Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Oct 2002
Teaching hospital physicians' skills and knowledge of resuscitation algorithms are deficient.
The resuscitation skills of 78 on-call physicians in a tertiary referral center were evaluated in a simulated sudden cardiac arrest (SCA). ⋯ Regular resuscitation education should be compulsory to all physicians responsible for on-call duties in hospitals. Hospitals should have at least one employee part-time responsible for this duty.
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Acta Anaesthesiol Scand · Oct 2002
Clinical Trial Controlled Clinical TrialThe prognostic value of global haemostatic tests in the intensive care unit setting.
Global haemostatic tests are often abnormal in critically ill patients, secondary to activation or consumption of coagulation factors or inhibitors. Methods for analysing plasma levels of these factors are, however, not widely available, and the predictive value of global tests is not known. We examined the clinical applicability to predict the outcome of the global haemostatic tests used at most hospitals. ⋯ The global haemostatic tests INR and APTT can predict survival in critically ill patients, and prolonged APTT in particular seems to be associated with a negative prognosis.
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Acta Anaesthesiol Scand · Oct 2002
Case ReportsParaplegia associated with combined spinal-epidural anaesthesia caused by preoperatively unrecognized spinal vertebral metastasis.
We describe a case of paraplegia following combined spinal-epidural anaesthesia. It was postoperatively determined that a tumour of the vertebrae which was compressing the spinal cord was responsible for this complication. We suggest that the pre-existing pathology of the spine must be borne in mind as a differential diagnosis of acute postoperative paraplegia.
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Acta Anaesthesiol Scand · Oct 2002
Comparative StudyAcceleromyography of the orbicularis oculi muscle II: comparing the orbicularis oculi and adductor pollicis muscles.
The orbicularis oculi (OO) muscle has been recommended for neuromuscular monitoring when the adductor pollicis (AP) muscle is not available. We investigated whether neuromuscular block could be measured reliably from the orbital part of the OO muscle by the use of acceleromyography. ⋯ A significant clinical disagreement exists between the degree of paralysis measured at the OO and the AP muscles. It is impossible to obtain a reasonable estimate of the degree of block at the AP muscle when the block is measured from the OO muscle with acceleromyography. If used, there is substantial risk of overlooking a residual block, and adequate recovery of the block should be confirmed by a final AP muscle measurement.