Resp Care
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Absenteeism from outpatient appointments is common. Telephone appointment-reminder calls reduce outpatient-appointment absenteeism in many clinic settings. ⋯ A policy of reminding outpatients of their appointments via telephone reduces absenteeism at a hospital-based pulmonary function laboratory. We found no difference in absenteeism between communicating the reminder via direct conversation versus via leaving a message on an answering machine.
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Comparative Study
A prospective comparison of 3 new-generation pulse oximetry devices during ambulation after open heart surgery.
To assess the clinical performance of 3 new-generation pulse-oximetry signal-processing software systems (Philips FAST, Masimo SET, and Nellcor N-3000) during ambulation after open-heart surgery. ⋯ There are significant differences among the 3 devices with regard to dropout and false alarms. High numbers of dropouts are problematic because no pulse-oximetry patient information is available during dropout. However, false alarms are even more problematic, because they desensitize clinicians to alarms and call into question the accuracy of displayed data. While our data highlight the statistical differences between the studied oximeters, the clinical implications of these differences warrant further study.
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The endotracheal tube (ETT) cuff-leak test (CLT) has been proposed as a relatively simple, noninvasive method for detecting the presence of laryngeal edema prior to tracheal extubation. ⋯ Failing the CLT was not an accurate predictor of PES and should not be used as an indication for either delaying extubation or initiating other specific therapy. Female patients, those whose ratio of ETT size to laryngeal diameter was > 45%, and patients intubated for > 6 d were more likely to develop PES.