China
Africa
Explore chapters and articles related to this topic
Cardiovascular Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Acute HF most commonly results from MI. Acute pulmonary oedema: When the pulmonary capillary pressure rises above 24 mmHg, fluid filters first into the interstitial space of the lung (interstial oedema) and then, as the pressure rises, into the alveoli as well (alveolar oedema). This leads to dyspnoea, hypoxia and the sensation of drowning, which causes anxiety. It is a medical emergency.Cardiogenic shock: This is a specific syndrome where the patient is hypotensive, oliguric or anuric and confused because of poor cerebral perfusion secondary to HF. Patients with cardiogenic shock can be categorized as wet (acute pulmonary oedema ± peripheral oedema) or dry (no oedema). The prognosis is very poor with a high inpatient mortality. IV inotropes (dobutamine, milrinone, levosimendan) and mechanical support with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) or a temporary left ventricular assist device (LVAD) are required in eligible cases with reversible causes.
An Approach to Medical Emergencies in Forced Displacement Settings
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Natalie Roberts, Louisa Baxter, Maryam Omar, Halfdan Holger Knudsen, Clare Shortall
The role of palliative care is increasingly recognised as an essential part of the package of care for displaced populations in acute and chronic emergencies and recent international guidance for these settings demonstrates how effective palliative care can be delivered here despite the constraints (see Chapter 12). Several key principles of palliative care in emergencies settings have been identified.5 The most fundamental goal not only of palliative care but also of medicine itself, including medicine practised in humanitarian emergencies and crises, is to relieve human suffering. Saving lives is one way to achieve this goal but not the only way. Medical emergency teams should consider having at least a physician or nurse with specialised palliative care skills. Palliative care in mass casualty situations where resources are overwhelmed presents a particular challenge and should be included in planning for triage and management of such incidents and rights (see Chapter 8.2and 12).
Cardiovascular disease
Published in Sally Robinson, Priorities for Health Promotion and Public Health, 2021
The individual should call an ambulance as this is a medical emergencystay calm and sit downtake 300 mg of aspirin immediately(British Heart Foundation, 2020c)
Tube Feed or Not Tube Feed: Ethics beyond the Consult Question
Published in The American Journal of Bioethics, 2023
Joan Henriksen, Nina Current, Scott Nelson
The ethics of whether to treat or not treat an eating disorder in a hospital may appear clear: we are ethically bound to treat a patient in need of medical care. Indeed, we know from experiences with cases much like this one that medical teams in acute care settings are generally unwilling to allow a young person to become critically ill and die from a cause that is so “easily” treated. But the decisions involved with how that treatment is provided, and the moral distress that may accompany those decisions, can create friction in the care team. Clinicians sometimes choose to prioritize their value of avoiding harm over competing values like respecting autonomy. For clinicians like hospitalists, the immediate problem leading toward death is lack of nutrition and hydration, which they can provide. Once indications like syncope or near syncope, electrolyte abnormalities, and anuria appear, pressure mounts for them to act. As in this case, clinicians may appeal to concepts like “medical emergency” which gain their perceived authority from both urgency and uncertainty. Declaring a medical emergency seems to imply a blanket permission to treat that is granted through societal agreement around professional obligations to rescue. That move might appear straightforward, but it can also obscure complex tensions around capacity and intensify inclinations toward paternalism. Members of the team, like Gloria, may express moral distress. Even with strong rational ethical analysis, ethics notes would be unlikely to convince the responsible physician to not intervene to “save” Ms. Johnson.
Emergency Medical Services Time Intervals for Acute Chest Pain in the United States, 2015–2016
Published in Prehospital Emergency Care, 2020
Eric R. Cui, Alexandra Beja-Glasser, Antonio R. Fernandez, Joseph M. Grover, N. Clay Mann, Mehul D. Patel
Chest pain is a leading reason for emergency department (ED) visits in the United States. In 2016, there were over 7.5 million patients with a chief complaint of chest pain (1). Sudden onset of chest pain can indicate an acute, life-threatening medical emergency, including a myocardial infarction (MI), aortic dissection, or pulmonary embolism (2, 3). Given the severity of these conditions, a significant delay in seeking or receiving emergency care is associated with poor outcomes and increased mortality (4, 5). Chest pain is also one of the most common symptoms that emergency medical services (EMS) encounters, accounting for around 10% of 9-1-1 responses in the United States (6, 7). Therefore, EMS ambulance crews must be prepared to respond quickly to patients experiencing chest pain, minimize time spent at the scene and rapidly transport to the ED for further evaluation and treatment. Recent studies suggest EMS undertriages a significant proportion of acute MI patients with chest pain (8), and women with chest pain are treated less urgently by EMS than men with chest pain (9). Additional research is needed into EMS triage and treatment of patients with chest pain.
Usefulness of F2-isoprostanes in early prognostication after cardiac arrest: a topical review of the literature and meta-analysis of preclinical data
Published in Biomarkers, 2020
George Karlis, Anastasia Kotanidou, Georgios Georgiopoulos, Stefano Masi, Nikolaos Magkas, Theodoros Xanthos
The sudden and unexpected cease of respiratory and cardiac function, known as cardiac arrest, is universally the absolute medical emergency (Papadimitriou 2006). All emergency care professionals will treat cardiac arrest patients, who have achieved return of spontaneous circulation (ROSC). Although there is substantial variation in the outcome of cardiac arrest (CA), the rate of survival to hospital discharge with good neurological outcome is generally poor. The European Registry of Cardiac Arrest (EuReCa) ONE study reported an overall survival of 10.3% for out-of-hospital CA (Grasner et al. 2016). Regarding in-hospital CA, the UK National Cardiac Arrest Audit (NCAA) reports a 18.4% survival to hospital discharge (Nolan et al. 2014). Furthermore, two thirds of deaths after ICU admission following cardiac arrest are attributed to neurological injury (Laver et al. 2004).