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Biomedical subjects

P McFeeley

Publications and source records attributed to P McFeeley.

10 recordsLinked to original sources
PubMed1997

Motor vehicle crashes and maternal mortality in New Mexico: the significance of seat belt use.

In recent years, as deaths from medical complications during pregnancy have declined, injuries-specifically those sustained in motor vehicle crashes-represent a growing proportion of all pregnancy-associated deaths. To investigate pregnancy-associated deaths in motor vehicle crashes in New Mexico, we scrutinized the database of the New Mexico Office of the Medical Investigator for all deaths during pregnancy and up to 6 weeks postpartum from 1986 through 1995. A total of 97 deaths were identified, 47 of which were injury-related. Motor vehicle crashes accounted for 33 (approximately 70%) of the injury-related deaths. We analyzed the data on motor vehicle crashes for decedent's age and ethnicity, fetal gestational age, time of crash, rural vs urban location of crash, seat belt use, and drug and alcohol use. Compared with non-Hispanic white women, proportionately higher numbers of Hispanic and American Indian pregnant women were killed in motor vehicle crashes. In searching for modifiable risk factors, we noted that 45% of the crashes involved alcohol and that the majority of pregnant women killed (77%) were not wearing seat belts at the time of the crash. We conclude that education about seat belt use during pregnancy (as well as the dangers of alcohol use and riding with intoxicated drivers while pregnant) is a promising strategy to reduce motor vehicle fatalities.

Accidents, Traffic↗
PubMed1993

Sensitivity of multiple-cause mortality data for surveillance of deaths associated with head or neck injuries.

PROBLEM/CONDITION: Multiple-cause mortality data was assessed as a source of information for surveillance of deaths associated with head or neck injuries. REPORTING PERIOD COVERED: 1985-1986 DESCRIPTION OF SYSTEM: Data on causes of death were abstracted from death certificates in New Mexico and coded according to criteria of the International Classification of Diseases, Ninth Revision (ICD-9). Deaths with an external cause-of-death (E) code as the underlying cause of death and one or more head or neck injury nature-of-condition (N) codes as contributing causes of death were considered head or neck injury deaths. These data were compared with data for head or neck injury deaths obtained from computerized records from the New Mexico Office of the Medical Investigator (OMI). Data for alcohol or drug use were abstracted from both systems. RESULTS: Of the 699 head or neck injury deaths coded by the New Mexico OMI system in 1985-1986, 536 were identified as head or neck injury deaths in multiple-cause mortality data (sensitivity = 76.7%). Firearms were the leading cause of head or neck injury deaths, followed by motor vehicles. Multiple-cause mortality data contained alcohol codes for only 3.7% of OMI records with blood alcohol concentrations > or = 0.10 mg/dL and contained drug codes for none of the OMI records with positive toxicology tests for drugs. INTERPRETATION: The sensitivity of multiple-cause mortality data was relatively high for surveillance of head and neck injury deaths.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidental Falls↗
PubMed1993

Cricothyrotomy performed by prehospital personnel: a comparison of two techniques in a human cadaver model.

Little is known about the proficiency of prehospital personnel when performing cricothyrotomies. The authors compared two techniques for establishing an airway through the cricothyroid membrane used by paramedic students. One technique used a prepackaged kit that consisted of a dilator that is passed percutaneously through a breakaway needle. This percutaneous device (PD) was compared with a standard surgical approach (SA) using a scalpel and endotracheal tube. Data was collected on a total of 44 paramedic students who were allowed to attempt each of the procedures. No significant difference in the success rate on the first attempt was found between the two procedures (86% for the SA and 73% for the PD; P = .186). The surgical approach was significantly faster (46 +/- 17 seconds v 103 +/- 62 seconds; P < .01). It was also judged to be significantly easier to perform when evaluated on a linear analog scale (SA, 2.6 +/- 2.0 v PD, 5.1 +/- 2.8; P < .001). Because some procedures were performed on cadavers whose cricothyroid membranes had already been violated, the procedures performed on intact membranes only were also analyzed. Similar, statistically significant differences for insertion time and ease of insertion were again found. Prehospital personnel can be trained to perform cricothyrotomies with a reasonable degree of proficiency. A traditional surgical approach, however, may be faster and less difficult to perform than a comparable procedure using a commercially available percutaneous device.

Airway Obstruction↗
PubMed1993

Diarrheal deaths in children living in New Mexico: toward a strategy of preventive interventions.

We reviewed 26 childhood diarrheal deaths examined by the New Mexico Office of the Medical Investigator, from 1980 through 1989, to identify circumstances surrounding the illness that might lead to strategies for prevention. Children who died were younger than 9 months of age (88%) and were from minority groups (American Indian 54%, Hispanic 23%); 12 (46%) had seen a physician within 3 days of death. Interventions to avert these deaths include educating parents to seek earlier treatment and health care providers to recognize that acutely dehydrating diarrhea can be fatal.

Diarrhea, Infantile↗
PubMed1991

Accidental firearm fatalities among New Mexico children.

STUDY HYPOTHESIS: Risk factors associated with unintentional gunshot fatalities among children include gender and race of the decedent, type of firearm used, and whether loaded guns are stored within the home. STUDY POPULATION: All New Mexico children 0 to 14 years old unintentionally killed by a firearm between 1984 and 1988. METHODS: The New Mexico Office of the Medical Investigator master mortality file was reviewed retrospectively to identify all unintentional firearm fatalities occurring in New Mexico children during a five-year period. Medical investigator, autopsy, and police reports were analyzed to identify epidemiologic factors associated with these deaths. Chi-square and Fisher's exact tests were used to analyze the data. RESULTS: Twenty-five unintentional firearm fatalities were identified. These deaths occurred most frequently among children playing with loaded firearms found within the home. A disproportionate number involved handguns. CONCLUSIONS: The study results provide a basis for preventive strategies that limit accessibility or decrease lethality of loaded firearms within the home.

Accident Prevention↗
PubMed1989

Increased pedestrian mortality among the elderly.

Elderly pedestrians struck by motor vehicles have the highest mortality rate of all pedestrian injury victims. One thousand eighty-two motor vehicle-pedestrian accidents occurring in a metropolitan area over a 5-year period were studied. Age-specific injury rates and fatality rates were evaluated with respect to the injury severity scores (ISS) for all fatally injured autopsied pedestrians. Of the 1,082 injuries, 131 fatalities occurred. Mean ISSs were found to be significantly higher for pedestrians dying at the scene of the accident (mean ISS, 54.83) and higher for those dying in the emergency department (mean ISS, 45.18), than for pedestrians who died in the hospital (mean ISS, 30.57) (P less than .0001). The mortality rate for pedestrians aged greater than or equal to 60 years was substantially higher than for those adults aged less than 60 years of age (P less than .001). Elderly patients involved in accidents were much more likely to die than younger pedestrians (44.6% v 10.4%; P less than .0001). Elderly pedestrians were significantly overrepresented in the group of pedestrians dying in the hospital compared with younger injury victims (52.5% v 21.5%; P less than .008). This study shows that elderly pedestrians struck by motor vehicles die at a higher rate because they succumb to injuries in the hospital more frequently than younger pedestrians. This may reflect the greater susceptibility of the elderly to metabolic, surgical, and infectious complications after admission to the hospital. A decrease in mortality rates of elderly patients suffering pedestrian injuries will probably follow improved in-hospital intensive care services for the elderly.

Accidents, Traffic↗
PubMed1988

Traumatic asphyxia in New Mexico: a five-year experience.

Compression of the chest causing facial petechiae, violaceous facial hue, subconjunctival hemorrhages, and frequent mental status abnormalities has been termed traumatic asphyxia. We identified 35 such cases occurring in the State of New Mexico from 1980 to 1985 from records of the Office of the Medical Investigator (n = 30) and from cases presenting to the University of New Mexico Trauma Center (n = 5). Among those found at highest risk for traumatic asphyxia were people ejected from motor vehicles, men working under cars that were inadequately supported and fell onto the victims, children under the age of 5 years who were crushed under household furniture, and people involved in construction activities. Traumatic asphyxia following a moving motor vehicle accident was significantly associated with alcohol ingestion (p less than 0.001). Preventive and therapeutic strategies should focus on the groups and events identified.

Accidents↗
PubMedDate not supplied

Right atrial tunnel to the left atrial appendage: a danger during balloon septostomy.

Right atrial tunnel to the left atrial appendage is a very rare anomaly not previously described. Per se, it has no physiological significance but is a source of potential disaster during balloon atrial septostomy. The precise anatomy is demonstrated and ways are proposed to avoid tearing the atrial wall during therapeutic cardiac catheterization.

Catheterization↗
PubMedDate not supplied

Fatality resulting from cyclizine overdose.

A case involving an overdose fatality of cyclizine is presented. Toxicological analysis revealed a cyclizine blood concentration of 80 micrograms/mL. The drug was quantified by gas chromatography/mass spectrometry (GC/MS). Qualitative analyses of urine and stomach contents were performed.

Adolescent↗