PubMed Health⌕ Search

Biomedical subjects

I McLellan

Publications and source records attributed to I McLellan.

At least 19 recordsLinked to original sources
PubMed1999

Maximizing the contribution doctors make to NHS management.

Management is an increasingly important issue for many doctors. If doctors wish to influence resource allocation, they must involve themselves in health service management. This article describes the results of an enquiry action learning project involving six doctors. As part of the project, clinical directors and their business managers were interviewed. In addition, the Police Force and BAA (formerly the British Airport Authority) were visited and their management structure, out-of-hours activities and planning for emergencies assessed. This article examines the reasons why many doctors do not involve themselves in management, such as increased time commitment and negative peer pressure, and suggests some solutions to these problems, including the need for a wider understanding of the role of clinical directors. It also considers how some organizations are already starting to address these issues, and how both doctors and hospitals can benefit from greater involvement of doctors in health service management.

Attitude of Health Personnel↗
PubMed1996

Bilateral and unilateral use of internal thoracic artery for myocardial revascularization. Comparison of extubation outcome and duration of hospital stay.

The left internal thoracic artery is usually used as arterial conduit for myocardial revascularization; however, there is an increasing popularity of bilateral use of this artery for grafting. We examined 180 patients with both types of arterial conduits to answer whether bilateral use of the internal thoracic artery makes the difference in postoperative extubation outcome and duration of hospital stay in comparison to the unilateral use of this conduit. Ninety-three patients with bilateral conduit and 87 patients with unilateral conduit, with comparable age, cardiopulmonary bypass, and aortic cross-clamp time have been studied. On the basis of statistical and retrospective analysis, we conclude that bilateral use of internal thoracic artery for myocardial revascularization prolongs required postoperative respiratory support (12.0 h against 7.6 h) not affecting the duration of the mean hospital stay.

Humans↗
PubMed1992

Central venous access in children via the external jugular vein.

Sixty-two children undergoing cardiac surgery were surveyed for the presence of external jugular veins. When present, these were used as a route for central venous catheterisation using a 'J' wire Seldinger technique. Only 54% of attempted insertions were successful but the results support greater efficacy in older children.

Adolescent↗
PubMed1988

Percutaneous transtracheal high frequency jet ventilation as an aid to difficult intubation.

A case is described where prophylactic high frequency jet ventilation through a percutaneous transtracheal cannula was performed. This guaranteed adequate ventilation of a patient who was known to be difficult to intubate, enabling a paralyzing dose of succinylcholine to be given and intubation to be performed safely in a well oxygenated patient scheduled for coronary artery bypass grafting.

Catheterization, Peripheral↗
PubMed1984

A disposable double-lumen tracheostomy tube--a prototype.

A prototype disposal double-lumen tracheostomy tube made of plastic has been developed and used successfully in two cases. It has definite advantages over a conventional double-lumen tube in facilitating suction and minimising the risk of kinking by virtue of its shorter length.

Disposable Equipment↗
PubMed1981

Nineteenth century resuscitation apparatus.

This paper describes three pieces of 19th century resuscitation apparatus. These pieces, and the widespread literature on the subject, illustrate the interest in artificial respiration in this period.

England↗