OVERVIEW organisms: Vibrio vulnificus and other species CLINICAL FEATURES tropical environments sea water borne cut to skin -> cellulitis -> necrotizing cellulitis profound multi-organ failure RISK FACTORS raw oyster consumption liver disease iron overload INVESTIGATIONS tissue culture blood cultures MANAGEMENT…
Léon Clément Le Fort (1829 – 1893) was a French surgeon. Eponym: Wagstaffe-Le Fort fracture (1886); Le Fort Operation for uterine prolapse; Le Fort amputation; Le Fort Male Catheter; and Le Fort sound. Godfather of FOAM 'Liberté de l'enseignement'
Waterborne Disease: major killer of the paediatric patient in the developed world
Stenotrophomonas maltophilia is an environmental global emerging Gram-negative MDRO that is most commonly associated with respiratory infections in humans
Spinal epidural abscess is considered a neurosurgical emergency; morbidity and mortality is worse with delayed diagnosis, and the worse the neurological deficit at the time of surgery the worse the outcome
Carotid Endarterectomy = removal of atheromatous plaque from the ICA. Artery clamped, open, plaque stripped and then closed directly or with a Gore-Tex vein patch.
GENERAL APPROACH Emergency or Elective End-organ damage Complications– brain injury– spinal cord ischaemia– ileus– MI– lower limb ischaemia– compartment syndromes– renal injury INTRODUCTION CUBICLE dialysis INFUSIONS vasoactives fluid boluses sedation analgesia transpyloric feeding: ileus, ischaemia TPN VENTILATOR mode level of…
GI Drug Absorption in Critical Illness; multi-factorial determinants influence the bioavailability of drugs; governed by factors altering transport of substances across cell membranes (diffusion, active transport, ultrafiltration)
Pseudocoma is the term used for a patient feigning a comatose state, however it is sometimes also used for conditions like locked-in syndrome where patients may involuntarily appear unconscious but are actually self aware
Spinal cord syndromes
Status epilepticus: continuous seizure activity for 5 minutes or more without return of consciousness, or recurrent seizures (2 or more) without an intervening period of neurological recovery
Watershed infarcts result from severe hypotensive insults. They occur in areas with relatively poor blood supply at the boundaries between territories of cerebral arteries or their branches.