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Clinical Trials as Topic↗
Biomedical subjects
David D Miller
Publications and source records attributed to David D Miller.
Combined application of organozinc chemistry and one-pot hydroboration-Suzuki coupling to the synthesis of amino acids.
Hydroboration using 9-BBN-H of the protected enantiomerically pure but-3-enylglycine derivative 11, prepared by copper-catalysed allylation of the serine-derived organozinc reagent 1, followed by Suzuki coupling of the derived borane with a variety of aromatic halides, 2-bromopyridine and 2-bromopropene gives the protected amino acids 14a-l and 15. This method augments our previous methods for the synthesis of phenylalanine homologues.
Amino Acids↗
Feasibility of sternal intraosseous access by emergency medical technician students.
OBJECTIVE: Emergency medical technician-basic (EMT-B) providers are not trained to establish vascular or intraosseous (IO) access on critically ill patients. This study was conducted to examine the feasibility of training EMT-B students to correctly place a commercial sternal IO infusion device (FAST-1). METHODS: Twenty-nine EMT-B students attended a two-hour training session. Subjects were subsequently tested in FAST-1 application using a modified resuscitation mannequin permitting IO needle deployment. Two observers assessed correct IO application and technique. Results were analyzed using descriptive statistics (binomial proportions and medians with 95% confidence intervals). Inter-rater agreement of observations was evaluated using kappa statistics and intraclass correlation coefficients (ICCs). RESULTS: Inter-rater agreement ranged from fair to excellent (kappa = 0.37-1.00) for all parameters except sternal notch identification (kappa = -0.03). Reliabilities of elapsed times were good (ICC = 0.83, 0.31). Correct identification of the sternal notch was accomplished by 28 of 29 students (96.6%; 95% CI: 82.2-99.9%). Correct application of the IO target patch was achieved by 29 of 29 (100.0%; 88.1-100.0%). First-attempt successful IO needle deployment was achieved by 16 of 29 (55.2%; 35.7-73.6%). Overall successful IO needle deployment within four attempts was achieved by 27 of 29 (93.1%; 77.2-99.2%). The protective dome was correctly applied by 27 of 29 (93.1%; 77.2-99.2%). The median time to needle deployment was 27.5 seconds (95% CI: 24-31). The median time to dome placement was 50 seconds (95% CI: 42-55). CONCLUSIONS: EMT-B students with minimal training demonstrated limited success with applying a commercial sternal IO device. Clinical application by EMT-Bs on critically ill patients may be possible with more intensive training.
Adult↗