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Isolated right atrial rupture because of external cardiac massage after coronary artery bypass grafting

References 1. Baringer JR, Salzman EW, Jones WA, Friedlich AL. External cardiac massage. New Eng J Med. 1961; 265: 62-5. 2. Machii M, Inaba H, Nakae H, Suzuki I, Tanaka H. Cardiac rupture by penetration of fractured sternum: a rare complication of cardiopulmonary resuscitation. Resuscitation. 2000; 43:151-3. 3. Noffsinger AE, Blisard KS, Balko MG. Cardiac laceration and pericardial tamponade due to cardiopulmonary resuscitation after myocardial infarction. J Forensic Sci. 1991; 36:1760-4. 4

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Quality and patient safety in anesthesia service: Thai survey


Background: The Royal College of Anesthesiologists of Thailand (RCAT) performed large-scale epidemiologic study of anesthesia-related complications and national incidents study in 2004 and 2007, respectively. Objectives: Evaluate the anesthesia service in Thailand with regard to status of quality and patient safety. Material and methods: A pre-planned structured questionnaire regarding demographic, administrative, preanesthetic, intraoperative postanesthetic variables and complications were requested to be filled in by nurse anesthetists attending the refresher course lecture of RCAT in February 2008. Descriptive statistics was used. Results: Three hundred fifty questionnaires were given and 341 respondents (97%) returned the questionnaires. Most of the respondents (90%) worked in government section. Thirty percent of respondents practiced in hospital without medical doctor anesthesiologist and 58% of nurse anesthetists worked in hospitals that have been accredited. Forty-six percent of respondents reported unavailability of a 24-hour recovery room. The questionnaires revealed of inadequacy of anesthesia personnel (64%), inadequate supervision during emergency condition (53%), inadequacy of patient information regarding anesthesia (57-69%), and low opportunity for patient to choose choice of anesthesia (19%). The commonly used monitoring were pulse oximeter (92% of respondents) and electrocardiography (63%). One-third (32%) of respondents had to provide of anesthesia for patients with insufficient NPO (non per oral) time. Common problems that the respondents experienced were miscommunication (49%), intraoperative cardiac arrest during the past year (35%), error related to infusion pump (24%) and medication error (8%). Fifty-five percent of respondents had to monitor at least one patient per month receiving spinal anesthesia. Conclusion: Suggested strategies for quality and patient safety improvement in anesthesia service are increasing personnel, increasing 24-hour recovery room, improvement of supervision, improvement of communication, compliance to guidelines and improvement of nurse anesthetist’s training regarding monitoring patient receiving spinal anesthesia and cardiopulmonary resuscitation.

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Mediastinal teratoma in a neonate with acute respiratory failure

-73. 11. Kuroiwa M, Suzuki N, Takahashi A, Ikeda H, Hatakeyama SI, Matsuyama S, Matsuyama S, et al. Life-threatening mediastinal teratoma in a neonate. Pediatr Surg. 2001; 17: 235-8. 12. De Lorimier AA, Harrison MR. Surgical treatment of tumor in the newborn. Am J Pediatr Hematol Oncol. 1981; 3: 271-7. 13. Mogilner JG, Fonseca J, Davies MR. Life-threatening respiratory distress caused by a mediastinal teratoma in a newborn. J pediatr Surg. 1992; 27:1519-20. 14. Wang KY, Yeh YC, Jean WH, Fan SZ. Cardiopulmonary

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Eff ects of hemin, a heme oxygenase-1 inducer in L-arginine-induced acute pancreatitis and associated lung injury in adult male albino rats

M, Ozkan O, Cavdar F, Yaman I, Aksit H, Ozyigit MO, Aslan F, Derici H. Th e eff ects of 2-aminoethyl diphenylborinate on L-Arginine induced acute pancreatitis in the rats. Medical Science and Discovery 2, 352-357, 2015. Zhang B, Wei X, Cui X, Kobayashi T, Li W. Eff ects of heme oxygenase 1 on brain edema and neurologic outcome aft er cardiopulmonary resuscitation in rats. Anesthesiology 109, 260-268, 2008. Zhong W, Xia Z, Hinrichs D, Rosenbaum JT, Wegmann KW, Meyrowitz J, Zhang Z. Hemin exerts multiple protective mechanisms and

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