Anaesthesia and intensive care
-
Anaesth Intensive Care · Feb 2007
Case ReportsDiagnostic dilemmas and management of fulminant myocarditis.
Myocarditis is commonly a diagnosis of exclusion. We report a case of fulminant myocarditis in a patient with cardiogenic shock in whom the initial diagnosis was unclear. ⋯ Complete recovery of cardiac function was achieved. This case highlights the difficulty in diagnosing myocarditis and the benefits of early intensive support.
-
Anaesth Intensive Care · Feb 2007
Anaesthesia for emergency caesarean section, 2000-2004, at the Royal Women's Hospital, Melbourne.
The provision of anaesthesia for emergency caesarean section is a major part of the workload of obstetric anaesthetists and the urgency often dictates the mode of anaesthesia that can be provided. We have audited the provision of anaesthesia for 'immediate' caesarean sections over a four-year period following the introduction of a 'Code Green' system to coordinate a rapid response to an obstetric decision to proceed with an 'immediate' caesarean section. The records of all patients for whom a Code Green was called between July 2000 and June 2004 were studied. ⋯ General anaesthesia was most used between the hours of 0700 and 1700 h. A swift response to the call for an immediate caesarean section can be achieved when suitable facilities and procedures are in place. Administering an epidural bolus into an already established epidural catheter that is working effectively can allow a decision-to-delivery interval almost as short as general anaesthesia.
-
Anaesth Intensive Care · Feb 2007
Case ReportsTranstracheal lignocaine: effective treatment for postextubation stridor.
Three cases of post-extubation stridor due to suspected laryngospasm are described in which a small dose of lignocaine injected intra-tracheally, through the cricothyroid membrane, produced rapid and effective relief of stridor with no early recurrence or side-effects. The procedure was performed safely and quickly and was well tolerated by patients. Trans-tracheal injection of local anaesthetic should be considered for treatment of post-extubation stridor in adults, so long as there is no risk of pulmonary aspiration, and pathological causes of laryngospasm have been excluded.