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Biomedical subjects

C K Stone

Publications and source records attributed to C K Stone.

76 records · Page 5Linked to original sources
PubMedDate not supplied

Does the ambulance environment adversely affect the ability to perform oral endotracheal intubation?

OBJECTIVE: Oral endotracheal intubation (ETI) is the preferred method of controlling the airway in critically ill or injured patients. It was postulated that time could be saved if intubation was performed in the ambulance en route to the hospital. This study was designed to determine whether the ambulance environment adversely affected the ability of emergency medical technicians at the advanced-intermediate level (EMT-AI) to perform oral ETI. HYPOTHESIS: The restrictive environment of a moving ambulance would affect adversely the ability of EMT-AIs to perform ETI compared with a controlled setting. This would result in a significant increase in the time necessary to perform ETI in the ambulance compared with a controlled setting not complicated by restrictive space and motion. METHODS: Twenty on-duty EMT-AIs were recruited to volunteer for this prospective, nonrandomized, nonblinded trial. All participants performed three consecutive oral ETIs on an airway mannequin in two settings: 1) in the back of a moving ambulance; and 2) on a table in the rescue squad station. Of the participants, 10 performed the intubations in the ambulance first; the remainder performed the intubations at the station first. Time for intubation with the mannequin was recorded by stopwatch. The mean times for intubation in both settings were compared by Student's t-test (p < 0.05). RESULTS: All intubation attempts were successful. The mean time for intubation in the station was 13.0 +/- 3.4 seconds. The mean time in the ambulance setting was 13.2 +/- 5.3 seconds. There was no significant difference between the intubation times in the two settings (p = 0.88). CONCLUSION: The environment of a moving ambulance does not appear to hinder the ability of EMT-AIs to perform oral ETI in a laboratory setting with a mannequin model.

Ambulances↗
PubMedDate not supplied

Copper-62-pyruvaldehyde bis(N-methyl-thiosemicarbazone) PET imaging in the detection of coronary artery disease in humans.

BACKGROUND: Copper-62 (II)-pyruvaldehyde bis(N(4)-methyl-thiosemicarbazone) (PTSM) has been proposed for cardiac imaging with positron emission tomography (PET). This study evaluated the agreement between Cu-62-PTSM and coronary angiography in the detection of occlusive coronary artery disease. The normalcy rate for Cu-62-PTSM PET in a group of healthy volunteers was also assessed. METHODS AND RESULTS: Forty-five subjects completed the study. Twenty-eight patients underwent stress technetium-99m sestamibi single photon emission computed tomography (SPECT) imaging and cardiac catheterization followed by Cu-62-PTSM rest/dipyridamole stress PET scans, and 17 volunteers underwent Cu-62-PTSM rest/dipyridamole stress PET scans. Cu-62-PTSM myocardial perfusion defects were identified in 100% of patients with 3-vessel disease (n = 8), 100% of patients with 2-vessel disease (n = 9), and 67% of patients with single-vessel disease (n = 6). When considering individual vessels, Cu-62-PTSM perfusion defects were seen in 72% of patients with occlusive disease in the left anterior descending artery territory, 67% in the left circumflex artery territory, and 60% in the right coronary artery territory, respectively. All 17 healthy volunteers had Cu-62-PTSM scans interpreted as normal, for a normalcy rate of 100%. CONCLUSIONS: Perfusion abnormalities are demonstrated by means of Cu-62-PTSM PET in 91% of patients with occlusive coronary artery disease seen at the time of cardiac catheterization, and it shows an excellent normalcy rate of 100%.

Adult↗
PubMedDate not supplied

Air vs ground transport and outcome in trauma patients requiring urgent operative interventions.

OBJECTIVE: To study trauma patients requiring urgent operative interventions to determine whether transport mode was associated with outcome difference. METHODS: Eligible patients were injured adults and children who presented over a 57-month period to the emergency department (ED) at the study hospital (annual ED census 36,000) after air or ground transport from trauma scenes or referring hospitals. Patients included were those whose ED lengths of stay were <60 minutes prior to transfer to an operating room. Data collected included injury severity score (ISS), ED and hospital lengths of stay, and mortality. Continuous data, which were not distributed normally, were analyzed using Wilcoxon nonparametric analysis. Categorical variables were analyzed using chi-square testing. Multivariate logistic regression was used to account for confounding variables and isolate the effects of transport mode on mortality. Alpha for all tests was set at 0.05. RESULTS: 272 patients were eligible for study; 168 air medical and 104 ground transports. No between-group differences were found for ED length of stay, ISS, or mortality. A significantly longer hospital stay was found for air-transported patients. Subgroup analysis of patients with penetrating trauma and ISS of > or =25 revealed mortalities of 28% and 45% for air- and ground-transported patients, respectively; this difference was not statistically significant (p = 0.24), but the study had a power of only 22% to detect a difference at this magnitude. CONCLUSION: This study failed to identify, but had insufficient power to rule out, outcome benefit to air medical transport in a subset of trauma patients requiring urgent operative interventions.

Adolescent↗