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Biomedical subjects

A J McLaughlin

Publications and source records attributed to A J McLaughlin.

12 recordsLinked to original sources
PubMed1981

The relationship between on-the-job accidents and patient-hazard incidents for a group of respiratory therapists during a 5-year period.

Safety has not traditionally been stressed in the health care industry to the same extent that it has been in other industries. This is ironic, because accidents in hospitals may endanger not only employees but patients as well. The safety records of 26 respiratory therapists who had had either on- or off-the-job accidents or who had been involved in patient-hazard incidents over a 5-year period were analyzed. There was a positive relationship between employees' involvement in on-the-job accidents and involvement in patient-hazard incidents. This indicates that, for this group, involvement in an on-the-job accident increased the possibility that an employee would be involved in a patient-hazard incident. Although this does not indicate a cause-and-effect relationship between the two factors, it does show that there was a definite relationship between them. Employees should be counseled for safety violations, not just in general terms but in terms specifically related to therapeutic procedures.

Accident Prevention↗
PubMed1981

Training and evaluation of respiratory therapists in emergency intubation.

Endotracheal intubation in emergency situations is a recognized function of respiratory therapists, as defined by the American Association for Respiratory Therapy in 1973. A training program based in the operating room, using one-on-one instruction, was the basis for a training program designed to meet JCAH standards for endotracheal intubation. To evaluate the success of our training and our system for attempting intubations, we recorded the results of 50 consecutive intubation attempts by our therapists. All 50 patients were eventually intubated, with 35 patients intubated on the first attempt. The average number of attempts per patient was 1.48. While 39 patients were intubated within one minute, 11 required more than one minute. In five patients, physicians had attempted intubation prior to a therapist's arrival; those intubations took eleven times longer than those that were attempted by therapists only. The average time for intubations attempted solely by therapists was 54 seconds.

Clinical Competence↗
PubMed1980

Cost of operation and reliability of two brands of volume ventilators.

Maintenance records during 12 months for 16 MA-1 ventilators, 7 BEAR-1 ventilators more than one year old, and 6 new BEAR-1 ventilators were compared. The MA-1 ventilators had the best record in every important category except cost for accessory parts and ventilator cost per patient hour with retrofit and preventive maintenance. The MA-1 ventilators needed repair once every 8,329 hours of use, compared with once every 2,500 hours for older BEAR-1 ventilators and once every 4,277 hours for newer BEAR-1 ventilators. Total costs of repairs were $430.84 for 16 MA-1 ventilators, and $3,064.44 for 7 BEAR-1 ventilators out of warranty. Costs of replacement parts were $3,097.01 for the MA-1 ventilators, $986.21 for the older BEAR-1 ventilators, and $845.32 for the newer BEAR-1 ventilators. The total cost per patient hour of use was 11 for the MA-1 ventilators and 13 and 3 respectively for the two BEAR-1 groups. Adding costs for retrofit for the MA-1 ventilators and projected costs for preventive maintenance of the BEAR-1 ventilators tripled the cost per hour of use for all three groups. The frequency of breakdowns for both brands of ventilators underlines the need for preventive maintenance, but substantial cost increases will result from those programs.

Costs and Cost Analysis↗
PubMed1980

Allergic contact dermatitis from oxygen cannulas.

A patient experienced allergic contact dermatitis on two occasions two months apart as a result of wearing the same brand of polyvinyl chloride oxygen cannula. In one instance the cannula was removed and not replaced, as continuing oxygen was unnecessary; on the other occasion the original cannula was replaced by a cannula of another brand. In both cases the dermatitis disappeared after removal of the original cannula. The reaction was probably to a resin remaining in the polyvinyl chloride after the curing process in the manufacture of the plastic from which the cannula was made. Allergic reactions to plastics have been documented in other medical products but have not previously been reported in respiratory therapy plastic appliances. Because of variability in residual resins in different brands and batches of plastics, and because of varying individual sensitivity, therapists and others should be alert to the possibility of allergic contact dermatitis from respiratory therapy devices.

Delaware↗
PubMed1979

Reliability of three different brands of adult volume ventilators in a one-year period.

The maintenance records covering a 12-month period for 16 Puritan-Bennett MA-1, 7 Bourns BEAR-1, and 3 Siemens-Elema Servo No. 900-B volume ventilators were compared. The MA-1s had an average of 15,555 hours use prior to the study, compared with 200 average hours on each BEAR and 2,600 on each Servo ventilator. The MA-1s required the least number of repairs and operated longest between repairs, with 18,999 average hours of use per repair, compared with 4,955 hours for the BEAR-1 and 599 hours for the Servo ventilator. The average time required for repair was highest for the MA-1. Most repairs to the BEAR-1 were compressor-related and most were performed in the hospital, as were the repairs to the Servo ventilators. All MA-1 repairs were performed at Puritan-Bennett. The technical advantages of the BEAR-1 and Servo ventilators are convenient, but because of the frequency of repair of these units they are probably more suited to institutions where close supervision and technical backup are available.

Adult↗
PubMedDate not supplied

Use of residual volume as a marker for enteral feeding intolerance: prospective blinded comparison with physical examination and radiographic findings.

High gastric residual volumes (RVs) are a frequent cause for cessation of total enteral nutrition (TEN). This study was designed to determine the RV that indicates intolerance or inadequate gastric emptying and to compare the RV findings in a blinded fashion with those findings obtained on physical examination and radiography. Twenty healthy normal volunteers (HNV), 8 stable patients with gastrostomy tubes (GTP), and 10 critically ill patients (CIP) were evaluated prospectively for 8 hours while receiving TEN. No subjects were clearly intolerant (ie, vomiting, aspiration). Of the total RVs recorded, 13.1% were greater than or equal to 150 mL in the CIP group, whereas only 2.4% of the RVs were greater than or equal to 150 mL in the HNV group. None of the RVs in the GTP group were greater than or equal to 150 mL. Objective scores on physical examination failed to correlate with RV (p = .397), as did objective scores on radiography (p = .742). However, objective scores on physical examination were significantly related to scores on radiography (p = .016). Abnormal physical examination findings were found in 4 out of 11 patients (GTP + CIP) with RVs less than 100 mL and in 6 out of 7 with RVs greater than or equal to 100 mL. Abnormal radiographic results were found in 6 out of 11 patients with RVs less than 100 mL, in 7 out of 7 patients with RVs greater than or equal to 100 mL, and in 4 out of 20 HNVs. There was no difference in RVs obtained from the supine or right lateral decubitus positions.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗