Biomedical subjects

D J O'Brien

Publications and source records attributed to D J O'Brien.

39 records · Page 3Linked to original sources

PubMedDate not supplied

The evolution of air transport systems: a pictorial review.

The air transport of patients began over seventy years ago in primitive biplanes. The ability to fly over the obstacles of the battlefield created enthusiasm in both the military and the medical communities. With the advent of vertical flight, the need for conventional runways was obviated allowing for casualties to be transported directly from the site of injury. After their introduction as air ambulances in 1945, helicopters soon supplanted ground ambulances with their speed and versatility. By the mid-1960s, civilian casualties were being transported by helicopter as regional trauma care developed in the United States. Today aeromedical programs continue to expand rapidly, even as closer scrutiny of their efficacy, cost, and safety are explored. A pictorial review highlighting the evolution of air transport systems is presented.

Aircraft↗

PubMedDate not supplied

Respiratory rates in emergency department patients.

The respiratory rate is a sensitive and nonspecific indicator of respiratory dysfunction. Establishing a "normal" respiratory rate has mainly been arbitrary. This study evaluated "normal" respiratory rates in 110 emergency department patients. The mean respiratory rate was 20.1 (+/- 4.0). Women had a more rapid respiratory rate 20.9 (+/- 3.9) than men 19.4 (+/- 4.0) (p less than .04). Smokers had a higher respiratory rate 20.5 (+/- 4.0) than nonsmokers 19.3 (+/- 4.0), but this was not statistically significant (P = 0.124). It was also noted that the respiratory rate measured by the nurse was almost always different from that measured by the medical student (P less than 0.0001). Based on a review of the literature concerning what constitutes a "normal" respiratory rate, we conclude that the "normal" respiratory rate may be higher than that suggested in the medical literature.

Adult↗

PubMedDate not supplied

The effectiveness of lights and siren use during ambulance transport by paramedics.

OBJECTIVES: To determine whether lights and siren (L&S) use during transport in the authors' EMS system results in reduced transport time to the hospital. Second, to determine whether L&S use results in any emergency department critical interventions in the time saved. METHOD: A convenience sample of transport times were measured for 75 ambulances traveling to the hospital with L&S and compared with measured simultaneous transport times for a personal observer vehicle traveling the same route as the ambulance. Upon hospital arrival, the driver of the observer vehicle proceeded to the patients' locations and noted the medical interventions accomplished at the hospital prior to his arrival. Interventions were reviewed to identify time-critical interventions that would have been delayed without L&S use. RESULTS: The mean ambulance transit time was 666 seconds and the mean observer transit time was 896 seconds. The mean difference in ambulance (L&S) transit time and the observer (no L&S) transit time was 230 seconds (3 min, 50 sec). There was a statistically significant correlation between transit time difference and number of stoplights encountered, traffic intensity, and distance traveled. Of the 75 patients transported, four patients were felt to have benefited clinically by the time saved. CONCLUSIONS: Use of L&S significantly shortens transport time. In this series of patients transported under the care of a paramedic, the time saved by the use of L&S was not usually associated with immediately apparent clinical significance.

Ambulances↗