China
Africa
Explore chapters and articles related to this topic
Neurology in Documentaries
Published in Eelco F. M. Wijdicks, Neurocinema—The Sequel, 2022
Withdrawal of life support in patients who fail to awaken is a common outcome, often prompted by advance directives but also after extensive deliberation about realistic outcomes with family members. Film depiction of a family conference would show the complexity of these conversations. Perhaps such a documentary could also include a discussion of the benefits of organ and tissue donation after a comatose patient becomes brain dead, especially how it may prove lifesaving for someone else. An ideal documentary would also cover the wide range of possible outcomes from a catastrophic brain injury including the promises and limitations of neurorehabilitation.49
Extracorporeal membrane oxygenation
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Thomas Pranikoff, Ronald B. Hirschl
Extracorporeal membrane oxygenation (ECMO) has been used to describe a method of extracorporeal life support (ECLS) using extrathoracic cannulation for cardiopulmonary support. ECLS is a supportive rather than a therapeutic intervention. It provides adequate perfusion and gas exchange (venoarterial bypass) or gas exchange alone (venovenous support), and so avoids deleterious effects from high oxygen concentration and positive pressure ventilation while allowing resolution of reversible heart and lung pathology.
End of life
Published in Gary Chan Kok Yew, Health Law and Medical Ethics in Singapore, 2020
Where the patient is mentally incapacitated, treatment may be administered based on the best interests of the patient. Difficult decisions arise when the patient is in a coma and tied to a life support system. The withholding of treatment via the life support system will likely result in the death of the patient (though some patients have been known to live several years after the withdrawal of the life support system). How would the “best interests” test be applied in cases where death is likely? Do doctors or family members have the right to decide whether the treatment should be withheld in such circumstances? What happens when they disagree?55
Does Controlled Donation after Circulatory Death Violate the Dead Donor Rule?
Published in The American Journal of Bioethics, 2023
Emil J. Nielsen Busch, Marius T. Mjaaland
To show how the current bioethical debate is affected by the assumption that donors must be dead before organs can be procured, it is helpful to start with a brief description of cDCD. Patients enrolled in cDCD protocols often have a catastrophic brain injury to a degree where withdrawal of life support is justified on the grounds of best interest, but they do not fulfill the neurological criterion for death − the irreversible loss of all brain functions. Instead, death is determined based on a circulatory criterion, the irreversible loss of circulatory and respiratory functions, following the withdrawal of life support (Manara, Murphy, and O’Callaghan 2012). When life support is withdrawn, it usually takes up to 60 minutes before circulation ceases. After circulation has ceased, a no-touch period follows where physicians must observe the patient to ensure that circulation and respiration do not resume spontaneously. Death is declared if no spontaneous resumption of circulation or respiration is observed during the no-touch period. Currently, most countries apply a five-minute no-touch period (Lomero et al. 2020). This means that physicians are required to observe the patient for a minimum of five minutes after circulation has ceased before death can be declared and organs procured.
Successful Resuscitation from Refractory Ventricular Fibrillation by BLS Providers Employing Double Sequential External Defibrillation: A Case Report
Published in Prehospital Emergency Care, 2020
John Laird, Cesar Costa-Arbulu, Melissa Marighetto, Anna Grochal, Ian R. Drennan, Sheldon Cheskes
Peel Regional Paramedic Services consists of two levels of paramedics: Primary Care Paramedics (BLS providers) and Advanced Care Paramedics (ALS providers). Basic Life Support providers are able to provide basic cardiopulmonary resuscitation (CPR) and ventilations, manual defibrillation, insert supraglottic airways, and in some situations initiate intravenous therapy. In addition, ALS providers are able to administer ACLS medications (e.g. epinephrine, antiarrhythmics), perform endotracheal intubation and intraosseous initiation. Cardiac arrest care is delivered in accordance with standards set out by the American Heart Association, the Heart and Stroke Foundation of Canada, and provincial medical oversight. Chest compression data is recorded using Real CPR HelpR® and CPR Stat-padz® and uploaded post-resuscitation for review.
SIRS, SOFA, qSOFA, and NEWS in the diagnosis of sepsis and prediction of adverse outcomes: a systematic review and meta-analysis
Published in Expert Review of Anti-infective Therapy, 2023
Xia Qiu, Yu-Peng Lei, Rui-Xi Zhou
Life support provided by the ICU is critical to saving the lives of patients with sepsis. However, indiscriminate triage of patients to the ICU can strain its capacity and limit cost-effectiveness. Therefore, there is a need to explore appropriate criteria for ICU triage to optimize resource allocation [106,107]. In our analysis, SIRS showed high sensitivity (0.84) but low specificity (0.29), while qSOFA showed low sensitivity (0.33) and high specificity (0.88). The comprehensive predictive ability of SIRS and qSOFA was not high. The predictive ability of NEWS for ICU admission was also found to be limited. A few studies on ICU admission were included in our meta-analysis and further investigation is warranted once relevant original studies are available.