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Biomedical subjects

I H Wilson

Publications and source records attributed to I H Wilson.

34 records · Page 2Linked to original sources
PubMed1989

A clinical sickness score for the critically ill in Central Africa.

Scoring systems provide a means for comparing results, ensuring consistent standards and evaluating changes in therapy. The APACHE II system depends partly on the results of laboratory tests which are not normally available in Central Africa. The aim of this study was to develop a scoring system based only on clinical observations. Six hundred and twenty-four consecutive admissions to the intensive care unit (ICU) were allocated a clinical sickness score (CSS) according to pulse rate, blood pressure, respiration rate, urine output, Glasgow Coma Scale, temperature and age. CSS was significantly associated with outcome, there being no significant difference between actual and predicted outcomes calculated by logistic regression analysis. There was a significant difference between mean scores for survivors and non-survivors in all diagnostic groups except diabetes. The proportional change in score from admission was also significantly associated with outcome on each subsequent day in ICU. The CSS provides an objective measure of illness severity for critically ill patients in Africa.

Developing Countries↗
PubMed1989

Perioperative mortality in Zambia.

An audit of 10,592 consecutive operations performed during 7 months in a central African teaching hospital is presented. Eighty deaths occurred within 6 days of operation, an overall mortality rate (OMR) of 7.55 per 1000 operations. Deaths are classified as avoidable or unavoidable. Avoidable deaths are those for which there was evidence of mismanagement of a type and degree sufficient to account for the death. There were 35 avoidable deaths, an avoidable mortality rate (AMR) of 3.3 per 1000 operations. Avoidable factors which contributed to death are classified as surgical, anaesthetic, and administrative. Surgery and anaesthesia at this hospital are described, and possible means of decreasing avoidable mortality discussed. The value of combined anaesthetic and surgical audit is emphasised.

Adult↗
PubMed1988

A drawover Boyle's machine. Development and evaluation in Zambia.

A standard Boyle International anaesthetic machine was modified to allow operation in either a continuous flow or a drawover mode. This was achieved by fitting a valve in the backbar which allows entrainment of air under drawover conditions. The details of the valve and modification are discussed and an evaluation of the machine in a Central African hospital is presented.

Anesthesia, Inhalation↗
PubMed1987

Single breath induction of anaesthesia with isoflurane.

This study has compared a single breath induction technique and a conventional inhalation induction technique using isoflurane in nitrous oxide and oxygen. Each group consisted of 36 unpremedicated patients. Single breath induction was associated with fewer problems on induction, but required more patient co-operation. Ninety-four percent of patients were willing to repeat the single breath induction technique, compared with 74% of patients receiving a conventional inhalation induction.

Adolescent↗
PubMed1987

An epidural infusion technique for labour.

A regimen to facilitate control of epidural infusions in labour has been developed which allows midwives to alter infusion rates to maintain satisfactory analgesia. The technique was used successfully in 30 patients and, in a prospective study, was compared with women who received conventional top-up epidurals. It was found that infusions provided comparable analgesia and decreased midwife workload but resulted in a higher dosage of bupivacaine.

Adult↗
PubMed1986

Regional analgesia with bupivacaine in dental anaesthesia.

Sixty (ASA 1) patients were studied to determine the effect of bilateral local infiltration with 0.25% bupivacaine plain during third molar extraction under general anaesthesia. Bupivacaine infiltration significantly reduced the incidence of wide complex extrasystoles (P less than 0.05) during surgery and the severity of dental pain (P less than 0.05), when assessed at 6 h after operation.

Adolescent↗