There are numerous case reports of APL valve trapping with old Draeger APL valves leading to an inability to ventilate which is often undiagnosed until later (by then it may be too late). Draegers newer design of APL valve has a bevel which minimises the risk of this happening. We want Draeger to recall and replace their old APL valves for patient safety. For more details see here: http://wp.me/p6ZAcV-3h Thanks
Indistinct chlorhexidine has been mistaken for other solutions such a s saline (injected into epidural space) and IV contrast (cerebral angiograms etc) with devastating consequences. We are trying to ban indistinct pourable chlorhexidine. Very interested in your thoughts and help. Please see this link for more details: http://wp.me/p6ZAcV-2Q Thanks
I would like your advice and opinions relating to the administration of a drug at the end of a lengthy failed resuscitation attempt. We can approach this hypothetically. A paediatric patient had been assessed to have suffered a cardiac arrest, and a resuscitation attempt had been carried out for more than half an hour. The patient was assessed to have been flatlined and non-shockable throughout the resuscitation attempt. A decision to cease the resuscitation attempt was then made. 4.2mls of intravenous Fentanyl (an intubation dose) was administered after ceasing resuscitation.
What would the possible rationale behind administering the drug to this patient be?
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I would try to improve the condition of this patient preoperatively-infusions,correction of anaemia,adequate intravascular volume, Echo-find out ejection fraction,pulmonary hypertension,valve function. In case of severe heart depression,CT brain -acute ischaemia,I would refuse the case. In case I would anesthetize this patient, I would discuss risk of this procedure with his family- highrisk patient, very old, complications including death. I would prefer epidural with placing catheter-unnecessary adequate iv volume.