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  • ISSN: 2333-6641
    Volume 3, Issue 2
    Research Article
    Rashmi Goswami*, Kanika and Sembian N
    Abstract:
    Cardiac or respiratory arrests are common emergencies in adults, children and neonatal period. Resuscitation is the art of restoring life or consciousness of one apparently dead. The main aim of the study was to assess and compare knowledge and practices regarding BLS among Nursing Students before and after administration of training program. A quasi experimental study was conducted on 42 B.Sc. Nursing III year students selected by simple random sampling technique of M.M College of Nursing, Mullana, Ambala, Haryana between December and January 2015.Knowledge and practices was assessed using structured knowledge questionnaire and practice checklist. The Nursing Students were divided into seven groups consisting six students per group. On the first day, pre-test to assess knowledge regarding BLS was conducted and on the same day training program was administered and post-test of knowledge was carried out for all the seven groups. On the day 2-8, pre-test of practices regarding BLS was conducted, demonstration was given and post-test was taken on the same day. On the 16th day, 2nd post test of knowledge was conducted for all the groups.Significant findings of the study were that the mean of post test knowledge score 14.12±1.15 was higher than the mean of pre test knowledge score 7.19±2.00. The study further revealed that mean of post test practice scores of BLS was 23±1.18was higher than the mean of pre test practice scores 10.31±3.84. Thus, the training program was effective in enhancing the knowledge and practices of Nursing Students regarding BLS.
    Chong Oon Tan*
    Abstract:
    Aim: Pain following shoulder surgery can be severe; interscalene brachial plexus blockade (ISB) and high dose opioid analgesia are commonly used management options, however both impair oxygenation by multiple mechanisms. We aimed to quantify the extent of, and explore the factors influencing, the largest decline/ nocturnal peak onset of postoperative oxygenation imp­airment.
    Methods: 114 shoulder surgery patients over the age of 50 were included. Binary logistic regression analysis was used to identify factors predisposing to a significant fall in patient's partial pressure of arterial oxygen: fraction inspired oxygen (PaO2:FiO2) ratios. Survival analysis was used to elucidate time to nocturnal PaO2:FiO2nadir.
    Results: 67 patients received ISB. Greatest postoperative reduction in PaO2:FiO2 ratio per patient was [mean (SD)] (179 [102]); in 22% of patients this occurred nocturnally. Only higher preoperative Sp02 (OR 3.9) was associated with a significant fall in PaO2:FiO2 ratio in the multivariate logistic regression model; opioid usage, use of ISB and all other factors were not. ISB was however strongly associated with much earlier time to greatest nocturnal fall in PaO2:FiO2 ratio (median survival time 205 minutes vs. 635 minutes, hazard ratio 24.3, p<0.0001 by Kaplan-Meier survival curve). Higher preoperative SpO2 was also strongly correlated to fall in PaO2:FiO2 ratio (Pearson's R = 0.7, p<0.0001), but not absolute lowest PaO2:FiO2 ratio per patient (Pearson's R = 0.15, p = 0.12).
    Conclusion: Whilst choice of analgesic technique does not influence the likelihood of profound impairment of oxygenation after shoulder surgery, use of ISB significantly shortens the time to onset of a nocturnal oxygenation nadir. Knowledge of this timing of peak respiratory impairment should be used to focus postoperative observation. As patients with normal preoperative room air SpO2may still suffer a significant nadir in postoperative PaO2:FiO2ratio, postoperative monitoring should be managed accordingly.
    Case Report
    Ozlem Ozmete*, Cagla Bali, Pinar Ergenoglu, Sule Akin and Anis Aribogan
    Abstract:
    During pregnancy % 0.75-2 of patients need surgery and anesthesia. Ovarian torsion which requires emergency surgery is one of them. When surgery is needed during pregnancy period, anesthetic management should be planned to protect both mother and fetus. In order to provide optimal safety of mother and fetus, each case should be managed in a multidisciplinary approach.
    In this case report we planned to present the anesthesia management of a 24 weeks pregnant patient who is scheduled for laparoscopic surgery due to acute abdomen, in company with literature.
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