Pain management is very crucial in nursing care. However due to lack of overall understanding, pain management by health professional is scarce. Therefore, knowledge and attitude of nurses towards effective management of pain in care post-operative care is pertinent. The effectiveness of postoperative nursing care is a basic part of a healthcare worker. The type of post-operative management emphasized in this article consists of the pain assessment and pain management by pharmacological and non-pharmacological tools. Post-operative follow-up care is required to alleviate pain and restore knee features and functions. The primary duty of nurses in postoperative care is to acknowledge preparation and implement suitable treatment. This article aims to provide information on increasing nurses’ knowledge in managing pain for post-operative care of Total Knee Replacement. Searches were performed by using electronic database for full text article in English language, original article published between 2000 and 2021. The database includes Springer, PubMed, British Medical Journal, Malaysian Orthopaedic Journal, SAGE Pub and ProQuest.
Morbidly adherent placenta (MAP) can be divided into placenta accrete, placenta increta and placenta percreta. It is associated with high parity, multifetal gestation, advanced maternal age, assisted reproductive technologies, placenta previa, and more importantly a history of caesarean section or uterine surgery. Globally, the incidence of placenta accrete has increased and seems to be in parallel with the increasing rate of caesarean section delivery.Despite rapidly evolving diagnostic imaging, and growing of surgical expertise, morbidly adherent placenta (MAP) remains an important cause of maternal morbidity and mortality, especially related with life-threatening postpartum haemorrhage. Although the choice of treatment for placenta accrete is puerperal hysterectomy, this procedure itself involves a greater risk of intra-operative haemorrhage.Elective caesarean hysterectomy using prophylactic bilateral internal iliac artery balloon occlusion offer an interesting approach which can minimize the risk of intra-operative haemorrhage. However, our case report describes the case of a 28-year old Gravida 3 Para 2 morbidly obese parturient diagnosed to have placenta previa type 3 posterior with accrete who experienced a complication of life threatening massive bleeding post-operatively after an elective caesarean hysterectomy using a prophylactic bilateral internal iliac artery balloon occlusion intra-operatively.
In admissions to the intensive care unit (ICU), there is a high possibility of a life-threatening condition and possible emotional distress for family members. When the family is distressed and hospitalized, a significant level of stress and anxiety will be generated among family members, thereby decreasing their ability to make responsible decisions. As a result, the family members need full and up-to-date details, helping them to retain hope, and this contributes to lower stress levels. While there is growing evidence of the effectiveness of shared decision-making for family members who are directly involved in decisions, particularly regarding shared decision-making in the Malaysian context, there is less evidence that supported decisions help overall outcome. This study aims to developing the family satisfaction with decision making in the Intensive Care Unit (FS-ICU)-33 Malay language version of family member’s satisfaction with care and decision making during their stay at the intensive care units. A quantitative, cross-sectional validation study and purposive sampling was conducted from 1st November 2017 and 10 October 2018 to January 2020 among 208 of family members. The family members of the ICU patients involved in this study had an excellent satisfaction level with service care. Higher satisfaction in ICU care resulting in higher decision-making satisfaction and vice versa.
The aim of this study is to measure the reliability and validity of the Family Satisfaction in the Intensive Care Unit (FS-ICU) Malay language version of family member’s satisfaction with care (19 items) during their stay at the intensive care units. A cross sectional study was conducted among 196 respondents. The self-administered FS-ICU comprises of three domains with a total of 19 items. Descriptive analysis, Cronbach’s alpha and Exploratory Factor Analysis (EFA) were performed on the Malay language version of FS-ICU. The final model EFA on the Malay language version of the FS-ICU indicated Bartlett’s Test of Sphericity was significant (Chi Square= 2321.013, p value <0.000) and the Kaiser-Meyer-Olkin (KMO) was 0.878. The EFA procedure has grouped 19 items into three domains, whereby one of the items from domain 3 was deleted since it failed to achieve the minimum requirement for factor loading of 0.6 and only 18 items were retained. The Cronbach’s alpha analysis of each domain in the FS-ICU exceeded the threshold value of 0.6. The study concluded that the instruments measuring the construct in this study has achieved the internal validity. Keywords: validity, reliability, exploratory factor analysis, FS-ICU-M, satisfaction, family members
The objective of this study was to highlight the emergence of COVID-19 bacteria pneumonia co-infections in patients infected with SARS-Cov-2 and risk factors related to its incidence and outcomes. We reported two cases of elderly patients with multiple comorbidities infected with SARS-Cov-2 and developed COVID-19 bacterial pneumonia requiring admission to intensive care unit (ICU) with one mortality preceded by septicemic shock and multi-organ failures. Observing the potential risk factors for being infected with SARS-Cov-2 and developing COVID-19 bacterial pneumonia we strongly advocate for rapid detection of COVID-19 bacterial pneumonia in SARS-Cov-2 infected patients and rapidly characterized the bacterial involved for a better outcome and importantly for efficient antimicrobial stewardship. COVID-19 bacterial pneumonia is an emerging disease requiring rapid detection and bacterial characterization with the ongoing management for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 Keywords: COVID-19, bacterial pneumonia, acute respiratory syndrome
Managing melioidosis with fulminant sepsis is difficult and challenging. We describe the case of a 30-year-old man with clinical presentation of non-specific septicemic shock with multi organ impairment and severe respiratory distress. The causative organism, Burkholderia pseudomallei was only identified on day 4 of ICU admission. Imaging investigation revealed multiple lung and splenic abscesses. This led to delay in the diagnosis and initiating specific antimicrobial therapy which arise from difficulties in clinical recognition and laboratory diagnosis. Our patient was managed in the ICU for 23 days with intensive antimicrobial therapy. As for now, we should increase the awareness of melioidosis in treating our patients and realize its burden to our community and hoping that a better diagnostic test will arise and helps us in achieving early confirmatory diagnosis and guide for better therapeutic efficacy and survival of the patients.
Objective:To highlight the importance of immediate initiation of perimortem caesarean delivery in maternal with sudden cardiac arrest. Case report: We reported the outcomes of three cases of perimortem caesarean delivery secondary to maternal cardiac arrest. A 28-year-old G3P2 at 36 weeks of gestation who developed severe hypoxaemia secondary to acute pulmonary oedema which was arise from pre-eclampsia related hypertensive crisis. The second case was a 29-year-old G1P0 at 38 weeks of gestation who developed severe hypoxaemia secondary to spinal anaesthesia complication (total spinal)and the third case was a 44-year-old G5P4 at 39 weeks of gestation who developed severe hypoxaemia secondary to failed intubation and ventilation during induction of anaesthesia. Observing the outcomes of the three maternal after post perimortem caesarean delivery, we are strongly agreed that the time from maternal cardiac arrest to the initiation of resuscitative hysterotomy should be shifted from 4 minute to immediately. Conclusion: Preparations for perimortem caesarean delivery should be made simultaneously with the initiation of maternal resuscitative efforts.
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