Irish medical journal
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Irish medical journal · Mar 1998
Dissemination and evaluation of AAP/AHA Neonatal Resuscitation Programme in Ireland.
We evaluated the need for a structured Neonatal Resuscitation Programme (NRP) by means of a questionnaire sent to 25 Irish maternity hospitals inquiring about staff availability and current teaching structures. Having taught NRP to almost 1000 health care providers, we present a descriptive evaluation of the programme by a sample of 429 NRP participants, exploring their opinions of NRP. Our results show that midwives were responsible for newborn resuscitation at all low risk deliveries. ⋯ Two thirds of participants found the lesson on medications the most difficult theory lesson, while 45% found endotracheal intubation the most difficult skills station. Because of the wide geographical distribution of deliveries in this country, we conclude that all perinatal professionals should be trained to perform newborn resuscitation in a coordinated, team-approach manner. NRP provides such training with a high degree of approval from Irish health care providers.
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There is an increasing problem with benzodiazepine co-abuse in the opiate dependent population of Dublin. The importance of early detection of this co-abuse is essential as there is an increased risk of dangerous injecting practices such as sharing of needles and criminality in those who co-abuse benzodiazepines and opiates. ⋯ Using a sample of those attending the clinic it was discovered that standard methods of urinalysis failed to identify 10% of co-abuse. For those patients whose abuse of flunitrazepam is undetected on screening, clinical interventions which aim to minimise the consequence of the co-abuse and reverse the chaotic drug using patterns fail to be put in place at the earliest possible time.
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Irish medical journal · Oct 1997
Comparative StudyElective tracheal intubation in cervical spine injuries.
Patients presenting for surgical stabilisation of an unstable cervical spine are at risk of sustaining a further iatrogenic spinal cord injury during intubation of the trachea. Controversy exists regarding the optimal anaesthetic technique for securing the airway. We reviewed the techniques employed for intubating the trachea in our hospital over a five year period. ⋯ Weighted traction was employed in all cases to immobilize the cervical spine during intubation. There was no new neurological sequelae with any of these techniques. Our study suggests that there is no optimal anaesthetic technique for intubating the trachea in patients with cervical spine injuries and it is noteworthy that in line traction was used in every case.