Sunday, August 17, 2014

Subphrenic Abscess as a Complication of Hemodialysis Catheter-Related Infection

Subphrenic Abscess

Subphrenic abscesses are localized collections of pus, usually underneath the right or left hemi-diaphragm.There is a accumulation of infected fluid between the diaphragm, the liver and the spleen

"We describe an unusual case of subphrenic abscess complicating a central venous catheter infection caused by Pseudomonas aeruginosa in a 59-year-old woman undergoing hemodialysis. The diagnosis was made through computed tomography, and Pseudomonas aeruginosa was isolated from the purulent drainage of the subphrenic abscess, the catheter tip and exit site, and the blood culture samples. A transesophageal echocardiography showed a large tubular thrombus in superior vena cava, extending to the right atrium, but no evidence of endocarditis or other metastatic infectious foci. Catheter removal, percutaneous abscess drainage, anticoagulation, and antibiotics resulted in a favourable outcome."

"Infection is a common complication of central venous catheters (CVC) used for vascular access in hemodialysis patients. Gram-positive bacteremia is the typical clinical presentation of CVC related infectious complications.Pseudomonas aeruginosa is a less frequent pathogen associated with catheter infection, accounting for 4–16% of isolates []. Nevertheless, this pathogen should always be considered as one potential causative agent of CVC related infections, especially in immunocompromised hosts. Metastatic infectious foci are important determinants of the morbidity and mortality of CVC related infections. Endocarditis, septic embolism, and visceral abscesses are rare but serious complications whose mere suspicion demands careful clinical and radiological search.
We report a case of a subphrenic abscess and CVC related bloodstream infection with Pseudomonas aeruginosa in a 59-year-old woman on haemodialysis."

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Subphrenic Abscess as a Complication of Hemodialysis Catheter-Related Infection

Caravaca, F., Burguera, V., Fernández-Lucas, M., Teruel, J.L. and Quereda, C. (2014) Subphrenic abscess as a complication of hemodialysis catheter-related infection. Case Reports in Nephrology. July 10th. [epub ahead of print].

Tuesday, August 12, 2014

American Heart Associations (AHA) Full Code Pro App

Full Code Pro App
The AHA’s Full Code Pro App (FCP 3.0) is a free, easy-to-use, mobile application that allows healthcare providers to quickly document critical interventions during cardiac arrest resuscitation events. This app enables providers to focus on the patient without sacrificing proper documentation.

This application allows medical professionals to use it in a real-time code.  It allows the medical professional the ability to record the entire code easily. It can also simplify data entry and helps providers increase the availability and accuracy of documentation. The information that providers log enables more robust data for review, debriefing and resuscitation quality improvement.
The AHA's Full Code App may be used by paramedics, EMT-Bs, emergency room nurses, emergency room physicians and other in- and out-of-hospital healthcare providers.
In using this application the medical provider can make notes, keep track of shocks delivered, when an IV was started, what medications were given, and when the Return of Spontaneous Circulation (ROSC) was achieved.  After the code, the medical provider can then email the information to the resuscitation team as well as use the information for documentation purposes.
To learn more about Advanced Cardiac Life Support (ACLS) and Pediatric Life Support (PALS) please visit us at Central Valley Medical.
To learn more about AHA's Full Code Pro App, visit their website and/or watch the video below.