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Secondary pyomyositis complicated by septic shock and sepsis-induced cardiomyopathy causing a massive erector spinae abscess in a patient after trigger point injection

Authors: Uwen Yeap, Yuto Makino, Kenji Sugimoto

Abstract Trigger point injection is a common pain control method widely practiced around the world. We report the case of a 53-year-old female who presented with lumbago and septic shock complicated with sepsis-induced cardiomyopathy three days after receiving a trigger point injection. She responded to sepsis treatment and empiric antibiotics but later required extensive drainage […]

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Post-surgical right coronary artery injury secondary to tricuspid valve repair

Authors: Andrés Parisi, Ying Tung Sia

Abstract Injury to the right coronary artery (RCA) is a rare complication of tricuspid annuloplasty. We report a 64-year-old woman with history of valvular heart disease that was admitted for decompensated right heart failure. The patient underwent aortic valve replacement and tricuspid annuloplasty. Shortly after tricuspid annuloplasty the patient developed right ventricular (RV) infarction with […]

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Intubation practices at Wellington Hospital Emergency Department: an eight month retrospective observational study

Authors: Kate Barnett, Ross Freebairn, Saptarshi Mukerji, Christopher Poynter, Louise Poynton, Christopher White

Abstract Objective: To determine the rate of intubations carried out in Wellington Hospital Emergency Department (tertiary hospital), New Zealand, to provide a description of intubating habits of clinicians including operator experience and methods, and to determine the rate of complications. Design: Eight month, retrospective, observational study. Setting: Wellington Hospital Emergency Department(WHED). Location: New Zealand. Patients […]

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Late pacemaker perforation of the right ventricle. A case report and review of diagnosis and management

Authors: Vivian Shokry, Ehab Gamil Daoud

Abstract Objectives: Pacemaker incidence and prevalence are on the rise over the last decade especially in the elderly population. Though complications are rare, most reported literature is about early pacemaker complication. Late complications are also reported, but mostly regarding malfunction or infections. Very few case reports and series report late cardiac perforations which could be […]

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Anticholinergic drug-induced benign unilateral anisocoria: common, but frequently overlooked side effect

Authors: Gaurav Gheewala, Salim Surani, Rizwan Ishtiaq, Sneha Reddy, Iqbal Ratnani

Abstract Sudden anisocoria have always been ominous signs among critically ill patients, which requires prompt attention. There are various causes of anisocoria, which call for comprehensive evaluation to rule out neurologic causes such as Adie’s pupil, uncal herniation, compression of third cranial nerve, meningeal irritation, and seizures as opposed to the pharmacological causes such as […]

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The optimal ICU organizational structure

Authors: Paul E. Marik, Joseph Varon

A variety of intensive care units (ICU) staffing models exist, which to a large extent are based on local practice and economic factors rather than cost-effectiveness and the quality of care delivered. The organizational structure of ICU in the United States are usually classified according to two types of models, namely a low- or high […]

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Toward having safe environment in critical care units: a multisite study

Authors: Loai Abu Sharour, Khaled Suleiman, Suhair Al-Ghabeesh

Abstract Objective: This study was conducted to assess the safety culture in Jordanian intensive care units. Design: The study was descriptive, cross-sectional design, and multisite. Setting: The Safety Attitude Questionnaire-Intensive Care Unit (SAQ-ICU) version was utilized. Three hundred completed questionnaires were returned from four critical care units. Results: The results offered a fundamental element for […]

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Case series: two cases of life threatening dynamic airway obstruction from thyroid mass

Authors: Yeeshay Lee, Haozheng Wong, Sing Chee Tan, Rana Muhammad Habibullah, Yoke Yeow Yap, Faheem Khan, Chee Keat Tan

Abstract We present 2 cases of dynamic airway obstruction with respiratory failure leading to cardiac arrest. Both have significant aetiology of cystic thyroid mass with sudden haemorrhagic changes leading to airway obstruction. We discuss the plausible pathophysiology leading to cardiopulmonary compromise where tracheobronchomalacia (TBM) and excessive dynamic airway collapse (EDAC) play a significant role. We […]

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Barriers to effective in-hospital resuscitation: lessons learned during implementation of a hospital-wide code system

Authors: Sharon Einav, Nechama Kaufman, Joseph Varon

Abstract Aims and objectives: To understand the barriers involved in effecting a hospital-wide code system and overcoming them during implementation. Background: Improving survival after in-hospital cardiac arrest involves standardization of both defibrillation equipment and staff’s abilities during codes. Design: Observational descriptive study. Methods: Observational study of the situation existing before implementation of an effective in-hospital […]

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Medication incompatibility in intravenous lines in a Paediatric Intensive Care Unit (PICU) of Indonesian hospital

Authors: Suci Hanifah, Patrick Ball, Ross Kennedy

Abstract Objectives: Currently, little is documented concerning the patterns of multiple concurrent medication use utilising single intravenous line. The in-line compatibility issues in Paediatric Intensive Care Units (PICUs) are not as well documented as in adult patients either. This study closely examined the combination of medications used concurrently in a PICU, recorded how medications were […]

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Association of vitamin D plasma concentration with the severity of illness among children with sepsis treated in Pediatric Intensive Care Unit

Authors: Dyah Kanya Wati, Putu Mas Vina Paramitha Cempaka, I Nyoman Budi Hartawan, Ida Bagus Suparyatha

Abstract Objective: To investigate whether vitamin D plasma concentration correlated with the severity of illness in sepsis children treated in a Pediatric Intensive Care Unit (PICU). Design: This was a cross sectional study. Settings: Pediatric Intensive Care Unit of Sanglah Hospital Denpasar, Bali, in May to November 2016. Patients and participants: Samples were patients aged […]

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SARS 15 years on – My reflection on how to motivate your team to overcome the crisis?

Authors: Dessmon YH Tai

Severe acute respiratory syndrome (SARS) was a new infectious disease that emerged in mid-November 2003 in Guangdong, southern China. By the time this global pandemic was declared contained on 5 July 2003 by WHO, it had afflicted 8090 patients in 29 countries. No other disease had such a phenomenal impact on healthcare workers (HCWs), as […]

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Cardiac tamponade in acute necrotising pancreatitis

Authors: Christopher Thong, Jolene Loi, Bryan Chong, Lu Hern Goh

Abstract Objective: This case report highlights cardiac tamponade as a potentially significant complication of severe acute pancreatitis. Settings: This patient was admitted to the Ng Teng Fong general hospital emergency department. He was subsequently admitted to the Intensive Care Unit (ICU) in the same hospital. Patients: A 58-year-old male presented with severe acute gallstone pancreatitis […]

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Respiratory arrest following CT guided selective cervical nerve root injection

Authors: Arran Keir, Umesh C. Pandey, Thomas Cheri, Ross Freebairn

CT guided cervical nerve root injection is performed for diagnostic purposes or to reduce inflammation and pain in cervical radiculopathy. Steroid and local anaesthetic are injected under CT guidance around the nerve root. This is performed as an outpatient procedure with most patients being able to be discharged 15-30 mins after the procedure. CT guidance […]

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