Journal of clinical medicine research
-
The management of cardiac arrest in pregnancy is an important task for the emergency physicians. The clinical outcome of mother or fetus will often depend on the successful resuscitation of the first few minutes. Furthermore, the resuscitation team leader should consider the necessity of emergency hysterotomy (cesarean delivery) as soon as a pregnant woman develops cardiac arrest. We report a case of a 28-year-old pregnant woman who had a ventricular fibrillation cardiac arrest. She was successfully resuscitated in our emergency department and a single male healthy infant was delivered via cesarean section at 36 weeks' gestation. Mother and baby were discharged survival and neurologically intact from the intensive care unit (ICU) on day 25. We emphasize that understanding the causes of cardiac arrest during pregnancy, its early recognition and prompt resuscitation by recent ACLS guidelines may decrease both maternal and fetal morbidity or mortality. ⋯ Cardiac arrest; Cardiopulmonary resuscitation; Cesarean delivery; Fetus; Pregnant.
-
Case Reports
Subclavian Vein Thrombosis Extending into the Internal Jugular Vein: Paget-von Schroetter Syndrome.
Paget-von Schroetter syndrome refers to spontaneous thrombosis of the subclavian vein and constitutes 0.5-1% of all venous thromboses. It is prevalent among young and healthy adult males who engage in sports. Early diagnosis and treatment is essential to avoid long-term sequelae. Herein, we report a 42-year-old male weightlifter who presented with swelling of the left arm, pain and a feeling of tightness in the anterior chest wall. At Doppler US and MR angiography, subclavian vein thrombosis extending into the internal jugular vein was detected. Thrombolytic treatment ensured continuous venous flow and the patient's complaints decreased. ⋯ Veins; Thrombosis; Thorombolytic therapy.
-
Despite emergence of early goal directed therapy, septic shock still carries a high mortality. Gram negative septicemia is notorious for rapid deterioration due to endotoxin release. Multi-organ damage due to septic shock carries poor prognosis, and such patients should be managed aggressively with multidisciplinary approach. We present a fatal case of a patient with gram negative septicemia who rapidly deteriorated, and died due to acute refractory severe septic shock. This patient probably developed urosepsis secondary to severe urinary tract infection. He also had infiltrates on chest radiograph. He expired within fifteen hours of presenting to the emergency department. This case emphasizes the importance of early recognition and management of septic shock. Early goal directed therapy has shown to improve mortality. Broad spectrum antibiotics should be started within one hour depending on local immunity of organisms. This case also highlights the fact that despite optimized treatment, this entity has very high mortality rates. ⋯ Hemodynamic deterioration; Refractory septic shock; Gram negative septicemia.