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P Smart

Publications and source records attributed to P Smart.

6 recordsLinked to original sources
PubMed1996

Oximeter reliability in a subzero environment.

BACKGROUND: Pulse oximeters optimize care in the pre-hospital setting. As British Columbia ambulance teams often provide care in subzero temperatures, we conducted a study to determine the reliability of 3 commercially-available portable oximeters in a subzero environment. NULL HYPOTHESIS: We hypothesized that there is no significant difference between SaO2 readings obtained using a pulse oximeter at room temperature and a pulse oximeter operating at sub-zero temperatures. METHODS: Subjects were stable normothermic children in intensive care on Hewlett Packard monitors (control unit) at room temperature. The test units were packed in dry ice in an insulated bin (temperature - 15 degrees C to -30 degrees C) and their sensors placed on the subjects, contralateral to the control sensors. Data were collected simultaneously from test and control units immediately following validation of control unit values by co-oximetry (blood gas). RESULTS: No data were unacceptable. Two units (Propaq 106EC and Nonin 8500N) functioned well to < -15 degrees C, providing data comparable to those obtained from the control unit (p < 0.001). The Siemens Micro O2 did not function at the temperatures tested. CONCLUSIONS: Monitor users who require equipment to function in subzero environments (military, Coast Guard, Mountain Rescue) should ensure that function is reliable, and could test units using this method.

Analysis of Variance↗
PubMed1994

Characteristics of dysphagia in children with cerebral palsy.

Videofluoroscopic modified barium swallow (VMBS) examinations may provide clinically relevant information regarding deglutition in children with cerebral palsy and dysphagia. A retrospective review of clinical evaluations and VMBS studies on 90 consecutive children with cerebral palsy and dysphagia was completed. Most children were referred because of concerns regarding airway protection during oral feedings. Most children had multiple disabilities and 93% were nonambulatory. The majority of children were totally dependent for oral feedings (80%). Oral and pharyngeal phase abnormalities were present in almost all patients. Abnormalities of deglutition were observed only while swallowing specific food textures in the majority of patients. Aspiration of specific food textures was significantly more common than aspiration of all food textures (p < 0.0001). Finally, aspiration was silent in 97% of the patients. VMBS studies can provide clinicians with valuable information regarding the most appropriate food textures and rates of oral feeding for children with cerebral palsy and dysphagia.

Adolescent↗
PubMed1994

Silent aspiration prominent in children with dysphagia.

Children with neurologically-based dysphagia are at high risk for silent aspiration. Aspiration can lead to complications such as acute pneumonia and chronic lung disease. Thorough evaluation of the oral, pharyngeal, and esophageal phases of swallowing is crucial for patients with dysphagia. The videofluoroscopic modified barium swallow study (MBS) is the procedure of choice for children to delineate the pharyngeal and upper esophageal phases of the swallow that can only be inferred by bedside clinical assessment. This study describes attributes of aspiration and pharyngeal motility in a large sample of infants and children assessed with MBS. Aspiration was observed in 48 (26%) of 186 children, primarily on liquid before or during swallows. Aspiration was trace (less than 10% of a bolus) and silent in 94%. Relationships to clinical history and implications for management are discussed. Given the lack of objective clinical information to identify children at risk for aspiration, MBS should be considered in all children with severe dysphagia to rule out or confirm aspiration.

Adolescent↗
PubMed1992

Linitis plastica carcinoma of the colon mimicking Crohn's colitis.

Primary linitis plastica carcinoma of the colon is an uncommon morphological type of colorectal carcinoma. Linitis plastica of the stomach may spread to the colon producing a similar lesion to primary colonic linitis plastica. This case report describes a case of linitis plastica of the colon that had many of the clinical, endoscopic, radiological and operative features of Crohn's colitis. The precise origin of the linitis plastica carcinoma was not clear: it may have been clonic or gastric, although the former is favoured. This case illustrates a number of facets of this unusual colonic carcinoma.

Biopsy↗
PubMedDate not supplied

Care of the injured pregnant patient.

Nursing care of the obstetric patient requires an understanding of normal changes that occur during pregnancy in order to make critical decisions concerning care for her and her infant. Trauma during pregnancy threatens not only the pregnant woman but also her infant. This article reviews the normal physiologic changes relating to pregnancy. It includes a checklist for orthopaedic nurses to use when caring for a pregnant patient.

Female↗