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Biomedical subjects

S Q Tighe

Publications and source records attributed to S Q Tighe.

36 records · Page 2Linked to original sources
PubMed1992

An audit of resuscitation and anaesthesia during Operation 'Safe Haven'.

The Royal Navy combined Surgical Support Team deployed for six weeks to Northern Iraq. Eighteen casualties of civilian and military trauma required active resuscitation, 10 of whom were under the age of 16. Three died. Triage of multiple casualties was necessary on three occasions. The principles of Advanced Trauma Life Support (ATLS) were adopted and the experience is described under the ABCDE headings of the primary survey. Deficiencies of training and equipment are identified. Seventy one anaesthetics, administered to 52 patients, were audited prospectively in detail. Systolic blood pressure was significantly higher with isoflurane and controlled ventilation (ICV), compared with halothane and trichloroethylene (HTCV) (P < 0.05). ICV patients recovered more quickly than with HTCV (P < 0.05), but were significantly older and heavier (P < 0.05). Isoflurane should replace the standard halothane/trichloroethylene combination. Controlled ventilation or ketamine anaesthesia allowed satisfactory SpO2 on air alone. With controlled ventilation, anaesthesia was entirely satisfactory for children down to 6.5 kg. Local anaesthetic procedures were useful. The entire anaesthetic drug cost was only 127 pounds. Three patients received a degree of intensive care. Recommendations are made to improve future outcome, but sophisticated resuscitation, anaesthesia and monitoring is now possible in the front line.

Adolescent↗
PubMed1991

Minimum oxygen requirements during anaesthesia with the Triservice anaesthetic apparatus. A study of drawover anaesthesia in the young adult.

Thirty-six servicemen were anaesthetised using the Triservice anaesthetic apparatus. They were allocated randomly into one of two groups, to breathe spontaneously or to receive artificial ventilation, and into subgroups who were given air alone, or air supplemented with 1 or 4 litres/minute of oxygen. A further 12 subjects were studied subsequently using 0.5 litres/minute of added oxygen. Intra-operative blood gases were compared with those of awake premedicated controls. Artificial ventilation was associated with an unchanged arterial oxygen tension with air alone; in the other subgroups arterial oxygen tension was higher than with spontaneous respiration when related to inspired oxygen fraction (p less than 0.05). Air anaesthesia caused significant hypoxaemia with spontaneous ventilation (p less than 0.05), and 50% of the subjects required assisted ventilation. There was also a significant respiratory acidosis (p less than 0.05). Intermittent positive pressure ventilation is the method of choice for field anaesthesia when oxygen is unavailable. Spontaneous respiration must be supplemented with at least 0.5 litres minute of oxygen.

Adolescent↗
PubMed1990

Laryngeal mask airway and tracheal tube insertion by unskilled personnel.

After a short training programme 11 naval medical trainees inserted a laryngeal mask airway (LMA) and a tracheal tube (ETT) in random order in a total of 110 anaesthetised patients. They were allowed 40 s for each attempt. Success was defined as the detection of expired carbon dioxide within 40 s of Guedel airway removal which subsequently rose to an end-tidal value of at least 4 kPa, together with satisfactory lung expansion and ventilation, without other airway intervention by the anaesthetist. 104 LMA insertions were successful compared with 56 of ETTs (p less than 0.01). All first attempts at LMA insertion were successful, whereas satisfactory ETT placement was progressive. Insertion was also quicker with the LMA (20 s) than with the ETT (35 s) (p less than 0.01). Further studies are indicated to assess the value of the LMA in emergencies.

Airway Obstruction↗
PubMed1989

Meningioma as an incidental finding in an intensive care unit.

A report on two hypotensive episodes secondary to post-operative haemorrhage is presented. Recovery was complicated by prolonged coma and a frontal meningioma was eventually discovered. The possible aetiology of this coma is discussed. Intracranial pathology should be suspected when coma persists on the intensive care unit.

Adenocarcinoma↗
PubMed1987

A comparison of halothane and trichloroethylene with isoflurane. A study of drawover air anaesthesia with the Triservice anaesthetic apparatus.

Induction and recovery times were not significantly different between two groups that received halothane with trichloroethylene and isoflurane, respectively. Maintenance of anaesthesia and analgesia was also satisfactory. Isoflurane resulted in a higher heart rate (p less than 0.01), a lower respiratory rate (p less than 0.01) and a higher inspired oxygen concentration (p less than 0.05). Respiration may be more efficient. Other potential advantages of isoflurane for anaesthesia in the field are discussed. Despite the fact that it is 15 times more expensive, the use of isoflurane as sole agent is recommended.

Adolescent↗
PubMed1983

Anaesthesia during the Falklands campaign. The experience of the Royal Navy.

The work of nine Naval anaesthetists deployed with the Task Force during the Falklands campaign is described. The anaesthetists worked in a field hospital (Ajax Bay), a hospital ship (SS Uganda), a troop ship (SS Camberra), aircraft carriers (HMS Hermes and HMS Invincible) and a Royal Fleet Auxiliary (Tidespring). The problems of staffing and providing the stores for various teams in different locations at short notice are discussed.

Anesthesia↗