The Western journal of medicine
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The role chest radiography plays in intensive care units (ICU) is unlike its role elsewhere because in the ICU a patient's underlying disease is usually known. Furthermore, additional diseases that develop in the ICU-such as pneumonia, hemorrhage, edema, lung collapse and effusion-often are radiographically indistinguishable. Nevertheless, an ICU radiograph of the chest is valuable, mainly in identifying such complications as malpositioned intravenous catheters, Swan-Ganz catheters, pacemakers, nasogastric tubes, endotracheal tubes, chest tubes, and mediastinal tubes, and ectopic gas related to mechanical ventilation. Understanding the limitations of the portable ICU chest film in the diagnosis of specific diseases and being alert to possible iatrogenic complications will increase the usefulness of ICU chest radiography.
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The effectiveness of cardiopulmonary resuscitation as a vital aspect of health care delivery in hospital was the basis for a ten-year study. All instances of cardiac arrest occurring outside the operating room and nursery were included. ⋯ A simple technique for expressing effect of cardiopulmonary resuscitation on hospital mortality is presented. The study shows the ability of a community hospital to establish, maintain and document a high level cardiopulmonary resuscitation program.
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Malignant neoplasms may cause life-threatening complications requiring prompt diagnosis and emergency therapy. Whether or not the underlying neoplasm is potentially curable, the physician can often provide worthwhile prolongation of life and dramatic symptomatic relief. Among the serious complications of neoplasia are superior vena cava obstruction, airway obstruction, pericardial tamponade, spinal cord compression, brain metastasis, meningeal involvement by cancer, hyperuricemia, hypercalcemia and hyperkalemia.