BACKGROUND Nursing officers are an integral component of any medical team.They participate in taking care of basic airway management and assist in advanced airway management,specifically amidst the current coronavirus...BACKGROUND Nursing officers are an integral component of any medical team.They participate in taking care of basic airway management and assist in advanced airway management,specifically amidst the current coronavirus disease 2019(COVID-19)pandemic.AIM To assess the efficacy of a standardized web-based training module for nurses in preparedness to fight against COVID-19.METHODS The training was held in three sessions of 1 h each,consisting of live audio-visual lectures,case scenarios,and skill demonstrations.The sequence of airway equipment,drug preparation,airway examination,and plans of airway management was demonstrated through mannequin-based video-clips.RESULTS Pre-and post-test scores as well as objective structured clinical examination scores were analyzed using Student’s t-test and the Likert scale was used for feedback assessment.It was found that the mean score out of the total score of 20 was 8.47±4.2 in the pre-test,while in the post-test it was 17.4±1.8(P value<0.001).The participants also felt self-reliant in executing the roles of airway assistant(63.3%)and drug assistant(74.3%).Fear of self-infection with COVID-19 was also high,as 66%of participants feared working with the patient’s airway.CONCLUSION Amidst this COVID-19 emergency,when the health care systems are being persistently challenged,training of nursing staff in the safe conduct of airway management can ensure delivery of life-saving treatment.展开更多
Severe acute pancreatitis often leads to pancreatic and peripancreatic collections but,rarely,it can lead to collections at sites remote from the pancreas.Three male patients presented with abdominal pain and inguinos...Severe acute pancreatitis often leads to pancreatic and peripancreatic collections but,rarely,it can lead to collections at sites remote from the pancreas.Three male patients presented with abdominal pain and inguinoscrotal swelling.They were initially misdiagnosed with obstructed inguinal hernia,epididymo-orchitis and hydrocele,respectively.Later,their diagnosis of acute pancreatitis was revealed on laparotomy in one patient and on computed tomography(CT)in the remaining two patients.All these cases had extensive peripancreatic necrosis and paracolic collections tracking along the psoas muscle,downwards towards the pelvis.These collections were initially managed by percutaneous drainage and saline irrigation as a part of the‘step-up’approach.Two of these patients required open necrosectomy,while all required incision and drainage of inguinoscrotal collections.All the patients were discharged in satisfactory condition.Inguinoscrotal swelling is unusual as a first presentation of acute pancreatitis.A high index of suspicion,with careful study of patient’s history and examination along with CT,may provide an accurate diagnosis.Local drainage may be required to control sepsis and also provide an egress route for intra-abdominal collections.展开更多
Intestinal loop stoma is a common surgical procedure performed for various benign and malignant abdominal problems,but it rarely undergoes spontaneous closure,without surgical intervention.Two male patients presented ...Intestinal loop stoma is a common surgical procedure performed for various benign and malignant abdominal problems,but it rarely undergoes spontaneous closure,without surgical intervention.Two male patients presented to our emergency surgical department with acute abdominal pain.One of them was diagnosed as having rectosigmoid perforation and underwent diversion sigmoid loop colostomy after primary closure of the perforation.The other was a known case of carcinoma of the rectum who had already undergone low anterior resection with covering loop ileostomy;the patient underwent second loop ileostomy,this time for complicated intestinal obstruction.To our surprise,both the loop colostomy and ileostomy closed spontaneously at 8 weeks and 6 weeks,respectively,without any consequences.Spontaneous stoma closure is a rare and interesting event.The exact etiology for spontaneous closure remains unknown,but it may be hypothesized to result from slow retraction of the stoma,added to the concept of a tendency towards spontaneous closure of enterocutaneous fistula.展开更多
文摘BACKGROUND Nursing officers are an integral component of any medical team.They participate in taking care of basic airway management and assist in advanced airway management,specifically amidst the current coronavirus disease 2019(COVID-19)pandemic.AIM To assess the efficacy of a standardized web-based training module for nurses in preparedness to fight against COVID-19.METHODS The training was held in three sessions of 1 h each,consisting of live audio-visual lectures,case scenarios,and skill demonstrations.The sequence of airway equipment,drug preparation,airway examination,and plans of airway management was demonstrated through mannequin-based video-clips.RESULTS Pre-and post-test scores as well as objective structured clinical examination scores were analyzed using Student’s t-test and the Likert scale was used for feedback assessment.It was found that the mean score out of the total score of 20 was 8.47±4.2 in the pre-test,while in the post-test it was 17.4±1.8(P value<0.001).The participants also felt self-reliant in executing the roles of airway assistant(63.3%)and drug assistant(74.3%).Fear of self-infection with COVID-19 was also high,as 66%of participants feared working with the patient’s airway.CONCLUSION Amidst this COVID-19 emergency,when the health care systems are being persistently challenged,training of nursing staff in the safe conduct of airway management can ensure delivery of life-saving treatment.
文摘Severe acute pancreatitis often leads to pancreatic and peripancreatic collections but,rarely,it can lead to collections at sites remote from the pancreas.Three male patients presented with abdominal pain and inguinoscrotal swelling.They were initially misdiagnosed with obstructed inguinal hernia,epididymo-orchitis and hydrocele,respectively.Later,their diagnosis of acute pancreatitis was revealed on laparotomy in one patient and on computed tomography(CT)in the remaining two patients.All these cases had extensive peripancreatic necrosis and paracolic collections tracking along the psoas muscle,downwards towards the pelvis.These collections were initially managed by percutaneous drainage and saline irrigation as a part of the‘step-up’approach.Two of these patients required open necrosectomy,while all required incision and drainage of inguinoscrotal collections.All the patients were discharged in satisfactory condition.Inguinoscrotal swelling is unusual as a first presentation of acute pancreatitis.A high index of suspicion,with careful study of patient’s history and examination along with CT,may provide an accurate diagnosis.Local drainage may be required to control sepsis and also provide an egress route for intra-abdominal collections.
文摘Intestinal loop stoma is a common surgical procedure performed for various benign and malignant abdominal problems,but it rarely undergoes spontaneous closure,without surgical intervention.Two male patients presented to our emergency surgical department with acute abdominal pain.One of them was diagnosed as having rectosigmoid perforation and underwent diversion sigmoid loop colostomy after primary closure of the perforation.The other was a known case of carcinoma of the rectum who had already undergone low anterior resection with covering loop ileostomy;the patient underwent second loop ileostomy,this time for complicated intestinal obstruction.To our surprise,both the loop colostomy and ileostomy closed spontaneously at 8 weeks and 6 weeks,respectively,without any consequences.Spontaneous stoma closure is a rare and interesting event.The exact etiology for spontaneous closure remains unknown,but it may be hypothesized to result from slow retraction of the stoma,added to the concept of a tendency towards spontaneous closure of enterocutaneous fistula.
