Singap Med J
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We report a case of cardiac arrest due to hyperkalaemia following administration of suxamethonium during a procedure to facilitate a change of endotracheal tube in a septic patient. The cause of this rare but fatal complication is briefly described and discussed. In view of this, suxamethonium should be used with great caution in patients with burns and other forms of physical injury, in a number of nervous system disorders, and in critically ill patients requiring prolonged ITU care.
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Early diagnosis of sepsis in the neonate is often difficult because symptoms and signs are usually non-specific. A study was conducted to evaluate C-reactive protein (CRP) as a screening tool for neonatal sepsis among very low birth weight (VLBW) infants. ⋯ CRP assay using laser nephelometry is a valuable adjunct in screening for neonatal sepsis, complementing clinical decision-making.
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This paper highlights hazards involved in moving critically ill patients between locations, discusses minimalisation of risks involved and the advantages of specialist teams. ⋯ Critically ill patients are moved within the hospital because of the need for surgical procedures or to have fixed facilities investigations performed. Interhospital movement of patients is necessary for specialised care available elsewhere. This has increased with centralisation of specialist services. This paper adopts a practical approach to the transfer process. It establishes the goals of conducting a safe transfer, highlights the deleterious effects of moving an ill patient, the risks and pitfalls of a transfer, and how to minimise them. Attention is drawn to the need for proper resuscitation and stabilisation of a patient before transport. The quality and outcome of the transfer depend on the experience of the transferring team and on adequate monitoring facilities. The benefits of a specialist transfer team is suggested.
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The immediate post-operative period in the recovery room is a known period of high risk for anaesthetic complications to occur. ⋯ Our recovery room complication rate is acceptably low. Knowing the type and frequency of problems (in this case, mainly pain and nausea and vomiting) can further improve the figure. The role of anaesthesiologists has expanded as they are not only expected to ascertain the safety but also the comfort of patients post-operatively.