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Biomedical subjects

P Elkjaer

Publications and source records attributed to P Elkjaer.

11 recordsLinked to original sources
PubMed2004

Anaesthesia in day case laparoscopic female sterilization: a comparison of two anaesthetic methods.

BACKGROUND: Laparoscopic sterilization (LS) in women is a procedure frequently carried out in a day case setting. The purpose of the study was to measure postoperative pain, nausea and vomiting (PONV), the incidence of unplanned overnight admissions and patient satisfaction with two different anaesthetic methods. METHODS: From August 1997 to January 1999 the LS patients were anaesthetized with propofol + fentanyl/alfentanil, N2O and atracurium, and from January 1999 to end of 2001 they were given TIVA with propofol + remifentanil. Postoperative pain was managed with standardized high doses of paracetamol and NSAID in both groups. Data were collected from hospital records and from questionnaires given to all the patients. RESULTS: Six hundred and eighty-one women were sterilized. There were no significant differences in postoperative pain between the two groups, with 8.2 and 12.1 per cent, respectively, experiencing severe pain. Significantly fewer patients experienced moderate or severe postoperative nausea after the introduction of remifentanil anaesthesia (3.3 vs. 11.7%, P = 0.001). Eleven patients (1.8%) were admitted overnight, with no difference between the two groups. 94.5% and 96.3% of the patients were either satisfied or very satisfied with their treatment (P = 0.50). CONCLUSION: Both anaesthetic methods provide equally good postoperative pain relief, few unplanned admissions and a high degree of patient satisfaction when combined with postoperative paracetamol and NSAID. Patients anaesthetized with remifentanil and propofol have less postoperative nausea.

Adult↗
PubMed1994

[Are ambulances manned by physicians used in a sufficient extent for trauma patients?].

The aim of the study was to investigate, how often a hospital-based ambulance manned by medical doctors from the intensive care unit took part in prehospital treatment and transportation of severely injured patients in the Holstebro area. The design was a retrospective investigation based on reports concerning all trauma patients admitted by ambulance to Holstebro Central Hospital during the period 1.1.1990 to 31.12.1990 (171 admissions). All cases were classified according to the AIS-scale (1990 version) and the ISS-score was calculated for all patients. Of a total of 198 calls where the hospital based ambulance was activated, only 18 (9.1%) were for trauma patients. Five of the trauma patients were dead when the ambulance arrived, and 13 were admitted to hospital. Median ISS in the group of patients that was transported by a standard ambulance was 8.6 (1-18), and 12.7 (1-43) in the group of patients that was transported by the special ambulance manned by medical doctors. Fifteen patients (68.2%) out of the group of patients with an ISS-score > 12 were transported by standard ambulance. We thus conclude that the activation of the hospital-based ambulance manned with medical doctors to trauma patients has to be improved, so that all severely traumatised patients are transported by this kind of ambulance instead of by a standard ambulance.

Ambulances↗
PubMed1989

[Pre-hospital care].

Organisatory and therapeutic characteristics for selected pre-hospital medical treatment systems are described. It is emphasized that all of the links in the therapeutic chain must function optimally to achieve effective treatment of acute disease and injuries. The importance of rapid decision-making by highly qualified medical staff is emphasized. On the basis of experience from Denmark and from abroad, a model for up-to-date pre-hospital treatment in Denmark is outlined.

Allied Health Personnel↗
PubMed1989

[Medically staffed ambulances for trauma victims].

During a period of 16 years, prehospital advanced life support was provided for a total of 123 trauma patients. The average age was 32 years. Fifty-five patients were dead on the arrival of the mobile intensive care unit. In 83% of the cases, the Causes of the injuries were traffic accidents. The median injury severity score was 23. Out of the 63 treated patients, 27 suffered from respiratory failure, 23 were in shock and 35 were unconscious. Potential life-saving treatment in the form of intubation and/or massive intravenous infusion was provided for 24 patients, six of whom survived. On the basis of these results it is recommended that advanced prehospital life support should be extended also to include trauma patients.

Adult↗
PubMed1989

[An mobile intensive care unit manned with medical personnel. Experience from a 16-year period].

An attempt is made to assess the value of a medically-staffed mobile intensive care unit which has functioned for 16 years at Holstebro Central Hospital. The medically-staffed ambulance responded to emergency calls concerning 2,048 patients. The average age was 56 years, 1,225 patients were men, 461 were women and in 362 cases the sex was not recorded. Of these 753 were non-cardiac cases, 883 were cardiac cases and in 412 cases, the diagnosis was not recorded. Resuscitation was commenced in 649 cases and this proved successful primarily in 175 cases (27%). Sixty-seven of these patients (38%) were discharged from hospital. In nine cases only defibrillation was performed while supplementary drugs were administered in 434 cases. Treatment consisted mainly of cardiovascular drugs, divretics, analgesics, intravenous fluid and in 518 cases intubation. The drug treatment required the presence of a doctor. The cost was modest, particularly as this arrangement has, hitherto, not required extra staffing. Improvements in the existing prehospital emergency treatment are proposed. In particular, the alarm system should be changed. A medically-staffed mobile intensive care arrangement will render commencement of thrombolytic treatment possible in cases of acute myocardial infarction as early as possible.

Adolescent↗
PubMed1988

Impaired pulmonary and cardiac function after maximal exercise.

The cardiopulmonary response to maximal rowing exercise of short duration was studied in six healthy well-trained oarsmen. The lung diffusing capacity for carbon monoxide was significantly decreased below the pre-exercise value for 2.5 days post-exercise (P less than 0.05). Residual volume (RV) showed a significantly increased value at 30 min of recovery (P less than 0.01) with no change in total lung capacity. There was no significant change in transthoracic electrical impedance following exercise but a decrease may have been masked by the increased RV. The changes in the pulmonary parameters may reflect the occurrence of a transient interstitial lung oedema. Exercise-induced bronchoconstriction may be a part of the cardiopulmonary response as peak expiratory flow rate (PEFR) was significantly reduced at 30 min of recovery. The reason for the increase in pulmonary extravascular water volume may be a marked distension of the lung capillaries due to increased blood volume in the lungs and as a consequence increased vascular permeability. The changes may also be caused by impaired myocardial contractility indicated by a split impedance dZ/dt waveform, not previously described in healthy persons, which occurred in all six subjects immediately following exercise.

Adolescent↗