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Biomedical subjects

L Vertesi

Publications and source records attributed to L Vertesi.

8 recordsLinked to original sources
PubMed1997

Effectiveness of verapamil-quinidine versus digoxin-quinidine in the emergency department treatment of paroxysmal atrial fibrillation.

STUDY OBJECTIVE: To determine the relative effectiveness of a verapamil-quinidine sequential combination versus digoxin-quinidine in the emergency department treatment of paroxysmal atrial fibrillation (PAF). METHOD: This prospective, double-blind, randomized, controlled trial involved patients, aged 18 to 75 years, with new-onset (< 48 hours) atrial fibrillation who presented to a community-based urban hospital with an annual ED census of 65,000. Exclusion criteria included ventricular response rate lower than 100 or higher than 200 beats/minute, allergy to study drugs, hypotension with evidence of end-organ hypoperfusion, and conduction abnormalities. Consenting patients were randomly assigned to receive rapid digitalization (1.0 mg over 2 hours) or i.v. verapamil (sequential 5-mg boluses up to 20 mg). After ventricular rate was controlled (< 100 beats/minute), oral quinidine (200 mg) was initiated and repeated every 2 hours until conversion to normal sinus rhythm (NSR) occurred, until 1 g of quinidine was administered, or until adverse effects supervened. Heart rate, blood pressure, cardiac rhythm, time to conversion, and adverse effects were documented. RESULTS: Forty-four patients received the study drugs. Three were withdrawn, leaving 19 in the verapamil-quinidine (VER-Q) group and 22 in the digoxin-quinidine (DIG-Q) group. Sixteen patients (84%) in the VER-Q group and 10 (45%) in the DIG-Q group converted to NSR within 6 hours (P < .02). Mean time to conversion (+/-SD) was 185 +/- 146 minutes for VER-Q and 368 +/- 386 minutes for DIG-Q patients (P = NS). Twelve VER-Q patients (63%) and 6 DIG-Q patients (27%) were discharged from the ED (P < .05). Minor adverse effects were more common in the VER-Q group. No mortality or significant morbidity occurred. CONCLUSION: The sequential combination of verapamil and quinidine, in the doses studied, is an effective treatment for PAF and is superior to digoxin-quinidine. Digoxin should no longer be considered the treatment of choice for uncomplicated PAF.

Adult↗
PubMed1994

The utility of a multicenter regional trauma registry.

We report on the experience of five trauma receiving hospitals (four general hospitals and one spinal cord unit) in establishing a multicenter trauma registry (TR) for the purpose of data sharing. To ensure data comparability, all coders were oriented to standard data definitions and injury severity scaling. Coders and their physician sponsors met regularly to review data. Data presented for the four general hospitals from January through September 1992 address comparison of mortality rates, resource implications of isolated hip fractures, and the utility of knowing regional neurosurgical (NS) trauma volumes. Because of a statistically significant higher mortality rate at hospital 2, 7.2% versus 4.7% overall, mortality data were further characterized by patient age, mean ISS, and frequency of severe head injury. This still failed to explain the mortality difference. Hip fractures utilized 11,120 (26.3%) of the total 42,341 TR hospital days. Interhospital differences in median length of stay in this population suggest that greater resource efficiencies can be realized. Earlier questions about the value of including isolated hip fractures in the data set have been answered by understanding the resource implications of this population. Problems of NS coverage arising from a regional shortage of neurosurgeons can now be addressed with a better appreciation of the intraregional differences in NS volumes. Use of congruent data sets, combined with a collaborative approach, has stimulated the application of multicenter TR data to quality improvement, and utilization and regional planning issues.

Abbreviated Injury Scale↗
PubMed1983

Cardiac arrest: comparison of paramedic and conventional ambulance services.

A prospective study conducted in the Greater Vancouver area compared survival rates in prehospital cardiac arrest managed by an advanced life support (paramedic) service with those in cardiac arrest managed by conventional ambulance service. Management by the paramedic service was associated with higher survival rates for patients found in cardiac arrest but not for patients who suffered the arrest while the ambulance was present. Cardiopulmonary resuscitation by bystanders was associated with a significant increase in survival rates when combined with paramedic services but not when only basic life support services were available.

Allied Health Personnel↗
PubMed1978

The paramedic ambulance: a Canadian experience.

Prehospital critical care provided by specially trained ambulance attendants in New Westminster, BC during a 27-month period was studied. Although the most important benefit of the improved care was the prevention of sudden death in a large proportion of persons with crises due to coronary artery disease, the skills learned to provide basic life support are applicable to a wide variety of other disorders that can result in death before the patient reaches hospital.

Allied Health Personnel↗