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Biomedical subjects

J Soar

Publications and source records attributed to J Soar.

At least 19 recordsLinked to original sources
PubMed2002

Sharp packaging.

Explore the source record for details and available documents.

Accidents, Occupational↗
PubMed2001

Cardiac arrest during surgery and ventilation in the prone position: a case report and systematic review.

We present a case report of successful resuscitation following cardiac arrest in a patient undergoing surgery in the prone position. A systematic review of the literature identified 22 further cases. Risk factors for intra-operative cardiac arrest in patients in the prone position include: cardiac abnormalities in patients undergoing major spinal surgery, hypovolaemia, air embolism, wound irrigation with hydrogen peroxide, poor positioning and occluded venous return. Cardiac arrest is also a risk in the increasing number of patients with acute respiratory distress syndrome ventilated in the prone position. Management of prone cardiac arrest may be improved by identification of high-risk patients, careful patient positioning, use of invasive monitoring and placement of self-adhesive defibrillator paddles. Suitable techniques for cardiopulmonary resuscitation including methods for chest compression, defibrillation and the management of air embolism are discussed.

Blood Loss, Surgical↗
PubMed1999

Out-of-hospital cardiac arrests in an urban/rural area during 1991 and 1996: have emergency medical service changes improved outcome?

Survival after out-of-hospital cardiac arrest is influenced by pre-hospital emergency medical care. This study compares outcome of cardiac arrest victims presenting to an emergency department serving a mixed urban/rural area (Norfolk, UK) in 1991 with 1996. Between these years the regional emergency medical service (EMS) was extensively re-organized. We identified 113 such cases of out-of-hospital cardiac arrest in 1991 and 147 in 1996. The age distribution, proportion of witnessed arrests, and initial rhythms were similar for the 2 years. In 1996 EMS response time was significantly slower and the proportion of cases where the EMS arrived before arrest was significantly lower. Fewer patients who had a witnessed arrest received immediate bystander CPR in 1996. The number of patients discharged home decreased from 15 in 1991 to 11 in 1996, but this difference did not reach statistical significance. The majority of survivors had restoration of spontaneous circulation prior to arrival in the emergency department (14 in 1991 and ten in 1996). Survival was greatest in those arresting in the presence of the EMS (ten in 1991 and nine in 1996). In conclusion changes in EMS provision have resulted in an increase in the response time. This was associated with a decrease in the number of survivors although this was not statistically significant.

Aged↗
PubMed1998

A revised role for the hospital cardiac arrest team?

This prospective study assesses the role of the hospital cardiac arrest team. We have determined who is responsible for return of spontaneous circulation in those patients who survive to discharge. A total of 83 adult patients were analysed over a 5 month period. Fifty-five patients had cardiopulmonary resuscitation after an in hospital cardiac arrest and circulation was restored in 14 (25.5%). Eight (14.5%) patients survived to discharge. All eight survivors had circulation restored by the first responder before arrival of the cardiac arrest team. Six survivors had witnessed ventricular fibrillation and successful defibrillation by nursing staff. The two other survivors had cardiac arrests in the presence of doctors. Twenty-eight patients had pre-hospital cardiac arrests and were attended by the cardiac arrest team in the emergency department. Six patients had circulation restored by the emergency medical services prior to hospital arrival and four (14%) survived to discharge. Two patients had circulation restored in the emergency department by the arrest team and none survived to discharge. All the survivors to hospital discharge had first responder return of spontaneous circulation. We suggest a revised role for the cardiac arrest team.

Adult↗
PubMed1997

Physician clinical communication systems--an Australian perspective.

Information systems are increasingly being adopted by both community- and hospital-based providers of health care services. A gap is in linkages between carers both within a hospital and between hospitals and community providers. A range of technologies is available to improve communication of patient clinical data and other information. This paper discusses the benefits and challenges of electronic communications and reports on a successful case of physician use of a hospital communication system (information systems, technology, physicians, health care).

Attitude of Health Personnel↗
PubMed1993

Achieving change and altering behaviour through direct doctor use of a hospital information system for order communications.

Direct use of hospital information systems, and particularly of order communications systems by doctors, is central to the anticipated benefits from hospital information systems in Australia and other countries. There is an expectation that doctors will accept this technology and that the benefits will flow from their use. Concord Repatriation General Hospital in Sydney is one of very few hospitals in the world where doctors directly use a hospital information system to access patient information, place orders for diagnostic services and retrieve results. This paper reports on research which explored the nature of the direct doctor use of the hospital information system at Concord Hospital, and the changing attitudes of the doctors there.

Attitude to Computers↗
PubMed1992

Does glycine antagonism underlie the excitatory effects of methohexitone and propofol?

We have investigated the pharmacological basis of CNS excitation that occurs in association with general anaesthesia in mice. Propofol produced sustained clonic movements during anaesthesia. Methohexitone produced intermittent non-rhythmic jerking during anaesthesia. Ethanol and pentobarbitone produced anaesthesia without associated clonic movements. Doses of all anaesthetic drugs were equipotent. Surface EEG recordings showed paroxysmal discharges consistent with interictal manifestations of cortical seizures with methohexitone or propofol, but not with ethanol or pentobarbitone. Strychnine, a glycine antagonist without effects on the cerebral cortex, and bicuculline, a GABAA antagonist with effects on the cerebral cortex, were used in doses that were equipotent-0.5 log units less than the ED10 for clonic convulsions. Strychnine potentiated both excitatory behaviour and EEG paroxysmal discharges when given with methohexitone or propofol, but not with ethanol or pentobarbitone. Bicuculline did not affect either behaviour or EEG with any of the anaesthetic drugs. Our data show that methohexitone and propofol produced CNS excitation, while pentobarbitone and ethanol did not. We propose that the pharmacological basis of this excitation may be glycine antagonism occurring in subcortical structures.

Anesthesia, General↗
PubMed1990

Determination of the 5-HT receptor subtype involved in 8-OH-DPAT-induced hyperlocomotion: potential difficulties arising from inadequate pharmacological tools.

Selective 5-HT1A receptor agonists such as 8-OH-DPAT (8-hydroxy-2-(di-n-propylamino)tetralin), flesinoxan, 5-methylurapidil and others, increased locomotor behaviour in rats following s.c. injection. Unfortunately, all available 5-HT1A receptor antagonists are non-selective, a fact which severely hampers their use. The inhibitory effects of (+)- and (-)-pindolol (1-10 mg/kg, -45 min s.c.) on locomotion induced by 8-OH-DPAT were investigated in rats pretreated with the beta-adrenoceptor antagonists, ICI 118,551 and betaxolol (both 1 mg/kg, -45 min s.c.). ICI 118,551 and betaxolol significantly enhanced the response to 8-OH-DPAT. Co-administration of (-)-pindolol (2-10 mg/kg) dose dependently antagonised the hyperlocomotion whereas (+)-pindolol was weakly effective at 10 mg/kg. The partial agonists ipsapirone (1-10 mg/kg, -45 min s.c.) and buspirone (0.1-1 mg/kg, -45 min) antagonised the effects of 8-OH-DPAT. This inhibition may, however, be due to alpha 1-adrenoceptor blockade and DA receptor antagonism, respectively. Finally, although spiroxatrine (0.1 and 1 mg/kg, -45 min s.c.) inhibited the response to 8-OH-DPAT, this inhibition may also be non-specific since spiroxatrine strongly reduced spontaneous locomotor activity. In conclusion, whilst much of our data is consistent with 8-OH-DPAT-induced locomotion being mediated by 5-HT1A receptors, only the data obtained with the pindolol enantiomers provide direct evidence for this. The results also suggest that, under normal circumstances, the 5-HT1A receptor antagonist effect of pindolol may be masked by the facilitating effect of beta-adrenoceptor blockade.

8-Hydroxy-2-(di-n-propylamino)tetralin↗
PubMed1989

A strategy for coordination of end-user computing in hospital departments.

This paper discusses issues associated with end-user computing and describes an approach for coordination of departmental end-user computing that was implemented at Concord Hospital, Sydney, Australia. There are a number of pressures for end-user computing. These include the inability of IS departments to provide the services that users require, the increasing spread of computing skills and the advent of the microcomputer. The traditional approaches to computing are discussed and the concern over security explained. The potential benefits of greater involvement of users in systems development and support is discussed. Information systems development needs to be a collaborative activity. At Concord Hospital, a number of departments have responsibility for their own local minicomputer and microcomputer based systems. Coordination of this systems effort was seen as important in order to maximize the benefits of end-user computing while seeking to minimize duplication of effort, data or systems, or security risks.

Hospital Bed Capacity, 500 and over↗