Cir Cir
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Providing medical assistance in emergencies and disaster in advance makes the need to maintain Medical Units functional despite the disturbing phenomenon that confronts the community, but conflict occurs when the Medical Unit needs support and needs to be evacuated, especially when the evacuation of patients in a Critical Care Unit is required. In world literature there is little on this topic, and what is there usually focuses on the conversion of areas and increased ability to care for mass casualties, but not about how to evacuate if necessary, and when a wrong decision can have fatal consequences. That is why the Mexican Social Security Institute gave the task of examining these problems to a working group composed of specialists of the Institute. The purpose was to evaluate and establish a method for performing a protocol in the removal of patients and considering always to safeguard both staff and patients and maintain the quality of care.
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Comparative Study Controlled Clinical Trial
[Infusional therapy: an alternative for shouder pain post-laparoscopy].
Neuraxial anesthesia in upper abdominal laparoscopic surgery decreases perioperative morbidity and mortality. However, shoulder pain is common and difficult to control. Use of a major opioid (e.g., fentanyl) for the control of this event may depress respiratory function. This is why we believe that a safe and effective therapeutic control of this disease pain is a multimodal analgesic scheme which we have called infusional therapy. ⋯ preemptive analgesia to infusional therapy with ketoprofen-tramadol at doses of 100 mg each is safe for laparoscopic surgery.
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Observational Study
[Preventive program for postoperative delirium in the elderly].
Delirium is a poorly recognized entity in surgical patients that may commonly be mistaken for dementia or cognitive dysfunction. It is of great importance to know the measures that can lower its incidence and insure early recognition in order to begin specific treatment. The main objective of this study was to prove that implementation of an educational program for health care professionals is an effective strategy to reduce delirium incidence and to help in early detection. ⋯ Implementation of a delirium prevention program is feasible. Due to the satisfactory results in our study it should be considered as an effective strategy for reducing incidence of this condition that may cause greater postoperative morbidity and mortality.K.
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Comparative Study Controlled Clinical Trial
[Bronchoscopy-guided percutaneous tracheostomy. A safe technique in intensive care].
When compared with conventional surgery, bronchoscopy-guided percutaneous tracheostomy has demonstrated some advantages. We compare the results obtained with bronchoscopy-guided percutaneous tracheostomy performed by Intensive Care Unit personnel with those of conventional surgery. ⋯ Bronchoscopy-guided percutaneous tracheostomy is a versatile and safe alternative for conventional tracheostomy when performed in Intensive Care Unit by personnel with expertise and appropriate training.