Medical ethics qs
Thread Starter Medical ethics qs Follow 1 day ago 1d ago Quote: Originally Posted by ugliestboieva but since all operations carry a risk of bleeding, wouldn't you just act on the patients wishes, and get a court order now before the operation? Yes. As I said in the last post, you could override the parents' refusal by getting a court order. For clarification, you are correct that you would obtain that before the operation. As the patient is only seven, could they even communicate their "wishes"? This would often be dealt with on a case-by-case basis however (can seven-year-olds be well-versed in medicine and the risks associated with a blood transfusion?), so I'm trying to be as general as possible.
Conclusion. There was no difference in TBL, intraoperative bleeding, and operation time, but HBL were higher in RA patients particularly in long-segmental operation. Steinbroker classification, DMARDs, the change of Hb, and allogeneic blood transfusion were independent risk factors for HBL in RA patients. Level of Evidence: 3
Conclusions: The current prevailing practice that is best described as institutional or provider centered should be supplemented with score-based protocol with auditing and monitoring tools to refine it. This review summarizes the current scoring models in predicting the need for MT in civilian and military trauma. Several questions remain open; i.e., do we need to develop new score, merge scores, modify scores, or adopt existing score for certain trauma setting?
Conclusion: All scoring systems were effective for predicting need for blood transfusion, rebleeding, and death. GBS had more predictive power for transfusion need, PERS and PEBS for rebleeding, and FRS for mortality. PERS, FRS, and FBS were found to be effective in predicting endoscopic treatment.
Perioperative coagulopathy and bleeding are common complications in cardiovascular surgery with cardiopulmonary bypass and result in an increased rate of allogeneic blood transfusion. Both bleeding and transfusion can increase postoperative mortality and morbidity. Patient blood management can significantly reduce allogeneic blood transfusions, improve clinical outcomes, and conserve blood resources; however, measures to protect platelets from destruction by cardiopulmonary bypass still are lacking.
CONCLUSIONS: Both conventional clotting tests and TEG values were poorly associated with bleeding in this critically ill cohort of patients with coagulopathy. PMID: 31403249 [PubMed - as supplied by publisher]
Goals: The aim of our study was to examine differences in length of hospital stay (LOHS) between patients with lower gastrointestinal bleeding who received either an early colonoscopy (within 24 h of presentation) or a standard colonoscopy (within 1 to 3 d). Background: Diagnostic management of lower gastrointestinal bleeding has been extensively debated in recent literature, especially whether colonoscopy within 24 hours of presentation is feasible and safe. Study: In this single center, nonblinded, randomized controlled trial, patients presenting at the emergency department with acute hematochezia w...
Authors: Tsuchiya S, Matsumoto Y, Doman T, Fujiya T, Sugisawa J, Suda A, Sato K, Ikeda S, Shindo T, Kikuchi Y, Hao K, Takahashi J, Hatta W, Koike T, Masamune A, Saiki Y, Horiuchi H, Shimokawa H Abstract An 83-year-old woman with severe aortic stenosis was admitted to our hospital due to heart failure with refractory anemia requiring blood transfusions. She had repetitive bleeding episodes from endoscopically proven angiodysplasia in the stomach. Moreover, she repeatedly underwent endoscopic argon plasma coagulation for hemostasis. Importantly, she had a deficiency of the high-molecular-weight (HMW) multimers of von...
Postoperative recovery after total knee arthroplasty (TKA) is associated with postoperative anemia, allogeneic transfusion, and stress immune responses to surgery. Carbazochrome sodium sulfonate (CSS) reduces bleeding through several mechanisms. We assessed the effect of CSS combined with tranexamic acid (TXA) on postoperative anemia, blood transfusion and inflammatory responses.
Inadvertent perioperative hypothermia (IPH), where core body temperature is less than 36 °C or 96.8°F, occurs in 26-90% of patients undergoing elective surgery. This preventable anesthesia- and surgery-related complication affects patients’ outcome and is associated with increased risk for surgical site infections (SSIs), bleeding, blood transfusions, and decreased patient thermal c omfort.
We present the statistical analysis of the HALT-IT trial. This plan was published before the treatment allocation was unblinded.Trial registrationCurrent Controlled Trials, ID:ISRCTN11225767. Registered on 3 July 2012;Clinicaltrials.gov, ID:NCT01658124. Registered on 26 July 2012.