Hemorrhagic complications from anticoagulants are very common. Their occurrence in a critical site such as the upper airways constitutes a vital emergency. Management must ensure antagonization of the anticoagulant effect and freedom of the upper airways. We will illustrate this through a clinical case with all the clinical signs that can alert a hematoma of the upper airways, the reversion strategies of old and new anticaogulants and respiratory management. We recommend admitting the patient to an intensive care unit, withholding anticoagulants and administering vitamin K and prothrombin complex concentrate as a means of reversing AVK. For direct oral anticoagulants, their cessation may be sufficient, otherwise non-specific reversion means are used, given the unavailability of antidotes apart from Idarucizumab for Dabigatran. For respiratory management we recommend a conservative attitude and in case of deterioration of the respiratory function a nasotracheal intubation under endoscopic guidance by an experienced doctor should be done. The resumption of anticoagulants must be decided according to the benefit risk ratio while involving the patient too and also taking into consideration the possibility of changing anticoagulants.
Subject Category: Social Sciences
Nov. 30, 2020
A Historical interrogation on Cameroon Government Retorts to Anglophone Marginalisation Expressions 1961-2016
Page Numbers : 238-246
DOI : 10.36348/sb.2020.v06i11.002
The Republic of Cameroon today torn apart by a seemingly failing effort of integration was established by reunifying two former factors of German Kamerun in 1961. This created in the new republic two constitutional identities; the Anglophone and the Francophone each made of an area and a people having been governed by the United Kingdom and France respectively under international supervision since the end of the First World War. The ensuing reunifying constitution made integrating these factions capital. This integration, the Anglophone faction have recurrently blamed for being bias as it subjected them to marginalisation. In this paper, note is taken of the array of literature on marginalisation to make an analyses of the efforts made by government in response to the expressions of marginalisation as decried by Anglophones. The paper observes existing realness in Anglophone marginalisation and argues that since reunification, government has continuously made responses to the plight of Anglophones though most often, these efforts are half-baked and emerge largely as a result of resistances which are at times violent from the marginalised minority. To this extent, marginalisation has continued unabated making the achievement of national integration problematic.