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Biomedical subjects

I Phair

Publications and source records attributed to I Phair.

5 recordsLinked to original sources
PubMed2003

Population based epidemiology of ankle sprains attending accident and emergency units in the West Midlands of England, and a survey of UK practice for severe ankle sprains.

OBJECTIVES: To estimate the incidence of ankle sprains and severe ankle sprains attending accident and emergency (A&E) units; to describe current practice for severe ankle sprains in A&E units in the United Kingdom. METHODS: Crude age and sex specific incidence rates were calculated for four health districts from cases ascertained from data on seven A&E clinical information systems. Case records of patients with ankle sprains at an A&E unit in another health district were audited and the proportion of severe ankle sprains calculated. UK A&E units were surveyed about their usual treatment of patients with severe ankle sprains. RESULTS: The estimate of the crude incidence rate of ankle sprains was a minimum of 52.7 per 10 000, rising to 60.9 (95% CI 59.4 to 62.4) when figures were adjusted for the proportion of patients without a diagnostic code (13.7%). There were important age-sex differences with unadjusted rates observed from 127.8 per 10 000 (CI 115.5 to 140.0) in girls aged 10-14 years to 8.2 (CI 4.2 to 12.3) in men aged 70-74 years. As 14% of ankle sprains attending A&E were classed as severe, this would equate to 42 000 severe ankle sprains per year in the UK. In the UK wide survey, there was a response rate of 79% (211 of 266). Among the responders, Tubigrip was used routinely in 55%, below knee casts in 3%, and braces in 2%. Boots were not used routinely in any unit. CONCLUSION: While there is considerable variation in severe ankle sprain management in UK A&E units, most are treated with the minimal mechanical support of Tubigrip.

Adolescent↗
PubMed2000

Physiological variables during open chest cardiopulmonary resuscitation: results from a small series.

OBJECTIVES: To evaluate the efficacy of open chest cardiac compressions for the resuscitation of pre-hospital cardiac arrest patients presenting with non-shockable rhythms on arrival at the emergency department. DESIGN: Prospective observational study of outcomes and physiological parameters during open chest cardiac compressions for non-traumatic pre-hospital cardiac arrest. SETTING: Large accident and emergency department receiving pre-hospital cardiac arrest patients with pre-hospital advanced life support provided by ambulance service paramedics. SUBJECTS: All patients in whom open chest cardiac compressions were performed by the author (JCC) during the period from January to May 1998 (seven patients). INTERVENTIONS: Assessment of artificial pulse and blood pressure generated by open chest cardiac compressions, measurement of arterial blood gases, recovery of spontaneous cardiac output, recovery of spontaneous ventilatory efforts and survival to admission and to discharge. RESULTS: Artificial pulse and recordable non-invasive blood pressures were generated in all patients; PO2 was physiological or supra-physiological in all patients; PCO2 was physiological or subphysiological in all patients; pH and base deficit were not corrected in the five patients with repeated samples (including two receiving 50 mEq sodium bicarbonate); three patients recovered spontaneous cardiac output (ROSC); two patients recovered spontaneous respiratory efforts (unrelated to ROSC); no patients survived to admission. CONCLUSIONS: Open chest cardiac compressions provide effective perfusion, enabling correction of ventilation parameters and showing clinical signs of adequate perfusion. However, acidosis was not corrected and the use of 50 mEq sodium bicarbonate was ineffective.

Aged↗
PubMed1994

Intravenous pyridoxine in acute ethanol intoxication.

Intravenous pyridoxine was evaluated as an agent for the reversal of ethanol-induced central nervous depression in a randomised double blind controlled study of 108 patients presenting with a clinical diagnosis of acute ethanol intoxication to two accident and emergency departments. Level of consciousness, measured by a modified Glasgow coma scale, showed no significant change after a single 1 g dose of intravenous pyridoxine when compared to controls given saline. The mean fall in blood alcohol concentration after one hour was 33 mg dl-1 (7.2 mmol l-1) in both groups suggesting that pyridoxine has no antidotal action and no short term effect on the rate of metabolism of ethanol.

Adult↗
PubMed1988

Achilles paratendonitis: an evaluation of steroid injection.

A prospective, randomised, double-blind study of 28 patients presenting with Achilles paratendonitis was undertaken in order to evaluate the role of peritendonous injection of methy prednisolone acetate (Depo Medrone). At presentation patients were either administered peri-tendonous injection of 40 mgs of methyl prednisolone acetate suspended in 1 ml of 0.25% marcaine or 2 ml of 0.25% marcaine alone. Response was gauged by resolution of pain, tenderness and return to normal activity. Patients who failed to respond to initial treatment were crossed over to the other group at 12 weeks. All patients received standardised physiotherapy. Results indicate that peri-tendonous injection of methyl prednisolone acetate is of no value in Achilles paratendonitis.

Achilles Tendon↗