Irish medical journal
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Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are a major cause of hospital admissions. Because of the consequent morbidity, mortality and burden on hospital resources, COPD management guidelines have been formulated. We reviewed 62 consecutive patients with AECOPD admitted from September 1st to December 18th 2000 in St. ⋯ Vincent's University Hospital is frequently suboptimal, and may be managed better with respiratory physician involvement. In particular, there could be more frequent spirometric confirmation of the diagnosis of COPD, better screening for long term oxygen therapy and more conservative use of antibiotics. Audit is complicated by difficulty accessing relevant data.
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Irish medical journal · Mar 2004
Brain death and organ donation: an audit in the Irish National Transplantation and Neurosurgical Centre.
We set out to identify the reasons why potential organ donors (PODs) fail to become actual donors and the causes of under-utilization of organs offered for donation. We audited 354 patients who died in the intensive Care Unit over 18 months. Of 155 PODs, 78 (50%) did not undergo brain stem testing (BST) because of (i) unavoidable death from non-CNS causes before BST (n = 50), (ii) treatment withdrawal without BST (n = 17) and (iii) preconditions for BST were not fulfilled (n = 11). ⋯ The commonest reason for failure to utilise potential organ donors was failure to perform BST. In most cases this was because BSTs were not possible but more aggressive management of and the routine performance of BST in all PODs could increase the number of donors. Not approaching relatives to ask consent for organ donation and a high rate of refusal by relatives also led to loss of organ donors.
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Irish medical journal · Oct 2003
A prospective analysis of inpatient consultations to a gastroenterology service.
The provision of a formal consultation service for inpatients between subspecialists is little studied. We prospectively surveyed the pattern of inpatient consultations from hospital-based generalists and surgeons to the gastroenterology (GI) service for inpatients in a large urban teaching hospital over a 5 month period. There are two GI consultants/attendings and five GI registrars/fellows on the service. ⋯ Subspecialty consultation provides an expert opinion, encourages discussion and learning, and improves patient care. In our experience, the provision of specialist advice and reassurance often speeded up a patient's work-up and expedited discharge. However, evaluating referral patients and subsequently providing ongoing inpatient and outpatient care and provision of endoscopy for these referrals contributes significantly to the workload of the GI service.