Sunday, October 15, 2023

Co-Locating Laryngeal Mask Airways With Automated External Defibrillators May Improve Cardiac Emergency Response

https://ihslc.mehmetakif.edu.tr/

Burdur Mehmet Akif Ersoy Üniversitesi 7. Uluslararası Sağlık Bilimleri ve Yaşam Kongresi 7-9 Mart 2024

1- CO-LOCATING LARYNGEAL MASK AIRWAYS WITH AUTOMATED EXTERNAL DEFIBRILLATORS MAY IMPROVE CARDIAC EMERGENCY RESPONSE

Assoc. Prof. Mehmet Eren Yuksel

Ankara Etlik City Hospital, Surgical Intensive Care Unit, Ankara, Turkiye,

e-mail: doctormehmeteren@yahoo.com

ABSTRACT

Background: Sudden cardiac arrest (SCA) requires rapid intervention, and automated external defibrillator (AED) has proven indispensable in this context. Effective airway management is equally vital for successful cardiopulmonary resuscitation (CPR). This study explores the integration of laryngeal mask airway (LMA) alongside AED in public access areas to hasten the cardiac emergency response. Aim: Our goal is to assess the feasibility and potential benefits of co-locating LMA with AED in public access areas. Methods: This investigation involves a comprehensive review of medical literature gathered from PubMed and Google Scholar. We analyze the advantages and difficulties of combining LMA and AED. The evaluation considers LMA’s effectiveness in managing airway during various medical emergencies. We also address training programs, maintenance, legal implications, resource allocation, and cost-effectiveness. Results: While the number of studies on the combination of LMA with AED is limited, co-locating LMA and AED points out the potential to significantly reduce response times. This, in turn, improves the likelihood of initiating successful CPR during cardiac arrests. LMA also provides more efficient airway management, increasing the chances of successful resuscitation. LMA’s user-friendly nature makes it accessible to both medical professionals and laypersons. Nevertheless, challenges include the need for well-structured training programs, maintenance procedures, and consideration of legal aspects. Discussion and Conclusion: The rapid airway management capability of LMA makes it invaluable in emergencies. Combining LMA with AED offers the prospect of enhancing cardiac emergency response and potentially saving lives. Achieving this goal requires collaborative efforts among medical professionals, regulatory bodies, training organizations, legal experts, and the community. Decisions in this regard should be based on a thorough risk-benefit analysis.

Keywords: Cardiac emergency response, Laryngeal mask airway, Automated external defibrillator, Cardiopulmonary resuscitation, Public access areas



2- CHALLENGES IN RE-ESTABLISHING PRESSURE-CONTROLLED VENTILATION MODES ON THE MECHANICAL VENTILATOR: RE-ADJUSTING VOLUME-CONTROLLED MODES IS EASIER

Huseyin Bugra Sahin*, Mehmet Eren Yuksel*

*Etlik City Hospital, Surgical Intensive Care Unit, Ankara, Turkiye

e-mail: h.b.sahin97@gmail.com

Introduction: Mechanical ventilation is vital in the intensive care unit (ICU), providing life support to patients with respiratory failure. The GE Healthcare Carescape R860 Mechanical Ventilator offers various ventilation modes (A/C VC, A/C PC, A/C PRVC, SIMV/VC, SIMV/PC, CPAP/PS, SBT, BiLevel, BiLevel VG, APRV, VS, NIV). However, resetting pressure-controlled ventilation modes such as synchronized intermittent mandatory ventilation/pressure control (SIMV/PC) and airway pressure release ventilation (APRV) is challenging.

Purpose: This study aimed to investigate the challenges faced by healthcare professionals when readjusting the GE Healthcare Carescape R860 Mechanical Ventilator post-aspiration and apnea events, particularly following endotracheal tube and oral cavity cleaning. Prolonged aspiration events triggered the backup mode. Therefore, we aimed to identify areas for improvement of adjustment of mechanical ventilator settings, thereby enhancing patient care in the ICU.

Method: A one-day observational study in the intensive care unit focused on nurses' experiences when adjusting the ventilator after aspiration and apnea events. We recorded settings and documented difficulties encountered.

Findings: Nurses encountered significant challenges in restoring pressure-controlled ventilation modes, especially SIMV/PC and APRV modes. In contrast, they found it easy to readjust volume-controlled modes such as synchronized intermittent mandatory ventilation/volume control (SIMV/VC) and assist-control/pressure-regulated volume control (AC/PRVC).

Discussion and Conclusion: Difficulties in resetting pressure-controlled ventilation modes may impact patient care, particularly in high-stress situations. Improved personnel training and a user-friendly mechanical ventilator interface might be the solution. This study highlights challenges in re-establishing pressure-controlled ventilation modes on the mechanical ventilator. Further research and potential interface modifications are essential for efficient patient care.

Keywords: Aspiration events, mechanical ventilation, nursing practices, pressure-controlled ventilation, volume-controlled ventilation


3- PREOPERATIVE UPPER GASTROINTESTINAL ENDOSCOPY TO IDENTIFY THE ETIOLOGY OF POST-CHOLECYSTECTOMY DYSPEPSIA 

Oğuzhan Ölmez*, Barış Cem Bülbül*,  Ahsen Kalender*, Mehmet Eren Yüksel** 

* Etlik City Hospital, Department of General Surgery, Ankara, Turkiye

e-mail: olmez_oguzhan@hotmail.com 

** Etlik City Hospital, Surgical Intensive Care Unit, Ankara, Turkiye

e-mail: doctormehmeteren@yahoo.com

ABSTRACT

Background: Cholecystectomy is a standard procedure for gallbladder-related issues, providing relief for most patients. However, a subset continues to experience dyspepsia postoperatively. Recent observations suggest that alkaline reflux gastritis, characterized by pyloric relaxation and duodenogastric bile reflux, may contribute to persistent dyspepsia in these individuals. Aim: This study explores the potential benefits of preoperative upper gastrointestinal endoscopy before cholecystectomy in identifying patients at risk for post-cholecystectomy dyspepsia due to duodenogastric bile reflux. Methods: A retrospective analysis was conducted, encompassing relevant literature. Google Scholar and PubMed databases were searched for studies on dyspeptic symptoms post-cholecystectomy and their association with alkaline reflux gastritis. Results: During upper gastrointestinal endoscopy, a subset of patients with post-cholecystectomy dyspepsia exhibited signs of alkaline reflux gastritis. Pyloric dilation and retrograde bile flow from the duodenum were observed. Literature review supported the idea that duodenogastric bile reflux might contribute to persistent dyspepsia after cholecystectomy. Discussion and Conclusion: These findings underscore the potential value of incorporating preoperative upper gastrointestinal endoscopy as a screening tool. Identifying patients at risk for alkaline reflux gastritis may allow for more targeted interventions, potentially preventing unnecessary cholecystectomy. These observations prompt further investigation into the mechanisms and risk factors associated with post-cholecystectomy dyspepsia. Preoperative upper gastrointestinal endoscopy could be a valuable tool in identifying the etiology of post-cholecystectomy dyspepsia. Recognition of alkaline reflux gastritis through pyloric dilation and duodenogastric bile reflux can guide clinical decision-making, potentially sparing individuals from unwarranted cholecystectomy.

Keywords: Alkaline Reflux Gastritis, Bile Reflux, Cholecystectomy, Dyspepsia, Pyloric Dilation, Upper Gastrointestinal Endoscopy


4- ASSESSMENT OF AWARENESS AND KNOWLEDGE AMONG ORTHOPEDIC SURGERY RESIDENTS REGARDING PULMONARY EMBOLISM FOLLOWING FEMORAL FRACTURES

Aziz Ahmet ULAŞ*, Mehmet Eren YÜKSEL**

*Ankara Etlik City Hospital, Department of Orthopedics and Traumatology, Ankara, Turkiye azizahmetulas@gmail.com

**Ankara Etlik City Hospital, Surgical Intensive Care Unit, Ankara, Turkiye

doctormehmeteren@yahoo.com 

ABSTRACT

Background: Following femoral fractures, pulmonary embolism (PE) is a serious consequence that requires immediate detection and treatment. For prompt care, orthopedic surgery residents must be informed of the early indicators of PE. Aim: The purpose of this study was to evaluate orthopedic surgery residents' awareness and understanding of PE after femoral fractures. Methods: To evaluate previous research on orthopedic surgery residents' awareness and comprehension of PE after femoral fractures, a review of the literature was performed by searching PubMed and Google Scholar with terms "femoral fracture", "pulmonary embolism" and "orthopedic surgery resident” between 2010 and 2023. Results: Few studies explicitly addressed orthopedic surgery residents' awareness and knowledge of PE after femoral fractures. However, existing research on physicians' general understanding of PE has highlighted the significance of early identification and timely therapy in order to enhance patient outcomes. Discussion: It is critical to evaluate orthopedic surgery residents' awareness and knowledge of PE, given the high prevalence of this complication after femoral fractures. To further improve resident education and patient care in this setting, more research is necessary. This includes developing focused educational interventions and putting standardized protocols into place.  Conclusion: This study emphasizes how important it is to conduct more research in the future to assess and resolve any knowledge gaps orthopedic surgery residents may have regarding PE after femoral fractures. Improving resident education in this field may result in better patient outcomes and a decrease in PE-related morbidity.

Keywords: diagnosis, femoral fractures, orthopedic surgery residents, pulmonary embolism 

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