Biomedical subjects
C L Muwanga
Publications and source records attributed to C L Muwanga.
Teaching trauma management in the accident and emergency department.
Since their introduction into the United Kingdom, Advanced Trauma Life Support Courses (ATLS) have preferentially offered places to Consultants and Senior Registrars. It is usual, however, for the initial resuscitation of the seriously injured patient to be performed by relatively inexperienced junior staff. It is incumbent upon those medical staff who are ATLS providers or instructors to design local courses, based upon ATLS principals, to train their junior staff in a structured approach to managing these patients. We describe one such local course which may serve as a model for others.
The incidence of recurrent soft tissue ankle injuries.
A prospective study was carried out to assess the incidence of recurrent soft tissue injuries to the ankle joint. Out of 310 patients with acute ankle injuries seen in the accident and emergency department at the Royal Victoria Infirmary, Newcastle upon Tyne, 101 (32.5%) had injuries which were severe enough to necessitate review in the follow-up clinic. Twenty-seven of these patients (26.7%) had sustained one or more previous injuries to the same ankle within the past 24 months. This rather high incidence of recurrence highlights the need to evaluate our current diagnostic and treatment policies in dealing with this common injury.
Cardiac contusion in patients wearing seat belts.
The incidence of myocardial contusion in patients wearing seat belts and requiring admission to hospital after road traffic accidents was examined. The criteria used for diagnosing contusion were serial electrocardiograms (ECGs) and estimation of CK-MB isoenzymes using the Isomune-CK (Roche) kit. Nine of the 14 patients (64 per cent) showed evidence of myocardial contusion. We suggest long-term studies to establish the true incidence among patients wearing seat belts.
A new treatment of stable lateral ligament injuries of the ankle joint.
A support for the treatment of stable injuries of the lateral ligament of the ankle has been designed. One hundred and seventy-five consecutive patients with acute injuries were studied. Unstable injuries were excluded by the use of the radiological anterior stress test. One hundred and forty-four patients with stable injuries were randomly allocated to three treatment groups: double Tubigrip, eversion strapping and the new support. The change in the range of movement was used as an objective measure of improvement. The new support was noticeably better than Tubigrip and eversion strapping.
Multiple rib fractures: transcutaneous nerve stimulation versus conventional analgesia.
We have used transcutaneous electrical nerve stimulation (TENS) to treat the acute pain of rib fractures. The study shows that it is an effective technique, achieving higher subjective pain relief scores by patients when compared with analgesic combinations, and achieving greater increases objectively in arterial oxygen concentrations and peak expiratory flow rates. TENS approaches the ideal analgesic in that it is continuous in effect and the dose is patient regulated. It is recommended as an important adjunct to conventional therapy.
Grade III injuries of the lateral ligaments of the ankle: the incidence and a simple stress test.
One hundred and seventy-five consecutive acute ankle injuries were assessed for instability. A simplified radiological anterior stress test, without anaesthesia, was used to assess instability. Nineteen patients (11%) showed evidence of gross instability (Grade III injuries). This is recommended as a simple screening test.
The measurement of ankle movements--a new method.
We describe a new goniometer for the measurement of dorsiflexion and plantarflexion of the ankle. It has been assessed for ease of use and reliability.