bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systematic Studies of Cerebral Resuscitation Potentials after Global Brain Ischemia (GBI)
Authors: Gisvold Sven Erik , Safar Peter 
Published: July 2016

Resuscitation of the brain after ischemic-anoxic brain injury remains a controversial topic. There is, however, presently a certain therapeutic optimism in this field. Ours is partly based on the recognition of a post-resuscitation disease, that is, treatable pathologic processes in all organsafterrestoration of adequate perfusion pressure and arterial oxygenation. Also, Hossmann has shown that neurons can survive longer periods of anoxia than previously assumed.There have been reports on experimentalfocalischemia indicating beneficial effects of barbiturates and moderate hemodilution before and after initiation of focal ischemia. After complete temporaryglobalbrain ischemia (GBI), as in cardiac arrest, however, results so far have been conflicting and controversial.
Experimental Study of Reversibility of a Diazepam Overdose by Physostigmine or Galanthamine
Authors: Havasi George , Gintautas Jonas , Warren Philip R. , Hayasi Ilona , Kraynack Barry J. 
Published: July 2016

Diazepam is a commonly used drug for suicidal attempts. The antagonistic effect of physostigmine in these patients is poorly understood.We studied the interaction of large doses of diazepam and either physostigmine or galanthamine hydrobromide using dose-response curves in 21 cats. After establishing dose-response curves for diazepam, half of the animals received 0.02 mg/kg of physostigmine intravenously. Two minutes later 8, 10, 12, or 14 mg/kg of diazepam was administered intravenously. After 2, 5, and 10 min, animals were evaluated for their response to noise and pain stimuli. The other half of animals were given 0.2 mg/kg of galanthamine intravenously and evaluated for diazepam effect using the same criteria. Sufficient number of days were allowed for the animals to recover from diazepam.
Induction of Ether Anesthesia Using Adjuvants for Emergency Treatment
Authors: Müller-Suur Niels , Kleemann Peter P. , Brost Frank , Halmagyi Miklos B. 
Published: July 2016

Ether is almost a unique anesthetic agent, because it may be given to traumatized patients without any additional oxygen supply. But the significantly high stage of excitement during ether anesthesia can be dangerous, especially in disaster situations.In the Netherlands, Crul developed a training program for application of ether anesthesia combined with droperidol as adjuvant. Incited by Crul's clinical training method, we studied, in comparison with Guedel's Table, the behavior of clinical signs during induction of ether anesthesia, using droperidol, diazepam or ketamine as adjuvants. We controlled especially the duration of induction, as well as the intensity of clinical signs in the stage of excitement.
The American Heart Association
Authors: Thwaites J. Keith 
Published: July 2016

The American Heart Association is a voluntary health agency with approximately 100,000 members. It has affiliate offices in every state and in major cities throughout the country. The primary objective of the organization is to decrease and eventually eliminate disability and death from cardiovascular disease. This is accomplished through three general areas of program responsibility, namely support of research, community programs, and public and medical education. Its financial support is derived from public voluntary contributions.There are close to one million deaths in the United States annually from cardiovascular disease, which include over 640,000 heart attack victims. Those of us working in the area of heart disease regard the problem as one of catastrophic proportions, and in fact, “disaster medicine.” With the cause of most cardiovascular diseases unknown, special emphasis is placed on research. However, the American Heart Association also has a responsibility to impart to the medical profession, and the public at large, what knowledge is known. Therefore, a great deal of emphasis is placed on prevention, particularly how it relates to heart attacks.
Disaster Assistance by Department of State, USA
Authors: Brooks Joyce A. 
Published: July 2016

The Agency for International Development (AID) of the U.S. Department of State administers most U.S. bilateral foreign aid for development. The AID Administrator is the President's Special Coordinator for International Disaster Assistance. The office of U.S. Foreign Disaster Assistance (ofDA) coordinates all U.S. Government assistance to help alleviate suffering of people affected or threatened by natural or manmade disasters that occur abroad. Persons in developing countries are the main beneficiaries of the program. In addition to providing emergency relief, AID's disaster assistance program aims to strengthen the capabilities of other governments to respond to disasters. It is hoped that such efforts will help decrease dependence on the donor community.OFDA response to disasters takes place only at the request of a foreign government to the U.S. Ambassador in the affected area. The Ambassador must then declare the existence of a situation warranting U.S. Government assistance. Once that disaster declaration has been made, he/she has the use of up to $25,000 which may be used as a donation or as a vehicle to purchase locally-available supplies to aid in relief efforts. Any amount above $25,000 must be approved by the OFDA.
Private International Assistance in Major Disasters: The Brother's Brother Foundation
Authors: Hingson Luke L. 
Published: July 2016

Over the past two decades, the general public in affluent western societies has become vividly aware of major disasters from around the world through the improving technology of the news media. Each one of us can readily recall the instantaneous reports on earthquake ravaged Guatemala in 1976; war-torn Nicaragua and Cambodia in 1979; and devastating earthquakes in Italy and Algeria in 1980.Once alerted to the magnitude of these disasters, private organizations (churches, foundations, civic clubs, etc.), some 300–400 in number, in dozens of countries mobilized public support through news reports, ads, public service announcements, speeches and circular letters. For example, the Pittsburgh area raised over one half million dollars for refugees in Southeast Asia in 1980 that was channeled through such groups as UNICEF, Catholic Relief Services, and the International Rescue Committee.
Computer Modeling for Predicting and Planning for Worldwide and Regional Problems
Authors: Lesh Donald R. 
Published: July 2016

How can the results of computer modeling be used most effectively to serve the public policy decision-making process? In considering that question, I find it useful to keep two factors very clearly in mind:First, simulation modelsneverprovide any final answers; they simply offer an accurate, rapid, and mathematically precise means of analyzing a number of complex variables and tracing their dynamic interactions over time.Second, the use of computer modeling therefore presupposes—evendemands—an ultimate higher level of decision —political, medical, or what have you—among the policy alternatives analyzed and compared in the model.
Air Disaster in Antarctica
Authors: Fahey Morgan 
Published: July 2016

On the 28th of November 1979, the fourth largest air disaster in the world occurred on the icy slopes of Mount Erebus, deep in Antarctica and 50 km from Scott Base. The 237 passengers and 20 crew were all killed instantly on impact, and their bodies and the wreckage were spread over an area 500 m long and 100 m wide. It had started out as a scenic flight, the 14th to Antarctica, and it had ended in tragedy. It was suffered, too, by an airline company which had maintained the highest standards of aviation safety.In an account of Scott's last Antartic expedition in 1910, Cherry Garrard wrote of the “worst journey in the world,” and he said, “I have seen Fuji, the most dainty and graceful of mountains—and also Kanchenjunga; only Mechelangelo among men could have conceived such grandeur.
Medical Mission to a Refugee Camp in Thailand
Authors: Adler Jakov , Bodner E. , Bornstein S. , Goldfarb J. , Englehard D. , Naparstek J. , Norkin B. , Sack J. , Shemer S. , Weiler D. 
Published: July 2016

During the latter part of 1979, hundreds of thousands Kampuchean refugees fled from all parts of their war- and hunger-ridden country to the Thai-Cambodian border, thousands perishing from hunger, disease and stepping on mine fields on the way. The majority of those who survived settled in several large villages straddling the border in relative security from the advancing Vietnamese army, receiving food and medical supplies from many international welfare organizations.Widespread public interest in the plight of these refugees arose in Israel after a television program late in October 1979, and a public campaign initiated by Mr. Abie Nathan, an Israeli citizen. The ensuing fund-raising efforts resulted in 1.2 million dollars, most of which originated from private donations. These contributions enabled the Israeli government to equip 5 medical teams and send them to Thailand, covering the last two months of 1979 and the first 4 months of 1980.
12. The Potential Benefits of a Fire Safety Program Within Emergency Medical Services: A Point-of-Contact Intervention
Authors: Pirrallo Ronald G. , Rubin Jonathan M. , Meyer Ronald K. , Murawsky Gloria A. 
Published: July 2016

Purpose: To determine how often house fires occur at addresses visited previously for emergency medical services (EMS) and were these visits missed opportunities for a point-of-contact fire safety intervention.Method: Retrospective analysis of all Fire Department (FD) responses during 1994. Data studied with descriptive statistics: reason for response, property type, dollar loss estimate, injuries, fatalities, fire cause, smoke detector operation.Results: The FD responded to 94,378 requests for service at 43,556 addresses. 27,406 addresses generated one response. However, 16,150 addresses had multiple requests, receiving 66,972 responses. For the multiple requests, 1,162 addresses had a fire condition of which 728 addresses requested EMS prior to the fire condition. 215 were one/two-family dwelling addresses receiving 489 responses; mean 2.3 EMS responses prior to the fire condition. 182/215 (85%) of these addresses had complete data, incurring a dollar loss estimate of [US]$2,017,470, 33 injuries and 0 fatalities. The top five causes for the fire condition were children playing with smoking materials, arson, suspicious, scorched food and undetermined. 87/182 (49%) of the one/two-family dwellings had a smoke detector present. However, only 31/182 (17%) of the dwellings had an operational smoke detector.
24. Comparison of a Transillumination Versus Direct Visualization for Endotracheal Intubation by Basic Emergency Medical Technicians
Authors: March Juan A. , Manring Eric , Lovelace Scott , Brown Lawrence H. , Yarborough Kimmie 
Published: July 2016

Purpose: The new Emergency Medical Technician (EMT) basic curriculum includes an optional session on intubation. Unfortunately little data is available regarding retention of endotracheal intubation skills by basic EMTs. The objective of this study was to examine endotracheal intubation skills by basic EMTs, and compare skills retention for a transillumination (TI) versus a direct visualization (DV) technique.Methods: A prospective, randomized trial was conducted over a five week period during a basic EMT class. EMT classes were randomized to train students to perform endotracheal intubation using either a transillumination or a direct visualization technique. Initial education was performed using an airway mannequin during a modified, accelerated three hour course, consisting of both a didactic and skills session. To assess performance, participants were tested using an airway mannequin and checklist currently implemented by our flight nurse program. Without further education or practice, students were then tested one week and five weeks later to assess short and long term retention.
41. Gastric Trauma and Pulmonary Aspiration at Autopsy After Cardiopulmonary Resuscitation
Authors: Felegi William B. , Doolittle Richard L. , Conston Alfred S. , Chandler Stephen V. 
Published: July 2016

Purpose: To determine the prevalence of gastric trauma and pulmonary aspiration after cardiopulmonary resuscitation (CPR) and to examine factors which may be associated with increased prevalence of these complications.Methods: Retrospective review of 1,928 consecutive autopsy reports in a suburban teaching hospital from January 1, 1977 – June 1, 1986 of which 860 received CPR and 1,037 did not. Of the 860 who received CPR, 527 received prehospital CPR and 333 arrested in hospital and received only hospital CPR. Thirty-one cases were excluded because of inability to accurately examine the stomach.Results: There were 3 cases of stomach mucosal laceration and 4 cases of through and through laceration of the stomach in the CPR group and only one occurred in the non-CPR group (p <0.03). All gastric trauma in the CPR group occurred in the prehospital group (p <0.05). Pulmonary aspiration occurred in 31% of prehospital CPR patients and only 10% of hospital CPR patients (p <0.0001). The prehospital group differed from the hospital group in the following factors: longer basic life support times without intubation, 14.0 minutes vs. 2.0 minutes (p <0.0001) and longer total resuscitation time 46.9 minutes vs. 34.6 minutes (p <0.0001).
46. The Accuracy of Medical Records and Police Reports in Determining Motor Vehicle Crash Characteristics
Authors: Grant Robert J. , Gregor Mary Ann , Maio Ronald F. , Huang Shaun S. 
Published: July 2016

Objective: To determine the accuracy of ambulance (AR), emergency department (EDR) and police (PR) records in describing motor vehicle crash (MVC) characteristics when compared to a standard - an in-depth motor vehicle crash investigation record (CIR).Methods: Fifty-six MVC patients transported to a suburban, university hospital emergency department via ambulance and included in a crash investigation were identified. The time period was January 1993 through December 1995. Data sources were the AR, EDR, PR and CIR. The CIR was abstracted to a standard form. The other data sources were abstracted to a standard form using a retrospective, blinded review. Variables included occupant position, restraint use, air bag deployment, type of impact, ejection, and external cause of injury code. Accuracy was measured by determining percent agreement and Kappa for each data source compared to the CIR.Results: Forty-six cases (82%) had one or more episodes of discordance. The mean percent agreement for the sources studied was AR 0.813, EDR 0.893 and PR 0.932. Mean values for Kappa were AR 0.712, EDR 0.831 and PR 0.885. Among variables, restraint use was determined with the least accuracy with means for percent agreement and Kappa of 0.792 and 0.674, respectively. For the AR, discordance was due to missing information almost 50% of the time.
35. Emergency Medical Services Use of Trauma Triage Criteria to Stratify Patients by Injury Severity and Need for Emergent Intervention
Authors: O'Connor Robert E. , Tinkoff Glen H. , Mascioli Susan , Megargel Ross E. 
Published: July 2016

Purpose: Prehospital triage criteria (PTC) have been used to classify patients according to risk of serious injury. This study was conducted determine whether PTC could be used to identify serious injury, the need for intensive care (ICU), or immediate operative intervention (IOI).Methods: Data for this observational study were gathered prospectively, at a level-I trauma center, from a patient cohort admitted to the trauma service from 01 February to 31 July 1995. Specific triage criteria, based on information given by EMS prior to arrival were used to categorize patients by severity. Patients classified as most serious (codes) had the following: shock, major anatomic injury or proximal penetrating trauma. Patients classified as more serious (alerts) had one of the following: abnormal vital signs, Glasgow Coma Scale <13, moderate anatomic injury, high-risk mechanism of injury, or co-morbid factors. Patients not meeting either set of criteria, but were admitted, served as controls (consults). Injury severity scores (ISS) and probability of survival (Probsurvival) were calculated for each patient. The percentage admitted to the ICU, operating room (OR), or requiring IOI, were tabulated. Statistical analysis was performed using ANOVA, Mest and chi-square.
23. Ambulance Sphygmomanometer Accuracy: Can It Affect Triage to the Trauma Center?
Authors: Cady Charles E. , Pirrallo Ronald G. , Grim Clarence E. 
Published: July 2016

Objectives: To determine the accuracy of sphygmomanometers (SPHYGs) from a metropolitan EMS system and quantitate the mis-triage of adult blunt trauma patients based on erroneous systolic blood pressure (SBP) readings.Methods-A: A cross-sectional, convenient sample of 150 SPHYGs was checked for accuracy using industry standards. Mean high and low deviations were calculated at 90 mmHg.Methods-B: Retrospectively, a frequency distribution of the initial SBPs of all blunt trauma patients, age ≥21, seen in 1994 was plotted to characterize our study population. The numbers of patients potentially over- or under-triaged were identified when their reported SBP was corrected for using the mean high and low deviation plus 2 SDs.Results-A: Overall, 25.3% of the SPHYGs were inaccurate. At 90 mmHg, 28.0% (42/150) were inaccurate with 16.7% (7/42) high by 4.6±1.5 mmHg and 81.0% (34/42) low by 6.2±4.2 mmHg; one was inoperable.Results-B: 1,005 adult blunt trauma patients were evaluated; 61 were eliminated: 35 had initial SBPs of 0 mmHg and 26 had no SBP recorded (n = 944). The mean initial SBP was 138 ±30mmHg, and 3.8% (36/944) of the patients had SBPs <90 mmHg. Potentially, 2.0% (19/944) of the patients were undertriaged (initial erroneously high SBP reading 90–98 mmHg) and 2.5% (24/944) over-triaged (initial erroneously low SBP reading 74–90 mmHg).
71. Prospective Evaluation of Criteria Allowing Paramedics to Treat and Release Patients Presenting with Hypoglycemia
Authors: Wolford Robert W. , Tisol William , Vasilenko Peter , Domeier Robert M. , Owensby Susan Bignall 
Published: July 2016

Purpose: Criteria (T&R) have been proposed to identify hypoglycemic patients who may be treated in the field and released without transport to the hospital. We prospectively evaluated the validity of these criteria.Methods: Patients presenting with hypoglycemia (blood glucose [BG] <80 mg/dL) to paramedics of 2 EMS systems were prospectively enrolled and the presence of T&R criteria determined. T&R criteria did not influence transport. Hospital records were reviewed to determine interventions and outcomes.Results: A total of 151 patients were enrolled (58% male, age 56 years (range 12–94), BG 33 ±16 mg/dL) and 99 (66%) were transported to the hospital and used to test the T&R criteria. Fifty-six patients (57%) were discharged from the ED and 43 (43%) received additional medications, or were admitted. T&R criteria identified 28 (29%) patients as appropriate for treatment and release. Of these, 5/28 (18%) received additional dextrose 50% (D50) or admission; 3 received D50 (despite normal mental status and documented ED BG >100 mg/dL), and 2 were admitted (transient ischemic attack and 1 hospital day, hypoglycemia and gastroenteritis and 2 hospital days). Sensitivity, specificity, negative and positive predictive values for the T&R criteria were: 41%, 88%, 51%, and 82%, respectively, and 44%, 95%, 54%, and 93%, respectively, if the 3 cases receiving D50 despite BG>100 mg/dL are excluded.
14. Health Related Quality of Life Among Survivors of Prehospital Cardiac Arrest
Authors: Jain Vipin , Brancel Jennifer A. , Bullard David A. , Sayre Michael R. , Breaux Todd F. , Uphus Michael F. 
Published: July 2016

Purpose: The purpose of this study was to measure the quality of life of cardiac arrest long-term survivors.Design: Prospective outcome evaluation.Setting: The emergency medical system of a mid-sized city.Type of participants: Prehospital cardiac arrest victims who had a resuscitation attempt from 5/93 through 12/95 and were discharged alive. Patients <18 were excluded.Measurements: Patients were surveyed by mail. Non-responders were telephoned. The questions assessed Glasgow-Pittsburgh overall performance (GPOP) scores before and after the cardiac arrest. Additional items assessed physical, role, affective, and cognitive functioning, and global health status.Main Results: 760 cases were collected. 40 had unknown vital status at hospital discharge. The survival rate to hospital discharge for the 270 patients with cardiac etiology and initial rhythm of ventricular fibrillation was 15%, and it was 6% for the other 450 patients. Of 68 survivors, 23 died before a survey was sent; two had unknown addresses. 21 patients (49%) responded, and four refused to participate. The mean interval from cardiac arrest to survey response was 531 days. Ten reported good post-arrest GPOP scores, 5 had moderate disability, 4 severe disability, and 2 were comatose. Cognitive function was improved in 1, unchanged 6, slightly worse 7, markedly worse 4, and none in 3. Eleven patients reported feeling happy. Global healdi was excellent for 2, very good 8, good 5, fair 2, and poor 3.
19. A Breathing Manikin Model for Teaching Nasotracheal Intubation to EMS Professionals
Authors: March Juan , Dunn Kathleen , Brown Lawrence , Farrow Johnny , Perkins Phillip 
Published: July 2016

Purpose: The wide spread use of orotracheal intubation with rapid sequence induction has made it difficult for EMS professionals to gain experience in nasotracheal intubation (NTI) in a controlled supervised setting. The purpose of this study was to determine if a training session on NTI with a breathing manikin can be used to improve skill and comfort of EMS professionals.Methods: A prospective trial was conducted with a convenience sample of 16 emergency medical service professionals, previously trained in nasotracheal intubation techniques. For the training session a Laerdal airway manikin was modified by replacing the lungs with a bag-valve mask device, to simulate breathing with an inspiratory and expiratory phase. Following verbal instruction, and with direct supervision, each participant practiced NTI using the breathing manikin. Each participant completed a questionnaire, both before and after the training session, to determine self assessed comfort and skill level for both oral and nasal intubations (0 = lowest, 10 = highest). The pre and post intervention scores were compared using the Wilcoxon signed-rank test, £ = 0.01.