Carotid endarterectomy (CEA) is a surgical procedure performed to restore carotid blood flow and reduce the incidence of embolic and thrombotic strokes. Although it is a preventive procedure, CEA carries the risk of perioperative complications: neurologic and cardiac. Major complications of CEA are intra and postoperative stroke, myocardial infarction, and death. To reduce the number of intraoperative stroke events, one of them is to develop intraoperative monitoring technology with electroencephalogram (EEG). In this case, a male patient, 62 years old, with statistics of recurrent stroke and left leg weakness was approved for CEA under general anesthesia. Surgeons decide to use shunt selectively by assessing EEG monitoring when clamping. Finally the shunt was not performed, the operation lasted for 6 hours, tinged with hemodynamic shocks that often occur in patients with carotid disease due to baroreceptor disorders. By managing anesthesia meticulously during and after surgery, the operation was successfully performed, and the results of the post on the left leg strengthening motor increased from 2 to 4.
Introduction: Trauma is currently the most common cause of death in the first four decades of life and is still a major public health problem in every country. Arterial blood gas analysis (AGDA) is known to be an important marker for poor patient outcomes and occult or compensatory hypoperfusion. This study also evaluated the relationship and influence of AGDA scores on the outcome and prognosis of patients with multiple trauma. The results of this study will be able to assist in the rapid triage of acute trauma patients, which will also help identify high-risk patients who develop severe complications. Method: This study assessed the relationship between initial arterial blood gas and initial hemostatic function in acute trauma patients who came to the emergency department at H. Adam Malik General Hospital Medan. This type of research is a retrospective analytic where data is taken from medical records to see the relationship between AGDA and coagulation profile in multiple trauma patients at H. Adam Malik General Hospital Medan. After recruiting research samples at Adam Malik Haji Center General Hospital Medan, it was found that 141 multiple trauma patients who underwent surgery at H. Adam Malik General Hospital Medan met the inclusion criteria and were not included in the exclusion criteria Results: In this study, there were significant results between the pH and the three hemostatic physiology, there were no significant results between pCO2 and the three hemostatic physiology, and there were significant results between the HCO3 value and the PT and INR values, but no significant results were obtained with the APTT. Some authors believe that arterial PCO2 at admission is a significant prognostic factor in patients with traumatic head injury, but several studies dispute the arterial blood gas (ABG) parameter as a reliable indicator of short-term outcome in these patients. The main goal of the management of critically ill patients is the maintenance and optimization of cellular (and organ) health. Conclusion: This goal can be achieved by maintaining oxygenation, perfusion, fluid, electrolyte, and acid-base balance. Acid-base and oxygenation disorders are also critical, especially when these disorders develop rapidly.
Background: Basic life support is an emergency action that can be done by ordinary people to free the airway, help to breathe and maintain blood circulation without using aids. Knowledge of basic life support (BLS) is a knowledge and skill because if you only know the theory without doing training or practice, then the motivation to help becomes lacking and mentally untrained when dealing with real events. Purpose: To determine the level of knowledge of students and staff of Madrasah Aliyah Al-Azhar Asy Syarif Islamic Boarding School Deli Serdang about BLS. Method: The design used in this study is a cross-sectional method. Data collection was in the form of a questionnaire containing questions about BLS training. Questionnaire collection was carried out twice, namely the pretest which was carried out before the BLS material and training were given by the instructor and the posttest which was carried out after the BLS material and training were given. Results: Respondents' post-test scores obtained fewer values, 5 respondents (4.24%) had enough values, and 113 respondents (95.76%) had good scores. It was found that respondents got quite a good score after training on BLS. Conclusion: Based on the level of knowledge of students and staff at MA Al-Azhar Asy Syarif Islamic Boarding School Deli Serdang about BLS, it is included in the good category.
Background and Objective: Intracerebral hemorrhage (ICH) accounts for 10% to 15% of all strokes and has a high mortality and morbidity rate in the world. The ICH score is valid for predicting the severity of intracerebral hemorrhage patients treated in the ICU. The increase in C-reactive protein (CRP) value is a predictor in the outcome of ICU patients. The aim of this study was to find out how the ICH, CRP and D-dimer scores correlated with the outcome in intracerebral hemorrhage patients. Subjects and Methods: The subjects of this study were 27 patients with intracerebral hemorrhage who were treated in the ICU of H. Adam Malik Hospital and the University of North Sumatra Hospital. Data were collected using consecutive sampling, then ICH, CRP, D-dimer scores were measured and the examination was analyzed by length of stay. Results: Out of a total of 27 patients, 22 (81.5%) patients moved to the ward and 5 (18.5%) patients died. The mean for ICH score was 2.70(0.67), CRP was 1.41(0.72), and D-dimer was 2757.96(1230.73). The results of the correlation between ICH score and length of stay found a positive correlation (r = 0.498; p = 0.008), a correlation between CRP and length of stay had a weak correlation (r = 0.315; p = 0.109) and a correlation between D-dimer and length of stay and found a correlation positive (r = 0.546; p = 0.003). Conclusion: It was found that ICH, CRP and D-dimer scores had an effect on the length of stay of patients with intracerebral hemorrhage.
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