Acta medica Lituanica
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Acta medica Lituanica · Jan 2018
Is the Trendelenburg position the only way to better visualize internal jugular veins?
A larger cross-sectional area (CSA) of the internal jugular vein (IJV) makes catheterization easier and the Trendelenburg position is used to achieve this. Unfortunately, it is not comfortable for conscious patients. The aim was to evaluate the impact of alternative manoeuvres on the enlargement of the CSA of the IJV and to compare these manoeuvres with the Trendelenburg position. ⋯ Hold of deep breath and 45-degree passive leg raise (the latter limited for the right side only) are alternative manoeuvres to improve visualization of internal jugular veins for conscious patients. Hold of deep breath was as effective as the Trendelenburg position.
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Acta medica Lituanica · Jan 2018
Effectiveness of treatment of occipital neuralgia using the nerve block technique: a prospective analysis of 44 patients.
There is a great deal of tools for treatment of occipital neuralgia but currently we are lacking a complete consensus among practitioners regarding the optimal approach to this debilitating condition. Occipital nerve block (ONB) is known as one of the management options but there is lack of scientific literature exploring its effectiveness. ⋯ Occipital nerve block with a local anaesthetic and corticosteroids provides a safe, simple, and effective treatment method for the patient with medically-refractory occipital neuralgia.
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Acta medica Lituanica · Jan 2018
Evaluation of PRE-DELIRIC (PREdiction of DELIRium in ICu patients) delirium prediction model for the patients in the intensive care unit.
Delirium not only compromises patient care, but is also associated with poorer outcomes: increased duration of mechanical ventilation, higher mortality, and greater long-term cognitive dysfunction. The PRE-DELIRIC model is a tool used to calculate the risk of the development of delirium. The classification of the patients into groups by risk allows efficient initiation of preventive measures. The goal of this study was to validate the PRE-DELIRIC model using the CAM-ICU (The Confusion Assessment Method for the Intensive Care Unit) method for the diagnosis of delirium. ⋯ The PRE-DELIRIC model predicted delirium in the patients within 24 hours of admission to the ICU. Preventive therapy could be efficiently targeted at high-risk patients if both of the methods are to be implemented.