Browsing by Author "Armijos Quichimbo, Sandra Natividad"

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Case report: compromise airway and orofacial trauma
(2022) Armijos Quichimbo, Sandra Natividad
Introduction: Facial trauma constitutes a challenge in perioperative management, since this anatomical zone possesses complex vital structures such as important vessel and nerve bundles, as well as the beginning of the upper airway. That is why an injury in this region requires rapid and effective diagnosis and management since ventilation can be seriously compromised by airway obstruction, either due to the object of trauma, or inflammatory reaction and edema; bruises, burns, or direct breakage. The vascular lesion can cause profuse bleeding, as well as aspiration of blood and fragments of tissues that were injured. Choosing the anesthesia technique is usually a challenge when a priori structures such as the mouth and nose are compromised. Method: A clinical case and bibliographic review are presented. Conclusion: Regional facial and neck anesthesia techniques together with adequate sedation are an alternative in the initial management of mild facial trauma. Key words: Facial trauma, regional anesthesia, nerve blocks of the face and neck, sedation.
Determinación de la localización anatómica de línea de Tuffier mediante ultrasonografía en pacientes sometidos a bloqueo neuroaxial en posición decúbito lateral. Hospital Vicente Corral Moscoso. Cuenca 2021.
(Universidad de Cuenca, 2023-05-04) Armijos Quichimbo, Sandra Natividad; Peñafiel Martínez, Nadia Rosalía
The Tuffier line for anesthesiologists is the reference point in neuroaxial anesthesia, not being a reliable data due to common variations that occur in its position. Objectives: To determine the exact anatomical location of Tuffier's line through ultrasonography in patients operated under neuraxial anesthesia in lateral decubitusat Hospital Vicente Corral Moscoso. Method: The present work is a cross-sectional analytical study, the sample was 334patients undergoing scheduled surgery under neuraxial anesthesia at the Vicente Corral Moscoso hospital, a form was designed and collected sociodemographic, clinical data and the location of the Tuffier Line. To determine the degree ofassociation, the PR and its 95% confidence interval were obtained. To determine statistical significance, the p value was obtained by chisquare, considering a p value < 0.05 statistically significant. Results: 334 patients were included, with a proportion of demarcation with Tuffier'sline above L4 in 41.3% of patients. In individuals aged 65 or over, an association was found with a location on L4 (p value = 0.006; PR 1.61; 95% CI = 1.20 - 2.14). There were no significant differences for sex, weight, height and nutritional status. Conclusions: Palpation as a single method is imprecise for the location of Tuffier's line, it must be confirmed by ultrasonography to avoid damage to the neuroeje.
Prevalencia y factores asociados a la prescripción inadecuada de fármacos en adultos mayores del Centro de Salud N°3, Cuenca 2015
(2017) Aguilar Gómez, Leslie Paulette; Armijos Quichimbo, Sandra Natividad; Roldán Fernández, José Vicente; Ojeda Orellana, Marco Ribelino
Background: Inappropriate prescribing is the greater risk of adverse effects, compared to clinical benefit. Studies show that the main factors associated with are; older age, malnutrition, polypharmacy and comorbidity. Objective: To determine the prevalence of inadequate prescriptions of medication with the STOPP/START instrument along with the associated factors in elder adults that receive medical attention in the Health Center Number 3, Nicanor Merchan in Cuenca, during 2015. Methodology: A cross-sectional analytical study was carried out, with randomized selection of clinical records of older adults; the statistical sample was 350 cases. The data were analyzed and processed in the SPSS V.15 program, the information was summarized through tables. In the descriptive analysis we used the frequency distribution (N °) and percentages (%), measures of central tendency; mean and dispersion measures; standard deviation. To quantify the intensity of the association, the Prevalence Ratio (PR) and 95% Confidence Interval were obtained. Results: The prevalence found under the STOPP-START criteria of inadequate prescription was 16.3%, and of the prescribed omissions of 2.9%. The factors that had a statistically significant association with inappropriate prescribing were polypharmacy (RP 3,364 p 0,000) and deficient nutritional status. (RP 1.72 p 0.048). Conclusions: Older adults are the most vulnerable to inadequate prescribing, a prevalence of (16.3%) was found, affecting more the male sex. It was evidenced that the risk factors statistically associated to an inadequate prescription are the polypharmacy and deficient nutritional status