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Biomedical subjects

N F Quiney

Publications and source records attributed to N F Quiney.

13 recordsLinked to original sources
PubMed1999

'Near-miss' hyperkalaemic cardiac arrest associated with rapid blood transfusion.

A case is presented in which a relatively modest blood transfusion resulted in acute hyperkalaemia with a 'near-miss' cardiac arrest. While transfusion-related hyperkalaemia usually occurs in association with massive transfusions, several factors may have increased the risk of such an acute reaction. A high index of suspicion is required, especially in patients with risk factors. Anaesthetists should not be lulled into a false sense of security simply because modest volumes of blood are being transfused.

Aged↗
PubMed1996

Pain following craniotomy: a preliminary study comparing PCA morphine with intramuscular codeine phosphate.

We have performed a prospective randomised trial of 30 patients undergoing craniotomy to compare intramuscular codeine phosphate with patient-controlled analgesia using morphine 1 mg bolus with a 10-min lockout and no background infusion. For 24 h postoperatively, pain, nausea, Glasgow coma score, respiratory rate and sedation score were assessed. There was a wide variation in the amounts of morphine requested by the patients in the patient-controlled analgesia group in the first 24 h postoperatively (range 2-79 mg, median 17 mg). There was a small, but non-significant, reduction in pain scores in the patient-controlled analgesia group. There were no significant differences between the two groups in respect of nausea and vomiting, sedation score or respiratory rate. No major adverse effects were noted in either group. Patient-controlled analgesia with morphine is an alternative to intramuscular codeine phosphate in neurosurgical patients which merits further investigation.

Adolescent↗
PubMed1995

Resuscitation skills amongst anaesthetists.

Resuscitation skills were assessed in a group of 24 anaesthetists of varying experience using 3 pre-determined scenarios. Seventy-nine percent of participants were found to be competent at resuscitation following the guidelines suggested by the Resuscitation Council (UK) in 1989. No one grade of anaesthetist was found to be consistently poor at resuscitation. Anaesthetists by the nature of their jobs may maintain the skills and knowledge of cardiopulmonary resuscitation as well as other groups in the hospital.

Anesthesiology↗
PubMed1995

The use of ultra-low-dose aprotinin to reduce blood loss in cardiac surgery.

One hundred patients due to undergo primary cardiac surgery were prospectively randomized to receive aprotinin or placebo. In the aprotinin group, 250,000 kallikrein inhibitory units (KIU) of aprotinin were added to the cardiopulmonary bypass prime solution. A further 250,000 KIU of aprotinin were infused intravenously over 30 minutes immediately before the start of cardiopulmonary bypass. The control group received 0.9% saline in equal volumes at identical times. The study was designed to have a 90% chance of demonstrating a 30% reduction in blood loss. No significant differences were found between the two groups. The median blood loss in the aprotinin group was 750 mL (interquartile range 556 to 1025 mL, 95% confidence interval 600 to 800 mL). In the control group, the median blood loss was also 750 mL (interquartile range 500 to 988 mL, 95% confidence interval 625 to 925 mL). In the aprotinin group, 12 patients received postoperative autotransfusion of shed mediastinal blood of median volume of 665 mL (interquartile range 500 to 925 mL, 95% confidence interval 450 to 1000 mL). In the control group, 14 patients received postoperative autotransfusion of mediastinal blood of median volume of 663 mL (interquartile range 600 to 800 mL, 95% confidence interval 600 to 700 mL). Five patients in the aprotinin group and seven patients in the control group required postoperative homologous blood transfusion. Reassessment of inclusion criteria showed a 19% reduction in blood loss in patients undergoing only aortocoronary bypass receiving aprotinin compared with controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Aprotinin↗
PubMed1994

Sudden death after central venous cannulation.

A previously fit 39-yr-old man was admitted with clinical findings suggestive of septicaemic shock. After routine insertion of a central venous catheter he developed electromechanical dissociation. Prolonged efforts to resuscitate the patient were unsuccessful. Post mortem examination showed a cyst arising from the tricuspid valve annulus which had prolapsed into the right ventricular outflow tract. The insertion of a central venous catheter probably caused the cyst to prolapse and cause cardiac arrest with electromechanical dissociation. This unique complication emphasises the importance of not allowing the Seldinger wire or central venous catheter to enter the heart during insertion. Correct positioning of central venous catheters during insertion is most safely confirmed by back flow of blood in the catheter and right atrial electrocardiography together with a follow up chest radiograph, rather than relying on the occurrence of cardiac arrhythmias during placement of the Seldinger wire or catheter. To avoid excessive lengths of Seldinger wire or catheter being inserted inadvertently during placement, both should be marked along their lengths.

Adult↗
PubMed1994

The inflatable wedge: an aid to bilateral hip arthroplasty.

A reusable inflatable wedge system is described for use during bilateral hip arthroplasty. It allows rapid repositioning during the procedure, with minimal interference to the surgical field. It is robust, cheap and provides minimal compromise to surgical asepsis. It has potential for use in a variety of procedures.

Equipment Design↗