PubMed Health⌕ Search

Biomedical subjects

John Murtagh

Publications and source records attributed to John Murtagh.

6 recordsLinked to original sources
PubMed2005

Optimal technique for intramuscular injection of infants and toddlers: a randomised trial.

OBJECTIVE: To compare the rates of adverse reactions and parental approval ratings for three different techniques for anterolateral thigh vaccination in children aged 2, 4, 6 and 18 months. DESIGN: Randomised, observer-blind trial. PARTICIPANTS: 375 children who received pertussis-containing vaccines in a regional New South Wales town between 29 May 2001 and 30 June 2002. INTERVENTIONS: Children were randomised to receive intramuscular injection with acellular pertussis-containing and Haemophilus influenzae type b vaccines with one of three recognised injection techniques (Australian, World Health Organization or United States). MAIN OUTCOME MEASURES: Local adverse reactions (bruising and redness/swelling), systemic adverse reactions (irritability, perceived fever, persistent crying/screaming, drowsiness, vomiting/poor feeding) and parental acceptance were assessed 24 hours after injection. RESULTS: 361 children (96%) were evaluated 24 hours after vaccination. The WHO technique resulted in significantly fewer children, than with the other two techniques, with the systemic adverse reaction variable "irritability" (P = 0.0039). There was a significant difference between the technique groups overall for the local adverse reaction "bruising" with acellular pertussis-containing vaccines (P = 0.0418), due to a lower reaction rate in the WHO group compared with the US group (P = 0.0356). CONCLUSION: The WHO technique appears to be the optimal technique for anterolateral thigh injection in children--it ensures that the injection is intramuscular, results in fewer adverse reactions, and is the easiest technique to perform as it does not require angling of the needle to the long axis of the femur.

Age Factors↗
PubMed2003

Workplace bullying.

Explore the source record for details and available documents.

Health Personnel↗
PubMed2003

Fits, faints and funny turns. A general diagnostic approach.

BACKGROUND: The patient presenting with a fit, faint or 'funny turn' can present a diagnostic dilemma for the general practitioner. OBJECTIVE: This article aims to provide an overview of the diagnostic approach to these 'episodes'. DISCUSSION: The key to diagnosis is to elicit a clear history focussing on the lead-up to the episode, a description of what took place and the events that took place after the episode. The patient's feelings, symptoms, circumstances and provocative factors give vital information.

Diagnosis, Differential↗
PubMed2003

Fatigue--a general diagnostic approach.

BACKGROUND: Fatigue or excessive tiredness of body or mind is a common presenting problem in general practice. OBJECTIVE: This article provides a diagnostic model for the diagnosis of fatique in general practice. DISCUSSION: Fatigue is not a diagnosis but rather a symptom. Fatigue is interchangeable with terms such as tiredness, weariness, loss of energy, listlessness and exhaustion. It can be a difficult and frustrating symptom for the general practitioner to evaluate.

Australia↗
PubMed2002

Needle length required for intramuscular vaccination of infants and toddlers. An ultrasonographic study.

BACKGROUND: To be maximally effective and to induce less adverse reactions, injection with many vaccine antigens must penetrate muscle rather than subcutaneous tissue. AIM: To determine the length of needle needed to penetrate muscle at the anterolateral thigh vaccination site in children aged two, four, six and 18 months. METHOD: Ultrasound measurements were made of the subcutaneous and muscle layer thickness of children aged two, four, six and 18 months at the junction of the upper and middle thirds of the anterolateral thigh with the probe applied parallel to the long axis of the leg and at 45 degrees to the vertical and at 90 degrees to the skin's plane. RESULTS: Subcutaneous tissue (SCT) and muscle layer (ML) thickness were measured in 57 children (2 months, n = 14; 4 months, n = 13; 6 months, n = 18; 18 months, n = 12) with mean SCT thickness of: 8.6 +/- 3.0 mm at 2 months; 9.4 +/- 2.0 mm at 4 months; 10.2 +/- 2.1 mm at 6 months; and 8.1 +/- 1.7 mm at 18 months. Muscle layer thickness in these children was: 10.5 +/- 2.4 mm at 2 months; 12.2 +/- 2.0 mm at 4 months; 14.8 +/- 2.0 mm at 6 months, and 16.5 +/- 4.6 mm at 18 months. CONCLUSION: The optimal needle length to routinely penetrate muscle of the anterolateral thigh in children aged two, four, six and 18 months depends on the technique employed. A 16 mm long needle is suitable with the WHO technique (injecting at 90 degrees to skin's surface) and 25 mm long needle with the NH&MRC and American techniques (injecting at 45 degrees to skin's surface).

Age Factors↗