Biomedical subjects

L J Parker

Publications and source records attributed to L J Parker.

7 recordsLinked to original sources

PubMed1997

Emergency department evaluation of geriatric patients with acute cholecystitis.

OBJECTIVE: To estimate the frequency of abnormal clinical symptoms, laboratory tests, and diagnostic imaging studies in the ED assessment of elderly (> or = 65 yr) patients with acute cholecystitis, and to compare these factors in young-old (65-74 yr), middle-old (75-84 yr), and old-old (> or = 85 yr) population groups. METHODS: A retrospective, cross-sectional study was performed by review of ED records, hospital charts, and surgical operative reports of consecutive elderly ED patients determined at surgery to have acute cholecystitis. Records were reviewed between April 1990 and April 1995 at a large Midwestern tertiary care facility with 65,000 annual ED patient visits. Clinical signs and symptoms were compared in the young-old, middle-old, and old-old population groups. RESULTS: Of the 168 patients reviewed, 141 (84%) had neither epigastric or right upper quadrant abdominal pain, and 8 (5%) had no pain whatsoever. Only 61 patients (36%) had back or flank pain radiation. Ninety-six (57%) experienced nausea, 64 (38%) had emesis, and 13 (8%) had visible jaundice. Ninety-four (56%) patients were afebrile and 69 (41%) had no increase of white blood cell count. Twenty-two (13%) patients had no fever and all tests were normal. No statistical difference was noted in any symptom or laboratory factor for the 3 age groups, except jaundice was more common among the patients aged > or = 85 years. Ultrasonography was diagnostic for 91%, and CT was beneficial for only 1 patient. Eight patients had normal results on their ultrasonographic and CT studies. CONCLUSION: Classic symptoms and abnormal blood test results are frequently not present in geriatric patients with acute cholecystitis. Increasing age does not appear to affect the clinical and test markers used by clinicians to diagnose this illness. A high degree of awareness is essential for correct diagnosis of acute cholecystitis in geriatric patients.

Acute Disease↗

PubMedDate not supplied

Importance of handwashing in the prevention of cross-infection.

Although the importance of handwashing is routinely acknowledged, a religious application of this practice still does not exist. Discussion in modern medicine on the subject of handwashing always states that it is the single most important factor in preventing hospital-acquired infection. This article continues the series on infection control and practical procedures by looking at the evidence that supports the above statement and discusses various handwashing methods and how to increase compliance to handwashing in the healthcare setting.

Cross Infection↗

PubMedDate not supplied

Current recommendations for isolation practices in nursing.

Attitudes have changed drastically over the centuries towards people with infections and how to contain them. Only as we approach the end of the 20th century are we starting to base our practices on scientific evidence and not on ritual, although rational thought is still not found in many practices and confusion surrounds the terminology used. With the introduction of clinical governance, and the statutory duty of health organizations to provide a quality service for patients supported by evidence-based practice, this article discusses isolation practices.

Attitude to Health↗

PubMedDate not supplied

Managing and maintaining a safe environment in the hospital setting.

On entering hospital, patients and visitors assume that they are in a safe environment. Maintaining a safe environment in hospitals depends on not only the infrastructure, but also the equipment and materials that are used on the premises. Complaints about hospitals often include comments on the environment, its lack of cleanliness, poor food and the general look of debilitation. Key legislation for managing a safe environment is the Health and Safety at Work Act 1974. Complementary guidance includes the Control of Substances Hazardous to Health Regulations 1999 and the Environmental Protection Act 1990. The Incorporation of such legislation into local policies and guidelines ensures that healthcare staff can set standards to maintain the integrity of the patient's environment. This article will consider aspects of hospital life involved in maintaining a safe environment.

Food Service, Hospital↗

PubMedDate not supplied

Infection control. 1: A practical guide to glove usage.

With increased demands from the general public for healthcare professionals to be accountable for their actions, many are becoming familiar with clinical governance and other initiatives to improve clinical practice. Good infection control is central to nursing practice. To achieve higher standards of clinical practice, especially when thinking about how to reduce the risk of cross-infection, it is necessary to not only do the right thing, but also do the thing right. Safe practice should be uppermost in the minds of healthcare professionals when caring for patients. This new series of articles attempts to look at the practical aspects of infection control, highlighting the requirements for risk assessment and applying the principles of infection control to a variety of patient care situations. This article investigates the use of protective clothing and gloves. It looks at the types of gloves available for use, the importance of choosing the correct glove for the task to be undertaken, and the modern day problems of allergies to latex.

Choice Behavior↗

PubMedDate not supplied

Urinary catheter management: minimizing the risk of infection.

With catheterization comes the risk of infection and therefore people should not be catheterized unless their clinical condition dictates that it is absolutely necessary. Nurses are responsible for both inserting catheters and the subsequent management of the catheterized patient. A high level of nursing knowledge and skill is required to achieve effective and safe management. This article continues the infection control series by reviewing the principles of catheter management with regard to controlling infection.

Cross Infection↗

PubMedDate not supplied

Biogel Reveal: a puncture indication system from Regent Medical.

Gloves provide an essential barrier against contamination and are an important item of personal protective equipment. Gloves used in clinical practice do leak although there is no direct evidence that such leaks result in transmission of infection. Double-gloving is recommended in theatre as a means of reducing hand injury during surgical procedures. Biogel Reveal is a double-glove puncture indication system that shows punctures as a visible green colour when damaged.

Cross Infection↗