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Biomedical subjects

G Purcell-Jones

Publications and source records attributed to G Purcell-Jones.

10 recordsLinked to original sources
PubMed1998

Medically certified work loss, recurrence and costs of wage compensation for back pain: a follow-up study of the working population of Jersey.

The 1 yr incidence, prevalence and wages compensation costs of work loss due to medically certified back pain in the working population of Jersey were identified by analysis of the Social Security database for the year 1994. A total of 2291 subjects absenting due to back pain during this period were followed for up to 3 yr to identify return to work rates and subsequent absences. Incidence and prevalence rates were 5.6 and 6.3%, respectively. The cost of wages compensation was 1.29 million pounds or 10.5% of such benefits paid. Work loss was greater for the second absence. The rate of return to work was broadly in line with that suggested by the Clinical Standards Advisory Group (CSAG), but the number still absent at 1 yr was less, suggesting that the CSAG figures for long-term absence may have been overestimated. The influence of compensation systems and unemployment on work-related absence due to back pain is highlighted.

Absenteeism↗
PubMed1997

Injuries sustained during major evacuation of the high-speed catamaran St Malo off Jersey.

The difficulties and injuries sustained during the emergency evacuation of 308 passengers and crew from the fast passenger catamaran M.V. St Malo are described. The vessel had hit a rock off Jersey and was listing severely. Fifty-three passengers were injured, 32 requiring hospital admission; one with a myocardial infarction and 31 with musculoskeletal injuries. Eighteen patients required operation for severe lower limb injuries. Increased numbers of emergency exits and the introduction of evacuation chutes to this type of twin-hulled vessel are recommended.

Accidents↗
PubMed1989

Paravertebral somatic nerve block: a clinical, radiographic, and computed tomographic study in chronic pain patients.

The spread of solution after a standardized paravertebral injection was studied to determine the precision and predictability of paravertebral spread. The spread of 5 ml of a solution of radiological contrast medium (sodium iothalamate) and local anesthetic mixture after 45 (34 thoracic, 11 lumbar) paravertebral injections was studied in 31 patients by radiography and computed tomography and correlated with the clinical effects. Spread confined to the paravertebral area occurred after only eight (18%) injections. Spread was epidural after 31 (70%) injections and exclusively so in 14 (31%) injections. Mean sensory loss was greater after epidural spread, but a wide range of sensation loss was observed with all patterns of spread. Intrapleural spread occurred after three injections, as did spread into the psoas muscle. In addition, measurements were made of 114 paravertebral spaces in 20 patients by means of computed tomography. Dimensional factors identified as possibly leading to complications of a paravertebral injection included narrow width of the thoracic transverse processes (mean, 3.18 cm; range, 2.1-4.2 cm) and the wide range in paravertebral dimensions. The distance from bony landmarks to pleura frequently fell outside the limits recommended by many standard texts. We conclude that the spread of a small volume of solution after paravertebral injection is imprecise and unpredictable. Neurolytic and diagnostic paravertebral injections performed without the aid of radiological imaging and contrast media should be regarded as hazardous and interpreted with extreme caution.

Analgesia, Epidural↗
PubMed1988

Delayed contralateral sympathetic blockade following chemical sympathectomy--a case history.

A young girl with an idiopathic degenerative nervous system disease developed delayed contralateral sympathetic blockade each time following lumbar paravertebral sympathetic block of either side. Bilateral sympathetic blockade developed on each occasion despite observed ipsilateral containment of X-ray contrast on injection. The aetiological mechanisms of this phenomenon are discussed.

Adolescent↗
PubMed1987

Comparison of the induction characteristics of thiopentone and propofol in children.

The induction characteristics of propofol 2.0-2.5 mg kg-1 were compared with those of thiopentone 4-5 mg kg-1 in 60 fit children aged between 3 and 16 yr. All patients received i.m. premedication with papaveretum 0.4 mg kg-1 (maximum dose 15 mg) and hyoscine 0.008 mg kg-1 (maximum dose 0.3 mg). Seven children (24%) complained of pain after injection with propofol, compared with three (10%) after thiopentone. No child in either group complained of severe pain. Excitatory effects were observed in 10 children (33%) receiving propofol as opposed to five children (16%) after thiopentone, but these were transient and minor and all occurred after completion of injection. Apnoea lasting longer than 30 s occurred in only four children (13%) in each group despite the use of opioid premedication. The mean duration of apnoea was similar in both groups. Propofol caused greater decreases in arterial pressures (systolic, diastolic, mean) than thiopentone, but only the difference in systolic arterial pressure achieved significance. There was a significant difference in heart rate, which did not change after propofol, but increased with thiopentone. The overall quality of induction was assessed as being good in all children receiving thiopentone compared with 20 (66%) of those receiving propofol.

Adolescent↗
PubMed1987

The use of opioids in neonates. A retrospective study of 933 cases.

This is a retrospective study on the use of postoperative opioids in neonates admitted to the surgical intensive care unit at Great Ormond Street over a 5-year period (1980-84). A total of 131 (14%) babies received opioids out of 933 neonates admitted to the unit. The use of opioids increased from 9.7% to 27.2% of admitted cases during the survey period. Postoperative ventilation of the lungs was necessary in 240 (25.7%) cases and 88 (36.6%) of these were given opioids. Four babies initially failed to wean from controlled ventilation as a result of opioid induced respiratory depression. A total of 51 (7.35%) spontaneously breathing neonates received opioids and seven (13.7%) of these developed apnoea or respiratory failure thought to be induced by opioids. The administration of opioids by nurses occurred most frequently in the late evening and early hours of the morning, when medical cover is at its lowest level.

Critical Care↗