Side Rails Research Articles

The Trauma Table as an Alternative to the Hubbard Tank in Burn Care

Because of disadvantages associated with the use of the Hubbard tank in the management of burn patients, the burn team at the University of Alabama replaced the tank with a trauma table that had been manufactured to their specifications. The trauma table is capable of being hydraulically raised or lowered, and maneuvered into Trendelenburg's position or its reverse. Another feature of the table is side rails that can be lowered. In contrast to the Hubbard tank, the trauma table has the following associated advantages: (1) quicker treatment sessions; (2) less pain to the patient; (3) elimination of patient exposure to contaminated water; (4) more comfort for the therapist; and (5) greater ease in patient handling, for example, rolling the patient onto a stretcher or bringing the patient into a sitting position.

Cable Ampacity in Tray with Raised Covers

Power cable tray systems in generating stations are installed with tray covers that may be raised over the tray side rail. Raising the tray cover allows installation of the cover without cutting and fitting the cover around conduits that terminate at the tray. There is no industry standard or guidance for calculation of cable ampacity in trays with raised covers. The heat transfer literature is reviewed in this paper and the results of the review are incorporated in a method for calculation of cable ampacity in raised cover tray. Calculations are presented that show that cable ampacity with raised covers is approximately two percent greater than cable ampacity with covers installed directly on the tray side rails.

How to reduce falls

The iatrogenic nature of hospitalization places patients at risk of falling, injury, and death. In this article, the major principles of providing protective and preventive interventions are outlined. The principles are the establishment of a multifaceted fall prevention program that targets fall interventions according to each etiologic factor; the recognition that fall protective and prevention interventions are distinct and serve a different function; the use of the fall monitoring system comprehensively; the creation of a clinical nurse specialist position, responsible for fall intervention; and a conscious and individualized approach to fall prevention. The process and problems of the varying nature of providing fall protection and fall prevention are discussed; for example, use of a side rail as a protective strategy may be successful with one patient but considered a hazard when used with a different patient. (Am J Infect Control 2002;30:376-80.)

Electronic recording of pressure exerted by cows against structures in free-stall housing

Pressure exerted by cows against the feeding rail and side rails, neck rail and brisket board of cubicles was recorded by means of pressure transducers. Video surveillance was used to examine the nature of the body contact.Pressure during feeding was recorded during a normal and a contrived situation at the feeding table, and during feeding from a manger elevated 16–18 cm above floor level. Forty-three percent of recordings were above 50 kg during the contrived situation and 8% when feeding from the standard manger.In the cubicle, side rails were leant against most often. The resting cow pressed more frequently on the left side rail than on the right one, viz. 28 vs. 10% of recordings over 50 kg. Occasionally, cows bumped the brisket board with their front legs. This could result in contusions to the knees. The neck rail was only occasionally touched by the cows.

Helmet treatment for plagiocephaly and congenital muscular torticollis

Plagiocephaly usually originates in late fetal life through aberrant constraint of the fetal head and is often associated with sternocleidomastoid torticollis. In some patients the obligue head shape may become a permanent, cosmetic disability. Individually fitted plastic helmets, similar in style to football helmets, have been successfully used to remold the deformed heads of four infants. Each helmet is designed to fit snugly against the prominent aspects of the infants' cranium and to be loose fitting where the head is shallow. As the brain grows, the head is molded to fit the helmet and thus acquires a more usual shape. The treatment has been safe and effective. When torticollis is persistent after the initiation of treatment, rubber straps can be fixed to the outside of the helmet and attached to the side rails of the crib. While the infant sleeps, the straps can be tightened to stretch the shortened sternocleidomastoid muscle.

Use of a wall cassette holder for lateral therapy films.

A wall cassette holder can be modified and mounted to the side rails of the treatment couch using stirrup holders to support a film for lateral therapy port films.

The large pigment cell of the compound eye of the house fly Musca domestica. Fine structure and cytoarchitectural associations.

The fine structure and cellular associations of the large pigment cells (LPC's) of the compound eye of the house fly were studied with high voltage and conventional electron microscopy. Depending on the sector of the compound eye, the facets are either rectangular or hexagonal. The underside of each facet has indentations exactly aligned with those on top into which inserts an angulated sleeve of LPC's. Under the rectangular lens facet 6 or 8 small compact (in cross section) LPC's join four elongate LPC's. Clusters of compact cells alternate in this ring with elongate ones. Compact cells compress together and become quadrangular (in cross section) several microns below their insertion into the lens and form "building block" corners while elongate cells form "side rails" for the rectangular type of distal pseudocone enclosure. Beneath hexagonal facets all LPC's are rather elongate with out corner cells. In both facet types LPC's enclose the pseudocone for a longitudinal distance of 4 mum and then are displaced as bordering cells by a sleeve of two corneal pigment cells (CPC's), each of which encloses half of the proximal pseudocone. For the following 6 mum of longitudinal distance these concentric sleeves of CPC's and LPC's form a double layer around the pseudocone. At about 10 mum below lens base the two sleeves separate; LPC's become attenuated and extend cable-like to the basement membrane and CPC's enclose the proximal pseudocone, Semper cells and distal retinula. The junction between lens and LPC's has critical structural value in that (1) this is the sole anchorage to the lens by the lengthy remainder of the ommatidium, and (2) LPC's enclose the semiliquid pseudocone in the most distal portion of the pseudocone. In addition to vertical support, the LPC's send out numerous lateral processes that make structural contact among themselves, with the corneal pigment cells and the photoreceptor cells. The structural features of this array are discussed relative to possible physiological roles.

Editorial: Prophylaxis in labor and delivery.

Providing patients with clear, informative explanations has the beneficial effect of allowing them to participate in their own care. In this week's Journal, Scott and Rose show that childbirth education reduces narcotic use, the number of forceps deliveries and recourse to nerve-block anesthesia during labor. Many physicians remain unconvinced about the advantages of maternal education and consider it costly in time and money.A mere decade ago, conventional wisdom accepted padded side rails, restraints, the wails and writhing of "twilight sleep" (scopolamine, a barbiturate and a narcotic) as the best obstetric practice. The mother had amnesia; the father, relegated . . .

A moving extension to augment the angiographic table in panarteriog- raphy.

Diagnostic angiography now ranges literally from “head to toe.” The femoral or axillary approach permits study of the carotid and vertebral arteries, brachiocephalic vessels, aortic arch, aortic branches, and femoral runoff either singly or in any combination. Not uncommonly, a patient will present with symptoms suggesting multivessel disease, e.g., hyper-tension with transient ischemic attacks or claudication of the lower extremities. To expedite diagnosis, the referring physician and angiographer may attempt to study each area of interest in one session. The average range of movement of the angiographic table is approximately 50 inches, which often falls short of the length necessary to move the patient from the rapid changer to the image intensifier in a muItivessel study. Therefore, the patient must be moved bodily along the table and onto the rapid film changer after placement of the catheter, e.g., in selective carotid catheterization following an aortic arch examination. Since the intracranial vessels are of a much smaller caliber than the brachiocephalic branches, the technician strives for the greatest clarity by having the head as close as possible to the surface of the changer unless magnification is used. Such movement of the patient is time-consuming, tedious and strenuous; moreover, it may also dislodge sterile drapes, intravenous tubes, electrocardiographic leads, and even catheters. Probably the greatest number of movements of the patient occur in selective catheterization of the right and left carotid and vertebral arteries following an aortic arch angiogram. The disarray of the patient's sterile field can be quite disconcerting to all involved. Movable plywood or Formica tops have been used, but they leave much to be desired because of the friction of the surfaces on the angiographic table. It is quite a strain for one technician, and additional help is usually necessary in moving the patient. With the help of a local x-ray representative, a a movable extension for the angiographic table has been devised, extending the range of the total table movement and expediting movement of the patient from the rapid changer to the image intensifier (and vice versa) with minimal effort. The range of the table has now been extended to 74 inches. Anodized aluminum stock is clamped onto the side of the angiographic table, and a Formica top from a discarded x-ray table is fitted with a series of ball-bearing rollers to facilitate easy movement of the top within the aluminum edges (Fig. 1). A clamp on the side of the aluminum side rails immobilizes the extension at any point along its course in the longitudinal axis. The superior aspect of the Formica top is cut to the outline of the upper body, permitting the head to be positioned as close as possible to the rapid changer for the lateral series of angiograms (Figs. 2–4).

Delirium in the Coronary Care Unit

To the Editor:— Parker and Hodge described Delirium [in 11 patients] in a Coronary Care Unit (201:702, 1967). This unit ... consisted of a 12-bed open ward with sliding curtains around each bed, and visitors were restricted to five minutes in each hour. Many... pulled at their oxygen tents, or tried to climb over the side rails of their beds. The rarity with which this situation has been encountered in our coronary care unit ( CCU) over a two-year period, and the inference from Parker and Hodge that it represents a significant complication of a CCU, prompted this letter. An air-conditioned, noise-free, tranquil environment with a private room for each patient and constant cardiac monitorization have been basic criteria for a coronary care unit.1-3Most clinicians have recommended oxygen administered nasally rather than routine use of an

Side-rail clamp for Killian-Lynch suspension laryngoscope.

At the Mayo Clinic, suspension laryngoscopy is now performed with a side-rail clamp used to anchor the Killian-Lynch suspension laryngoscope (Fig 1). Previously, a wooden board was used. 1-4 The disadvantages of the board were lack of portability and difficulty of removal when used in combined procedures necessitating flexion of portions of the table or placement of the patient in the reverse Trendelenburg position. The clamp, machined out of steel, is fastened to the side rail (Fig 2). A shim can be placed on the clamp to adapt it to the other size of side rail found in our operating suite (Fig 3).

Furnaces with side rails for heat treating pipes

Furnaces with side rails for heat treating pipes

Evaluating Student Performance

A 75 year-old patient objected to side rails on her bed. Miss Bardin noted that the patient was able to move freely. She asked permission to remove the casters from the bed to allow the patient to move in and out of bed more independently and with greater safety and comfort. (later notation: removed casters from bed.)

Pointers to Preventing Accidents

Henrietta K, age 29, is respected for her efficient manner in discharging the duties of assistant head nurse. But during the past 18 months, her record in the nursing office shows, she has been directly or indirectly involved in several accidents on the ward, such as failure to note medications given and failure to replace side rails. Last month she spilled some water on the floor at a patient's bedside and did not have it mopped up; a half hour later an aide fell on the slippery floor, incurring bruises which kept her out of work for three days.

HEAD BANGING IN EARLY CHILDHOOD

Head banging is a curious behavior pattern sometimes seen in infants and young children. This activity is characterized by repetitive movements marked by a definite rhythm and monotonous continuity. The head is struck rhythmically against the head board, side railing of the crib, or other objects. This is not a tantrum type of behavior but is marked by an almost compulsive repetitiveness. Characteristically, it appears to commence sometime in the last half of the first year and is usually preceded by other less dramatic rhythmic motor behavior such as head or body rolling and crib rocking. While this behavior has come to the attention of medical practitioners, very little in the way of descriptive material or controlled research has been done. Gesell states, "Rocking on hands and knees and bedshaking are common forms of deviation. Head banging and head rolling also have their origins in this period from 40 weeks to 21 months" (5, p. 308). Spock (i2) discusses this rhythmic behavior under the subheading of "Common Nervous Symptoms." Lourie (io) noted head banging in a study of 130 children who manifested a variety of rhythmic patterns. Other writers have noted this behavior, and references appear in medical, psychological and popular literature (i, 2, 4, 6, 7, 8, 9, 13)The purpose of this paper is to describe systematically head banging behavior of normal, not hospitalized young children. Specifically, this report describes the positions in which head banging takes place, the age of onset, the frequency and persistency, the tempo, and related factors. In addition, reaction to metronome stimulus and a follow-up study of behavioral patterns of a portion of the sample are described.' Thirty-three head bangers were observed under normal bedtime conditions; 23 were boys and Io were girls. The age range for the total group was from io to 49 months; average age was 26.6 months. All of the observations described in this report took place in the homes of the subjects. Twenty-six of the 33 subjects in this sample were obtained from referrals of practicing physicians in cities of upstate New York. Seven cases were found through personal contacts.

A simple device for obtaining lateral acetabular views of the hip in infants.

The acetabular lateral view of the hip has considerable usefulness in orthopedic work in infants, especially in cases of congenital dislocation. It is difficult, however, to get comparable projections of both hips routinely, and with the usual method someone must stand in the direct x-ray beam during the exposure. The method to be described not only eliminates irradiation to personnel but makes it easier to obtain satisfactory pictures. The device is a modification of the acetabular box used elsewhere. Basically it is made in the form of the letter “T” with a slot across the top into which a cassette can be inserted vertically. Side rails are attached to the base of the “T” so that a compression band can be used and an extension of the “T” above the slot makes it possible to immobilize the legs and feet in a Flexi-cast (Fig. 1). A separate base on which a circular track is mounted permits the acetabular box to be rotated 360° on three large ball bearings which are attached to the box and fit onto the trac...

Mr. A. M. Sillar

ARTHUR MOLYNEUX SILLAR, one of the early pioneers of electric lighting, died on March 6 at the age of seventy-two years. He was educated at Shrewsbury, and from 1882 until 1886 he was engaged with the Jablochkoff Electric Light and Power Co. He was chief engineer to the Electrical Engineering Corporation until 1890, and in 1895 he with Mr. E. M. Lacey started practice as consulting engineers. His firm carried out the electrification of the Blackburn tramways in 1897, and in 1902 completed the Bournemouth tramways, this being the first example of a side rail slot system in Great Britain.

HEAD REST FOR EXPOSURE OF THE CEREBELLUM

Various contrivances have been devised to support the head in the face-downward position necessary for the surgical exposure of the cerebellum. Finding all of them with which I was familiar to be either too complicated or not sufficiently adaptable, I explained their defects to Mr. G. F. Linde of the Scanlon-Morris Company, who devised the head rest which I now have. The suggestion of several of my friends that its principle might be generally useful has prompted me to publish this brief note. Essentially, the head rest consists of a steel supporting frame, with brackets fitting over the side rails of an operating table, to which is attached a horseshoe shaped cupped steel rest. The rest is molded to fit the face and forehead comfortably, and the slotted opening allows the anesthetist free access to the mouth and nose of the patient. In these respects the head rest differs little

Attachment for Sweet Eye Localizer

A great many roentgenologists who are called upon to make only an occasional localization of foreign body in the eye or orbit are using the original Sweet localizer, because of the cost of the improved model Sweet localizer. Anyone who has worked with the original model has certainly been confronted with the annoyance of having the localizer shift out of place after the proper alignment has been accomplished, because the small base allows very easy movement in any direction. The exact interpretation of the results obtained in localization is made on the relative positions of the shadows of the foreign body and of the cone and ball, and it is, therefore, essential that, once the correct alignment has been obtained, the localizer shall remain in the correct position. The writer submits herewith a simple addition to the original Sweet model, consisting of side rails and a Spencer mechanical stage to which is attached a small plate upon which the localizer is permanently fixed. With this arrangement, lateral and forward movements of the localizer are accurately and easily made, and, when once aligned, there is no fear of its moving about. The mechanical stage can be moved along the side rail so as to compensate for the short forward travel; it can also be used on either side, for right or left eye localization. The cost is small, while the time saved and the assurance that the localizer will stay put,” are well worth it.