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Biomedical subjects

R McGlone

Publications and source records attributed to R McGlone.

18 recordsLinked to original sources
PubMed2001

A comparison of intramuscular ketamine with high dose intramuscular midazolam with and without intranasal flumazenil in children before suturing.

OBJECTIVES: (a) To compare the use of high dose intramuscular midazolam with and without intranasal flumazenil in children after suturing. (b) To compare the use of high dose intramuscular midazolam with low dose intramuscular ketamine in children before suturing. METHODS: 87 children, aged between 1 and 7 years, presenting with simple wounds needing sedation, were studied. Children considered combative (n=47) were given ketamine (2.5 mg/kg intramuscularly). The remaining 40 children were given midazolam (0.4 mg/kg intramuscularly) with and without flumazenil (25 microg/kg, intranasally). RESULTS: The median oxygen saturation was 97% in both midazolam groups. Flumazenil significantly reduced the amount of agitation during recovery (p=0.048) and also the time at which children were ready for discharge (median 55 versus 95 minutes, p value <0.001). After discharge both midazolam groups had an unsteady gait (75%) and there was no significant difference in the duration. As expected because of the deliberate selection of combative children into the ketamine group, the pre-sedation behaviour was slightly more disturbed compared with the midazolam group (p=0.10). However, the ketamine group was less agitated during local anaesthetic and suturing p<0.001. CONCLUSION: Intramuscular midazolam (0.4 mg/kg) did not effectively sedate the children, in that a significant number still had to be restrained. However, none could remember the suturing. Intranasal flumazenil seems to be effective in shortening the time to discharge. If midazolam is to be used then a dose high enough to produce full amnesia should be used, there seems to be no advantage in increasing the dose further. Low dose intramuscular ketamine remains the drug of choice.

Administration, Intranasal↗
PubMed1995

Laparoscopic training for theatre personnel.

Many theatre units have begun to liaise with surgeons and with manufacturers to train theatre personnel to work as part of a team carrying out laparoscopic surgery. Indeed, some courses are already well established. This short article describes the experience of one theatre unit of such a training programme.

Education, Nursing, Continuing↗
PubMed1990

Use of Ames SG10 Urine Dipstick for diagnosis of abdominal pain in the accident and emergency department.

In a prospective study of 1112 patients presenting to the Accident and Emergency Department with abdominal pain; the SG10 Ames Urine Dipsticks were shown to be a valuable screening test for the detection of infected urine. Introducing this technique would reduce by at least 37% the number of urgent requests for microscopy of midstream urines (MSUs). Dipstick testing however was not a reliable screening test for microscopic haematuria.

Abdominal Pain↗
PubMed1990

Reducing the pain of intradermal lignocaine injection by pH buffering.

The effect of pH on the pain of administration and efficacy of 1% lignocaine was investigated in a prospective, double-blind, randomized study of 20 adult volunteers. Onset and spread of anaesthesia by intra-dermal injection were not altered, but there was a significant reduction in pain scores with a higher pH. Overall, pain scores appear to be more dependent on the speed of injection rather than alteration of pH.

Adolescent↗
PubMed1989

Do we need to cross-match blood in closed fractures of the shaft of the femur?

A total of 50 patients with isolated closed fractures of the shaft of the femur are presented. Eleven per cent of the blood specimens were merely grouped and saved on arrival, and the remaining 39 (78 per cent) were crossmatched between 2 and 6 units. Overall, 138 units of blood were crossmatched and only 16 units were used (11.5 per cent), none of them actually in the accident and emergency department. We can find no record of blood being given for resuscitation. The use of blood appeared to depend on the occurrence and timing of operation. We suggest that local policy for crossmatching blood for such patients takes into account the orthopaedic surgical plan, but that the routine instruction to cross-match blood on arrival be abandoned.

Adolescent↗
PubMed1988

Gastric lavage.

Explore the source record for details and available documents.

Ampicillin↗
PubMed1988

The use of muscle relaxant to supplement local anaesthetics for Bier's blocks.

In searching for the 'ideal' muscle relaxant for use with intravenous regional anaesthesia, muscle relaxation was assessed with and without the addition of Atracurium to Bier's Block in four volunteers. This was followed by a clinical study of 36 patients with wrist fractures to confirm the drug's safety and examine the possible clinical advantages of using a muscle relaxant. The addition of 2 mg of Atracurium to the Bier's Block improved the ease of reduction (P less than 0.025) and the quality of analgesia (P less than 0.05) (Mann-Whitney U test). The authors conclude that the addition of Atracurium to a Bier's Block is useful in selected patients with a wrist fracture.

Anesthesia, Local↗
PubMed1988

Hypnozoites in Bradford.

We present two paediatric cases of a condition that should be considered when a child of an immigrant family presents to the A&E department with a pyrexia with no obvious focus of infection.

Animals↗
PubMed1987

Femoral nerve block in the initial management of femoral shaft fractures.

The aim of this study was to demonstrate that the under-used technique of femoral nerve block (F.N.B.) (Berry, 1977) has excellent analgesic action for femoral shaft fractures when performed by junior staff. It had no recorded side effects and was used in all age groups for fractures at all levels along the femoral shaft. Twenty-seven consecutive patients were studied as they presented in an accident room, all received a femoral nerve block (10 ml 1% Lignocaine with 1:200,000 adrenaline) from unsupervised junior accident and emergency staff instructed in the technique. Each case was subsequently followed up, and both the delay before the onset of analgesia and total duration of analgesia, together with its efficacy, were assessed. A further F.N.B. using a different agent (10 ml 0.5% bupivacaine) was performed and the same parameters were assessed. Both agents gave effective analgesia of varying duration at all levels of fracture site.

Analgesia↗
PubMed1986

Sarcoidosis presenting with pathological fracture of a metacarpal.

We describe a patient who presented with pathological fracture of the fifth metacarpal which on further investigation, was found to be due to Sarcoidosis. There is no previous record of the condition presenting in this way, with a pathological fracture.

Chronic Disease↗