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Biomedical subjects

C B Gatrell

Publications and source records attributed to C B Gatrell.

9 recordsLinked to original sources
PubMed1991

Spontaneous rupture of the spleen in initial presentation of Hodgkin's disease.

A 46-year-old man presented with a four-week history of fevers, occasional chills, and a two-week history of sweats and poor appetite. He also complained of progressive weakness and lethargy. After initial evaluation, while awaiting further consultation, the patient developed rapidly progressing abdominal pain and light-headedness. He was moved immediately into the emergency treatment area. He was noted to have an acute abdomen and was taken to surgery. An enlarged Hodgkin's-infiltrated spleen with an actively bleeding hematoma was removed. The patient denied any history of trauma.

Abdomen, Acute↗
PubMed1990

Emergencies in continuous dialysis patients: diagnosis and management.

The number of patients undergoing long-term hemodialysis and peritoneal dialysis is growing in the United States. To provide adequate emergent care to these patients emergency physicians must understand the alterations in normal physiologies present in these patients and how this may affect care. Cardiovascular disease and infection (especially Staphylococcus aureus sepsis) are the leading causes of death among dialysis patients. These patients are also subject to a significantly higher incidence of life-threatening electrolyte disturbances, particularly hyperkalemia and hypercalcemia, than the general population. Suicide, cardiac tamponade, intracranial hemorrhage, bleeding disorders, and bowel infarction are also much more frequent. The inability of dialysis patients to excrete drugs, metabolites, toxins, and fluids significantly alters their responses to common emergencies and should directly influence their care. Failure to recognize these differences in physiology may result in the use of standard forms of emergency therapy that may compound, rather than treat, the underlying disorder. Although most dialysis patients who come into an emergency department have conditions that can, and should, be managed by their nephrologist, the presence of a life threatening emergency requires prompt, appropriate therapy by the emergency physician.

Cardiovascular Diseases↗
PubMed1988

Evaluation of a rapid theophylline test strip assay in the emergency department setting.

Test strips recently have become available to measure theophylline levels. One such test strip (AccuLevel) had not been tested in an actual clinical situation with nontechnician personnel. We prospectively evaluated the test strip on consecutive emergency department patients, comparing it with the agglutination inhibition method used by our hospital laboratory. Nurses and medics who ran the test were given only a brief demonstration and explanation of the manufacturer's instructions. The 61 test strip levels correlated highly with the laboratory results (r = 0.92, slope = 0.89, y-intercept = 0.99). The test strip results were available in less time (mean of 0.51 hours vs 1.89 hours for the laboratory, P less than .0001). The most accurate readings were obtained by those who ran the test most frequently. Caffeine intake did not influence the test. Cost was significantly lower than charges at local hospitals.

Caffeine↗
PubMed1984

Unrecognized esophageal intubation with both esophageal obturator airway and endotracheal tube.

Two trauma patients with fatal injuries had unrecognized esophageal insertion of an endotracheal (ET) tube despite the presence of an esophageal obturator airway (EOA). Prehospital training must emphasize clinical verification of correct airway placement. If adequate ventilation is obtained with an EOA, endotracheal intubation should not be performed in the field. The EOA does not necessarily guide the ET tube into the trachea. Difficulty removing an EOA after insertion of an ET tube may indicate that both are in the esophagus.

Adult↗