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Biomedical subjects

R H Dailey

Publications and source records attributed to R H Dailey.

At least 19 recordsLinked to original sources
PubMed1992

Appropriate management of chemical dependency in emergency medicine residents.

When chemical dependency is suspected in an emergency medicine resident physician, prompt and appropriate action must be taken to ensure the best possible outcome for all involved. Although residency program accreditation requires that program directors be able to appropriately deal with a chemically dependent resident, few programs have a formal policy in place, and little if any information exists for the formulation of such a policy. Presented here is a discussion of the disease of chemical dependency and how it affects emergency medicine residents, along with practical recommendations for appropriate management.

Algorithms↗
PubMed1988

Fatality secondary to misuse of TAC solution.

The death of a 7 1/2-month-old girl from the misuse of tetracaine/adrenalin/cocaine solution for wound anesthesia is reported. Ten milliliters of the solution inappropriately came into contact with nasal mucous membranes, causing excessive drug absorption. The patient's death probably was due to cocaine toxicity (post-mortem blood level, 11.9 mg/L).

Anesthetics, Local↗
PubMed1987

Intravenous phenobarbital for alcohol withdrawal and convulsions.

In a prospective, uncontrolled study, 62 alcoholic patients received IV phenobarbital (IV-PB) to treat the alcohol withdrawal (AW) syndrome. Initially 260 mg of IV-PB were administered followed by 130 mg every 30 minutes to an end point of light sedation. A mean loading dose of 598 (+/- 192) mg of IV-PB resulted in a mean increase in the serum PB level of 13.9 (+/- 4.7) microgram/mL. Thus, the serum PB level rose 1.65 micrograms/mL for each mg/kg of IV-PB administered to these adult patients in AW. Forty-six of 48 tremulous patients (96%) showed improvement in their AW tremors. None of the 38 patients who presented with AW seizures had another convulsion during a mean observation period of three hours and 47 minutes. Transient ataxia or over-sedation occurred in three of 62 patients (5%) and was exacerbated by concurrent ethanol, diazepam, or phenytoin (six of 17), who were excluded from the study. We conclude that IV-PB is a safe and efficacious therapy for mild to moderate AWS, and IV-PB may prevent AW seizures.

Acute Disease↗
PubMed1985

Femoral vein cannulation: a review.

The femoral vein is an excellent potential venous access site. The technique of cannulation is described and its applications and complications are reviewed. More extensive future use of this technique is necessary to determine its proper role in emergency medicine.

Bacterial Infections↗
PubMed1985

"Code Red" protocol for resuscitation of the exsanguinated patient.

A "Code Red" protocol for resuscitation of the exsanguinated patient is presented. It consists of two phases initial massive crystalloid infusion, followed by rapid access to, and infusion of, blood. It is simple and requires minimal time, equipment, personnel, or expertise. The femoral vein is the principal access site; it is cannulated percutaneously by the Seldinger technique and allows simultaneous infusion and CVP measurement.

Blood Transfusion↗
PubMed1984

Standards for attending staff in an emergency medicine residency program.

An academic emergency department established comprehensive standards for its attending staff. Extensive input from multiple levels of emergency department (ED) personnel were utilized. There was uniform agreement that written roles and responsibilities were needed for a more efficiently operating department. Written standards for attending staff represent a novel approach in ED administration.

California↗
PubMed1983

Acute upper airway obstruction.

Methods for controlling the airway in a variety of clinical situations are comprehensively reviewed. Use of mechanical ventilatory support should be considered when spontaneous respiration is inadequate, but the modality chosen must be adapted to the individual patient.

Acute Disease↗
PubMed1979

Ketamine dissociative anesthesia--emergency department use in children.

An on-going study to determine the efficacy and safety of ketamine dissociative anesthesia in the emergency department for children less than 10 years of age is presented. Preliminary results of the first 30 cases indicate that this technique may be safe and convenient if used within the appropriate protocol.

Child↗
PubMed1977

Central venous cannulation and pressure monitoring.

Central venous pressure (CVP) varies directly with circulating blood volume and vascular tone and inversely with right heart competency. Indications for central cannulation include cardiorespiratory arrest. The two general approaches to cannulation of central veins are peripheral and central. The physician's skill, patient's body habitus, clinical circumstances, age and thoracic deformity all influence the choice of technique. Three of the possible complications discussed are pneumothorax, arterial puncture and air embolus. Accurate measurement of CVP depends on the patient being supine, a patent and accurately located catheter and the establishment of a baseline external zero point.

Carotid Artery Injuries↗
PubMed1976

Pseudoasthma: a new clinical entity?

A functional syndrome resembling either asthma or airway obstruction, or both, is described. It is probably caused by voluntary glottic closure. Therapy with sedation and reassurance has proven successful. Patients with this syndrome must be carefully examined and observed to exclude the possibility of organic upper airway obstruction.

Adult↗
PubMedDate not supplied

External jugular vein cannulation and its use for CVP monitoring.

The techniques of external jugular vein (EJV) cannulation and central venous pressure (CVP) catheter placement using a J-tipped wire guide is described in detail. This technique has a high success rate with virtually no complications.

Catheterization, Central Venous↗