PubMed HealthSearch

Biomedical subjects

E L Nagel

Publications and source records attributed to E L Nagel.

At least 19 recordsLinked to original sources

Complications of cardiac resuscitation.

In a prospective study of the complications of cardiac resuscitation, 705 cases were autopsied to identify the cause of death and the pathologic findings attributable to cardiac resuscitation. Thoracic complications were observed in 42.7 percent of the cases. A total of 31.6 percent had rib fractures, 21.1 percent had sternal fractures, and 18.3 percent were reported as having anterior mediastinal hemorrhage; 20.4 percent of the cases had an upper airway complication. Abdominal visceral complications were noted in 30.8 percent of the cases, and pulmonary complications occurred in 13 percent of the resuscitation population. Life-threatening complications, such as heart and great vessel injuries, occurred in less than .5 percent of the cases.

Abdominal Injuries

Prehospital use of the military anti-shock trouser (MAST).

Complications of prehospital use of the military anti-shock trouser (MAST) in treating hypotensive and hypovolemic patients have been few and minor. Undesirable consequences--compromised respiratory excursion or autonomic disturbances such as emesis, urination or defecation--were rare. Forty-seven (88.7%) of 53 patients with conditions classed as potentially lethal or severe survived. Close communications between prehospital and emergency department personnel can assure accurate transmission of circumstances of MAST application and result in optimal responses and improved inhospital patient care. Both "false positives" (supposed initial hypotension or hypovolemia) and "false negatives" (seeming stability in the face of major anatomic derangements) require a carefully structured operational sequence. Further evaluation of the device, particularly in cardiovascular/cardiopulmonary cases, is in progress.

Allied Health Personnel

Spontaneous recovery of the thumb twitch from neuromuscular block by suxamethonium in anaesthetized man.

The neuromuscular blocking effect of repeated bolus administration of suxamethonium 1 mg/kg was observed in 10 healthy surgical patients under enflurane-nitrous oxide-oxygen anaesthesia. Tachyphylaxis and slow recovery of the thumb twitch occurred in close dose-relationships with transition of Phase I block to Phase II, using train-of-four fade as an indicator of the transition. Failure of the thumb twitch to recover to 75% of control, and subsequent step-wise depression from additional doses of suxamethonium had a sudden onset shortly after establishment of marked train-of-four fade.

Adult

Emergency care.

Prehospital ventricular fibrillation can be treated successfully by rescue (paramedic) personnel. By retrospective history, one-half of prehospital sudden death victims experienced no prior warning and collapsed either instantaneously or within one minute of symptoms. The follow-up course was analyzed. Of 301 such subjects, 199 were defibrillated successfully, but only 101 survived long enough to be hospitalized, and only 42 were discharged alive. Predictors for successful outcome were initially rapid post-defibrillation heart rates and atrial fibrillation or sinus tachycardia rhythms. In the hospitalized group, 57% suffered repeat ventricular fibrillation and/or ventricular tachycardia usually during the first 24 hours. Among those discharged from the hospital, mean survival was 13 months with 28% dying suddenly regardless of presence of antiarrhythmic therapy. Intensive antiarrhythmic therapy and monitoring of this survivor population seems indicated.

Allied Health Personnel

Fire in the OR.

Explore the source record for details and available documents.

Accident Prevention