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Biomedical subjects

K J Power

Publications and source records attributed to K J Power.

13 recordsLinked to original sources
PubMed1992

Pre-registration house surgeons. A questionnaire study of anaesthesia-related knowledge and approach to pre-operative investigations.

A group of newly qualified pre-registration House Officers completed a questionnaire relating to their knowledge of anaesthetic drugs and to their appreciation of complications which may, in whole or in part, have required some knowledge of anaesthesia. Considerable gaps in knowledge were demonstrable, not only in matters that might arguably be regarded as strictly within the province of anaesthesia, but also in respect of basic pharmacology. The same House Officers were also questioned as to the necessity for various basic pre-operative investigations prior to six everyday surgical procedures. This demonstrated a marked propensity for House Officers to overinvestigate patients as compared to the requirements of practising anaesthetists. The discrepancy was most marked with respect to pre-operative chest X rays. However, considerable disparity was also demonstrable amongst a group of experienced anaesthetists as to their requirements for pre-operative investigations. Permitting students greater exposure to anaesthesia in the undergraduate curriculum could go a long way towards improving this situation.

Adult↗
PubMed1990

Foam cuffed tracheal tubes: clinical and laboratory assessment.

The efficiency of a foam cuffed tracheal tube has been studied in protecting the pulmonary tree from aspiration of oropharyngeal and gastric contents. Following instillation of methylene blue dye above the cuff, subsequent fibreoptic bronchoscopy revealed no instance of dye staining of the tracheal mucosa. A "bench" study was undertaken subsequently to estimate the likely pressure that the cuff would exert on the tracheal mucosa as a result of elastic recoil properties of the foam. The results suggested that, under normal clinical conditions, the pressure is not likely to exceed a value at which impairment of the mucosal blood supply would occur.

Female↗
PubMed1990

Postpartum thrombosis of the great vein of Galen.

Severe fits occurred in a patient 52 hours after placental abruption. Early use of computerised tomography scanning enabled a definitive diagnosis of thrombosis of the great vein of Galen to be made. The case illustrates the point that not all fits in the early postpartum period should be attributed to eclamptic toxaemia.

Adult↗
PubMed1989

Anaesthesia for day case oral surgery.

A study was undertaken to evaluate the quality of recovery and the extent of morbidity following the extraction of wisdom teeth on an outpatient basis. Two anaesthetic techniques were compared, one based on spontaneous respiration and the other on mechanical ventilation, both were based on propofol and were in other respects tailored to the requirements of the short stay patient. Objective tests of recovery demonstrated no differences between the groups at 30 and 60 minutes postoperatively, and there was similarly no difference in the incidence of morbidity symptoms apart from a 16% incidence of severe muscle pain associated with the use of suxamethonium. The overall patient acceptability for the procedure was high; 80% in each group. It is argued that recent improvements in agents available for short stay anaesthesia should enable many patients hitherto treated as inpatients to be transferred to the outpatient setting with considerable economic benefit.

Adult↗
PubMed1989

Extradural analgesia in the intrapartum management of a patient with pulmonary hypertension.

We describe the intrapartum management of a patient with severe pulmonary hypertension using extradural analgesia with a low dose of 0.125% bupivacaine and fentanyl 20 micrograms ml-1 by continuous infusion at a rate of 2.5 ml h-1. This provided effective analgesia and haemodynamic stability. The importance of continuous direct measurement of pulmonary artery pressure is emphasized.

Adult↗
PubMed1988

Spinal anaesthesia for day case surgery.

Postoperative morbidity in fifty day care patients undergoing spinal anaesthesia was evaluated by means of a postoperative questionnaire. Despite the use of a 26G spinal needle in all patients, there was an overall incidence of spinal headache of 18%, which rose to 39% when considering patients under 40 years of age. Several spinal headaches of three to five days' duration were reported. Patients receiving spinal anaesthesia were compared with a smaller group of patients receiving general anaesthesia for similar procedures, and this group showed no evidence of post-operative morbidity after 48 h. In agreement with a previous study, it is concluded that spinal anaesthesia is not a suitable technique for the young day care patient.

Adult↗
PubMed1986

Intensive care aspects of severe Legionella pneumonia.

A case of extensive Legionella pneumonia is presented. The patient required an extended period of artificial ventilation, notably punctuated by episodes of dysrhythmia and severe haemodynamic instability, but who nevertheless eventually recovered. Intensive care aspects of Legionnaires' disease are discussed.

Critical Care↗
PubMedDate not supplied

The legal and ethical implications of consent to nursing procedures.

Nurses are increasingly expanding their practice to include many more invasive procedures. Consequently, there is a need to re-examine nurses' responsibilities in relation to obtaining consent for nursing as opposed to medical procedures. Fully informed consent is not a legal requirement in England, for either medical or nursing procedures. However, this article argues that to comply with the standard set by the Code of Professional Conduct nurses should obtain informed consent for any proposed procedure they undertake. The concept of informed consent is examined and applied to practice. Ultimately, nurses are charged with four key tasks in relation to securing consent for nursing procedures: educating themselves about the risks and benefits of the procedures they propose to undertake; conveying this information to patients; assessing their understanding of the information given; and endeavouring to support the patient in his/her decision.

Disclosure↗