Background:Cardiopulmonary resuscitation (CPR) is one the most commonly performed procedures in the intensive care unit (ICU). However, success rate of CPR vary widely from 3.1% to 16.5%.Patients and Methods:We conducted a retrospective study of all cardiac arrests prompting CPR in our ICU for a period of 12 months. Data retrieved from ICU records included patients demographic characteristics, diagnosis at admission, length of ICU stay, time and day of cardiac arrest, cardiac rhythm, duration of CPR and outcome of CPR.Results:A total of 156 CPRs were performed within the study period with 8.3% success rate. Male: female ratio was 1.2:1. Indications for ICU admission, length of stay in ICU, time and day of cardiac and duration of CPR were found to be determinants of outcome.Conclusions:There is an urgent need to constitute a cardiac arrest team (CAT) which will be available at all times for improved successful outcome after cardiac arrest in our ICU.
Introduction. Suxamethonium, a deepolarizing muscle relaxant, increases intraocular pressure. It is therefore advised to be avoided in open globe surgery, for fear of extruding ocular contents. Several anecdotal reports support this fear. Some workers however, dispute this claim. There is as yet no formal case report in the literature on the subject. Case Presentation. A 34-year old Nigerian male, was involved in a road traffic accident. He presented at the Accident & Emergency Unit of our hospital about 2 hours after the accident. Clinical examination revealed right corneal laceration (with intact ocular contents) and intra-abdominal visceral injury. Emergency laparotomy was scheduled, to be followed with corneal repair. Anaesthesia was induced with 10 mg midazolam, 100 mg ketamine, and 100 mg suxamethonium given intravenously in sequence. After laparotomy, the ophthalmologists reported for the corneal repair, only to find that the vitreous humour has been extruded. Conclusion. The fear about the use of suxamethonium in open globe situations is real. It will be good clinical judgment to use alternative drugs and techniques to effect rapid muscle relaxation, in the anaesthetic management of the open globe patient. This would be of interest to anaesthetists, ophthalmologists and clinical pharmacologists among others.
A 34-year old gravida 5, para 1 +3 (none alive), presented with an 8-hour history of labour at 36 weeks gestation. On examination, she was grossly obese (BMI 43), had a pulse rate of 92 bpm, blood pressure of 100/70 mmHg and bilateral pedal oedema. She had a singleton fetus, lying transverse. Emergency Caesarean section was planned. In the operating theatre, she had spinal (subarachnoid) blockade with a 25-G Whitacre spinal needle and 2.2 ml of 0.5 % hyperbaric bupivacaine. Shortly thereafter, she complained of a progressively worsening respiratory difficulty, for which she was intubated and ventilated. Large amounts of blood -stained frothy fluid poured out of the pharynx at laryngoscopy, and from the endotrachial tube after intubation. She had cardiac arrest, and all resuscitative efforts failed.
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