The West Virginia medical journal
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Venomous snakebites are a rare but dangerous and potentially deadly condition in the U. S.. Most bites in the U. ⋯ When allergic reactions do occur, they are usually of mild to moderate severity. With the improved risk-benefit ratio of CroFab, antivenom is indicated with any grade of envenomation. In this a retrospective study, we will review our experience with 25 snakebite victims admitted to the West Virginia University over a five years period.
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Case Reports
A case for combined spinal-epidural anesthesia for Cesarean section in a patient with aortic stenosis.
This is a report of a patient with moderate aortic stenosis and twin gestation who presented for elective Cesarean section. These patients are at high risk of anesthesia related mortality from the pathophysiology of the cardiac lesion, exacerbated by the cardiovascular changes of pregnancy and complicated by the hemodynamic aberrations caused by anesthesia. This case shows that a slowly induced spinal-epidural anesthetic, with invasive blood pressure monitoring, is a safe and effective anesthetic.
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Case Reports
Prolonged mechanical ventilation: are your ventilator patients ready to be cared for outside ICU?
A significant number of patients in the ICU require prolonged periods of ventilator support. We present here, four such patients and incorporate the recent recommendations of a consensus conference on prolonged mechanical ventilation. We hope our case studies will enable physicians to better manage and care for this challenging group of patients.
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Staffing of rural emergency departments (ED) with residency-trained, board certified emergency physicians has been an ongoing challenge in the field of Emergency Medicine. ⋯ Just over half of all physicians staffing WV's EDs are residency trained or board certified in EM, a number that lags well behind the national average. Rural EDs report even lower numbers, although the proportion has increased since the 1996 WV study. WV EM practitioners, particularly in more rural locations, continue to provide emergency care with less formal training, certification credentials, and specialty back-up.