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Biomedical subjects

J Wasserberger

Publications and source records attributed to J Wasserberger.

53 records · Page 3Linked to original sources
PubMed1985

Coagulation abnormalities in traumatic shock.

Coagulation abnormalities can pose a threat to hemorrhaging patients and to attempts at surgical correction. We have shown that 97.2% of our 180 patients who died of trauma had evidence of coagulation defects prior to fluid or blood treatment. Twelve of 180 patients could not be cross-matched due to inability of their blood to coagulate in the tube. Clinically 50% of these patients had excessive oozing from venipuncture sites, and 28% had excessive hematoma formation not associated with vascular injury. The most frequently abnormal test was the prothrombin time, in 97% of patients followed by platelet count in 72%, and partial thromboplastin time in 70%. The greatest degree of coagulation abnormality occurred in patients with head trauma, followed in decreasing order by gunshot wounds, blunt trauma, and stab wounds to the body. Because 97.2% of the patients had abnormal coagulation studies prior to fluid and blood replacement, this abnormality most likely was due to disseminated intravascular coagulation. We propose using the tube-clot test to give a rapid indication of coagulation in traumatized patients while awaiting laboratory test results.

Adolescent↗
PubMed1985

Rat bites: fifty cases.

A prospective study of 50 patients with uninfected rat bite wounds was undertaken to determine the natural incidence of wound infection without prophylactic antibiotics. All open wounds were cultured; bacterial isolates were cultured from 30% of wounds. Of bacterial isolates, 43% were Staphylococcus epidermidis and the remainder were Bacillus subtillus, diphtheroids, and alpha hemolytic Streptococcus. Only one patient (2%) developed an infection. Seventy-two percent of the bites occurred while the patient was sleeping, probably accounting for the fact that 84% of the wounds were on the exposed areas of the upper extremities and face. Treatment recommendations include good surgical management and avoidance of prophylactic antibiotics due to a low natural infection rate. If the wounds become infected, then a cephalosporin or penicillinase-resistant penicillin should be sufficient for treatment with appropriate surgical care of the wounds. Rabies prophylaxis usually is not required, but we suggest that tetanus prophylaxis is mandatory because most of our patients were deficient in this regard.

Adolescent↗
PubMed1985

110 bullet wounds to the neck.

Selective management of 110 patients with bullet wounds to the neck resulted in 31 explored and 79 observed. There was an overall mortality rate of 2.7%, well within that reported in the literature, which ranges from 2 to 6%. At our institution, it is believed that a substantial number of patients can be selectively managed, depending on the signs and symptoms, the site and direction of the trajectory, and whether the interval of time between injury and entrance to the hospital is longer than 6 hours. Patients who are stable and lack physical signs of obvious major neck injury are evaluated by diagnostic radiologic and endoscopic techniques. If no significant injury is found, they are admitted for observation. The efficacy of this mode of management is strengthened by savings in the costs of hospitalization, risks of undergoing an additional operation, overall negative exploration rate in the mandatory exploration studies, and our own results of selective management. We do not recommend this form of management for all institutions. It has been found that in this well-staffed teaching hospital with an extensive trauma service, experienced personnel doing careful and repeated physical examinations, in addition to 24-hour availability of radiologic and endoscopic modalities, the policy of selective management of bullet wounds to the neck can be adhered to. Further studies need to be done into the various mechanisms of penetrating neck trauma, separating each mechanism into morbidity, mortality, and treatment.

Adolescent↗
PubMed1984

Efficacy of absorption of sublingual and intravenous Cardio-Green.

To simulate the effect of sublingual injections on pediatric patients, open-chested kid goats were injected sublingually or peripherally with Cardio-Green while being supported by internal cardiac massage. Our study demonstrates that there is statistically a ten-fold lower central blood level after sublingual injection compared to that after use of the peripheral intravenous route. Our experiment casts doubt on whether absorption through the sublingual route is adequate, and shows that if a peripheral intravenous line cannot be started, vigorous attempts should be made to obtain a central line rather than taking valuable time to inject sublingual drugs. Further studies must be done before these results can be applied to clinical situations.

Absorption↗
PubMed1984

Wound ballistics: theory and practice.

Ballistics is the study of the natural laws governing projectile missiles and their predictable performances, and wound ballistics is the study of a missile's effect on living tissue. A knowledge of these topics is essential to determine the extent and type of injury from a missile. The type of missile can often be determined by radiography. The caliber can be measured directly if the bullet is close to the x-ray plate and the x-ray tube is at least six feet from the film. Changing these distances can result in a maximum magnification of the bullet image of 20%, and the exact amount can be calculated using a formula provided. Definitions of ballistic and wound ballistic terms are provided, as are examples of wound ballistics in application.

Humans↗
PubMed1984

Intravenous prochlorperazine for the rapid control of vomiting in the emergency department.

In this study, 40 patients whose active vomiting stemmed from various causes were given 2.5 mg of prochlorperazine by slow intravenous push. If no response was observed within 20 minutes, the dosage was repeated. Of 35 patients, 32 responded to doses of 2.5 to 5.0 mg. Three patients experienced no relief of vomiting while in the emergency department, after a total of 5 mg each, in divided doses. These three patients had received morphine sulphate for acute myocardial infarctions. The mean time to cessation of vomiting was 8.5 minutes, versus 35 minutes for a similar group receiving intramuscular prochlorperazine. This difference was statistically significant using analysis of variance (P less than .05). None experienced extrapyramidal reactions, or developed hypotension. We concluded that 2.5 mg of intravenous prochlorperazine given over one minute is an effective, safe treatment for the control of vomiting in the emergency department, until the etiology of the nausea and vomiting is determined and treated specifically. Further double-blind, controlled studies are warranted.

Adolescent↗
PubMed1983

Outpatient management of 357 gunshot wounds to the chest.

There is, at present, little literature to guide one in the management of a patient with a gunshot wound to the chest with normal vital signs, physical examination, and as a normal chest X-ray. The present study followed up 357 patients as outpatients at 48 hours, then 1 and 3 months. No major complications developed. Minor complications included chronic wound pain, chronic wound swelling, and the uncomfortable sensation of being able to palpate one's own subcutaneous bullet. The wound infection rate was only 1.5% with or without antibiotics, showing that prophylactic antibiotics are probably not warranted if good surgical wound care is practised. We conclude that patients with gunshot wounds to the chest with normal vital signs, physical examinations, and normal X-rays can be reasonably treated as outpatients after 4 hours of observation, at the physician's discretion.

Adolescent↗
PubMedDate not supplied

AIDS and breast milk.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗