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Biomedical subjects

P Staniforth

Publications and source records attributed to P Staniforth.

At least 19 recordsLinked to original sources
PubMed1996

"Fast tracking" patients with a proximal femoral fracture.

OBJECTIVE: To assess the management of elderly patients presenting to the accident and emergency (A&E) department with a proximal femoral fracture. METHODS: A retrospective audit carried out on 30 patients with proximal femoral fracture showed an unacceptably long waiting time in the A&E department. A new "fast track" system for managing these patients, involving the use of a flow chart for expediting admission, was devised. A prospective study of 100 patients > 60 years of age with proximal femoral fracture admitted by fast track system was then carried out. RESULTS: Implementation of the fast track system resulted in earlier admission to the ward (median time to admission 2.5 h v 4.5 h in the retrospective audit, P < 0.001). Eighteen patients were not admitted by fast track during the study period, in some cases because of inconclusive diagnosis or because there was no identifiable orthopaedic bed; mean admission time for this group was 4 h 8 min. CONCLUSIONS: The fast track system was of benefit to all involved, including the patient, A&E staff, ward staff, and orthopaedic personnel.

Aged↗
PubMed1991

Scaphoid fractures and wrist pain--time for new thinking.

As with the practice of all medicine, an early accurate diagnosis is essential. The same applies after injury. The diagnosis should be made at the earliest opportunity--this should be done as soon as an appropriate expert is able to examine the patient, assess adequate radiographs and, where necessary, order special investigations such as a bone scan. By this means, distal radial fractures, injuries of the radioulna joint, dislocated lunates, Bennett's fractures, dorsal capsular wrist sprains, avulsion fractures etc. can be managed accordingly. Those patients in whom clinical examination, plain radiographs and/or bone scans show minor injuries can be advised about pain relief whilst staying active either at work or in the home using a light supportive removable bandage or splint. Where doubt remains and whilst keeping the patient comfortable, a bone scan may be requested. Its availability together with updated clinical and, if necessary, radiological assessment, will define a further group of patients who can be advised definitively either about active treatment or a return to normal activity. Only a few wrists will continue to defy definitive diagnosis requiring the continuance of expert advice and investigation. When a scaphoid fracture is diagnosed, its site, degree of displacement and any associated instability should determine the degree of intervention and the length of time required in plaster. This again gives the patient more information about the long-term future than many have had hitherto. The patient's individual requirements may be taken into account; some are happy to tolerate 2-3 months in plaster whilst others want the early function which an uncomplicated operation might offer.(ABSTRACT TRUNCATED AT 250 WORDS)

Carpal Bones↗
PubMed1987

Urinary retention after total hip replacement. A prospective study.

We report a prospective study of the factors associated with acute urinary retention after total hip replacement in 103 consecutive male patients. Eleven patients (10.7%) developed retention after operation. Of the factors investigated before operation three had predictive value: inability to pass urine into a bottle whilst lying in bed, urinary peak-flow rates indicative of obstruction, and a history of previous bladder outflow problems. This study suggests that patients showing one or more of these factors should be assessed and if necessary treated by a urologist before arthroplasty, so as to avoid the need for catheterisation, and the consequent risk of deep infection.

Adult↗
PubMed1979

Intravenous regional anaesthesia in upper limb trauma.

Practical experience in the use of Bier block anaesthesia of the upper limb is described. The revival of this well-tested technique is particularly relevant in circumstances where, for a variety of reasons, the administration of a general anaesthetic is impracticable. The quality of surgery, the safety of anaesthesia and the patient's comfort can be well maintained by following a few simple rules. We have satisfied these criteria in this series by using low doses which are safe and sufficient in a busy accident department.

Adolescent↗