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Biomedical subjects

G A Pane

Publications and source records attributed to G A Pane.

13 recordsLinked to original sources
PubMed1991

Health care access problems of medically indigent emergency department walk-in patients.

OBJECTIVES: To obtain health care access data on emergency department walk-in patients and to determine factors associated with delayed access to care. DESIGN: Survey of stable ED walk-in patients in the triage area. SETTING: University of California Irvine Medical Center, an urban, 493-bed, noncounty, Level I teaching hospital treating 38,000 emergency patients annually. PARTICIPANTS: A quota of 1,000 consecutive patients derived from a representative selection of service days was included; 94% of eligible patients agreed to participate. Patients with obstetrical problems (more than 20 weeks' gestation) were excluded. INTERVENTIONS: Pretested health access survey, available in both Spanish and English, administered by investigator. RESULTS: Public aid/self-pay insurance status was significantly associated with routine use of the ED for care (P less than .003), income of less than $10,000 (P less than .0002), refusal of care by health provider (P less than .001), refusal of care at an ED (P less than .03), and delay in seeking health care (P less than .0002). Income of less than $10,000 was significantly associated with routine use of the ED for care (P less than .02), and delay in seeking health care (P less than .04). Statistical analysis done using chi 2 with continuity correction and with the binomial test for comparison of two proportions. CONCLUSION: Among stable ED walk-in patients surveyed at our facility, low-income individuals and those with public aid/self-pay insurance status were significantly more likely to use the ED as a routine source of health care, and more likely to delay in seeking needed health care, than higher income and fully insured individuals. These data should be useful to health policymakers in formulating rational, cost-effective strategies that improve access to early treatment and prevention.

Adult↗
PubMed1991

Aggression directed toward emergency department staff at a university teaching hospital.

STUDY OBJECTIVE: To determine the scope and magnitude of patient and visitor aggression directed toward emergency department staff. DESIGN: One-year retrospective review of university police log records and ED staff incident reports. SETTING: Medium-sized, urban, noncounty, university Level I teaching hospital treating approximately 40,000 ED patients annually. TYPE OF PARTICIPANTS: All violent incidents involving patients/visitors and ED staff that triggered a police response to the ED area were included in the study. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: All ED violent episodes were recorded and categorized by shift, type of incident, type of police response, perpetrator, and site of incident. It was found that police responded to the ED nearly twice daily; the night shift had 32% of the cases with only 13% of the patient volume; custody and medical psychiatric clearance patients accounted for 40% of the cases; more than 20% of incidents occurred in the waiting room; and 4.2% of the incidents represented a significant threat to ED staff. CONCLUSION: ED violence is a significant and under-reported problem at our medium-sized university teaching hospital. These data are useful in objectively quantifying the scope of violence in our institution, and they underscore the potential risk to emergency patients, visitors, and staff. There is an acute need for additional studies in other settings so that appropriate and cost-effective security recommendations can be formulated.

California↗
PubMed1989

Targeted recruitment of senior citizens and cardiac patients to a mass CPR training course.

CPR courses attract a predominance of young, healthy adults. Targeted recruitment of senior citizens and family members of cardiac patients has been suggested but inadequately studied. We used a targeted recruitment strategy for our annual mass CPR training course to determine if such an approach would be effective in attracting the target group. Targeting significantly increased the percentage of senior citizen participants and participants who took the course because they or a close friend or relative had cardiac disease (P less than .00001). These data have important implications regarding potential future CPR training course recruitment methods compared with nontargeted recruitment approaches.

Adolescent↗
PubMed1987

A survey of participants in a mass CPR training course.

To determine demographic data and reasons for CPR course taking among 891 participants of a mass CPR training event, a questionnaire was distributed at the time of the course. Of the 728 persons completing this initial survey, 379 (52.6%) were less than 20 years of age. Only 41 (5.6%) took the course because of a family member or close relative with cardiac disease. Of this subgroup, seven (17.1%) had taken a previous CPR course, compared with 25.7% for the entire population. Thirty-eight percent of the 60-and-over age group mentioned cardiac disease as their reason for taking the course, compared to only 2.1% for the under-20 age group. To assess recall and actual performance of CPR, a follow-up survey was mailed to all participants six months after the course. Seventy-two percent were still confident in their ability to perform CPR, although no one had performed the technique on a real victim; 61.9% thought there should have been more manikin practice time; 92.2% still had their CPR refresher card. Only 32.3% would perform CPR on a known AIDS patient. This survey provides demographic and personal data that should be considered when planning future large-scale CPR training programs.

Adolescent↗
PubMed1986

Glucose.

Disorders of glucose metabolism are commonly seen by practicing emergency physicians. Reagent strips such as Visidex and Chemstrip are useful as a quick and accurate method of glucose estimation provided the procedure is followed correctly. These reagent strips are particularly useful for rapid screening in the unresponsive patient. The accuracy of glucose analysis obtained from the clinical laboratory is improved when methods to prevent glycolysis are used and when enzymatic methods of glucose analysis are used. The common and important indications for routine glucose analysis include evaluation of symptomatically ill patients with known diabetes or patients with altered mental status or coma of unknown etiology; patients on insulin or sulfonylureas; sick neonates; patients with a variety of drug intoxications; and patients suffering from significant systemic illness or injury likely to manifest with physiologic stress expressed as glucose intolerance.

Blood Glucose↗
PubMed1985

The Cincinnati DC-9 experience: lessons in aircraft and airport safety.

Twenty-three passengers died on June 2, 1983, when a McDonnell Douglas DC-9 experienced an inflight rear lavatory fire near Cincinnati, OH. Evidence of toxic fume inhalation was developed by investigators, demonstrating lethal levels of carbon monoxide and cyanide in the victims' blood. An analysis of the inflight progression of fire and smoke, and the subsequent extension of this following the emergency landing at Greater Cincinnati Airport has been accomplished. This data is augmented by other data from previous accidents of this type. Data from interviews with survivors was collected, including inflight experiences, emergency escape processes and airport disaster management during the emergency. Several practical means of respiratory protection both inflight and during emergency evacuation are documented. Onboard preventive measures in regard to this type of emergency have been identified. Emergency evacuation and modern airport disaster management techniques are codified and described. This recent accident provides information for future adoption by the responsible authorities so that inflight and postflight fires do not continue to cause significant numbers of fatalities. Modified lightweight passenger breathing apparatus, upgraded flight attendant and aircrew portable breathing apparatus, floor level guidance to exits, less flammable and toxic interior materials, improved passenger evacuation information, tailored airport emergency response procedures, and upgraded toilet smoke detector equipment are examples.

Accidents, Aviation↗
PubMed1983

Nontraumatic suppurative mediastinitis presenting as acute mediastinal widening.

A case of acute nontraumatic suppurative mediastinitis in a 56-year-old man is presented. The patient was admitted with signs and symptoms of a left lower lobe pneumonia and acutely developed mediastinal widening on chest radiograph. A mediastinal abscess was drained by posterior mediastinotomy after a complicated hospital course. Mediastinitis is a rare complication of pneumonia. It is a serious condition, requiring prompt diagnosis and aggressive therapy, and should be considered in the differential diagnosis of acute mediastinal widening.

Anti-Bacterial Agents↗