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Burn sheetings
Injury: the British Journal of Accident Surgery Vol. 1 ~/NO. 2
176 Cardiopulmonary resuscitation
Red cell deformability and burns
Depressing the sternum of a person whose heart is not beating has more effect on the blood flow by increasing ressure within the chest than by direct action on the ! eatt. Synchronizing inflation pressures of 60 -1 IO cm water with depression of the sternum increased arterial flow, on average, to two and a half times that achieved by conventional resuscitation by compression and artificial ventilation. The clinical applicability of the new method has yet to be established. Chandra N., Rudikoff M. and Weisfeldt M. L. (1980) Simultaneous chest compression and ventilation at high airway pressure during cardiopulmonary resuscitation. Lancet 1, 175.
The deformability of red cells is reliably reflected and easily measured by their filterability and is an indication of cellular abnormality that has many causes but enhances hypoxia and may consequently delay healing. Adequate resuscitation, restoration of oxygen, carrying capacity and abundant calories help to overcome the metabolic disturbance. Baar S. (1979) The functional significance of red cell deformability and its significance in bums. Burns 6, 85. Film burn wound coverings
Bacteriology
and infection
Recovery from tetanus
The 50 patients in this series were treated over a period of 16 years; 29 had regained normal health, 9 were still improving. Twelve regarded their health as being permanently impaired but in only 2 was the deterioration serious or certainly a result of the tetanus. All but 5 of those at work when taken ill returned to their usual work. Sixteen were able to recall the unpleasantness of their treatment and 19 suffered some psychological disturbance. In spite of more or less stricture of the trachea (on average to about half the normal area) few patients were troubled by it and there was little evidence of permanent disorder of the lungs. Flowers M. W. and Edmondson R. S. (1980) Long-term recovery from tetanus: a study of 50 survivors. Br. Med. J. 1,303.
Burns Burn sheetings
Sixty-five per cent cottonand 35 per cent polyester sheets were compared with unwoven rayon sandwiching polyurethane foam and rayon with attached polyethylene films. The last was the best, absorbing well and sticking little, as well as being fairly resistant to tearing. It had the disadvantage that absorbed liquids readily spread within it, together with bacteria presumably. Rodeheaver G. T., Haury B., Rust E. et al. (1979) A critical evaluation ofbum sheetings. Burns 6, 105.
Films made of a co-polymer of acrylonitrile and dimethvlaminoethvlmethacrvlate can be impregnated with antibacterial -substances. Discs so impregnated were placed upon cultures of various organisms; the most useful drug to counteract the organisms usually found on bums-was silver sulphadiazme 10 per cent. This gradually passed out of the film. The effect on a burned surface has yet to be tested. Park G. B. and Mollison D. S. (1979) In vitro bacteriological study on film bum wound coverings. Burns 6,96. Erythrocyte filterability and burns
These workers found the filterability to be reduced to about one-sixth of normal but to return to normal after a few days, given adequate resuscitation. They were not able to identify with certainty any cause for the changes in the red cells. Johnson G., Lineberger T., Hothem A. L. et al. (1979) Erythrocyte filterability in the burned patient. Burns 6,9 1.
Miscellaneous Hypothermia
Below 50 m the temperature of the North Sea is less than 10 “C and in spite of pumping warm water through the diving suit divers became hypothermic without much discomfort. This may explain some of the deaths that have occurred and it can be prevented by ensuring an environmental temperature of 35 “C. Keatinge W. R., Hayward M. G. and Mclver N. K. I. (1980) Hypothermia during saturation diving in the North Sea. Br. Med. J. 1,29 1.
176 Cardiopulmonary resuscitation
Red cell deformability and burns
Depressing the sternum of a person whose heart is not beating has more effect on the blood flow by increasing ressure within the chest than by direct action on the ! eatt. Synchronizing inflation pressures of 60 -1 IO cm water with depression of the sternum increased arterial flow, on average, to two and a half times that achieved by conventional resuscitation by compression and artificial ventilation. The clinical applicability of the new method has yet to be established. Chandra N., Rudikoff M. and Weisfeldt M. L. (1980) Simultaneous chest compression and ventilation at high airway pressure during cardiopulmonary resuscitation. Lancet 1, 175.
The deformability of red cells is reliably reflected and easily measured by their filterability and is an indication of cellular abnormality that has many causes but enhances hypoxia and may consequently delay healing. Adequate resuscitation, restoration of oxygen, carrying capacity and abundant calories help to overcome the metabolic disturbance. Baar S. (1979) The functional significance of red cell deformability and its significance in bums. Burns 6, 85. Film burn wound coverings
Bacteriology
and infection
Recovery from tetanus
The 50 patients in this series were treated over a period of 16 years; 29 had regained normal health, 9 were still improving. Twelve regarded their health as being permanently impaired but in only 2 was the deterioration serious or certainly a result of the tetanus. All but 5 of those at work when taken ill returned to their usual work. Sixteen were able to recall the unpleasantness of their treatment and 19 suffered some psychological disturbance. In spite of more or less stricture of the trachea (on average to about half the normal area) few patients were troubled by it and there was little evidence of permanent disorder of the lungs. Flowers M. W. and Edmondson R. S. (1980) Long-term recovery from tetanus: a study of 50 survivors. Br. Med. J. 1,303.
Burns Burn sheetings
Sixty-five per cent cottonand 35 per cent polyester sheets were compared with unwoven rayon sandwiching polyurethane foam and rayon with attached polyethylene films. The last was the best, absorbing well and sticking little, as well as being fairly resistant to tearing. It had the disadvantage that absorbed liquids readily spread within it, together with bacteria presumably. Rodeheaver G. T., Haury B., Rust E. et al. (1979) A critical evaluation ofbum sheetings. Burns 6, 105.
Films made of a co-polymer of acrylonitrile and dimethvlaminoethvlmethacrvlate can be impregnated with antibacterial -substances. Discs so impregnated were placed upon cultures of various organisms; the most useful drug to counteract the organisms usually found on bums-was silver sulphadiazme 10 per cent. This gradually passed out of the film. The effect on a burned surface has yet to be tested. Park G. B. and Mollison D. S. (1979) In vitro bacteriological study on film bum wound coverings. Burns 6,96. Erythrocyte filterability and burns
These workers found the filterability to be reduced to about one-sixth of normal but to return to normal after a few days, given adequate resuscitation. They were not able to identify with certainty any cause for the changes in the red cells. Johnson G., Lineberger T., Hothem A. L. et al. (1979) Erythrocyte filterability in the burned patient. Burns 6,9 1.
Miscellaneous Hypothermia
Below 50 m the temperature of the North Sea is less than 10 “C and in spite of pumping warm water through the diving suit divers became hypothermic without much discomfort. This may explain some of the deaths that have occurred and it can be prevented by ensuring an environmental temperature of 35 “C. Keatinge W. R., Hayward M. G. and Mclver N. K. I. (1980) Hypothermia during saturation diving in the North Sea. Br. Med. J. 1,29 1.