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Biomedical subjects

T Raybould

Publications and source records attributed to T Raybould.

3 recordsLinked to original sources

A multidisciplinary audit of manual hyperinflation technique (sigh breath) in a neurosurgical intensive care unit.

Manual hyperinflation of the lungs (sigh breath) is a technique which is used to deliver a large volume of gas to the lungs. The purpose of this technique is to either maintain or improve the respiratory status of the patient. However, the volume of gas delivered is rarely measured, and therefore there is little evidence that hyperinflation occurs. Through the process of audit staff were able to examine the technique critically and improve it. With the addition of measurement tools a defined standard was developed against which performance was measured. To explore the effects of a particular technique it is essential that the delivery of that technique is standardised. This audit has enabled staff to achieve a standard technique and create a position from which research into its effects can now take place.

Clinical Protocols

Osteoradionecrosis of the jaw bones at the University of Kentucky Medical Center.

There is disagreement over the management of teeth in irradiated head and neck cancer patients. Some oral surgeons support preirradiation extraction; others favor maintaining teeth. Before 1974, The University of Kentucky Department of Radiation Medicine found osteoradionecrosis (ORN) of the jaw in 10.9% of 220 irradiated cancer patients. After a program of oral care was instituted, the incidence declined to 2.7%. Of 109 patients who received radiotherapy between 1976 and 1985, only three (2.7%) developed ORN of the mandible. There was also a reduction in patients treated with interstitial therapy during this time. A review of the most recent experiences shows that, with present management methods at the University of Kentucky, ORN is not a significant problem. Of 30 patients treated in 1986, only one had ORN, and this was of the maxilla. Post-irradiation extractions were not identified as a significant risk for necrosis. Hyperbaric oxygen is used as a treatment for persistent ORN.

Head and Neck Neoplasms