ABSTRACT
Objective: To gather the opinion of attendants accompanying admitted patients in CMH Lahore about their satisfaction with existing eating and sleeping arrangements
Study Design: Cross sectional survey
Place and Duration of Study: Combined Military Hospital Lahore Pakistan, from Jul to Aug 2016
Material and Methods: For this descriptive observational study attendants of patients admitted in the hospital for more than 24 hours were administered a questionnaire. Only one family member per patient was surveyed
Results: Three hundred attendants were interviewed for the study of which 162 were males. One hundred and twenty eight 128 [42.7 percent] came from within the city. One hundred and eighty seven [62.3 percent] intended to stay with the patients till the time they were discharged. A total of 185 [61.7 percent] patients had only one attendant whereas 59 [19 percent] of patients had no attendants available. Two hundred and thirty one [77 percent] attendants were blood relatives. The hospital canteen served food to 140 [46.7 percent] attendants. Only 25 [4.3 percent] attendants were satisfied with their existing eating arrangements. One hundred and seventy eight [59.3 percent] of attendants slept inside the hospital wards whereas 54 [18 percent] slept within hospital premises. One third of them were satisfied with their sleeping arrangements whereas the remaining desired more comfortable residential facilities or [Sarais] which were affiliated with the hospital. Sixty four [52 percent] attendants experienced difficulties in affording their boarding and lodging expenses
Conclusion: Patients and families bear the emotional and financial cost of illness. Findings suggest that attendants are not satisfied with their existing sleeping
ABSTRACT
Objective: To evaluate clinical judgment in ruling out pneumothorax during the removal of the chest tube by auscultating the chest before removal and after the extubation of the chest tube in comparison to x ray radiological results
Study Design: Descriptive cross sectional study
Place and Duration of Study: Combined Military Hospital [CMH] Lahore Pakistan, from August 2015 to March 2016
Material and Methods: A sample size of 100 was calculated. Patients were selected via non probability purposive sampling. Children under 14 years were not included. The patients with mal-positioned chest tube, surgical site infection, air leak and the patients with more than one chest tube on one side were excluded. A proforma was made and filled by one person. Chest tubes were removed by two trained senior registrars according to a protocol devised. It was ensured that there was no air leak present before removal clinically and radiologically. Another chest x-ray was done within 24 hours of extubation to detect any pathology that might have occurred during the process. Any complication in the patient clinically was observed till the x-ray film became available. Two sets of readings were obtained. Set A included auscultation findings and set B included x ray results
Results: Out of 100 patients, 60 [60%] were males and 40 [40%] females. The ages of the patients ranged between 17-77 years. Mean age of the patient was 43.27 +/- 17.05 years. In set A out of 100 [100%] no pneumothorax developed clinically. In set B out of 100 patients 99 [99%] showed no pneumothorax on chest x ray, only 1 [1%] showed pneumothorax which was not significant [less than 15% on X ray]. However, the patient remained asymptomatic clinically and there was no need of reinsertion of the chest tube
Conclusion: Auscultatory findings in diagnosing a significant pneumothorax are justified. Hence, if the chest tube is removed according to the protocol, clinically by auscultation we can be sure that no significant pneumothorax developed during extubation, thus there is no need of x-ray after wards