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Biomedical subjects

J S Stapczynski

Publications and source records attributed to J S Stapczynski.

15 recordsLinked to original sources
PubMed1995

Automated external defibrillators used by emergency medical technicians: report of the 1992 experience in Kentucky.

Automated external defibrillators (AED) have been authorized for use by Emergency Medical Technicians (EMT) in Kentucky since March 1991. Emergency Medical Services (EMS) which use these devices are required to submit annual reports to the EMS Branch. During 1992, 17 services were approved to use AEDs. The device was used by 12 services on 93 victims of out-of-hospital cardiac arrest. Of the 93 victims, 27 were defibrillated, eight were resuscitated to hospital admission, and three survived to hospital discharge. The overall survival rate was 3/93 (3.2%). For patients receiving defibrillatory shocks, the survival rate was 3/27 (11%). This percentage is comparable with the survival rates reported from other predominately rural states where AEDs have been used by EMTs. Possible protocol violations and inadequate documentation were also identified from these reports. In summary, EMTs in predominately rural Kentucky can use AEDs to achieve survival rates for out-of-hospital cardiac arrest comparable with other rural states.

Adult↗
PubMed1991

Localized depigmentation after steroid injection of a ganglion cyst on the hand.

Presented is the case of a man who had localized depigmentation after local injection of triamcinolone diacetate. Search of the literature indicates that this is a rare complication of such therapy. Localized depigmentation may have important cultural implications for dark-skinned patients. There is some experimental evidence that less-potent and shorter-acting steroid preparations have a lower likelihood for depigmenting side effects, and such agents may be more appropriate when injecting subcutaneous structures to prevent this complication.

Adult↗
PubMed1990

Emphysematous cystitis: a complication of urinary tract infection occurring predominantly in diabetic women.

The case of a patient with emphysematous cystitis who presented with complaints of lower abdominal pain, dysuria, and pneumaturia is presented. The presenting symptoms, differential diagnosis, and radiographic and cystoscopic appearances of emphysematous cystitis, a rare complication of lower urinary tract infection occurring almost exclusively in diabetics, are reviewed. Treatment consists of urinary drainage, prompt initiation of antibiotic therapy, and strict glucose control. The prognosis usually is excellent.

Combined Modality Therapy↗
PubMed1988

Update on antiarrhythmic drugs in emergency medicine.

Most patients presenting to the Emergency Department with acute arrhythmias can be adequately treated with the available, conventional antiarrhythmics. Recent studies have taught us to use them with better understanding. In the future, several new antiarrhythmics look promising for use in the Emergency Department when given by the intravenous route; particularly, pirmenol, encainide, esmolol, amiodarone, sotalol, and magnesium. However, there have been few comparison studies between various antiarrhythmics, and experience must be gained for a full understanding of the benefits and risks of these agents.

Adrenergic beta-Antagonists↗
PubMed1988

Update on the emergent treatment of arrhythmias.

The interpretation and treatment of arrhythmias presents a continuing challenge to the emergency physician. Better understanding of the mechanisms involved and development of additional drugs will provide the physician with an enhanced ability to treat these patients effectively in the Emergency Department.

Anti-Arrhythmia Agents↗
PubMed1984

Duration of hypoglycemia and need for intravenous glucose following intentional overdoses of insulin.

To assess the treatment of intentional insulin overdoses with intravenous (IV) glucose, we reviewed the records of 17 attempts in 15 patients seen during a ten-year period. The mean age of our patients was 29 +/- 9 years, and the mean overdose of insulin was 386 +/- 276 units. Eight patients were insulin-dependent diabetics and seven patients had no history of diabetes. We found that the nondiabetics were more likely to present with hypoglycemia (serum glucose less than 50 mg/dL) and develop recurrent hypoglycemia, despite oral intake and IV glucose infusion, than were diabetic patients (P less than .05, Fisher's exact test). We also found a significant relation (P less than .01) between the amount of insulin taken as a single overdose and either the total amount of IV glucose administered or the total time of IV glucose treatment until the hypoglycemic effects of excess insulin had resolved (glucose [g] = 52 + (.699) (dose U), R = .929 and time [h] = 10.5 + (.028) (dose U), R = .817). No patient sustained permanent complications from hypoglycemia. We conclude that prolonged, aggressive IV glucose infusion and serial monitoring of serum glucose levels is required in insulin overdoses. These patients may become hypoglycemic much later than predicted from the conventional duration of action of the various insulin preparations.

Adult↗
PubMed1983

Hemodynamic effects of pneumatic external counterpressure in canine hemorrhagic shock.

To assess the effects of external counterpressure in a hypovolemic canine model, mean right atrial pressure (RA), left ventricle end-diastolic pressure (LVEDP), mean aortic pressure (Ao), and cardiac output (CO) (indicator dilution technique or electromagnetic ascending aortic flow) were measured in eight closed-chest mongrel dogs following phlebotomy to an Ao of 50 to 60 mm Hg. Inferior vena cava (IVC) flow was measured electromagnetically with a cannulating probe in four animals. The antishock garment was inflated to pressures of 40, 60, 80, and 100 mm Hg. An extended shock "control" period preceded inflation to minimize the effect of reflex circulatory responses to acute blood loss. IVC flow (2 +/- 1 mL/min/kg) during and immediately following antishock garment inflation was not significantly different from control (3 +/- 1 mL/min/kg) regardless of inflation pressure. Ao, RA, and LVEDP measured 30 seconds and 15 minutes after garment inflation were increased, but CO was not significantly different from control values at each inflation pressure. Garment inflation significantly increased peripheral vascular resistance (PVR) at all inflation pressures, and there was a significant correlation (r = .53; P less than .001) between the change in Ao and PVR. These results indicate that the change in arterial pressure produced by external counterpressure is the result of an increase in PVR and not the result of an autotransfusion and subsequent increased left heart outflow in the canine shock model.

Animals↗
PubMed1982

Persistent hiccups.

We present the case of a patient who presented with persistent hiccups induced by a hair irritating the tympanic membrane and activating the vagally mediated hiccup neural reflex arc. Commonly identified etiologies and treatments of this condition are then reviewed.

Adult↗
PubMed1982

Blast injuries.

Explore the source record for details and available documents.

Animals↗
PubMed1981

Cardiac conduction and rhythm disturbances following suicidal ingestion of mesoridazine.

The phenothiazine derivatives, particularly chlorpromazine and thioridazine, are known to produce significant electrocardiographic abnormalities. Until now, documented life-threatening arrhythmias have not been reported following large doses of mesoridazine, the besylate salt of a metabolite of thioridazine and a relatively recent addition to the phenothiazine group. We describe such a case in which alterations in both impulse conduction (first-degree atrioventricular block, prolonged QRS duration, and right axis deviation) and impulse formation (supraventricular and ventricular tachycardia) were noted following a suicidal ingestion of mesoridazine. The electrophysiologic mechanisms underlying phenothiazine-induced arrhythmogenesis are reviewed.

Adult↗
PubMed1981

Colchicine overdose: report of two cases and review of the literature.

Colchicine overdose is an uncommon but serious problem that may be missed or ignored unless the physician is aware of the significant potential for, and the various stages of, toxicity. We report two fatal cases in which the potential for lethal complications was not initially realized. Both patients developed multiple organ damage characteristic of severe colchicine toxicity. Awareness and appropriate initial therapy are important if death is to be prevented in colchicine overdose.

Adolescent↗