The electrical properties of the skin, also known as electrodermal activity (EDA), are considered as an indirect measure of autonomous nervous system. Along with that, the effects of noise-induced stress in intensive care units, is well explored. This study explores the noise-induced acute electrodermal activity changes in adult critical care patients and to compare these changes with cardiovascular effects of the same stress (noise) stimulus. Skin conductance variability, noise level, selected hemodynamic and respiratory parameters were monitored during 4 hour routine daytime intensive care nursing and treatment in an adult Intensive Care Unit. Average ambient noise levels during the time window (4 min) before the stimulation were 54.33(2.65) dB for Group A and 55.65(3.31) dB, while the noise stimulation was on average for Group A 70.8 (1.98) dB, and for Group B: 71.31(3.31) dB. EDA changes to noise stimulus were more distinct than hemodynamic and respiratory parameters. Yet, a weak relation was found between all EDA parameters and the particular noise level changes. Noise-induce stress causes more distinct EDA changes when measured immediately post stimulus. In addition, sedation level seems to affect the intensity of these changes. However, further studies are needed in to order to reach a definite conclusion. Continue reading
The case of a 33y old man is presented, who after a car accident, was transferred to the ED with a right hip dislocation and slightly obtunded but in a stable hemodynamic condition. After an emergent CT scan, a thoracic aortic rupture along with intestine rupture and retroperitoneal hematoma were noted. The patient was administered 1 g tranexamic acid (TXA) and 1 g fibrinogen concentrate (FC) preoperatively and then was transferred to the OR, where primarily, under monitored anesthetic care (MAC) the aortic trauma was restored intraluminally and then, under general anesthesia, he underwent laparotomy and hip dislocation reduction. During operation, no diffuse bleeding was noted, nor was any transfusion of blood or blood product necessary. After a short ICU stay the patient was discharged in good general health state. The aim of this case report is to present a case of traumatic aortic rupture bleeding, effectively managed with prophylactic tranexamic acid (TXA) and fibrinogen concentrate (FC) administration without need of any kind of transfusion. Continue reading
- Γράμμα από τη Σύνταξη.
- Politics and Safety: Health Care for Immigrants.
- Διαχείριση υγρών στη μαιευτική αναισθησία.
- The effect of PEEP on the right ventricle. A transeosophageal echocardiography and tissue Doppler study.
- Διαχείριση προνοσοκομειακών περιστατικών από διασώστες. Πρόδρομη ανάλυση 1010 περιστατικών από τη Βόρεια Ελλάδα.
- Central Venous Catheter malposition. Case report and short review of the literature.
In this issue of the Greek e-journal of Perioperative Medicine for 2018 there is a wide coverage of interest in scientific articles.
The review article of Passakiotou M describes the safety and policy concerning the public health consequences of the massive arrival of migrants from various parts of the world, which puts the national health systems under pressure. The article emphasizes in public health interventions and intersectoral and international collaboration in order the arrived migrants and refugees to receive a more systematic health-reception which also will protect the public health of host countries.
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Europe is currently experiencing an unprecedented influx of refugees, asylum seekers and other migrants. More than 1.5 million people arrived in the European Union (EU) and European Economic Area (EEA) in 2015, fleeing countries affected by war, conflict or economic crisis. Member States are increasingly faced with the need to address the public health consequences of this massive arrival of migrants from various parts of the world, which puts national health systems under pressure.
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Current evidence suggests that the combination of fluid administration and vasoconstrictive medications should be the main strategy for prevention and management of hypotension accompanying neuraxial anesthesia procedures during cesarean section. Research is still underway in relation to the most appropriate timing for fluid administration, the most appropriate fluid volume as well as the type of fluid that should be administered.
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The aim of this study was to determine how low and moderate levels of PEEP affect right ventricular structure and function.
The study involved 14 patients under mechanical ventilation (pressure controlled). To perform the study, we used transesophageal echocardiography (M-mode, two-dimensional,tissue Doppler) and 10 parameters were recorded. Measurements were performed initially with PEEP 0 cmΗ2Ο, then 10 minutes after applying PEEP 5cmΗ2Ο and 10 minutes after applying PEEP 10cmΗ2Ο.
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This is the first study in Greece that aims prehospital care by Emergency Medical Services staff and the factors that affecting it. In a prospective 5 month survey study , 13 EMTs recorded data (45 variables) about 1450 cases;1010 of which were included for further analysis. Six (6%) of the cases were characterized as super-emergencies, 46% non-emergent and 35% as emergent. Fourty five (45%) of the cases were recorded in the 15.00-23.00 shift. Geographical distribution of the calls is very different from the pre-located ambulance bases and varies with the type (non-urgent/ urgent) of the call. In 152 the characterization of the call was changed after arrival on the spot.
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Central venous catheters (CVC) are an extremely usefull tool in clinical medicine. Yet, its placement and use is not without complication. In the present paper, a case report of Central venous catheter malposition is presented.
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Η συντακτική ομάδα του περιοδικού βρίσκεται στην ευχάριστη θέση να ανακοινώνει και για το 2018 την αναβάθμιση του συντελεστή απήχησης (Impact Factor).
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