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Biomedical subjects

E M Holmes

Publications and source records attributed to E M Holmes.

9 recordsLinked to original sources
PubMed1990

A comparison of emergency medical helicopter accident rates in the United States and the Federal Republic of Germany.

The purpose of this study was to compare accident rates of helicopter emergency medical services (USA-HEMS) to domestic air taxi service (USA-Taxi) and helicopter emergency medical services in the Federal Republic of Germany (FRG-HEMS). Contingency tables compared the total hours flown to the number of fatal and non-fatal accidents for USA-HEMS (1982-7) vs. USA-Taxi (1980-5) and USA-HEMS (1982-7) vs. FRG-HEMS (1982-7). The overall accident rate for USA-HEMS was 11.7/100,000 h, with the fatal accident rate being 4.7/100,000 h. This was significantly different from the USA-Taxi overall accident rate of 6.7/100,000 h and the fatal accident rate of 1.6/100,000 h (chi 2 = 20.441, p = 0.0001). The USA-HEMS overall and fatal accident rates were not significantly different than the FRG-HEMS overall (10.9/100,000 h) and fatal (4.1/100,000 h) accident rate (chi 2 = 0.061, p = 0.97). These data suggest that emergency air transport is inherently more risky than routine air taxi services.

Accidents, Aviation↗
PubMed1985

The impact of an air ambulance system on an established trauma center.

Hospital competition for air ambulance business has resulted in implementation of a helicopter service before the medical staff can prepare for the increased patient load. We reviewed the effect of an air ambulance on an already established trauma center (TC) by analyzing the impact of the helicopter trauma patient load during the initial year of operation. The helicopter carried a three-member flight crew consisting of a pilot, paramedic, and critical care nurse. Admission data of all flights from February 1982 through February 1983 were reviewed. Of the 325 air missions launched, 192 (59%) were for the transport of trauma victims. One hundred forty (73.6%) patients were transported from local hospitals, the remaining 52 (26.4%) from the accident scene. Ninety per cent of the injuries were due to motor vehicle accidents. Forty-nine per cent of the flights occurred on weekends and 68.8% were launched between 7:00 P.M. and 3:00 A.M. The average flight times from hospital and accident scenes were 37 min 30 sec and 13 min 30 sec, respectively. Of all trauma missions flown, 126 (65.8%) were considered new or 'captured' by the air ambulance system and brought to the TC. Thirty-seven (19.3%) patients died in flight, were DOA, or died within 1 hour of TC arrival. Eighty per cent of the deaths were from massive head injuries. The average injury severity score was 35.58 (all patients), 32.9 (survivors), and 45.80 (deaths).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1983

The freeze-fractured median eminence. II. Developmental changes in the neurohemal contact zone of the median eminence of the rat.

The neurohemal contact area of the median eminence was examined in adult, young, neonatal, and fetal rats in freeze-fracture preparations. While no specializations of the membranes of axonic terminals abutting on the perivascular space was observed, adjacent areas of the same membranes are rich in signs of hormone release. Signs of exocytosis are defined in the manner of Theodosis et al. (1978). Exocytotic pits with a single dense granule as a core are identified on P-faces along with mounds on corresponding E faces. These features appear near the time of birth, are especially numerous at 3 days, 3 weeks, and 5 weeks, and continue in lesser numbers into adulthood. Even more numerous and appearing even earlier, by the last day of fetal life, were P-face clusters of large particles usually in a pit, and pits without particles. These fall into 2 significantly different categories distinguished by the size of the pit. E face counterparts are large and small protuberances, respectively. Fenestrae of adult size and distribution are observed along the endothelium of portal vessels from the 20th day of fetal life on. Their frequency correlates well with other structural manifestations of a median eminence ready for the onset of functional activity at about the time of birth (Monroe and Paull 1974).

Age Factors↗
PubMed1982

The freeze-fractured median eminence. I. Development of intercellular junctions in the ependyma of the 3rd ventricle of the rat.

Ependymal junctions in both the ventro-lateral wall and infundibular floor of the 3rd ventricle were examined in adult, young, neonatal, and fetal rats in freeze-fracture preparations. During late fetal and early postnatal life, tight junctions developed in both ventro-lateral and floor ependyma with, first, the appearance of an area of waffle-like or honeycomb texture in the membrane where tight junctions will appear; second, the decoration of P-face crests of this honeycomb with individual particles; and lastly, fusion of these particles into smooth strands. In adults, tight junctions were rare in the lateral ependyma, but persisted on the floor as a loose network. Many small ependymal gap junctions were already present at the earliest fetal stage (17 days) examined. They occupied significantly larger proportions of the membranes on the ventro-lateral wall than on the floor throughout the time course due to an increase in their size but not in their numbers. The smallest gap junctions were regarded as the newest in a process of renewal throughout life. The development of both junctional types parallels what is known on the onset of neuroendocrine functions in the median eminence. In the rat, this is apparently just before, at, or just after birth.

Animals↗
PubMed1981

Reduction of acute anterior shoulder dislocations using the Milch technique: a study of ski injuries.

During the 1977-78, 1978-79, and 1979-80 ski seasons, 76 acute anterior shoulder dislocations were treated by one of three Orthopedic Surgeons at the Rutland Vermont Hospital Emergency Room: 68 (89.4%) were reduced on first attempt using the Milch technique of abduction and external rotation. Four (5.2%) required general anesthesia and four were reduced using meperidine hydrochloride (Demerol, Winthrop) and diazepam (Valium, Roche) and a traction-countertraction technique. Of the 68 shoulders reduced with the Milch technique, 47 (69.1%) required no analgesics or muscle relaxants. There were no complications attributable to the technique itself. Males were injured more frequently than females in a 4.4:1 ratio. Left shoulder injuries were as common as right. Recurrent dislocations occurred more frequently in younger individuals. Fractures of the greater tuberosity were associated injuries in five (6.6%) of all dislocations. These all occurred in individuals older than age 39 years and were coincident with primary dislocations.

Adult↗
PubMed1966

Otoplasty.

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Ear Deformities, Acquired↗