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2011年9月22日星期四

Appeals court tosses out conviction in drug case

The Oregon Court of Appeals has reversed a 2007 drug conviction against a Jackson County woman, ruling Wednesday that Medford police illegally obtained key evidence against her.

After a lengthy appeal process, Medford resident Sheryl Diane Singer's May 2007 guilty plea to possession of a controlled substance will be removed from her record in about two months, Jackson County District Attorney Mark Huddleston said.

The Appeals Court ruled the evidence against Singer should have been suppressed because new case law clarifies the officer had no lawful basis to detain Singer or seize her property, Huddleston said.

"This puts the case back in our lap without any evidence," Huddleston said.

Huddleston added that Singer will not be retried barring any unexpected requests from the Oregon Department of Justice.

Singer could not immediately be reached for comment Wednesday.

According to court records and the published opinion, Singer, 53, was a front-seat passenger in a car whose driver made an unlawful turn. A Medford police officer pulled the car over. But instead of ticketing the driver, the officer's attention quickly focused on Singer, who "appeared to be nervous," the document said.

The officer searched for warrants against Singer and discovered she had a conviction for a drug-related crime. He then asked her to step out of the car and remove her sunglasses so he could see her eyes. The officer asked for and received permission to search her for drugs. Finding none, he asked to search her purse. Singer warned him she had a "rig" — which the officer understood to refer to a hypodermic needle used to inject drugs.

Singer admitted the syringe contained heroin and was arrested for possession of a controlled substance.

Before her trial in Jackson County Circuit Court, Singer moved to suppress the evidence on the grounds that the search was illegal.

Judge William Purdy denied the motion and Singer entered a conditional guilty plea to unlawful possession of heroin. But Singer reserved her right to appeal the court's denial of her suppression motion.

She appealed her case all the way to the Oregon Supreme Court, which sent the case back to the Appeals Court for reconsideration in light of new case law.

"The Supreme Court directed the appeal be reconsidered," Huddleston said. "It appears the trial court was wrong to deny the motion to suppress the evidence."

2011年8月15日星期一

Are nasal cannulas the best way to deliver oxygen to patients with COPD?

The use of nasal cannulas is common for patients with chronic obstructive pulmonary disease (COPD). This is often patient choice, as cannulas allow them to eat, drink and speak, and are often more comfortable than masks when they are receiving oxygen for long periods of time. Cannulas can also feel less claustrophobic, which is an important consideration for a patient experiencing breathlessness.

A note of caution however. Nasal cannulas may not be suitable in acute exacerbations of COPD. Oxygen administration is described as controlled or uncontrolled. Nasal hypodermic needle cannula, simple face masks and non-rebreathe masks are uncontrolled, while fixed high-flow concentration masks such as Venturi deliver controlled oxygen.

The amount of oxygen a patient receives from an uncontrolled device depends on variables including depth and rate of breathing, which can alter during acute episodes and produce unexpectedly high concentrations of inspired oxygen. This issue is important, especially for patients with chronic hypercapnia, and can lead to serious or even fatal consequences. These patients require controlled oxygen therapy during an acute phase. This allows oxygen of a known concentration to be delivered and titrated according to the patient’s oxygen saturation (target saturation 88-92%) irrespective of breathing pattern, without the risk of hyperoxia and worsening hypercapnia (BTS, 2008). Nasal cannulas can be substituted once the patient has stabilised.