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Biomedical subjects

P J Shirley

Publications and source records attributed to P J Shirley.

At least 19 recordsLinked to original sources
PubMed2006

Retrieval medicine: a review and guide for UK practitioners. Part 1: clinical guidelines and evidence base.

It has been proposed that formalisation of training to encompass prehospital and retrieval medicine should be considered in the UK, using those currently involved in immediate care as the core providers of these services.(1) Although there is an overlap in some aspects of "prehospital" and "retrieval" medicine, there are some distinct differences, both in terms of the skill base and service provision required. Retrieval medicine is the term used to indicate the use of an expert team to assess, stabilise and transport patients with severe injury or critical illness. Implicit in this process is the early provision of specialised advice to the health providers at the patient's side. In the UK, there is currently no national and often no regional strategy to coordinate the provision of secondary retrieval services for critically ill patients. International models do exist, which may be of help in this respect.

Ambulances↗
PubMed2006

Retrieval medicine: a review and guide for UK practitioners. Part 2: safety in patient retrieval systems.

Retrieval and transfer of critically ill and injured patients is a high risk activity. Risk can be minimised with robust safety and clinical governance systems in place. This article describes the various governance systems that can be employed to optimise safety and efficiency in retrieval services. These include operating procedure development, equipment management, communications procedures, crew resource management, significant event analysis, audit and training.

Clinical Competence↗
PubMed2006

Critical care delivery: the experience of a civilian terrorist attack.

It has been recognised for some time that a terrorist incident was threatened in the U.K. and it has been noted previously in the JRAMC that the locations for terrorist atrocities are likely to be more diverse than previously experienced. July 7th 2005 witnessed the first terrorist suicide bombing on the U.K. mainland, targeting the public transport system in London. These attacks were unprecedented in both scale and intensity but they were anticipated in London. However there were clear difficulties, relating to multiple sites, their location underground and early problems with communication (2). This article highlights some of the experiences and learning points of the Intensive Care Medicine Service at the Royal London Hospital (RLH) in the wake of the July 7th bombings. The RLH was the single biggest receiver of casualties (195); seven of whom were admitted to the Intensive Care Unit. The Defence Medical Services have tri-service representation (both regular and reserve) at the RLH in Emergency Medicine and Pre-hospital Care, Surgical Services and Intensive Care Medicine.

Adult↗
PubMed2000

Transportation of the critically ill and injured patient.

Transferring the seriously ill and injured is becoming a more formalized procedure in the UK. Whether from an accident site to medical care or between hospitals, the public expects that organized services are in place for safe patient transfer. As this is a developing subspeciality it is necessary to review the developments that have occurred over the previous 5 years.

Air Ambulances↗
PubMed1998

Parental anxiety before elective surgery in children. A British perspective.

This study measures the anxiety levels in 100 parents of children scheduled for elective surgery at the Royal Aberdeen Children's Hospital. Anxiety levels were quantified using the Leeds scale for self-assessment of anxiety. Forty-two per cent of parents were significantly anxious. Mothers were identified as being more pathologically anxious than fathers. The 'anxious' parents were specifically more anxious about the surgery, anaesthesia, postoperative pain and treatment, and hospitalisation in general. All parents, whether identified as anxious or not, agreed on factors likely to reduce anxiety: pre-operative information from staff, being able to accompany their child to the operating theatre and being present at induction of anaesthesia.

Adolescent↗