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T Wisborg

Publications and source records attributed to T Wisborg.

At least 37 records · Page 2Linked to original sources
PubMed1995

Is the pencil point spinal needle a better choice in younger patients? A comparison of 24G Sprotte with 27G Quincke needles in an unselected group of general surgical patients below 46 years of age.

Reports have indicated that there are less postoperative complaints after the use of pencil pointed spinal needles. We compared a 24G Sprotte needle with a 27G Quincke needle in a randomised study of 200 healthy patients (49% females), aged 15-46 years. Four patients (2%) reported postdural puncture headache, three with the 24G Sprotte needle and one with the 27G Quincke needle. Thirteen patients (7%) suffered with nonspecific headache, with no significant difference between the two groups. Of the 57 (29%) who reported backpain, a significantly higher proportion had received spinal anaesthesia with the Sprotte needle (OR = 2.06). There was a significantly higher incidence of insufficient blocks after dural puncture with the Sprotte needle. Ease of needle insertion and number of puncture attempts was the same for both needle types.

Adolescent↗
PubMed1994

[Ethical dilemmas when teaching intubation techniques--what does the population think?].

Maintaining a clear airway and sufficient ventilation is vital in emergency medicine, but junior doctors and medical students rarely get sufficient training in the relevant techniques. These can be taught on mannequins, anaesthetised patients, or on recently deceased patients. The Norwegian and British medical associations recently banned the use of dead patients for intubation training for ethical reasons. A telephone survey of a random sample of 1,050 persons revealed that 69% would allow themselves to be practised on if they were anaesthetised, while 58% would accept that a close relative who had just died in hospital be used. Most of those who would not give their consent or who were unsure feared being injured, or the idea upset them. These results challenge previous assumptions about the attitude of the general public, and the medical associations' stand on the issue may have to be reconsidered for the sake of improving the teaching of vital skills.

Adolescent↗
PubMed1994

The potential of an anaesthesiologist-manned ambulance service in a rural/urban district.

The use of anaesthesiologists in prehospital emergency care is controversial. We wanted to assess the impact of an anaesthesiologist and a short time interval from acceptance of a mission to take-off at survival rates in a rural/urban emergency medical service. Prospectively registered data for 991 consecutive patients through a 12-month period were retrospectively evaluated by an independent foreign expert. Of all primary missions, 3.3% were considered probably lifesaving from site of injury to receiving hospital. Of these, the lifesaving result in 50% were dependent on both the qualifications of the anaesthesiologist and a short response time. Survival from hospital admission to discharge was 44%. All patients were discharged to their own homes, able to live a fully functional life. The consistent use of anaesthesiologists compared to less qualified personnel and the maintaining of response times below presently required minima doubles the potential for lives saved in services comparable to the one studied.

Adult↗
PubMed1993

[Attitude of the public to autopsy. A questionnaire study].

A high autopsy rate is a requirement for confirming or correcting clinical diagnoses and for providing opportunities for medical education on pre- and postgraduate level. A telephone survey was conducted to obtain information about the opinion of the Norwegian public on this matter. A randomised sample of 1,050 persons over 15 years of age were asked whether they would consent to autopsy if a close family member died in a hospital. Of the 954 (91%) who agreed to answer, 86% (95% CI 84-89) would consent, while 14% (95% CI 11-16) were unsure or would object. Demographical background variables did not significantly influence the response. When asked if they would give prior consent to an autopsy on themselves, should they die in a hospital, 84% (95% CI 82-87) said they would agree, while 16% (95% CI 13-18) were unsure or would object. Age between 31-50 years, male sex and married civil status significantly increased the likelihood of a positive attitude towards autopsy. The survey revealed a generally favourable attitude in the population towards autopsy. This positive confidence has to be maintained through careful talks with relatives about autopsy, and arrangements for relatives to be informed of the result of an autopsy.

Adolescent↗
PubMed1993

[Public opinion on organ donations from recently decreased persons. A questionnaire study].

Organ transplantation is at present hampered by a shortage of organs. This problem is increasing, and can be helped by more information and knowledge among health professionals and the general public. The frequency of families who consent to donation of organs from a recently deceased family member varies from country to country and has previously not been examined in Norway. In this survey a random sample of 1,050 persons (15 years and older) were interviewed. 71% (95% CI 68-74) would consent to donation of an organ from a close family member.

Adolescent↗
PubMed1993

Intrathecal anaesthesia in patients under 45 years: incidence of postdural puncture symptoms after spinal anaesthesia with 27G needles.

Postoperative headache and backpain has limited the use of intrathecal anaesthesia in younger patients (15-45 years). We studied postoperative complaints among 133 healthy young patients (mean age 30.0 years, 47% females) who received spinal anaesthesia with a 27G needle. Postoperatively, 5 patients (4%) complained of postdural puncture headache (PDPH), 18 (14%) reported nonspecific headache, while 27 (20%) suffered from backpain. PDPH was not related to sex, age, day-care surgery, number of puncture attempts, or obstetric procedures. Backpain was significantly more common among females, and among in-patients. One hundred and sixteen patients (87%) would accept spinal anaesthesia if they were to undergo the same surgical procedure again. Compared to other studies, we find the incidence of postanaesthetic complaints to be acceptable, also among day-care patients. The PDPH seemed to be lightly incapacitating, and only one patient required blood patching.

Adolescent↗
PubMed1992

[Prevention of acute renal failure in muscular injuries].

Rhabdomyolysis may be caused by sustained, continuous pressure to skeletal muscle. The syndrome is characterized by hypovolemia, hyperkalemia and release of excessive amounts of myoglobin to the circulation. If untreated, the syndrome becomes complicated by potentially fatal acute renal failure. Two case reports are presented which illustrate the importance of early and aggressive fluid substitution where forced alkaline diuresis seemed to prevent life threatening renal complications.

Acute Kidney Injury↗
PubMed1992

[Semiautomated defibrillator. Experiences with the use in ambulances in a rural district].

Early defibrillation has been shown to be the single most effective intervention in resuscitation from sudden cardiac death. The new semi-automated defibrillators are safe and easy to use and are effective and precise instruments for interpreting cardiac rhythm. In our rural area, ambulance staff received six hours training in the use of a semi-automated defibrillator (Heartstart 2000, Laerdal Medical) before the apparatus was installed in the ambulance. During the first year after installation, eight cases of cardiac arrest were treated by the ambulance staff. Four patients received defibrillation, two of whom were resuscitated successfully. Increased local interest in treatment of cardiac arrest, including increased awareness of the need to provide early resuscitation, has strengthened the chain of response, where the procurement of a semi-automated defibrillator represents a link that seems to have improved the prognosis for patients with cardiac arrest in our district.

Aged↗
PubMed1991

Percutaneous placement of permanent central venous catheters: experience with 200 catheters.

The prospective registration of 200 percutaneous placements of permanent central venous catheters (Hickman catheters and subcutaneous infusion ports) was conducted in 172 patients aged 3 months-95 years. The insertions were reviewed to assess whether certain groups of patients or physicians were associated with more complications than others. Complications occurred in 16 patients (8.0%), of which 12 were arterial punctures. Two attempts (1%) at catheter placement failed. None of the complications required treatment. Of the catheter placements, 70% were performed by one of the three authors, and the rest by seven other experienced anesthesiologists. The complication rates were not different between the two groups. Nor was the complication rate significantly higher in small children. Percutaneous placement of permanent central venous catheters thus proved to be a safe and reliable technique, even in small children. The method is easily learnt by physicians experienced in central venous catheterization. Using this method, permanent venous access may be offered to a large number of patients.

Adolescent↗
PubMed1991

Crush injuries in arctic off-shore fisheries: initial treatment to prevent acute renal failure.

Rhabdomylosis following crush injuries represents an occupational hazard in the off-shore fisheries. In northern countries this can be complicated by hypothermia and a long transport time to the nearest hospital. If treatment is delayed, what is initially a local limb injury can result in a potentially life threatening acute renal failure as a result of the nephrotoxic effects of the various intracellular muscle components released into the circulation. Therefore early and aggressive fluid treatment in the field, and during the transport of crush injury victims is very important. Forced alkaline diuresis is the main prophylaxis against hyperkalemia and acute myoglobinuric renal failure. A case history which demonstrates some of the aspects and challenges in the treatment of crush injuries is presented.

Accidents, Occupational↗
PubMed1991

Anesthesiologist-manned helicopters and regionalized extracorporeal circulation facilities: a unique chance in deep hypothermia.

Norway has nine light ambulance helicopters, four heavy sea rescue helicopters and seven ambulance air planes in 24-hours duty spread all over the country. Most are manned with anesthesiologists. Five regional hospitals in all parts of the country, offer facilities for extracorporeal circulation. A case in which a 33 year old woman was found hypothermic at 21 degrees C is presented. She developed ventricular fibrillation at the time of her rescue. She was intubated and received chest compression for 70 minutes until she was rewarmed by extracorporeal circulation. She was discharged without signs of cerebral damage. The decision to bypass less advanced hospitals en route to the regional hospital proved correct in this case, and is suggested as standard procedure in deep hypothermic patients.

Adult↗