Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 2005
Case ReportsCase report. Successful use of tenecteplase in massive pulmonary embolism with cardiopulmonary resuscitation immediately following tracheostomy.
The use of thrombolytics for the treatment of massive pulmonary embolism with cardiopulmonary resuscitation is being controversially discussed. This is one of the first reports on the successful use of tenecteplase in a 59-year-old man who survived a massive pulmonary embolism after tracheostomy followed by a 30-minute cardiopulmonary resuscitation without cerebral damage. In such a dramatic clinical event, the immediate and simple use of this modern thrombolytic appears to be a justifiable last-resort treatment option until controlled studies in sufficiently sized patient populations will have proven or refuted its efficacy and safety.
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Today, quality is part of our practice. Anaesthetists are involved in a medical science and want to be excellent at it. Anaesthetists are also involved in departmental organisation and are providers of care, a service to the patients. ⋯ On the other hand, health care is a public matter and in most countries depends on a governmental financing. Quality means efficacy, ethics and economics, including medico-legal aspects. But how can we use a quality and management concept (QMDA) in our daily practice? This is the subject of the paper.