PubMed Health⌕ Search

Biomedical subjects

J Benger

Publications and source records attributed to J Benger.

17 recordsLinked to original sources
PubMed2006

Lower limb amputation with CPR in progress: recovery following prolonged cardiac arrest.

Intravenous drug users (IVDUs) often present to the emergency services with the medical complications of drug use. We report a case in which an acutely ischaemic lower limb of one such patient was thought to be the cause of cardiac arrest occurring during treatment in the emergency department (ED). Amputation of the limb was performed with cardiopulmonary resuscitation (CPR) in progress, spontaneous cardiac output was restored, and the patient made an excellent neurological recovery despite a total arrest time of 85 minutes. Possible causes of cardiac arrest, in relation to the release of potassium and metabolic toxins are discussed, as well as the decision making processes of the involved clinicians and other possible management strategies.

Adult↗
PubMed2005

Automatic external defibrillation in a 6 year old.

A case is reported in which an automatic external defibrillator (AED) was used during the successful resuscitation of a 6 year old child in out-of-hospital cardiac arrest, despite the fact that these devices are not recommended in children under 8 years. The interpretation of resuscitation protocols is discussed and new developments in this area reported.

Cardiopulmonary Resuscitation↗
PubMed2005

Prevalence and healthcare burden of illegal drug use among emergency department patients.

OBJECTIVES: Illegal drug use is common in emergency department (ED) patients, but previous prevalence studies have relied upon approaches that may underestimate the true extent of the problem. The aim of this study was to examine illegal drug use in a typical adult ED. METHODS: We employed an independent researcher to prospectively and anonymously interview patients attending an inner city adult ED throughout all 168 hours of a typical week. Additional information collected from the treating clinician indicated whether each presentation was directly or indirectly related to illegal drug use. RESULTS: We found that 6.9% of all patient attendances were directly or indirectly related to illegal drug use, and hospital admission was required in nearly half of these. The majority of drug related problems were acute injuries, overdose, and the medical complications of drug use. CONCLUSIONS: This suggests that the emergency healthcare burden related to illegal drug use is substantial, and higher than previously reported.

Adolescent↗
PubMed2003

Nitrous oxide in emergency medicine.

Safe and predictable analgesia is required for the potentially painful or uncomfortable procedures often undertaken in an emergency department. The characteristics of an ideal analgesic agent are safety, predictability, non-invasive delivery, freedom from side effects, simplicity of use, and a rapid onset and offset. Newer approaches have threatened the widespread use of nitrous oxide, but despite its long history this simple gas still has much to offer. "I am sure the air in heaven must be this wonder-working gas of delight". Robert Southey, Poet (1774 to 1843)

Analgesics, Non-Narcotic↗
PubMed2001

The effect of resolution, compression, colour depth and display modality on the accuracy of accident and emergency telemedicine.

There are no current recommendations regarding the minimum technical specification for realtime telemedicine consultation in accident and emergency (A and E) practice. We assessed the effect of image resolution, compression, colour depth and display modality on perceived image quality and telediagnosis. Test sets of digitized radiographs and clinical images were subjected to a series of standardized manipulations and the resulting output files were evaluated by an expert panel using image scoring and receiver operating characteristic (ROC) analysis. For telemedicine in A and E work, the minimum technical specification should be regarded as images containing at least 250,000 pixels, compressed at up to JPEG 50 (or GIF for colour images) and displayed on a high-resolution computer monitor. These specifications resulted in average file sizes of 17 kByte for digital images and 9 kByte for radiographs.

Emergency Medicine↗
PubMed2000

A review of telemedicine in accident and emergency: the story so far.

Recent developments in information and communications technology have the potential to revolutionise health care. This has been recognised at government level, and plays a significant part in the new information strategy for the NHS "Information For Health". Telemedicine (literally, medicine at a distance) is one of the most successful techniques in this rapidly expanding field, and in preliminary studies has proved to be both successful and popular with patients and health care professionals. In the UK telemedicine has been mainly applied to two major areas of accident and emergency (A&E) practice. These are the transmission of computed tomography scans for urgent neurosurgical opinion and the ongoing support of minor injuries units. The latter also involves transmission and interpretation of radiographs, usually peripheral limb films. Telemedicine is not a medical subspecialty in itself, but a facilitator of all medical and surgical specialties. While recent modernisation initiatives have permitted A&E departments to purchase a range of telemedical equipment, overall progress is hampered by a lack of large or scientifically rigorous studies, and a complete absence of data on the economic implications of this new technique. This review introduces A&E telemedicine in terms that avoid jargon and complex technical details. After a brief consideration of the origins of the subject, attention is given to recent publications relating to minor injuries support and A&E teleradiology. The technical and clinical feasibility of A&E telemedicine are demonstrated, and a case is made for the transmission and interpretation of minor injuries radiographs using a relatively simple and inexpensive system, supported by timely radiological reporting. After a brief study of various legal and ethical issues, the likely developments of the future are discussed.

Emergency Medicine↗
PubMed1999

A review of minor injuries telemedicine.

Video support in the management of minor injuries was pioneered in the mid-1970s in the USA, but remained little more than a technical curiosity pending the development of acceptable equipment some 20 years later. Minor injuries telemedicine has developed very successfully over the last few years in the UK, the first reported UK minor injuries telemedicine link being set up in 1994. Peripheral services are generally staffed by emergency nurse practitioners, who can use a telemedicine link when required to obtain realtime advice from a doctor at a main hospital accident and emergency department. There is now a considerable body of experience to show that the technique is safe and effective, and also some limited data about its economic benefits. The majority of minor injuries teleconsultations involve transmission of radiographs and most minor injuries teleradiology is undertaken on the understanding that a definitive radiologist's report will be issued in due course. Studies show that satisfactory interpretation of plain radiographs is possible using a low-cost/low-resolution telemedicine link. This is supported by other studies which have shown that even a teleradiology system at reduced cost and technical specifications can yield adequate images. It seems likely that teleconsultation will become an essential component in the provision of accident and emergency services.

Emergency Treatment↗
PubMed1999

Protocols for minor injuries telemedicine.

Protocols are essential in a nurse-led minor injuries unit. They allow the identification of agreed steps that need to occur in a sequential and timely fashion for a given process. Protocols fall into four categories: (1) for the management of specific clinical conditions; (2) for ordering and interpreting radiographs; (3) for prescribing and dispensing medications; (4) for conducting the teleconsultation itself. Current examples are given which offer a clear demonstration of the types of protocol that are in use in the UK for minor injuries telemedicine and how they are presented.

Clinical Protocols↗
PubMed1976

[Basic concept for the judgement of the results of dustfall measuring in the Alps (author's transl)].

At the time extensive measurements are made in the Austrian part of the Alps to find out the elevation of the fundamental load of dustfall according to the methode of BERGERHOFF. Thereby the authors had to solve the fundamental question to find a system for estimation. In Austria the results of measurements of dustfall were classified usually according to the "Technische Anleitung zur Reinhaltung der Luft 1964." It appeared that the introduction did not achieve the problem because of the special geografical, meteorological and economical data of the researched part of the Alps which at that time has about 30 000 km2. Similar applies to the new standards of the TAL 1974 and that recommendations of the "Deutscher Bäderverband" to estimate health resorts, recreation areas and mineral springs. Therefore a special model for estimating was developed which differentiate among the average of a year and the maximum of the average of a month, the general housing-areas, recreation areas and standards for industrial areas. The suggested limits are under the limits which are used today in Germany. The results of measurements of dustfall are discussed.

Air Pollution↗