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Biomedical subjects

A M Dalton

Publications and source records attributed to A M Dalton.

9 recordsLinked to original sources
PubMed1995

Prehospital intravenous fluid replacement in trauma: an outmoded concept?

Details of 235 consecutive trauma patients brought to the Washington Hospital Trauma Center with intravenous infusions in situ were entered into the study. The volume of intravenous fluid administered prior to arrival at hospital and the time over which it was given (the infusion time) was recorded. The initial systolic blood pressure (SBP) on scene and the SBP on arrival at hospital were documented. A mean volume of 383 ml of intravenous fluid was administered over a mean time of 17 min. Of non-trapped patients 98% had infusion times of less than 30 min. Trapped or hypotensive patients were not given significantly more fluid than those who were not trapped or had SBPs of over 100 mm Hg. Because of the uncertain benefits and potential complications of this procedure, intravenous cannulation and fluid replacement may not be appropriate where expected prehospital time is likely to be less than 30 min.

Adolescent↗
PubMed1993

Use of blood transfusions by helicopter emergency medical services: is it safe?

All injured patients given prehospital blood transfusions by flight nurses of the 'Lifeflight' Helicopter Emergency Medical Service (HEMS) programme based at Emanuel Hospital, Portland, Oregon, USA, between 1985 and 1991 were included in the study. Of the 112 patients, there were no documented adverse reactions directly related to the administration of O-negative packed red cells, although one patient suffered transient shortness of breath. It is a safe and practical prehospital procedure. Further studies are required to assess the advantages over other fluids.

ABO Blood-Group System↗
PubMed1992

Helicopter doctors?

All roadside procedures carried out by doctors of the Royal London Hospital Helicopter Emergency Medical Service were recorded. Of 100 injured patients treated consecutively, 68 patients required 73 treatments or procedures that were beyond the current training of the ambulance paramedic in the United Kingdom. Doctors are therefore an essential part of HEMS operations and allow earlier live-saving medical intervention in the prehospital phase of care.

Aircraft↗
PubMed1992

The Royal London Hospital Helicopter Emergency Medical Service: first phase 1990.

A Helicopter Emergency Medical Service (HEMS) has been introduced to improve trauma care in the Southeast of England. The majority of the workload comes from the area bounded by the M25 ring road. In 1989 a Dauphin 365N helicopter equipped for pre-hospital primary rescue and emergency inter-hospital secondary transfer was certified by the Civil Aviation Authority. The helicopter commenced carrying patients with a paramedic and a doctor on board early in 1990. In September 1990 this service was further improved by the opening of a helipad at the Royal London Hospital and a designated HEMS desk at London Ambulance Service central control. Eighty-four patients were transported in primary rescue missions and 107 as emergency transfers in 1990.

Aircraft↗
PubMed1991

A review of radiological abnormalities in 135 patients presenting with acute asthma.

Six hundred and ninety-five attendances were made to the Accident and Emergency Department of a district general hospital over a 6-month period by patients with acute asthma. On hundred and thirty-five chest radiographs were performed, and the radiologists' reports analysed. Nineteen abnormalities were reported (14%) which may have altered the management of the patient. It is recommended that chest radiographs be considered in patients who do not rapidly respond to initial therapy.

Acute Disease↗
PubMed1991

Massive chloroquine overdose--a survivor.

Large chloroquine overdoses are almost inevitably fatal. We describe the presentation and management of a patient with such an overdose who survived, due to general supportive care and new specific treatment.

Adult↗
PubMed1989

Notting Hill Carnival 1988.

The injuries sustained at the 1988 Notting Hill Carnival were documented in order to suggest ways in which these might be reduced in future years. Sixty-four patients presented to six hospitals participating in the study over a 48-h period, most of whom were victims of accidents (63%) rather than assaults (37%). Many of the accidents were caused by motorized floats or by stepping on broken glass.

Emergency Medical Services↗
PubMed1989

Does the warming of local anaesthetic reduce the pain of its injection?

One hundred and fifty-seven patients who warranted the injection of local anaesthetic were divided into two groups. One group received local anaesthetic at room temperature (21 degrees C) and the other at body temperature (37 degrees C). The pain resulting from the injection was assessed using a visual analogue scale. There was no significant difference in the level of pain experienced by the two patient groups. It is concluded that no advantage is gained by the warming of local anaesthetic before its administration.

Adolescent↗