Delayed diagnosis of right ventricle perforation after blind needle pericardiocentesis

A case of right ventricle perforation in a 63-year old man after blind needle pericardiocentesis for pericardial effusion is presented, focusing on the delayed diagnosis of this serious complication. During surgical repair, the pigtail catheter was found to enter the right ventricle with its tip resting within the pulmonary artery

Making clinical skills education real - Transition from simulation to ward

Transition from classical clinical skills teaching to simulation-based training has contributed to better medical education. However, a gap still exists between Clinical Skills Lab (CSL) training and the clinical setting. In response, the Transition Programme from CSL to Clinical Reality Setting was designed and implemented in the Medical School of AUTH

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine

[This corrects the article DOI: 10.1186/s13054-016-1208-6.]

Feasibility of flexible lightwand-guided tracheal intubation with the intubating laryngeal mask during out-of-hospital cardiopulmonary resuscitation by an emergency physician

Background and objective: We tested the feasibility of using the intubating laryngeal mask airway Fastrach(TM) (ILMA) as a ventilatory device and for flexible lightwand-guided tracheal intubation for out-of-hospital cardiopulmonary resuscitation by an emergency physician.\ud \ud Methods: After completion of a training programme, a single experienced emergency physician used the technique for all patients requiring out-of-hospital tracheal intubation over a 10-month period. If access to the head and neck was limited, the intubating laryngeal mask airway was inserted from below and to the side, otherwise it was inserted from above the head. Data about the time for the ambulance to reach the patient, whether or not access to the head and neck was limited, whether or not circulation was successfully restored, and the insertion and intubation success rates were noted.\ud \ud Results: The mean (range) time for the ambulance to reach the patient was 12 (10-20) min. Access to the head and neck was limited in 8/37 (22%). Circulation was successfully restored in 10/37 (27%). The intubating laryngeal mask airway was successfully inserted at the first attempt in 35/37 (95%) and at the second attempt in 2/37 (5%). The tracheal tube was successfully inserted in 25/37 (67.5%) at the first attempt, 7/37 (19%) at the second attempt and 5/37 (13.5%) at the third attempt. There were no overall failures for intubating laryngeal mask airway insertion or tracheal intubation. There were no differences in success rate between positions. Oesophageal intubation was detected and corrected in 2/37 (5%).\ud \ud Conclusion: The intubating laryngeal mask airway has a high success rate as a ventilatory device and as a flexible lightwand-guided airway intubator during out-of-hospital cardiopulmonary resuscitation by a well-trained emergency physician. This technique may be particularly useful when there is limited access to the head and neck

Electrodermal Activity during Blood Pooling for Arterial Blood Gases Analysis in Sedated Adult Intensive Care Unit Patients

Electrodermal activity (EDA) is considered a measure of autonomous nervous system activity. This study performed an exploratory analysis of the EDA changes during blood pooling for arterial blood gas analysis in sedated adult critical care patients and correlated the variations to other monitored parameters. EDA, along with other parameters, were monitored during 4 h routine daytime intensive care nursing and treatment in an adult ICU. 4 h measurements were divided into two groups based upon the sedation level. Selected recordings before and after blood pooling for arterial blood gases analysis (stress event) was performed. Nine stress events from Group A and 17 from Group B were included for further analysis. Patients’ demographics, laboratory exams, and severity scores were recorded. For both sedation levels, EDA changes are much greater than any other monitoring parameters used. The changes are noticed in both measurement (15 s and 60 s), even though in the 60 s measurement only selected EDA parameters are significantly changed after the start of the procedure. EDA measurements are more sensitive to a given stress event than cardiovascular or respiratory parameters. However, the present results could only be considered as a pilot study. More studies are needed in order to identify the real stress-load and clinical significance of such stimuli, which are considered otherwise painless in those patients