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Recovery Unit (recovery + unit)
Selected AbstractsEndotoxin-like reaction following once-daily gentamicinACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 6 2009E. E. ALY An endotoxin-like reaction is a host response to an agent that induces the release of endogenous pyrogens, including cytokines. The typical reaction that is associated with gentamicin is fever and chills, rigor, shivering, tachycardia with hypertension or hypotension, respiratory symptoms and muscle cramps. We report a case of a 92-year-old patient who developed an endotoxin-like reaction in the post-operative recovery unit following 200 mg of gentamicin. The reported side effect is not included in the drug sheet or in the British National Formulary. No similar incidents were reported in the UK. We discuss the clinical picture of this rare event, along with a review of the literature and recommendations. [source] SIMULTANEOUS RECOVERY AND DETECTION OF FOUR HEAT-INJURED FOODBORNE PATHOGENS IN GROUND BEEF AND MILK BY A FOUR-COMPARTMENT THIN AGAR LAYER PLATEJOURNAL OF FOOD SAFETY, Issue 2 2006VIVIAN C.H. WU ABSTRACT A four-compartment thin agar layer (4-TAL) system was developed to improve operation efficiency and recover injured foodborne pathogens simultaneously. The system consisted of a layer of nonselective agar overlaid on four different selective agars (xylose lysine desoxycholate [XLD], cefsulodin irgasan novobiocin [CIN], modified Oxford medium [MOX] and MacConkey sorbitol agar [MSA]) housed in a four-compartment petri dish. We applied this system to simultaneously recover heat-injured (55C, 10 min) Escherichia coli O157:H7 (MSA), Listeria monocytogenes (MOX), Salmonella Typhimurium (XLD) and Yersinia enterocolitica (CIN) from ground beef and pasteurized milk. No significant difference (P > 0.05) occurred between the single recovery unit (nonselective agar overlaid on one selective agar in a standard petri dish) and the 4-TAL for detecting four heat-injured pathogens in tested samples. Both TAL methods showed greater recovery of four heat-injured pathogens than the pathogen-specific selective media (P < 0.05). The 4-TAL system appears to be efficient for recovery and detection of injured pathogens in food in terms of operation, material and labor costs, and space of incubation. [source] Mortality related to anaesthesia in France: analysis of deaths related to airway complications,ANAESTHESIA, Issue 4 2009Y. Auroy Summary Death certificates from the French national mortality database for the calendar year 1999 were reviewed to analyse cases in which airway complications had contributed to peri-operative death. Respiratory deaths (and comas) found in a previous national 1978,82 French survey (1 : 7960; 95% CI 1 : 12 700 to 1 : 5400) were compared with the death rate found in the present one: 1 : 48 200 (95% CI 1 : 140 000 to 1 : 27 500). In 1999, deaths associated with failure of the breathing circuit and equipment were no longer encountered and no death was found to be related to undetected hypoxia in the recovery unit. Deaths related to difficult intubation also occurred at a lower rate than in the previous report (1 : 46 000; 95% CI 1 : 386 000 to 1 : 13 000) in 1978,82 vs 1 : 176 000 (95% CI 1 : 714 000 to 1 : 46 000) in 1999, a fourfold reduction. In most cases, there were both inadequate practice and systems failure (inappropriate communication between staff, inadequate supervision, poor organisation). This large French survey shows that deaths associated with respiratory complications during anaesthesia have been strikingly reduced during this 15-year period. [source] Clinical implications of sugammadexANAESTHESIA, Issue 2009J. E. Caldwell Summary Sugammadex is a cyclodextrin molecule that encapsulates and inactivates rocuronium and vecuronium. As a result, any degree of neuromuscular block produced by rocuronium or vecuronium can be rapidly and completely reversed without autonomic effects. Because sugammadex is optimised for reversing rocuronium it is most likely to be used in conjunction with this drug. Sugammadex will allow deep levels of block to be maintained until the very end of surgery, and will allow block to be reversed at any time after rocuronium administration, even just a few minutes. The recommended dose-range is 2,16 mg.kg-1 (ascender), depending on the level of block. The availability of sugammadex reversal may increase the use of rocuronium, and decrease the use of suxamethonium and benzylisoquinoline neuromuscular blocking drugs. In addition, it will certainly increase pharmacy costs, which may be offset by faster recovery and discharge from the post-anesthesia recovery unit. Sugammadex may also change monitoring practices in that post-tetanic count will be required to quantify deep block, and quantitative monitoring of recovery may be driven by cost concerns in order to allow the use of the smallest dose of sugammadex that gives a satisfactory train-of-four ratio. Alternatively, monitoring may essentially be abandoned since a large dose of sugammadex will reliably reverse any degree of rocuronium-induced block. The ultimate clinical utility of sugammadex will be clear only after large-scale clinical use. [source] Monitor-induced tachycardia in a patient with a rate-responsive pacemakerANAESTHESIA, Issue 4 2006S. Houtman Summary A patient with a ventricle-paced, ventricle-sensed and inhibited, respiratory rate-responsive pacemaker presented for orthopaedic surgery. She had been operated upon recently without any adverse effects. In the recovery unit her electrocardiograph showed a paced ventricular tachycardia of about 140 beats.min,1 without any other adverse sign or symptom. Although this tachycardia initially decreased to 70 beats.min,1 after about 30 min, it later rose again to 140 beats.min,1. A pacemaker technician was consulted, who suggested that there may be interference between the bioelectric impedance signals of the patient monitoring system that was being used to measure respiratory rate and the pacemaker's own measurement systems. [source] | ||||||||||