Irish journal of medical science
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Randomized Controlled Trial Clinical Trial
Epistaxis and nasotracheal intubation--prevention with vasoconstrictor spray.
Eighty patients having anaesthesia for oral surgery requiring nasal intubation were randomly allocated to be intubated with either a plain Magill red rubber or cuffed polyethylene endotracheal tube and in a double blind manner, to receive xylometazoline 0.1% vasoconstrictor nasal spray. The extent of any epistaxis occurring was assessed by an independent observer. With the Magill tube there was bleeding in one out of twenty patients in both the vasoconstrictor group and non vasoconstrictor group at intubation and no bleeding in either of the two groups at extubation. ⋯ This improved to seven out of twenty with the administration of vasoconstrictor drops at intubation (chi square 10.2; p < 0.01) in the polyethylene tube group. At extubation ten out of twenty patients had bleeding in the non vasoconstrictor group improving to two out of twenty with the administration of the vasoconstrictor (chi square 9.6; p,0.01). The use of the vasoconstrictor xylometazoline helped to reduce epistaxis that occurred during nasal intubation and further study into the type of endotracheal tube is recommended.
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The aim of this study was to find out what kind of physiotherapy service is available in the community. Two groups were studied (i) private practitioners and (ii) community physiotherapists employed by health boards. The results indicate that the private practitioners provide a service in the community to a mainly young, or middle-aged and mobile population. ⋯ The community physiotherapy service provided by the health boards served mainly the very young, i.e. 0-15 years and the elderly. The conditions seen were mostly long-term, viz. strokes and cerebral palsy. The community physiotherapist saw 50% of cases in the patient's own home, while the private practitioners saw 93% of cases in the practice premises.