Irish medical journal
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Irish medical journal · Sep 2013
Case ReportsPulmonary sequelae of severe H1N1 infection treated with high frequency oscillatory ventilation.
During the recent influenza A (H1N1) pandemic, due to severe respiratory failure many patients required treatment with alternative ventilator modalities including High Frequency Oscillatory Ventilation (HFOV). We present four such patients treated with HFOV at an academic, tertiary referral hospital in Ireland. We detail outcomes of clinical examination, pulmonary function testing, quality of life assessment and radiographic appearance on CT Thorax at follow-up at 6 months. ⋯ Post-inflammatory changes on CT thorax at 6 months were seen in all 4 cases. To our knowledge this is the first report to document the long-term effects of severe H1N1 infection requiring high frequency oscillation on respiratory function. We conclude that the effects on respiratory function and pulmonary radiological appearance are similar to those observed following conventional treatment of Acute Respiratory Distress Syndrome [ARDS].
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Irish medical journal · Sep 2013
Comparative StudyChinese whispers in the post anaesthesia care unit (PACU).
We audited verbal handover of information by anaesthetists to recovery room nurses based on Situation, Background, Assessment and Recommendation. In Audit A, 100 handovers for elective procedures were included. For audit B, a second cohort of 100 patients was examined post educational session. ⋯ Nurse satisfaction with handovers improved by 12%. We conclude that a structured process of information transfer, led to improved handover of immediate care. Further education focussed on the importance of instructions for the ward to maintain continuity of care is recommended.
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Irish medical journal · Jun 2013
Non heart beating organ donation in adults: a clinical practice guideline.
Non heart beating organ donation (NHBD) occurs when a patient donates organs following the determination of death by cardiorespiratory criteria. It is also know as Donation after Cardiac Death (DCD) or Donation after Circulatory Death (DCD). ⋯ When compared to international protocols, the NHBD protocol at Beaumont Hospital is both conservative and restrictive. It offers an alternative when conditions of brainstem death (BSD) cannot be satisfied and, since implementation a number of successful transplants have been performed from NHB donors.
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Since 2008, government funding of the Health Service Executive (HSE) has decreased significantly. Our hospital, Cork University Hospital (CUH), implemented "cost saving" measures including scheduled operating theatre closures. We studied their affect on urological surgical activity at the hospital. ⋯ We have shown that scheduled theatre closures have reduced the number of procedures performed and have impacted on urology training. Scheduled theatre closures are expected to become more frequent in the future. Potential solutions to lessen the impact include providing simulation training using the Royal College of Surgeons in Ireland (RCSI) mobile skills unit during these theatre closures.