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Biomedical subjects

J Clinton

Publications and source records attributed to J Clinton.

At least 37 records · Page 2Linked to original sources
PubMed1986

A comparison of the supraclavicular approach and the infraclavicular approach for subclavian vein catheterization.

Five hundred emergency department patients requiring subclavian vein catheterization were randomized prospectively into one of two groups, supraclavicular or infraclavicular. If catheterization was unsuccessful in a few attempts using the randomized approach, catheterization with the alternate approach was attempted. Two catheters were available for use, a short, 8-French introducer and a long, 16-gauge catheter. There were 38 failures (15.5%) among 245 patients in the supraclavicular group, with one malposition and five complications. There were 51 failures (20.0%) among 255 patients in the infraclavicular group, with 21 malpositions and 13 complications. No differences were significant except that of malpositions (P less than .01). The combination of infraclavicular approach and 16-gauge catheter accounted for 21 of 22 malpositions. When catheterization by the randomized approach failed, catheterization by the alternate approach was successful in all but seven cases, resulting in an overall success rate of 98.6%. Analysis of this series suggests that both the infraclavicular and supraclavicular approaches to subclavian vein catheterization are acceptable alternatives, with little difference in success rate or complications. Using an alternate approach if the initial approach was unsuccessful produced a high overall success rate and a low overall complication rate. A physician who is familiar with both approaches will be more successful at placing central venous catheters safely.

Adolescent↗
PubMed1984

Emergency catheterization of the superior vena cava in pediatric patients.

All emergency department attempts at superior vena caval catheterization at Hennepin County Medical Center from 1978 to 1982 in patients less than 13 years of age are reviewed. There were 60 attempts on 41 patients who had life-threatening conditions. Forty-one (68.3%) catheterization attempts were successful, and 37 (90.2%) of the patients had at least one central catheter placed. There were no complications that affected any patient's hospital course or outcome. This series demonstrates that percutaneous central venous catheterization can be performed on seriously ill or injured children, under emergency conditions, with a high rate of success and low incidence of complications.

Catheterization↗
PubMed1984

MAST usage in cardiopulmonary resuscitation.

The medical antishock trouser (MAST) has been advocated as potentially beneficial in the resuscitation of patients in cardiac arrest. Currently available data indicate that the MAST will increase the blood pressure generated by external cardiopulmonary resuscitation. In addition, there may be an increased survival of patients found in cardiac arrest with an initial cardiac rhythm of pulseless idioventricular rhythm when the MAST is used. The physiologic parameters affected by the MAST may be similar to those caused by vasopressor agents in animal studies and implicated in increased survival rates. The clinical implications of these data and their relation to future investigations are discussed.

Gravity Suits↗
PubMed1981

An analysis of news flow on the nation's nurse shortage.

Using data from national newspaper clipping services, this article analyzes characteristics of 1978 news coverage of the nation's nurse shortage. Based on a content analysis of nearly 3,000 newspaper articles, findings revealed that 14 per cent of the articles mentioned problems of nurse supply. Articles on nurse shortage were most frequent in the Pacific, Mid-Atlantic and South-Atlantic states and occurred least in the West-North Central and East-South Central states. Articles mentioning nurse shortage were more frequently placed on page 1, associated with clinical nursing in hospital settings and explained as the result of maldistribution of nurses, poor salaries, deficient working conditions and lack of job satisfaction. The reading public was confronted with three major consequences of current and continued shortages in nursing: 1) decline in the availability and diversity of health services; 2) erosion in the quality of care offered the public and jeopardized patient welfare; and 3) escalating health care costs. Solutions to the nurse shortage appear to be closely tied to further expansion of the issue among the public, the initiation of remedial governmental action and timely relocation of scarce resources within the health care industry.

Humans↗
PubMed1979

Clinical assessment of patients undergoing CPR in the emergency department.

A problem frequently encountered in the emergency department is assessing the effectiveness of cardiopulmonary resuscitation (CPR), particularly when it is continued over a period of time. To evaluate the effectiveness of CPR in our emergency department we use a mechanical cardiopulmonary resuscitator (Michigan Instruments, Thumper) together with early invasive monitoring of pulse and blood pressure. This also allows for frequent monitoring of blood gases. Three patients are presented who underwent longterm CPR (ie, longer than one hour), and invasive monitoring. Results indicate that better management of the clinical status of patients undergoing prolonged resuscitation can be obtained by using continuous blood pressure and pulse monitoring, and frequent blood gas analysis. In addition, when frequent arrhythmias are taking place, this system allows for better determination of appropriate procedures and medications.

Aged↗