The evolution of a rural EMT-intermediate training program.
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Biomedical subjects
Publications and source records attributed to E J Allison.
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We have described two cases involving unusual rectal foreign bodies and their subsequent removal. Suggestions are included to aid in the removal of colorectal foreign bodies, as well as references to provide for the appropriate management of these cases in the emergency department. Primary care providers need to be aware of the issue of colorectal foreign bodies as a clinical entity and the fact that their occurrence is expected to continue to rise dramatically. Patient education of the dangers inherent in the insertion of objects into the colorectal area should be more prevalent. At the very least, all physicians need to be aware of anal eroticism and the necessity to take a careful medical history.
Presented are the cases of four patients who sustained similar dominant hand injuries while riding a mechanical bull apparatus. The injuries included fractures of the second metacarpals as well as of the index finger phalanges. The mechanism of injury in each case occurred not from striking or catching the injured hand on the bull or by falling off the apparatus, but secondary to the extreme torque forces applied to the extremity during the severe gyrations.
A study was undertaken to determine the incidence of failures and complications of EGTA. The life history of 31 airways was followed. Ten failed prior to 5 usages. Paramedics successfully intubated 88% of the patients but experienced difficulties maintaining adequate airways in 15%. While the EGTA is a valuable tool in prehospital care, its utilization to the exclusion of endotracheal intubation should be carefully considered.
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The military antishock trousers (MAST) continue to be used widely. The physiologic mechanisms of action have been further elucidated. There are many potential complications associated with their use, some of which are serious. While most observations in the past were based on dog studies or human volunteers, clinical studies are now providing new information that questions the usefulness of the MAST.
The use of thrombolytic agents for both coronary and noncoronary indications is a rapidly progressing field. There has been substantial debate over which disease processes ultimately benefit from the use of thrombolytic agents. In addition, many recent studies have focused on comparing different thrombolytic agents and dosing regimens in an attempt to gain optimal therapeutic benefit with minimal risk. This paper discusses the current status of thrombolytic therapy for coronary artery disease, pulmonary embolus, peripheral vascular thrombosis, and cerebrovascular infarction.
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We present the case of a 33-yr-old female patient who, along with members of her family, attempted to extort approximately $6000.00 from our institution and her insurance company. This attempted extortion was done under the guise of a missed retained foreign body. The patient initially presented to our emergency department with a laceration to her right forearm; X-ray studies obtained after the wound had been sutured revealed no foreign body. Several days later, the patient and family members approached our administrative staff demanding recompense for metal fragments discovered in the patient's wound at another facility. Comparison of radiographs revealed that the metallic fragments were placed in the wound after she was treated and released from our emergency department, and monetary compensation was denied.
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