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Biomedical subjects

M T Morgan

Publications and source records attributed to M T Morgan.

36 records · Page 2Linked to original sources
PubMed1986

Conjunctival oxygen tension monitoring during helicopter transport of critically ill patients.

To investigate the utility of conjunctival oxygen tension measurement during helicopter transport, we monitored conjunctival oxygen tension (PcjO2) in 36 clinically unstable patients. Sixteen (44%) of the patients were found to have ventilatory or circulatory compromise as determined by PcjO2 less than 50 torr. In only three of these patients would vital sign determinations have detected the unstable clinical states. In 12 patients (33%), respiratory intervention or expansion of intravascular volume resulted in improvement of tissue oxygenation and clinical state. These results demonstrate that a substantial fraction of our patients transported by helicopter had underlying physiologic abnormalities that were not apparent by monitoring of vital signs, but were detected and corrected by measurement of conjunctival oxygen tension.

Adolescent↗
PubMed1977

The clinical investigation and management of chest pain in an emergency department: quality assessment by criteria mapping.

Criteria Mapping, a recently developed chart review method, was tested for its ability to assess the quality of symptom investigation and management for the presenting complaint of chest pain in an emergency department. A criteria map, which is based on decision making logic and permits use of criteria relevant to individual patients, was used to review the records of 137 patients who were examined for chest pain and subsequently discharged from the emergency department. All 111 patients assessed as receiving adequate process had positive outcomes. Twenty-six charts (19 per cent) were determined to have inadequate process, having failed at least one relevant and critical criterion; 23 of these 26 patients had positive outcomes. Review of the unmet criteria in these 23 charts revealed their uncertain predictive validity regarding immediate risk of death. We conclude that the Criteria Mapping method--the first reported technique for evaluating care for patient problems (as opposed to diagnoses)--provides an effective and feasible means for assessing the quality of symptom investigation and management.

Adult↗
PubMed1977

Selective use of radiography of the skull and cervical spine.

Based on the findings of a five-month study, the authors suggest that physicians should be more discriminating in using radiography of the skull, especially when dealing with patients who are minimally injured. The low incidence of fractures disclosed by radiography in patients with insignificant head injuries is a primary factor in arriving at this recommendation. A lack of correlation between skull fractures, and cerebral injury, and subsequent therapy is another factor. Finally, the prohibitive cost of medical care generally (and radiographs in particular) makes greater selectiveness imperative. Although the number of cervical spine fractures in this study was small, the findings indicate that based on history and physical examination there can and should be increasing selectivity in ordering routine cervical spine series, without increasing the risk of missed fractures.

Cervical Vertebrae↗