Abdominal Compartment Syndrome (ACS) is a sustained intra-abdominal pressure greater than 20 mm Hg. This syndrome is associated with organ failure or dysfunction. If ACS is not recognized and treated promptly it can result in mortality. Cases that are not recognized and treated promptly have a 90% to 100% mortality rate. 46.8% pediatric doctors can recognized ACS, this is not near the percentage that it needs to be. Only 51% of pediatric doctors have had to treat a child with ACS so it is not an extremely common disease. ACS can be diagnosed bedside by measuring the IAP of the patient. In a case study concerning a 13 year old boy, he was brought to the emergency room after being kicked by a horse. The patient was taken into surgery for an exploratory
Dr. Murray, the chief resident who arrived around 8:00pm, charted Lewis’ heart rate as normal and noteds a probable ileus; however, nursing documentation at the same time recorded a heart rate of 126 beats per minute (Monk, 2002). Subsequent heart rates at midnight and 4:00am arewere charted as 142 and 140 beats per minute respectively without documented intervention (Monk, 2002 ). On Monday morning Lewis noted that his pain suddenly stopped after being very constant and staff charted that they were unable to get a blood pressure recording in either arm or leg from 8:30-10:15am despite trying multiple machines (Monk, 2002; Solidline Media, 2010).
Authors have a variety of motives for writing, which are termed as the author’s purpose. The four main purposes for writing are to express oneself, to explain or inform, to entertain, or to persuade. In the nonfiction story, "The First Appendectomy" written by Dr. William Nolen, the author's purpose is to inform.
In a healthy individual receiving a general anaesthetic, the anaesthetist must be aware of the causes and treatment of acute onset AF, both intra-operatively and peri-operatively. Patients with AF often develop a decline in left ventricular performance and other hemodynamic instabilities including reduced diastolic filling and tachycardia mediated cardiomyopathy1, all of which can reduce cardiac output and pose difficulties for the anaesthetist.
Surgical errors are seen in every hospital; however, hospitals are not required to report such incidents. Unintended retained foreign objects, often abbreviated as URFOs, are among those events that are often not reported.
5), many hospitals in conjunction with the Joint Commission's 2012 National Patient Safety Goals has been rallying for hospitals to use evidenced-based practices (EBP) to the prevention of CAUTIs because evidence is growing showing that many are avoidable. Such practices such as utilizing a nurse-driven protocol to assess and evaluate the appropriateness and use of urethral catheter to determine how long a patient should have an indwelling catheter and when to discontinue it. Several factors have been identified that pose as risk factors to CAUTI which include but not limited to drainage bag not being below the level of the bladder, healthcare personnel not practicing standard precautions and utilizing aseptic techniques during insertion of catheters, unsterile equipment, and unnecessary placement of urinary
Jarvis, C. (2012). Abdomen. In Physical examination & health assessment (6th ed.). St. Louis, Mo.: Elsevier/Saunders.
Today, for achieving a flat and firm abdomen, many of us strive for intensive weight loss and exercise. However, in some cases, these methods fail to achieve the desired goals. A loose, protruding or sagging abdomen is also witnessed in individuals with normal body weight and proportion. The reasons may include weight fluctuations, aging, heredity or any prior surgery. Sometimes, large weight loss or multiple pregnancies may cause weakening of abdominal muscles. As a result, the skin in that region becomes stagging.
What? The patient is 65-year-old man Mr. John Douglas who is suffering from dysphagia and have been admitted to the surgical ward for insertion of a percutaneous endoscopic gastrostomy (PEG). Apart from that, he is a Type 1 diabetes patient and has weakness in his right leg and arm because of right-sided hemiplegia. He is thin in appearance and has stage 1 pressure sore on his right heel.
A postoperative ileus is another complication of undergoing abdominal surgery. Autonomic nervous dysfunction is thought to be the lead factor in causing postoperative ileus. The sympathetic nervous system becomes over active during the time after surgery. This causes a reduced release of the neurotransmitter acetylcholine and increased ...
The patient I have chosen who has an issue with ventilation and perfusion is A.Z., a
Irritable bowel syndrome (usually referred to as IBS) is a disorder of the large intestine that lasts for a long period of time. People who have IBS experience symptoms like constipation or diarrhea. These symptoms can occur one after another. A person can experience constipation at some times and diarrhea at other times. Occurrences of lower bowel irritation may also be accompanied by mild pain, swelling of the stomach and a lot of digestive gas. Other names for IBS are spastic bowel, spastic colon, irritable colon syndrome, and functional bowel disease.
“Whoa-oa-oa! I feel good, I knew that I would now. I feel good….”. My “I feel good” ringtone woke me up from the depths of slumber during my first night call in internal medicine rotation. My supervising intern instructed me to come to the 4th floor for a patient in distress. Within moments, I scuttled through the hospital hallways and on to the stairs finally arriving short of breath at the nurses’ station. Mr. “Smith”, a 60 year old male with a past medical history of COPD was in respiratory distress. He had been bed bound for the past week due to his severe arthritis and had undergone a right knee replacement surgery the day before. During evening rounds earlier, he had no signs of distress. However, now at 2 AM in the morning, only hours later since rounds, he was minimally responsive. My intern and I quickly obtained the patient’s ABG measurements and subsequently initiated a trial of BIPAP. This resolved Mr. Smith’s respiratory distress and abnormal ABG values. To rule out serious causes of dyspnea, a stat chest x-ray and CT were obtained. Thankfully, both studies came back normal.
Imagine, being born with your intestines hanging out of your belly. Sounds painful and uncomfortable right? "About 2,000 babies are born with gastroschisis each year in the United States" (Gastroschisis. (n.d.). Retrieved May 9, 2014, from http://www.cardinalglennon.com/fetalcareinstitute/conditions/AbdomenIntestines/Pages/Gastroschisis.aspx). Thats about 1 in every 5,000 babies born, not rare, but fairly uncommon for it to be seen in children. Most are born prematurely, but are often delivered naturally without any surgery on the mother.
As defined by Baillie, Garrett, Garrett, and McGeehan, the health care formulation of the principle of autonomy states that “you shall not treat a patient without the informed consent of the patient or his or her lawful surrogate, except in narrowly defined emergencies” (Health Care Ethics: Principles and Problems, 2009, p.32). An abdominal aortic aneurysm is a very high-risk diagnosis, but is non-emergent unless the aortic wall ruptures. It may seem that the patient is assuming very illogical and risky behavior, but it is still her right as a patient to deny the surgery if she so chooses. Unfortunately, the physician’s actions cannot be justified in this case because although the diagnosis was an acute one, it was not yet emergent. The surgeon
680,000 cases of Acute Appendicitis are reported each year (“Statistics about Acute Appendicitis”). With this many cases, one would think that doctors have a standard for performing an appendectomy. Depending on the situation, a patient could have a choice of which surgery he wants. Although open and laparoscopic appendectomies both successfully save patients, the methods of surgery differ in risk of infections, recovery time, and post-operative pain.