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Biomedical subjects

P J Tomlin

Publications and source records attributed to P J Tomlin.

At least 19 recordsLinked to original sources
PubMed1979

Health problems of anaesthetists and their families in the West Midlands.

A survey of all anaesthetists in the West Midlands region--that is, 10% of all the anaesthetists in England and Wales--showed that one in 10 of their children had been referred to a consultant because of a congenital or nonacquired anomaly. Abortions among anaesthetists' families were also common but more so when the mother was an anaesthetist. The anomalies were concentrated particularly in the central nervous system and musculoskeletal system, and girls were worst affected. The mean birth weights were below normal, more so when the mothers were anaesthetists. Girls with anomalies were particularly underweight. Other effects observed were unexpected infertility, cancer both in the adults and in the children, and, possibly, impaired intellectual development in the children. Many anaesthetising areas were inadequately ventilated, and scavenging devices despite their inefficiency are recommended as a stopgap measure. The results of the study closely resemble those of other studies with similar high response rates to requests for information.

Abnormalities, Drug-Induced↗
PubMed1979

Hypercapnia and hyperkalaemia.

Studies in patients undergoing peritoneal laparoscopy, in which carbon dioxide was used as insufflating gas, showed that artificial hyperventilation was an effective means of preventing serious hypercapnia. The hypercapnia caused a rapid hyperkalaemia and there was a linear relationship between the two. Reversal of the hypercapnia caused the serum potassium to fall towards normal but the speed of this fall did not match the speed of reduction in Paco2. It is suggested that the changes in serum potassium following changes in Paco2 may have some clinical relevance in potassium-depicted patients.

Adult↗
PubMed1978

Balanced regional analgesia--an hypothesis.

An hypothesis is advanced, based upon observation of patients undergoing selected types of regional analgesic blocks, that total patient care during any regional analgesic technique consists of maintaining a balance of local analgesia, tranquillity and the use of a centrally acting analgesic. The latter is required to relieve non-specific distress unrelated to the operation which appears to be caused by a disturbance of sensory input to the cerebral cortex, possibly the proprioceptive input. A small group of patients will not respond to any sedation accompanying regional analgesia and need general anaesthesia. It is suggested that failure to appreciate all three parts of this triad may contribute to uncertainty of patient control during regional block.

Anesthesia, Conduction↗
PubMed1978

Intensive care--a medical audit.

A 4-year audit of one Intensive Care Unit, during which time 1718 patients were admitted, shows that allocating 1% of all acute beds for intensive care purposes is not adequate. This is reflected by the high mortality among the patients discharged from the unit. Sophisticated monitoring equipment led to a marked improvement in mortality rates in each group to which it was applied. Simple to use, automated, biochemical equipment was very cost effective for blood gas measurement but less so for electrolyte determinations. Intensive care is very labour intensive, but the cost benefit in terms of lives saved is large. It is suggested that audits of this type help to identify the consequences, including adverse consequences, of decisions by administrators.

Adolescent↗
PubMed1977

SI units and acidity.

Explore the source record for details and available documents.

Hydrogen-Ion Concentration↗
PubMed1977

An unusual solvent.

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Anesthesia, Epidural↗
PubMed1977

Intravenous sedation and regional analgesia.

A double-blind study of 229 patients with the use of intravenous diazepam as compared with a placebo to produce sedation during local analgesia showed that significantly improved sedation occurred when diazepam was used. The diazepam was dissolved in cremophor and this reduced the pain of intravenous injection of the diazepam. One patient who received Cremophor only, showed a moderately severe allergic reaction. It is suggested that a small test dose should always be given before giving any drug which is dissolved in Cremophor.

Adolescent↗