Free Republic

Patients receiving neuromuscular blocking medications as part of their anesthetic regimen should be carefully monitored to ensure best care, according to guidelines from the American Society of Anesthesiologists and the European Society of Anaesthesiology and Intensive Care. Medications that provide neuromuscular blockade are frequently used in anesthesia, both to ease placement of a breathing tube at the beginning of the anesthetic (intubation) and to provide optimal conditions for the surgery itself. Both ASA and ESAIC guidelines for the management of neuromuscular blockade recommend patients be monitored quantitatively as part of the process, meaning that the degree of muscle relaxation is...

Intubation of an infant with any lung condition, or even an adult with severe COVID-19 using either ventilation or extra-corporeal membrane oxygenation (ECMO), comes with risks and side effects that could cause permanent damage not limited to the lungs. Consider this: The human intestine receives almost one-third of the body's cardiac output. What if we could spare oxygen in the gut and redistribute oxygen to other body districts to avoid intubation? Researchers have found that an extra amount of oxygen is available to organs critical for the survival of the individual, including the heart, brain, kidneys and liver, by reducing...

I've been curious about this for a long time so I thought I would ask the smartest people I know. Last year my sister passed away from Cardiac Arrest due to pneumonia caused by being on the ventilator. I never had any experience with anything like this before and aside from the grief and Trauma I gained a lot of awareness I was ignorant to previously. Since covid started I have noticed a pattern that it really seems like a death sentence once you get on the ventilator for this disease. It occurred to me that a tracheostomy would be...

On April 27, 2020, the Portland Press-Herald reported, "Rye [New Hampshire] police are advising surfers to catch a wave elsewhere or face the prospective of a fine. "Rye Police Chief Kevin Walsh said his officers are weary of chasing off surfers in groups as large as 10 who are ignoring beach closures. "Many are parking in church lots and on private property, so Walsh is seeking permission from these property owners to ticket and tow the vehicles. Police may also start issuing tickets to surfers for trespassing on the beach." Chief Walsh's efforts were in vain. Guarding 19 miles of...

One doctor at the Albert Schweitzer municipal hospital in Rio de Janeiro told the Associated Press that for days health workers diluted sedatives to make their stock last longer. Once it ran out, nurses and doctors had to begin using neuromuscular blockers and tying patients to their beds, the doctor said. “You relax the muscles and do the procedure easily, but we don’t have sedation,” said the doctor, who agreed to discuss the sensitive situation only if not quoted by name. “Some try to talk, resist. They’re conscious.”

In a medical first, doctors used plastic particles and a 3-D laser printer to create an airway splint to save the life of a baby boy who used to stop breathing nearly every day. It’s the latest advance from the booming field of regenerative medicine: making body parts in the lab. In the case of Kaiba Gionfriddo, doctors didn’t have a moment to spare. Because of a birth defect, the little Ohio boy’s airway kept collapsing, causing his breathing to stop and often his heart, too. Doctors in Michigan had been researching artificial airway splints, but had not implanted one...

Not long after complaining of shortness of breath at her Quinlan home, Patricia Cannon was in a Hunt County ambulance heading north toward Greenville with a drug dripping into her veins capable of paralyzing every muscle in her body.The drug, succinylcholine, was administered by a paramedic. The intent was for Cannon, thought to be suffering from a blood clot in the lung, to be immobilized while a breathing tube was placed in her windpipe.But something happened along the way that prevented the tube from being inserted correctly. The job wasn't done until the ambulance delivered Cannon, 41, to the emergency...

For two hours on Monday, an ambulance sat in the parking lot of Sunnybrook hospital's emergency department with a suspected SARS case on board. In the back of the ambulance, two paramedics kept a close eye on the deteriorating and contagious patient, all within the tiny 1.5-by-2.5-metre isolation unit on wheels. The paramedics had called ahead to tell the hospital to prepare a negative pressure room and be ready for this patient. It didn't matter. They were forced to sit and wait. "There's a lot running through your mind," said paramedic Marty Bulai, who had a similar incident at Scarborough...

SARS is loosening its stranglehold on Ontario, officials announced yesterday. "The second cluster is tapering off," said Dr. Colin D'Cunha, Ontario's medical officer of health. "But we need to continue to be hyper-vigilant, while heading towards the new normal." Freedom is a sweet sign of success, too. The number of people in quarantine plummeted, from 5,500 on Tuesday to 1,078 yesterday -- including 91 health-care workers. 3 NEW CASES Officials announced three new cases, two from an intubation at North York General a week ago that infected health-care workers, along with one patient that was being monitored. D'Cunha also announced...

 HELEN BRANSWELLCanadian Press TORONTO (CP) - Intubating SARS patients is such a risky procedure that all hospitals treating SARS patients need to train and specially equip their staff to do them, using protective gear some liken to spacesuits, a variety of experts now insist. Despite using high-level precautions and having had weeks of experience in treating SARS patients, Toronto hospital workers who take part in intubations continue to contract the disease. As recently as the middle of last week, at least two nurses became infected during a relatively easy intubation at North York General Hospital. Given that as many as...

Note: This article is being made available on the Web prior to publication in the Canada Communicable Disease Report (CCDR). It will be published in an upcoming issue of the CCDR. Infections among healthcare workers (HCWs) have been a common feature of severe acute respiratory syndrome (SARS) since its emergence. The majority of these infections have occurred in locations where infection control precautions either had not been instituted or had been instituted but were not followed. Recommended infection control precautions include the use of negative pressure isolation rooms where available; N95 or higher level of respiratory protection; gloves, gowns, and...

NEW YORK (Reuters Health) - "Super-spreaders" of SARS are unlikely to be infected with a particularly virulent form of the virus, a panel of experts said here Saturday at the New York Academy of Sciences. Instead, it seems they spread the disease to so many people because their infection went unrecognized, the panel said. Like other people with SARS, or severe acute respiratory syndrome, such patients are best dealt with by isolation and quarantine, according to the experts. "We saw most clearly in Singapore that secondary cases are linked to other cases and that quarantine can limit transmission," said Dr....

The Prince of Wales Hospital (PWH) has been at the forefront of the outbreak of severe acute respiratory syndrome (SARS) in Hong Kong.1 We relate our experience at this hospital. A working definition of SARS is important,2 although clinical conditions rarely remain within artificial boundaries. Some patients might not have all features, others may present unusually. Fever is a cardinal symptom but not always so, and is sometimes absent in elderly patients. Some patients have presented with diarrhoea or, in at least two cases, with severe acute abdominal pain requiring exploratory laparotomy. All these patients developed typical SARS. Patients presenting...

Virus can live 24 hours outside host, study finds By CAROLYN ABRAHAM MEDICAL REPORTER Tuesday, April 22, 2003 Doctors struggling to contain the SARS outbreak have laboured for more than a month under the notion that this insidious virus can live no more than a few hours outside a human host. But disturbing new research has discovered otherwise. Studies by the U.S. Centers for Disease Control and Prevention suggest that, unlike most respiratory viruses medicine knows, the microbe behind SARS can survive up to 24 hours on inanimate objects, turning any surface into a possible point of transmission. In response,...

TORONTO - In a frightening new twist, health officials say the SARS virus is able to survive outside the human body -- and pose a danger -- for at least 24 hours, in addition to being spread by face-to-face contact. The tenacity of the mysterious severe acute respiratory syndrome virus may explain a new cluster of infections in Toronto. Hospital workers there have caught the disease despite being protected from head to toe by gowns, gloves, masks and eye shields. "We know that the (precautionary) measures that have been recommended should be adequate to deal with those (patients)," said Dr....

SARS has killed a 14th Canadian and infected a new cluster of Toronto hospital workers even though they were protected from head-to-toe in gowns, gloves, masks and eye shields. The latest cluster has heightened concerns the mysterious Severe Acute Respiratory Syndrome virus can be spread via objects, in addition to face-to-face contact, and can remain potent on objects for much longer than previously believed. Also, one expert predicted yesterday that SARS is likely to remain in Canada -- despite the current battle to contain it -- because people will continue to "import" it from lesser developed countries. The latest Canadian...

Breath tubes spread SARS By ROB GRANATSTEIN - Toronto Sun SARS spread slowing in Asia Toronto doctors have admitted SARS is being spread to health-care workers when tubes are put down patients' throats to help them breathe -- and the physicians don't know how to stop it. Dr. Don Low, chief microbiologist at Mount Sinai hospital, said Toronto's two newest SARS cases that will be reported today are a result of procedures, called intubations, that infected health-care workers last Wednesday. "Intubation is a major issue with SARS patients," Low said. "Why? I don't know why. It's not easily explainable. "We're...