Biomedical subjects

L Doan-Wiggins

Publications and source records attributed to L Doan-Wiggins.

6 recordsLinked to original sources

PubMed1995

Can emergency physicians correlate between vehicle damage and velocity change?

The objective to this study was to examine the ability of emergency physicians to correlate between vehicle damage and velocity change. Participants were five emergency medicine physicians at the Emergency Department, Loyola University Medical Center, Maywood, IL. Ten slides of passenger cars crashed at speeds between 22 and 70 mph by the Insurance Institute for Highway Safety were shown to study participants. Study subjects were asked to estimate vehicular velocity based on the visible damage. Only 23 (46%) of the estimates were within 10 mph of the vehicular speed at the time of the crash. The average error was 14.5 mph (range: -20 to +45 mph). Vehicular velocity was overestimated in 70% of the appraisals. We conclude that the ability of emergency physicians to correlate between vehicle damage and velocity change is limited. Underestimation of vehicular damage associated with low velocity accidents may result in misdiagnosis of severe injuries in motor vehicle accident victims.

Accidents, Traffic↗

PubMed1995

Practice satisfaction, occupational stress, and attrition of emergency physicians. Wellness Task Force, Illinois College of Emergency Physicians.

OBJECTIVE: To define sources of job satisfaction and stress among emergency physicians and assess self-projected career longevity. DESIGN: A survey containing questions regarding emergency medicine (EM) practice satisfaction was mailed to 1,317 diplomates of the American Board of Emergency Medicine (ABEM). Specific sources of practice satisfaction and dissatisfaction, self-reported burnout or impairment, and plans for remaining in the specialty were assessed. Data were compared between two groups of physicians, namely, those residency-trained in EM and those attaining certification through the practice or special category tracts. RESULTS: Of the physicians returning the survey, 25.2% stated that they felt burned out or impaired and 23.1% planned to leave the practice of EM within five years. Perceptions of burnout/impairment and plans to stop practice were associated with less overall practice satisfaction but were not significantly different between the two groups of physicians. Burnout/impairment was linked with psychiatric, drug, or alcohol problems and the feeling that EM had contributed to that problem. CONCLUSION: This study confirms the relatively high levels of projected attrition in EM and supports the perception that stress and burnout are associated with the specialty. Differences in job satisfaction and stress between those ABEM diplomates who were residency-trained in EM and those who became eligible for the board examination through practice or special-category eligibility appear minor.

Adult↗

PubMed1994

The impaired driver: hospital and police detection of alcohol and other drugs of abuse in motor vehicle crashes.

STUDY OBJECTIVES: To determine the incidence of drugs of abuse and alcohol use in admitted drivers involved in motor vehicle crashes (MVCs) and to determine the rate of police detection of alcohol and drug use in these motorists. DESIGN: Retrospective chart review of hospitalized drivers involved in MVCs and review of corresponding police reports. SETTING: Two Level I trauma centers in a large metropolitan region. PARTICIPANTS: All MVC drivers/motorcycle operators admitted to the trauma service from January 1, 1990, to December 31, 1990. MEASUREMENTS AND MAIN RESULTS: The records of 634 injured motorists were reviewed; 200 (32% of the 625 patients with serum alcohol levels) were legally drunk (serum alcohol of 100 mg/dL or more), and 132 (22.6% of the 585 urine drug screens) had positive urine drug screens. Cocaine was the most prevalent drug of abuse, present in 51 patients (8.7%). Two hundred eighty-five patients (45.0%) were considered impaired (alcohol of 100 mg/dL or more and/or positive drug screen), representing almost half of all motorists admitted. The impaired motorists were younger, more often male, less likely to use a seat belt or helmet, and had higher Injury Severity Scores than their unimpaired counterparts. Police reports were available for 446 patients, 139 (31.2%) of whom were legally drunk and 67 (15%) of whom had positive drug screens, yielding an overall impairment rate of 46.2%. Only 34 (16.5%) patients were cited for driving under the influence. CONCLUSION: An exceedingly high rate of impairment existed in this population of seriously injured motorists in a metropolitan region, the majority of whom were not charged by the police. Although alcohol is the most prevalent source of driver impairment, other drugs of abuse are also important contributors to this problem.

Accidents, Traffic↗

PubMed1994

Drug therapy for obstetric emergencies.

Drug therapy for the treatment of obstetric emergencies frequently consists of medications not commonly used by the emergency physician such as Rho(D) immune globulin, 15-methyl prostaglandin F2a (carboprost), and ritodrine hydrochloride. This article focuses on those agents for which emergency use is confined to the obstetric emergency or where the administration of a commonly used drug acquires unique characteristics because of the clinical situation. In either case, a thorough understanding of the indications, contraindications, dose, route of administration, and side effects of these drugs will allow prompt and effective management of a variety of obstetric emergencies.

Emergencies↗

PubMed1991

Tick-borne diseases.

Ticks may transmit a variety of human pathogens and are second in importance only to the mosquito as a vector of human disease. The majority of tick-borne diseases are nonspecific in their initial clinical and laboratory presentation and may be confused with a variety of more common illnesses. A history of tick exposure is frequently not available. Although specific serologic tests exist for confirming the diagnosis of many of these diseases, the time required for confirmation of results makes them of little use in the acute situation. Recognition of the epidemiology of tick-borne pathogens and clinical suspicion are of key importance in making the appropriate diagnosis. Early and specific therapy is a principal factor in reducing the morbidity and mortality associated with these diseases.

Animals↗

PubMed1987

Hypertensive disorders of pregnancy.

Pre-eclampsia/eclampsia, or pregnancy-induced hypertension, is an uncommon but life-threatening complication of pregnancy associated with significant perinatal morbidity. When superimposed on underlying chronic hypertension, its impact on the fetus becomes even greater. Although the pathophysiology of the disease has not been fully defined, vasospasm appears to be the principal, underlying, etiologic mechanism. Therapy of the disease is principally aimed at controlling convulsions with magnesium sulfate and controlling hypertension with the antihypertensive agent hydralazine. Because development of the disease depends on the presence of trophoblastic tissue, the only true cure for pre-eclampsia/eclampsia is removal of the trophoblast through delivery of the infant. The timing and type of delivery is dependent on the severity of the disease and gestational age of the infant.

Anticonvulsants↗