Nederlands tijdschrift voor geneeskunde
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Medical assistance by doctors on board an aircraft The number of in-flight medical emergencies continues to increase due to the rise in the number of (older) passengers, the greater capacity of new airplanes and the constant increases in the distances flown. The most common medical problems on board an aircraft are vasovagal collapse, dizziness, and gastro-intestinal and cardiac complaints. ⋯ The chances of being involved in a lawsuit afterwards are, however, very small because the usual medical standards do not apply and because the patient usually does not know the doctor that has assisted him. Even if it should come to a legal procedure, the chance that a physician will be found guilty of malpractice is very small because of the special circumstances and limitations in an airplane.
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Ned Tijdschr Geneeskd · Mar 2006
Review[The guideline 'Treatment of acute carbon-monoxide poisoning' from doctors in clinics with a tank for hyperbaric ventilation].
The guideline 'Treatment of acute carbon-monoxide poisoning' from doctors in clinics with a tank for hyperbaric ventilation Carbon-monoxide (CO) poisoning is a potentially life-threatening emergency. Its prognosis is determined by prompt recognition and treatment. CO is toxic because it binds to haemoglobin (Hb), thus impairing oxygen transport and causing tissue hypoxia. ⋯ In patients requiring artificial ventilation, 100% oxygen for 8 hours is recommended. In pregnant women and in patients who are or have been comatose, hyperbaric oxygen can be considered. In all other symptomatic patients, use of a non-rebreathing mask with 100% oxygen for 8 hours is recommended.
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Ned Tijdschr Geneeskd · Mar 2006
Case Reports[Episodes of angioedema in children with C1 esterase inhibitor deficiency].
A 6-year-old boy and a 3.5-year-old girl presented with unexplained episodes of angioedema without urticaria. Low serum C1 esterase inhibitor activity was found in both children. Family history revealed autosomal dominant inheritance in the girl. ⋯ Treatment consists of substitution of synthetic C1 esterase inhibitor during episodes of edema carrying a risk of upper airway obstruction. In patients who have more than one episode of severe angioedema per month, daily treatment with tranexamic acid should be considered. Both of these patients were not receiving daily treatment.
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Ned Tijdschr Geneeskd · Mar 2006
[The use of complementary and alternative medicine in children at a general paediatric clinic and parental reasons for use].
To determine the prevalence of and reasons for the use of complementary and alternative medicine (CAM) in paediatric patients, and to determine the parental need for appropriate information from their paediatrician. ⋯ Almost one-third of patients visiting a general paediatrician had used complementary or alternative medicine in the past year. Given the possible interactions with conventional therapies and the desire of parents to receive more information on CAM, paediatricians should expand the patient history assessment to include questions regarding the use of CAM.