Tenderness of beef roasts. Microwave vs. conventional cooking methods.
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Biomedical subjects
Publications and source records attributed to J A Bennett.
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A trial was conducted of Entonox for pain relief in minor, but painful, procedures which are conducted in wards, accident centres, and radiological units. The gas was self-administered by the patient using a demand apparatus. The administration was supervised by qualified nurses, specially trained in the properties of Entonox and the inhalational unit. The results confirm that the gas is safe in the hands of these personnel. Gratifying pain relief occurred in most patients with almost complete freedom from undesirable side effects. It is suggested that patient comfort in hospital can be considerably improved by utilizing this method of analgesia to the full.
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STUDY OBJECTIVE: To compare the hemodynamic, emergence, and recovery characteristics of desflurane-nitrous oxide (N2O) anesthesia with those of isoflurane-N2O anesthesia in elderly patients. DESIGN: Randomized study. SETTING: Main operating room of a major U.S. teaching hospital. PATIENTS: Thirty-four ASA physical status II and III patients aged 65 or older undergoing surgical procedures of greater than 1 hour duration. INTERVENTIONS: Group 1 (17 patients) received desflurane in 60% N2O for their surgical procedure. Group 2 (17 patients) received isoflurane in 60% N2O. Thiamylal 2 mg/kg administered intravenously (IV) induced anesthesia, and succinylcholine 1.5 mg/kg i.v. facilitated intubation. Muscle relaxation was maintained with vecuronium. Titration of the anesthetics maintained hemodynamics to within 20% of the patients' preinduction values. MEASUREMENTS AND MAIN RESULTS: Measurement of hemodynamics occurred every 2 minutes prior to skin incision and every 5 minutes thereafter. The times for discontinuation of inhaled anesthetics to eye opening, hand grip on command, and recall of name and date of birth were measured in a standardized fashion for both groups. The time to discharge from the postanesthesia care unit (PACU) was determined by a blinded PACU nurse using standard published criteria. The two groups did not differ with respect to demographics, hemodynamic stability, and times to eye opening (5 +/- 3 minutes for desflurane vs. 8 +/- 4 minutes for isoflurane), hand grip on command (9 +/- 4 minutes vs. 12 +/- 1 minutes), and recall of name and date of birth (13 +/- 8 minutes vs. 12 +/- 7 minutes). The median duration of PACU stay was significantly shorter (p < 0.03) in the desflurane group (80 minutes) compared to the isoflurane group (128 minutes). CONCLUSIONS: Desflurane may benefit elderly patients by providing a more rapid recovery from anesthesia, leading to a shorter PACU stay.
With the mounting incidence of human immunodeficiency virus infection not projected to peak until a decade into the next century, the question of nurses' willingness to engage in acquired immunodeficiency syndrome (AIDS) care remains important. Published data, however, do not support the frequently cited view that positive attitudes are exceptional. This analysis suggests reasons for misperceptions and also cautions that a continued focus on attitudes may not be useful unless we validate their influence on nursing action in clinical situations. Researchers must ask not only what differentiates the willing from the unwilling but also what alters the extent of nurses' willingness to engage. Even more important may be what influences how nurses engage, that is, what knowledge and skills they need to provide compassionate, effective care. The salience of these questions is especially apparent when we recognize how consistent the finding of positive AIDS-care attitudes has been through the last decade's plethora of studies. Without overlooking negative attitudes about, and some nurses' reluctance to participate in, AIDS care, research at this time should perhaps start with the premise that nurses want to nurse, and then focus on what they need to learn--cognitively, affectively, and technically--to do so competently and comfortably. In other words, the essential question is: What do nurses need to learn?
Dehydration is a serious risk for elders because total body water decreases with age, aging kidneys are less able to concentrate urine, and the sensation of thirst decreases. Geriatric nurses traditionally have assessed for dehydration, but its signs are difficult to detect in many patients. Instead, nurses, assistive personnel, and family members must work to prevent dehydration in elders. In contrast, dehydration may be beneficial to patients during the final stage of a terminal illness, although the decision to withhold or withdraw medical hydration may present a legal and ethical dilemma for nurses.
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