Ugeskrift for laeger
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Ugeskrift for laeger · Jun 1990
[Intensified prehospital treatment of heart arrest increases the number of survivors with good cerebral function].
Psychological assessment in the form of a test for dementia was carried out in 69 individuals. Thirty of these were survivors of cardiac arrest outside hospital. ⋯ The result of the investigation demonstrates that the more intensive the prehospital treatment of cardiac arrest, the more patients survive with good cerebral function. In particular, the percentage of cerebral damage was least in cases where a medically staffed ambulance was employed.
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Ugeskrift for laeger · Jun 1990
Case Reports[Proximal bilateral humeral fractures with posterior dislocation of the head of the humerus].
Seizures as the cause of skeletal fractures are well recognized. The commonest is fracture of the humerus. Bilateral fractures are rare and extremely rare in combination with posterior dislocation of the shoulder joint. ⋯ The mechanism of the injury is described and the treatment discussed. Regardless of the method of primary reposition employed, no difference in the subsequent joint function appears to be observed. Nevertheless, recognition of the condition and early reduction are of importance for the result.
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Ugeskrift for laeger · Jun 1990
[Continuous subcutaneous morphine--treatment of pain in patients with terminal cancer].
Nine patients with terminal cancer were treated for pain with continuous subcutaneous injection of morphine via a portable battery-driven injection pump. Treatment was instituted on account of failure of other forms of treatment with oral or epidural morphine derivatives or on account of severe nausea and vomiting which necessitated parenteral administration. ⋯ Two of the patients could be treated in their homes. The method is thus considered as suitable for treatment of pain in patients with terminal cancer.
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The three main nerves from the lumbar plexus may be blocked by injection of local anesthetic into the facial envelope of the femoral nerve ("three-in-one block"). The femoral nerve may be localized by obtaining paresthesia, by employing a nerve stimulator or by the loss of resistance technique. ⋯ The "three-in-one block" may be employed for immediately pain relief of pain and for treatment of postoperative pain from fractures in the hip, femur and knee. Introduction of a catheter into the femoral nerve sheath is recommended to provide continuous block of the lumbar plexus for relief of postoperative pain.
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In perioperative hypothermia, a central temperature of less than 36 degrees C develops in connection with anaesthesia and operation. Perioperative hypothermia constitutes a daily problem which results in increased morbidity and mortality in risk groups. The influence of anaesthetic agents on temperature regulation is reviewed. ⋯ The risk groups and prophylactic methods for hypothermia are mentioned. Higher temperatures in the anaesthetic room, prewarming of infusion fluids and employment of infusion warmers should be employed with all anaesthetics. In patients in risk groups, extensive employment of combined methods of prevention of hypothermia is recommended.