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Biomedical subjects

J E Gilligan

Publications and source records attributed to J E Gilligan.

At least 19 recordsLinked to original sources
PubMed2002

Camel racing: a new cause of extradural haemorrhage in Australia.

Camel racing is a relatively new sport in Australia. A 52 year old woman fell from her camel during a country race. Although she was wearing an approved equestrian helmet, she suffered a skull fracture and a life-threatening extradural haematoma. Her treatment highlights the key issues of management of head injuries in remote places. A paramount requirement is close collaboration between country medical practitioner, neurosurgeon and retrieval specialist.

Accidental Falls↗
PubMed1996

An airborne intensive care facility (fixed wing).

A fixed-wing aircraft (Beechcraft KingAir B200 C) fitted as an airborne intensive care facility is described. It completed 2000 missions from 1987-1992 for distances up to 1300 km. Features include: 1. Space for carriage of two stretchers, medical cabin crew of up to five persons and equipment and two-pilot operation if necessary. A third stretcher may be carried in emergencies. 2. Two CARDIOCAP (TM) fixed monitors for ECG, invasive and noninvasive pressures pulse oximetry and end-tidal C02 plus SIEMENS 630(TM)/PROPAQ(TM) compact monitors for the ground transport phase of missions, or the total duration. 3. A medical oxygen reservoir of 4650 litres sufficient for two patients on IPPV with FiO2 = 1.0 for a four-hour trip. The medical suction system is powered from the engine or a vacuum pump. 4. Other medical equipment and drugs in portable packs, for ground transport and resuscitation needs and for replenishment by nursing staff at the parent hospitals. 5. Stretchers compatible with helicopter and road ambulance vehicles used. 6. A stretcher loading device energized from the aircraft, operating through a wide (cargo) door. 7. Provision of 24Ov AC (alternating current) and 28v DC (direct current) electrical energy. 8. Pressurization and climate control. 9. Satisfactory aviation performance for conditions encountered, with single-pilot operation.

Air Ambulances↗
PubMed1992

A longitudinal study of 100 consecutive admissions for carbon monoxide poisoning to the Royal Adelaide Hospital.

A longitudinal study of one hundred consecutive admissions to the Royal Adelaide Hospital for carbon monoxide poisoning was conducted from 1986 to 1989. Twenty-five patients left hospital with persistent symptoms and signs of this poisoning. Five subsequently recovered. Twenty-four other patients, who were well when they left hospital, did not attend for a review one month after discharge. Extensive neuropsychiatric testing at this time showed 32% (24 of 76) had obvious sequelae of their exposure. Overall, the frequency of neuropsychiatric sequelae in the patients who only received oxygen at atmospheric pressure was 63% (N = 8) on discharge and 67% (N = 6) on one month follow-up. The frequency of sequelae among those who were given one hyperbaric oxygen treatment only was 46% (N = 24) on discharge and 50% (N = 20) on one month follow-up. In contrast, the frequency of sequelae in patients who had two or more hyperbaric oxygen treatments was only 13% (N = 68) on discharge (P less than 0.005) and 18% (N = 50) on follow-up (P less than 0.005). the frequency of sequelae was also significantly greater if hyperbaric oxygen was delayed (P less than 0.05). No markers of severe poisoning could be identified.

Adolescent↗
PubMed1990

A simple percutaneous tracheostomy technique.

PCT techniques have significant advantages when compared with the standard techniques of tracheostomy. We have developed an instrument that facilitates the operation of PCT, which we found increased the simplicity and safety of the procedure.

Equipment Design↗
PubMed1988

Extradural haemorrhage: strategies for management in remote places.

A study of 109 cases of extradural haemorrhage (EDH) treated in South Australia over a period of 7 years showed that 35 cases (32.1 per cent) presented in country areas at considerable distances from a neurosurgical service: the mortality in these country cases was 22.9 per cent, comparing unfavourably with a mortality of 12.2 per cent in metropolitan cases. The country series contained a disproportionately large number of cases with multiple intracranial haemorrhages, which are known to have a poorer outcome; when these cases were excluded, the rural mortality (12.5 per cent) was only a little over the metropolitan mortality (9.7 per cent). These data suggest that it is possible to manage extradural haemorrhages successfully even in places remote from a neurosurgical centre, if communications and air transport are used effectively. However, it was found that emergency operations carried out in country hospitals were sometimes inadequate or done too late. Medical retrieval teams based on city hospitals were sent out on 15 occasions, either to assist a general surgeon to complete an emergency operation, or to provide intensive care during transfer to a neurosurgical unit. Osmotherapy (mannitol and/or frusemide) has been useful in gaining time for transfer; the choice between immediate operation and transfer may be difficult, and decisions should take transfer time, clinical state and rate of deterioration into account.

Acute Disease↗
PubMed1982

Hypercalcemia associated with parenteral amino acid and dextrose infusion.

A patient receiving parenteral nutrition with an amino acid dextrose solution developed hypercalcemia which seemed related to the rate of nutrient infusion. In a retrospective study of patients receiving parenteral nutrition over a 3-month period six of 72 (8%) developed hypercalcemia. After changes in infusion rate there were corresponding changes in the serum calcium concentration. There was a significant correlation between the serum calcium concentration and the average infusion rate over the preceding four days (p = 0.012). This was even more significant (p less than 0.005) when ionized calcium was calculated to diminish the effects of calcium binding by proteins.

Adolescent↗
PubMed1976

The role of intensive care units.

The indications for intensive care are discussed. Selection of patients should be based upon the apparent reversibility of disease processes and the likelihood of producing worthwhile relief of suffering. Admission statistics for one II-bed unit are also presented, and survival rates exceeding 90% of three "model" conditions-namely, fat embolism, tetanus and Gullain-Barré syndrome-are reported. The hospital costs for treating critically ill patients are approximately three times those for treating the "average" patient.

Adolescent↗