ABSTRACT
This report presents a pilot study on the effectiveness of hypnosis in the control of pain during dressing changes of burn patients. Eight patients were treated, and all evaluated the interventions as beneficial. The treatment of four patients was more closely analysed by obtaining pain and anxiety ratings daily. Results show a 50-64 per cent decrease in reported pain level for three patients and a 52 per cent increase of pain for one patient. The mean decrease for these four patients was 30 per cent (for overall as well as worst pain during dressing changes). A 30 per cent reduction of anxiety level and a modest reduction of medication use were achieved concurrently. It is concluded that hypnosis is of potential value during dressing changes of burn patients. Comparison of global evaluations and daily pain ratings shows that systematic research in some cases leads to conclusions opposite from clinical observations or follow-up evaluations. Limitations of this study are discussed and recommendations for future studies are given.
Subject(s)
Burns/complications , Hypnosis , Pain/prevention & control , Adolescent , Adult , Aged , Anxiety/psychology , Bandages , Humans , Male , Middle Aged , Pilot ProjectsSubject(s)
Burns/therapy , Dermatologic Agents/therapeutic use , First Aid , Bandages , Humans , Transportation of PatientsSubject(s)
Burns/therapy , Critical Care , Shock/therapy , Burns/complications , Burns, Inhalation/therapy , Fluid Therapy , Humans , Shock/etiologyABSTRACT
In a prospective study, the clinical relevance of a quantitative chromogenic endotoxin assay in plasma (detection limit 10 ng/L, assay time 2.5 hours) versus blood cultures was evaluated in 51 critically ill patients with increased susceptibility for infectious complications. Of the 400 samples tested, the endotoxin assay and bacterial culture both were negative in 342 samples. In 21 samples from 15 patients, gram-negative aerobic microorganisms were cultured. Corresponding endotoxin assays were positive in 14 samples (mean 100 ng/L). Twenty-three samples grew gram-positive bacteria. The associated endotoxin assays all were negative. Twelve samples were found to be endotoxin-positive without a corresponding gram-negative bacterial culture. In 7 of these 12 positive endotoxin assays, a laboratory or clinical explanation for these positive tests could be provided. In view of the high sensitivity, specificity, and predictive values obtained, the authors conclude that the endotoxin assay used is a useful clinical adjunct for both the detection and exclusion of gram-negative septicemia.
