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PLASTIC SPUTUM FLASKS
518
April 20. She never showed any great improvement and gradually deteriorated until on May 15 she became semicomatose. She was given cortisone, but she died within twenty-four hours. Necropsy showed normal architecture in the pituitary gland, although there was a relative decrease in the number of a andcells compared with chromophobe cells. The adrenals were very small (left, 1-2 g. ; right, 0-5 g.), and section showed advanced cortical atrophy with patchy fibrosis and lymphocytic infiltration. The thyroid was normal.
on
very
advantages over the easily available one pound jam jar with its smooth-surfaced, wide opening and cheap plastic lid. The latter is obviously more easily cleaned.
’
used too late and it seems reasonable to assume that had it been given earlier the outcome would have been different. St. Alfege’s Hospital, E. T. BASSADONE. London, S.E.10. In the second
case
cortisone
was
PREVENTION OF AIRBORNE INFECTION
Hammersmith Chest Clinic, London, W.12.
PETER
STRADLING.
UMBILICAL HERNIA IN INFANTS 6 about Dr. Woods’s the publicity which her give likely paper she deserves. A controversy has now become apparent between Dr. Woods’s supporters on the one hand, and " strappers and binder,-," on the other. A further cleft is developing between the " S and B" group upon the length and distribution of the restrictive apparatus. Perhaps your intention was to describe the length, arrangement, and distribution of the strapping which should not be used. For very many years now,I have avoided all forms of strapping or binding for umbilical herniæ, partly because of the facts now published by Dr. Woods, and partly because many babies keenly resent these appliances and demonstrate their resentment by crying. Crying and coughing are two most efficient methods of forcing abdominal contents into a hernial sac-truss or no
SiR,-Your annotation of Feb. seems
to
SiR,-The prevention of airborne infection seems to be of the greatest importance in the treatment of burns, judging from the results of Dr. Lowbury’s work (Feb. 6), and it seems strange that no reports have been forthcoming on the use of continuous-flow germicidal aerosols in wards, theatres, and dressing-rooms in use for burns patients. Aerosols of hexylresorcinol have been shown by numerous workers over the past 15 years to be rapidly lethal to airborne vegetative bacteria, 90-95% kills’ in truss. 5 minutes being reported from the use of this compound W. A. JACKMAN. at an aerial concentration of 0-2 mg. per c.m. Thermal generators capable of treating 5000 c. ft. of air per hour, at a cost of under 4 3d. per hour, are available TELEVISION FOR RESPIRATOR PATIENTS and can be plugged into existing mains ; renewal of the SIR,—To the patient with respiratory paralysis who germicide cup after 500 hours use is the only attention must spend a long time in a respirator, television is a required. ’This surely is a far cheaper, easier, and quicker boon. But it is not always easy to arrange. method of air-conditioning than the installation of lying prone in a respirator can see the screen bulky air-conditioning plant. I would add that it has of Aanpatient ordinarily placed set by the use of two mirrors. But been used as a supplement where air-conditioning was in this involves awkward adjustments and an alteration to the use. The rate of kill quoted above is equivalent to about set to show an inverted 30 air-changes per hour in the removal of infectivee picture on the screen; agents. Air changes of that order can cause considerable the final image can then be seen by the patient discomfort, amounting, as they do, to a minor gale. Hexylresorcinol aerosol should prevent" the infection of overhead in the second but is not readily patients by the " resident contaminants and eventually mirror, visible to relatives or remove these altogether, at the same time preventing cross-infections from patient to patient and staff to friends who may be sitby. The white ceiling patient. The prevention of direct droplet infection ting may be used as the screen must, of course, still be taken care of by masking, of a projection television set placed on its back, barrier-nursing, and other means. "
"
Aylesbury Research Laboratories (Consulting Entomologist), Goring-on-Thames.
PLASTIC SPUTUM FLASKS SiR.—The sputum flask now issued by the London County Council, and described by Dr. Hartston last week (p. 445), appears satisfactory in basic design ; but the method of use described can be improved upon. Dr. Hartston suggests that antiseptic be placed in the pocket flask before travelling : this involves the risk of spilling when in use or of leakage if the cap is not screwed on tightly. Both the antiseptics suggested-lysol and Miltherex’ (’ Milsol’)—are not innocuous if so spilt. If miltherex is used, and this is by far the most satisfactory agent yet on the market, the sputum can be dissolved and sterilised by adding the fluid to the flask after 12 to 24 hours’ expectoration. The flask can then be cleaned very easily without boiling. If this procedure is followed it can be carried dry, thus eliminating the danger of spilling a caustic and bleaching agent. The half an ounce of miltherex advised by Dr. Hartston will certainly be inadequate to dissolve the sputum of a freely expectorating patient, as I have already shown.! It will be found that two to four ounces will be required in many cases. Finally, I doubt whether the new flask, with its screwthreaded orifice has, at the bedside, any outstanding 1.
Stradling, P.
ceilings in this hospital are too near the patient’s head to give clear definition of so large a picture. Captain G. T. Smith-
but the
A. HOWARD BAKER.
Lancet, 1953, ii, 1185.
Clarke, chairman of the
Coventry Hospital
Man-
agement Committee, arranged to have a gantry made from welded tubular steel, on which a television set could be
securely perched
at
a
suitable angle, as shown in the accompanying figure. The relatives sitting behind the patient’s head also have a satisfactory view. This device proved a great success, and another one has recently been made for a second respirator patient. The gantry is 7 ft. 2 in. tall at the back and 6 ft. 2 in. at the front of the sloping platform on which the television set is fixed. The width is 3 ft. The slope of the platform is 60° to the horizontal. The screen is a little bigger than 9 in. wide, and it is 4 ft. 2 in. from the patient’s eyes, with the gantry in its optimum position. To protect the case of the television set ’Sorbo ’ rubber is used on the platform and under the retaining batten. The four legs of the gantry are mounted on castors, so that it can be moved back out of the way when not in use. Whitley Hospital, J. F. GALPINE. Coventry.
,
April 20. She never showed any great improvement and gradually deteriorated until on May 15 she became semicomatose. She was given cortisone, but she died within twenty-four hours. Necropsy showed normal architecture in the pituitary gland, although there was a relative decrease in the number of a andcells compared with chromophobe cells. The adrenals were very small (left, 1-2 g. ; right, 0-5 g.), and section showed advanced cortical atrophy with patchy fibrosis and lymphocytic infiltration. The thyroid was normal.
on
very
advantages over the easily available one pound jam jar with its smooth-surfaced, wide opening and cheap plastic lid. The latter is obviously more easily cleaned.
’
used too late and it seems reasonable to assume that had it been given earlier the outcome would have been different. St. Alfege’s Hospital, E. T. BASSADONE. London, S.E.10. In the second
case
cortisone
was
PREVENTION OF AIRBORNE INFECTION
Hammersmith Chest Clinic, London, W.12.
PETER
STRADLING.
UMBILICAL HERNIA IN INFANTS 6 about Dr. Woods’s the publicity which her give likely paper she deserves. A controversy has now become apparent between Dr. Woods’s supporters on the one hand, and " strappers and binder,-," on the other. A further cleft is developing between the " S and B" group upon the length and distribution of the restrictive apparatus. Perhaps your intention was to describe the length, arrangement, and distribution of the strapping which should not be used. For very many years now,I have avoided all forms of strapping or binding for umbilical herniæ, partly because of the facts now published by Dr. Woods, and partly because many babies keenly resent these appliances and demonstrate their resentment by crying. Crying and coughing are two most efficient methods of forcing abdominal contents into a hernial sac-truss or no
SiR,-Your annotation of Feb. seems
to
SiR,-The prevention of airborne infection seems to be of the greatest importance in the treatment of burns, judging from the results of Dr. Lowbury’s work (Feb. 6), and it seems strange that no reports have been forthcoming on the use of continuous-flow germicidal aerosols in wards, theatres, and dressing-rooms in use for burns patients. Aerosols of hexylresorcinol have been shown by numerous workers over the past 15 years to be rapidly lethal to airborne vegetative bacteria, 90-95% kills’ in truss. 5 minutes being reported from the use of this compound W. A. JACKMAN. at an aerial concentration of 0-2 mg. per c.m. Thermal generators capable of treating 5000 c. ft. of air per hour, at a cost of under 4 3d. per hour, are available TELEVISION FOR RESPIRATOR PATIENTS and can be plugged into existing mains ; renewal of the SIR,—To the patient with respiratory paralysis who germicide cup after 500 hours use is the only attention must spend a long time in a respirator, television is a required. ’This surely is a far cheaper, easier, and quicker boon. But it is not always easy to arrange. method of air-conditioning than the installation of lying prone in a respirator can see the screen bulky air-conditioning plant. I would add that it has of Aanpatient ordinarily placed set by the use of two mirrors. But been used as a supplement where air-conditioning was in this involves awkward adjustments and an alteration to the use. The rate of kill quoted above is equivalent to about set to show an inverted 30 air-changes per hour in the removal of infectivee picture on the screen; agents. Air changes of that order can cause considerable the final image can then be seen by the patient discomfort, amounting, as they do, to a minor gale. Hexylresorcinol aerosol should prevent" the infection of overhead in the second but is not readily patients by the " resident contaminants and eventually mirror, visible to relatives or remove these altogether, at the same time preventing cross-infections from patient to patient and staff to friends who may be sitby. The white ceiling patient. The prevention of direct droplet infection ting may be used as the screen must, of course, still be taken care of by masking, of a projection television set placed on its back, barrier-nursing, and other means. "
"
Aylesbury Research Laboratories (Consulting Entomologist), Goring-on-Thames.
PLASTIC SPUTUM FLASKS SiR.—The sputum flask now issued by the London County Council, and described by Dr. Hartston last week (p. 445), appears satisfactory in basic design ; but the method of use described can be improved upon. Dr. Hartston suggests that antiseptic be placed in the pocket flask before travelling : this involves the risk of spilling when in use or of leakage if the cap is not screwed on tightly. Both the antiseptics suggested-lysol and Miltherex’ (’ Milsol’)—are not innocuous if so spilt. If miltherex is used, and this is by far the most satisfactory agent yet on the market, the sputum can be dissolved and sterilised by adding the fluid to the flask after 12 to 24 hours’ expectoration. The flask can then be cleaned very easily without boiling. If this procedure is followed it can be carried dry, thus eliminating the danger of spilling a caustic and bleaching agent. The half an ounce of miltherex advised by Dr. Hartston will certainly be inadequate to dissolve the sputum of a freely expectorating patient, as I have already shown.! It will be found that two to four ounces will be required in many cases. Finally, I doubt whether the new flask, with its screwthreaded orifice has, at the bedside, any outstanding 1.
Stradling, P.
ceilings in this hospital are too near the patient’s head to give clear definition of so large a picture. Captain G. T. Smith-
but the
A. HOWARD BAKER.
Lancet, 1953, ii, 1185.
Clarke, chairman of the
Coventry Hospital
Man-
agement Committee, arranged to have a gantry made from welded tubular steel, on which a television set could be
securely perched
at
a
suitable angle, as shown in the accompanying figure. The relatives sitting behind the patient’s head also have a satisfactory view. This device proved a great success, and another one has recently been made for a second respirator patient. The gantry is 7 ft. 2 in. tall at the back and 6 ft. 2 in. at the front of the sloping platform on which the television set is fixed. The width is 3 ft. The slope of the platform is 60° to the horizontal. The screen is a little bigger than 9 in. wide, and it is 4 ft. 2 in. from the patient’s eyes, with the gantry in its optimum position. To protect the case of the television set ’Sorbo ’ rubber is used on the platform and under the retaining batten. The four legs of the gantry are mounted on castors, so that it can be moved back out of the way when not in use. Whitley Hospital, J. F. GALPINE. Coventry.
,