Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række
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Clostridium difficile infection is discussed relatively rarely as a nosocomial problem in Norway. Epidemiological studies have shown Clostridium difficile diarrhoea to be frequently an antibiotica-associated nosocomial disease. ⋯ These and five other patients probably had a hospital-acquired Clostridium difficile infection. We discuss the nosocomial aspect and the clinical characteristics of the disease in our material.
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Tidsskr. Nor. Laegeforen. · Apr 1995
[Use of a mask as an alternative to endotracheal intubation in acute respiratory failure].
Acute respiratory failure that is unresponsive to medical treatment requires ventilatory support. Non-invasive treatment with a nose or face mask is an alternative to endotracheal intubation in awake and cooperative patients. ⋯ The method reduces the need for endotracheal intubation and hence the time spent by the patient in the intensive care unit, but the need for personnel resources is equal. Possible clinical problems are skin erosions on the bridge of the nose due to pressure from the mask, and systemic hypotension.
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Patients attending a casualty department often have diseases or injuries needing urgent medical attention. Early and correct diagnosis and treatment may be of major importance for the medical outcome. ⋯ Quality assurance at a casualty department through good training, introduction of written rules, a good flow of information to the staff and local licensing of doctors are factors which can assure that the quality of the medical service remains the best. This paper presents the work done at The Tromsø Municipal Casualty Department to assure the quality of the medical service to the population.
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Tidsskr. Nor. Laegeforen. · Mar 1995
[Medical emergency service. Descriptions of a one-year activity at an emergency communication center].
The emergency medical communication centre, Vestfold Central Hospital, receives emergency medical calls (phone 113), from 200,000 citizens in Vestfold county. Calls are categorised by urgency (red, yellow or green) according to the Norwegian Index to Emergency Medical Assistance, a criteria-based dispatch manual. In 1993, 2,440 red (suspected life-threatening conditions), 3,502 yellow and 6,505 green calls were received. ⋯ Efforts were made 628 times to give basic life support instruction by telephone. An ambulance was the most frequent response, general medical practitioners were called upon relatively seldom. The response was estimated to adequate in 79% of the incidents, exaggerated in 9% and inadequate in 3%.
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Tidsskr. Nor. Laegeforen. · Feb 1995
Case Reports[Persistent pulmonary hypertension in a newborn infant treated with extracorporeal membrane oxygenation].
Extracorporeal membrane oxygenation is a recent addition to our therapeutic arsenal in infants with life-threatening respiratory failure. We have treated a neonate with persistent pulmonary hypertension secondary to meconium aspiration with veno-arterial extracorporeal membrane oxygenation. Both conventional, pressure-controlled ventilation and high-frequency jet ventilation having failed, extracorporeal membrane oxygenation was life-saving for this infant. ⋯ In spite of this complication the child was found to be normal upon neurodevelopmental evaluation at one year of age. Extracorporeal membrane oxygenation is a high-technology therapy which should probably be centralized to only one to two units in Norway. It may be life-saving for selected patients who do not respond to other forms of therapy, but the risk of sequelae is not insignificant.