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Auteur Stewart K
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Dlamini N, Voermans NC, Lillis S, et al.
Neuromuscular disorders : NMD, 2013, 23, 7, p. 540-548
Revue : Neuromuscular disorders : NMD, 23, 7 Titre : Mutations in RYR1 are a common cause of exertional myalgia and rhabdomyolysis Type de document : Article Auteurs : Dlamini N ; Voermans NC ; Lillis S ; Stewart K ; Kamsteeg EJ ; Drost G ; Quinlivan R ; Snoeck M ; Norwood F ; Radunovic A ; Straub V ; Roberts M ; Vrancken AFJE ; van der Pol WL ; de Coo RIFM ; Manzur AY ; Yau S ; Abbs S ; King A ; Lammens M ; Hopkins PM ; Mohammed S ; Treves S ; Muntoni F ; Wraige E ; Davis MR ; van Engelen B ; Jungbluth H Année de publication : 2013 Pages : p. 540-548 Langues : Anglais (eng) Mots-clés : douleur musculaire ; équilibre calcique ; gène RYR1 ; hyperthermie maligne ; muscle squelettique ; mutation génétique ; myopathie congénitale ; rhabdomyolyse Résumé :
Accès au résumé PubMed / to PubMed abstract
Pubmed / DOI : DOI : 10.1016/j.nmd.2013.03.008 / Pubmed : 23628358Voir aussiCollectif, Stewart K, Grey N
2009, p. 71
Titre : Community critical care outreach – A model for the UK (Poster) Type de document : Article Auteurs : Collectif ; Stewart K ; Grey N Année de publication : 2009 Pages : p. 71 Langues : Anglais (eng) Résumé : The concept of community critical care within the UK is fairly new. Pockets of this type of care and management exist across the country but it is often carried out on an informal or limited basis even though there are over 3000 patients who are registered as receiving home mechanical ventilation (excluding continuous positive airway pressure) invasively and non invasively.1 These patients are a heterogeneous group and include those with neuromuscular disease, rib cage deformity, spinal injury, COPD and obesity. Their numbers have increased exponentially over the past few years and this trend is set to continue form any reasons such as technical advances, increased understanding of such disease processes and survival from prolonged critical illness. These patients, there fore, will require input at home or in an intermediate care facility from a critical care team to support and manage symptoms, give psychological support, change ventilatory requirements during exacerbations, facilitate a weaning programme when appropriate and support palliative care issues. Sending patients home from acute care who require invasive ventilation is fraught with obstacles, anxiety, lack of understanding and prejudice from all areas of the healthcare system with the largest driving force being how cost effective is home mechanical ventilation (HMV)? However, this nilhistic approach to HMV is no longer acceptable and a change in attitude from health care professionals and society as a whole needs to be realised. Developing community critical care as a model of care for the 21st century in order to meet the needs of this patient group is paramount and requires a partnership between primary and secondary care trusts, the independent sector and industry. At all times it must aim to maintain quality in terms of process, patient quality of life and life satisfaction and equality across disability. Reference : 1 Lloyd-Owen et al (2005) Patterns of home mechanical ventilation use in Europe. Eur Respir J 25 : 1025-1031
A pathway home : discharging the complex ventilator dependent patient into the community. A UK perspective (Poster)Collectif, Doherty Y, Perry A, et al.
2009, p. 73
Titre : A pathway home : discharging the complex ventilator dependent patient into the community. A UK perspective (Poster) Type de document : Article Auteurs : Collectif ; Doherty Y ; Perry A ; Bayker E ; McGee L ; Grey N ; Boysen N ; Dicks C ; Cumming N ; Stewart K Année de publication : 2009 Pages : p. 73 Langues : Anglais (eng) Résumé : Introduction Advances in life prolonging and life saving interventions over the past 30 years have lead to a rapidly growing subgroup of patients who are unable to be weaned from mechanical ventilation in the long term. These patients, therefore, will either require invasive mechanical ventilation for the rest of their life or a protracted weaning plan outside the acute care facility. The plight of these patients is often difficult as there are limited resources within the community, no national guidelines to direct the process of care and management of this group of patients and a lack of appropriate intermediate care facilities to discharge the patient to outside the acute care setting. Background The Lane Fox Respiratory Unit (LFRU) is a national weaning centre for Greater London and the South East of England. It is very experienced in discharging the complex ventilator dependent patient back into the community. It is through this experience that a pathway of care has been developed to help guide all healthcare professionals in an adult critical care setting to successfully discharge the complex ventilator dependent patient. The Pathway The pathway should be used as a guide/framework in the process of discharge. The key to its success is nominating a dedicated coordinator throughout the discharge process. The pathway has 4 phases (see Figure 1). This is not a prescriptive framework and will require adaptation based on the needs of the individual patient and family, the availability of resources and local practice. Summary With careful planning and use of the pathway, discharge to the community can succeed but the healthcare team need to be aware of the common difficulties that often thwart the process and include : • Delays in funding • Unsuitable housing • Lack of appropriate intermediate care • Failure to recruit appropriately trained carers or qualified nurses