JOURNAL OF IRANIAN SOCIETY ANAESTHESIOLOGY AND INTENSIVE CARE
Year:2015 | Volume:37 | Issue:3 (91)|Papers Count:10

Introduction: DVT is a serious threat for operating patients although it is preventiveand an accident of hospitalization. Dvt is the reason of 10% death of the hospital general population. Different items are introduced as the risk factors of DVT. This research has done with the aim of determination the effective risk factors on dvt appearance in surgery part patient.Materials and methods: This research is a subjective – analysis study that has done a hospitalized surgery patients in intensive care units of educational hospitals in kerman medical university in 2014. The studing frame work is all hosptalized patients in intensive care unites of educational hospitals in kerman city, that study were operated. Samples were completed with a questionar of demogerafic charactristics and the standard assessment of DVT risk factors in the first 3 month of year 2014. The validityof data collection method was sacial appearance with the number of 0.9 and the method of releability was chrombakh alfa with number of 0.78the data collection method was a demographic questioner and the estandard assessment of DVT risk factors related to interview or informations shet.the data collection was done after satistical accetance central and scatter indices were analysied with statictical software spss number 19 with.T. test experiment.Results: In research of demographic characteristic the average range of age was 42.5 with the deviation of 18.08 and the relation between age and effecting factors on DVT were not meaning full with in the limit of 0.05. there was a meaning full relation with the sex of male and appearance of dvt risk factoras with p) 0.03.The T- test results showed that there is meaning full relation sheef between body mass index and DVT risk factors with the meaning fyll level of 0.01, that is the weight increase the probablyyyyyhlhty of the srsk will increase. The average PT of the samples were 13.6 and the deviation was 2.26. also the aveage of PTT was reported33.09 with the deviation of 37.6 while the sampels average INRwas 1.07 with the deviation of 0.27 in total research of risk factors 86 prcent of the samples were low risk and 0.9 percent were moderate risk and 5 percent were high risk.Conclusion: In the study of the research results just the age did not have any meaning full relation with the risk factors while according to the research results most of the patients 86% had a low risk factor of DVT.

Introduction: Pediatric sedation for diagnostic procedures is essential. The drug of choice and standard protocol in pediatric procedural sedation and analgesia (PSA) was not introduced till now.The aim of present study was to compare the efficacy of oral midazolam, ketamine and chloral hydrate in PSA.Materials & Methods: In this double-blinded clinical trial, 60 children undergoing diagnostic CT scan or audiometry were randomly divided into three groups; midazolam (M, 0.5mg/kg), ketamine (K, 5mg/kg) and chloral hydrate (CH, 50mg/kg).Separation condition, sedation and anxiety score were recorded every 5 minutes and movement score were recorded in 0, 15, and 30 minutes after starting procedure and compared between groups.Results: the mean score of separation condition in CH group was significantly lower than others (p=0.000) and in K group lower than M group (p=0.001).the mean of separation time in M group (27.00±6.165) was significantly more than K group (20.26±5.13) and CH group (17.75±4.375) but there was no significant difference between K and CH groups. Sedation score in CH group was lower than others (p=0.000) and in K group lower than M group (p=0.000) with no difference between K and M groups (p=0.734). The mean of movement score in CH group was significantly lower than others (p=0.000) with no difference between K and M groups (p=1.00). There was no serious side effect or significant difference in mean of the sedation duration and hospital stay between three groups (p=0.659).Conclusion: Oral Midazolam, Ketamine and Chloral hydrate are safe and effective for PSA and Midazolam anxiolysis effect was more than others which makes improvement in separation condition.

Introduction: The studies of WHO in various parts of the world indicates that within 5 to 25 percent of the hospitalized patients get hospital infection, whereas in the ICU departments of the modern countries the rate of getting infection is 25% and the rate is up to 50% in the developing countries. The appearance of hospital infection can increase two times the risk of death. Since such a study on the rate of hospitalized patients getting infected hasn’t yet been carried out this study on the exploration of the rate and the types of hospital infection in the trauma ICU departments of kermani hospitals was carried out.Materials and methods: This research is a kind of descriptive, analytical and temporal study that was carried out on all of the hospitalized patients in the trauma ICU departments of Kermani hospitals during the first half of 1393.The criterion of entering the population of the study was getting hospitalized for at least 72 hours at trauma departments, also the criterion of excluding the study was existence of symptoms of infection or having the diseases that cause getting infected, at the beginning of entering the department. To collect data two questionnaires namely 1. The questionnaire of demographic features 2. The questionnnnaire of exploration of hospital infections was used.Results: After collecting the information using SPSS software the version 20 and descriptive statistics the data was analyzed. The results indicated that the largest rate, 69.2 and the biggest part of the bacteria factor was caused by Asintobacterin respiratory infection. Studying the blood infection status of the patients the biggest bacteria factor was Kalbsilaand it was observed in 6.5% of the patients whereas, in the study of urinate infection the largest factor of causing infection was Asinobacter that was detected in 1.4% of the patients.Conclusions: Studying the hospitalized patients at trauma ICU department the Kermani hospitals it was observed that most of the patients got respiratory infection that was caused by Asinobacter that was in correlation with the results of a similar study conducted in an ICU department of a Korean hospital conducted by Yong that the largest infection proportion appeared in the special respiratory departments. Since the most of the ICU patients use the Ventilator set the prediction of such a results isn’t difficult. With regard of infection rate exerting more care and caution to avoid appearance of infection in ICU departments seems necessary.

Background and aim: Administering medication is an important and high risk duty in nursing. Duo to statistically high rate of errors in drug administration, increased mortality and hospital costs and its negative impact on the quality of nursing care, identification of factors involving the incidence and the extent of these errors, is very important for adopting strategies that can minimize those items. The aim of this study was to determine of medicine administration errors and factors affecting its occurrence in intensive critical care units of hospitals Semnan.Material and methods: This was descriptive, crosssectional study of nurses' community of intensive critical care units. Data were collected by using a questionnaire that included demographic data, type of medicine administer errors in three human and organizational, medical and management areas. Data analysis was performed by SPSS16.Results: From the 56 nurses who participated, 39 (69.5%) showed medicine administer errors, most of these errors were improper timing (30.4%), improper dosing (26.8%) and improper infusion rate (19.6%). Among the factors related to human and organization, medical and management, respectively, fatigue from overtime working, similarly packed drugs and a shortage of nurses to patients, were the most important error factors.Conclusion: Given the prevalence of errors in medicine administration in intensive care units, detection and analysis of the causes can be helpful in better planning to avoid errors and improving the quality of nursing care.

Background: Surgical stress response to an involuntary response to tissue damage and changes in the form of autonomic, hormonal and metabolic appears And fluctuations in blood sugar leads. The purpose of this study was to evaluate the effects of spinal anesthesia and sedation in patients undergoing surgical abortion is blood sugar fluctuations.Materials and methods: In this cross-sectional study, 50 patients admitted for elective abortion, including the method selected and assigned to two groups of 25 sedation and spinal anesthesia were divided. In both groups, blood sugar 10 minutes before making the animals unconscious minutes, 20 and 60 min after induction were evaluated. Data Analysis with SPSS software, version 19 with t-test and chi-square tests.Results: The levels of blood sugar, 10 minutes before the start of anesthesia in sedation groups 89.96 ±13.32 and in the spinal anesthesia group 88.60±16.98, which was not significantly different (p=0.706). The levels of blood sugar, 20 min after induction in sedation group 80.88±13.13 and spinal anesthesia group 85.88 ± 15.05, which was not significantly different (p=0.268).60 min after induction, the blood sugar in sedation group 83.24±15.78 and in the spinal anesthesia group 90.04±16.26, which did not show a significant difference (p=0.140).Conclusion: The change of glucose in response to the stress of surgery under spinal anesthesia and Sedation in both groups had the same type of anesthesia had no significant effect on blood glucose.

Introduction: patient in end of life is potentially threatening and disease is family event. Truth telling is quite related to culture. In Iran Role of family is important in care of end of life patients.Objective: The object of this study was to determine attitude of patient’s family towards truth telling in hospitals supervised by Kerman University of Medical Science in 2014.Materials and methods: This study employed an analytical cross sectional design.124 patient’s family members enrolled. A self-designed questionnaire was developed. It consisted two parts: demographic information and attitude questions.Data were analyzed using SPSS 19 software and some statistical tests.Results: results found attitude of family members toward truth telling in end of life is moderately positive (3.23±0.30).spouse and sister and brother of patient had more positive attitude toward truth telling (p=0.03) Conclution: truth telling has psychological, social, ethical and cultural aspect. Today there is more positive attitude toward truth telling because of progress in medical science and people knowledge.Good family relations decrease distress of truth telling.

Introduction: Cough is a common problems after post extubation in general anesthesia. In this study we evaluated to effect of intracuff and intra venous lidocaine in cough and mean arterial pressure and heart rate after extubation in urmia emam hospital.Materials and methods: Patients with ASA physical status I, II were enrolled 20 to 60 years old and scheduled for elective surgery under general anesthesia Mean Heart rate and mean arterial pressure, SPO2 and Coughs in three time 0, 10 and 30 minutes after extubation were ducumented.Results: There was no statistically significant difference in prevalence of cough in three groups of 0 minutes after extubation, 10 minutes after extubation and 30 minutes after extubation (p=0.190). There were no differences in mean HR or MAP and O2sat in 0, 10 and 30 minutes after extuation.Discussion: We were not found difference in cough prevalence comparing to other groups (intra cuff saline and IV lidocaine) in different times after extubation.

Cardiac transplantation has become the standard therapy for dilated cardiomyopathy and end stage is clinical heart disease & heart failure. With the introduction of newer lmmunosuppressants, together with better patient selection, improved period er at I' ve monitoring and care, the overall survival of recipients has improved. An increasing number of patients who received a transplant present for either elective or emergency non_cardiac surgery. We hereby discuss the period era give management of such a patient who came for emergency surgery for upper limb amputation.