Acta clinica Croatica
-
Acta clinica Croatica · Apr 2023
OPTIMIZATION OF PRE-HOSPITAL FIRST AID MANAGEMENT STRATEGIES FOR PATIENTS WITH INFECTIOUS DISEASES IN HUIZHOU CITY USING DEEP LEARNING ALGORITHM.
The aim of the study was to optimize the pre-hospital first aid management strategy for patients with infectious diseases in Huizhou city, which is expected to provide a basis for the epidemic prevention and control, to save lives, and increase the pre-hospital first aid efficiency. At the Department of Emergency, Huizhou Third People's Hospital as the research subject, the common pre-hospital first aid procedure for infectious diseases was identified. The Petri net was used to model and determine the execution time of each link of the pre-hospital first aid process. ⋯ In terms of the emergency path, deep learning was combined with the reinforcement learning model to construct the reinforcement learning model for ambulance path planning. Isomorphic Markov chain analysis revealed that the patient status when returning to the hospital, the time needed for the ambulance to come to designated location, and the on-site treatment were the main problems in the first aid process, and the time needed for the pre-hospital first aid process was reduced by 25.17% after optimization. In conclusion, Petri net and isomorphic Markov chain can optimize the pre-hospital first aid management strategies for patients with infectious diseases, and the use of deep learning algorithm can effectively plan the emergency path, achieving intelligent and informationalized pre-hospital transfer, which provides a basis for reducing the suffering, mortality, and disability rate of patients with infectious diseases.
-
Acta clinica Croatica · Apr 2023
ASSESSMENT OF STANDARD ANTHROPOMETRIC AIRWAY CHARACTERISTICS RELEVANT FOR AIRWAY MANAGEMENT OF PATIENTS WITH OBSTRUCTIVE SLEEP APNEA SYNDROME DURING SLEEP BREATHING DISORDER SURGERY: A RETROSPECTIVE, SINGLE CENTER STUDY.
The aim of this study was to explore standard anthropometric airway characteristics of patients with obstructive sleep apnea syndrome (OSAS) and determine the incidence and risk factors for difficult airway management. Final analysis included 91 patients with polysomnography-verified diagnosis of OSAS who underwent sleep breathing disorder surgery under general anesthesia with direct laryngoscopy oroendotracheal intubation. The incidence of difficult manual mask ventilation during anesthesia induction, difficult intubation and immediate postextubation respiratory complications was 17.6%, 7.7% and 7.7%, respectively. ⋯ The OSAS patients with difficult intubation had more Cormack-Lehane score ≥3 (p=0.002) in comparison to those without difficult intubation. Our study demonstrated that manual mask ventilation during anesthesia induction was the most troublesome airway management task in OSAS patients during sleep breathing disorder surgery. Cormack-Lehane score was a relevant determinator of difficult mask ventilation and difficult intubation, while Mallampati score and BMI were relevant determinators only for difficult manual mask ventilation.
-
Acta clinica Croatica · Apr 2023
VOICE CONDITION FOLLOWING SHORT-TERM ENDOTRACHEAL INTUBATION IN HEAD AND NECK SURGERY: STUDY PROTOCOL FOR CLINICAL TRIAL.
Endotracheal intubation is an airway management procedure commonly performed under general anesthesia. It is linked with postoperative voice changes. The incidence and reasons of hoarseness and vocal cord injury are not very well investigated, especially after short-term anesthesia and intubation in head and neck surgery. ⋯ Endotracheal intubation is a safe method of airway management although it can temporarily alter a patient's voice quality. It is not known how much of this is the result of anesthesia, general condition of the patient, or surgery. This trial is expected to shed some light on this issue.
-
Acta clinica Croatica · Apr 2023
IS CARDIOPULMONARY RESUSCITATION OUTCOME IN PRE-HOSPITAL EMERGENCY MEDICINE RELATED TO AIRWAY MANAGEMENT TECHNIQUE?
According to current European Resuscitation Council guidelines, priorities in advanced life support in adult are chest compression with minimal interruption and early defibrillation. Endotracheal intubation is still considered the gold standard in airway management, but guidelines suggest that securing the airway be incremental, ranging from basic techniques to more complex ones. Doctors who work in pre-hospital emergency medicine teams (EMT) in Croatia usually lack sufficient education and expertise. ⋯ There were 968 patients, mean age 70. In 74.61% of patients, the cause of arrest was of cardiac etiology. Our study did not find a statistically significant in difference of CPR success among the three groups analyzed according to the airway management technique of choice (p=0.74, χ2-test).
-
Acta clinica Croatica · Apr 2023
ReviewIS SURGICAL TREATMENT OF VELOPHARYNGEAL INSUFFICIENCY BY MYOMUCOSAL POSTERIOR PHARYNGEAL FLAP A CONTRAINDICATION FOR NASAL INTUBATION? A NARRATIVE REVIEW.
Velopharyngeal insufficiency is a disorder where the soft palate directs the air through the nose. It is often present in patients with previous cleft or short palate, but also in many other conditions. Symptoms are primarily to be found in speech, with very distinct nasal sound. ⋯ The high risk of damage to the flap with possible bleeding can put the anesthesiologist in a very unpleasant situation if not aware of the permanent effect of this surgery. During preanesthetic assessment, if there is information on a previous pharyngoplasty, one should consider alternative options for nasotracheal intubation. All nasal insertion procedures must be either avoided or carried out with great caution, under fiberoptic visual control.