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Biomedical subjects

G H Adkisson

Publications and source records attributed to G H Adkisson.

6 recordsLinked to original sources
PubMed1995

The safe practice of anesthesia in developing countries.

Nurse anesthetists providing services in developing countries must be aware of the hazards inherent in such a mission. Proper planning and preparation are essential to insure safe, quality anesthesia care. Working conditions are austere; electrical supplies may be erratic, oxygen sources inconsistent, and up-to-date monitoring systems nonexistent. Medications and supplies will be limited, mandating conservation, reuse, and strict adherence to infection control procedures. Safe, reliable anesthesia delivery systems, preferably with the ability to scavenge waste anesthetics are required. Patients frequently have diseases endemic to the area and language barriers cause confusion and misunderstandings. The nurse anesthetist's role in these situations is multifaceted. This article describes how the nurse anesthetist must be creative, adaptable, and self-reliant to provide a high standard of anesthetic care and prevent mishaps in austere environments.

Anesthesia↗
PubMed1990

Inner ear decompression sickness combined with a fistula of the round window. Case report.

Inner ear barotrauma with rupture of the round or oval window secondary to diving and decompression sickness (DCS) of the inner ear can be a difficult diagnosis to differentiate. The dive profile or associated elements of DCS will often confirm the diagnosis. Occasionally, diagnosis is made during recompression or during operation. The differential diagnosis is important, since immediate recompression is indicated for inner ear DCS, while it is contraindicated in cases of inner ear barotrauma. We have found no cases reported in the world literature in which both diseases have been diagnosed and proven simultaneously. We present a case of a diver who developed DCS with inner ear manifestations complicated by a round window fistula. Treatment and clinical outcome are discussed along with a brief review of the suspected cause.

Audiometry↗
PubMed1989

Cerebral perfusion deficits in dysbaric illness.

Decompression sickness (DCS) is usually categorised as type I (mild; peripheral pain, non-neurological) or type II (serious; neurological). Type II is regarded as predominantly a spinal cord disease with infrequent cerebral involvement. Cerebral perfusion was studied by injection of 99Tcm-hexamethylpropyleneamine oxime and single photon emission tomography in 28 divers with confirmed incidents of DCS and cerebral arterial gas embolism (CAGE). Cerebral perfusion deficits were present in all 23 cases of type II DCS and in all 4 cases of CAGE. No deficits were present in the single case of type I DCS. Type II DCS should be recognised as a diffuse, multifocal, central nervous system disease.

Adolescent↗
PubMed1988

99Tcm-HMPAO single photon emission tomography in the diagnosis of cerebral barotrauma.

Cerebral barotrauma, or the neurological manifestation of the "bends", is a relatively common disease of divers and aviators. To date, however, no-one has succeeded in demonstrating a cerebral or spinal cord lesion in vivo following a decompression incident, despite the presence of definitive clinical signs and symptoms of central nervous system involvement. This paper describes the use of 99Tcm-labelled hexamethylpropyleneamine oxime (99Tcm-HMPAO) with single photon emission tomography in a study of three individuals involved in driving accidents. All three suffered cerebral barotrauma during decompression and all exhibited clinical signs and symptoms of dysbarism to a varying degree. Imaging was performed at time intervals ranging from 2 h to several days following the incidents. The results showed well defined cerebral ischaemic lesions in all three subjects. We conclude that 99Tcm-HMPAO imaging provides a significant advance in locating and demonstrating cerebral lesions following barotrauma and will contribute greatly to our understanding of the pathophysiological processes involved.

Adolescent↗