WMJ : official publication of the State Medical Society of Wisconsin
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Case Reports
A case of supraventricular tachycardia associated with Wolff-Parkinson-White syndrome and pregnancy.
A 25-year-old pregnant woman was admitted with frequent episodes of supraventricular tachycardia associated with Wolf-Parkinson-White syndrome. She was treated acutely with adenosine therapy during induction of labor and post-partum. ⋯ Adenosine is the first choice for acute treatment of supraventricular tachycardia in pregnancy; several other options exist, but all have the potential for negative side effects for mother and fetus. Direct-current cardioversion is acceptable in all stages of pregnancy.
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Postoperative nausea and vomiting (PONV) is a major source of patient dissatisfaction and is the leading cause of discharge delays and unanticipated postsurgical hospital admissions. The objective of this study was to examine the efficacy of PONV management consensus guidelines at the institutional level. ⋯ Implementation of consensus PONV prevention guidelines significantly reduced incidence at an institutional level. However, patients with 3 or more risk factors remain at risk for PONV. Risk stratification remains important and greater intervention is required in this subgroup at our institution. In response to publication of procedural consensus guidelines, individual institutions should consider modification of practices and assessment of outcomes following application.