Ann Acad Med Singap
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Ann Acad Med Singap · May 1998
Clinical TrialOutcome of patients with traumatic brain injury managed on a standardised head injury protocol.
A standardised protocol in the management of severe head injury in our hospital enables pre-determined critical care-paths and consistent treatment regimes to be instituted. In Singapore there has been no previously reported data on the outcome of severely head injured patients. Over a 6-month period, 48 consecutive patients who were enrolled in our severe head injury protocol were prospectively studied. ⋯ The use of a protocol with standardised treatment goals in the management of traumatic brain injury allows for the optimal use of limited resources and provides consistency in treatment. Good outcome is related to early aggressive resuscitation to prevent hypotension and hypoxia, prompt evacuation of surgical mass lesions and the maintenance of an adequate cerebral perfusion pressure. Our results are comparable with that reported in other established neurotrauma systems.
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Ann Acad Med Singap · May 1998
Case ReportsFive paediatric case reports of the use of adenosine in supraventricular tachycardia.
The efficacy, safety and diagnostic usefulness of adenosine in the treatment of supraventricular tachycardia in children were prospectively studied over a 2-year period. Only patients who were stable and without hypotension were included. Adenosine was given at a dose of 0.1 mg/kg and increased to 0.2 mg/kg for the second and third doses if there was no response. ⋯ One out of 3 patients who were old enough to report side-effects, experienced chest discomfort and dizziness lasting 5 seconds. All side-effects were transient and mild. We concluded that adenosine is effective and safe in terminating supraventricular tachycardia in children after vagal manoeuvres have failed.
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Ann Acad Med Singap · May 1998
Audit of 2431 admissions to the Surgical Intensive Care Unit, Singapore General Hospital.
A prospective analysis of 2431 patients admitted to the Surgical Intensive Care Unit (SICU) of Singapore General Hospital was conducted between January 1994 and June 1997. All patients were followed up until hospital discharge. This ongoing project serves as both audit and quality assurance in the SICU. ⋯ Thirty (29%) died before the SICU discharge. SICU mortality was 9.46%, hospital mortality was 10.86% and standardised mortality ratio was 1.95. Computerised tools that analyse ICU utilisation patterns and outcomes have the potential to better target resources and so lower hospital costs, reducing futile medical care by selecting patients for appropriate expensive ICU care.
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Ann Acad Med Singap · May 1998
Comparative StudyA retrospective study of near-drowning victims admitted to the intensive care unit.
A retrospective study was conducted to evaluate the outcome of near-drowning patients admitted to the intensive care unit (ICU) comparing seawater and freshwater drownings. A chart review was used to identify near-drowning patients admitted to ICU from 1 April 1989 to 1 May 1996 for biodata, physiological data and outcome. Seventeen near-drowning patients were admitted to ICU over a period of nearly 7 years. ⋯ Patients that survived to hospital discharge had full neurological recovery and stayed an average of 4.5 days. We concluded that near-drowning victims that survive to be admitted to ICU have significant oxygenation defect with nearly half requiring ventilatory support. Mortality is appreciable, but those that survive to hospital discharge had full neurological recovery.