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Biomedical subjects

R L Krome

Publications and source records attributed to R L Krome.

At least 37 records · Page 2Linked to original sources
PubMed1983

Resuscitation of the multiply injured patient.

The resuscitation of the traumatized patient with multisystem injuries begins on the scene of the incident, continues into the emergency department, and finally includes the surgeon and the operating room. Treatment of the traumatized patient requires a systematic approach to best utilize all facilities and personnel while limiting duplication of service. The patient must go to the facility that best meets his or her needs. Stabilization in the emergency department should proceed in an orderly and organized fashion. Care must be taken when establishing the airway to protect the cervical spine. Massive hemothorax, tension pneumothorax, cardiac tamponade, intraabdominal bleeding, and retroperitoneal bleeding, as well as flail chest, must be remedied before stabilization and resuscitation can come to a successful outcome. Internal cardiac massage may need to be done for cardiac tamponade or when resuscitation has failed. Fluid repletion must be vigorous and aggressive. Albumin is probably of no benefit to the patient and, in fact, may be deleterious. Hetastarch may turn out to be a valuable addition to the fluid management of these patients. The patient is entitled to one physician who can call the consultants together. In addition, there should be a single physician for the patient who can control the timing of operative intervention as well as coordinate the overall management by the consultants.

Blood Transfusion, Autologous↗
PubMed1982

The certification examination in emergency medicine: an update.

The 1977 field test and first administration of the American Board of Emergency Medicine certification examination produced data which support the assumption upon which it was originally developed. A total of 22 fourth-year medical students, 36 emergency medicine residents, and 36 emergency physicians participated in the field test held in Lansing, Michigan. The examination was found to be highly reliable, to distribute scores among groups according to presumed competence, and to support the concept of treating the examination as a total instrument rather than one subdivided by content areas. Patient management problems were found to be inefficient as a test format. The first administration of the examination, which tested 616 candidates, confirmed the original field test findings.

Certification↗
PubMed1981

Peripheral vs central circulation times during CPR: a pilot study.

The circulation time during closed chest cardiac compression was studied using Cardio-Green injected in either the right antecubital vein or right subclavian vein during CPR. Arterial blood was obtained from a right femoral arterial catheter at 30-second intervals for five minutes following injection. Six patients, in two groups, comprised the study population. The arterial sample for Cardio-Green after central venous injection revealed a high concentration of the dye at 30 seconds and an emerging second peak at five minutes. After peripheral injection, no peak concentration of the dye was achieved during the five-minute sampling method. Our preliminary study indicates reduced concentrations and significant delay in arrival of injected agents that are introduced at a peripheral intravenous site during closed chest compression.

Blood Circulation Time↗