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Biomedical subjects

P G Morton

Publications and source records attributed to P G Morton.

At least 19 recordsLinked to original sources
PubMed2000

Risk factors for nosocomial pneumonia in critically ill trauma patients.

Nosocomial pneumonia is the most common pulmonary complication in trauma patients and the leading cause of death in nosocomial infections. A comprehensive review of pneumonia studies is provided. The Centers for Disease Control's nosocomial pneumonia pathogenesis model is reviewed and was used to guide the selection of risk factors evaluated in this study. The purposes of this research were to identify underlying dimensions (factors) of variables that increase the risk of nosocomial pneumonia and to identify predictors of nosocomial pneumonia in critically ill trauma patients.

Adult↗
PubMed2000

Predictors of atrial dysrhythmias for patients undergoing coronary artery bypass grafting.

BACKGROUND: Coronary artery bypass grafting is a commonly used and effective procedure for treating coronary artery disease. Atrial dysrhythmias are common after this surgery, but definitive characteristics that predict the development of such dysrhythmias postoperatively have not been determined. OBJECTIVES: To determine demographic, preoperative, intraoperative, and postoperative factors that are predictive of atrial dysrhythmias that occur after coronary artery bypass grafting. METHODS: A descriptive design was used to study a convenience sample (N = 162) of adult patients undergoing coronary artery bypass grafting. Data were collected via prospective chart review. Patients were grouped according to whether or not atrial dysrhythmias developed after coronary artery bypass grafting. Univariate analyses followed by multivariate analyses were conducted by using forward stepwise logistic regression to determine variables that are predictive of atrial dysrhythmias after coronary artery bypass grafting. RESULTS: Postoperative atrial dysrhythmias developed in 52 patients (32.1%). Univariate predictors of postoperative atrial dysrhythmias included older age (P < .001) and presence of right coronary artery disease (P = .004). Multivariate predictors of postoperative atrial dysrhythmias included age (odds ratio by decade = 1.93, 95% CI = 1.86-2.00, P < .001) and right coronary artery disease (odds ratio = 2.67, 95% CI = 1.14-6.23, P = .02). Hospital stay was significantly longer (P = .003) in patients who had postoperative atrial dysrhythmias than in patients who did have these dysrhythmias. CONCLUSIONS: Age and right coronary artery disease can be used to predict which patients will be at increased risk for atrial dysrhythmias after coronary artery bypass grafting.

Adult↗
PubMed2000

Challenging writer's block. How experienced authors make time to write.

Each of us can think of a thousand excuses why we can't write for publication. In reality each of these excuses is a writer's block that can be overcome. By using the tips described in this article, you will have the tools to conquer writer's block. With skillful planning you will be successful in publishing and the profession will benefit from your work. Just remember, once you see how nice your work looks in print, you won't be able to stop writing!

Adaptation, Psychological↗
PubMed1999

The evolution of internal defibrillators.

ICDs have reduced mortality from SCD to 2% per year, which is a record unmatched by any other form of therapy. With continued evolution, ICD systems should become easier to implant, smaller, more effective in managing a variety of abnormal rhythms, and more comfortable for the patient. Implementation of technological innovations in future-generation devices should continue to extend the frontiers as clinicians consider ICDs for an expanding range of therapeutic applications.

Arrhythmias, Cardiac↗
PubMed1999

The expanding role of signal-averaged electrocardiography.

Signal-averaged electrocardiography is a valuable diagnostic tool for determining which patients recovering from myocardial infarction are at risk of sudden death due to ventricular arrhythmias. Additionally, the value of this technique in determining which patients with ischemic heart disease and unexplained syncope are likely to have inducible sustained ventricular tachycardia has been established. This noninvasive screening procedure has shown promise in other clinical situations, but more investigation is needed before definitive recommendation can be made. Critical care nurses can help promote the success of signal-averaged electrocardiography by educating patients, promoting acquisition of a quality recording, helping allay patients' concerns, and participating in research activities.

Coronary Disease↗
PubMed1998

How to succeed in job interviewing.

Effective interviewing skills are critical for any nurse seeking a position in today's challenging job market. The successful applicant is more than just poised, appropriately dressed, and courteous. Jobs go to applicants who are well prepared, qualified, confident, and motivated. To win a competitive edge, convince employers of your genuine desire for the position, your ability to do the job, your positive attitude, and the strengths that distinguish you from other applicants.

Humans↗
PubMed1997

The pacemaker and defibrillator codes: implications for critical care nursing.

Scientific advances in the past few decades have resulted in the development of complex devices capable of treating both brady-dysrhythmias and tachydysrhythmias. Because critical care nurses play a vital role in the safe and effective functioning of these devices, they must understand the operation of the devices and patients' physiological and psychosocial responses to the technology. Careful monitoring, open and caring communication, and relevant patient education will make the important difference in patients' adjustment to use of an antidysrhythmic device.

Abbreviations as Topic↗
PubMed1997

Using a critical care simulation laboratory to teach students.

Critical care nursing is a dynamic and continuous process involving knowledge, values and attitudes, and motor skills. When combined with other teaching methods, a critical care simulation laboratory provides learners with an effective means to achieve the cognitive, affective, and psychomotor competencies necessary for the complexities of clinical practice.

Clinical Competence↗
PubMed1996

Using the 12-lead ECG to detect ischemia, injury, and infarction.

The 12-lead ECG is extremely valuable in helping the critical care nurse detect the presence of myocardial ischemia, injury, and infarction. With an understanding of the 12-lead ECG, the nurse can relate the ECG findings to the patient's coronary artery disease and can anticipate the clinical consequences both for the functioning of the cardiac muscle and for the cardiac conducting system.

Coronary Circulation↗
PubMed1996

Academic education. Creating a laboratory that simulates the critical care environment.

Educating students and practicing nurses for the complexities and demands of critical care is a challenge. Training in a laboratory that simulates the critical care setting is an excellent teaching method that can be used to supplement lectures and clinical experiences. Developing such a laboratory is an exciting and rewarding process that will promote learning and ultimately benefit the care of critically ill patients.

Clinical Competence↗
PubMed1995

Diagnosis and treatment of acute myocardial infarction.

Rapid diagnosis and treatment of myocardial infarction are essential for maximizing patient survival. Recent advances in early detection of creatine kinase myocardial band isoforms and other chemical markers, as well as increased use of echocardiography, magnetic resonance imaging, and nuclear imaging, have enhanced the diagnostic capabilities for providers caring for a patient suspected of myocardial infarction. In management of myocardial infarction, the focus continues to be primarily on using thrombolytics, percutaneous transluminal coronary angioplasty, and coronary bypass surgery. In addition, an array of pharmacologic agents aimed at reducing cardiac muscle damage, alleviating reperfusion injuries, and preventing thrombus formation are undergoing clinical trials. These agents may hold promise for the future treatment of myocardial infarction.

Angioplasty, Balloon, Coronary↗
PubMed1994

Update on new antiarrhythmic drugs.

Although strides have been made in the surgical and technological management of arrhythmias, the widespread use of antiarrhythmic drugs continues as a therapeutic approach. Based on a review of cellular electrophysiology and the classification system of antiarrhythmic drugs, this article addresses the actions, indications, adverse effects, and nursing implications for new antiarrhythmic drugs. Nurses are provided with the essential information about these drugs so that safe and effective therapy can be achieved.

Anti-Arrhythmia Agents↗
PubMed1993

The anaerobic reaction of bovine hemoglobin with divinyl sulfone: structural changes and functional consequences.

The anaerobic reaction of bovine hemoglobin with divinyl sulfone results in a non-cross-linked intramolecularly-modified new derivative. This chemically-modified hemoglobin is homogeneous with respect to its molecular mass (64 kDa) and electrophoretic properties. The absence of any 32 kDa band from its SDS-PAGE pattern proves the lack of intramolecular cross-linkage, while a single-peak high-performance gel-permeation chromatogram demonstrates the absence of intermolecular cross-linkage. The oxygen binding properties determined at 37 degrees C, 0.15 M Cl- and pH 7.4 display a P50 of 52 mmHg and a Hill coefficient n of 1.9. Under the same experimental conditions the oxygen affinity is not sensitive to chloride anions, suggesting that the covelant modification is in the beta-cleft. The maximum number of Bohr protons released is 0.8/tetramer, which is half that of normal bovine hemoglobin. The retention time in circulation, measured in rats, is similar to that of native bovine hemoglobin. Using a high molar ratio of divinyl sulfone to modified hemoglobin, it is feasible to effect anaerobic intermolecular cross-linkage. The polymerized material, isolated from a 24 h reaction, is a mixture of modified intermolecularly-crosslinked hemoglobins with a molecular mass range from 130 to approx. 500 kDa. The oxygen-transport characteristics of the polymerized material are similar to those of the modified non-cross-linked derivative, whereas its retention time in rats is increased three-fold with respect to native bovine hemoglobin.

Allosteric Regulation↗
PubMed1992

Bovine hemoglobin anaerobically reacted with divinyl sulfone: a potential source for hypothermic oxygen carriers.

The bifunctional reagent divinyl sulfone was anaerobically reacted with bovine hemoglobin to give a noncrosslinked intramolecularly-modified new derivative (HbBv-DVS). By employing a high molar ratio of divinyl sulfone to HbBv-DVS, it was possible to effect anaerobic intermolecular crosslinkage. The polymerized material (Poly HbBv-DVS) was shown to consist of a mixture of modified intermolecularly-crosslinked hemoglobins characterized by molecular masses ranging from 130 to -500 kDa. Some functional properties of HbBv-DVS and Poly HbBv-DVS have been evaluated in vitro and in vivo. Viscosities of HbBv-DVS solutions at temperatures as low as 15 degrees C and concentrations up to 14.0 g/dl were proved to be much lower than that of normal human blood at 37 degrees C (-4 cp). Poly HbBv-DVS (14.0 g/dl) was iso-oncotic (COP = 23 mm Hg) with plasma, and had viscosities of 3.37 and 4.57 cp at 37 and 15 degrees C, respectively. The clearance of Poly HbBv-DVS from the circulation was significantly delayed (T1/2 = 270 min), compared with those of HbBv and HbBv-DVS (T1/2 = 80 and 100 min, respectively. The P50 values were substantially increased (P50 = 52 and 61 mm Hg at 37 degrees C, 0.15 M Cl- and pH 7.4 for HbBv-DVS and Poly HbBv-DVS, respectively). Due to their right-shifted oxygen equilibrium curves, these derivatives still yielded P50 values of about 20 mm Hg at the low temperature of 15 degrees C, as compared with only 7 mm Hg for native bovine hemoglobin. These properties make HbBv-DVS and Poly HbBv-DVS potential new candidates for low-temperature organ perfusion.

Animals↗