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Biomedical subjects

L J Guzzardi

Publications and source records attributed to L J Guzzardi.

9 recordsLinked to original sources
PubMed1987

Noninvasive transcutaneous cardiac pacing in prehospital cardiac arrest.

This study evaluated the efficacy of prehospital external cardiac pacing in cardiac arrest patients. From October 1984 to June 1985, 91 patients were paced. Mean time from cardiac arrest to advanced life support (ALS) intervention in this metropolitan-rural ALS system was 14.5 minutes. Electrical capture occurred in 85 (93%), mechanical capture (pulses) occurred in ten (11%), and a measurable blood pressure occurred in three (3%) of the 91 patients. Despite a high rate of electrical capture, palpable pulses were produced only in 11%, and no patients survived to be discharged from the hospital. There was no difference in the frequency of electrical capture, palpable pulses, or outcome for patients receiving pharmacologic intervention before or after pacing. Likewise there was no difference in the frequency of electrical capture, palpable pulses, or outcome for patients receiving ALS therapy within or after ten minutes of their arrest. Although we found that external cardiac pacing was easily used in the prehospital setting, pacing did not result in any increase in survival in cardiac arrest patients.

Adult↗
PubMed1984

Role of the emergency physician in treatment of the poisoned patient.

Toxicology is part of the core knowledge necessary for the practice of emergency medicine. The basic principles outlined in this article include initial emergency department treatment; prehospital management; the special problems of ocular and cutaneous exposures and inhaled toxins; the definitive treatment of ingested toxins; and the indications for discharge from the emergency department.

Antidotes↗
PubMed1984

Role of the emergency physician in treatment of the poisoned patient.

Toxicology is part of the core knowledge necessary for the practice of emergency medicine. The basic principles outlined in this article include initial emergency department treatment; prehospital management; the special problems of ocular and cutaneous exposures and inhaled toxins; the definitive treatment of ingested toxins; and the indications for discharge from the emergency department.

Antidotes↗
PubMed1983

Inhalation of products of combustion.

The atmosphere of a fire is deadly to breathe. Firefighters or building occupants may be victims of the heat, irritating smoke, depleted oxygen, carbon monoxide, and such other toxic gases as cyanide, hydrogen chloride, and acrolein. Increasing numbers of homes and public buildings are being built and furnished with highly flammable synthetic materials that give off copious smoke and toxic gases when burned. Whether or not there are cutaneous burns, the possibility of inhalation injury must be considered in any fire victim. All victims of a fire environment should be presumed to have CO intoxication and should be treated with 100% oxygen until the HbCO level is within normal limits. In an extreme situation, cyanide intoxication should be suspected and administration of sodium thiosulfate may be lifesaving. Upper airway occlusion may result from thermal damage or edema secondary to burns from soluble toxic gases. Chemical injury to the lower airway and alveoli may result from inhalation of insoluble irritant gases and toxic gases adsorbed on carbon particles. Upper respiratory tract obstruction may be suggested by the clinical presentation (eg, pharyngeal burns, stridor, hoarseness, dysphagia), but only by means of fiberoptic bronchoscopy can it be recognized or excluded with certainty. Intubation may be necessary. Lower respiratory tract injury may be manifest clinically by dyspneas, wheezing and chest tightness, as well as by hypoxemia and reduced FEV1 and FVC. Treatment is symptomatic, but close observation for progressive respiratory insufficiency is necessary.

Arrhythmias, Cardiac↗