Crit Care Resusc
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Case Reports
Pulmonary haemorrhage associated with negative-pressure pulmonary oedema: a case report.
Negative-pressure pulmonary oedema caused by upper airway obstruction after tracheal extubation is well recognised, but extensive pulmonary haemorrhage is rare. We report a case of post-extubation, laryngospasm-induced pulmonary oedema with associated pulmonary haemorrhage. The patient required mechanical ventilation with high positive end-expiratory pressure.
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To investigate analgesic prescription patterns and administration in postoperative cardiac surgery patients in the ICU in a tertiary hospital. ⋯ We recommend introducing scoring of patient pain in the ICU, both at rest and with movement, and provision of a designated area on the ICU flow chart for these scores. Paracetamol or other simple analgesics could be prescribed regularly, and staff need education about premedication of patients before removal of chest drains.
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We describe a case of abrupt cardiac arrest in an 80 year old woman. Emergent transoesophageal echocardiography (TOE) helped clarify the diagnosis of pulmonary embolism, and guide management and ongoing resuscitation. This case highlights the utility of TOE in the peri-arrest setting and in the diagnosis of massive pulmonary embolism. TOE can also be useful in providing prognostic information and determining the choice of therapeutic drug treatment and vasopressor support.