Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Jan 2010
[Helicopter emergency medical service missions at night: 2 years of experience in the Dutch Regional Emergency Healthcare Network East].
To study whether there are differences between day and night in the dispatch of helicopter emergency medical services (HEMS) and in their response and travelling times, medical treatment and transport of patients. ⋯ The number of dispatches of the HEMS team at night was higher than expected, but night missions were cancelled more often due to weather conditions than missions by day. Prehospital times and operations of the Netherlands HEMS differed slightly between day and night.
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Ned Tijdschr Geneeskd · Jan 2010
[Crisis in human resources for health: millennium development goals for maternal and child health threatened].
International migration of health care workers from low-income countries to the West has increased considerably in recent years, thereby jeopardizing the achievements of The Millennium Development Goals, especially number 4 (reduction of child mortality) and 5 (improvement of maternal health). This migration, as well as the HIV/AIDS epidemic, lack of training of health care personnel and poverty, are mainly responsible for this health care personnel deficit. It is essential that awareness be raised amongst donors and local governments so that staffing increases, and that infection prevention measures be in place for their health care personnel. Western countries should conduct a more ethical recruitment of health care workers, otherwise a new millennium development goal will have to be created: to reduce the human resources for health crisis.
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Ned Tijdschr Geneeskd · Jan 2010
[Delirium on intensive care frequently missed: clinical impression alone is not enough].
To compare the sensitivity and specificity of a routine assessment (clinical impression) with a structured assessment which uses a validated assessment scale for the recognition of delirium on the intensive care unit (ICU). ⋯ The diagnosis delirium is frequently missed on the ICU when only based on clinical impression. Routine assessment using a validated assessment scale such as the CAM-ICU might possibly improve this.
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A 51-year old male was admitted to the hospital with complaints of fever, a productive cough and exercise-related shortness of breath. These complaints were caused by a pneumatocele, which was successfully treated with antibiotics.
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An 82-year-old woman presented with dyspnoea and palpitations. The patient was admitted to the cardiology ward on suspicion of atrial fibrillation and reduced cardiac output. Examination revealed position-dependent deoxygenation. ⋯ Curative treatment consisted of percutaneous closure of the foramen ovale. A persistent asymptomatic foramen ovale is common and can be revealed in later life. Platypnea-orthodeoxia syndrome is a relatively unfamiliar disorder.