medical emergency in their dental office. The most prevalent diagnosis was syncope (1.88-2.44/dentist/year) followed by hypoglycaemia (0.20-0.25/dentist/year), hypertensive crisis (0.4/dentists/year) and anaphylaxis (0.3/dentists/year). There were no cardiac arrests reported in the dentists’ entire careers. 85.1 % (n=239) of dentists underwent postgraduate BLS training, 87.4 % (n=209) of them in the last 5 years. Responding dentists estimated that they are most capable of dealing with syncope and least proficient in dealing with stroke, cardiac arrest and a hypertensive crisis. They felt generally more prepared to manage than diagnose a medical emergency. Only 58.1 % (n=161) of dentists have access to a self-inflating bag with a reservoir, and 54.9 % (n=152) to an oxygen mask. Only 4.0 % (n=11) of them have a full set of equipment recommended by Medical Chamber of Slovenia.

Conclusions. Results support modification of the undergraduate and postgraduate curriculum for dental students to address specific medical emergencies and the usage of limited equipment. They support more rigorous regulations concerning postgraduate education and specific equipment for dealing with medical emergencies in dental offices in Slovenia.

Key words: emergencies, dental office, equipment, curriculum

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Treatment of non-oliguric hyperkalaemia with inhaled salbutamol in premature infants with severe respiratory distress syndrome

Abstract

Non-oliguric hyperkalaemia (NOHK) in neonates is defined as a plasma potassium level > 6.5 mmol/L in the presence of urine output ≥ 1 mL/kg/h during the first 72 hours of life. It is characterized by a rapid rise of serum potassium to excessively high values, a high risk of cardiac arrhythmias and no occurrence after 72 hours of birth. NOHK commonly occurs in premature neonates, especially in those with a gestational age <28 weeks, with only a few reports of this entity in moderate or late preterm neonates. The effectiveness and safety of different treatments for NOHK is uncertain and currently there is no firm treatment recommendation. We describe the case of a moderately premature neonate (32+ 2 weeks gestation), with severe neonatal respiratory distress syndrome, who developed NOHK that was treated with inhaled salbutamol. When salbutamol is used for the treatment of NOHK, an initial paradoxical rise in potassium levels should always be taken into account to avoid cardiac arrhythmias.

Key words: non-oliguric hyperkalaemia, premature, infants, salbutamol, hyperkalaemia

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Major differences between conventional and compression-only cardiopulmonary resuscitation

Dear Editor,

I read the article by Skulec et al. “Rescuer fatigue does not correlate to energy expenditure during simulated basic life support,” with great interest. (1) Although conventional cardiopulmonary resuscitation (CCPR) has been considered a standard CPR method since 1960, compression-only CPR (COCPR) has emerged as an alternative method to CCPR because of some evidence favoring COCPR. (2,3)

Therefore, numerous studies have attempted to determine whether COCPR could indeed improve the quality of CPR. A systematic review of these studies confirmed several obvious differences. (4)

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New challenges in hemodynamics and intensive care medicine – 2nd International congress and workshops

University Hospital Dubrava, Zagreb, Croatia, March 8th – 9th 2018

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Intensive care management of patients with left ventricular assist device

Abstract

Mechanical circulatory support devices, especially left ventricular assist devices (LVADs) represent an important treatment modality for patients with end-stage heart failure (HF). In a 1-year period (from January to December 2017) in our intensive care unit (ICU) we had a total of 8 patients with LVAD implantation. LVADs are devices with unique physiology which restore tissue circulation by increasing blood supply, nevertheless, they can be challenging to manage and are associated with significant complications.

Keywords: Critical Care, Heart-Assist Devices, Heart Failure, Hemodynamics, Hemodynamic Monitoring, Cardiac surgery, Postoperative Complications

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