General hospitals acute-type

In this section, results obtained in a case study (Itoh and Andersen 2008, 2010) will be reviewed to illustrate the contribution of safety culture to safety outcome. In a case study, a questioimaire-based survey concerning staff reactions after the adverse event introduced in the last section, was conducted in addition to the safety culture survey. At the same time, incident reports for three years (2004-06) submitted by nurses were obtained from one of the hospitals (Hospital M) that participated in the safety culture survey. Hospital M was a private, acute-type general hospital, located in Tokyo. This hospital covered almost all clinical specialties and, at the time of the survey in 2006, it had about 500 inpatient beds, 160 full-time doctors and 360 full-time nurses. Nurses belonged to any one of 18 clinical work units 14 inpatient wards, an outpatient clinic, operating room, kidney centre, and medical examination unit. 

A 29-year-old man presented with acute pancreatitis after a period of heavy cannabis smoking. Other causes of the disease were ruled out. The pancreatitis resolved itself after the cannabis was stopped and this was confirmed by urinary cannabinoid metabolite monitoring in the community. There were no previous reports of acute pancreatitis associated with cannabis use in the general population. Drugs of all types are related to the etiology of pancreatitis in approximately 1.4-2% of cases k Pancreatic toxicity. The dried leaf, smoked by a 19-year-old woman, was active. The subject was hospitalized with pancrea-titis . 

Four major and five minor clinical patterns of acute phencyclidine intoxication have been described in 1000 patients (7). Major patterns were acute brain syndrome (24.8%), toxic psychosis (16.6%), catatonic syndrome (11.7%), and coma (10.6%). Minor patterns included lethargy or stupor (3.8%) and combinations of bizarre behavior, violence, agitation, and euphoria in patients who were alert and oriented (32.5%). Patients with major patterns of toxicity usually required hospitalization and had most of the complications. Patients with minor patterns generally had mild intoxication and did not require hospitalization, except for treatment of injuries or autonomic effects of phencyclidine. There were various types of injuries in 16%, and aspiration pneumonia in 1.0%. There were 22 cases of rhabdomyolysis (2.2%), and three patients required dialysis for renal insufficiency. One patient who had been comatose died suddenly with a pulmonary embolism. 

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