PubMed Health⌕ Search

Biomedical subjects

R S Goodman

Publications and source records attributed to R S Goodman.

5 recordsLinked to original sources
PubMed1991

Malpractice and the National Practitioner Data Bank: what OR nurses need to know.

The National Practitioner Data Bank will record any payments made for any reason related to a malpractice suit in a central data bank available to a number of designated parties. Hospitals will be required to request this information to screen applicants and at least every 2 years for appointment renewals. The data bank may also be consulted by hospitals and state licensing boards as they deem necessary and by professional societies when reviewing membership applications. It is in the best interests of all malpractice defendants to insist on adequate representation of their personal, professional, and financial interests, which may necessitate insurance carriers providing each defendant with individual counsel.

Databases, Factual↗
PubMed1990

Caught between law & nursing.

Nursing has entered a new era. It is no longer accountable only to tribunals that measure scientific and technical accuracy. As health-care providers, nurses must also be able to document and justify risks, costs, complications, diagnostic and therapeutic choices, and any other decision made in the course of practicing their profession. Additionally, acceptance and adjustment must be made for working within the new parameters established by the law. James Laughlin said, "A fox was crossing a meadow and the sheep went running, but the fox has no interest in them. He is interested in a field mouse or a chipmunk. People also have such problems." The third parties and government agencies are looking for mice. As competent nurses, you must ensure that the fox has no interest in you.

Defensive Medicine↗
PubMed1976

Cardiac and pulmonary failure secondary to adenotonsillar hypertrophy.

For over 15 years, upper respiratory tract obstruction due to adenotonsillar hypertrophy has been known to cause hypoxia, hypercapnia, increased pulmonary vascular resistance and thereby cor pulmonale and congestive heart failure. This is now an uncommon but not rare entity and three recent cases prompted this report. The typical patient is dyspneic with retractions, cyanosis, occasional periods of apnea and somnolence. Edema and hepatomegaly and at times splenomegaly are common. X-rays show cardiomegaly, which on electrocardiogram is found to involved mainly the right ventricle. The strict definition of cor pulmonale is right ventricular hypertrophy secondary to lung disease or abnormal pulmonary function, a definition that may logically be stretched to include abnormal respiratory function secondary to upper airway pathology. The mechanisms by which this occurs are generally agreed upon. Hypoxia has been demonstrated to cause pulmonary vasoconstriction. Acidosis and hypercapnia are thought by some to have the same effect. Pressure across the pulmonary vascular bed is also increased, as predicted by Poiseuille's law, by the high rate of blood flow required to maintain tissue oxygenation with poorly oxygenated blood. Conditions producing hypoxia of hypercapnia or both lead to hypertrophy and eventually to dilatation of the right ventricle. Three cases of children who underwent cardiac catheterization while suffering from cor pulmonale due to adenotonsillar hypertrophy are reported. Right ventricular pressure averaged 44/5, PAO2 72, pH 7.32, and PACO2 52. All were clinically improved following adenotonsillectomy. Cardiac catheterization was repeated in one case, with right ventricular pressure dropping from 44/5 to 21/2, pulmonary vascular resistance from eight units to three, and PACO2 from 62 to 44.

Adenoidectomy↗