Acta medica Croatica : c̆asopis Hravatske akademije medicinskih znanosti
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Review Case Reports
[Rapid sequence intubation (RSI) in a patient with severe head injury on the island--a case report and review of the literature].
A significant proportion of acute airway management occurring outside the operating room is being performed by non-anesthesiologists. Rapid sequence intubation (RSI) as a modification of endotracheal intubation (EI) has been recognized as a core procedure within the domain of emergency physician. The technique is termed rapid sequence because it involves simultaneous induction of sedation and neuromuscular blockade, usually with succinylcholine. ⋯ The standard protocol of RSI is shown where pharmacologic adjuncts to intubation are applied after the neccesery preparation. Some specific problems in the emergency care of severely injured patients on the island of Korcula are pointed out, suggesting the need to improve the education of physicians working in emergency medicine with the introduction of specialization in emergency medicine. It is an imperative to proceed with the implementation of recent programs with the purpose of emergency medical service improvement in the country, especially on distant islands.
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Umbilical cord blood (UCB) is a source of the rare but precious primitive hematopoietic stem cells (HSC) and progenitor cells that can reconstitute the hematopoietic system in patients with malignant and nonmalignant disorders treated with myeloablative therapy. UCB cells possess an enhanced capacity for progenitor cell proliferation and self-renewal in vitro. UCB is usually discarded, and it exists in almost limitless supply. ⋯ Consequently, such pluripotent or, perhaps, multipotent stem cells have been proposed as elements suitable for cellular therapy and regenerative medicine. Up to date there are no conclusive data regarding these possibilities but preliminary in vitro and animal studies in the field of tissue regeneration suggest some degree of plasticity and/or transdifferentiation. UCB cells are showing their unique qualities and potential, and consequently UCB banks might dramatically increase the scope of their clinical application.
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The aim of the study was to determine the influence of the heparin bolus, which was administered to a patient due to incapability to aspire heparin from the dysfunctional lumen of dual lumen central venous catheter (CVK), on activated partial thromboplastin time (APTT) values during hemodialysis (HD), as well as to determine the need of additional administration of heparin during HD. ⋯ Patients who received the heparin bolus from the dysfunctional lumen of dual lumen CVK needed an additional administration of heparin during hours 3 and 4 of HD in order to reduce the frequency of clotting in the extracorporeal circuit system. The frequency of clotting during HD in this study was not dependent on the total dosage of administered heparin, but rather on the means of its administration.