Intubation in burns patients: a 5-year review of the Manchester regional burns centre experience.

Despite criteria to guide intubation from the American Burn Association (ABA), concerns remain regarding over-intubation of burns patients. The purpose of this study was to review appropriateness of intubation at a UK regional burns centre over a 5-year period. A 5-year retrospective review of adult patients admitted to the Manchester Burns Centre who underwent intubation at or prior to admission was performed. Intubations for non-burn indications or burns >40%TBSA were excluded. Patient demographic and burn characteristics data were extracted from medical records. Indications for intubation were compared to ABA and Denver criteria. 47 patients were identified, of which 40 met inclusion criteria for analysis. 72.5% and 95% of these patients met ABA or Denver criteria respectively. 30.8% of patients were extubated within 48 h. 50% patients extubated within 48 h had ≤1 indication for intubation or negative laryngoscopy. Complications related to intubation and ventilation were noted in 37.5% of patients, with ventilation associated pneumonia (VAP) being the most common occurring in 27.5%. 95% of patients fulfilled recognised criteria for intubation. However, 30% were extubated within 48 h, suggesting potentially avoidable intubation. This study suggests current intubation criteria may over-estimate risk of airway compromise and supports results from non-UK studies that a proportion of patients may be suitable for close observation rather than early intubation.

Astronomical time-of-flight photon speedometer.

A dual-band, fiber-optic, photon time-of-flight instrument was developed. Its design was optimized for measuring the velocity of visible photons emanating from relatively dim astronomical sources (apparent magnitude m>12), such as distant galaxies and quasars. We report the first direct photon group velocity measurements for extragalactic objects. The photon group velocity is found to be 3.00±0.03×108 ms-1 and is invariant, within experimental error, over the range of redshifts measured (0≤z≤1.33). This measurement provides additional validation of general relativity and is consistent with the Friedmann-Lemaître-Robertson-Walker and hyperbolic anti-de Sitter metrics but not with the elliptical de Sitter metric.