Intrahospital transportation: Monitoring and risks

Patients' intrahospital transport is considered as part of the mediconursing care continuum, since patients frequently need diagnostic or therapeutic procedures not performed at the bedside (Waddell 1975, Rutherford & Fisher 1986). Severe complications, such as airway obstruction, artificial airway or intravenous line removal, arterial blood gas and blood pressure changes, and arrhythmias or cardiac arrest, have been described during this transportation, especially in critically ill patients (Taylor et al 1970). Risks can be diminished if the patients are appropriately selected and carefully monitored during transportation (Venkataraman & Orr 1992). © 1996 Pearson Professional Ltd

Needle-knife fistulotomy versus needle-knife precut papillotomy for the treatment of common bile duct stones

Background: The aim of this prospective study was to evaluate and compare the efficacy and safety of two different precutting techniques in the treatment of 103 consecutive patients with choledocholithiasis. Methods: The patients were randomized into two groups. The first group included 74 patients who underwent needle-knife fistulotomy avoiding the papillary orifice followed by standard papillotomy. Fifty-two of these patients had a final diagnosis of choledocholithiasis. The second group included 79 patients who underwent needle-knife precut papillotomy starting from the papillary orifice followed by standard papillotomy. Fifty-one of these patients had a final diagnosis of choledocholithiasis. Results: Precutting was successful in 90.54% of patients in the needle-knife fistulotomy group and 88.6% of patients in the needle-knife precut papillotomy group. Stone extraction without mechanical lithotripsy was achieved in 40 of 48 (83.33%) patients in the needle-knife fistulotomy group and 45 of 46 (97.82%) patients in the needle-knife precut papillotomy group (p < 0.05). For the other patients, stone extraction was achieved with the aid of a mechanical lithotriptor. Complications were as follows for the needle-knife fistulotomy and needle-knife precut papillotomy groups, respectively: bleeding, 6.75% and 5.06%; perforation, 2.7% and 2.53%; cholangitis, 1.35% and 0; pancreatitis, 0 and 7.59% (p < 0.05); hyperamylasemia, 2.7% and 17.72% (p < 0.01); and death, 0 and 1.26%. Conclusions: Both methods are effective in the management of choledocholithiasis. When needle-knife fistulotomy is performed, however, lithotripsy is needed more often. Needle-knife fistulotomy is safer than needle-knife precut papillotomy with respect to pancreatic complications

Factors associated with back pain in nursing staff: A survey in Athens, Greece

Factors associated with self-reported back pain were investigated using questionnaire data on 407 female nurses from a large hospital in Athens, Greece. Factor analysis was used to construct indices of pain and its impact on normal life, and also to summarize work load descriptions. Pain factors were examined in relation to work load and personal characteristics by logistic regression. Statistically significant items, in relation both to pain and impact, were the existence of previous back injury, self-reported headaches and the 'carrying and lifting' factor of work load which principally included moving equipment. Age, height and weight were not associated with back pain. Compared to a similar study by Harber and colleagues in California, United States of Amercia, the factors associated with back pain were quite similar in this study even though the prevalence of back pain was much higher among Greek nurses and their work load was physically much more demanding