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Biomedical subjects

M Canter

Publications and source records attributed to M Canter.

4 recordsLinked to original sources
PubMed1998

Suicide by cop.

STUDY OBJECTIVE: "Suicide by cop" is a term used by law enforcement officers to describe an incident in which a suicidal individual intentionally engages in life-threatening and criminal behavior with a lethal weapon or what appears to be a lethal weapon toward law enforcement officers or civilians to specifically provoke officers to shoot the suicidal individual in self-defense or to protect civilians. The objective of this study was to investigate the phenomenon that some individuals attempt or commit suicide by intentionally provoking law enforcement officers to shoot them. METHODS: We reviewed all files of officer-involved shootings investigated by the Los Angeles County Sheriff's Department from 1987 to 1997. Cases met the following criteria: (1) evidence of the individual's suicidal intent, (2) evidence they specifically wanted officers to shoot them, (3) evidence they possessed a lethal weapon or what appeared to be a lethal weapon, and (4) evidence they intentionally escalated the encounter and provoked officers to shoot them. RESULTS: Suicide by cop accounted for 11% (n=46) of all officer-involved shootings and 13% of all officer-involved justifiable homicides. Ages of suicidal individuals ranged from 18 to 54 years; 98% were male. Forty-eight percent of weapons possessed by suicidal individuals were firearms, 17% replica firearms. The median time from arrival of officers at the scene to the time of the shooting was 15 minutes with 70% of shootings occurring within 30 minutes of arrival of officers. Thirty-nine percent of cases involved domestic violence. Fifty-four percent of suicidal individuals sustained fatal gunshot wounds. All deaths were classified by the coroner as homicides, as opposed to suicides. CONCLUSION: Suicide by cop is an actual form of suicide. The most appropriate term for this phenomenon is law enforcement-forced-assisted suicide. Law enforcement agencies may be able to develop strategies for early recognition and handling of law enforcement-forced-assisted suicide (suicide by cop). Health care providers involved in the evaluation of potentially suicidal individuals and in the resuscitation of officer-involved shootings should be aware of law enforcement-forced-assisted suicide as a form of suicide.

Adolescent↗
PubMed1990

Anesthesia for angioembolization of brain arteriovenous malformations: a retrospective assessment.

We reviewed the anesthetic management of 55 patients under 18 years of age during angioembolization of arteriovenous malformations. Patients were grouped according to age: less than 1 month (A), 1-11 months (B), 1-5 years (C) and 7-13 years (D). All had general endotracheal anesthesia. In groups A and B, approximately 43% received pure narcotic and 43% balanced while only 14% had pure inhalational anesthesia. In groups C and D, 41 and 52% received pure inhalation and balanced anesthesia, respectively, while only 7% had pure narcotics. Hypotension was induced in 50% (C and D) and in 20% (A and B) of the patients. Intraoperative lasix or phlebotomy was used in 28, 16, 13 and 0% of groups A, B, C and D, respectively. Two arrests occurred immediately after the injection of the embolizing material. From our review, no single type of anesthesia can be advocated over all others. The use of invasive monitoring (arterial and central venous lines), precise fluid management and the avoidance of nitrous oxide will help to decrease the incidence of intraoperative complications during anesthesia.

Anesthesia, General↗
PubMed1989

Sufentanil pharmacokinetics in neurosurgical patients.

The effects of respiratory alkalosis and dehydration on the pharmacokinetics of sufentanil have been determined. Forty neurosurgical patients entered the study: group I (n = 20) had spinal surgery while group II (n = 20) had elective craniotomies. All patients received a single intravenous bolus of sufentanil (2 micrograms/kg) during induction of anesthesia. Patients in group II received furosemide (40 mg) and mannitol (1 g/kg) prior to surgery and were hyperventilated to a PaCO2 below 30 mmHg. The anesthetic management was identical in both groups. Arterial blood samples were collected to determine sufentanil concentrations (RIA), blood gases, pH, hematocrit and electrolytes. Patients in group II had significantly higher blood pH and urinary output when compared to group I (p less than 0.05). Plasma sufentanil concentrations were best fitted to a bi-exponential curve and the pharmacokinetic variables calculated using a curve stripping program (STRIPE). No significant differences were observed between groups regarding plasma sufentanil concentrations or pharmacokinetic parameters. Our results demonstrate that respiratory alkalosis and dehydration do not alter the pharmacokinetics of sufentanil after intravenous bolus administration.

Alkalosis↗