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Biomedical subjects

G C Hamilton

Publications and source records attributed to G C Hamilton.

At least 19 recordsLinked to original sources
PubMed2001

Case study on chronic organophosphate poisoning.

Ernest and Leslie Rea, two farmers in their mid-fifties, contacted their local County Agricultural Extension Office in Cape May, New Jersey, regarding health problems associated with their use of pesticides. They were referred to Dr. Hamilton and the Environmental and Occupational Health Sciences Institute (EOHSI) clinic for consultation and evaluations. They were diagnosed with chronic intoxication of organophosphate pesticides. Recommendations were made to decrease health risks in the farming operations. These included the usage of personal protective equipment while handling or applying pesticides, transportation of pesticides in a separate trailer behind the farm truck, and construction of separate storage areas for herbicides, insecticides and fungicides. A separate wash site was also constructed for use at the end of the work day. Compliance with these strategies resulted in improvements in health for both farmers.

Journal Article↗
PubMed1998

Definition of emergency medicine.

This SAEM position paper clarifies the role of emergency medicine in health care delivery. It builds upon the working definition of emergency medicine developed by the American College of Emergency Physicians in 1994 by describing the health care role of emergency physicians (EPs). EPs are first-contact providers who care for all patients regardless of age, gender, time of presentation, or ability to pay. They remain the only continuously accessible specialty for patients seeking help and solace in the health care system. They are an essential link in the health care continuum between primary care physicians, specialists, the out-of-hospital system, the patient, inpatient services, and communication services. The EP's role is in organizing and monitoring the emergency care delivery system. Part of this role is to better align the health care provider training and ability with the specific medical needs of a patient. The emergency health care system remains the essential medical safety net for all individuals needing care in this country.

Emergency Medicine↗
PubMed1996

Optimal positioning for cervical immobilization.

STUDY OBJECTIVE: We hypothesized that optimal positioning of the head and neck to protect the spinal cord during cervical spine immobilization can be determined with reference to external landmarks. In this study we sought to determine the optimal position for cervical spine immobilization using magnetic resonance imaging (MRI) and to define this optimal position in a clinically reproducible fashion. METHODS: Our subjects were 19 healthy adult volunteers (11 women, 8 men). In each, we positioned the head to produce various degrees of neck flexion and extension. This positioning was followed by quantitative MRI of the cervical spine. RESULTS: The mean ratio of spinal canal and spinal cord cross-sectional areas was smallest at C6 but exceeded 2.0 at all levels from C2 to T1 (P < .05). At the C5 and C6 levels, the maximal area ratio was most consistently obtained with slight flexion (cervical-thoracic angle of 14 degrees) (P < .05). For a patient lying flat on a backboard, this corresponds to raising the occiput 2 cm. More extreme flexion or extension produced variable results. CONCLUSION: In healthy adults, a slight degree of flexion equivalent to 2 cm of occiput elevation produces a favorable increase in spinal canal/spinal cord ration at levels C5 and C6, a region of frequent unstable spine injuries.

Adult↗
PubMed1994

A preliminary epidemiological study of the patient population visiting an urban ED in the Republic of China.

The objective of this study was to evaluate the characteristics of the patient population of an urban emergency department (ED) in The People's Republic of China. A prospective observational study was conducted at a university-affiliated hospital adult ED medical unit and included all patients visiting the medical unit of the ED during a 2-week period. A data collection log was designed and placed in the ED. Data were recorded by the attending ED physician for all patients presenting during the study period. There were 569 patients recorded in the 2-week period. The major presenting complaints were fever (20.9%), abdominal pain (20.1%), and chest pain (11.4%). The most common diagnosis were upper respiratory tract infection (11.6%), angina pectoris (6.3%), and acute gastritis (4.9%). Eight percent of the patients were admitted, 29.0% were held in an observation unit, and 0.6% died. The average length of stay in the ED observation unit was 5.6 days. These data offer emergency physicians a preliminary understanding of the clinic presentations and diagnoses of patients seen in a university-affiliated urban hospital ED in China. The number and length of time patients were held in observation unit point out the shortage of in-hospital beds. This study is useful for describing and understanding characteristics of the patient encounter and for improving the delivery of emergency care in China.

Adolescent↗
PubMed1991

Objectives to direct the training of emergency medicine residents on off-service rotations: electrocardiology.

This is a continuing series of objectives to direct resident training in emergency medicine. Electrocardiography may not receive individual attention in many training programs. However, the importance, omnipresence, and medicolegal potential of electrocardiography in the practice of emergency medicine suggests its individual attention. Contents and specific learning objectives are presented to provide guidelines for resident mastery, following the format presented by preceding subjects.

Arrhythmias, Cardiac↗
PubMed1991

Autonomous departments of emergency medicine in contemporary academic medical centers.

There are currently 20 autonomous departments of emergency medicine in United States medical schools. EDs seeking autonomous status should institute a faculty development program to channel faculty energy into worthwhile research projects; establish protected time for clinical faculty to increase research productivity; develop expertise to compete for extramural funding; initiate an intramural research program so that faculty can learn the basics of grantsmanship; teach health care issues in ambulatory medicine; become involved in interdisciplinary teaching programs and curriculum development; maintain the present faculty commitment to 24-hour attending coverage; and develop university-based programs that originate from the ED. Program directors should establish liaisons with the medical school dean to acquaint him with the advantages of an autonomous department of emergency medicine; attempt to assess other relationships within the medical school to determine support for emergency medicine and to uncover and address opposition to autonomous departmental status; attempt to serve on medical school committees to meet other faculty, solve problems with them and develop trusting relationships; and develop broad-based support for autonomous departmental status both within and outside of the university. By devising and following a deliberate approach to attaining departmental status, emergency medicine will be assured of continued growth in the important decade ahead.

Academic Medical Centers↗
PubMed1989

Influence of emergency medical services systems and prehospital defibrillation on survival of sudden cardiac death victims.

This article reviews the influence of emergency medical systems and prehospital defibrillation on survival of sudden cardiac death. The historical perspective and epidemiologic considerations of prehospital sudden cardiac death are highlighted. Factors predictive of successful resuscitation and impact of community activity on sudden death are discussed. Influences of emergency medical services on outcome of prehospital cardiac arrest are reviewed, with emphasis on the role of dispatchers, emergency medical technicians, and paramedics. The recent emergence of prehospital automatic defibrillation by emergency medical technicians, first responders, and lay persons is discussed in depth, as it has great potential to positively influence outcome of prehospital sudden cardiac death.

Death, Sudden↗
PubMed1989

Content listings for consistency of policies and procedures in an academic department.

Communicating expectations is central to effective management. In a large academic department spread over several sites, written guidelines are often necessary to limit misinterpretation of these expectations. Three "operation manuals" for residents, faculty, and support staff were developed to supply these guidelines. They have evolved into an effective means of communicating departmental policy and standards for performance. The table of contents are provided as a guide for those developing new academic departments.

Communication↗
PubMed1986

Hemoglobin/hematocrit and other erythrocyte parameters.

The authors review erythrocyte physiology, blood collection, and laboratory methodology for enumerating blood cells. The clinical interpretation of abnormal erythrocyte parameters is discussed, and the emergency department approach to anemia and polycythemia is detailed.

Anemia↗
PubMed1986

Platelet count.

An estimate of the platelet count is usually given as part of the complete blood count (CBC). It should not be neglected when reviewing CBC results as it is a fair screening test and satisfactory for most purposes in the emergency department. It is a quantitative study, and the functional status of the platelet must always be considered in interpretation of clinical significance. Patients presenting with abnormal bleeding histories, particularly women with mucosal origin bleeding, should have an evaluation of platelet quantity by an accurate method and functional quality by a bleeding time. Though rarely used, the emergency physician should be familiar with the indication and mechanics of platelet transfusions. The laboratory charge for the platelet count is $17.00 to 18.00, whether it is automated or hand counted.

Adult↗