Ugeskrift for laeger
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Ugeskrift for laeger · Mar 1997
[Relevance of the 112-emergency calls among the clientele of the emergency department of the Herlev hospital admitting office].
It is a common view, shared by Emergency Department staff and ambulance crews, that a large number of patients unnecessarily use Emergency Service ambulances instead of transporting themselves to the hospital by other, more appropriate means. In this retrospective study, 528 consecutive Emergency Service calls to the Herlev Hospital Casualty/Emergency Department during a six week period were reviewed for relevance. Attention was solely aimed at the relevance of the use of Emergency Service ambulances in each case, but not on patient or health care providers' perception of urgency. ⋯ Seventeen point six percent of all calls were deemed irrelevant. Thirty-three percent of all calls not resulting in admission were deemed irrelevant. The results confirm Emergency Department health care providers' and ambulance crews' view that Emergency Service ambulances are used inappropriately by the public.
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We investigated the guidelines for patient selection and drug regimens for use of antibiotic prophylaxis in relation to Caesarean section in the maternity clinics in Denmark. A questionnaire was sent to all the Danish maternity clinics that perform Caesarean section, concerning indications for use of antibiotic prophylaxis and antibiotic regimens to patients undergoing acute and elective Caesarean section. All departments (n = 48) returned the questionnaire. ⋯ The most frequent first choice drug was cefuroxim, employed by 27 departments (56%). Concerning timing, 21 departments (44%) gave antibiotics after cord clamping and 13 departments (27%) before incision. We propose a nation-wide prospective investigation on the rate of infections associated with Caesarean section to set up rational guidelines for antibiotic prophylaxis.
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Ugeskrift for laeger · Feb 1997
Review[Tuberculosis and the HIV pandemic. Risk of nosocomial tuberculosis infection].
Spread of human immunodeficiency virus (HIV) infection has had a major impact on the epidemiology of tuberculosis. In several African countries the incidence of tuberculosis has doubled, and the prevalence of HIV infection among patients with tuberculosis is 20 to 60%. A similar change has occurred in some developed countries. ⋯ The mortality among patients has been high, and there have been several cases of transmission to healthcare workers. Analyses of these recent outbreaks indicate that it is possible to intervene by well known prophylactic measures. Rapid diagnosis and treatment, and correct isolation procedures are essential to prevent outbreaks.
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Ugeskrift for laeger · Feb 1997
Clinical Trial Controlled Clinical Trial[Continuous measurements of cardiac output in the perioperative period].
Management of critically ill patients is based on knowledge of fundamental physiological variables. Automatized and continuous measurement of these variables is preferable. A new system based upon the thermodilution method has been developed to measure cardiac output automatically and continuously. ⋯ In conclusion, the CCO measurement technique is a promising clinical method. The method is straightforward, requires no calibration, is independent of vascular geometry and measures with its limitations volumetric flow. Finally automatic and continuous patient monitoring provides more information and has potential to reveal previously undetected haemodynamic events.