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This Game Had a Bad Ending
Published in Michael S. Wogalter, Forensic Human Factors and Ergonomics, 2018
James M. Miller, Bradley T. Cook
Physicians made the difficult decision to wait for the inflammation, edema, and infection to resolve before undertaking reconstructive surgery. During this waiting period, Carl was kept in a medically induced coma and was fed through a tube. One month later, the throat reconstructive surgery was done, but three rings of his trachea had to be removed, thus affecting the swallowing muscle. Carl has since physically recovered, albeit with a severe speech impediment.
Injury Scoring Systems and Injury Classification
Published in Melanie Franklyn, Peter Vee Sin Lee, Military Injury Biomechanics, 2017
Melanie Franklyn, Christine Read-Allsopp
Difficulties arise in assigning the GCS when there are factors which may affect the response, for example, the patient is intubated, in a drug-induced coma or under the influence of alcohol. Opinions differ as to when to assess the GCS in these cases: options include assessing the patient pre-sedation (for a drug-induced coma) and pre-intubation, or using the motor component of the score only, e.g. in the case of intubation (Jennett 2002).
Electrical Brain Stimulation to Treat Neurological Disorders
Published in Bahman Zohuri, Patrick J. McDaniel, Electrical Brain Stimulation for the Treatment of Neurological Disorders, 2019
Bahman Zohuri, Patrick J. McDaniel
EEG can also be used in intensive care units for brain function monitoring to monitor for non-convulsive seizures/non-convulsive status epilepticus, to monitor the effect of sedative/anesthesia in patients in medically induced coma (for treatment of refractory seizures or increased intracranial pressure), and to monitor for secondary brain damage in conditions such as subarachnoid hemorrhage (currently a research method).
Preclinical validation of occupational and environmental safety of an isolation system for noninvasive ventilation in COVID-19 and other aerosol-transmitted infections
Published in Expert Review of Medical Devices, 2020
Claudio Almeida Quadros, Maria Carolina Bezerra Di Medeiros Leal, Carlos de Almeida Baptista-Sobrinho, Carolina Kymie Vasques Nonaka, Bruno Solano De Freitas Souza, Juliana Cristina Milan-Mattos, Aparecida Maria Catai, Valéria Amorim Pires Di Lorenzo, Antonio Gilberto Ferreira
The development of the ISATI, presented in this manuscript, was only possible through the partnership between Brazilian universities, research institutions and the industry. The process started in March 2020 and took place during the peak of COVID-19 cases in Brazil. It required the commitment of the researchers who needed to travel three times, a distance of 1,600 Km, to conduct the validation tests presented in this manuscript. The objective was to obtain an isolation system that would allow the use of noninvasive ventilation or HFNO in COVID-19 hypoxemic patients, ensuring occupational and environmental safety against aerosol contaminated with SARS-CoV-2. Safety in the isolation of viral particles was the main objective, but the isolation system also needed to be easy to handle, to be widely available and to be possible to use in any hospital, especially in the less complex ones. All of these goals have been achieved. The results of the preclinical validation tests described here secured approval for clinical use of ISATI by the Brazilian National Health Surveillance Agency (ANVISA). ISATI started to be produced under the brand name of BhioCOVID® and used in clinical practice in Brazil. In the beginning of the pandemic, guidelines in Brazil indicated to proceed with early orotracheal intubation in cases of moderate hypoxia. Initially, the offer of noninvasive ventilation intended to be an emergency alternative of offering oxygen to hypoxemic COVID-19 patients, in view of the imminent lack of ICU beds. BhioCOVID® could guarantee the emergency supply of oxygen through noninvasive ventilation until ICU vacancies were available. But with the clinical use of BhioCOVID®, allowing the offer of CPAP and HFNO, it could be observed that several patients with COVID-19 who initially had hypoxia and criteria for orotracheal intubation, did not need to undergo mechanical ventilation through the adoption of CPAP sessions or continuous use of HFNO. This was a great benefit to these patients, as they were able to overcome the hypoxia caused by COVID-19 without requiring mechanical ventilation, avoiding the consequences that can result from a prolonged induced coma. In addition to reducing the hospital costs of treating these patients. The greatest proof of BhioCOVID®’s effectiveness was the success of its use in clinical practice. It is an easy-to-use tool that allows delivery of CPAP and HFNO in patients with respiratory infections transmitted by aerosol, with occupational safety, without requiring patients to be in isolated rooms with negative pressure. It can be a simple alternative to deliver CPAP, HFNO or permit the use of nebulization treatments during the COVID-19 pandemic or in other aerosol transmitted respiratory infections.