Medical notes of 123 patients with subarachnoid haemorrhage were examined. No patient deteriorated at the time of lumbar puncture. All but 2 patients with associated intracerebral haematomas had markedly impaired consciousness or focal signs. Two of 30 patients with meningitis were initially diagnosed as subarachnoid haemorrhage, and one died without lumbar puncture. If consciousness is not mar...

and employing authorities are being asked to review their consultant requirements to achieve a consultant led service. The increase in the numbers of consultants previously recommended by the British Paediatric Association4 is supported in the report; this will mean a further increase in training grades. In future, training in paediatrics at all levels will need to include work in hospitals and...

Human sepsis is characterized by a set of systemic reactions in response to intensive and massive infection that failed to be locally contained by the host. Currently, sepsis ranks among the top ten causes of mortality in the USA intensive care units. During sepsis there are two established haemodynamic phases that may overlap. The initial phase (hyperdynamic) is defined as a massive production...

Tracheoesophageal puncture enlargement in laryngectomized patients is a significant problem due to complications such as aspiration pneumonia. There are several management methods including conservative and nonconservative techniques. A total closure of the enlarged tracheoesophageal puncture is needed in some cases when conservative approaches have failed. At this point, the insertion of a sil...

introduction: post dural puncture headache is still a common complication among young women undergone cesarean section, although use of small size spinal needles reduced its prevalence. several methods have been suggested for prevention and treatment of this side effect; such as complete bed rest, hydration, non-opioid analgesics, caffeine, codeine, which none of them proved to be totally effec...

objective whatever the health field, compliance with the recommended practice guidelines or parameters for diagnosis by specialists and expert health professionals benefits the patients. this study was conducted to determine the whether or not these guidelines or parameters are applied to the evaluation of children with first simple febrile convulsion (sfc) in a regional teaching hospital. mate...

background: although a variety of methods have been suggested to reduce stress, anxiety and pain intensity due to spinal needle skin puncture, their adverse effects restrict theirs widespread administration. in this study we evaluated the effects of oral tizanidine on the reduction of pain caused by spinal needle puncture and hemodynamic responses. methods : in this double blind randomized clin...

Arterial blood gas (ABG) analysis can yield information vital to the management of both acute and chronic disorders affecting gas exchange. In the setting of a restrictive ventilatory impairment due to chest-wall deformities (eg, scoliosis), hypercapnia indicates severe impairment and should prompt consideration of noninvasive ventilation.1 However, arterial puncture is often painful, particula...

Post-dural puncture cephalgia is a complication often encountered by the anesthesia practitioner. Disruption in the continuity of the dura incurred during diagnostic procedures (such as myelography or cerebral spinal fluid harvesting) also increases the number of patients requiring treatment for severe to incapacitating cephalgia. The anesthetist's ability to differentiate, evaluate, and assist...