Biomedical subjects
T McConnell
Publications and source records attributed to T McConnell.
Circulatory and respiratory changes in patients with Laennec's cirrhosis of the liver.
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Tibial portal placement: the radiographic correlate of the anatomic safe zone.
OBJECTIVE: To identify the radiographic correlate of the anatomic safe zone for tibial portal placement. DESIGN: Cadaveric, anatomic, and radiographic study using twenty cadaveric knees. Kirschner wires were placed in the anatomic safe zone. Anteroposterior and lateral radiographs were taken to evaluate the portal placement. SETTING: Anatomy laboratory. OUTCOME MEASUREMENTS: Radiographic measurements of Kirschner wires placed in the anatomic safe zone. RESULTS: The safe zone for tibial nail placement as seen on radiographs is just medial to the lateral tibial spine on the anteroposterior radiograph and immediately adjacent and anterior to the articular surface as visualized on the lateral radiograph. There is some variance on the anteroposterior radiograph but no variance on the lateral radiograph. CONCLUSIONS: The placement of tibial nails in the superior portion of the tibia in the documented position generates the least risk to the intraarticular structures of the knee.
Must consent always be obtained for a do-not-resuscitate order?
Using cardiopulmonary resuscitation for cardiac or respiratory arrest unless there is an explicit do-not-resuscitate order is a policy adopted by all hospitals. Such a policy usually requires the patient's (or surrogate's) consent for a do-not-resuscitate order to be instituted. This article, however, presents the argument that consent need not always be obtained. In the case discussed, the well-being of the patient, other patients, and the health care providers all support a unilateral decision by the physician not to attempt resuscitation at the time of death. The medical community and society need to acknowledge that such cases exist and to develop policies that respect not only the interests of patients but also those of health care providers and society.