{"title":"Emergent airway management in intensive care unit without peripheral intravenous access","authors":"Tariq Janjua, Otto Villa, L. Moscote-Salazar","doi":"10.4103/sccj.sccj_68_20","DOIUrl":"https://doi.org/10.4103/sccj.sccj_68_20","url":null,"abstract":"","PeriodicalId":345799,"journal":{"name":"Saudi Critical Care Journal","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121086369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Wankhade, A. Abdel Hadi, Z. Alrais, Gopala Kumar Naidu, H. Eid
Tracheoinnominate fistula (TIF) is a rare but potentially life-threatening complication after tracheostomy. TIF was mostly observed within 7–21 days after tracheostomy but can present even years after tracheostomy. The risk factors for TIF are high cuff pressure, mucosal trauma from malpositioned cannula tip, low tracheal incision, excessive neck movement (hyperextension), radiotherapy, prolonged intubation, and high-riding innominate artery (HRIA). HRIA is also a rare anatomical variation of the innominate artery (IA) whereas IA bifurcates above the sternoclavicular joint. We report a rare case of TIF in a patient with HRIA, who presented with airway bleeding 2 months after percutaneous tracheostomy (PT) and was successfully managed with aggressive resuscitation and midline sternotomy. Knowledge of anatomical variation of the aortic arch and its major branches is essential for the physician who is routinely performing or managing tracheostomy. All the health-care workers involved in the management of tracheostomy should bear this complication in mind while dealing with any airway bleed. We recommend the routine use of bedside neck ultrasonography before all PTs to locate any aberrant vessel within the vicinity of tracheostoma to prevent this complication.
{"title":"Tracheoinnominate fistula due to high-riding innominate artery: A rare but potentially life-threatening complication following long-term tracheostomy","authors":"B. Wankhade, A. Abdel Hadi, Z. Alrais, Gopala Kumar Naidu, H. Eid","doi":"10.4103/sccj.sccj_58_20","DOIUrl":"https://doi.org/10.4103/sccj.sccj_58_20","url":null,"abstract":"Tracheoinnominate fistula (TIF) is a rare but potentially life-threatening complication after tracheostomy. TIF was mostly observed within 7–21 days after tracheostomy but can present even years after tracheostomy. The risk factors for TIF are high cuff pressure, mucosal trauma from malpositioned cannula tip, low tracheal incision, excessive neck movement (hyperextension), radiotherapy, prolonged intubation, and high-riding innominate artery (HRIA). HRIA is also a rare anatomical variation of the innominate artery (IA) whereas IA bifurcates above the sternoclavicular joint. We report a rare case of TIF in a patient with HRIA, who presented with airway bleeding 2 months after percutaneous tracheostomy (PT) and was successfully managed with aggressive resuscitation and midline sternotomy. Knowledge of anatomical variation of the aortic arch and its major branches is essential for the physician who is routinely performing or managing tracheostomy. All the health-care workers involved in the management of tracheostomy should bear this complication in mind while dealing with any airway bleed. We recommend the routine use of bedside neck ultrasonography before all PTs to locate any aberrant vessel within the vicinity of tracheostoma to prevent this complication.","PeriodicalId":345799,"journal":{"name":"Saudi Critical Care Journal","volume":"209 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132675622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Alharbi, A. Alghamdi, Rashid Albakistani, M. Alshehri
Background: Cardiac arrest (CA) is a sudden collapse of cardiac mechanical function as evidenced by the absence of detectable pulse and the absence or gasping of breath, which all combined with a loss of consciousness. Although researches on resuscitation efforts have been increasing significantly recently, little investigations have been done on the incidence of unexpected CA among intensive care unit (ICU) patients, in particular, in Saudi Arabia. Aim: The main goal of this research is to explore the rate and patient characteristics of unexpected CA among in ICU patients in the National Guard Health Affairs hospitals in Jeddah, Riyadh, and Al Ahsa. Materials and Methods: This study was a retrospective analysis of ICU patients who experienced unexpected CA. Settings: The study was conducted at the ICUs of three National Guard hospitals in Saudi Arabia. Results: Findings showed that only 11% of the ICU patients who received cardiopulmonary resuscitation (CPR) had a successful return of spontaneous circulation and the overall mortality rate was 89%. The most common cause of unexpected CA is sepsis, found in 348 out of 1233 patients (28%). The most common medical history accompanied by the ICU patients' medical history is a multi-organ dysfunction, found in 184 out of 1233 (14.9%) patients. We found a weak negative relationship between patients' gender and the causes of unexpected CA (relative risk = −0.069 and P < 0.05). Conclusion: The findings are in line with prior studies confirming that mortality increases when unexpected CA occurs on patients with sepsis. There was no significant relationship seen between patients' age and CPR outcomes.
{"title":"Incidence of unexpected cardiac arrest among intensive care unit patients in national guard hospitals in Jeddah, Riyadh, and Al Ahsa","authors":"A. Alharbi, A. Alghamdi, Rashid Albakistani, M. Alshehri","doi":"10.4103/sccj.sccj_4_21","DOIUrl":"https://doi.org/10.4103/sccj.sccj_4_21","url":null,"abstract":"Background: Cardiac arrest (CA) is a sudden collapse of cardiac mechanical function as evidenced by the absence of detectable pulse and the absence or gasping of breath, which all combined with a loss of consciousness. Although researches on resuscitation efforts have been increasing significantly recently, little investigations have been done on the incidence of unexpected CA among intensive care unit (ICU) patients, in particular, in Saudi Arabia. Aim: The main goal of this research is to explore the rate and patient characteristics of unexpected CA among in ICU patients in the National Guard Health Affairs hospitals in Jeddah, Riyadh, and Al Ahsa. Materials and Methods: This study was a retrospective analysis of ICU patients who experienced unexpected CA. Settings: The study was conducted at the ICUs of three National Guard hospitals in Saudi Arabia. Results: Findings showed that only 11% of the ICU patients who received cardiopulmonary resuscitation (CPR) had a successful return of spontaneous circulation and the overall mortality rate was 89%. The most common cause of unexpected CA is sepsis, found in 348 out of 1233 patients (28%). The most common medical history accompanied by the ICU patients' medical history is a multi-organ dysfunction, found in 184 out of 1233 (14.9%) patients. We found a weak negative relationship between patients' gender and the causes of unexpected CA (relative risk = −0.069 and P < 0.05). Conclusion: The findings are in line with prior studies confirming that mortality increases when unexpected CA occurs on patients with sepsis. There was no significant relationship seen between patients' age and CPR outcomes.","PeriodicalId":345799,"journal":{"name":"Saudi Critical Care Journal","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125474686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Coronavirus disease-2019 (COVID-19) has led to a pandemic that pushed many intensive care units (ICUs) worldwide beyond their limits. To maintain efficient critical care services and to protect critical care staff, reengineering the ICU workflow became a necessity. The care of COVID-19 patients occurred in designated ICUs. High-efficiency particulate air filters were installed in rooms that did not have negative pressure. Non-ICU wards were used for care of critically ill patients. Handover between physicians, multidisciplinary rounds, and entry into the ICU were changed to avoid large gathering inside the units. Tiered staffing approach was used to maintain an adequate nurse-to-patient ratio. The care of non-COVID-19 patients took place in clean ICUs by a dedicated medical team to avoid cross contamination. As visitation was prohibited during the pandemic, communication with families of patients was done via advanced telecommunication methods such as videoconferencing. To protect ICU staff, appropriate donning and doffing of personal protective equipment were monitored and corrected by qualified personnel. Reuse or extended use of such equipment was carried out due to supply shortage.
{"title":"Reengineering Workflow in the Intensive Care Units during COVID-19 Pandemic","authors":"H. Al-Dorzi, A. A. Al bshabshe, H. Sakkijha","doi":"10.4103/sccj.sccj_39_20","DOIUrl":"https://doi.org/10.4103/sccj.sccj_39_20","url":null,"abstract":"Coronavirus disease-2019 (COVID-19) has led to a pandemic that pushed many intensive care units (ICUs) worldwide beyond their limits. To maintain efficient critical care services and to protect critical care staff, reengineering the ICU workflow became a necessity. The care of COVID-19 patients occurred in designated ICUs. High-efficiency particulate air filters were installed in rooms that did not have negative pressure. Non-ICU wards were used for care of critically ill patients. Handover between physicians, multidisciplinary rounds, and entry into the ICU were changed to avoid large gathering inside the units. Tiered staffing approach was used to maintain an adequate nurse-to-patient ratio. The care of non-COVID-19 patients took place in clean ICUs by a dedicated medical team to avoid cross contamination. As visitation was prohibited during the pandemic, communication with families of patients was done via advanced telecommunication methods such as videoconferencing. To protect ICU staff, appropriate donning and doffing of personal protective equipment were monitored and corrected by qualified personnel. Reuse or extended use of such equipment was carried out due to supply shortage.","PeriodicalId":345799,"journal":{"name":"Saudi Critical Care Journal","volume":"86 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124738990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Alsolamy, Ameera A. Cluntun, S. Aldekhyl, A. Sabbagh, Tariq S. Alshehri, S. Yousif, W. Abuznadah, Salman Alharthi, A. Alshamrani, M. Bodrick
The World Health Organization declared COVID-19 a pandemic in March 2020. It is accepted that the associated severe acute respiratory syndrome requires intensive care unit (ICU) management. Therefore, considering the rapid spread of the disease, a specific educational response in the form of a critical care course was designed for non-ICU physicians. The course involved purpose-driven learning that used backward education design, the six-step curriculum process, and blended learning. The course included critical care essentials, COVID-19 infection prevention and control, nontechnical skills, and physician wellness. The course was implemented in two parts: A self-directed online knowledge-focused component and a practical hands-on approach to ensure non-ICU physicians gained the necessary critical care skills. The practical simulation-based part was implemented combined with infection control measures. The central coordination team provided on-going scientific, organizational, and logistical support for this non-ICU physician course that would directly address the identified need for surge capacity planning.
{"title":"A National Initiative: Training Nonintensivists in Critical Care, an Educational Response to the COVID-19 Pandemic","authors":"S. Alsolamy, Ameera A. Cluntun, S. Aldekhyl, A. Sabbagh, Tariq S. Alshehri, S. Yousif, W. Abuznadah, Salman Alharthi, A. Alshamrani, M. Bodrick","doi":"10.4103/sccj.sccj_50_20","DOIUrl":"https://doi.org/10.4103/sccj.sccj_50_20","url":null,"abstract":"The World Health Organization declared COVID-19 a pandemic in March 2020. It is accepted that the associated severe acute respiratory syndrome requires intensive care unit (ICU) management. Therefore, considering the rapid spread of the disease, a specific educational response in the form of a critical care course was designed for non-ICU physicians. The course involved purpose-driven learning that used backward education design, the six-step curriculum process, and blended learning. The course included critical care essentials, COVID-19 infection prevention and control, nontechnical skills, and physician wellness. The course was implemented in two parts: A self-directed online knowledge-focused component and a practical hands-on approach to ensure non-ICU physicians gained the necessary critical care skills. The practical simulation-based part was implemented combined with infection control measures. The central coordination team provided on-going scientific, organizational, and logistical support for this non-ICU physician course that would directly address the identified need for surge capacity planning.","PeriodicalId":345799,"journal":{"name":"Saudi Critical Care Journal","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131274012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Z. A. Al Aseri, T. Alaama, W. Alhazzani, Faisal A. Al-Suwaidan, Y. Arabi
Preparedness for coronavirus disease 2019 (COVID-19) started early in the Kingdom of Saudi Arabia before the World Health Organization declared COVID-19 as a pandemic. In this article, we narratively describe critical care surge planning in Saudi Arabia from an organizational perspective. In Saudi Arabia, the surge capacity response focused on seven domains, critical care surge capacity codes, communications, staff, space structure, supply, and strategies.
{"title":"Critical Care Surge Capacity in Saudi Arabia in Response to COVID-19 Pandemic","authors":"Z. A. Al Aseri, T. Alaama, W. Alhazzani, Faisal A. Al-Suwaidan, Y. Arabi","doi":"10.4103/sccj.sccj_51_20","DOIUrl":"https://doi.org/10.4103/sccj.sccj_51_20","url":null,"abstract":"Preparedness for coronavirus disease 2019 (COVID-19) started early in the Kingdom of Saudi Arabia before the World Health Organization declared COVID-19 as a pandemic. In this article, we narratively describe critical care surge planning in Saudi Arabia from an organizational perspective. In Saudi Arabia, the surge capacity response focused on seven domains, critical care surge capacity codes, communications, staff, space structure, supply, and strategies.","PeriodicalId":345799,"journal":{"name":"Saudi Critical Care Journal","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132137443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Saudi Critical Care Research from Middle East Respiratory Syndrome to COVID-19","authors":"Y. Arabi","doi":"10.4103/sccj.sccj_64_20","DOIUrl":"https://doi.org/10.4103/sccj.sccj_64_20","url":null,"abstract":"","PeriodicalId":345799,"journal":{"name":"Saudi Critical Care Journal","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116980469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Bawazeer, T. Nouh, A. Alburakan, Wail Tashkandi
The World Health Organization has announced COVID-19 as a pandemic in late 2019. It spread around the world, and the first case in Saudi Arabia was discovered in February of 2020. All types of patients have been affected including the surgical patients. In this review, we describe how the care of the surgical patients affected by the pandemic. The types of the surgical patients during the pandemic are described. These patients could be non-COVID patients or COVID patients requiring surgery. We describe as well how we take care of these patients if they require a surgical intervention. This review is part of the collaborative initiatives of the Saudi critical care trials group.
{"title":"How the COVID-19 Pandemic Affected the Care of the Surgical Patients in the Intensive Care Unit","authors":"M. Bawazeer, T. Nouh, A. Alburakan, Wail Tashkandi","doi":"10.4103/sccj.sccj_48_20","DOIUrl":"https://doi.org/10.4103/sccj.sccj_48_20","url":null,"abstract":"The World Health Organization has announced COVID-19 as a pandemic in late 2019. It spread around the world, and the first case in Saudi Arabia was discovered in February of 2020. All types of patients have been affected including the surgical patients. In this review, we describe how the care of the surgical patients affected by the pandemic. The types of the surgical patients during the pandemic are described. These patients could be non-COVID patients or COVID patients requiring surgery. We describe as well how we take care of these patients if they require a surgical intervention. This review is part of the collaborative initiatives of the Saudi critical care trials group.","PeriodicalId":345799,"journal":{"name":"Saudi Critical Care Journal","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124777776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Critical care pharmacist is essential member of the intensive care unit (ICU) multidisciplinary team. ?During COVID-19 pandemic, ICU pharmacists showed their vital role in conceptualizing, appraising, and drafting prevention and treatment protocols, as well as evaluating the available evidence and providing the best references to develop national and institutional guidelines in COVID-19 management. In addition, their responsibilities include ensuring that the patient is receiving the safe and effective treatment. In addition, during this pandemic, clinical pharmacists around the Kingdom played a crucial role in mitigation of drug shortages.
{"title":"Clinical Pharmacy Service in the Intensive Care Unit during COVID-19 Pandemic","authors":"J. Gramish, M. Abuzaid, M. Khobrani","doi":"10.4103/sccj.sccj_46_20","DOIUrl":"https://doi.org/10.4103/sccj.sccj_46_20","url":null,"abstract":"Critical care pharmacist is essential member of the intensive care unit (ICU) multidisciplinary team. ?During COVID-19 pandemic, ICU pharmacists showed their vital role in conceptualizing, appraising, and drafting prevention and treatment protocols, as well as evaluating the available evidence and providing the best references to develop national and institutional guidelines in COVID-19 management. In addition, their responsibilities include ensuring that the patient is receiving the safe and effective treatment. In addition, during this pandemic, clinical pharmacists around the Kingdom played a crucial role in mitigation of drug shortages.","PeriodicalId":345799,"journal":{"name":"Saudi Critical Care Journal","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124086719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shortly after the COVID-19 pandemic announcement, health-care systems across the world were hugely affected by the mitigation measures to contain the infection. The training programs in different specialties were compromised, and the educational process was interrupted. The training program leaders have worked effortlessly to balance the educational process’s continuation with their trainees’ safety in ways that adhere to the mitigation measures. This review briefly discusses the challenges and opportunities to critical care training programs during the COVID-19 pandemic. The main challenges were interruptions of the educational process, reduced supervision, burnout, and reduced support. On the contrary, many opportunities have emerged including exposure to a new clinical disease and disaster response, virtual education, self-directed reading and assessment, and comprehensive support.
{"title":"Challenges and Opportunities to Critical Care Training Programs during COVID-19 Pandemic","authors":"Farhan Alenez, M. Algamdi","doi":"10.4103/sccj.sccj_54_20","DOIUrl":"https://doi.org/10.4103/sccj.sccj_54_20","url":null,"abstract":"Shortly after the COVID-19 pandemic announcement, health-care systems across the world were hugely affected by the mitigation measures to contain the infection. The training programs in different specialties were compromised, and the educational process was interrupted. The training program leaders have worked effortlessly to balance the educational process’s continuation with their trainees’ safety in ways that adhere to the mitigation measures. This review briefly discusses the challenges and opportunities to critical care training programs during the COVID-19 pandemic. The main challenges were interruptions of the educational process, reduced supervision, burnout, and reduced support. On the contrary, many opportunities have emerged including exposure to a new clinical disease and disaster response, virtual education, self-directed reading and assessment, and comprehensive support.","PeriodicalId":345799,"journal":{"name":"Saudi Critical Care Journal","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126339731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：