Good job, Kristen!
I completely agree with Courtney about performing pulmonary vein ablation on this patient. Radiofrequency catheter ablation for AF has become a common used second-line therapy after failure of at least one antiarrhythmic drug (Bunch & Cutler, 2015). The authors stated that multiple clinical trials report arrhythmia free survival of 50-75% at 1-year post ablation in contrast to only 10-30% with antiarrhythmic drugs. Hence, there is a chance that in near future, pulmonary vein ablation should become a first-line therapy for atrial fibrillation (AF).
I would like to share the information about one of the serious safety concerns regarding pulmonary vein ablation, especially in patients who underwent pneumectomy for tumor resection.
This essay describes how the anaesthetic machine and airway management equipment are prepared in operating theatres and discusses how they are ensured safe for use. It evaluates the Association of Anaesthetists of Great Britain and Ireland (AAGBI) guidelines related to safe practice and the preparation of the ET tubes, laryngeal masks, guedels, Naso pharyngeal airways and the laryngoscope. The function of the anaesthetic workstation is to deliver a mixture of anaesthetic agents and gases safely to the patient during the induction process and throughout surgery. In addition, it also provides ventilation to support breathing and monitors the patient’s vital signs to minimise the anaesthetic risks to the patient whilst in the care of health professionals. The pre-use check is vital to patient safety as an inadequate check of the anaesthetic machine or airway management equipment can and does lead to significant harm of the patient including mortality (Medicines and Healthcare Products Regulatory Agency (MHRA), 2008 and Magee, 2012).
It occurs because of repetitive electrical activity. This can occur in a patient with early or late heart failure, because there is damage to the heart tissue and the heart beats faster to try to supply the body with blood. Recommended treatment is elective cardioversion. Drugs used include an antidysrhythmic such as Mexitil or Sotalol (Ignatavicius &Workman, p. 728-729).
(15)Patel M, Mahaffey K, Garg J, Pan G, Singer D, Hacke W, Breithardt G, Halperin J, Hankey G, Piccini J, Becker R, Nessel C, Paolini J, Berkowitz S, Fox K.. (2011). Rivaroxaban versus warfarin in nonvalvular atrial fibrillation.. New England Journal Of Medicine. 365 (10), 883-91.
Although lung cancer is generally operable, by using either traditional open surgery, or one of the less intrusive and more sophisticated video-assisted thoracoscopic surgeries (VATS), often it may not be considered to be the best option for a patient. Where ill-health is a factor, or either the size and location of the tumor is deemed to be a consideration, other forms of treatment may well have to be considered.
Being a twin sister to more or less an average sister (with all the usual arguing, competing, the typical sibling rivalry stuff), I've learned a lot about the meaning of the term "it takes a village". My sister was born with Pulmonary Atresia (a closed heart valve). Though no one but herself could truly appreciate the endurance and pain of what she had to go through, I too developed a sense of immense appreciation on how many different medical specialists, physical therapists, social workers and other multiple specialists are involved in helping patients like my sister; not just survive but thrive! Volunteering at a Pediatric Medical office over the last three years has made me realize how great things happen when multiple fields come together.
... radiofrequency.” (Pub Med Health). Open heart surgery is always an option because it offers a permanent cure for Wolff-Parkinson White syndrome.
In the operating room, there are many things that come into play to keep the patient and staff safe at all times. The safety checks that are double-checked before the surgery are extensive and they are
...m, and also a nuclear heart scan can all be performed. For treatment the women will need to stay in the hospital until the symptoms subside. The women might have to use a balloon heart pump; go through immunosuppressive therapy; and possibly a heart transplant if severe congestive heart failure continues.
It’s a risky, yet it makes one wonder if it were available, why not go to a real doctor who knows what they’re doing. There would be more of a chance of dying or being seriously injured if done the prior alternative method. Being specialist that knows what to do would be the safest way to go; this just leads furthermore into why it should remain legal.
Cancer has some very painful and serious effects on a person's body. Most of this uncomfort is due to the numerous treatments people go through to destroy the cancer cells. One of the more dangerous treatments is surgically removing the cancer. There is a huge possibility that it may take many surgical procedures to remove the cancer areas, and there are always risks that there will be complications. An example of this is when Peter Teeley went under the knife for a standard removal of a cancerous tumor on his appendix. The surgeon forgot to inform the anesthesiologist that Peter had been throwing up all week, and when it happened in the operation, fluid rushed into his lungs causing aspiration pneumonia (Bashe and Teeley16). Of course this does not happen all the time but is always a huge risk when under the knife.
Alcohol consumption will need to be discontinued, especially if this is a cause. Moderate exercise should be encouraged within the limitations of the patient (Bennett). Medical treatment is generally aimed at relieving symptoms of heart failure and improving cardiac output. Patients are often given medications such as ACE inhibitors and Beta-blockers. Antiarrhythmic drugs, implantable defibrillators, and pacemakers are other treatments used for dilated cardiomyopathy patients. Anticoagulants are also an important treatment for dilated cardiomyopathy patients due to the increased risk of developing thrombus from poor systolic function, atrial fibrillation, and poor circulatory flow. Cardiac transplantation is another treatment option but heart donors are very limited (Lily).
Some treatments can be used. An electronic pace-maker can be inserted and it will send electronic impulse to the heart stimulating it to beat at a normal rhythm. Pace-makers are only inserted when the heart beats too slow. Tachycardis can also be very serious. It can lead to disabling symptoms and even death.
Cardiac dysrhythmias come in different degrees of severity. There are heart conditions that you are able to live with and manage on a daily basis and those that require immediate attention. Atrial Fibrillation is one of the more frequently seen types of dysrhythmias (NIH, 2011). The best way to diagnosis a heart condition is by reading a cardiac strip (Ignatavicius &Workman, 2013). Cardiac strips play an chief part in the nursing world allowing the nurse and other trained medical professionals to interpret what the heart is doing. In a normal strip, one can clearly identify a P wave before every QRS complex, which is then followed by a T wave; in Atrial Fibrillation, the Sinoatrial node fires irregularly causing there to be no clear P wave and an irregular QRS complex (Ignatavicius & Workman, 2013). Basically, it means that the atria, the upper chambers of the heart, are contracting too quickly and no clear P wave is identified because of this ‘fibrillation’ (Ignatavicius & Workman, 2013).
My case study encompasses pulmonary embolism and a saddle pulmonary embolism. The patient I chose was a female who had just given birth with no complications during labor, but developed a pulmonary embolism that later on was confirmed to be a saddle pulmonary embolism. Not known to me before this clinical study pulmonary embolism is a leading cause of death among pregnant women in the developed world. A pulmonary embolism is a sudden blockage in a lung artery. The blockage is usually by a blood clot that travels to the lung from the vein in the leg. A clot that forms in one part of the body and travels in the bloodstream to another part of the body is called and embolus (NAT13). Pulmonary embolism is a serious condition that can damage your lung due to lack of blood flow to your lung tissue, which can lead to pulmonary hypertension. Pulmonary hypertension is increased pressures in the pulmonary artery. PE can also cause low oxygen levels in your blood and damage other organs in your body because of a lack of oxygen. If a blood clot is very large it can cause death. A pulmonary embolism can also be called a venous thromboembolism.
Coleman, S. A. (2014). Protecting yourself against surgical smoke. OR Nurse 2014, 8(2), 40-46. Retrieved April 18, 2014, from http://journals.lww.com/ornursejournal/Fulltext/2014/03000/Protecting_yourself_against_surgical_smoke.9.aspx