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Biomedical subjects

J Wasserberger

Publications and source records attributed to J Wasserberger.

At least 37 records · Page 2Linked to original sources
PubMed1988

Shotgun wound ballistics.

Shotguns are popular world wide and more of these weapons exist than the rifled types. With an increasing incidence and prevalence of gunshot wounds it is important for traumatologists to be familiar with shotgun wound ballistics. Shotgun wounds differ from those of other missiles because the spectrum of wound severity is large owing to the fact that the pellets scatter as they travel. Close-range shotgun wounds can be as destructive as those from a high-velocity rifle, but longer weapon-victim ranges may produce only minimal injury. The type of shot (size and weight of pellets) used also determines the type of injury, with more serious injuries produced by the larger type of buckshot (greater than 0.14 inches in diameter). The severity of injury from birdshot depends mainly on the "effective" weapon-victim range which can be calculated from the shot size and shot pattern either clinically or from X-ray. Wounds may then be classified according to severity, yielding information on prognosis and extent of investigation and treatment required. We propose a four-level severity scale based upon birdshot pellet scatter patterns which correlate well with morbidity and mortality rates.

Firearms↗
PubMed1987

Intravenous prochlorperazine for the rapid control of nausea and vomiting in acute myocardial infarction: a clinical observation.

Sixteen patients with acute myocardial infarctions who were either vomiting or nauseated were given an intravenous injection of prochlorperazine. All patients obtained relief with exception of one patient who was in acute renal failure. No patient developed symptomatic hypotension. Intravenous prochlorperazine in the dose of 2.5 mg is a rapid, effective, and safe method to relieve vomiting and nausea in patients who have sustained an acute myocardial infarction.

Aged↗
PubMed1987

Serum digoxin levels and mortality in 5,100 patients.

A retrospective study of 5,100 patients on digoxin, with a four-week follow up after digoxin levels were measured, was done to determine the mortality rate. A significant increase in mortality was correlated with an increasing serum digoxin level, up to 50% at a level of 6.0 ng/mL and more. Clinical toxicity was suspected in only 0.25% of all patients on digoxin, although almost 10% had levels above the therapeutic range. Deliberate digoxin overdoses were fatal in 50% of cases. This study shows a correlation between increasing digoxin levels and increasing mortality rates. We recommend the use of serum digoxin measurements to identify those asymptomatic patients with elevated levels. The physician should seriously consider the indications for initiating or continuing digoxin treatment in any patient because of an increased mortality in patients with levels of more than 1.0 ng/mL.

Adult↗
PubMed1987

Electronic gun (Taser) injuries.

The Taser is an electrical weapon used for immobilization. Two hundred eighteen patients who were shot by police with a Taser for violent or criminal behavior were compared to 22 similar patients shot by police with .38 Specials. The long-term morbidity rate was significantly different for "tasered" victims (0%) and for those with bullet wounds (50%) (P less than .05). The mortality rate was also significantly different between "tasered" victims (1.4%), and gunshot wound victims (50%) (P less than .05). Possible complications associated with Taser wounds included contusions, abrasions, and lacerations (38%); mild rhabdomyolysis (1%); and testicular torsion (0.5%). Although 48% of "tasered" patients required hospitalization, all but one was for a preexisting injury or toxic or psychiatric problem. We conclude that Tasers are relatively safe when compared to shooting with more conventional weapons.

Adolescent↗
PubMed1987

Base station prehospital care: judgement errors and deviations from protocol.

During a three-year period 5,944 paramedic runs were reviewed at the King/Drew Medical Center for deviations from prehospital management protocols established by the Los Angeles Paramedic Training Institute, and from standard medical practice. An overall compliance to the prehospital management protocols of 94% was found. Compliance to standard medical care was 97%. The most common deviations were failure to administer prophylactic lidocaine to patients having chest pain suggestive of myocardial ischemia and failure to apply cervical spine precautions in patients with suspected head trauma. Fifty percent of the radio operators who deviated from algorithms also were found to be making errors in judgment in standard medical care.

Algorithms↗
PubMed1987

Homemade guns.

Explore the source record for details and available documents.

Adolescent↗
PubMed1986

Iatrogenic pulmonary overpressure accident.

An unconscious victim of an overdose was intubated with an endotracheal tube to prevent aspiration. The respiratory therapist deflated the cuff of the endotracheal tube to allow for a retrograde oral air leak and then tightly attached the oxygen tube directly to the endotracheal tube. Seconds later there was a loud pop as the oxygen tube blew off the end of the endotracheal tube. The patient sustained both a hemodynamic and a neurologic decompensation as the result of marked pulmonary overinflation, with bilateral pneumothoraces and probable cerebral and coronary artery air emboli. We present the case in the hope that it will help avoid any such future occurrences.

Adult↗
PubMed1985

Effect of heparin on arterial blood gases.

To evaluate changes in arterial blood gas samples caused by the addition of liquid heparin, 50 patients had three simultaneous blood samples drawn, each with one of three amounts of heparin. The liquid heparin decreased statistically the PCO2, PO2, HCO3, and base excess, while the pH remained unchanged. By using a 2-cc blood sample with a 5-cc glass syringe and a 11/2-inch, 18-gauge needle to draw the heparin solution up to the 2-cc mark, and then completely evacuating it, we found that 0.025 cc of solution remained to coat the syringe. Although this remaining solution would cause a 1.25% error in the blood gas results, the error would be acceptable because it is generally less than the standard deviation of the laboratory results. Excess liquid heparin statistically exaggerated or produced false results consistent with a metabolic acidosis with respiratory compensation. We recommend that the complete evacuation of liquid heparin from the sampling syringe be included when performing an arterial blood gas analysis.

Acidosis↗