PubMed Health⌕ Search

Biomedical subjects

Adam Fox

Publications and source records attributed to Adam Fox.

5 recordsLinked to original sources
PubMed2002

The efficacy of noncontact oxygen delivery methods.

OBJECTIVES: "Wafting" oxygen is a possible strategy to deliver oxygen to a patient who may not tolerate delivery systems that involve contact on the face. We wished to assess the concentration of oxygen delivered to the patient with various methods of "wafting" oxygen. DESIGN: Three methods of wafting oxygen were examined: an infant resuscitator bag, a standard pediatric Hudson RCI face mask, and a piece of standard green oxygen tubing. Contour lines for oxygen concentrations of 30% to 70% in 10% intervals were found with a Teledyne oxygen meter, at an oxygen flow rate of 5 L/min and 10 L/min. Experimental conditions simulated an infant in a cot in a pediatric ward. RESULTS: The resuscitator bag can not be recommended for wafting oxygen delivery, as the flow-back valve may close and result in insignificant levels of oxygen delivery. Oxygen tubing gave a useable area too narrow for use with an active patient, with 30% oxygen concentration being available in an area with width of only 18 cm. This is, however, a suitable method in short-term attended administration, either during feeding, or in the situation of a neonatal resuscitation. The standard pediatric Hudson RCI face mask, at a flow rate of 10 L/min, delivers 30% oxygen to an area 35 cm wide and 32 cm from the top of the mask. At 10 L/min, 40% oxygen is delivered to an area 16 cm wide and 14 cm from the top of the mask. This is an area large enough to be usable in the infant who will not tolerate other methods of oxygen delivery. The contour lines are presented graphically. CONCLUSIONS: Although wafting can never replace conventional methods of oxygen delivery to children, if these have failed, a standard pediatric oxygen mask can give significant oxygen therapy without irritating the patient. Care should be taken to place the mask in the area described (ie, opposite the chest) to give the maximum benefit. Short-term administration can be appropriate with standard oxygen tubing aimed at the airway.

Child↗
PubMedDate not supplied

Physicians as barriers to successful transitional care.

There has been a dramatic increase in the number of sufferers of chronic childhood diseases surviving into adulthood. Effective transition of these children from paediatric to adult medical services is a considerable challenge. A lack of integrated planning for this event can present barriers to successful transition. These barriers may be generated by the patient, his family or by political or logistical factors. However, physicians themselves can also become barriers in this process. Paediatricians may resist the transition process as they lack confidence in their adult colleagues. Emotional, academic, financial and cultural issues will also influence both child and adult physician's attitude to the hand-over of care. Increasingly poor understanding of their disease process by Paediatric trained doctors, makes transfer of care essential for adolescents. The move towards a culture of personal responsibility for health care is also crucial for the promotion of the maturing patient's independence. Development of adolescent services and closer links between the services could do much to enhance the transition experience of emerging adults.

Adolescent↗