Explosive separation of a Comweld oxygen regulator.
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Adult↗
Biomedical subjects
P Grove
Publications and source records attributed to P Grove.
Endotracheal tube stability in the resuscitation environment.
Evidence presented in the anaesthetic and emergency medical services literature warns of the possibility of accidental or insidious displacement of endotracheal tubes in intubated patients. In particular, there is evidence that head movement in intubated patients can lead to displacement of the distal tip of an endotracheal tube in the trachea while its depth markings remain fixed in relation to the patient's lips or teeth. Immobilisation of the heads of all intubated patients should be considered, to prevent the possibility of accidental endotracheal tube displacement. In addition, all intubated patients must be clinically assessed for proper endotracheal tube placement and maintenance of adequate ventilation after every movement during resuscitation and diagnostic measures.
Adult↗
Refractory hypotension in trauma: a case study.
In the patient with blunt trauma, diagnosis of the cause of ongoing hypotension may be difficult. A number of causes may contribute to refractory hypotension, either alone or in combination. However, by following standard algorithms for the management of these patients, causes can be excluded or identified, then managed appropriately. The following case study highlights one of the diagnoses of exclusion for refractory hypotension in the blunt trauma victim. Ongoing considerations and implications for the nursing care of spinal injured patients are also discussed.
Aged↗
Monoclonal immunoglobulin G1-kappa fibrillary glomerulonephritis.
We report here a case of fibrillary glomerulonephritis arising in a 43-year-old man with a polyclonal gammopathy, who presented with progressive renal insufficiency, microscopic hematuria, and mild proteinuria (0.7 g/d). Ultrastructural studies showed deposits of randomly oriented fibrils in the glomerular mesangium and adjacent portions of some glomerular basement membranes, with a mean fibril thickness of 14.3 nm, highly consistent with fibrillary glomerulonephritis. The Congo red stain was negative on histologic sections. Immunofluorescence studies revealed strong mesangial and focal glomerular capillary staining for immunoglobulin (Ig) G, complement (C) 3, and kappa light chains, with minimal staining for IgA, IgM, C1q, or lambda light chains. The IgG present was entirely of the IgG1 subclass. This case is quite unusual for fibrillary glomerulonephritis, which typically presents with polyclonal IgG deposits and IgG4 as the dominant IgG subclass present. Monoclonal deposits are more frequently associated with immunotactoid glomerulopathy, characterized ultrastructurally by microtubule-like structures 30 to 50 nmn thick, often in parallel arrays. The present case illustrates that although fibrillary glomerulonephritis and immunotactoid glomerulopathy might be distinguishable on ultrastructural grounds, there is overlap between these two entities with respect to the potential composition of the glomerular deposits present.
Adult↗