Methanol poisoning: a review and case study of four patients from Central Australia

Methanol intoxication, a rare and potentially lethal form of poisoning, usually results from ingestion and occasionally inhalation of methanol. Initial symptoms of blurred vision, elongated anion gap and metabolic acidosis are typically delayed and may not at first be recognised as methanol-related complaints. Once diagnosed, treatment must be prompt and definitive. As well as general supportive care, ethanol infusion, dialysis and alkalinization form the mainstays of treatment.

The cases described in this paper are compared to previous reports from other countries worldwide and contrast the variance in outcome often seen in methanol poisoning. The paper describes two tragic deaths and two lucky survivors, all of whom had consumed a cocktail of methanol and other alcoholic beverages at the same party.

The ICU nurse's role in managing the methanol-intoxicated patient relies on that person's sound knowledge of the unusual biochemical reactions occurring in the body and the need to institute definitive and supportive measures to help both patient and family recover.     

Nurses need to become better patient educators

Education is an important and necessary part of patient care. To achieve this nurses need to develop patient teaching as a major part of their role. There is little evidence that nurses are doing this effectively at present. Many obstacles seem to interfere with this practice but all of them seem to originate from inadequate preparation.This paper looks at the nurse's role as a patient educator, at its effectiveness now, and at the current obstacles. It suggests that urgent curriculum review is necessary so that this important area does not continue to be neglected.     

Children of the mentally ill: a qualitative focus group approach

Children of the mentally ill constitute a group neglected by mental health care providers. Increased rates of psychopathology, impaired attention processes, disturbances in interpersonal relationships, and reduced overall adaptive functioning are reported as significant outcomes for offspring of parents with a mood disorder. While epidemiological studies underscoring the risks from a hereditary standpoint are many, there are few studies examining the subjective experience of living with a depressed parent. Findings from this pilot study elucidate the subjective experience of preadolescents/adolescents living with an affectively ill parent, applying a qualitative focus group design. Videotaped sessions were analysed using methods consistent with qualitative research. 'Struggle to understand the illness', 'managing the illness', 'recognizing the signs', and 'impact of parent's hospitalization' emerged as central themes, capturing the essence of participants' experiences. The first two themes were further divided into subthemes. Findings illuminate the need to broaden nursing interventions and research, to include family perspectives, particularly when parental mental illness is a factor.     

Staff perceptions of substance use among acute psychiatry in-patients

This paper reports on a small-scale study undertaken in two inner city acute psychiatric wards to identify the proportion of patients known to use drugs or alcohol and the perceptions of staff regarding these patients. Data collection involved a retrospective audit of patient notes and the administration of a questionnaire to nursing staff. The findings were broadly consistent with other research studies. Over half of the patient sample was reported to use illicit drugs or alcohol and in one third of cases this use was thought to have contributed to their current admission. Questionnaire results indicated that staff felt ill-equipped to offer an adequate response although all respondents welcomed opportunities to develop their knowledge and skills. The findings are discussed in light of the existing literature, and some tentative conclusions are drawn concerning the development and provision of effective integrated services for individuals with psychiatric and psychoactive substance use disorders.