26
|
Ballard K. Use of the Polaroid Macro 3 SLR camera in wound assessment. Br J Community Nurs 2001; 6:318-9. [PMID: 11873209 DOI: 10.12968/bjcn.2001.6.6.7079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Patient assessment is essential to effective care and facilitates systematic care planning. Assessment must be performed in combination with good documentation and accurate record keeping. Clinical governance, risk management and accountable practice are continuously emphasized by the UKCC (1992, 1998) and Department of Health (1998), and in the light of increasing litigation, it is imperative that planned and given care is accurately documented.
Collapse
|
27
|
Ballard K, Baxter H. Promoting healing in static wounds. NURSING TIMES 2001; 97:52. [PMID: 11954459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
|
28
|
Schulze HJ, Lane C, Charles H, Ballard K, Hampton S, Moll I. Evaluating a superabsorbent hydropolymer dressing for exuding venous leg ulcers. J Wound Care 2001; 10:511-8. [PMID: 12964233 DOI: 10.12968/jowc.2001.10.1.26038] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A new hydropolymer dressing was compared with an alginate dressing in a multicentre, prospective, controlled, randomised, stratified, open label trial of 113 patients with exuding venous leg ulcers. The study aimed to evaluate the performance of the dressings in terms of their ability to handle exudate, patient and user acceptability and cost-effectiveness. Patients were stratified according to volume of wound exudate (moderate/heavy) and randomised to the hydropolymer dressing or the alginate plus a secondary dressing. A statistically significant difference between treatment groups was observed in mean wear time, with a longer wear time observed in the hydropolymer group (3.91 days) compared with the alginate group (3.09 days, p = 0.001). In terms of patient and user acceptability, all 10 overall evaluations made by both patient and investigator were markedly in favour of the hydropolymer dressing (p < 0.001 to p = 0.020). The use of the hydropolymer dressing for patients with moderate to heavily exuding venous leg ulcers has statistically significant advantages over the alginate dressing in terms of wear time and investigator and patient acceptability. It is anticipated that this reduction in dressing frequency will translate into a cost-effective wound treatment.
Collapse
|
29
|
Ballard K, McGregor F, Baxter H. An evaluation of the Parema four-layer bandage system. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2000; 9:1089-94. [PMID: 12785090 DOI: 10.12968/bjon.2000.9.16.5481] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This article gives an overview of the treatment and causes of venous leg ulcers and focuses on a new four-layer bandage system (K-Four from Parema) which can be used in the treatment of these ulcers. The article features preliminary observations of this new system, which was used on 10 patients who had previously worn multilayer compression.
Collapse
|
30
|
Ballard K, Baxter H. Essential wound healing. Part. 7. Managing acute wounds. COMMUNITY NURSE 2000; 6:suppl 1-7. [PMID: 11982128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
|
31
|
Ballard K, Baxter H. Developments in wound care for difficult to manage wounds. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2000; 9:405-8, 410, 412. [PMID: 11111435 DOI: 10.12968/bjon.2000.9.7.6319] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Research and development in wound healing has ensured that issues relating to chronic wound management remain high in the nursing agenda. Since the advent of modern wound dressings, which retain a moist wound healing environment, work has continued to progress into more advanced, interactive products which aim to alter the wound bed in order to promote a suitable environment for cell migration and growth. Rapid wound healing is advocated and necessary to reduce morbidity and mortality in patients with large chronic wounds and to reduce the financial and manpower implications of long-term wound care in the hospital or community setting. Vacuum-assisted closure, artificial skins, growth factors and larval therapy are discussed in order to give an overview of some of the emerging practices being adopted for difficult to manage wounds.
Collapse
|
32
|
Taylor A, Lane C, Walsh J, Whittaker S, Ballard K, Young SR. A non-comparative multi-centre clinical evaluation of a new hydropolymer adhesive dressing. J Wound Care 1999; 8:489-92. [PMID: 10827652 DOI: 10.12968/jowc.1999.8.10.26210] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This study evaluates the performance of a new hydropolymer adhesive dressing in the treatment of chronic or acute wounds, in the presence of blood and/or low levels of exudate, in 74 patients, in a five-site multi-centre non-comparative clinical trial of four weeks' duration. The primary efficacy variable was defined as the incidence of central island dressing adherence to the wound bed in the final stages of healing. The hydropolymer dressing performed extremely well with 98.4% (240 out of 244) of the dressings not adhering to the wound bed.
Collapse
|
33
|
Baxter H, Ballard K, McGregor F. Wound care. Concentrated care. NURSING TIMES 1999; 95:66-8. [PMID: 10847087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
|
34
|
Taylor AA, Shepherd AM, Polvino W, Mangoo-Karim R, Ballard K, Sunthornyothin S, Luther RR, Pool JL. Prolonged fenoldopam infusions in patients with mild to moderate hypertension: pharmacodynamic and pharmacokinetic effects. Am J Hypertens 1999; 12:906-14. [PMID: 10509549 DOI: 10.1016/s0895-7061(99)00068-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Thirty-three patients with mild-to-moderate essential hypertension received either placebo or fenoldopam, a selective dopamine-1 agonist, by intravenous infusion at a fixed infusion rate ranging from 0.1 to 0.8 microg/kg/min for 48 h during a double-blind, placebo-controlled, randomized inpatient clinical trial. Blood pressure and heart rate were measured every 15 min for 24 h before, during, and 24 h after the 48-h drug infusion. Plasma concentrations of racemic fenoldopam were measured at frequent intervals during and for 24 h after fenoldopam infusion. In the 26 patients who received fenoldopam, there were dose-dependent reductions in systolic and diastolic blood pressure, which usually reached a nadir within 2 h of beginning infusion and were significant even at the lowest dose studied (-9 and -9 mm Hg for systolic and diastolic blood pressure, respectively, at 24 h for the dose of 0.04 microg/kg/min, P < .05). There were associated increases in heart rate that were greater in the first than in the last 24 h of drug infusion. Compared to the average 24-h control blood pressure, maximum mean reductions in systolic and diastolic blood pressures of 33 and 21 mm Hg, respectively, were noted in patients receiving fenoldopam at 0.8 microg/kg/min and occurred 4 and 1 h, respectively, after beginning infusion. Tolerance to the blood pressure lowering effects of the drug developed slowly during the 48 h of drug infusion; the half-life for this effect was 60 h. No serious adverse clinical effects were noted in any patient. These results demonstrate that fenoldopam is effective in reducing blood pressure of patients with mild-to-moderate hypertension at doses as low as 0.04 microg/kg/min, is well tolerated at doses up to 0.8 microg/kg/min, maintains most of its antihypertensive efficacy throughout 48 h of continuous, constant rate infusion, and produces neither prolonged pharmacodynamic effects nor rebound hypertension when discontinued. The pharmacodynamic effects of the drug are best predicted by pharmacokinetics of racemic and R-fenoldopam.
Collapse
|
35
|
Ballard K, Baxter H. The tendering process for beds and mattresses. PROFESSIONAL NURSE (LONDON, ENGLAND) 1998; 13:450-4. [PMID: 9653280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
As increasing numbers of expensive, sophisticated bed and mattress systems become available, more trusts are negotiating contracts for supply, maintenance and training. It is important that tissue viability nurses become involved in such decision-making.
Collapse
|
36
|
Zabel DD, Tinkoff G, Wittenborn W, Ballard K, Fulda G. Adequacy and efficacy of lateral cervical spine radiography in alert, high-risk blunt trauma patient. THE JOURNAL OF TRAUMA 1997; 43:952-6; discussion 957-8. [PMID: 9420111 DOI: 10.1097/00005373-199712000-00015] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The purpose of this study was to determine the adequacy and accuracy of lateral cervical spine radiographs in the initial evaluation of alert, high-risk trauma patients evaluated at a Level I trauma center. METHODS Data were obtained retrospectively through review of trauma service admissions from January 1, 1994, to July 31, 1995. Included were all patients triaged to a trauma response team with age > 15 years, Glasgow Coma Scale score > 13, and blunt mechanism of injury. Lateral cervical spine radiograms were obtained routinely before secondary survey and were reviewed for technical adequacy (all seven cervical vertebrae, C7/T1 interspace). The presence of cervical symptoms (pain, tenderness, neurologic deficits) was recorded. Sensitivity and specificity were calculated for lateral cervical spine radiography and cervical symptoms in predicting the presence of cervical spine injury. Bayesian analysis, which allows for the current probability of occurrence to be factored by previously reported probabilities of occurrence, was used to determine the negative predictive probability of lateral cervical spine radiography and absence of cervical symptoms to predict the absence of injury to the cervical spine. RESULTS Three hundred fifty-three patients received lateral cervical spine radiograms, of which 223 (63%) were determined to be adequate for interpretation. Cervical symptoms were present in 77 patients (20%). Only 32 (42%) of this group's lateral cervical spine radiograms were adequate. Nine patients (2.4%) had acutely fractured cervical vertebrae or ligamentous disruption. Lateral cervical spine radiography showed the injury in only six of these patients. The sensitivity, specificity, and negative predictive probability for lateral cervical spine radiography were 67, 58, and 1.4%, respectively, and for absence of cervical symptoms, 89, 81, and 0.32%, respectively. CONCLUSION The higher accuracy and lower negative predictive probability make the absence of cervical symptoms in the alert, high-risk, blunt trauma patient a better screening test than lateral cervical spine radiography. We suggest that lateral cervical spine radiography is not needed in the initial evaluation of alert patients who have sustained blunt trauma.
Collapse
|
37
|
Ballard K. Pressure-relief mattresses and patient comfort. PROFESSIONAL NURSE (LONDON, ENGLAND) 1997; 13:27-32. [PMID: 9393050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The ideal pressure-relieving support system is comfortable, relieves pressure and prevents tissue damage. In order to ensure patient compliance with the choice of mattress, patient comfort and quality of sleep should be among the most important factors involved in the decision-making process.
Collapse
|
38
|
Ballard K. Know how. Pulsating air suspension therapy. NURSING TIMES 1997; 93:66-7. [PMID: 9205363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The realisation that pressure sores are caused by shearing forces and tissue distortion rather than simply by pressure, had led to the development of specialised patient support systems. The pulsating air suspension system was developed to help reduce the incidence of oedema formation. All health-care professionals using specialised bed therapy have a responsibility to understand the principles of that therapy in order to ensure appropriate patient selection, which may be aided by the development of placement criteria. The concept of pulsation therapy has been a stimulus for new thinking on the causes and treatment of pressure sores and has highlighted the need for further research on the part played by the lymphatic system and oedema on pressure sore formation, although there is already strong evidence that there is a link between tge two.
Collapse
|
39
|
Abstract
When a patient is intubated with an endotracheal tube for artificial ventilation the humidifying, warming and filtering functions of the nose and upper airways are bypassed. This article reviews the need for the provision of artificial humidification, optimal levels that should be provided and the two types of device which are available to achieve this, namely, the heat and moisture exchanging devices and the heated vaporising or nebulising humidifiers. Finally a study is presented which documents the exact level of moisture delivered to patients by the cascade water bath humidifier.
Collapse
|
40
|
Peters RH, Ballard K, Oatis JE, Jollow DJ, Stuart RK. Cellular glutathione as a protective agent against 4-hydroperoxycyclophosphamide cytotoxicity in K-562 cells. Cancer Chemother Pharmacol 1990; 26:397-402. [PMID: 2225310 DOI: 10.1007/bf02994088] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Exposure of cells of the K-562 erythroleukemia cell line to 4-hydroperoxycyclophosphamide (4-HC), an analog of activated cyclophosphamide, causes a concentration-dependent inhibition of in vitro colony formation by these cells. For investigation of the role of glutathione (GSH) in the metabolism of 4-HC, GSH levels of K-562 cells were modulated by exposing the cells to buthionine sulfoximine (BSO), a specific inhibitor of GSH synthesis, and/or to GSH ethyl esters. Both the mono- and diethyl esters of GSH were synthesized in our laboratories and their identities were determined by chromatographic methods and fast-atom-bombardment mass spectrometry. An HPLC method including electrochemical detection used for thiol determination was applied for the measurement of GSH esters. Incubation of the cells with BSO depleted GSH levels to approximately 11% of control values and potentiated the cytotoxicity of 4-HC. By contrast, exposure to GSH esters approximately doubled GSH levels and protected the cells against the toxicity of 4-HC. Moreover, when cellular GSH levels were first depleted by BSO exposure and then replenished by incubation with GSH esters, the BSO-associated potentiation of 4-HC cytotoxicity was abolished. The work described herein extends the application of an HPLC method used for thiol determination to the measurement of GSH ethyl esters. In addition, it established that GSH acts as a competitive protecting agent against the in vitro toxicity of 4-HC in the K-562 cell line.
Collapse
|
41
|
Ballard K. Showing where the money goes. Cost-effective care in ICU. PROFESSIONAL NURSE (LONDON, ENGLAND) 1990; 5:656-8. [PMID: 2120709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
As resource management is implemented around the country, nurses are being asked to become more cost conscious, while maintaining standards of patient care. Staff in one ICU were introduced to the effects of their care on the unit budget.
Collapse
|
42
|
Ballard K. Teaching about medication is role for nurses. THE AMERICAN NURSE 1984; 16:3. [PMID: 6561008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
|
43
|
Mais D, Knapp D, Halushka P, Ballard K, Hamanaka N. Synthesis of thromboxane receptor antagonists with the potential to radiolabel with 125I. Tetrahedron Lett 1984. [DOI: 10.1016/s0040-4039(01)81396-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
44
|
Ballard K, Perl W. Osmotic reflection coefficients of canine subcutaneous adipose tissue endothelium. Microvasc Res 1978; 16:224-36. [PMID: 739904 DOI: 10.1016/0026-2862(78)90057-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
45
|
Ballard K, Netto DJ. Temperature control of a plethysmograph used to measure minute changes in tissue volume. Microvasc Res 1976; 12:231-5. [PMID: 979670 DOI: 10.1016/0026-2862(76)90020-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
46
|
Ballard K, Alliapoulos JC. The response of blood flow to altered perfusion pressure in canine adipose tissue. PROCEEDINGS OF THE SOCIETY FOR EXPERIMENTAL BIOLOGY AND MEDICINE. SOCIETY FOR EXPERIMENTAL BIOLOGY AND MEDICINE (NEW YORK, N.Y.) 1975; 150:65-70. [PMID: 1187712 DOI: 10.3181/00379727-150-38975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
It is concluded that subcutaneous adipose tissue autoregulates its blood flow only weakly or not at all in the range of perfusion pressures employed in our studies. Instead, these experiments demonstrate that when perfusion pressure is altered in the fat pad, vascular resistance must change in an opposite direction since there is little tendency for the flow to return to control values. Therefore, the vascular bed is responding passively. Furthermore, there was little evidence of autoregulation in denervated tissues indicating that the extrinsic neural control does not mask an underlying ability to modulate flow.
Collapse
|
47
|
Ballard K, Malmfors T, Rosell S. Adrenergic innervation and vascular patterns in canine adipose tissue. Microvasc Res 1974; 8:164-71. [PMID: 4140457 DOI: 10.1016/0026-2862(74)90091-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
|
48
|
Ballard K. Blood flow in canine adipose tissue during intravenous infusion of norepinephrine. THE AMERICAN JOURNAL OF PHYSIOLOGY 1973; 225:1026-31. [PMID: 4745198 DOI: 10.1152/ajplegacy.1973.225.5.1026] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
|
49
|
Ballard K, Fredholm BB, Meng HC, Rosell S. Heparin-induced release of lipase activity from perfused canine subcutaneous adipose tissue. PROCEEDINGS OF THE SOCIETY FOR EXPERIMENTAL BIOLOGY AND MEDICINE. SOCIETY FOR EXPERIMENTAL BIOLOGY AND MEDICINE (NEW YORK, N.Y.) 1971; 137:1490-3. [PMID: 5138478 DOI: 10.3181/00379727-137-35816] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|
50
|
Ballard K, Rosell S. Adrenergic neurohumoral influences on circulation and lipolysis in canine omental adipose tissue. Circ Res 1971; 28:389-96. [PMID: 5551888 DOI: 10.1161/01.res.28.4.389] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Vascular resistance, capillary filtration coefficient (CFC) and changes in blood volume were determined in canine omental adipose tissue. Release of glycerol and free fatty acids (FFA) were measured. Basal values in acutely denervated tissue for blood flow and CFC were 11 ml/min/100 g (range 4 to 26, N = 36) and 0.05 ml/min/100 g/mm Hg (range 0.018 to 0.090, N = 38), respectively. Stimulation of the sympathetic nerves (1 to 9 Hz) caused initial vasoconstriction, maintained for 1 to 3 minutes. At lower frequencies (1 to 3Hz), the blood flow increased gradually after the initial decrease. At higher frequencies, the constriction often reverted to vasodilatation. The CFC was not changed or increased initially. The clearance rate of locally injected
125
I decreased in spite of a constant blood flow and blood volume was reduced initially. After α-receptor blockade, nerve stimulation caused vasodilatation, which in turn was inhibited by β-receptor blockade. Infusion of norepinephrine produced a pattern of vascular and lipolytic responses similar to those evoked by nerve stimulation. The release of glycerol and FFA was increased by nerve stimulation and by norepinephrine. The lipolytic response was inhibited by β-receptor blockade. It is concluded that sympathetic nerves are physiologically important for the regulation of vascular reactions and control of lipid metabolism in omental adipose tissue. Whether this is also the case for circulating catecholamines remains to be established.
Collapse
|