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Biomedical subjects

M Eliastam

Publications and source records attributed to M Eliastam.

At least 19 recordsLinked to original sources
PubMed1991

Role-playing for teaching ethics in emergency medicine.

Ethical issues are becoming increasingly complicated. As with all specialties, emergency medicine has ethical dilemmas unique to the field. We describe a method for teaching students to identify and analyze ethical issues in emergency medicine. The course is designed for clinical medical students and house officers and is structured around various situations in which the students role-play. The course requires about 20 to 30 hours and covers a variety of topics from consent to treatment and confidentiality to teaching and education in the emergency department.

Emergency Medicine↗
PubMed1988

Pacing hazards in helicopter aeromedical transport.

A 62-year-old man with third-degree atrioventricular block and hemodynamically unstable ventricular tachycardia had a cardiac arrest during helicopter transport to a specialized cardiac care unit. Before transport, his ventricular tachycardia had been successfully terminated by a rapid overdrive pacing technique. The failure of "burst suppression" and the absence of pacer spike artifact on the electrocardiographic monitor raise questions about the potential hazards of using various pacing techniques during helicopter transports. Most significantly, this case points to the possibility of interference by exogenous electromagnetic signals in the medical compartment of the helicopter.

Aircraft↗
PubMed1988

Seatbelt cervical injury in an intersection type vehicular collision.

The seatbelt syndrome represents a spectrum of traumatic entities reported in restrained survivors of sudden impact decelerations, who may exhibit bruising of the torso along the site of seatbelt placement. The case is presented of a patient sustaining cervical spine dislocation and quadriplegia attributed to impingement upon a 3-point attachment harness restraint.

Accidents, Traffic↗
PubMed1986

Intravenous diltiazem for the treatment of supraventricular tachycardia.

To determine the effects of diltiazem hydrochloride on patients with paroxysmal supraventricular tachycardia, we administered intravenous diltiazem, 0.25 mg/kg to patients who presented to the Stanford Medical Center Emergency Department with this rhythm. Blood pressure was recorded prior to administration, and monitored for 20 min thereafter. Six of the ten patients converted to sinus rhythm a mean of 7.75 min (+/- 4.4) after drug administration. The remaining four experienced slowing of heart rates from a mean of 177 to 166 beats/min. Systolic blood pressure fell a mean of 12.4 mmHg during treatment, but returned to pretreatment level or higher within 20 min following diltiazem administration. This mean degree of blood pressure reduction compares favorably with effects produced by intravenous verapamil under comparable circumstances. Intravenous diltiazem appears to be a safe and effective drug for the conversion of paroxysmal supraventricular tachycardia.

Adult↗
PubMed1985

Verapamil in the treatment of ventricular tachycardia.

Verapamil, the drug of choice for conversion of most cases of paroxysmal supraventricular tachycardia, has also displayed some efficacy in the treatment of ventricular tachycardia. A case in which the administration of intravenous verapamil resulted in conversion of ventricular tachycardia to sinus rhythm is presented. Experimental and clinical studies of verapamil in the treatment of this arrhythmia have revealed markedly variable results. Verapamil does not appear to be consistently effective in converting ventricular tachycardia. It has, however, demonstrated utility in some instances, especially in cases resistant to more traditional therapeutic agents, as well as relatively unusual forms of ventricular tachycardia. Verapamil may be most effective in suppressing ventricular tachycardia initiated by certain mechanisms.

Aged↗
PubMed1984

Randomized comparison of intravenous versus intracoronary streptokinase for myocardial infarction.

The efficacy of intravenous (i.v.) thrombolytic therapy has not been firmly established in comparison with the intracoronary (i.c.) route of administration. In a randomized trial of 28 patients who underwent angiography before and during i.v. and i.c. administration of streptokinase (STK), recanalization was achieved in 73% of patients who received the drug by the i.c. route, compared with 62% of patients who received the drug by the i.v. route (difference not significant). Reopening took 28 minutes for i.c. STK and 39 minutes for i.v. STK. Patients in whom recanalization was successful using either route of administration had shorter euglobulin lysis times and lower fibrinogen levels than did patients in whom it was not successful (p less than 0.05). Bleeding complications were closely correlated with heparinization after thrombolysis rather than with STK itself. These results in a limited patient series suggest that early administration of i.v. STK in the emergency department may yield recanalization rates similar to those for the i.c. route and may benefit myocardial preservation by restoring flow much earlier.

Aged↗
PubMed1984

The retention of cardiopulmonary resuscitation skills.

Although a great emphasis has recently been placed on training both the medical profession and the general public in cardiopulmonary resuscitation (CPR), studies have demonstrated that retention of resuscitation skills is poor. Although CPR certification is generally valid for a 1- to 2-year period, evaluation of trainees at all levels has demonstrated a marked lack of proficiency over this course of time. This paper reviews the studies that have disclosed this lack of skills retention, as well as proposed solutions and reinforcement techniques. CPR course content and certification criteria must be appropriate to maximize retention as well as learning. To this end a simplification of basic life-support training curricula is recommended.

Certification↗