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C Conroy

Publications and source records attributed to C Conroy.

At least 37 records · Page 2Linked to original sources
PubMed1992

Fatal occupational injury related to helicopters in the United States 1980-1985.

This paper discusses characteristics of occupational traumatic deaths, caused by helicopters, during 1980-1985. Death certificate data are used to describe demographic characteristics and causes of death. Information from National Transportation Safety Board (NTSB) investigations is used to describe pilot experience and environmental circumstances surrounding the incident. During 1980-1985, 374 worker deaths involving helicopters were identified in the National Traumatic Occupational Fatality (NTOF) database. The majority of deaths resulted from trauma to body organs (including the brain). According to NTSB investigations, 59% of crashes in this study were attributed to pilot error, compared to 16.5% from mechanical failure of the helicopter. Thirty percent of deaths were related to military use of helicopters. While death due to occupational exposure to helicopters is not common, some workers (e.g., helicopter pilots) appear to be at especially high risk. This group should be studied further to develop better strategies for their protection.

Accidents, Aviation↗
PubMed1991

Representativeness of deaths identified through the injury-at-work item on the death certificate: implications for surveillance.

BACKGROUND: This research investigated the accuracy of the injury-at-work item on the death certificate for surveillance of occupational injury deaths in Oklahoma during 1985 and 1986. METHODS: Representativeness of occupational injury deaths identified by death certificates was assessed by comparing these deaths with all occupational injury deaths identified through death certificates, workers' compensation reports, medical examiner reports, and OSHA records for categories of occupation, industry, and external causes of death. RESULTS: Certain external causes of death (e.g., motor vehicle traffic deaths) and certain occupations (e.g., farming) and industries (agriculture and services) are more often underidentified through death certificates. CONCLUSIONS: The findings of this study support Baker's observation that no single data source contains all deaths or all the data elements necessary to describe occupational injury deaths. Data sources may be combined to improve representativeness through more complete case ascertainment.

Accidents, Occupational↗
PubMed1990

Medical examiner/coroner records: uses and limitations in occupational injury epidemiologic research.

Epidemiologic research often relies on existing data, collected for nonepidemiologic reasons, to support studies. Data are obtained from hospital records, police reports, labor reports, death certificates, or other sources. Medical examiner/coroner records are, however, not often used in epidemiologic studies. The National Institute for Occupational Safety and Health's Division of Safety Research has begun using these records in its research program on work-related trauma. Because medical examiners and coroners have the legal authority and responsibility to investigate all externally caused deaths, these records can be used in surveillance of these deaths. Another use of these records is to validate cases identified by other case ascertainment methods, such as death certificates. Using medical examiner/coroner records also allows rapid identification of work-related deaths without waiting several years for mortality data from state offices of vital statistics. Finally, the records are an invaluable data source since they contain detailed information on the nature of the injury, external cause of death, and results of toxicologic testing, which is often not available from other sources. This paper illustrates some of the ways that medical examiner/coroner records are a valuable source of information for epidemiologic studies and makes recommendations to improve their usefulness.

Accidents, Occupational↗
PubMed1989

Suicide in the workplace: incidence, victim characteristics, and external cause of death.

Although there is considerable information on suicide in the general population, little is known about those who kill themselves at work. This research uses data from the National Traumatic Occupational Fatality data base to describe suicide in the workplace. During 1980 to 1985, 3% of deaths in the NTOF data base were suicides, and the average annual rate was 2.3 per million workers. Risk of workplace suicide increases with increasing age. Men have more than seven times the risk of women; whites have a risk ratio of 1.6 compared with blacks. Women use the same methods but in different proportions than men at work or suicide victims in general. Men in military service and in the agriculture/forestry/fishery industry appear at highest risk of killing themselves at work based on these data.

Adolescent↗
PubMed1989

Blood alcohol tests, prevalence of involvement, and outcomes following brain injury.

We collected data on all residents of San Diego County, California who were hospitalized for or died from a brain injury in 1981. The objectives were to assess the frequency of blood alcohol concentration (BAC) testing and the associations of BAC prevalence with the external cause of the brain injury and case outcome. We found that high BAC levels were most frequent among brain-injured subjects between the ages of 25 and 44 and among those subjects involved in motor vehicle crashes and assaults. Contrary to expectations, injury severity and hospital mortality were inversely related to BAC level, controlling for other predictors. We believe that these inverse associations might be due to differential rates of BAC testing by severity. Among brain-injured survivors with more severe injuries, however, we found that BAC level was positively associated with the prevalence of physician-diagnosed neurological impairment at discharge and with the length of hospitalization.

Accidents↗
PubMed1988

Survival after brain injury. Cause of death, length of survival, and prognostic variables in a cohort of brain-injured people.

Injuries are the leading cause of death in the United States for those between 1 and 44 years of age and brain injuries are a major component of trauma. This report examines survival in a cohort of San Diego County, California, residents who incurred a brain injury in 1981. Cumulative risk of death over time, using the Cox Proportional Hazards Model, and predictors of death (determined by logistic regression) are used to evaluate survival. The results showed that about half of all brain-injured people who died, died in less than 2 h. Severe overall body damage and severe brain injury are the greatest causes of prehospital death. Even if they survived to the hospital, most people who die have brain injury as their underlying cause of death. Age as well as nature and severity of brain injury are the important predictors of in-hospital death. People who are discharged alive from the hospital have survival comparable to that of the population they came from. However, more die from trauma-related causes than would be expected.

Adolescent↗
PubMed1987

Incidence, severity, and outcomes of brain injuries involving bicycles.

We performed a population-based study of bicycle-related brain injuries in San Diego, California, residents during 1981. Incidence rates among males were three times higher than for females and were highest at ages 10-14 years for males. Only one-third of bicycle-related brain injuries involved collision with a motor vehicle, and this proportion was independent of age or gender. Brain injuries from motor-vehicle collisions were more severe than those resulting from other causes. Over half the brain-injured bicyclists aged 15 and older who were blood alcohol tested were legally intoxicated.

Accidents, Traffic↗
PubMed1987

Pediatric brain injuries: the nature, clinical course, and early outcomes in a defined United States' population.

Acute brain injury is the cause of approximately 100,000 pediatric hospital admissions per year in the United States. This report examines the nature of the brain injury, clinical diagnosis, hospital course, and discharge outcome of all pediatric cases in the population of San Diego County, California, for 1981 (N = 709). Brain-injured children were identified from hospital records, death certificates, and coroners' records. Severity of injury was determined using the Abbreviated Injury Scale and the Glasgow Coma Scale. Three percent of brain-injured children died at the accident site; an additional 3% died in the hospital. All in-hospital deaths occurred among the 5% of children with Glascow Coma Scale scores of 8 or less, and in this group the case fatality rate was 59%. Fractures of the skull, present in 23% of cases, seemed to be associated with excess mortality even after type of lesion was considered. Type of lesion, but not presence or absence of a skull fracture, had some predictive power for disability among survivors. Concussion was the most frequent diagnosis. Mildly brain-injured children accounted for 93% of all cases and about 90% of all hospital days.

Adolescent↗
PubMed1986

Incidence, severity, and external causes of pediatric brain injury.

The number of fatal brain injuries and hospital admissions for brain injuries in children up to 15 years old in San Diego County, California, were ascertained from emergency room and hospital records, coroners' reports, death certificates, and nursing home and extended-care records for 1981. The annual brain-injury rate per 100 000 children was 185 (235 for boys and 132 for girls). The major causes of pediatric brain injury were falls (35%), recreational activities (29%), and motor vehicle crashes (24%). The case-fatality ratio was six deaths per 100 injured children. Of those children admitted to a hospital alive, 88% had a mild brain injury and 44% had no evidence of loss of consciousness. Two thirds of children with mild brain injuries and one third of those with serious brain injuries were transported to a hospital in private nonemergency vehicles.

Accidents, Traffic↗
PubMed1986

The relationship of family income to the incidence, external causes, and outcomes of serious brain injury, San Diego County, California.

Among residents of San Diego County, California the incidence and external causes of serious brain injury were related to the median family income of the census tract of residency. Low income tracts had high incidence rates--a finding not changed by adjustment for age and race/ethnicity. For those injured, the type of emergency transport, time from injury to treatment, and outcome of treatment were not related to the median income of the census tract of residency.

Brain Injuries↗
PubMed1985

Survival times and case fatality rates of brain-injured persons.

Survival time after injury (the time from injury to death) imposes an important constraint on the timing of the delivery of postinjury medical care. From a population-based study of brain-injured people, the survival times in 542 cases with fatal outcomes were studied. Prehospital deaths as well as hospital deaths were included. Survival times were considerably shorter for 95 people with untreatable injuries (Abbreviated Injury Scale level 6) than for the remaining 447 whose injuries were potentially treatable. For the former group, the median survival time was 10 minutes; for the latter, it was 2 hours. For those with potentially treatable injuries, the median time from injury to receiving medical assistance was approximately 30 minutes and 82% received medical assistance within 1 hour of injury. Short survival time was associated with prehospital death, young age, high Injury Severity Score, and having a nonbrain injury as the most severe injury. For patients who arrived alive at a hospital, intracranial surgery was associated with increased survival time.

Brain Injuries↗
PubMed1984

Strain differences among inbred mice in protein kinase C activity.

A protein kinase was identified in mouse organs whose activity is strictly dependent on the presence of Ca++ and phosphatidylserine when assayed at pH 6, and thus has the characteristics of protein kinase C. The relative order of specific activities was brain greater than spleen greater than lung greater than heart, an order similar to that found previously for rat organs. Mice from seven strains had the same level of protein kinase C activity, but strain A/J had half as much activity in each organ as did the other strains. F1 hybrid mice resulting from a cross between A/J and BALB/cByJ mice had levels of activity intermediate to the parental strains, indicating additive inheritance of this genetic difference.

Animals↗
PubMed1979

Unusual presentation of choriocarcinoma. A case report.

We report the management of a case of malignant trophoblastic disease which presented initially as a haematemesis and melaena from a gastric metastasis. The patient had had a tubal sterilization 4 years previously. The management of trophoblastic disease in general is also discussed, and the importance of chemotherapy is stressed.

Adult↗
PubMedDate not supplied

Emergency medical services assessment and treatment of children with special health care needs before and after specialized paramedic training.

INTRODUCTION: This study evaluates whether a continuing education program for paramedics, focusing on Children with Special Health Care Needs, improved paramedics' assessment and management. METHODS: Emergency Medical Services responses for children, 21 years of age or younger, with a congenital or acquired condition or a chronic physical or mental illness, were identified. The responses before and after the specialized education program were reviewed by a multidisciplinary team to evaluate assessment and management of the children. Interreviewer agreement between the nurses on the team and between the physicians on the team was assessed. We also evaluated whether there was an improvement in assessment and care by paramedics completing our education program. RESULTS: Significant improvement was seen in appropriate assessment and overall care by paramedics who completed our specialized education program. Reviewers also noted an appropriate rating for the initial assessment category more often for responses involving paramedics who had the training. Agreement on whether assessment and treatment was appropriate for all five reviewers varied considerably, ranging from 32% to 93%. Overall there was a high percentage of agreement (>70%) between the nurses and between the physicians on most items. However, kappa statistics did not generally reflect good agreement except for most of the focused assessment items and some treatment and procedure items. CONCLUSION: Most of the documentation on the EMS records indicated appropriate assessment and treatment during all responses for Children with Special Health Care Needs. Nevertheless, the results indicate that paramedics may improve their assessment and management of these children after specialized continuing education.

Arizona↗
PubMedDate not supplied

Training paramedics: emergency care for children with special health care needs.

OBJECTIVE: To enhance knowledge and comfort related to the emergency care of children with special health care needs (CSHCN) through an innovative continuing education program for paramedics. METHODS: A self-study program presenting in-depth information about common problems that affect the assessment and management of a child's airway, breathing, circulation, disability, and environment (ABCDEs), regardless of the child's diagnosis, was developed. This program used a manual, a video, practice mannequins, and skills evaluations to teach skills to paramedics employed at a municipal fire department. RESULTS: Pre- and posttraining surveys found that the paramedics were significantly more comfortable with the assessment and management of CSHCN after the completion of the self-study program, with a pretraining average of 2.83 and posttraining average of 4.20 on a five-point Likert-type scale, t(37) = 12.87, p < 0.001. A skills evaluation showed that skills performance varied widely across 21 skills, ranging from skills mastery to low skills knowledge. On the posttraining survey, between 74% and 94% of the paramedics rated each topic (tracheostomies, indwelling central venous catheters, cerebrospinal fluid shunts, gastrostomies, child abuse, and latex allergy) as applicable to their practices as paramedics. CONCLUSION: Given the growing population of CSHCN, it is important to provide specialized education to increase an EMS provider's preparedness to respond to emergency situations involving children with special health care needs.

Child↗
PubMedDate not supplied

Use of emergency medical services by children with special health care needs.

OBJECTIVE: This study describes emergency medical services (EMS) responses for children with special health care needs (CSHCN) in an urban area over a one-year period. METHODS: A prospective surveillance system was established to identify EMS responses for children, 21 years of age or younger, with a congenital or acquired condition or a chronic physical or mental illness. Responses related to the special health care needs of the child were compared with unrelated responses. RESULTS: During a one-year period, 924 responses were identified. Fewer than half of the responses were related to the child's special health care need. Younger children were significantly more likely to have a response related to their special needs than older children. Among related responses, seizure disorder was the most common diagnosis, while asthma was more common for unrelated responses. Almost 58% of the responses resulted in transport of the child to a hospital. CONCLUSIONS: Emergency medical services responses related to a child's special health care needs differ from unrelated responses. The most common special health care needs of children did not require treatment beyond the prehospital care provider's usual standard of care. These results are relevant for communities providing EMS services for CSHCN.

Adolescent↗