Emergency bedside cesarean delivery: lessons learned in teamwork and patient safety.
Kinney MA, Rose CH, Traynor KD, Deutsch E, Memon HU, Tanouye S, Arendt KW, Hebl JR.
BMC Res Notes. 2012 Aug 6;5:412. doi: 10.1186/1756-0500-5-412.
Abstract
BACKGROUND:
Maternal cardiovascular and pulmonary events during labor and delivery may result in adverse maternal and fetal outcome. Potential etiologies include primary cardiac events, pulmonary embolism, eclampsia, maternal hemorrhage, and adverse medication events. Remifentanil patient-controlled analgesia is an alternative when conventional neuraxial analgesia for labor is contraindicated. Although remifentanil is a commonly used analgesic, its use for labor analgesia is not clearly defined. CASE PRESENTATION: We present an unexpected and unique case of remifentanil toxicity resulting in the need for an emergent bedside cesarean delivery. A 30-year-old G3P2 woman receiving subcutaneous heparin anticoagulation due to a recent deep vein thrombosis developed cardiopulmonaryarrest during labor induction due to remifentanil toxicity. CONCLUSION: A rapid discussion among the attending obstetric, anesthesia, and nursing teams resulted in consensus to perform an emergent bedside cesarean delivery resulting in an excellent fetal outcome. During maternal cardiopulmonary arrest, a prompt decision to perform a bedside cesarean delivery is essential to avoid significant maternal and fetal morbidity. Under these conditions, rapid collaboration among obstetric,anesthesia, and nursing personnel, and an extensive multi-layered safety process are integral components to optimize maternal and fetal outcomes.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3532410/pdf/1756-0500-5-412.pdf
Cesárea perimortem.
Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Perimortem caesarean section.
Boyd R, Teece S.
Emerg Med J. 2002 Jul;19(4):324-5.
Abstract
A short cut review was carried out to establish whether there is any evidence to show that perimortem caesarean section in the third trimester can save the life of the child or mother. Altogether 1210 papers were found using the reported search, of which one presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this paper are tabulated. A clinical bottom line is stated.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1725896/pdf/v019p00324a.pdf
Cesárea postmortem y perimortem: consideraciones históricas, religiosas y éticas.
Postmortem and perimortem cesarean section: historical, religious and ethical considerations.
Fadel HE.
J IMA. 2011 Dec;43(3):194-200. doi: 10.5915/43-3-7099.
Abstract
Guillimeau was the first to use the term cesarean section (CS) in 1598, but this name became universal only in the 20th century. The many theories of the origin of this name will be discussed. This surgery has been reported to be performed in all cultures dating to ancient times. In the past, it was mainly done to deliver a live baby from a dead mother, hence the name postmortem CS (PMCS). Many heroes are reported to have been delivered this way. Old Jewish sacred books have made references to abdominal delivery. It was especially encouraged and often mandated in Catholicism. There is evidence that the operation was done in Muslim countries in the middle ages. Islamic rulings support the performance of PMCS. Now that most maternal deaths occur in the hospital, perimortem CS (PRMCS) is recommended for the delivery of a fetus after 24 weeks from a pregnant woman with cardiac arrest. It is believed that emergent delivery within four minutes of initiation of cardiopulmonary resuscitation (CPR) improves the chances of success of maternal resuscitation and survival and increases the chance of delivering a neurologically intact neonate. It is agreed that physicians are not to be held legally liable for the performance of PMCS and PRMCS regardless of the outcome. The ethical aspects of these operations are also discussed including a discussion about PMCS for the delivery of women who have been declared brain dead.
KEYWORDS: Catholicism, Islam, Judaism, Postmortem cesarean section, brain death, history of medicine, medical ethics, perimortem cesarean section
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3516125/pdf/jima-43-3-7099.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
Kinney MA, Rose CH, Traynor KD, Deutsch E, Memon HU, Tanouye S, Arendt KW, Hebl JR.
BMC Res Notes. 2012 Aug 6;5:412. doi: 10.1186/1756-0500-5-412.
Abstract
BACKGROUND:
Maternal cardiovascular and pulmonary events during labor and delivery may result in adverse maternal and fetal outcome. Potential etiologies include primary cardiac events, pulmonary embolism, eclampsia, maternal hemorrhage, and adverse medication events. Remifentanil patient-controlled analgesia is an alternative when conventional neuraxial analgesia for labor is contraindicated. Although remifentanil is a commonly used analgesic, its use for labor analgesia is not clearly defined. CASE PRESENTATION: We present an unexpected and unique case of remifentanil toxicity resulting in the need for an emergent bedside cesarean delivery. A 30-year-old G3P2 woman receiving subcutaneous heparin anticoagulation due to a recent deep vein thrombosis developed cardiopulmonaryarrest during labor induction due to remifentanil toxicity. CONCLUSION: A rapid discussion among the attending obstetric, anesthesia, and nursing teams resulted in consensus to perform an emergent bedside cesarean delivery resulting in an excellent fetal outcome. During maternal cardiopulmonary arrest, a prompt decision to perform a bedside cesarean delivery is essential to avoid significant maternal and fetal morbidity. Under these conditions, rapid collaboration among obstetric,anesthesia, and nursing personnel, and an extensive multi-layered safety process are integral components to optimize maternal and fetal outcomes.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3532410/pdf/1756-0500-5-412.pdf
Cesárea perimortem.
Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Perimortem caesarean section.
Boyd R, Teece S.
Emerg Med J. 2002 Jul;19(4):324-5.
Abstract
A short cut review was carried out to establish whether there is any evidence to show that perimortem caesarean section in the third trimester can save the life of the child or mother. Altogether 1210 papers were found using the reported search, of which one presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of this paper are tabulated. A clinical bottom line is stated.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1725896/pdf/v019p00324a.pdf
Cesárea postmortem y perimortem: consideraciones históricas, religiosas y éticas.
Postmortem and perimortem cesarean section: historical, religious and ethical considerations.
Fadel HE.
J IMA. 2011 Dec;43(3):194-200. doi: 10.5915/43-3-7099.
Abstract
Guillimeau was the first to use the term cesarean section (CS) in 1598, but this name became universal only in the 20th century. The many theories of the origin of this name will be discussed. This surgery has been reported to be performed in all cultures dating to ancient times. In the past, it was mainly done to deliver a live baby from a dead mother, hence the name postmortem CS (PMCS). Many heroes are reported to have been delivered this way. Old Jewish sacred books have made references to abdominal delivery. It was especially encouraged and often mandated in Catholicism. There is evidence that the operation was done in Muslim countries in the middle ages. Islamic rulings support the performance of PMCS. Now that most maternal deaths occur in the hospital, perimortem CS (PRMCS) is recommended for the delivery of a fetus after 24 weeks from a pregnant woman with cardiac arrest. It is believed that emergent delivery within four minutes of initiation of cardiopulmonary resuscitation (CPR) improves the chances of success of maternal resuscitation and survival and increases the chance of delivering a neurologically intact neonate. It is agreed that physicians are not to be held legally liable for the performance of PMCS and PRMCS regardless of the outcome. The ethical aspects of these operations are also discussed including a discussion about PMCS for the delivery of women who have been declared brain dead.
KEYWORDS: Catholicism, Islam, Judaism, Postmortem cesarean section, brain death, history of medicine, medical ethics, perimortem cesarean section
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3516125/pdf/jima-43-3-7099.pdf
Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org
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