Shawn Tyrrell

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Analysis of the increasing incidence of caesarean section in an English teaching hospital over a 15-year period revealed that emergency caesarean section for the diagnosis of fetal distress in labour made a major contribution to this increasing trend. A retrospective audit of a sample of these operations by the consultants of the hospital indicated that 30%(More)
Charge nurses are part of the nurse manager leadership team, yet they are often appointed to their roles with minimal, if any, leadership training, education, or mentoring. Literature shows that nursing leadership affects staff retention, satisfaction, and patient outcomes. In this study, charge nurses were surveyed about their learning needs, the barriers(More)
We describe a case of small, open spina bifida that was detected on the basis of maternal serum alpha-fetoprotein levels but consistently missed on careful ultrasound examination. This prompted us to reexamine the policy (adopted by an increasing number of departments) of relying exclusively on ultrasound examination for the detection of spinal lesions. In(More)
We studied the relationship between preoperative umbilical artery Doppler waveforms and umbilical vein pO2 and pH at elective cesarean section. An absence of end-diastolic velocities had a strong statistical association with hypoxia and acidosis, and was an accurate clinical test for hypoxia (sensitivity 78%, specificity 98%, positive predictive value 88%,(More)
OBJECTIVE To compare routine versus highly selective use of Doppler ultrasound and biophysical scoring in higher risk pregnancy. DESIGN A pragmatic randomized trial. SETTING St James's University Hospital, Leeds. SUBJECTS 500 pregnant women at high risk of intrauterine growth retardation or still birth. INTERVENTIONS Regular monitoring with(More)