https://www.um.edu.mt/library/oar/handle/123456789/123151 2026-04-13T08:14:01Z 2026-04-13T08:14:01Z https://www.um.edu.mt/library/oar/handle/123456789/123413 2024-06-11T08:05:38Z 2024-01-01T00:00:00Z

Title: Patient Earth is critically ill Abstract: If planet earth was a patient she would be diagnosed with multi-organ failure and transferred immediately to intensive care. The list of problems afflicting ‘Earth’ would include runaway hyperthermia despite numerous attempts to control this, respiratory failure and decreasing ability to maintain proper oxygenation, circulatory failure with multiple thromboses in major arteries, and renal and hepatic failure with inexorable accumulation of body wastes. On top of all of these ailments, intermittent bouts of extreme dehydration alternating with fluid overload as well as sporadic unexpected infections would have contributed to a steady decline in her health over the past few decades, culminating in the need for life support.

2024-01-01T00:00:00Z Camilleri, Elaine Falzon, Sharona Collict, Mandy https://www.um.edu.mt/library/oar/handle/123456789/123294 2024-06-06T08:47:52Z 2024-01-01T00:00:00Z

Title: Maternal admissions at Central Delivery Suite in Mater Dei Hospital Authors: Camilleri, Elaine; Falzon, Sharona; Collict, Mandy Abstract: BACKGROUND: Central Delivery Suite is a specialised ward in Mater Dei Hospital (MDH) dedicated for intra-partum care. It consists of nine delivery rooms, an admission room, an operating theatre and a neonatal resuscitation room. Currently, all pregnant mothers of 22 weeks gestation and above are reviewed in this ward. The aim of this audit is to assess the management of bed space at Central Delivery Suite in the absence of a maternity unit triage room.; METHODS: All Central Delivery Suite admissions, over a 4 week period, were logged using the labour ward admission book. Data collected included demographic data, reasons for (planned as well as acute presentations), whether delivery was achieved or not and whether patient was admitted or not. Reasons for acute presentations between the admitted and non-admitted population were compared.; RESULTS: Out of 488 patients, 122 patients (25%) had an elective LSCS or IOL. 366 patients (75%) presented to the labour ward with an acute complaint. Of these, 224 patients (61.2%) were admitted and 142 patients (38.8%) were discharged after review. Out of the 224 patients that were admitted, 171 patients (76.3%) delivered during that admission and 53 patients (23.7%) did not deliver.; CONCLUSION: This audit showed that 53.3% of women who had an unplanned presentation to Central Delivery Suite did not need to block a bed in the labour ward and could have been assessed in a maternity assessment unit. This means better management and utilisation of beds and resources.

2024-01-01T00:00:00Z Gouder, Caroline Borg, Darren Corso, Stefano Debono, Ivan Montefort, Stephen https://www.um.edu.mt/library/oar/handle/123456789/123293 2024-06-06T08:47:28Z 2024-01-01T00:00:00Z

Title: Knowledge on the use of adrenaline autoinjectors among healthcare professionals Authors: Gouder, Caroline; Borg, Darren; Corso, Stefano; Debono, Ivan; Montefort, Stephen Abstract: BACKGROUND: Adrenaline auto-injectors are indicated in the emergency treatment of allergic reactions including anaphylaxis prescribed to patients at increased risk for anaphylaxis, intended for immediate self-administration as emergency supportive therapy only and not a substitute for immediate medical care. The objective of this audit was to study the knowledge of indications for prescription and administration, mode of administration and post-administration management of an adrenaline autoinjector among health care professionals at our local hospital.; METHOD: 86 medical doctors across various working grades in the Department of Medicine and 16 pharmacists were asked to complete a questionnaire in the presence of the investigator in July 2018 at Mater Dei Hospital, Malta.; RESULTS: The mean age was 27.5years and 57% were females. 21 participants had previously prescribed an Epipen®. Questions answered correctly were as follows: dosage in adults 63% and children 54%; correct indication for prescription 73%; correct indication for administration 100%; correct injection end of autoinjector 79.4%; incorrect patient positioning for injection 13%; correct site of administration 99%; correct duration of injection 56.8%; common side effects 73.5%; referral to A&E post-administration 75%; timing of repeat injection 80%; contraindications 86.7%. 68.6% participants did not feel confident explaining to patients when to use it while 72.5% participants did not feel confident explaining how to use it.; CONCLUSION: It is evident that education is urgently needed among health care professions on the indications for prescription, mode of administration as well as post-administration management of this potentially life-saving medication.

2024-01-01T00:00:00Z Galea, Joanna Hallett, Kimberley Busuttil, Gerald Pace, Keith https://www.um.edu.mt/library/oar/handle/123456789/123292 2024-06-06T08:45:15Z 2024-01-01T00:00:00Z

Title: Audit of inpatient chronic urinary retention management Authors: Galea, Joanna; Hallett, Kimberley; Busuttil, Gerald; Pace, Keith Abstract: BACKGROUND: Chronic urinary retention (CUR) occurs when urine accumulates in the bladder secondary to incomplete voiding. The aim of this audit was to assess compliance to the Mater Dei Hospital Urinary Retention Management Guidelines in a cohort of patients admitted between August 2019 and February 2020.; METHODOLOGY: Patients admitted because of CUR were included. Data was acquired from medical files, discharge letters, hospital electronic record systems and urology outreach records.; STANDARD USED: The Urinary Retention Management Guidelines, published in 2018, were considered standard for outcome comparison.; RESULTS: The quantitative results included data on clinical presentation, inpatient management and medium-term outcomes. 55% had a successful TWOC after CUR. 45% were treated pharmacologically, 35% had a trans-urethral resection of the prostate, 10% started a self-intermittent catheterisation (SIC) programme, 5% remained with a long-term catheter and 5% required a re-trial without catheter (TWOC).; CONCLUSION: Compliance to MDH guidelines was suboptimal in some cases. This audit highlights CUR management issues which can be optimised and also current outcomes of patients presenting in CUR. 55% of patients presented with a degree of acute kidney injury. Nephrology specialists were rarely involved in the management of these patients.

2024-01-01T00:00:00Z