A5049904362- Hemodynamic Monitoring and Therapy
- Cardiac, Anesthesia and Surgical Outcomes
- Ultrasound in Clinical Applications
- Airway Management and Intubation Techniques
- Anesthesia and Pain Management
- Respiratory Support and Mechanisms
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Electrolyte and hormonal disorders
- Sepsis Diagnosis and Treatment
- Spinal Hematomas and Complications
- Spine and Intervertebral Disc Pathology
- Renal function and acid-base balance
- Nausea and vomiting management
- Cardiac Arrest and Resuscitation
- Trauma Management and Diagnosis
- Non-Invasive Vital Sign Monitoring
- Trauma and Emergency Care Studies
- Pulmonary Hypertension Research and Treatments
- Surgical Sutures and Adhesives
- Traumatic Brain Injury and Neurovascular Disturbances
- Medical Imaging and Pathology Studies
- Thermal Regulation in Medicine
- Immune Cell Function and Interaction
- Anesthesia and Sedative Agents
- Immunotherapy and Immune Responses
Northampton General Hospital
2010-2024
University of Northampton
2023
Pulmonary and Critical Care Associates
2021-2023
Intensive Care Foundation
2021
Northampton General Hospital NHS Trust
2011-2021
Newcastle upon Tyne Hospitals NHS Foundation Trust
2018
Stamford and Rutland Hospital
2014
Wrexham Maelor Hospital
2010
Nottingham University Hospitals NHS Trust
2007-2009
Nottingham City Hospital
2009
Failure of effective handover is a major preventable cause patient harm. We aimed to promote accurate recording high-quality clinical information using an Electronic Handover System (EHS) that would contribute sustainable improvement in care and safety. Within our hospital the human factors associated with poor communication were compromising unnecessarily increasing workload staff due quality handovers. Only half handovers understood by doctors expected complete them, more than medical felt...
Dysphagia aortica describes swallowing difficulty caused by external compression from a tortuous or aneurysmal aorta. We present 5 cases in which dysphagia to solids accompanied localised high pressure barrier (HPB) on manometry suggestive of aortica, and explore other investigation modalities useful confirm the diagnosis.Four females 1 male with median age 56 years (range 47-58) were investigated. All underwent endoscopy, chest radiography, CT scanning, barium swallow, video solid bolus...
Traditional ultrasound teaching is normally delivered using large, costly and often quite advanced cart-based systems. These carts are large systems on wheels, usually limited to the departments that own them i.e. clinics, wards or radiology. Portability has been further improved by development of laptop style systems, which easier wheel in-between patients/departments. In our experience anecdotally, many these can be intimidating novice lead early attrition poor uptake into clinical...
An operation for arthrodesis of the first metatarsophalangeal joint described previously has been performed on 85 toes in 68 patients over a 20-year period. The notes and X-rays have reviewed to determine incidence bony fusion find out whether operative position was maintained until union occurred.Arthrodesis achieved 83 (97.6 per cent) operated on. Where there had no previous surgery 100 cent.As determined by certain defined criteria is strong indication that technique occurred.
The case is described of a 36 year old woman who presented with large left sided haemothorax. A thoracic computed tomographic (CT) scan suggested there was bony outgrowth arising from the fourth rib. This resected surgically and found to be an osteochondroma which surrounded by blood clot. No definite site bleeding identified, but it thought that tumour may have traumatised lung, pericardiacophrenic artery, or superior pulmonary vein, resulting in life threatening haemorrhage.
Summary We report the case of a 38 year‐old woman who presented initially as driver in road traffic accident with Glasgow Coma Score 14, agitated, tachycardic, tachypnoeic and hypertensive. The combination an abdominal CT scan clinical findings led to decision perform emergency laparotomy. Her persisting symptoms laboratory results revealed her be manifesting acute thyroid storm; TSH < 0.10 IU.l −1 , free T4 59.8 pmol.l T3 20.20 .
FUSIC haemodynamics (HD) - the latest Focused Ultrasound in Intensive Care (FUSIC) module created by Society (ICS) describes a complete haemodynamic assessment with ultrasound based on ten key clinical questions: 1. Is stroke volume abnormal? 2. responsive to fluid, vasopressors or inotropes? 3. aorta 4. aortic valve, mitral valve tricuspid severely 5. there systolic anterior motion of valve? 6. regional wall abnormality? 7. Are features raised left atrial pressure? 8. right ventricular...
Fluid management of critically ill patients and those undergoing major surgery can be extremely difficult. It is important to predict which will respond volume expansion in order avoid undesired hypovolaemia fluid overload. Traditionally, central venous pressure pulmonary artery occlusion have been used guide management. However, assimilation available evidence from the past twenty years demonstrates that neither nor appears a useful predictor haemodynamic response challenge. Recent suggests...
The objectives of this initiative were to produce nationally tested audit tools, influence the content national guidelines, and enable performance indicators be set for clinical transfusion process. Audit tools developed blood practice through a collaboration between Royal Colleges specialist Societies with an interest in transfusion. National audits carried out involving 50 hospitals first 23 same second. Over 20% participating did not have Hospital Transfusion Committees. Most had written...
Although one-lung ventilation (OLV) increases right ventricular afterload, cardiac output is unaltered [1, 2]. Little known about the effects of OLV on function. This study aimed to describe changes in function associated with using transoesophageal echocardiography. Written consent was obtained from 10 patients aged between 25 and 75 years age, due undergo thoracic surgical procedures requiring a period OLV. Patients’ tracheas left main bronchi were intubated their lungs ventilated 100%...
Daily dose schedules of 100-200 mg almitrine bismesylate improve arterial blood gases in patients with hypoxaemic chronic obstructive airways disease (COPD) but related side effects are evident. In the present study, daily doses approximately half those previously used were employed a randomised double blind manner 85 (age 35-79 years) COPD. After one month period to check stability gases, allocated (A) or placebo (P) using an unequal code (60% A, 40% P). Tablets, 50-100 stopped for after 3,...
Should we aim to intervene and control fever in the critically ill patient? The answer is not straightforward there certainly no universal agreement on subject. This article aims discuss whether should over-ride nature disallow it take it's course, particularly where appears that this evolutionary response invading pathogens actually becoming harmful patient. Also discussed here are physiology of temperature scope our current understanding impact patients manifesting systemic inflammatory...
Critically ill patients are predisposed to stress-induced hyperglycemia. Recent evidence suggests that uncontrolled hyperglycemia is associated with poor outcomes within the population of surgical and medical intensive care units. We retrospectively audited our practice in management critically ill, order identify reasons periods time deviations blood glucose control most likely, make recommendations on how improve this. Our study showed compliance current for glycemic highlighted need a...