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Biomedical subjects

R H Riley

Publications and source records attributed to R H Riley.

At least 19 recordsLinked to original sources
PubMed2002

Life-threatening pulmonary oedema secondary to tracheal compression.

We present a case of negative pressure pulmonary oedema due to an overlooked cause. A 45-year-old female patient presented to the emergency department unconscious with severe pulmonary oedema. Subsequent investigations revealed a thyroid goitre causing significant tracheal compression. This case report highlights an extremely rare but potentially dangerous sequela of upper airway obstruction.

Airway Obstruction↗
PubMed1997

Anaesthetists' attitudes towards an anaesthesia simulator. A comparative survey: U.S.A. and Australia.

Anaesthesia simulation has been suggested as a method to enhance the training of clinicians without exposing patient to risk. Recently, two anaesthesia simulators have become commercially available in the U.S.A. Attitudes towards anaesthesia simulators have not been previously surveyed. With institutional approval, a survey questionnaire was given to 1. all clinical staff of the Department of Anesthesiology, University of Pittsburgh Medical Center, and 2. all anaesthetists attending the Annual General Meeting of the Australian Society of Anaesthetists. An information sheet containing details about anaesthesia simulation in general and the special capabilities of a particular commercial anaesthesia simulator was included with the survey instrument. The survey was anonymous and contained 15 questions. Attitudinal responses were recorded using an anchored visual analog 100 mm scale. We surveyed anaesthetists during September-October 1993. Completed forms were returned by 183 anaesthetists. Respondents were aged 25-67 years (mean age 41 +/- 10 yr) and were grouped by staff position (78% faculty, 22% trainees), sex (79% male; 21% female), country of practice (44% Aust, 56% U.S.A.) and years in practice. Seventy-three per cent staff were in favour (VAS > 60) of departmental purchase of a simulator (with no significant difference between countries) and 76% expressed willingness (VAS > 60) to undergo testing in their own time (with Australian anaesthetists significantly more willing to do so). However, 65% were not in favour (VAS < 40) of the compulsory use of a simulator for re-certification or re-accreditation of anaesthesia practitioners, with American anaesthetists (anesthesiologists) significantly more opposed to it. The most frequent comment related to the cost. There is majority support for the purchase of an anaesthesia simulator but there is widespread concern for its high cost. In general, anaesthesia simulation is perceived more as an education tool rather than an instrument for (re)certification.

Accreditation↗
PubMed1997

Prevalence of obesity in surgical patients: a comparative survey in the United States and Australia.

STUDY OBJECTIVE: To determine and compare the prevalence of obesity in adult patients undergoing surgery in an Australian and a United States teaching hospital. DESIGN: Retrospective and prospective surveys. SETTING: Operating theatres at two university hospitals. INTERVENTIONS: Patients scheduled for surgery during two consecutive months at Royal Perth Hospital (RPH) in Perth, Western Australia, and Montefiore-University Hospital (MUH) in Pittsburgh, Pennsylvania, were studied. Age, sex, American Society of Anesthesiologists class, height, and weight data were collected from anaesthesia records. Body mass index (BMI) was calculated according to the formula: BMI = weight/height2 (kg m-2). Obesity was defined as BMI > or = 30, morbid obesity as BMI > or = 35, and overweight as BMI = 25-30. RESULTS: Data from 1604 patients were analysed. Patients ranged in age from 15 to 93 years (mean +/- SD = 52.4 +/- 20). The RPH group was slightly older (RPH = 54 +/- 20 years; MUH = 50 +/- 19 years). Men from MUH were significantly taller (MUH = 176 +/- 8 cm; RPH = 174 +/- 9 cm) and MUH women were also significantly taller (MUH = 162 +/- 8 cm; RPH = 160 +/- 8 cm) than Australian patients. Mean weight was significantly different between hospitals (RPH = 73.5 +/- 16 kg; MUH = 77.9 +/- 20 kg). Mean BMI was also significantly different between hospitals (RPH = 25.8 +/- 5; MUH = 27.3 +/- 7). The proportion of obese men (RPH = 15.7%; MUH = 21.0%), obese women (RPH = 21.9%; MUH = 30.2%), morbidly obese men (RPH = 2.1%; MUH = 6.8%), and morbidly obese women (RPH = 7.8%; MUH = 15.1%) was significantly greater in the MUH study population. However, the proportion of overweight patients was similar between countries. A greater proportion of women were found to be obese or morbidly obese in both hospitals. CONCLUSION: Obesity is more prevalent among surgical patients at MUH than at RPH, and is more common among women. The proportion of obesity seen in this survey is greater than results from general population surveys.

Adolescent↗
PubMed1997

Analgesia following thoracotomy: a survey of Australian practice.

This survey examines pain management after thoracotomy in Australian hospitals. Questionnaires were sent to senior thoracic anaesthetists at 27 hospitals (16 public and 11 private) with thoracic surgical units. Twenty-six anaesthetists replied and 24 responses were included in the analyses. Seventy-two percent of respondents were from hospitals with acute pain services (APS), and in 94% of these hospitals patients are reportedly visited by the APS. The most frequently used analgesic modalities are epidural analgesia, intravenous patient-controlled analgesia (IVPCA), and nurse-controlled intravenous opioid infusions. Over half of the anaesthetists reported using local anaesthetic intercostal nerve block, non-steroidal anti-inflammatory drugs (NSAIDs), or paracetamol. Combinations of analgesic techniques were cited frequently. Respondents reported that cryoanalgesia, interpleural blockade, paravertebral blockade, subarachnoid infusions, ketamine, and transcutaneous electrical nerve stimulation are used infrequently. Anaesthetists from public hospitals reported using epidural analgesia, IVPCA and NSAIDs more frequently than those from private hospitals. When epidural analgesia is used, most respondents place the catheter in the mid-thoracic region (91%), use a regimen of opioids plus local anaesthetic (96%), use a constant infusion technique (100%), and continue analgesia for up to three days (83%). Over half of the respondents reported that post-thoracotomy patients are nursed in a high-dependency area. Seventy-nine percent of respondents selected epidural analgesia as the best available analgesia technique, whereas 21% consider IVPCA to be the best. Only 75% of respondents reported that the type of analgesia they consider best is also the type which they use most frequently.

Acetaminophen↗
PubMed1994

Effects of caffeine or diphenhydramine on visual vigilance.

The effects of two drugs having opposite effects on the central nervous system were investigated using a newly developed visual vigilance task. Twenty-four male volunteers (median age = 20) performed the task on three separate occasions; after consuming placebo, caffeine (200 mg), or diphenhydramine (25 mg), in a double-blind, Latin Square design. At least 2 days intervened between drug administrations. Caffeine use was restricted for 10 h and smoking for 3 h before drug administration. When compared with placebo, caffeine significantly increased the number of correct responses and decreased response times, whereas diphenhydramine decreased the number of correct responses and increased response times. Low habitual consumers of caffeine (< 100 mg/day) and non-smokers had more correct responses than did high habitual caffeine consumers (> 100 mg/day) and smokers, but only in the placebo condition. Non-smokers had faster response times than smokers only in the placebo condition. Both caffeine and diphenhydramine altered certain aspects of mood.

Adult↗