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Biomedical subjects

M L Birnbaum

Publications and source records attributed to M L Birnbaum.

At least 37 records · Page 2Linked to original sources
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Beginning, growth, and transition.

This is what has happened and is happening. For those offended along the way, I apologize--but try us now. Prehospital and Disaster Medicine no longer is an experiment to see if a Journal of this ilk can be a success. It is. The experiment is over. Prehospital and Disaster Medicine is here to stay. Clearly, it meets many of the needs of a broadly based audience, and could meet needs of those who still are not participating in this exciting and enriching endeavor. I am grateful for the support of each of you, for that of the sponsoring organizations, and to the advertisers and publisher. A new phase has begun. The state of the Journal is dynamic, and it will continue to improve. It only can better meet your needs if you participate with us in its evolution. As always, your input is requested. Our aim is to provide you with the very best, and only with your continued input and support can we continue to build the medical disciplines of prehospital and disaster medicine.

Emergency Medicine↗
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Only an ounce.

Explore the source record for details and available documents.

Emergency Medical Technicians↗
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Comparison of inhaled metaproterenol via metered-dose and hand-held nebulization in prehospital treatment of bronchospasm.

INTRODUCTION: Although the efficacy of the administration of beta-adrenergic bronchodilators has been demonstrated, the best method available for the delivery of these drugs in the prehospital setting has not been defined. This paper compares the effects of administration of metaproterenol when administered by paramedics using either a metered-dose inhaler (MDI) or a hand-held nebulizer (HHN). HYPOTHESIS: There is no difference in the effects produced in patients suffering from smooth bronchiolar muscle spasm by metaproterenol when delivered either by a standard metered-dose inhaler or with a hand-held nebulizer. PARTICIPANTS: Consecutive prehospital patients complaining of difficulty breathing with clinical evidence of bronchospasm and with a history of asthma, chronic obstructive pulmonary disease, or emphysema who were not in extremis. METHODS: Prior to the administration of metaproterenol, a peak expiratory flow rate (PEFR) was obtained. This measurement was repeated five minutes following the conclusion of the administration of metaproterenol. Patients in Burbank, California, received the treatment using a standard metered-dose inhaler, and those in Madison, Wisconsin, received the drug using a hand-held nebulizer. Peak expiratory flow rates were compared using Student's t-tests with Bonferroni's correction. Statistical significance was set at p < 0.05. RESULTS: Data were collected from 36 consecutive patients by the paramedics of the Burbank Fire Department and from 32 consecutive patients by the paramedics of the Madison Fire Department. For the metered-dose inhaler group, the mean value for peak expiratory flow rate for the pre-treatment test was 95.4 +/- 88.1 l/min, and after treatment was 109.4 +/- 89.3 l/min (p < 0.001). For the hand-held nebulizer group, the mean value for peak expiratory flow rate before the administration of the metaproterenol was 96.1 +/- 76.3 l/min and following the treatment was 149.1 +/- 92.9 l/min (p < 0.001). The mean values for the differences between the control peak expiratory flow rate and the post-treatment peak expiratory flow rate for the metered-dose inhaler group was + 140.0 +/- 27.4 l/min, and for the hand-held nebulizer group was + 53.0 +/- 69.1 l/min (p < 0.003). CONCLUSIONS: In the prehospital setting, the administration of metaproterenol using a hand-held nebulizer is more effective than delivering the drug using a metered-dose inhaler. The hand-held nebulizer is easier to use and delivers a higher dose of the drug than is convenient using the metered-dose inhaler.

Administration, Inhalation↗