The aim of this study was to evaluate resuscitation skills and knowledge of the nursing staff of University Hospital “AHEPA”, who have previously successfully participated in a validated training CPR/AED course, held in ourhospital.In our study 60 professionally active nurses were involved. After completion of a predesigned questionnaire, they were expected to respond to a simulated cardiac arrest-CA scenario in an area where automated external defibrillation-AED was available. The questionnaire consisted of several questions regarding demographic data, participant’s personal opinion on the resuscitation training program, CPR performance and nurse’s attitudes when facing a CA. Participants were evaluated according to the European Resuscitation Council assessment form for basic life support-BLS with the use of AED (consisting of performance in 17 skills).The vast majority of the study population were female nurses (86.7% and 83.3% respectively), 41-50 years old (70%) with more than 21years working experience (53.3%).
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The Fontan procedure and its modifications is the definitive therapy for a number of congenital heart diseases. Anesthesia for semi-elective Caeserian section in a pregnant woman with a history of such surgery history can be a real challenge due to probability of high perioperative morbidity and mortality. We present the anesthetic management of a young parturient with a history of a partially repaired complex cyanotic congenital heart disease and perform a literature review.
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Acute Chest Syndrome (ACS) is a rare but often fatal complication in patients with micro-drepanocytic anemia as in those with beta Sickle Cell Disease (SCD). This case report refers to a female patient with known micro-drepanocytic anemia who was admitted to our ICU due to ACS. Treatment included RBC transfusions with WBC reduction, administration of FFP and plasmapheresis within 48 hours from the ICU admission. At the 3rd ICU day, HbA2 level was found elevated up to 77%. The following ICU days, the patient presented absence of the white series of the blood’s cellular components. After twelve days in the ICU the patient died due to hemodynamic shock and herniation of the brain stem. Given that sickle cell crises are potential precursors of this deadly syndrome, everyday practice should prioritize the prevention of sickle cell crises developing into ACS.
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Neurologic complications after liver transplantation are quite common, with central pontine myelinolysis (CPM) being a rare but fatal complication. In this report, we describe the case of female liver transplant recipient who developed CPM after orthotopic liver transplantation (OLT).A 62-year old woman was admitted to the ICU for postoperative recovery after OLT. The procedure was described as uneventful. The patient had a history of decompensated cirrhosis, tension ascites, class I hepatic encephalopathy and chronic hyponatremia which necessitated repeated hospitalizations in the year prior to transplantation.The patient was unable to be weaned from ventilator support and did not show an improvement in mental status (GCS=5) despite the cessation of sedation. After neurologic consultation, a brain MRI was performed which showed evidence of CPM in the pons. Despite supportive therapy, the patient did not show an improvement of mental status and after a 55-day hospitalization in the ICU she died from septic complications.The etiology of CPM is multifactorial, with liver transplant recipients being at an increased risk. Supportive treatment is the standard of care, and there are not enough evidence supporting other types of treatment.
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- Letter from the Editors
- Fascia Iliaca Block (FIB) in elderly patients outside the operating room for pain management of proximal femur fractures.
- Can we predict a difficult airway? review of the literature
- Combination of Oral Tramadol and Midazolam versus Midazolam alone as a premedication in children undergoing adenotonsillectomy
- Immediate postoperative complications in kidney transplant recipients requiring ICU admission: A 20-year study
- Meningitis treatment through an epidural catheter. Case report
- Primary malignant schwannoma of the brachial plexus causing monoplegia
Dear collegues,
On behalf of the editorial board of the Greek e-Journal of Perioperative Medicine with great pleasure we welcome you to our new website www.e-journal.gr. This website was created in order to enlarge and modernize our e-journal. We would like to inform you that the Greek e-Journal of Perioperative Medicine is the electronic version of the official publication of “The Society of Anesthesiology and Intensive Medicine of Northern Greece” (ISSN 1109 – 6888). It has recognized by the Ministry of Health among the National Scientific Journals (FEK 964/20-7-2006). Publications in the journal are copyrighted. In this open access e-journal, material submitted for publication include: Editorial articles, Special articles, Clinical studies, Experimental studies, Case reports, and Correspondence letters to the editors in the field of Perioperative Care, Anesthesia, Critical care and Emergency Medicine.
Recently, our e-journal has officially accepted by the following medical libraries: DRJI – Directory of Research Journal Indexing, Journal Index.net, Medical Journal Link, ResearchBib. The 2013 Impact Factor for the journal The Greek e–journal of Perioperative Medicine is 0.638.
In this effort and following the rapid evolution of medicine and technology and always with the full support of The Society of Anesthesiology and Intensive Medicine of Northern… Continue reading
Fractures of the proximal femur are of the most frequent, especially in elderly patients. The increased frequency of these fractures highlights the need for effective management of those patients and the impact of these fractures regarding the cost to the national health system. The effects of pain in elderly patients is extremely aggravating, frequently leading to mental (confusion, delirium) and physical (cardiovascular) deterioration and complications.
The pain management of these patients in the emergency department (ED) with intravenous administered analgesics might complicate the status of these patients. The use of non-steroidal anti-inflammatory drugs (NSAID’s) might increase the risk of gastric ulceration, gastric haemorrhage and coronary syndromes, while the use of IV opioids–especially in elderly-incorporates the risk of respiratory depression, delirium, hypotension and constipation. The pain management of these patients with the use of fascia iliaca block applied in ED, or even in a prehospital setting from doctors of various specialties, paramedics or nurses seems to gain acceptance because of its steep learning curve, the simple technique, the high success rate and the low rate of significant complications.
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Difficulties or failure in airway management are common factors leading to death and brain damage as a direct result of anesthesia. Prediction of the difficult airway enables the anesthetists to prepare for this challenging clinical scenario. Although the ability to predict accurately a difficult airway preoperatively would be of great value, it is evident from the literature that no single airway assessment can reliably predict a difficult airway. The purpose of this paper is to define the difficult airway and to review the current literature on methods used for prediction of difficult airway.
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The aim of this study was to compare the combination of oral tramadol and midazolam to oral midazolam alone, in children undergoing adenotonsillectomy, as an oral premedication, regarding also sedation and postoperative pain relief. Sixty children selected for elective adenotonsillectomy were enrolled in this randomized, controlled prospective study. Patients were randomly allocated into two groups. Group M (n=30) received 0.5 mg.kg-1 oral midazolam and group MT (n=30) received 0.2 mg.kg-1 oral midazolam with 1 mg.kg-1 oral tramadol as a premedication 30min preoperatively. Standard general anesthesia technique was used.
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This study was undertaken to evaluate the immediate postoperative complications in renal transplant recipients requiring Intensive Care Unit (ICU) admission. All renal transplant recipients with immediate post-transplantation complications (<1 week) admitted to our ICU from 1992 to 2012 were studied. Patients’ characteristics, transplant variables and prognosis were evaluated and data were analyzed to identify factors of outcome. Over the study period 13 men and 3 women, (26.2 % of renal transplant recipients requiring ICU admission) aged 45.4±10 years, were included in the study. APACHE II and SOFA scores on ICU admission were 17.8±4.6 and 8.4±3.6 respectively.
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