PubMed Health⌕ Search

Biomedical subjects

N Flomenbaum

Publications and source records attributed to N Flomenbaum.

15 recordsLinked to original sources
PubMed2001

Resident interpretation of emergency CT scans in the evaluation of acute appendicitis.

PURPOSE: Radiology resident interpretation of computed tomographic (CT) scans at academic institutions often guides management of cases of suspected acute appendicitis in the emergency department. The purpose of this study was to compare resident and faculty interpretation of CT scans obtained for acute appendicitis. MATERIALS AND METHODS: From December 16, 1999, to July 13, 2000, CT was performed in 103 consecutive patients between the hours of 9:00 PM and 8:00 AM who were suspected of having acute appendicitis. The authors compared the residents' preliminary written interpretations with both the final reports written by the faculty and the surgical findings. The faculty interpreting the CT scans were aware of resident interpretations but were not aware that a study was being conducted. RESULTS: The final faculty interpretation and the preliminary resident interpretation were identical in 96 of the 103 patients (93%; 95% confidence interval: 87.8%, 97.2%). In only one patient was a scan originally interpreted as negative interpreted as positive by the faculty member. Clinically, the patient did not have acute appendicitis, and surgery was not perforrmed. CONCLUSION: In the diagnosis of acute appendicitis, image interpretations made by adequately trained radiology residents can be expected to closely match those of the radiology faculty, and the practice of after-hours interpretation of such studies by radiology residents is safe.

Acute Disease↗
PubMed2000

Alterations of preliminary readings on radiographic examinations minimally affect outcomes of trauma patients discharged from the emergency department.

BACKGROUND: We hypothesized that trauma patients could be discharged safely from the emergency department (ED) before the availability of official readings for their radiologic examinations. We also sought to determine whether trauma patients were more prone to alterations of preliminary interpretations than other ED patients. METHODS: Alterations of preliminary readings (PR) for patients discharged from the ED were reviewed. If the official readings conflicted with the PR used for the patient's disposition, attempts were made to contact the patient and provide the appropriate follow-up. Data recorded included the type of radiographic examination, the presence of a missed injury, and the follow-up. By using institutional data, the incidence of inaccurate PR were compared for trauma patients and other ED patients (chi2 test, Fisher exact test, p < 0.05). RESULTS: Between January of 1998 and December of 1998, 102 of 38,260 discharged ED patients had official readings differing from PR. Forty-three of the changed readings involved 42 of the 1,073 discharged trauma patients, who were more likely to harbor inaccurate PR (<0.0001) than other discharged ED patients. Twenty-eight altered readings involved plain films and 15 involved computed tomographic scans. The most common altered readings involved computed tomographic scans of the head and face (n = 13). Twelve missed injuries were detected, most commonly related to a missed injury of the extremity (7 cases). Nine other cases involved the detection of incidental pathologic conditions. Eight patients required repeat ED visits for clinical and radiographic evaluation, and one patient required subsequent hospital admission. CONCLUSION: Discharged trauma patients are more likely to harbor alterations of preliminary interpretations than other ED patients. Although the official readings for these trauma patients will occasionally reveal previously undetected pathologic conditions, the majority of such cases can be managed with outpatient follow-up.

Diagnostic Errors↗
PubMed1986

Recognition and management of antidepressant overdoses: tricyclics and trazodone.

Serious overdoses associated with tricyclic and tetracyclic antidepressants are frequently lethal. Problems associated with tricyclic antidepressant overdoses are usually the result of an acute or an acute-on-chronic overdosage. The patient who overdoses on tricyclic antidepressants may die, despite every medical effort to save him. An overdose of trazodone significantly differs from an overdose of a tricyclic antidepressant. The currently available clinical data indicate that coma and hypotension are the main concerns with trazodone overdose, and heretofore have been successfully treated with lavage, fluid therapy, and observation.

Adolescent↗
PubMed1984

Management of overdose with psychoactive medications.

General management of the patient who has ingested an overdose of psychoactive medication is emphasized, since the suicidal patient has almost invariably taken multiple substances and often alcohol as well. The drug groups considered in detail include the sedative hypnotics, tricyclic antidepressants, phenothiazines, and lithium.

Antidepressive Agents, Tricyclic↗
PubMed1982

Teaching the recognition of odors.

Odor recognition is a valuable skill for the emergency services provider, particularly when dealing with the poisoned patient. A simple "ten-tube sniffing bar" emphasizing sensory recognition of common toxins in association with representative case histories in an effective emergency services teaching tool. The odor, toxin, case history, and appropriate references are described for each component of the sniffing bar.

Emergency Medicine↗
PubMed1982

Anticholinergic poisoning.

Since the fall of 1979 numerous patients have been brought to emergency departments in New York City after being poisoned with an alcoholic beverage. On admission to the emergency services, they were noted to manifest significant anticholinergic toxicity. An analysis of the case histories, clinical presentations and laboratory data suggests that scopolamine eyedrops were deliberately used to poison these patients.

Adult↗
PubMed1979

Self-administered nitrous oxide: an adjunct analgesic.

In a pilot study of 26 patients, a mixture of 50% nitrous oxide and 50% oxygen (N2O-O2) appeared to be an effective and safe analgesic for the incision and drainage of closed-space infections. The analgesic effect of N2O-O2, as measured by a Mean Analgesic Index, is augmented by both amnesic and dissociative effects, ie, patients remembered experiencing significantly less pain than they complained of during the procedure (p less than .01) and reported significantly more pain than they appeared to be having, as recorded by an observer (p less than .01). The patient's recollected pain, however, correlated well (r = .68) with the observer's assessment. Forty-two percent of patients had undergone a similar or identical procedure in the past without the benefit of N2O-O2 and made uniformly favorable comparative statement concerning the analgesic effect of the gas.

Abscess↗
PubMedDate not supplied

Unstable angina.

Explore the source record for details and available documents.

Angina Pectoris↗