Biomedical subjects

Erick M Itoman

Publications and source records attributed to Erick M Itoman.

3 recordsLinked to original sources

PubMed2005

Dental fracture risk of metal vs plastic laryngoscope blades in dental models.

BACKGROUND: Dental fracture is a complication of laryngoscopy and endotracheal intubation. PURPOSE: The purpose of this study is to compare the potential fracture rates in dental models using metal laryngoscope blades with those using plastic laryngoscope blades. METHODS: Size 3 Macintosh plastic and metal laryngoscope blades were applied against 4 different dental model materials at varying torques to determine when the dental model material would fracture. RESULTS: The plastic blade did not fracture any of the dental model materials. The metal blade fractured the glass dental model material even at the lowest torque setting. At a moderate torque setting, the plastic blade showed evidence of structural failure, whereas the metal blade did not fail at any torque setting. Fracture of wooden dowel and ceramic teeth model materials occurred with the metal blade but only at torque settings higher than what the plastic blade could achieve. CONCLUSION: Based on the dental fracture models studied, plastic laryngoscope blades have a lower potential for dental fracture compared with metal blades. Plastic laryngoscope blades would be best suited for trainees performing routine intubations under direct supervision. Metal blades would be more advantageous in difficult intubations preferably done by experienced intubators.

Equipment Design↗

PubMed2005

Pediatric prescription pick-up rates after ED visits.

OBJECTIVE: To determine the compliance rate in filling outpatient medication prescriptions written upon discharge from the emergency department (ED). METHODS: Emergency department records of children during a 3-month period were examined along with pharmacy claim data obtained in cooperation with the largest insurance carrier in the community (private and Medicaid). Pharmacy claim data were used to validate the prescription pick-up date. RESULTS: Overall, 65% of high-urgency prescriptions were filled. The prescription pick-up rate in the 0-to 3-year age group (75%) was significantly higher than in the rest of the cohort (55%) ( P < .001). Children with private insurance were more likely to fill their prescriptions (68%) compared to children with Medicaid insurance (57%) ( P = .03). CONCLUSION: This study demonstrates that filling a prescription after discharge from an ED represents a substantial barrier to medication compliance.

Adolescent↗

PubMed2005

Lumbar puncture needle length determination.

INTRODUCTION: Appropriate lumbar puncture (LP) needle length selection may be more difficult for less experienced practitioners or for patients who are of unusually large or small body habitus. The purpose of this study is to determine if there is a relationship between body height and weight, and the percutaneous depth to the spinal canal, which can more reliably assist in selecting an LP needle length. METHODS: This is a retrospective cohort study of patients who received an abdominal computed tomographic scan (for any reason) from July 1999 to December 2000. Lumbar puncture depth was measured on the computed tomographic scan and was used to derive a formula. RESULTS: The final data pool consisted of 175 patients, aged 25 days to 80 years, with height of 48 to 181.5 cm, weight of 3.0 to 127.3 kg, and body mass index of 11.7 to 49.7 kg/m2. Using this data set, the formula for predicting the required LP depth is (weight in kilograms, height in centimeters): LP depth (cm) = 1 + 17 x weight/height. Using linear regression comparing the skin to mid-spinal canal depth measurements with the calculated LP depths, R2 was 0.81 (P < .001). This formula selected a needle that was too short in 6% (less than that of 4 other previously published LP needle length selection methods) and a needle that was too long in 31%. CONCLUSION: Compared with other formulas, this formula might be a more reliable predictor for estimating the required LP needle length, but this must be validated by further studies. It should be noted that none of the formulas were perfect.

Adolescent↗