Irish medical journal
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Irish medical journal · Jul 2012
Case ReportsPancreatico pleural fistula: an unusual complication of chronic pancreatitis.
Pancreatico-pleural fistula secondary to chronic pancreatitis is a rare cause of pleural effusion. This case report presents a case of a middle aged female, a known case of chronic pancreatitis who presented with severe epigastric pain and progressive shortness of breath. CT and MRCP were useful in visualising the fistulous communication between the pancreas and pleural cavity. Treatment consisted of ERCP placement of a pancreatic stent, which facilitated internal drainage of pancreatic fluid thus resolving the pleural effusion and promoting healing of the fistula.
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Irish medical journal · Jul 2012
Improving patient care--the first year in a dedicated surgical assessment unit.
A surgical assessment unit (SAU) was established in October 2009 at the Mid-Western Regional Hospital. We assessed this servic in its initial year and compared it to Emergency Department (ED) services. We audited SAU and ED databases and theatre logbooks from November 2009 to October 2010. 1949 patients were referred to the SAU and 857 patients were admitted (44%). ⋯ To summarise, we found that almost 2,000 patients who would otherwise have presented to the ED were referred to the SAU. Waiting times for admission and theatre were significantly shorter. Further resource allocation could expand the service and improve it further, by diverting more patients from the ED.
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Irish medical journal · Jul 2012
"In somno securitas" anaesthetists' noise exposure in Orthopaedic operating theatres.
Excessive noise exposure can have adverse effects on the health and performance of healthcare providers. Irish statutory regulations limit daily workplace noise exposure to 87 A-weighted decibels [dB(A)]. The World Health Organisation recommends noise levels remain under 35 dB(A) in patient treatment rooms. ⋯ Sound levels recorded were lower than recognised levels associated with hearing loss. Sound regularly exceeded World Health Organisation (WHO) recommended levels for patient comfort and safety. Anaesthetists need to be aware of the influence of environmental noise on clinical practice.