Table Of ContentI ntensive Care
I ntensive Care
Edited by
ERIC SH ER WOOO JON ES
Whiston Hospital, Prescot, Merseyside
~
MTPPR
LlMITED'LANCASfER'ENGLAND
International Medical ?ubli her
Published by
MTP Press Limited
Falcon House
Lancaster, England
Copyright © 1982 MTP Press Limited
Softcover reprint of the hardcover 1st edition 1982
British Library Cataloguing in Publication Data
Intensive care.
1. Critical care medicine.
I. Sherwood Jones, Eric
616' .028 RC86.7
ISBN-13: 978-94-009-7315-2 e-ISBN -13: 978-94-009-7313-8
DOl: 10.1007/978-94-009-7313-8
All rights reserved. No part of this publication
may be reproduced, stored in a retrieval
system, or transmitted in any form or by any
means, electronic, mechanical, photocopying,
recording or otherwise, without prior permission
from the publishers.
Phototypesetting by Georgia Origination, Liverpool
Printed by Butler & Tanner Limited, Frome and London
Contents
Preface Vll
Contributors IX
Acknowledgements XI
Intravenous feeding
HARRY LEE
2 Immunology 31
BOB PARKES
3 Microbial infection 47
STEPHEN ATHERTON AND DAVID WHITE
4 Coagulopathies 78
BARBARA BAIN
5 Shock 114
WILLIAM SCHUMER
6 Blood transfusion 129
BARBARA BAIN
7 Intermittent positive pressure ventilation 142
PAUL LAWLER
8 Respiratory distress syndrome of shock and trauma 179
JAMES HOLCROFT AND WILLIAM BLAISDELL
9 Head injuries 192
BRYAN JENNETT
v
INTENSIVE CARE
10 The brain dead kidney donor: from death to donation 215
ANDREW LUKSZA
11 Chest injuries 232
MALCOLM WRIGHT
12 Spinal cord injuries 253
BILL DAVIES
13 Acute myocardial infarction 282
THOMAS PORTS, DAVID HESS AND KANU CHATTERJEE
14 Acute poisoning 324
NOEL WRIGHT
15 Guillain-Barre syndrome 357
HENNING SUND KRISTENSEN
16 Tetanus 366
ROBERT EDMONDSON, MARY COOKE AND MICHAEL FLOWERS
17 Botulism 388
PETER BALL AND ROWLAND HOPKINSON
18 The recovery room 400
JOHN FARMAN
19 Training the nurse: UK style 432
PAT ASHWORTH
20 Teaching the medical undergraduate 444
MAURICE RAPIN AND JEAN-ROGER LE GALL
Index 449
vi
Preface
A comprehensive text of intensive care would readily fill the equivalent of
the Shorter Oxford English Dictionary. This is because the diseases treated
are both numerous and varied; thus the patient can be medical, surgical,
trauma or obstetric. It follows that the sum total of knowledge which needs
to be available is truly encyclopaedic. This compact volume represents only
a fragment of such information. The contributors were chosen because of
their experience and because their methods were well-tried. The text
therefore summarizes the best of current therapy and includes the
controversial. The contributors come from four countries, adding an
international flavour. One topic - The Recovery Room - outside the
confines of intensive care has been included for two reasons. The recovery
room is an important but neglected aspect of care, and it also seems
important to define its relationships with the intensive care unit. It is hoped
that the book will help the nurses and doctors involved in intensive care
and, therefore, the patient.
ERIC SHERWOOD JONES
Vll
Contributors
P.M. ASHWORTH K. CHATTERJEE
Department of N •. using Medicine Cardiology Division
University of Manchester University of California San
Stop ford Building Francisco
Oxford Road Cardiovascular Research Institute
Manchester M 13 9PT, UK Moffitt Hospital Rm. 1186
San Francisco
California 94143, USA
S. T. ATHERTON
Intensive Care Unit
Whiston Hospital E.M. COOKE
Prescot Department of Microbiology
Merseyside, UK University of Leeds
Leeds LS2 91Z, UK
B.J. BAIN
Department of Haematology W.E. DAVIES
St Mary's Hospital Medical School Spinal Injuries Unit
Praed Street Princess Alexandra Hospital
London W2 I PG, UK Ipswich Road
Brisbane
Queensland
A.P. BALL Australia 4102
Infectious Diseases Unit
Cameron Hospital
Windygates R. S. EDMONDSON
Fife, KY8 5RR, UK Department of Anaesthesia
Leeds General Infirmary
Leeds LSI 3EX, UK
F. W. BLAISDELL
Department of Surgery
University of California J. V. FARMAN
Davis Medical Center Department of Anaesthesia and
4301 X Street, Rm. 257 Intensive Care Unit
Sacramento Addenbrooke's Hospital
CA 95817, USA Cambridge CB2 2QQ, UK
viii
CONTRIBUTORS
M. W. FLOWERS H.A.LEE
Accident and Emergency Department Department of Renal and Metabolic
Leeds General Infirmary Medicine
Leeds LSI 3EX, UK University of Southampton
St Mary's Hospital
Portsmouth
D.S. HESS Hants P03 6AD, UK
Medicine Cardiology Division
University of California
San Francisco J.-R. LE GALL
Cardiovascular Research Institute Service de Reanimation medicale
Moffitt Hospital Rm. 1186 H6pital Henri Mondor
San Francisco 94010 Creteil
California 94143, USA France
J. W. HOLCROFT A.R. LUKSZA
Department of Surgery Intensive Care Unit
University of California Whiston Hospital
Davis Medical Center Prescot
4301 X Street, Rm. 257 Merseyside L35 5DR, UK
Sacramento
CA 95817, USA
R.P.F. PARKES
Intensive Care Unit
R. B. HOPKINSON Princess Alexandra Hospital
Intensive Therapy Unit Ipswich Road
East Birmingham Hospital Brisbane 4102
Birmingham B9 5ST, UK Queensland
Australia
W.B. JENNETT
Southern General Hospital T.A. PORTS
Glasgow GSI 4TF, UK Medicine and Cardiology Division
University of California
San Francisco
H. S. KRISTENSEN
Cardiovascular Research Institute
Departments of Infectious Diseases
Moffitt Hospital Rm. 1186
and Anaesthesia
San Francisco
Rigshospitalet - University Hospital
California 94143, USA
18 Tagensvej
DK 2200 Copenhagen
Denmark M. RAPIN
Service de Reanimation medicale
H6pital Henri Mondor
P.G.P. LAWLER
94010 Creteil
Intensive Therapy Unit
France
South Cleveland Hospital
Marton Road
Middlesbrough
Cleveland TS3 4BW, UK
IX
INTENSIVE CARE
W. SCHUMER D.M. WRIGHT
Department of Surgery Intensive Care Unit
University Health Science Princess Alexandra Hospital
The Chicago Medical School at VA Ipswich Road
Medical Center Brisbane 4102
North Chicago Australia
IL 60064, USA
N. WRIGHT
D.J. WHITE Regional Poisoning Treatment Centre
Bacteriology Department Dudley Road Hospital
Whiston Hospital Dudley Road
Prescot Birmingham BI8 7QH, UK
Merseyside, UK
x
Acknowledgements
Portions of Chapter 5, including Figure 5.1, are reproduced with
permission from the following journals: Comprehensive Therapy, Journal
of the American Medical Association, and Surgery. In Chapter 8 Figure 8.1
is reproduced with permission from Surgical Forum. In the recruiting of
contributors the editor was helped by Dr Brian Davis, Dr Malcolm Wright
and Professor lain Ledingham. The edited version was typed by Miss
Frances Twist, and help with the references was given by the Librarian of
the Liverpool Medical Institution.
xi
