Oxygen Bubble Bottles or Bacteria Swimming Pools?

Humidified oxygen is widely administered in hospitals and EMS vehicles and this is presumed to alleviate nasal and oral discomfort in the non-intubated patient. Humidification of supplemental oxygen is commonly delivered by bubbling oxygen through either cold or warm sterile water before it reaches the patient. However, the effect on patient comfort is negligible. Bubble humidifiers may, however, represent an infection hazard and should not be used.

 

Acute Pancreatitis

  • Pancreatitis is diagnosed by a combination of clinical features (epigastric pain with radiation to back, nausea/vomiting etc) and diagnostic tests (lipase 3x normal, CT scan)
  • A RUQ US should be performed looking for gallstones as this finding significantly alters management
  • The focus of management is on supportive care. IV fluids, while central to therapy, should be given judiciously and titrated to end organ perfusion
  • BISAP Score (Wu 2008Papachristou 2010) is a clinical score used to predict mortality from pancreatitis.

  • Patients with mild pancreatitis who are tolerating oral intake and can reliably follow up, can be discharged home

 

Nine-point plan to improve care of the injured patient: A case study from Kenya

Nine-point plan to improve care of the injured patient: A case study from Kenya.

Bachani AM, Botchey I, Paruk F, Wako D, Saidi H, Aliwa B, Kibias S, Hyder AA.
Surgery. 2017 Oct 16. pii: S0039-6060(17)30389-6. doi: 10.1016/j.surg.2017.05.020. [Epub ahead of print]

Patient characteristics of the Accident and Emergency Department of Kenyatta National Hospital, Nairobi, Kenya: a cross-sectional, prospective analysis

Patient characteristics of the Accident and Emergency Department of Kenyatta National HospitalNairobiKenya: a cross-sectionalprospective analysis.

Myers JG, Hunold KM, Ekernas K, Wangara A, Maingi A, Mutiso V, Dunlop S, Martin IBK.
BMJ Open. 2017 Oct 11;7(10):e014974. doi: 10.1136/bmjopen-2016-014974.

WHO Guidelines for essential trauma care

 

The Guidelines for essential trauma care seek to set achievable standards for trauma treatment services which could realistically be made available to almost every injured person in the world. They then seek to define the resources that would be necessary to assure such care. These include human resources (staffing and training) and physical resources (infrastructure, equipment, and supplies).