Obstetric Early Warning scores – the 4 P’s study - Peter WatkinsonIntensive Care Society
Dr Peter Watkinson, Associate Professor of Intensive Care Medicine, is joint clinical lead for the Critical Care Research Group based at the Kadoorie Centre for Critical Care Research & Education at the John Radcliffe Hospital, Oxford.
He is an NHS consultant in intensive care and acute medicine and is part of the senior clinical team at the Oxford University Hospitals NHS Foundation Trust. His research interests focus on the identification of the deteriorating patient in hospital and he has designed and run a number of studies in the field of wearable monitoring devices. The research group is now exploring the opportunities offered through non-contact monitoring and standard electronically-recorded descriptors of a patient’s condition.
The research group has a strong link with the University of Oxford Institute of Biomedical Engineering. Using data collected from thousands of patients’ vital signs in Oxford and elsewhere the multi-disciplinary team investigates ways to locate patterns which precede and predict clinical deterioration in hospitalised patients.
Other areas of interest for the research group include development of electronic monitoring systems, use of human factors techniques to introduce new technology into the healthcare environment, and assessing the longer-term effects of critical illnesses on patients’ quality of life.
Clinical Practice Guidelines for Traumatic Brain Injury 2556Utai Sukviwatsirikul
Clinical Practice Guidelines for Traumatic Brain Injury 2556
แนวทางเวชปฏิบัติกรณีสมองบาดเจ็บ (Clinical Practice Guidelines for Traumatic Brain Injury) พิมพ์ครั้งที่ 1 2556
http://pni.go.th/pnigoth/wp-content/uploads//2013/10/Clinical-Practice-Guidelines-for-Traumatic-Brain-Injury.pdf
Obstetric Early Warning scores – the 4 P’s study - Peter WatkinsonIntensive Care Society
Dr Peter Watkinson, Associate Professor of Intensive Care Medicine, is joint clinical lead for the Critical Care Research Group based at the Kadoorie Centre for Critical Care Research & Education at the John Radcliffe Hospital, Oxford.
He is an NHS consultant in intensive care and acute medicine and is part of the senior clinical team at the Oxford University Hospitals NHS Foundation Trust. His research interests focus on the identification of the deteriorating patient in hospital and he has designed and run a number of studies in the field of wearable monitoring devices. The research group is now exploring the opportunities offered through non-contact monitoring and standard electronically-recorded descriptors of a patient’s condition.
The research group has a strong link with the University of Oxford Institute of Biomedical Engineering. Using data collected from thousands of patients’ vital signs in Oxford and elsewhere the multi-disciplinary team investigates ways to locate patterns which precede and predict clinical deterioration in hospitalised patients.
Other areas of interest for the research group include development of electronic monitoring systems, use of human factors techniques to introduce new technology into the healthcare environment, and assessing the longer-term effects of critical illnesses on patients’ quality of life.
Clinical Practice Guidelines for Traumatic Brain Injury 2556Utai Sukviwatsirikul
Clinical Practice Guidelines for Traumatic Brain Injury 2556
แนวทางเวชปฏิบัติกรณีสมองบาดเจ็บ (Clinical Practice Guidelines for Traumatic Brain Injury) พิมพ์ครั้งที่ 1 2556
http://pni.go.th/pnigoth/wp-content/uploads//2013/10/Clinical-Practice-Guidelines-for-Traumatic-Brain-Injury.pdf
Chest injuries ranks 3rd after head injuries and extremity injuries in a case of multisystem trauma.It is of two types blunt chest trauma and peneterating chest trauma.The main cause of blunt chest trauma is road side accidents due to vehicles. Peneterating chest trauma is more dangerous and is common in war injuries and civilian terroism.In this ppp I have discussed some useful uncommon and important aspects of chest injuries
39. LIFE THREATENING CHEST INJURES
“COMMON”
1.Tension Pneumothorax
2.Opened Pneumothorax
3.Massive Hemothorax3.Massive Hemothorax
4.Cardiac Tamponade
5.Flail Chest and Lung Contusion
40.
41. ชายไทย อายุ 42 ป ถูกรุมทุบแทงที่หลังดานซาย
ER - BP 140/80 P 120 RR 22
- Decrease BS Lt
- Abdomen - soft
42.
43. ทําอะไรดีเอ่ย ??
ชายไทย 43 ปี ZALENG ชน TAXI สลบชัวครู่ ตืนแล้วแน่นหน้าอก 30 นาที PTA
ER - บ่นแน่น เจ็บหน้าอก นอนร้องครวญคราง
- RR 48, P100, BP 146/95
- O2 Sat 88%
A - on collar, patent airway, tracheaA - on collar, patent airway, trachea
shrift to the right
B - tachypnea, decrease BS Lt> Rt
- hyper-resonance on left hemithorax
C - scalp laceration
Action :
95. CASE STUDY
ชายไทย 49 ปี ถูกรถชนอัดก๊อปปีhก่อนมา ร.พ. 20 นาที
00.35 น. พูดคุยได้ เหนือยมาก ICD ไม่ได้อะไร
Decrease BS Lt Acetar 2 L
FAST Negative On ET tubeFAST Negative On ET tube
BP 80/40 P120 NG tube ไม่ได้เลือด
Fx both thigh
O2 Sat ไม่ได้
96. 00.50 น. BP 100/60 P114
FAST Negative
01.10 น. BP 74/48 P126 PRC push
O2 Sat ไม่ได้
01.30 น. Unconscious
CASE STUDY (ต่อ)
01.30 น. Unconscious
BP 88/50 P130
FAST Positive
01.45 Arrest ER Thoracotomy
