Nurse-aid management of neurological emergencies.

People with altered levels of consciousness cannot be responsible for themselves. This article highlights the steps a nurse aider must take at the scene of an accident and discusses the importance of the environment in the neurological emergency.

Nurse-aid management of hypovolaemic shock.

Shock is a potentially life-threatening situation and the nurse aider must therefore be able to recognize its development and take immediate action. This article describes the actions that a nurse aider must take at the scene of an accident.

Behaviour at the scene of an accident.

Remember that your behaviour at the scene of an accident will directly influence the actions of the other people present. Be aware of your own safety at all times. Double-check that vehicles, machinery and smokers involved in the accident pose no further threat. Be mindful of spinal injuries. Do not move injured patients unless their lives are in immediate danger. Never leave an unconscious patient's airway unsupervised. If a motor cyclist's helmet is removed, it must be done slowly and smoothly.

The Ommaya reservoir: newly recognized complications and recommendations for insertion and use.

Two of 27 patients treated with intraventricular chemotherapy via an Ommaya reservoir developed unusual life-threatening complications attributable to the reservoir. In one patient treated for meningeal Burkitt's lymphoma, the cause of death was a large mass of tumor cells growing around the cannula. Also the tip of the cannula was found in the contralateral cerebral peduncle. In the other patient, the tip of the cannula apparently perforated the ventricular wall postoperatively and migrated into the contralateral thalamus. In both cases evidence for methotrexate-associated leukoencephalopathy was present at autopsy. Based on the experience with these two patients, we offer specific recommendations for reservoir insertion and use.