A&A practice
-
This survey study evaluates the user experience of an electronic maternal early warning system that generates automated pages. Survey domains included the system's effect on patient care, alarm fatigue, and continued use of the system. ⋯ A majority, 83%, felt that the system should remain in use, and 64.5% felt it improved patient safety. Of those who believed that they had received a page, 51.4% felt that they received pages "too frequently." Although alarm fatigue was not fully evaluated, providers on our unit support the continued use of this automated maternal electronic surveillance system.
-
Neuraxial catheters are typically removed without complications. In rare cases, however, breakage of the catheter may lead to a retained catheter fragment. ⋯ The computed tomography scan of the lumbar spine revealed hypertrophic spinous processes (Baastrup disease) and a retained catheter fragment located in the thecal sac at L3-L4, terminating at the anterior portion of the interspinous ligament at L4-L5. Proper precautions should be taken when removing neuraxial catheters to prevent this complication.
-
Case Reports
Neuroleptic Malignant Syndrome Secondary to Quetiapine in Critical Care: A Case Report.
Quetiapine, an atypical antipsychotic, is widely used to treat delirium in intensive care units (ICUs). Studies demonstrate its efficacy and favorable safety profile. We report a case of an elderly patient who developed clinical and biochemical evidence of neuroleptic malignant syndrome (NMS) 5 days after quetiapine was commenced. ⋯ Quetiapine-induced NMS has occurred with long-term use in the elderly in the outpatient setting. However, NMS has not previously been reported after treatment of ICU delirium. NMS is an important complication to consider before prescribing quetiapine in the ICU.