NEWS IN ORbit

Campus Nursing College health services a t the University of Georgia, Athens, are now being made available to students where they can feel most a t ease-in their living quarters. After realizing students were not coming to the university health service to seek health guidance from nurses, nurses decided to go to the students. Formal and informal contacts, in groups and individually, are carried on in dormitories across the campus. TO avoid being identified as an authority figure, the nurse wears street clothes and sets up "headquarters" in each dormitory a t a spot away from the office of the house director, where traffic i s heavy.

An understanding nurse and an environment conducive to free discussion have provided much-needed health guidance to this university population.

(AJNI

Central registry A central registry will record all cases of liver disease occurring in children in Bronx County, New York City. It i s being established under a grant to the Albert Einstein College of Medicine. information collected i s expected to assist research aimed a t prevention of liver

diseases, including hepatitis related to illegal drug use in children and the chronic forms of hepatitis. (Pediatric Herald)

As a result, contact with students has become easier and more natural. The nurse is sought as an advisor and counselor in health matters and intimate problems otherwise not taken to a remote figure established behind infirmary walls.

The rate at which a wound heals can be controlled by the amount of oxygen reaching the injured area, according to Thomas F. Hunt, MD, associate professor of surgery, University of California, San Francisco.

Popular topics for discussion and advice have been contraception, childbirth, grades, and school failures.

Oxygen may be applied directly to the wound or systemically, by face mask or nasal tube.

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Hastening healing

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Dr. Hunt cites an example of a patient with an ulcerated heel which resisted skin grafts and was being considered for amputation. A continuous flow of oxygen was piped into a plastic bag which surrounded the patient's foot and within 24 hours there was evidence of healing. (Today's Health)

Protection for 'whiplash' Head restraints required in all cars do not protect against whip-lash injuries to the head and neck unless they are raised, according to Harold Portnoy, MD, Pontiac General Hospital, Michigan. Unless the headrest i s continually close to the back of the head, a sudden collision from the rear may whip the head in a to and fro position and damage the neck. (Science Digest)

Saving Babies Death rate among American babies could be reduced 40% to 60% with more widely available health services and better nutrition, according to experts at the National Institutes of Health. (Today's Health)

Floating Hospitals United States hospital ships, the USS Repose and her sister ship, the USS Sanctuary, because of their rapid availability for treatment, have established a probability for survival rate of more than 98%. In emergency conditions each ship can accommodate 750 patients, but the normal capacity i s 560 beds. They have been operating in waters off Vietnam for the past four years, although the Repose returned home recently. The ships' three operating rooms are equipped for any surgical procedure, including corneal transplants and brain surgery. They have equipment to detect brain hemorrhage. Civilians also have been taken care of in these hospital ships off Vietnam. Care i s provided as space i s available to obstetrical, war-inflicted injuries, pediatric and elective

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surgery. A hyperbaric chamber is also available for the treatment of aviation accidents, diving problems and in the incident of medical disorders as clostridial infection. (Hospifols)

25 years of fluoride Fluoridation of water supply has demonstrated that the cost of corrective dental care for children i s less than half what must be spent in a city without it, according to David 8. Ast, MD, medical officer of the New York State Health Department. Some 84 million persons in 5,000 United States communities now use fluoridated water. (Science News)

Low-salt diet in pregnancy A kidney expert at the University of Chicago states that low-salt diets in pregnancy may be hazardous and are based on false scientific premises. Because the kidney's filtering action i s increased about 40% during pregnancy, according to Victor E. Pollack, MD, the pregnant woman requires a normal or higher amount of salt. The amount of salt, among other things, removed from the blood i s increased in pregnancy and leads to further need. Dr. Pollack based his statements on several research studies showing that the early symptoms of eclampsia, along with weight gain and fluid accumulation, occurred three times more frequently in low salt versus high salt experimental groups. These conclusions are not receiving wide acceptance because of belief in false premises which include: 1) the kidneys work the same in pregnant as in nonpregnant women; and 2) low-salt diets prevent the accumulation of fluids in the body which can lead to undesirable weight gain. Even though frequently prescribed, lowsalt diets are seldom adhered to by the

AORN Journal

pregnant women. "The women themselves seem to sense that they need more salt," comments the physician. (Los Angeles Times)

Ozone effect When mice were exposed to varying concentrations of ozone, one of the irritants in smog, b y G. L. Huber, MD, and associates, Harvard School of Public Health, i t was found that a concentration as low as .1 million parts of air may suppress the body's capacity to combat infection. (Today's Health)

Seasonal pattern in heart defect Coarctation of the aorta appears more often in children born January through March and September through November than a t any other time of the year. This was the conclusion of a team of cardiologists at The Children's Hospital Medical Center. Noted was that children born in August account for the fewest cases of heart defect. Findings were based on a review of 560 cases of coarctation of the aorta seen by the hospital between 1950 and 1965.

This new information suggests that a specific defect may be caused by an intrauterine viral or bacterial infection appearing during certain seasons. (Pediatric Herald)

Mental illness therapy Not only the patient, but members of his family are being hospitalized in a new experiment in treating the mentally ill. According to Gene M. Abroms, MD and Carl H. Fellner, MD, of the University of Wisconsin, Madison, the experiment, which provides the oportunity for the patient and his family to work out their problems together, seems to be producing good results. (Today's Heahh)

Cessation of brain function becomes medical criterion A new law in Kansas provides two alternative definitions of death:

174

A person will be considered medically and legally dead if in the physician's opinion, based on ordinary standards of medical practice, there is the absence of spontaneous respiratory and cardiac function. The alternative definition says that ''a person shall be regarded as medically and legally dead, if i n the opinion of a physician, using a basic of an ordinary standard of medical practice, there is absense of spontaneous brain function; and if, based on ordinary standards of medical practice, during reasonable attempts to either maintain or restore spontaneous circulatory or respiratory functions in the absence of aforesaid brain function, it appears that further attempts o t resuscitation will not succeed, death will have occurred at the time when these conditions first coincide." (The Physician's Legal Brief)

Air transpert less pollurEng Studies of the United States Department of Transportation reveal that air pollution from transportation could be reduced to oneeighth its current level if commuters between suburbs and cities could be transported aboard currently available small aircraft instead of automobiles. (Science News)

Do-ibyourseff test Although public sale is not yet coontemplated, a simple self-administered pregnancy test has been developed by the Ames Co., a division of Miles Laboratories. Market research being conducted on the pregnancy test has shown 95% accuracy, which the developers call "comparable with other pregnancy tests." A chemical reagent, in a dry state, enclosed i n a plastic capsule, is employed in the test. The user adds a drop of urine to this reagent and a drop of water to the other half of the capsule, closes the capsule, shakes it, and lets i t stand for one hour. If the subiect i s pregnant, some pregnancy-

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related proteins r w c t with the reagent and a brownish ring appears i n the center of the reopened capsule. Unanswered questions relate to the possible drugstore counter sales versus use only in doctor's offices and clinical laboratories. (Los Angeles Times)

Medical aid signs A new highway sign designed to help the traveler who may be suddenly faced with illness or accident, i s being used on a trial basis in several northern Indiana counties. The white on blue markers bear the AMA Emergency Medical Service Symbol, label an available facility as hospital, clinic, or dispensary, point the direction, and state the distance to emergency medical care. Approval for nationwide use i s expected following evaluations of the Indiana trial. (JAMA)

White bread and vifamins Processing wheat into white flour removes much of the natural B vitamins and vitamin E, according to United States Department of Agriculture scientists. The fate of other important nutrients i n wheat processing is now being examined. Vitamin B, was the most effected of the vitamins and adding i t to enriched flour i s being discussed. (Science News)

B

Caution aibut iron Only anemia with iron deficiency should ever be treated with any form of iron medication according to M. John Murray, MD, of the University of Minnesota School of Medicine, Minneapolis. To take iron in other cases of anemia could lead to excessive and harmful accumulation of iron in the body. (Today's Health)

not required b y their conditions often are placed on patients. Self-help materials and medically approved explanations of what has happened to them should be provided to patients. Hospitals should think about helping patients profitably use their free time during iIIness. (Modern Hospital)

Now it's nerve transplants. Two patients with severely damaged hands who received nerve transplants from human cadavers a t the Neurosurgical Hospital in Munich, Germany are receiving impulses from the transplanted sections of nerve. The section of the nerve to be used is preserved by the same dry-freezing process used with eye corneas. Until this new method was developed, surgeons either tried to suture the severed nerve together or replaced it with a nerve from the same area. (Science Digest)

OR nursing liability The nurse i s never fullly excused from liability to her patient merely because she acts under the direction and control 06 the physician or because her negligent conduct occurs under the furtherance of her employee relationship. The law will hold the nurse responsible for her actions on the basis of the facts in each individual situation. The potential legal hazards present in OR nursing are greater than in any other area.

Hospitdidon-educaVion

While i t i s true that in most negligence suits, the plaintiff usually sues the doctor or the hospital, the nurse may be made a party to the action. The doctrine of "respondeat superior" applies to the nurse when she i s acting under the direction and control of a physician olr hospital.

Hospitals should create an atmosphere of learning and self-renewal instead of boredom and frustration for patients. Constraints

The OR negligence suits in which nurses are most often involved are those where (Continued on Page 180)

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foreign body was left in the patient. The law never excuses carelessness or gross dis-

New vaccine co'mbo

regard for the safety of patients while they

Sharp and

are in the nurse's care and will hold the

single injection,

nurse responsible if she fails to fulfill her legal obligation to the patient.

Federal

license has been granted Merk, Dohme for

production

of a

rubella-mumps vaccine.

Approximately 16 to 17 million children, between the ages of one and puberty, who

So the nurse must have proper training and orientation-and

always be vigilant. (Hospital Topics)

have not had these diseases, nor been innoculated for either disease, remain susceptible. The vaccine i s not recommended for preg-

Total-care acne clinic: or "growing up made easier"

nant women, or women who may become

General Hospital and Children's Hospital in Cincinnati have established the first com-

pregnant within three months after vaccination.

(JAMA)

prehensive acne treatment center in the United

States. This all-inclusive

program

features a preventive phase, begining when a child i s six years old, and ranges through full medical and surgical treatment during puberty, teen years and adulthood. In addition to medication, strong emphasis i s also placed on avoidance of psychological scarring before and after visible acne traces have been eliminated. (The Post & Time Star) Cincinnati, Ohio

Rapid t e s i fer VD Using a fluorescent

antibody technic,

a

newly devised test for detecting gonorrhea while the patient waits in the physician's office has been developed by Nancy Larson, a technician a t the Wilmington Medical Center, Delaware, with the aid of Wm. J. Holloway, MD, and Janet Clark, MD, of the center's research labs.

lnhdation therapy and gram-negative bacieria Nebulizers using aerosols may harbor gramnegative organisms disseminated b y the exhalations of users. The organisms reproduce readily in the nebulizer liquid and may infect a patient who has lost resistance to these invaders with chronic, degenerative lung disease. The respirator heads, tubing and solution should be ETO sterilized and the patient's circuit changed every 24 hours. A program of frequent regular sterilization should be adhered to. Thorough cleaning i s essential to remove all organic debris before sterilization. When optimum sterilization cannot b e attained, liquid chemicals may be used for disinfection after thorough cleaning.

The test takes less than three hours to

Monthly biological monitoring of equipment, fog emitted from nebulizers, and

determine gonocacci in urethral or cervical

solutions will determine the safety of meth-

swabs.

ods established. (Modern Hospital)

Physicians used to start antibiotic treatment whenever the disease was suspected, because, by conventional methods it took

Penethrane linked to kidney d'isturbances

2-7 days for diagnosis. With the new test,

In a study of 22 patients, all 12 who ran-

antibiotics may be wifhheld unit1 diagnosis

domly received penethrane as a n anesthetic showed signs of kidney disturbance, reports

i s certain. (Today's Health)

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a Stanford University research team.

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Halothane was the anesthetic given to the other 10 patients. They had a normal postoperative course. (Los Angeles Times)

At the Sixth World Congress of OB-GYN in New York City, E. E. Rawlings, MD, English investigator, described the many advantages of such a plan.

Wooden clogs

Comfortable, home-like delivery units, in close proximity to the main hospital should complications arise, free more beds for the main hospital. Parents and children a t home are happier having mother home right away. Babies have suffered no ill-effects, and infection incidence has been negligible.

Surgical teams and dentists in Denmark wear white, sterilizable wooden-soled clogs to reduce foot fatigue. According to some medical experts, the backless wooden clogs, now in vogue, are goad for the feet, in that the shoes exercise the feet, aid circulation, and provide foot comfort for those who must stand for long periods of time. A Danish pediatrician warns, however, that although beneficial for adults, the clogs are not suitable for the feet of growing children. (Family Physician/GPj

The offbeat heart Extra heart fibers which "short circuit'' the muscle contracting signals in the heart may be the cause of Wolfe-Parkinson-White syndrome which affects about 1% of the population.

This abnormality in some persons does not produce any serious effects but in others can bring on fast muscle contractions severe enough to produce life-threatening heart failure. John Baineau, MD, Duke University Medic q l Center and E. N. Moore, MD, University of Pennsylvania School of Veterinary Medicine, state that when the condition is serious enough to warrant treatment, i t is correctable by surgery. When patients with the abnormality had the fibers removed surgically, they reverted to normal heart rhythm. (Today's Health)

OB-British

style

When the new Women's Hospital and Maternity Center of Chicago i s completed, (groundbreaking i s scheduled for June 1971), a new idea will be borrowed from the British. Mother and newborn will be sent home a few hours after delivery.

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The average length of stay from admission to discharge has been 10% hours. Since only healihy women with no obvious obstetrical complications were admitted to the unit, fetal mortality was low. (JAMA)

Premature infank In a controlled study of 98 premature infants weighing 1250 to 2000 gm, continuous use of "phototherapy" for the first six days of life prevented hyperbilirubinemia, reduced the need for exchange transfusions, and probably prevented brain damage from kernicterus. Half the control group was placed in isolettes, in the nude with eyes covered, and exposed to cool white fluorescent light for six days and nights. Daily bilirubin determinations revealed levels under 15 mg in the treated group. The untreated group reached dangerous l e v t h of bilirubin.

J. E. Hodgman, MD, and A. Schwarts, MD, of USC School of Medicine, who reported this safe and easy form of treatment, point out that phototherapy would be inadequate in rapid blood destruction, such as erythroblastosis, but seemingly can prevent the slower rise of hypsrbilirubinemia common to premies.

(MD)

Blood platelets clue to rejection A change in the normal population of blood platelets in the body i s a warning that tis-

AORN Journal

sue rejection may soon appear in transplant

X-rays in color

patients, according to Max E. Rafelson, MD,

A new electronic technic whereby standard black and white x-ray plates are projected on a TV screen i n living color enables radi-

of Rush-Presbyterian St. Luke's Medical Center. He has observed that platelet changes appear about 10 days before clinical symptoms of rejection.

ologists at the Medical Center Hospital of Vermont to mare clearly interpret data from ordinary x-rays.

Centrifuged human platelets separate into four density groups simply labeled A,

B, C, D. Generally, band C cells constitute about

50% of platelets in a sample from a

The new technic has also shown i t s value in radioisotope scintiscans of the kidney and liver. Mammography

plates,

when trans-

healthy person, band D about 20%. Marked

lated into color, have shown existing con-

changes in these ratios have been correlated

ditions which were missed when previously

with subsequent episodes of tissue rejection. (Science News)

read as black and white plates. X-ray plates have also been projected as isometric images on a monochrome TV

New procedure for admitting patients

screen, producing dimensional images which

A new procedure has been instituted a t Maryvale Samaritan Hospital, Phoenix, for incoming patients to go directly to their

give more conclusive diagnoses. Radiologists and engineers working under a grant from the National Aeronautics and

rooms. After being made comfortable by

Space Administration

the nursing personnel on the floor, necessary information and signatures are then ob-

produce a combined color a n d dimensional

tained b y a member of the admitting office. This hospital, with a 147-bed capacity ad-

plates.

mits an average of 40 patients per day.

"This direct admission process was affected to make the admitting procedure faster and easier for the patient" said the hospital's executive vice president. (Hospifal Forum)

hope t o

ultimately

radiograph from standard black and white (Medical World News)

How to make the switch The obvious but difficult solution in making the switch to high filtration masks i s to remove the gauze ones completely. The next step i s to establish a month-long trial of three to four different high filtration masks. The choice of these from all the available

Polio eliminalted?

ones should b e based on evaluation of

It was hoped that the Salk and Sabin polio vaccines would eventually control the outbreak of poliomyelitis epidemics throughout the world. However, statistics compiled b y the World Health Organization for 1966 reveal that this dreadful disease has not yet been conquered. World-wide totals account for 14,793 reported cases, with a total of 988 deaths from the disease.

Of all the countries reporting, Australia and New Zealand remained absolutely free of polio in 1966. (JAMA)

184

studies on filtering efficiency. Doctors and nurses should give their evaluation of the trial samples on the basis of fit, comfort, ease of application, ease of breathing and odor. Cost shouldn't

be a

factor since the two types of masks are competively priced. (Modern Hospital)

,Breast cancer screening Community response to an effective screening program for breast cancer in New York City has been so encouraging that Philip

AORN Journal

Straux, MD, director of radiology at La Guardia Hospital, New York, hopes his mass screening idea will spread to other cities.

repair), and abdominoplasties (removal of excess fatty tissue). (Medical World News)

Because early detection of breast cancer must be done with accuracy, speed and convenience. Dr. Strax and his colleagues devised a four-step testing procedure that takes about ten minutes per patient.

A striking reduction in mortality and morbidity rates for patients with ischemic coronary heart disease has been attributed to the use of chondroitin sulfate A (CSA).

The four steps, performed by trained paramedical personnel, under MD supervision, include interview of patient, clinical examination and recording of breast characteristics, roentgenography of mammary gland and the thermography test. Definite diagnosis i s performed by the physician. A mobile van, containing a 70 mm mammography device, developed by Dr. Strax, will be in operation next summer. This machine can screen 20 women per hour. The neighborhood screening center idea could potentially become a pattern for nationwide use.

(JAMA)

Cosmetic surgery Twenty-five years ago, surgical resculptoring, or cosmetic surgery, was performed mostly on aging dowagers or actors. Today, the housewife, businessman, middle-class youngster, and ghetto resident, most 04 whom are in good health, are taking advantage of this type of available surgery. Of the 1200 board-certified plastic surgeons in this country, about 200 do almost exclusively elective cosmetic surgery. Realizing that appearances affect a patient's well-being, physicians are referring patients for "aesthetic" procedures to these specialists for rhinoplasties (nose repair), rhytidectomies (tightening of sagging skin of face and neck), blepharoplasties (eye-lid skin tightening), breast augmentations (enlarging or reshaping), mentoplasties (chin

186

Cormairy incidents

A four-year control study of 120 patients with myocardial infarct and/or coronary artery disease b y Lester Morrison, MD, Loma Linda University School of Medicine, Calif, reveals coronary incidents to be about onesixth less for CSA-treated patients. Although permission to use the agent CSA has been granted in the United States only for Dr. Morrison's control group, he has made an appeal to the American College of Angiology for a massive double blind study, on the grounds that over one million heart attacks a year might well be prevented in this country.

(JAMA)

13 million quit cigarettes A report from the First National Conference on Smoking and Health in San Diego indicates that 13 million Americans have successfully quit smoking cigarettes since 1966. There are actually 4% million fewer smokers in the United States now than there were in 1966 despite an estimated population gain of more than 8 million. Experts were astonished and labeled the statistics as "unique in the public health

field ." Contributing factors were thought to have originated with the cancer scare of the 195Os, continued with the 1964 Surgeon General's report, and assisted by the anticigarette television commercials.

In 1970, 42% of American men and 31 9'0 of American wamen smoked cigarettes, compared with 52% men and 34% women in

1966.

AORN Journal

Despite the encouraging change, "cigar-

trained in the proper care of the sick child,

ette smoking remains the biggest single

thereby reducing chances for the post-hos-

problem in the entire field of preventive medicine in the Western nations of Europe and North America."

pita1 accident.

(Los Angeles Times)

After detailed instructions, the mother i s seldom idle. Her responsibilities may include bathing, feeding,

ministering

medications,

collecting urine and stool specimens, and

Mulltiple births Fertility drugs are believed to be a con-

recording pertinent chart information on a

tributing factor in today's rise in multiple births. A recent study of 78 Israeli women

daily diary sheet.

who had taken fertility drugs prior to their pregnancies, revealed that 31 of the group

Massachusetts and elsewhere have been initiated, resulting in happier parents and

had multiple births. Twenty-three had twins,

children.

five had triplets, two had quadruplets. There was one set of sextuplets. (American Family Physician/GP)

Similar

programs in Texas,

California,

(Medical World News)

AMA and drugs The House of Delegates of the American

Lifesaving and the elderly patient

lutions pertaining to drugs a t their recent

An overwhelming majority of elderly people

Chicago meeting.

said they would not want heroic methods used t o prolong their lives, if death from an incurable illness were imminent, according to a survey by the University of Southern California, Los Angeles. Only 4% said they would want the doctors to use every medical treatment a n d device available t o keep them alive.

Medical Association passed several reso-

The Food and Drug Administration came under fire for their recent removal of certain drugs from the market without first consulting clinical experts and informing the medical profession. Such practices resulted in great confusion among patients being treated with such medicines. A resolution protesting that "the medical

This survey took place in the upper middle

profession should b e assured a voice in the

class and another survey i s being done among poorer people in rural areas.

ency action that i s contrary t o the public

(10s Angeles Times)

MID'S aid: mother In much of the world, Europe included, parents assume the semiprofessional role of

decisions made by the FDA to prevent aginterest" was to be sent to the commissioner of food and drugs. In the interest of patient safety, a resolution was passed pertaining t o advertising

caring for their hospitalized children. Observing Korean families during his military

practices

service, Vernon 1. James, MD, pediatrician, has successfully implemented the same idea

surveillance of proprietary drug regulations

at the University of Kentucky Medical Center. Putting one parent to work, usually the mother, results in the child getting the best possible care and recuperating faster; parents' worries are allayed; staff workload and costs are reduced; and parents are

188

for

nonprescription

drugs.

The

House recommended that more adequate b e enforced by governmental agencies. The House also supported passage of legislation to control the manufacture, distribution and dispensing of barbiturates and amphetamines, thereby curtailing the illicit production

and

illegitimate

diversion

of

these drugs.

(JAMA)

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