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Biomedical subjects

D C Bryden

Publications and source records attributed to D C Bryden.

6 recordsLinked to original sources
PubMed1999

Meeting the standards for interhospital transfer of adults with severe head injury in the United Kingdom.

In December 1996, the Association of Anaesthetists of Great Britain and Ireland produced a series of recommendations outlining the safe conduct of interhospital transfers for patients with acute head injuries. We assessed the current ability of UK hospitals to implement these recommendations and opinions on the formation of transfer teams, using a postal questionnaire. This was sent to all Royal College of Anaesthetists tutors, 268 of whom replied (94% response rate). Of the hospitals surveyed, 208 received adult head-injury patients but did not have on-site neurosurgical facilities. In 171 (86.8%) of these hospitals, senior house officers could be expected to accompany the patient during subsequent transfer. The majority of hospitals (192, 92.3%) were able to monitor ECG, pulse oximetry and blood pressure during the journey, but only 97 (46.6%) had facilities to monitor end tidal carbon dioxide levels. As a result of the anaesthetist's involvement in the transfer, emergency operating could be delayed in 169 (81.3%) hospitals. One hundred and fifty-eight (76%) respondents thought that the formation of transfer teams to transport critically ill patients would have some merit. Hospitals are responding to the published guidelines, but improvements are still needed in levels of equipment and insurance provision, along with the identification of a designated consultant at each hospital with responsibility for transfers.

Adult↗
PubMed1998

Tracheal intubation via the laryngeal mask airway: a viable alternative to direct laryngoscopy for nursing staff during cardiopulmonary resuscitation.

Eight nurses with no previous experience of advanced airway management were randomly assigned to be taught tracheal intubation either by direct laryngoscopy or via a laryngeal mask. Once competent in the technique using a manikin, they attempted a maximum of ten intubations on anaesthetised patients. They were then taught the alternative technique and the assessment repeated. Median times for practice were the same for both techniques. Intubation in under 30 s was successful via the laryngeal mask in 60% of patients (42/70) compared to 39% (27/70) when using a laryngoscope (P = 0.11). It appears that non-medical personnel can be successfully taught to intubate the trachea using the laryngeal mask as a conduit, for those circumstances where a cuffed tracheal tube is considered essential during resuscitation.

Adult↗
PubMed1998

An investigation into changes in lung function and the subjective medical benefits from breast reduction surgery.

The aim of this study was to assess the respiratory changes following reduction mammaplasty in women presenting for elective surgery; In addition, to assess whether these changes might be related to any symptomatic improvement. This was a prospective study examining women attending for breast reduction surgery over a 3-month period. Preoperative pulmonary function studies (PFTs) and a symptom questionnaire were completed before operation. These were repeated 6-8 weeks after surgery. Pulmonary function testing was carried out in all cases by the same operator. The study was carried out within a sub regional centre for plastic and reconstructive surgery. Local Ethics committee approval was obtained. Nineteen healthy women mean age 34.9 years and with a mean Body Mass Index of 27.62 were recruited. The mean weight of excised breast tissue was 1546 g. All preoperative pulmonary function tests were within normal limits. Six of the women smoked, none changed their smoking habits over the course of this study. Changes in pulmonary function studies were analysed using the paired t-test. A 'P' value of < 0.05 was considered to be significant. Seventeen women had a post operative improvement in PFTs. Statistically significant improvements were obtained for changes in peak expiratory flow rate (PEFR, P = 0.005) and peak inspiratory flow rate (PIFR, P < 0.0001). The 'P' values for changes in FEV1 (forced expired volume in 1 second) and FEV1/FVC (forced vital capacity) did not reach significance, whilst the 'P' value for the change in FVC was statistically significant (P = 0.01), although the actual mean change was small (0.07 litres). The study sample was too small to relate these changes to mass of excised tissue or BMI. All women taking part claimed an increased confidence and a cessation in analgesic use. Other reported benefits included an improved exercise tolerance (12/19), reduced sleep disturbance (4/19) and reduced breathing difficulties (1/19).

Adult↗