Irish medical journal
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Irish medical journal · Mar 2008
Comparative StudySedation with oral chloral hydrate in children undergoing MRI scanning.
In the absence of a general anaesthetic facility for MRI scanning in children, we introduced a sedation protocol using chloral hydrate. Our aim was to evaluate the success and safety of our protocol. This was a retrospective study enrolling 36 children over a 7 month period. ⋯ For children greater than 5 years of age the success rate was 70%. 92% of developmentally normal children and 83% of developmentally delayed children were successfully sedated. Success rates were poorer in children older than 5 years and in those with developmental delay. Our findings suggest that this protocol could be safely used in units where general anaesthetic facilities are unavailable for MRI and for other radiological investigations.
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Care of the dying can be a complex and challenging area of healthcare. For some patients as they enter the terminal phase of their illness and start to die, new symptoms can emerge, whilst other pre-existing symptoms become more troublesome. ⋯ Within the specialty of palliative medicine such symptoms are known as refractory symptoms and there is the practice of using sedation therapy for the relief of such symptoms. This article will review the use of sedation to relieve refractory symptoms in the terminally ill.
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Irish medical journal · Feb 2008
The impact of a pre-hospital medical response unit on patient care and emergency department attendances.
A rapid response team was instigated in Cork to improve prehospital care and reduce unnecessary Emergency Department (ED) visits. This consisted of a Specialist Registrar (SpR) in Emergency Medicine and a Paramedic who attended all "999" calls in a designated rapid response vehicle on the allotted study days. Two hundred and sixty-three patients were seen on designated days between Jan 2004 and March 2006. ⋯ Intravenous medications were administered in 21% of these patients--morphine sulphate was the most common drug given. It was possible to safely discharge 31% of patients on scene. In our experience skilled Emergency Medicine doctors attending at scene could provide advanced care and reduce ambulance transportation and patient attendance.