domingo, 28 de noviembre de 2010

Resucitación cardiopulmonar


 

----- Mensaje reenviado ----
De: Victor Whizar-Lugo <vwhizar@anestesia-dolor.org>
Para: maximocuadros@yahoo.es
Enviado: jue,25 noviembre, 2010 12:51
Asunto: Resucitación cardiopulmonar

Anestesia y Medicina del Dolor
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No:327     

Noviembre 24, 2010
 Tradiciones

Estimad@ Maximo Jesus Cuadros Chavez:

 

Aspectos destacados de las guías de la American Heart Association de 2010 para RCP y ACE

Mary Fran Hazinski, RN, MSN
© 2010 American Heart Association


La presente publicación "Aspectos destacados de las guías" resume las principales cuestiones y cambios de las Guías de la American Heart Association (AHA) de 2010 para reanimación cardiopulmonar (RCP) y atención cardiovascular de emergencia (ACE). Se ha desarrollado con el objetivo de que los proveedores de reanimación y los instructores de la AHA se enfoquen en la ciencia y en las recomendaciones que son más importantes, las que fueron más discutidas o las que resultarán en cambios en la aplicación de la reanimación o en el modo de entrenarse para ello. Además, se ofrecen los fundamentos de dichas recomendaciones.


Artículo en PDF

Atentamente
Enf. Rosario Camacho

Anestesiología y Medicina del Dolor


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Medicina Intensiva


 

Sedation of Ventilated Patients and Analgesia.
Sandiumenge, Alberto MD, PhD
One of every 3 patients admitted in an intensive care unit undergoes mechanical ventilation. Sedation and analgesia are required to facilitate patient tolerance to such an aggressive procedure, diminishing stress response, relieving pain and anxiety, ensuring patient comfort, and facilitating nursing care. However, misuse of sedatives and analgesics may impact negatively on critically ill patients. The recognition of the potential for enduring effects derived from sedative and analgesic misuse, the availability of new agents, and the growing emphasis on cost containment have led to important changes in the way that sedation and analgesia practices are implemented. The aim of the present review is to discuss the agents, indications, complications, and most important strategies to optimize the sedation and analgesic practices in the intensive care unit.


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Sedation of Ventilated Patients and Analgesia....


Maximo Cuadros Chavez posted in cibermedicos.
Sedation of Ventilated Patients and Analgesia.  Sandiumenge, Alberto MD, PhD One of every 3 patients admitted in an  intensive care unit undergoes mechanical  ventilation. Sedation and  analgesia are required to facilitate patient  tolerance to such an  aggressive procedure, diminishing stress response,  relieving pain and  anxiety, ensuring patient comfort, and facilitating nursing  care.  However, misuse of sedatives and analgesics may impact negatively on   critically ill patients. The recognition of the potential for enduring  effects  derived from sedative and analgesic misuse, the availability of  new agents, and  the growing emphasis on cost containment have led to  important changes in the  way that sedation and analgesia practices are  implemented. The aim of the  present review is to discuss the agents,  indications, complications, and most  important strategies to optimize  the sedation and analgesic practices in the  intensive care unit.  Clin Pulm Med 2010;17: 290–299 PDF (461 K) http://www.facebook.com/l/2b97azD73sIpFIAiod9tXCO69aQ;pt.wkhealth.com/pt/re/merck/pdfhandler.00045413-201011000-00006.pdf;jsessionid=MyJVCkcGDpK2bVR2MgTFHJPtx0T1hqG5fl4W1B7psyGb51GpGsym!1173397540!181195629!8091!-1  Atte. Dr.Máximo Cuadros Chávez Celular 99199698 – Movistar - rpm #800515  http://www.facebook.com/l/2b97avSIOYqlN8HF8or5Z3ojjKw;es.groups.yahoo.com/group/interno_residente_medico_PERU/ http://es-la.facebook.com/people/Maximo-Cuadros-Chavez/100001101314342 http://www.facebook.com/l/2b97aYBg96px6dDuOMoo9Juzsuw;medicalia.ning.com/ http://www.facebook.com/l/2b97aKWkCqFmXBdJtT7YPZFy5Pg;www.medsocial.org/ http://www.facebook.com/l/2b97arWz_PsRntUj8w9rxf1xfDg;medbook.ning.com/ UNYK: 245 HRP
Maximo Cuadros Chavez 8:46am Nov 28
Sedation of Ventilated Patients and Analgesia.
Sandiumenge, Alberto MD, PhD
One of every 3 patients admitted in an intensive care unit undergoes mechanical
ventilation. Sedation and analgesia are required to facilitate patient
tolerance to such an aggressive procedure, diminishing stress response,
relieving pain and anxiety, ensuring patient comfort, and facilitating nursing
care. However, misuse of sedatives and analgesics may impact negatively on
critically ill patients. The recognition of the potential for enduring effects
derived from sedative and analgesic misuse, the availability of new agents, and
the growing emphasis on cost containment have led to important changes in the
way that sedation and analgesia practices are implemented. The aim of the
present review is to discuss the agents, indications, complications, and most
important strategies to optimize the sedation and analgesic practices in the
intensive care unit.

Clin Pulm Med 2010;17: 290–299
PDF (461 K)
http://www.facebook.com/l/2b97azD73sIpFIAiod9tXCO69aQ;pt.wkhealth.com/pt/re/merck/pdfhandler.00045413-201011000-00006.pdf;jsessionid=MyJVCkcGDpK2bVR2MgTFHJPtx0T1hqG5fl4W1B7psyGb51GpGsym!1173397540!181195629!8091!-1

Atte.
Dr.Máximo Cuadros Chávez
Celular 99199698 – Movistar - rpm #800515

http://www.facebook.com/l/2b97avSIOYqlN8HF8or5Z3ojjKw;es.groups.yahoo.com/group/interno_residente_medico_PERU/
http://es-la.facebook.com/people/Maximo-Cuadros-Chavez/100001101314342
http://www.facebook.com/l/2b97aYBg96px6dDuOMoo9Juzsuw;medicalia.ning.com/
http://www.facebook.com/l/2b97aKWkCqFmXBdJtT7YPZFy5Pg;www.medsocial.org/
http://www.facebook.com/l/2b97arWz_PsRntUj8w9rxf1xfDg;medbook.ning.com/
UNYK: 245 HRP

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Protocolo diagnóstico del coma...



sábado, 27 de noviembre de 2010

Guias de tratamiento de la fibrilación auricular


 

----- Mensaje reenviado ----
De: Victor Whizar-Lugo <vwhizar@anestesia-dolor.org>
Para: maximocuadros@yahoo.es
Enviado: sáb,27 noviembre, 2010 09:46
Asunto: Guis de tratamiento de la fibrilación auricular

Anestesia y Medicina del Dolor
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No:330     

Noviembre 27, 2010
 Tradiciones

Estimad@ Maximo Jesus Cuadros Chavez:

 

Guías para el manejo de la fibrilación auricular 

Guidelines for the management of atrial fibrillation.
The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC)
Developed with the special contribution of the European Heart Rhythm Association (EHRA)
Endorsed by the European Association for Cardio-Thoracic Surgery (EACTS)
Authors/Task Force Members: A. John Camm (Chairperson) (UK)*, Paulus Kirchhof (Germany), Gregory Y.H. Lip (UK), Ulrich Schotten (The Netherlands),Irene Savelieva (UK), Sabine Ernst (UK), Isabelle C. Van Gelder (The Netherlands), Nawwar Al-Attar (France), Gerhard Hindricks (Germany), Bernard Prendergast
(UK), Hein Heidbuchel (Belgium), Ottavio Alfieri (Italy), Annalisa Angelini (Italy),Dan Atar (Norway), Paolo Colonna (Italy), Raffaele De Caterina (Italy), Johan De Sutter (Belgium), Andreas Goette (Germany), Bulent Gorenek (Turkey), Magnus Heldal (Norway), Stefan H. Hohloser (Germany), Philippe Kolh (Belgium),Jean-Yves Le Heuzey (France), Piotr Ponikowski (Poland), Frans H. Rutten (The Netherlands).
European Heart Journal (2010) 31, 2369-2429. doi:10.1093/eurheartj/ehq278


Preamble
Guidelines summarize and evaluate all currently available evidence on a particular issue with the aim of assisting physicians in selecting the best management strategy for an individual patient suffering
from a given condition, taking into account the impact on outcome, as well as the risk-benefit ratio of particular diagnostic or therapeutic means. Guidelines are no substitutes for textbooks. The legal implications of medical guidelines have been discussed previously. A large number of Guidelines have been issued in recent years by the European Society of Cardiology (ESC) as well as by other societies and organizations. Because of the impact on clinical practice,quality criteria for development of guidelines have been established in order to make all decisions transparent to the user. 
Guidelines summarize and evaluate all currently available evidence on a particular issue with the aim of assisting physicians in selecting the best management strategy for an individual patient suffering
from a given condition, taking into account the impact on outcome, as well as the risk-benefit ratio of particular diagnostic or therapeutic means. Guidelines are no substitutes for textbooks. The legal implications of medical guidelines have been discussed previously. A large number of Guidelines have been issued in recent years by the European Society of Cardiology (ESC) as well as by other societies and organizations. Because of the impact on clinical practice,quality criteria for development of guidelines have been established in order to make all decisions transparent to the user.
The recommendations for formulating and issuing ESC Guidelines can be found on the ESC Web Site (http://www.escardio.org/knowledge/guidelines/rules).

 

 

Artículo en PDF

Atentamente
Anestesiología y Medicina del Dolor


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lunes, 22 de noviembre de 2010

Intensive CAre Medicine Vol 36 N 12 Dec 2010



Enjoy it!!!



Intensive CAre Medicine Vol 36 N 12 Dec 2010

Intensive Care Medicine Volume 36, Number 12 / December, 2010
ICMcovr-facSimil.jpg 

Content

http://www.springerlink.com/content/0342-4642

Link


Murillo Santucci Cesar de Assunção
Unidade de Terapia Intensiva adulto
Disciplina de Anestesiologia, Dor e Terapia Intensiva
Escola Paulista de Medicina
Rua Napoleão de Barros,715
Vila Clementino - São Paulo - CEP: 04024-002
Tel/Fax: +55-11-55757768
Tel/Fax: +55-11- 55764069










Murillo Santucci Cesar de Assunção
Unidade de Terapia Intensiva adulto
Disciplina de Anestesiologia, Dor e Terapia Intensiva
Escola Paulista de Medicina
Rua Napoleão de Barros,715
Vila Clementino - São Paulo - CEP: 04024-002
Tel/Fax: +55-11-55757768
Tel/Fax: +55-11- 55764069










Critical Care Medicine Dec 2010 - Vol 38 - Issue 12




Critical Care Medicine Dec 2010 - Vol 38 - Issue 12

ccm.jpg 
Critical Care Medicine Dec 2010 - Vol 38 - Issue 12
Content
http://journals.lww.com/ccmjournal/pages/currenttoc.aspx

Link


Murillo Santucci Cesar de Assunção
Unidade de Terapia Intensiva adulto
Disciplina de Anestesiologia, Dor e Terapia Intensiva
Escola Paulista de Medicina
Rua Napoleão de Barros,715
Vila Clementino - São Paulo - CEP: 04024-002
Tel/Fax: +55-11-55757768
Tel/Fax: +55-11- 55764069










Murillo Santucci Cesar de Assunção
Unidade de Terapia Intensiva adulto
Disciplina de Anestesiologia, Dor e Terapia Intensiva
Escola Paulista de Medicina
Rua Napoleão de Barros,715
Vila Clementino - São Paulo - CEP: 04024-002
Tel/Fax: +55-11-55757768
Tel/Fax: +55-11- 55764069










domingo, 21 de noviembre de 2010

Neurologic Emergencies

 


 

Gregory Henry, Neal Little, Andy Jagoda, Thomas Pellegrino, Douglas Quint, "Neurologic Emergencies, Third Edition"
MgH | 2010 | ISBN: 0071635211 | 396 pages | CHM | 6,3 MB

Complete guidance on how to diagnose and treat neurologic emergencies in any acute care setting!

Uniquely organized by presenting complaint, Neurologic Emergencies helps you quickly identify, evaluate, stabilize, treat, and manage the full range of neurologic symptoms--from dizziness to trauma. Striking the perfect balance between thoroughness and readability, this trusted classic delivers the authoritative guidance you need to ensure the best possible outcomes possible for patients presenting with neurologic emergencies. The Third Edition has been updated with a valuable primer on neuroimaging technologies and includes the latest evidence-based treatment strategies and expert advice.

Features:

•Organized by presenting symptoms, rather than by disease, for unmatched clinical relevance
•Written by a team of authors highly experienced in managing patients with neurologic complaints
•Numerous algorithms and tables offer immediate access to critical information
•Emphasizes patient history, physical exam, and rapid assessment
•Everything you need to know in the acute care setting:
Review of Basic Neuroanatomy, Neuroimaging, Evaluation of a Neurologic Complaint, Altered States of Consciousness and Coma, Acute Focal Neurological Deficit, Acute Weakness, Movement Disorders, Headache; Acute Double Vision, Blindness, and Abnormal Pupils; Neurologic Trauma, Psychogenic Neurologic Problems, Seizures, Syncope, The Dizzy Patient, Neck and Back Pain

http://uploading.com/files/7c2fa5m6/0071635211Neurologic3ed.rar/



Best regards

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jueves, 11 de noviembre de 2010

Ketamina en urgencias



 

----- Mensaje reenviado ----
De: Victor Whizar-Lugo <vwhizar@anestesia-dolor.org>
Para: maximocuadros@yahoo.es
Enviado: jue,11 noviembre, 2010 17:12
Asunto: Ketamina en urgencias

XLIV Congreso Mexicano de Anestesiologia

Anestesia y Medicina del Dolor
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No:242     

Noviembre 11, 2010
 Tradiciones

Estimad@ Maximo Jesus Cuadros Chavez:

 

 

Auditoría de la seguridad y la eficacia de la ketamina para la sedación de procedimientos en el servicio de urgencias

Audit of the safety and effectiveness of ketamine for procedural sedation in the emergency department
J M Vardy, N Dignon, N Mukherjee, D M Sami, G Balachandran, S Taylor.
Emerg Med J 2008;25:579-582   doi:10.1136/emj.2007.056200

 

Abstract
Aim: To examine the effectiveness and safety of the sedative agents used in the emergency department following the introduction of ketamine as an agent for procedural sedation. Methods: A 2-year prospective audit of sedation practice was undertaken. This specifically examined the rationale behind a doctor's choice of sedative agent, the depth of sedation achieved, adverse events and the time taken to regain full orientation. Results: 210 patients were included of whom 85 (40%) were given ketamine, 107 (51%) midazolam and 18 (9%) propofol. The median time to full orientation was 25 min for ketamine, 30 min for midazolam and 10 min for propofol. Complications occurred in 15.9% of sedations overall (14.6% of those given ketamine, 15.8% given midazolam and 22.2% given propofol). Apnoea and hypoxia most often occurred with midazolam and propofol, while hypertension and hypertonicity were encountered more frequently with ketamine. In addition, 19.5% of patients given ketamine suffered the re-emergence phenomenon. The association between deep sedation with no response to pain and adverse events encountered with midazolam does not occur with ketamine.  Conclusions: Ketamine is both safe and effective and compares favourably with midazolam as an agent for procedural sedation in the emergency department. Although the re-emergence phenomenon occurred, no psychological sequelae were encountered after return to full orientation. Ketamine may be particularly useful in groups of patients at high risk of adverse effects with midazolam

 

Artí­culo en PDF

Atentamente
Anestesiología y Medicina del Dolor


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