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Biomedical subjects

E J Allison

Publications and source records attributed to E J Allison.

At least 55 records · Page 3Linked to original sources
PubMed1988

Organizational characteristics, occupational stress, and depression in rural emergency medical technicians.

A model of organizational characteristics, occupational stress and mental health in emergency medical technicians (EMTs) is developed and tested. Supervisor behavior and work group support are used as predictors of negative role perception. Negative role perception is specified as intervening between the organizational variables and occupational stress. Occupational stress is hypothesized to directly influence depression. Data collected from 250 EMTs is used in a structural equation analysis to estimate model parameters. The sample is mostly male (74%), white (94%), and married (68%). Results suggest that there is a direct relationship between perceived occupational stress and increased depression. Role perception is a critical intervening variable between supervisor behavior, work group support, and occupational stress. The findings suggest that EMTs are more satisfied when supervisory practices result in an environment which encourages open expression and group problem solving. This work environment leads to more supportive relationships among squad members, reduced role ambiguity, and decreased occupational stress and depression.

Allied Health Personnel↗
PubMed1987

Prevention of "irreversible" hemorrhagic shock by the preservation of cellular integrity.

The clinically encountered state of hypovolemic shock results from a series of metabolic and cardiovascular responses to tissue hypoperfusion. Recent advances have increased our understanding of the consequences of tissue hypoxia, and identified at the cellular level those changes which cause the damage to be "irreversible", or refractory to treatment. To be successful, therapeutic interventions should be designed to 1) limit, if not reverse, the subcellular alterations in membrane stability and mitochondrial function which herald the transition from compensated to decompensated shock, and 2) re-hydrate the individual to restore normal circulatory dynamics and to prevent further cellular damage. It is proposed that calcium channel blocking agents and/or high energy phosphate compounds may delay the positive feedbacks which cause irreversible tissue damage, and thus may be useful initial interventions in the treatment of hypovolemic shock.

Adenosine Triphosphate↗
PubMed1987

A required, combined ACLS/ATLS provider course for senior medical students at East Carolina University.

A course that combines advanced cardiac life support (ACLS) training with advanced trauma life support (ATLS) training for senior medical students was evaluated for its ability to integrate concepts of students' prior clinical experience and to stimulate achievement of provider certification. Since initiation of this program in 1982, students have uniformly praised the combined ACLS/ATLS provider course in anonymous, post-course evaluations. The experience was judged to integrate significantly concepts and principles acquired in students' previous 18 months of clinical training. The opportunity to apply these concepts in unique and challenging clinical simulations was noted by students. Evaluation of pretest and post-test data for the class of 1984 (n = 39) using a t test for matched pairs indicates a significant improvement in post-test examination performance (P less than .001). These data are supported by skills stations testing and achievement of provider certification. Ninety-five percent of student participants achieved provider certification in ACLS; 92% achieved provider certification in ATLS.

Certification↗
PubMed1987

Specific occupational satisfaction and stresses that differentiate paid and volunteer EMTs.

A survey completed by 265 emergency medical technicians (EMTs) who provide emergency prehospital care in a rural area included a stress inventory for health professionals and a job satisfaction scale. Logistic regression indicated that the 118 paid EMTs were more likely to be dissatisfied with the freedom they have on the job than were the 147 volunteer EMTs. Paid EMTs also are less likely to be satisfied with the recognition they receive and more likely to cite work interference with family life and perceptions that others are trying to take advantage of them as sources of stress. Volunteer EMTs are more likely to be dissatisfied with the way their days off work are scheduled and to report stress attributable to work responsibilities different from those they had anticipated. Additional information about the demographic characteristics of EMTs from a rural area is provided.

Allied Health Personnel↗
PubMed1985

Flexible fiberoptic sigmoidoscopy in the emergency department.

Endoscopic examination of the large bowel is an historically old procedure. It has become an important element in the initial evaluation of colorectal disorders. Recently the flexible fiberoptic sigmoidoscope (FFS) has displaced the rigid scope because of increased patient comfort and compliance and markedly improved accuracy in diagnosing left colon lesions. The FFS is a valuable adjunct to the routine investigation of acute and chronic colorectal complaints seen in the emergency department. It has been endorsed by the American Cancer Society and is an easily learned and safe procedure when taught properly.

Colonic Neoplasms↗
PubMed1985

Comparison of EMT blood pressure measurements with an automated blood pressure monitor: on scene, during transport, and in the emergency department.

Auscultation or palpation of blood pressure in critically ill patients by emergency medical technicians (EMTs) can be difficult, if not impossible, because of ambient noise, motion artifact, limited access to patients, or weak pulses. Automated blood pressure monitors (ABPMs) have been designed to overcome these problems during field emergencies and patient transport. Our study compared blood pressure measurements taken by EMTs with measurements provided by a Lifestat ABPM. Measurements in emergency patients on scene, during transport, in the emergency department (ED), and in a controlled environment were compared. Measurements in the various sites were obtained from 57 patients, and provision was made for two measurements at each site. Comparison of on-scene systolic blood pressures yielded a mean absolute systolic difference of 10.46 +/- 1.42 mm Hg and a mean absolute diastolic difference of 9.33 +/- 1.32 mm Hg. During transport systolic pressures showed a mean absolute difference of 11.50 +/- 1.72 mm Hg, and diastolic pressures showed a mean absolute difference of 7.59 +/- 1.16 mm Hg. Mean absolute differences in the ED were 11.23 +/- 1.49 mm Hg systolic and 8.37 +/- 1.25 mm Hg diastolic. Ninety comparison measurements in a controlled environment yielded a mean absolute systolic difference of 8.74 +/- 0.87 mm Hg and a mean absolute diastolic difference of 7.97 +/- 0.72 mm Hg. Comparison of mean diastolic pressure differences between EMT and ABPM measurements in various settings revealed some small, but statistically significant, discrepancies that were not considered clinically relevant.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Pressure↗
PubMed1985

The psychological impact of disaster on rescue personnel.

Seventy-nine rescue, fire, and medical personnel and police officers who treated victims of an apartment building explosion completed a questionnaire describing their emotional and coping responses to the disaster. Eighty percent had at least one symptom of posttraumatic stress disorder (PTSD). Eight of 21 PTSD symptoms were present in at least 10% of respondents. The most frequently reported symptom, intrusive thoughts about the disaster, occurred in 74% of those working with or searching for victims at the disaster site. On-the-scene rescue workers had significantly more (P less than .02) PTSD symptoms than did inhospital staff. Fifty-two percent of the respondents reported that family members and coworkers were supportive or very supportive in meeting their emotional needs following the disaster; 36% noted that support networks were not helpful. The coping behaviors most frequently used were to remind oneself that things could be worse (57%) and to try to keep a realistic perspective on the situation (53%). Eleven percent reported seeking emotional support from others or looking to others for direction. Emergency workers responding to a contained, small-scale disaster are likely to experience mild stress responses. Planning for the emotional aspects of these events is needed.

Adaptation, Psychological↗
PubMed1985

Comparison of intravenous and oral routes of theophylline loading in acute asthma.

In a prospective, randomized clinical trial, 19 patients with an acute exacerbation of asthma were given a loading dose of aminophylline by the IV (n = 10) or oral route (n = 9) of administration following treatment with epinephrine. Plasma concentrations of theophylline were measured prior to giving the loading dose, and one, two, three, and 24 to 48 hours later. Therapeutic effectiveness was evaluated by analyzing spirometric measurements prior to giving the loading dose, and one, three, and 24 to 48 hours later. Side effects also were recorded. In the IV group, the mean peak plasma theophylline concentration was 15.1 micrograms/mL one hour after loading, and in the oral group the mean peak serum theophylline concentration was 14.2 micrograms/mL three hours after loading. There was no correlation between theophylline concentrations and normalized change in spirometric values. There was no significant difference in spirometric values between the IV and oral groups. Nausea was slightly more common in the IV group. We conclude that there is no therapeutic advantage to giving a loading dose of aminophylline by the IV route rather than orally in patients with mild-to-moderate exacerbation of asthma initially treated with epinephrine.

Acute Disease↗
PubMed1984

Sigmoid volvulus in a young patient.

The case of an 18-year-old man with sigmoid volvulus and recurrent abdominal pain is presented. He was seen in the emergency department three times in a 4-month period, each time complaining of cramping left lower quadrant pain of one to two hours duration without vomiting or diarrhea. Physical examination on each occasion revealed left lower quadrant tenderness without mass, guarding, or rebound. Radiologic evaluation on the first visit revealed sigmoid volvulus, which was reduced by barium enema. Despite identical clinical presentation on two subsequent occasions, radiologic studies showed no evidence of recurrent volvulus. During the ensuing two years, the patient has had no further symptoms.

Abdomen, Acute↗
PubMed1983

Thigh compartment syndrome without lower extremity trauma following application of pneumatic antishock trousers.

Reported are two cases of thigh compartment syndrome following application of a pneumatic antishock trouser suit. Both patients developed compartment syndromes after prolonged antishock suit use in the absence of any apparent leg trauma. We recommend that suit compartment pressures be no more than required to restore adequate blood pressure. The duration of application should be no longer than is clinically necessary. Patients with prolonged application (greater than 120 minutes) should be closely monitored for the development of compartment syndromes.

Adult↗