1,721,032 research outputs found
Resuscitation fluids
No full textBackground and Objectives: The aim of this review was to summarize the properties of the commonly available resuscitation fluids and highlight where knowledge of the characteristics of individual fluids might guide their use in clinical practice. Some of the current controversies surrounding resuscitation fluids are also discussed. Blood or blood products, or strategies of fluid administration, are not focused upon. Conclusions: The clinical trial data does not support the concept of a therapeutic advantage for either crystalloids or colloids, despite claimed theoretical advantages for both classes of fluid. The available colloid solutions have quite distinct profiles of activity, both in terms of their plasma volume expansion profile and other physiological and pharmacological properties. Recent data suggests that physiologically balanced crystalloid and colloid solutions may improve clinical outcomes when compared with saline-based fluids
Pre-oxygenation before extubation. Comment on: Oxygen therapy and anaesthesia: too much of a good thing?
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Ketamine for emergency anaesthesia at very high altitude (4243 m above sea-level)
No full textA 22-year-old woman presenting with postpartum haemorrhagic shock at 4243 m altitude required anaesthesia to identify and treat the source of bleeding. Slow intravenous administration of ketamine (0.5 mg x kg(-1)) resulted in deep anaesthesia and apnoea requiring hand ventilation for 5 min. Haemodynamic stability was maintained throughout the procedure. Haemostasis was achieved following uterine packing and suture of a second-degree vaginal tear and small cervical tear. Confusion and visual hallucinations occurred upon awakening but recovery was otherwise uneventful. Ketamine can be used for emergency anaesthesia in a wilderness environment over 4000 m but it is probable that the benefits outweigh the risks only where life or limb are acutely threatened. Careful titration of the administered dose is strongly advised, particularly in patients where hypovolaemia and/or hypoxaemia are present. The availability of airway management equipment and the skills to use them may significantly reduce the risks associated with anaesthetic administration at very high altitude
Outcome measures for orthopaedic interventions on the hip
No full textOrthopaedic outcome measures are used to evaluate the effect of operative interventions. They are used for audit and research. Knowledge of these measures is becoming increasingly important with league tables comparing surgeons and hospitals being made accessible to the profession and the general public. Several types of tool are available to describe outcome after hip surgery such as generic quality-of-life questionnaires, disease-specific quality-of-life questionnaires, hip-specific outcome measures and general short-term clinical measures. We provide an overview of the outcome measures commonly used to evaluate hip intervention
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