Biomedical subjects
Publications and source records attributed to G E Bergman.
Four preadolescent children had paroxysms of intractable sneezing. After days of hospitalization and numerous local and systemic drug treatments had failed, a psychogenic cause of their problem was entertained. This uncommon form of conversion reaction most often occurs between the ages of 9 and 15 years, and prognosis is good if the appropriate interventions are undertaken.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Orthostatic changes in pulse rate and blood pressure were assessed on 455 normovolemic children between 4 and 17 years of age who visited emergency departments with a variety of complaints. Blood pressures and pulse rates were measured in the upper extremity with the patient supine, sitting, and standing. The postural changes in pulse rate and blood pressure for age groups 4 to 9 years, 10 to 13 years, and 14 to 18 years were computed, and statistical analyses were performed to identify factors predisposing to changes in pulse rate and blood pressure. In all categories of chief complaint, comparable numbers (average 25.4%) of patients had an increase in pulse rate of greater than 20 beats/min. An average of 10.7% of children in each category had a fall in systolic blood pressure greater than 20 torr. Only increasing body temperature, especially in the youngest children, and diarrhea, particularly if more than 12 hours in duration, predisposed to having a "positive tilt test" using these criteria. The "tilt test" for assessing orthostatic hypotension is of little value in assessing normovolemic children presenting for acute care. A positive test result is very nonspecific.
Explore the source record for details and available documents.
A lack of documented criteria for determining which emergency patients should have blood crossmatched for possible transfusion led us to review the records of all patients for whom blood was crossmatched in the emergency unit of our hospital in 1977. Of 378 patients who had blood crossmatched for 1,230 units, only 105 (28%) received blood transfusions (331 units total). Variables showing relationship to transfusion of blood were consolidated into four criteria: 1) shock; 2) hematocrit less than 30%; 3) observed blood loss of at least 500 ml or grossly visible gastrointestinal bleeding; and 4) emergency surgery with anticipated blood loss. Application of these criteria identified 55% of patients who did not receive transfusions and 41% of units unnecessarily crossmatched, while failing to identify only three patients received single-unit transfusions. Use of the criteria would have reduced the crossmatch/transfusion ration from 3.7:1 to 2.6:1.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.