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Biomedical subjects

B M Thompson

Publications and source records attributed to B M Thompson.

45 records · Page 3Linked to original sources
PubMed1983

Resuscitation time in ventricular fibrillation--a prognostic indicator.

Length of resuscitation in prehospital ventricular fibrillation patients was studied to define its relationship to survival. Five hundred sixty-five patients presenting with the initial rhythm of ventricular fibrillation to the Milwaukee County Paramedic System between January 1978 and April 1982 were resuscitated successfully. Pediatric patients and patients with trauma, poisoning, and drowning were excluded. Of the 565 resuscitated patients, 262 (46%) were discharged alive and 303 (54%) died during hospitalization. For all 565 patients the resuscitation time and times from arrival of paramedics until the first sustained pulse were plotted against survival to define a curve. The curve demonstrated rapidly declining survival rates for resuscitation time up to 20 minutes; thereafter, survival declined more gradually with respect to resuscitation time. The mean resuscitation time for those eventually discharged alive was 12.6 minutes, which was statistically shorter (P less than .0001) than the mean resuscitation time of 23.9 minutes for those who eventually died. The overall survival curve of witnessed arrest patients was not statistically different from that of unwitnessed patients. The survival curve of those patients receiving bystander cardiopulmonary resuscitation (CPR) was similar to the curve of those who received no CPR. We conclude that resuscitation time is a heretofore undefined significant predictor of survival of resuscitated prehospital ventricular fibrillation patients.

Aged↗
PubMed1983

Use of calcium in prehospital cardiac arrest.

All records of patients presenting to the Milwaukee County Paramedic System for the period of January 1 to December 31, 1980 were reviewed retrospectively. One hundred seventy-nine patients initially presented in asystole, and 116 patients initially presented in electromechanical dissociation (EMD). All patients with trauma and poisoning were excluded. The in-field successful resuscitation rates for asystole were 8/105 (8%) in the calcium group versus 8/24 (33%) in the no-calcium group (P less than .002); for EMD they were 10/63 (16%) in the calcium group versus 8/18 (44%) in the no-calcium group (P less than .02). A successful resuscitation is defined as the conveyance of a patient to the emergency department with a pulse and cardiac rhythm. There were no significant differences between the calcium and no-calcium groups in both the asystole and EMD patients. The use of calcium in the prehospital setting in the currently recommended dosage for cardiac arrest with initial arrest rhythms of asystole and EMD is highly suspect.

Aged↗
PubMed1983

Rapid fluid resuscitation with central venous catheters.

We attempted to determine whether central venous catheters are effective for rapid fluid administration in moderately to severely hypovolemic patients. Comparative maximum flow rates with water and blood products were tabulated for various central and peripheral catheters. The USCI 8 and 9 French introducers (USCI Cardiology and Radiology Division, CR Bard, Inc, Ellerica, MA) had the fastest flow rates of all catheters tested (P less than .05). The best peripheral catheter, IV extension tubing cut to 12-inch length, had slightly less flow than did the introducers (P less than .05). The Deseret Subclavian Jugular Catheter (Deseret Co, Sandy, UT) had by far the slowest measured flow rates. Several parameters were evaluated that alter flow rates regardless of catheter size, including a pressure infusion cuff, packed red blood cells diluted with normal saline, and a Fenwal blood warmer (Fenwal Laboratories, Division of Travenol Laboratories, Inc, Deerfield, IL). Central venous catheters can be effective adjuncts for rapid fluid administration.

Blood Cells↗
PubMed1983

The effect of a paramedic system on mortality of major open intra-abdominal vascular trauma.

In a 12-year period (1970-1981), there were 112 patients operated on with major open intra-abdominal vascular trauma (MOIVT). These were any penetrating injuries to the aorta, inferior vena cava, portal vein, or their primary branches. Sixty-four patients were treated without benefit of paramedics. Only four of 43 patients who had emergency department blood pressures of 60 mm Hg or greater upon entry died (9.3%), whereas 18 of 21 (85.7%) patients with blood pressures of less than 60 mm Hg died (p less than 0.0001). Forty-eight of the 112 patients have been treated by paramedics during the past 4 years. Entry level blood pressures are those first recorded by the paramedics in the field. The mortality in those with blood pressures of 60 mm Hg or greater remained essentially unchanged. However, 11 of 22 patients with blood pressures of less than 60 mm Hg survived compared to three of 21 (p less than 0.025). Over the past 12 years, the community's homicide rate has been stable (71/yr), but the case incidence of MOIVT has risen from an average of 8/yr to 12/yr during the paramedic years. The average annual aggravated assault rate increased from 796 to 1,119. It is believed the improvement in the salvage rate is due to early intervention by trained paramedics functioning within a trauma care system.

Abdominal Injuries↗
PubMed1982

Glycosaminoglycan synthesis by Dupuytren's cells in culture.

Glycosaminoglycan synthesis by cells cultured from nodule or band tissues of patients with Dupuytren's disease was compared with that of skin fibroblasts cultured from uninvolved areas of the palm. No differences were observed in culture which could account either for the abnormal glycosaminoglycan content or the increased cellularity of the diseased tissues. It is suggested that the behavior of Dupuytren's cells in vivo may result from a response to local conditions within the palm rather than from the expression of an irreversible change in their glycosaminoglycan metabolism.

Adult↗
PubMed1979

Further data on the acute effect of intravenous steroids on canine CSF secretion and absorption.

Considerable difference of opinion has arisen as to whether intravenously administered steroids affect cerebrospinal fluid (CSF) production in the acute laboratory animal undergoing ventriculocisternal perfusion. Our experiments with ventriculocisternal perfusion in dogs indicate that, when given intravenously, neither dexamethasone, methylprednisolone, hydrocortisone, nor aldosterone result in a significant, acute effect upon CSF production. Similarly, CSF absorption and outflow resistance mechanisms are not acutely affected by intravenous methylprednisolone, hydrocortisone, and aldosterone. Dexamethasone also probably does not produce an immediate effect upon CSF absorption.

Aldosterone↗
PubMedDate not supplied

An historical commentary on the physiological effects of music: Tomatis, Mozart and neuropsychology.

This article provides an overview of the theoretical underpinnings of the Tomatis Method, along with a commentary on other forms of sound/music training and the need for research. A public debate was sparked over the "Mozart Effect." This debate has turned out to be unfortunate because the real story is being missed. The real story starts with Alfred Tomatis, M.D., scientist and innovator. Dr. Tomatis was the first to develop a technique using modified music to stimulate the rich interconnections between the ear and the nervous system to integrate aspects of human development and behavior. The originating theories behind the Tomatis Method are reviewed to describe the ear's clear connection to the brain and the nervous system. The "neuropsychology of sound training" describes how and what the Tomatis Method effects. Since Dr. Tomatis opened this field in the mid 20th century, no fewer than a dozen offshoot and related systems of training have been developed. Though each new system of treatment makes claims of effectiveness, no research exists to substantiate their claims. Rather, each simplified system bases its "right to exist and advertise" on the claimed relationship to Tomatis and his complex Method. Research is desperately needed in this area. The 50 years of clinical experience and anecdotal evidence amassed by Tomatis show that sound stimulation can provide a valuable remediation and developmental training tool for people of all ages. Offshoot systems have watered down the Tomatis Method without research to guide the decisions of simplifying the techniques and equipment.

Auditory Pathways↗