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Biomedical subjects

T Wisborg

Publications and source records attributed to T Wisborg.

At least 55 records · Page 3Linked to original sources
PubMed1991

[Exchange transfusion in cases of falciparum malaria].

Malaria is diagnosed in 50-70 patients each year in Norway. Severe malarial infection with cerebral involvement as well as hypoglycaemia, circulatory collapse and renal failure is often difficult to diagnose since the condition is only rarely seen in Scandinavia. This report describes a 49 year old seaman, who was admitted to hospital with a clinical picture of sepsis with multiorgan involvement including cerebral affection. Subsequently, it turned out that the patient had a severe infection with Plasmodium falciparum, involving more than 50 per cent of the red blood cells. Despite being comatose for one week with repeated attacks of grand mal type, and requiring 11 days mechanical ventilation plus dialysis for 4 weeks, he recovered uneventfully and was dismissed from hospital with only minor neurological sequelae. Even severe malaria with cerebral involvement can result in full restitution if the diagnosis is made early and exchange transfusion plus treatment with relevant drugs are instituted promptly.

Animals↗
PubMed1991

[Intra-osseous infusion--a simple, rapid and lifesaving method].

One of the major challenges in the initial treatment of critically ill or injured patients is the establishment of a well functioning intravenous access. This can be very difficult in patients with circulatory collapse, and almost impossible in infants. Central venous cannulation is time-consuming and requires skill. Nor can intratracheal and rectal administration of drugs and fluids fully replace the intravascular route. In such situations the old but forgotten technique of intraosseous infusion represents an elegant and easy way of gaining rapid intravascular access. The method is simple, safe and almost foolproof, and can easily be performed under field conditions, e.g. by paramedical personnel. Very few contra indications exist, and the success rate even by untrained personnel is high. In this review the physiological aspects and the technique itself is discussed and illustrated by case reports.

Aged↗
PubMed1991

[The laryngeal mask: a new tool for creating a free airway].

The laryngeal mask airway represents a new concept in airway management of anesthetised patients. It is inserted without any instruments and is very easy to use, even for unskilled personnel. It reduces the problem of waste gas pollution in the operating theater, and it leaves the hands of the anaesthetist free for record keeping and monitoring. It is well tolerated by the patients. In this article the technique is presented together with indications and limitations. Based on our experience we find the laryngeal mask airway an excellent alternative to the face mask, even in procedures of short duration.

Anesthesia, Inhalation↗
PubMed1990

[Resuscitation].

Explore the source record for details and available documents.

Humans↗
PubMed1990

[Instruction and training in emergency care procedures of recently deceased patients].

The need for medical personnel to be able to perform certain emergency medical procedures, such as endotracheal intubation, intravascular acess, defibrillation, and tracheotomy cannot be questioned. However, it is difficult to practise these techniques on patients and mannequins. Using newly deceased persons is an alternative which allows the procedures to be performed under nearly realistic circumstances, but this educational approach could raise certain ethical objections among staff who are not adequately informed about the educational objectives. A survey of the ten largest Norwegian hospitals revealed that only two had adopted this practice. The rest had considered it, but had decided not to start this routine. None of the hospitals had refrained from it after thoroughly analysing the ethical issues involved. Six hospitals used cadavers for other instruction. The practice represents a unique opportunity for training, and the ethical implications are justifiable provided that the training is conducted with respect and compassion for the deceased.

Education, Medical↗
PubMed1990

Health workers and the human immunodeficiency virus: knowledge, ignorance and behaviour.

The attitude of health personnel towards the human immunodeficiency virus (HIV) has a great influence on public opinion. Thus appropriate knowledge about HIV and its routes of transmission, plus safe and professional behaviour are crucial. A survey of 359 Norwegian health workers (75% response) revealed that factual knowledge was good. Fear of occupational transmission was substantial, but was not reflected in behaviour: 25-50% of the personnel reported not using gloves when exposed to blood. No relationship was found between knowledge and behaviour. A majority (79%) of the sample held the view that every hospital patient should be routinely tested on admission. Seventy-four per cent advocated preoperative screening, with special precautions if the results are positive. Knowledge did not seem to influence these attitudes. It is concluded that the behaviour of health personnel in relation to occupational risks is unrelated to factual knowledge, and further studies are needed to uncover behavioral determinants.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Paediatric anaesthesia in a developing country.

A suitable anaesthetic technique was needed for oral surgery in infants in a developing country. As an air compressor was present, and oxygen accessible, a continuous flow technique was chosen. Two Boyle's machines--useless due to lack of soda lime and nitrous oxide--were converted without increasing susceptibility to technical and supplemental deficiencies. The challenge to simplify techniques without reducing patient safety is discussed, and the solutions in an Ethiopian hospital are presented.

Anesthesia↗
PubMed1990

HIV infection and health personnel: health care workers' opinions concerning some ethical dilemmas.

A survey was made of a sample of 359 Norwegian health workers to assess attitudes towards HIV infected colleagues, and how the respondents would behave if they themselves became HIV infected. Two thirds of the 268 (75%) who responded would not allow that a HIV positive health worker treated their family, and 47% supported routine HIV screening of health workers to protect patients. Most of the respondents were opposed to disability pensioning of HIV infected health personnel in general, and would not ask for this if were found HIV positive. One hundred ninety-six would not tell colleagues if they became HIV infected. Within this group, the proportion (153/196) that would not accept practising HIV positive health personnel was significantly larger than that among those who would report own seropositivity (24/64). The study revealed substantial anxiety, and inconsistencies between expected behaviour of others, and the respondents' own reactions also were found.

Allied Health Personnel↗
PubMed1990

Permanent venous access via subcutaneous infusion port in severe asthma.

A subcutaneous infusion port was implanted in a 34-year-old patient with frequent and severe asthma attacks to ensure prompt and reliable venous access. Difficulties with peripheral venous access were possible cofactors necessitating mechanical ventilation on two occasions before this implantation. The method described is simple and seems useful for asthmatics in need of frequent parenteral medication.

Acute Disease↗
PubMed1989

[Rational fiberoptic bronchoscopy under local analgesia].

Bronchoscopy with the fibre bronchoscope under local analgesia influences circulatory and pulmonary function, depending partly on the form of premedication employed, anticholinergic preparations, the local analgesic and the form of application. Physiological and pharmacological knowledge is available on which a rational choice of the method of examination may be based. In order to reduce untoward sequelae of the examination, the following are recommended: avoidance of sedative premedication, which appears to be unnecessary, administration of supplementary oxygen during and for at least two hours after the examination (special care is required in cases of chronic hypercapnia) and employment of anticholinergic preparations, particularly in asthmatic patients. Nevertheless, slight degrees of bronchoconstriction may be anticipated during and after the examination. Examination via an endotracheal tube is warned against in patients with respiratory difficulties. There is much to recommend the choice of lidocaine as the routine analgesic and this is administered in the form of inhalation from an atomizer. On the basis of absorption investigations, the dosage may probably be raised to approximately 7 mg/kg. Patients with cardiac and liver disease have, however, reduced distribution volumes and clearance.

Anesthesia, Local↗
PubMed1989

Postdural puncture headache. A comparison between 26- and 29-gauge needles in young patients.

The incidence of postdural puncture headache after spinal anaesthesia with two types of 26- and 29-gauge needles was investigated in 149 patients less than 30 years old. Ten patients, (6.7%), six men and four women, developed typical symptoms of postdural puncture headache, while six (4.0%) developed headache of other origin. There were no headaches in the 29-gauge group. Spinal anaesthesia in four patients (8%) was impossible to perform with the 29-gauge needle. By using the latter, spinal anaesthesia can be given to young adults with little risk of postdural puncture headache.

Adolescent↗
PubMed1989

Norwegian dentists' knowledge, attitudes, and behavior concerning the HIV.

Knowledge about routes of HIV transmission and attitudes to HIV antibody testing was studied in a group of Norwegian dentists. Personal protection by gloves was also recorded. Eighty-three of 120 (69%) dentists in Bergen (private practitioners) completed a postal questionnaire. More than half of these considered themselves to be in potentially infectious situations daily. Overall knowledge was good, although one fifth gave wrong answers about the relation between antibody status and infectivity. About half the respondents had attitudes to antibody testing not consistent with Centers for Disease Control (CDC) guidelines. These dentists scored significantly lower on the knowledge questions. Seventy-five (92%) reported consequent use of gloves. A low knowledge score was found among non-users. The present study indicates that lack of knowledge is related to non-recommended attitudes and behavior. The study underlines the need for continuous education and information about HIV.

Attitude of Health Personnel↗