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Biomedical subjects

D Fuller

Publications and source records attributed to D Fuller.

65 records · Page 4Linked to original sources
PubMedDate not supplied

Hospital follow-up of patients categorized as not needing an ambulance using a set of emergency medical technician protocols.

OBJECTIVE: Using hospital outcomes, this study evaluated emergency medical technicians' (EMTs') ability to safely apply protocols to assign transport options. METHODS: Protocols were developed that categorized patients as: 1) needs ambulance; 2) may go to emergency department (ED) by alternative means; 3) contact primary care provider (PCP); or 4) treat and release. After education on application of the protocols, EMTs categorized patients at the scene prior to transport but did not change current practice. Hospital charts were reviewed to determine outcome of patients whom EMTs categorized as not needing an ambulance. Category 2 patients were assumed to need the ambulance if they were admitted to a monitored bed or intensive care unit. Category 3 and 4 patients were assumed to need the ED if they were admitted. RESULTS: The EMTs categorized 1,300 study patients: 1,023 (79%) ambulance transport, 200 (15%) alternative means, 63 (5%) contact PCP, and 14 (1%) treat and release. Hospital data were obtained for 140 (51%) patients categorized as not needing ambulance transport. Thirteen of 140 (9%) patients who transporting EMTs determined did not need the ambulance were considered to be undertriaged: five in category 2, six in category 3, and one in category 4. Six of 13 (46%) undertriaged patients had dementia or a psychiatric disorder as one of their presenting complaints. CONCLUSION: These protocols led to a 9% undertriage rate. Patients with psychiatric complaints and dementia were at high risk for undertriage.

Adult↗
PubMedDate not supplied

Fever in a returned traveller.

An 8-year-old boy, presenting with fever after returning from a visit to Papua New Guinea, was found to have typhoid, despite immunization against this disease prior to travel. This most likely represented vaccine failure, although it is also possible that he acquired the infection from overseas visitors who had stayed with his family prior to his travel, or that he contracted the disease from his father. This case highlights the importance of considering typhoid as a cause of fever in a returned traveller, even if they have been previously immunized against this disease. It also highlights that, in addition to taking the patient's travel history, information should be specifically sought about contact with visitors from overseas and the travel history of other household members.

Anti-Bacterial Agents↗
PubMedDate not supplied

High- versus low-top shoes for the prevention of ankle sprains in basketball players. A prospective randomized study.

Using a prospective, randomized experimental design, 622 college intramural basketball players were stratified by a previous history of ankle sprains to wear a new pair of either high-top, high-top with inflatable air chambers, or low-top basketball shoes during all games for a complete season. Subjects were asked to complete a history questionnaire and were given a complete ankle examination. They were allowed to wear these shoes only during basketball competition. Followed over the course of a 2-month intramural season, 15 ankle injuries occurred during 39,302 minutes of player-time: 7 in high-top shoes, 4 in low-top shoes, and 4 in high-top shoes with inflatable air chambers. The injury rates (injuries per player-minute) were 4.80 x 10(-4) in high-top shoes, 4.06 x 10(-4) in low-top shoes, and 2.69 x 10(-4) in high-top shoes with inflatable air chambers. There was no significant difference among these 3 groups, leading to the conclusion that there is no strong relationship between shoe type and ankle sprains.

Adult↗
PubMedDate not supplied

Operant acuity of toddlers and developmentally delayed children with low vision.

The present report describes an operant procedure for the assessment of grating acuity in young and/or developmentally delayed children. Prior to testing, the child was trained to point to a grating presented on one of two equally bright screens. A reward was given to the child for each correct response. During the test, the gratings became progressively finer until the child no longer made consistently correct choices. Normative data from 90 children show improvement in grating acuity during years one to five (from 20/50 to 20/17). Results were also obtained from 100 consecutive pediatric patients who were thought to be visually unresponsive or visually impaired by the referring ophthalmologist. Overall, 12% of these children tested within the normal range, 53% had grating acuities better than 20/200 but below normal, 27% had acuities below 20/200, and 8% were not measurable. These results suggest that a wide range of visual potential exists in this population and that some of these children may benefit from visual aids and training.

Adolescent↗
PubMedDate not supplied

Challenging ageism through our speech.

Aspects of ageism that are directed towards older people can sometimes be reflected in speech. This study puts some of the relevant literature to the test by finding out the opinions of some older people about the way they are spoken to and communicated with. The research suggests that ageism through speech is very real, but the reinforcements of these attitudes are perhaps also to do with the behaviour of older people themselves.

Aged↗