Seizures, Status Epilepticus, and Continuous EEG in the Intensive Care Unit

Effect of Algoplaque Hydrocolloid Dressing Combined with Nanosilver Antibacterial Gel under Predictive Nursing in the Treatment of Medical Device-Related Pressure Injury

It was aimed at the clinical value of predictive nursing and Algoplaque hydrocolloid dressing (AHD) combined with nanosilver antibacterial gel in treating medical device-related pressure injury (MDRPI). 100 patients, who underwent surgery in Chongqing Qijiang District People's Hospital from February 2019 to February 2020, were selected as the research objects and were randomly divided into the experimental group (50 cases) and the control group (50 cases). For the characterization test, a nanosilver antibacterial gel was created first. Patients in both groups received predictive nursing, but those in the experimental group received AHD and nanosilver antibacterial gel, and those in the control group received gauzes. MDRPI incidence, pressed skin injury severity, comfort level, clothing changes, nursing satisfaction, and other factors were all compared. The particle size of the nanosilver gel was 45-85 nm, with a relatively homogeneous distribution with the medium size, according to the findings. The incidence of MDRPI in the experimental group was lower than that in the control group significantly (6% vs. 30%, P < 0.05). The degree of injury of pressured skin in the experimental group was milder than that in the control group (P < 0.05), the degree of comfort and nursing satisfaction was higher in the experimental group than in the control group (P < 0.05), and dressing change count was lower than that in the control group (P < 0.05). In the treatment of MDRPI, predictive nursing and AHD using nanosilver antibacterial gel showed high clinical application value.

Status epilepticus: review on diagnosis, monitoring and treatment

Status epilepticus (SE) is a frequent neurological emergency associated with high morbidity and mortality. According to the new ILAE 2015 definition, SE results either from the failure of the mechanisms responsible for seizure termination or initiation, leading to abnormally prolonged seizures. The definition has different time points for convulsive, focal and absence SE. Time is brain. There are changes in synaptic receptors leading to a more proconvulsant state and increased risk of brain lesion and sequelae with long duration. Management of SE must include three pillars: stop seizures, stabilize patients to avoid secondary lesions and treat underlying causes. Convulsive SE is defined after 5 minutes and is a major emergency. Benzodiazepines are the initial treatment, and should be given fast and an adequate dose. Phenytoin/fosphenytoin, levetiracetam and valproic acid are evidence choices for second line treatment. If SE persists, anesthetic drugs are probably the best option for third line treatment, despite lack of evidence. Midazolam is usually the best initial choice and barbiturates should be considered for refractory cases. Nonconvulsive status epilepticus has a similar initial approach, with benzodiazepines and second line intravenous (IV) agents, but after that, aggressiveness should be balanced considering risk of lesion due to seizures and medical complications caused by aggressive treatment. Usually, the best approach is the use of sequential IV antiepileptic drugs (oral/tube are options if IV options are not available). EEG monitoring is crucial for diagnosis of nonconvulsive SE, after initial control of convulsive SE and treatment control. Institutional protocols are advised to improve care.