Ugeskrift for laeger
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Ugeskrift for laeger · Feb 2009
[Argatroban treatment of heparin-induced immune-mediated thrombocytopenia].
Heparin-induced immune-mediated thrombocytopenia (HIT) is a life-threatening complication of heparin treatment. When HIT is clinically suspected, heparin treatment should immediately be replaced with an alternative, fast-acting, anticoagulant agent, and blood tests should be carried out to verify or to exclude the diagnosis. Argatroban has recently been approved for HIT treatment in Denmark. Recommendations for dosing of argatroban in HIT patients with and without comorbities are presented.
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Ugeskrift for laeger · Feb 2009
[Fascia iliaca block performed by emergency department physician trainees in hip fractures].
Patients with hip fractures (HF) may have severe pain on arrival to the emergency department (ED) and have traditionally been treated with systemic opioids. The aim of this study was to investigate the effect of fascia iliaca compartment block (FICB) performed by ED physician trainees in patients with HF. ⋯ FICB performed by the ED trainees is a suitable method for acute pain relief in patients with HF, but only results in adequate pain relief at rest in 1/3 of the patients.
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The aim of this study was to estimate to which extent patients with abnormal vital signs on general wards had their vital signs monitored and documented and to establish if staff concern for patients influenced the level of monitoring and was predictive of increased mortality. ⋯ In more than half of the patients, the abnormal vital signs were not identified by staff because the vital signs were not measured. In two out of three patients, staff decided to intervene because of abnormal vital signs measured by study personnel, indicating a need to reevaluate monitoring routines at general wards.
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Ugeskrift for laeger · Jan 2009
Case Reports[Double cardiac arrest caused by amniotic fluid embolism during caesarean section].
Amniotic fluid embolism is a rare unpredictable complication of pregnancy with high maternal morbidity and mortality rates because of the risk of cardio-respiratory collapse and/or disseminated intravascular coagulation (DIC). We here report a case of a patient who survived without any sequelae after two cardiac arrests and subsequent DIC due to amniotic fluid embolism during a caesarean section. Early consideration of the diagnosis after prompt resuscitation is needed to reduce morbidity and mortality.
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Ugeskrift for laeger · Jan 2009
Case Reports[In-hospital resuscitation with automated external defibrilliator].
Early defibrillation is a determinant of survival in cardiac arrest. We report a Danish case of successful in-hospital resuscitation using an automated external defibrillator (AED). This case illustrates important aspects of implementation of in-hospital use of an AED, i.e. location of the AED, education of the staff, systematic registration and data collection and technical aspects of AED use. If in-hospital AED implementation is carefully executed, its use may provide a safe and effective way of obtaining early defibrillation.