Biomedical subjects

M A Murdock

Publications and source records attributed to M A Murdock.

6 recordsLinked to original sources

PubMed1993

Reported use of autotransfusion systems in initial resuscitation areas by one hundred thirty-six United States hospitals.

INTRODUCTION: The purpose of this study was to determine autotransfusion system availability and use in the initial resuscitation area. METHODS: A 22-item questionnaire was mailed to 290 facilities across the country; 136 (46.8%) were returned. Questions included availability and use of the autotransfusion system, patient population, resistance to the system, frequency of in-service programs, use of anticoagulants, and recommendations regarding the use of autotransfusion systems. RESULTS: One hundred seven hospitals (79%) reported autotransfusion system availability. Frequency of autotransfusion system initiation was as follows: always, 17 (15.9%); most of the time, 34 (31.8%); occasionally, 41 (38.3%); and never, 15 (14%). Not all patients who had an autotransfusion system initiated received shed blood. The most frequent reasons for not using an autotransfusion system were as follows: "not requested by medical staff," n = 50; "no need for autotransfusion system," n = 33; "preferred banked blood," n = 25; and "did not use [often] enough to maintain skill," n = 21. Those with more than one in-service program per year were more likely to use an autotransfusion system than those with one in-service program per year. DISCUSSION: The majority of hospitals surveyed had autotransfusion system availability; however, autotransfusion system use was inconsistent. Two major areas influencing autotransfusion system use were having specific criteria for use and educational factors.

Attitude of Health Personnel↗

PubMed1991

Helmet use improves outcomes after motorcycle accidents.

To determine the effects of motorcycle helmet use on the outcome of patients admitted to a Level I trauma center, we studied patient outcomes and demographic and epidemiologic variables of 474 patients injured in motorcycle collisions and treated at such a center over a 45-month period. Of those involved in a motorcycle collision, 50% were not wearing a helmet, 23% were wearing a helmet, and in 27% helmet use was unknown. Those who were wearing a helmet had fewer and less severe head and facial injuries, required fewer days on a ventilator, and sustained no serious neck injuries; fewer patients who wore helmets were discharged with disability, and hospital charges were lower. These data support the need for both increased public education regarding helmet use and mandatory helmet use legislation.

Accidents, Traffic↗

PubMed1990

Alcohol and trauma. An endemic syndrome.

Injuries are a pervasive and costly problem, and alcohol use appears to be an important risk factor for injury. We examined the blood alcohol levels and selected demographic and epidemiologic variables recorded on trauma patients by 1 trauma center for a 28-month period. A total of 2,262 trauma patients were admitted to the trauma center during this period, of whom 75% were male and 72% were injured in vehicle-related incidents. Blood alcohol levels of 2,095 patients (93%) were measured, and alcohol was present in the blood of 855 (41%). Of those patients with a blood alcohol level done, 32% had a level higher than 100 mg per dl. We conclude that the level of alcohol involvement in trauma is high and that this involvement must be addressed by the medical community and the health care system.

Adolescent↗

PubMed1986

Transection of the thoracic aorta: assessment of a trauma system.

A large, heavily populated area regionalized the care of critical trauma in 1980. To evaluate the system, we reviewed patient outcome for thoracic aortic transection due to blunt injury for the first 18 months of trauma system operation. Of the total of 86 patients, 43 were transferred to trauma centers, 8 to nontrauma centers, and 35 were either directly transported to the coroner or dead on arrival at the hospital. Of the eight patients transported to non-trauma centers, seven were in cardiopulmonary arrest during transport and the eighth was pronounced dead shortly after admission to the emergency department. Twenty-seven of the 43 patients transferred to trauma centers were dead within 24 minutes of admission. The cause of death was rupture of a transected aorta in 22 patients and other multiple injuries in the remaining 5. Sixteen were alive long enough in the emergency department for evaluation. Nine of these patients underwent correction of aortic transection as well as other injuries and all survived. Two of the nine survivors sustained partial or complete spinal cord damage. The remaining seven patients died, but in only one patient did the undiagnosed aortic injury contribute to the cause of death. This patient had a normal cineangiogram and the diagnosis was made at autopsy. He was considered potentially salvageable, so 9 of 10 potentially salvageable patients survived (90 percent). Of the total of 86 patients with aortic transection, 77 died (90 percent). This study shows that regionalization of trauma care offers an excellent chance for survival of patients with thoracic aortic transection.

Accidents, Traffic↗

PubMed1986

A method for evaluating field triage criteria.

The primary goal of triage is to identify the majority of field trauma victims at risk for life-threatening injuries. When triage criteria are made sufficiently sensitive to accomplish this goal, high rates of overtriage occur. Orange County's original physiologic criteria were associated with an overtriage rate of 18-40% depending on the definition of a major trauma victim. During the first year's experience with the original physiologic criteria, 21% of non-CNS motor vehicle trauma deaths occurred in nondesignated hospitals. When the criteria were made more sensitive by adding non-time dependent triage criteria such as anatomic and mechanism of injury criteria, deaths in nondesignated hospitals dropped to 4.4%, but the rate of overtriage doubled. Despite this apparent high rate of overtriage, only 5.5% of all paramedic transports were for patients judged to have met field triage criteria. Based on this experience, an approach is suggested for evaluating the balance between over- and undertriage that occurs for a given set of triage criteria. Once this balance has been defined, triage guidelines can be modified to meet regional triage objectives.

Accidents, Traffic↗

PubMedDate not supplied

Injury prevention: a nursing responsibility.

Injury represents a major health care problem in the United States today. The rise in the number of violent crimes as well as unintentional injuries has touched Americans of all ages and in all socieconomic groups. Advances in prehospital care, acute care, and rehabilitation provided to trauma victims have helped to decrease the toll that trauma takes, but the most effective intervention is to prevent these deaths and injuries from ever occurring. Nurses are in key positions to educate the public on prevention practices, identify injury trends, influence the passage of prevention legislation, and help decrease the number of traumatic deaths and injuries occurring in our society.

Health Education↗