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Biomedical subjects

A J Haftel

Publications and source records attributed to A J Haftel.

7 recordsLinked to original sources
PubMed1990

Hanging leg weight--a rapid technique for estimating total body weight in pediatric resuscitation.

The accuracy of two methods of rapidly estimating total body weight in children was assessed. The first method correlated patient length to known total body weight, and the second correlated the weight of both legs weighted together to known total body weight. One hundred children undergoing general anesthesia in the operating rooms of Childrens Hospital of Los Angeles were entered into the study. Each child had a known preoperative body weight. After induction of anesthesia, each child's supine length was measured and hanging (inert) legs were weighted. There was excellent linear correlation between hanging leg weight and total body weight (correlation coefficient [r2], 0.95) for all patients, and good linear correlation between supine length and total body weight, r2, 0.86). Range restriction analysis for both techniques showed poor correlation for total body weights of less than 10 kg and poor correlation for the supine length technique when total body weight was more than 25 kg. The hanging leg weight of an inert child has excellent correlation to total body weight for children weighing more than 10 kg.

Adolescent↗
PubMed1988

Abdominal CT scanning in pediatric blunt trauma.

The use of the emergency IV contrast-enhanced abdominal computed tomography (CT) scanning was evaluated in 90 pediatric patients sustaining blunt abdominal trauma. Medical records, CT scans, and operative and postmortem reports, when applicable, were reviewed retrospectively. By identifying the organs of injury, CT scans of the abdomen, with IV contrast, proved to be useful to the surgeon in deciding whether to operate in the setting of blunt abdominal trauma. The failure rate for conservative, non-operative management (four of 33) in "positive" scans was low, and represented progression of known injuries, not the appearance of unexpected injuries. Similarly, the (unplanned) surgery rate in the "negative" scan cases was low (one of 57). Abdominal CT scans cannot be relied on to consistently diagnose gastrointestinal perforation or pancreatic injury.

Abdominal Injuries↗
PubMed1987

The clinical utility and evaluation of drug screening techniques.

A better understanding of the methods of drug detection, their sensitivities, and limitations increases the efficiency of medical decision making for better patient care. Many of the sociomedical and medicolegal questions are yet to be answered through court challenge. The physician must remember his or her role as a clinician, and practice the art in a fashion that best serves the interest of his or her teenage patient.

Adolescent↗
PubMed1987

Treatment of hemorrhagic shock with intraosseous administration of crystalloid fluid in the rabbit model.

Intravenous access can be very difficult to obtain in small hypotensive infants. We studied the ability of the intraosseous route to accept a large volume of resuscitation fluid administered to hypovolemic rabbits. Hypotension induced by withdrawing one-third of the blood volume of rabbits was treated by infusion of saline, IV or intraosseously. A control group was bled, but received no saline. All three groups experienced a drop in mean arterial blood pressure (MAP) to at least 50% of the prebleed baseline value. Also, all groups' heart rates dropped to between 90 and 95% of prebleed baseline values. A ten-minute infusion of a saline volume equal to three times the volume of blood removed reversed hypotension equally by the intraosseous and IV routes. After one-half of the fluid was administered, the MAP was 107 +/- 4% and 104 +/- 11% of baseline in the intraosseous and IV groups, respectively. In contrast, the control group had a MAP of 70 +/- 8% of baseline at the same time. At the end of the fluid bolus the intraosseous group had a MAP of 97 +/- 3% of baseline and the IV group a MAP of 99 +/- 8%. The control group continued to have a low MAP of 72 +/- 6% of baseline. Heart rates rose during fluid administration in both the intraosseous and IV groups, reaching 103 +/- 2% and 99 +/- 3%, respectively, at the end of fluid administration. The control group was 88 +/- 2% of baseline at the same time. The differences between the treatment groups and the control group were significant at the .05 level. The intraosseous route will allow sufficient flow of fluid to rapidly reverse hypotension secondary to hemorrhage in a small mammal (ie, the rabbit).

Animals↗
PubMed1977

Traumatic acute pericardial tamponade.

Pericardial tamponade should always be suspected in the clinical setting of any penetrating wound to the thorax or upper abdomen. The most reliable diagnostic criterion is the triad of hypotension, tachycardia and an elevated central venous pressure. Pericardiocentesis should be performed as a temporizing measure until definitive surgical therapy can be carried out. If the patient suddenly decompensates or arrests in the emergency department, immediate thoractomy with evacuation of the pericardial clot and open chest cardiac massage should be performed. Four case reports are presented. The pathophysiology and treatment are reviewed in detail.

Adult↗