Biomedical subjects

J B Franaszek

Publications and source records attributed to J B Franaszek.

4 recordsLinked to original sources

PubMed1985

The 1980 patient urgency study: further analysis of the data.

The patient urgency study was a comprehensive nationwide evaluation of patient and physician perceptions of the urgency of need for medical care. Half of the patients in the study were between the ages of 13 and 21. The necessity for immediate care, specifically emergency department care, and admission varied proportionately with increasing age. There was little variation in patient volume by day of the week, although the 8:00 AM to 4:00 PM shift was demonstrably the busiest; the midnight to 8:00 AM shift, however, had proportionately more sick patients. Sixty percent of the patients came to the ED because they believed that they had an emergency problem; 62% of patients had a personal physician. The average number of patients admitted in the ED population was 12.5%, with a range of 4.1% to 22.9%. ED residents underestimated the urgency of need for medical care 6.7% of the time, in comparison with only 3.7% for career emergency physicians. Physicians noted that 7.4% of patients who left without being seen initially required immediate care.

Adolescent↗

PubMed1983

Moonlighting.

Explore the source record for details and available documents.

Clinical Competence↗

PubMed1982

Emergency diagnosis, resuscitation, and treatment of acute penetrating cardiac trauma.

The controversy concerning the mode of resuscitation in acute penetrating cardiac trauma has been resolved in recent years. Most large centers are aggressive, and pericardiocentesis is used in life-threatening situations only as a temporary measure until thoracotomy can be performed. There are at least 32 publications which recommended emergency department thoracotomy for resuscitation of the critically injured heart. The physician should be alerted when patients arrive with penetrating chest and upper abdominal wounds. Cardiac injury must be ruled out as soon as possible, for minutes may mean the difference between successful resuscitation and irreversible myocardial damage. Most penetrating chest wounds are easily managed in the emergency department with fluid resuscitation and chest tube drainage. Patients who have an isolated penetrating cardiac injury will have the best prognosis; moribund patients who are suffering from extrathoracic injuries, especially CNS injuries, will have a dismal prognosis. The keys to successful resuscitation of the traumatized heart are a high index of suspicion, early recognition, and rapid intervention.

Cardiac Tamponade↗

PubMed1979

Alcoholic ketoacidosis in a pregnant woman.

A case of alcoholic ketoacidosis in a 23-year-old chronic alcoholic, gravada V, para IV, is reported. Symptoms were constant, severe, nonradiating pain with crampy exacerbations, anorexia, nausea and vomiting. The patient had a tender and irritable full-term uterus. She was treated inhospital with vigorous fluid therapy and 5% dextrose in normal saline, sodium bicarbonate, glucose and insulin and showed improvement overnight. Alcoholic ketoacidosis has not been reported in pregnant women. Metabolic derangements combine to produce ketoacidosis more readily in the pregnant alcoholic. Differentiation of alcoholic ketoacidosis and diabetic ketoacidosis is important since treatment varies. For alcoholic ketoacidosis, treatment is vigorous rehydration with dextrose-saline while diabetic ketoacidosis usually requires multiple therapeutic modalities.

Acidosis↗