Biomedical subjects

S Quirke

Publications and source records attributed to S Quirke.

4 recordsLinked to original sources

PubMed1997

Development of a sedation scoring protocol.

The creation of a research and development post within the Intensive Therapy Unit (ITU) environment at St Helier has provided the opportunity to review all aspects of practice to ensure that the care delivered is evidence-based and not merely rooted in routines and rituals. The first aspect of care to be examined was our sedation practice. It was felt that sedation procedures varied at times and that a research-based protocol was necessary to ensure that patients receive optimal levels of sedation consistently. A 'sedation scoring group' was set up in order to achieve this. Questionnaires were sent to all members of staff and the resulting data used to formulate a sedation scoring system and algorithm as well as a protocol which included information on sedative drugs and the effects of over- and under-sedating patients.

Algorithms↗

PubMed1996

Changing ventilator tubing circuits every seven days versus every 72 hours: proposed practice based on literature review.

The changing of ventilator circuitry is a costly, time-consuming exercise. The current practise of changing circuits every 72 hours is not supported by research and is therefore being challenged. This literature review supports a change in practice from changing circuits every 72 hours to every 7 days or between patients, whichever occurs first. Previous research studying the time interval between circuit changes is reviewed. Contributing factors such as the contamination of tubing by various means are discussed and finally research-based proposals for future practice will be made.

Equipment Contamination↗

PubMed1993

The development of a pressure area scoring system for critically ill patients: a pilot study.

At present no suitably sensitive scoring system is available to differentiate degrees of risk of developing pressure sores in critically ill people. The object of this study is to produce a tool that has been validated to identify and weight risk factors associated with critically ill patients. In a pilot study data were collected on 50 patients and analysed, using multiple regression analysis, to produce a set of weighted coefficients (C) suitable for use as a scoring system. The feasibility of the technique is demonstrated and five highly significant factors are described: adrenaline infusions (C = 14), noradrenaline infusions (C = 15), diabetes (C = 15), restricted movement (traction, post-operative pain, intra-aortic balloon pump and haemofiltration) (C = 8) and patients too unstable to turn (C = 17). All coefficients not equal to 0 with p < 0.05. Risk factors which may become significant in a larger study are identified. In order to develop the full tool a further multi-centre study is proposed.

Aged↗

PubMed1991

Lymphocyte transformation and thiuram sensitization.

The use of a lymphocyte transformation test (LTT) to confirm allergic contact dermatitis from thiurams has been investigated. The responses of peripheral blood mononuclear cells (PBMC) from thiuram-sensitive and non-sensitive individuals following culture with dimethylcarbamoyl-protein (human serum albumin; HSA) and dimethylthiocarbamoyl-HSA conjugates has been compared. Only PBMC from those patients who were patch-test-positive with thiuram-mix and sensitized to tetramethylthiuram monosulphide (TMTM) or TMTM and tetramethylthiuram disulphide (TMTD) exhibited significant proliferative responses to these conjugates. Thiuram-patch-test-negative patients and control donors with no history of allergic contact dermatitis failed to mount a significant response to any concentration of either conjugate. Two of the thiuram-sensitive patients were also nickel-patch-test-positive, and PBMC isolated from these donors, but not from nickel-patch-test-negative patients, proved positive in a nickel LTT. The data reveal that relevant hapten-protein conjugates are capable of provoking specific human lymphocyte proliferative responses in vitro, and that, using this technique, the LTT can, in principle, be used for the investigation and/or diagnosis of skin sensitization to lipophilic contact allergens.

Cell Division↗