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Biomedical subjects

J L McCabe

Publications and source records attributed to J L McCabe.

6 recordsLinked to original sources
PubMed1992

Intravenous adenosine in the prehospital treatment of paroxysmal supraventricular tachycardia.

STUDY OBJECTIVE: To determine the clinical efficacy and safety of IV adenosine administration in the field for the treatment of paroxysmal supraventricular tachycardia (PSVT). DESIGN: Prospective, consecutive case series. SETTING: An urban emergency medical services system. PARTICIPANTS: Thirty-seven adult patients in whom paramedics made the diagnosis of PSVT. INTERVENTIONS: Six milligrams of adenosine was administered by rapid IV bolus. If there was no effect within two minutes, a 12-mg bolus was given. This dose was repeated once if necessary. If there still was no effect, the medical command physician was contacted for further management. MEASUREMENTS: Vital signs, symptoms, and a single-channel ECG were recorded before, during, and after the administration of adenosine. RESULTS: On review of the ECG tracings, 26 patients (70%) were in PSVT. Eleven had rhythms other than PSVT on review, including five with atrial fibrillation, four with sinus tachycardia, and two with ventricular tachycardia. Of the 26 patients with PSVT, 23 (88%) converted to sinus rhythm after adenosine administration. Eleven patients were hypotensive at presentation. Seven of these were in PSVT and became hemodynamically stable on conversion with adenosine. The four hypotensive patients with rhythms other than PSVT (two with atrial fibrillation and two with ventricular tachycardia) had no change in blood pressure after adenosine administration. Nine patients were subsequently found to have wide-complex tachycardia. None of these patients suffered hemodynamic compromise after adenosine administration, and side effects were infrequent, mild, and transient. CONCLUSION: Adenosine appears to be effective and safe for the pre-hospital treatment of PSVT.

Adenosine↗
PubMed1991

Ventilation-perfusion scintigraphy.

Ventilation-perfusion scintigraphy remains an important diagnostic tool in the evaluation of patients suspected of having PE. It is important for the emergency physician to be able to use the information from a lung scan appropriately in the diagnostic management of this elusive and life-threatening disorder. This requires a clear knowledge of how these scans are interpreted as well as a consultative approach between the physician ordering the lung scan and the nuclear medicine physician interpreting it. Each can ultimately contribute to the development of an effective management plan. It is important for the clinician to understand that a low-probability lung scan does not rule out PE, but in fact can have up to a 40% probability of PE when clinical suspicion is high.

Adult↗
PubMed1988

Pregnancy after corticosteroid administration in premature ovarian failure (polyglandular endocrinopathy syndrome).

A patient with polyglandular failure syndrome first had documented ovarian failure at age 28 years. Fifteen years later after treatment for Addisonian crisis, she resumed menses, conceived, and was delivered of a normal infant. Patients with this syndrome should be identified because they are at risk for other endocrinopathies and because they may have a treatable form of ovarian failure.

Addison Disease↗
PubMed1988

Epstein-Barr virus infection complicated by acute rhabdomyolysis.

A patient presented with infectious mononucleosis complicated by acute rhabdomyolysis following physical exertion. This infrequent complication should be identified and treated quickly to prevent serious sequelae of rhabdomyolysis, which may include renal failure and disseminated intravascular coagulation.

Acute Disease↗
PubMedDate not supplied

Complete recovery following an unusual cardiac stab wound.

A 17-year-old female was stabbed in the chest and found by paramedics in extremis. She arrived at the receiving hospital with spontaneous respirations and an improved blood pressure. Upon thoracotomy in the operating room, lacerations through the main pulmonary artery and the left atrium were found. The combined efforts of a sophisticated EMS system providing rapid in-field stabilization and transport, a ready in-house trauma team able to quickly assess and provide definitive care, and a prepared operating room team, including cardiopulmonary bypass capability, resulted in a complete and uncomplicated recovery from this rare and lethal injury.

Adolescent↗