摘要:

Injury severity scales of proven reliability and validity are essential for the appropriate allocation of therapeutic resources, for prediction of outcome, and for evaluation of the quantity and quality of emergency medical care in differing facilities and over time. Quantitation of injury severity in the field is particularly necessary. Existing scales are too imprecise to permit comparisons of management or systems of care. In this paper, the authors present the Triage Index, a measure of injury severity based on five simple variables observed in a design data set of 1084 patients. The Triage Index has been developed with state-of-the-art multivariate statistical techniques, meets the requirements of an interval ranking scale, and has been both validated and assessed for interuser reliability. The Triage Index is proposed as a validated system of early, rapid, noninvasive, accurate patient assessment permitting appropriate matching of trauma victims with available therapeutic resources as a means of reducing mortality and morbidity.

ISSN:0090-3493    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Ten normocalcemic critically ill patients who had experienced a decrease in cardiac index ≥0.5 liter/min/m2after incremental changes of PEEP received 7 mg/kg of CaCl2as a slow iv bolus, followed by an infusion of 20 mg/kg CaCl2over 60 min. Hemodynamic pressures and flow, oxygen uptake and transport, and blood chemistry variables were determined over a 120-min period. The results indicated that: (1) hemodynamic variables were not affected except for left ventricular stroke work index and mean blood pressure, which increased slightly; (2) both serum calcium and ionized calcium concentrations increased significantly, sometimes to dangerous levels; (3) colloid osmotic pressure and hemoglobin levels decreased slightly but consistently. In conclusion, CaCl2administration failed to improve hemodynamic function depressed by PEEP. If CaCl2can play a relevant role in the management of cardiovascular depression, further identification of appropriate doses and patients is necessary.

ISSN:0090-3493    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Electrocardiographic (ECG) abnormalities were found in 15 of 20 consecutive children (75%) admitted to the Pediatric ICU (PICU) with central nervous system injury produced by trauma or neurosurgical procedures. The ECG abnormalities included prolonged qTc, U waves, and notched T waves as well as ventricular arrhythmias. The high frequency and potential seriousness of this problem in infants and children suggests that neurogenic ECG changes should be looked for in all infants and children with neurological insults.

ISSN:0090-3493    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Thirty-five families were interviewed by members of the intensive care nursery staff 2–4 months after the death of their newborn. Of the families interviewed, 74% wanted to review the events leading to their child's death and ask questions about information they already knew. Most families who were interested in the autopsy findings used the results to find out “how normal everything else was.” Topics frequently discussed by parents involved feelings of guilt and problems that arose after the infant's death (isolation by friends, somatic complaints, marital and sexual problems, memories of prior losses, problems with siblings, and disposal of baby's things). One-third of the families were felt to need continuing emotional support due to their inability to assume previously accepted responsibilities. For many families, the physician may be the only individual who can tolerate listening to their distress.

ISSN:0090-3493    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

Pipeline systems are used in most hospitals today to deliver medical oxygen to patient care areas. Intermittent reports have appeared concerning serious problems and failure with these systems. Mandated reserve systems have not provided the necessary backup at times. This article describes an auxiliary system to supply oxygen in a zonal fashion to wall outlets. The system will function during most failure situations; a hazard is inherent in the knowledge of this technique and will be examined.

ISSN:0090-3493    

出版商:OVID    

年代:1980

数据来源: OVID

ISSN:0090-3493    

出版商:OVID    

年代:1980

数据来源: OVID

ISSN:0090-3493    

出版商:OVID    

年代:1980

数据来源: OVID

ISSN:0090-3493    

出版商:OVID    

年代:1980

数据来源: OVID

ISSN:0090-3493    

出版商:OVID    

年代:1980

数据来源: OVID

ISSN:0090-3493    

出版商:OVID    

年代:1980

数据来源: OVID