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Biomedical subjects

L Symington

Publications and source records attributed to L Symington.

6 recordsLinked to original sources
PubMed2006

A review of the use of propofol for procedural sedation in the emergency department.

Sedation for short but potentially painful procedures is often undertaken in the emergency department. The ideal sedative regimen should provide analgesia and anxiolysis with minimal side effects and cardiorespiratory depression and rapid recovery post-procedure. Propofol has found increasing popularity with anaesthetists for sedation in the operating theatre. This is a review of the current literature looking at the use of propofol for procedural sedation in the emergency department. A comprehensive literature search of Medline from 1966 to week 4 of 2005, Embase from 1980 to week 10 of 2005, and the Cochrane Library was carried out using the OVID interface. Eight articles were selected for review. The evidence suggests that propofol is both effective and safe to use in the emergency department. However, several of the papers reviewed used deep levels of sedation that are not recommended in the UK by non-anaesthetists.

Emergency Service, Hospital↗
PubMed2006

Sedation practice in a Scottish teaching hospital emergency department.

OBJECTIVES: To conduct a prospective survey in a teaching hospital emergency department to evaluate performance according to safe sedation principles, to establish the demographics of those sedated, and to review the drugs used and doses given to patients in the department. Any adverse events were reviewed for identification of preventable causes. METHODS: Pre-sedation checklists, peri-procedural observations, and patient notes were reviewed for 101 cases from 4 December 2004 to 3 September 2005. There are departmental guidelines outlining the principles of safe sedation. RESULTS: Emergency department procedural sedation was performed for a variety of acute conditions in patients aged from 7 to 91 years old. A variety of sedation agents were administered, morphine and midazolam being used most frequently. Drug administration, maximum sedation level, and time to recovery and discharge were recorded. Four adverse events were reported, none of which were clinically significant. Departmental guidelines were followed. CONCLUSION: Emergency department sedation is a safe and effective procedure if appropriately trained practitioners follow the principles of safe sedation.

Adolescent↗
PubMed2005

Toxic alcohol but not intoxicated--a case report.

Ethylene glycol is recognised as a potentially lethal poison if ingested. Approximately 100 mls may be fatal in a 70 kg adult. Current Toxbase guidelines are the accepted standard of treatment of such poisonings in the United Kingdom. These guidelines suggest that symptoms of significant poisoning are usually present within 30 minutes of ingestion i.e. ataxia, dysarthria, nystagmus, nausea and vomiting, haematemesis, coma and convulsions. In the absence of these symptoms, metabolic acidosis or ethylene glycol concentration more than 8 mmol/l a single loading dose of ethanol and observation were the recommended course of management until recently. We report a case of a patient who remained relatively asymptomatic for almost 24 hours but then developed clinical symptoms with marked metabolic acidosis and renal impairment requiring intensive treatment including haemodialysis.

Acidosis↗
PubMed1982

Transposon-specified site-specific recombination.

Cointegrate DNA molecules containing two copies of a transposable element appear to be intermediates in the transposition process. These structures are resolved by site-specific recombination to yield the normal end products of transposition. The transposable element gamma delta (Tn1000) synthesizes a product interchangeable with the Tn1/3tnpR protein in promoting Tn1/3 site-specific recombination. These data support the hypothesis that cointegrates containing directly repeated copies of Tn1/3 are obligatory intermediates in interreplicon transposition of Tn1/3. In addition, we show here that the reaction is independent of the element-encoded tnpA gene product. Tn501, which specifies mercury resistance, also produces cointegrates as intermediates in interreplicon transposition. The appearance of Tn501-specified recombination activity that can act on these cointegrates requires growth of cells in the presence of Hg2+.

DNA Transposable Elements↗