Biomedical subjects

P M Wax

Publications and source records attributed to P M Wax.

3 recordsLinked to original sources

PubMed1992

Rapid quantitative determination of blood alcohol concentration in the emergency department using an electrochemical method.

STUDY OBJECTIVE: To determine the reliability of a recently developed electrochemical meter to rapidly (within 60 seconds) measure blood alcohol concentration (BAC) in the emergency department. DESIGN: A prospective study comparing the meter data with that of immunoassay and gas chromatography criterion standards undertaken during a ten-week period. SETTING: Adult ED of a municipal hospital. PARTICIPANTS: Three hundred eighty-three consecutive patients with altered mental status or suspected alcohol intoxication. INTERVENTIONS: Each patient underwent routine phlebotomy, and blood samples were obtained for meter and immunoassay BAC determinations. The first 60% of patients also underwent gas chromatography BAC determination. RESULTS: Two hundred nineteen patients (60%) had BAC detectable by both meter and immunoassay. BAC measurement by the meter correlated strongly with immunoassay and gas chromatography determinations (Pearson's correlation coefficient, r = .94; P less than .00000001 for both correlations). CONCLUSION: The electrochemical meter provides a rapid and reliable BAC measurement in the ED.

Adolescent↗

PubMed1992

Decreased plasma cholinesterase activity enhances cocaine toxicity in mice.

The illicit use of cocaine continues in epidemic proportions. Despite the incidence of life-threatening complications from cocaine use, little is known of the individual determinants of cocaine toxicity. In vitro analysis demonstrating that cocaine is poorly metabolized by the serum of patients with low plasma cholinesterase (PCh) activity (succinylcholine sensitivity) led to the hypothesis that altered PCh activity might modulate cocaine toxicity. An in vivo mouse model was created to test this theory. Mice were pretreated s.c. with either parathion [a mixed plasma and red blood cell cholinesterase (RBCCh) inhibitor], tetraisopropyl pyrophosphoramide (a selective PCh inhibitor) or placebo, and cholinesterase activity was determined at 24 hr. Incremental doses of i.p. cocaine were administered in a controlled and blinded fashion, and lethality was observed. Ten mg/kg s.c. parathion produced a mean suppression of 68 +/- 9 and 61 +/- 8% of PCh and RBCCh activity, respectively. One mg/kg s.c. tetraisopropyl pyrophosphoramide produced a mean suppression of 78 +/- 3 and 9 +/- 8% of PCh and RBCCh activity, respectively. Each pretreatment produced a statistically significant increase in cocaine lethality throughout the dose-response curve. Our results suggest that PCh activity is an important determinant of cocaine toxicity. This effect appears to be independent of either RBCCh activity or manifestations of organophosphate intoxication.

Animals↗

PubMed1989

Advances in cutdown techniques.

Emergency Department physicians must be expert in rapidly obtaining adequate intravenous access. Cutdown techniques are an essential part of this endeavor. We have described the step-by-step techniques of placement of a variety of upper- and lower-extremity cutdowns in the Emergency Department.

Bloodletting↗