Postgraduate medicine
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Postgraduate medicine · Oct 1989
ReviewSuccessful weaning from mechanical ventilation. Strategies to avoid failure.
The majority of patients who require mechanical ventilation can be weaned quickly from the ventilator. Patients with severe lung disease and multisystem disease often require a more prolonged, gradual reduction of ventilatory support. Identification of patients who are ready to be weaned, correction of common problems that occur in weaning, and use of a standard approach during weaning trials can improve the likelihood of successful discontinuation of mechanical ventilation.
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Information about healthcare "bargains" is easy to obtain. Physicians who take the time to familiarize themselves with costs in their hospitals and clinics can help reduce charges for tests and drugs and can avoid wasteful use of supplies and misuse of staff time that can lead to additional charges. Education is effective in fighting rising healthcare costs, but efforts need to be ongoing if patients and medical institutions are to benefit in the long run.
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Postgraduate medicine · Sep 1989
Case ReportsForeign body in upper airway. Unsuspected cause of obstruction.
Airway obstruction from a foreign body is usually an acute life-threatening event. In this case, a complete upper dental plate was the unsuspected cause of intermittent respiratory distress. The authors discuss the clinical and laboratory findings and suggest ways to prevent unnecessary delays in diagnosis and treatment.
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Postgraduate medicine · Sep 1989
ReviewPotentially catastrophic bleeding disorders. Approach to diagnosis and management.
Clinical and laboratory evaluation of severe bleeding can detect the presence of an intrinsic or acquired coagulation disorder. The three most common inherited coagulation disorders are factor VIII deficiency (hemophilia A), factor IX deficiency (hemophilia B), and von Willebrand's disease. ⋯ Screening tests that measure prothrombin time, partial thromboplastin time, thrombin time, and platelet count permit initial classification and guide selection of more specific tests. Results can then be used to determine appropriate therapy.