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Biomedical subjects

R Goode

Publications and source records attributed to R Goode.

24 records · Page 2Linked to original sources
PubMedDate not supplied

Cyanide poisoning in victims of fire: analysis of 364 cases and review of the literature.

Cyanide is produced by the combustion of natural and synthetic materials. It is assumed that cyanide poisoning is a major component of smoke inhalation injury; however, scientific verification of this assumption is lacking. In this study we examined blood carboxyhemoglobin and cyanide levels in fire fatalities. Carboxyhemoglobin levels of 433 fatalities averaged 44.9% and exceeded fatal (> or = 50%) levels in 195 cases. Cyanide levels of 364 fatalities averaged 1.0 mg/L and exceeded fatal levels (> 3 mg/L) in 31 cases. For victims with cyanide levels above 3 mg/L the mean carboxyhemoglobin level was 62.5%. Cyanide poisoning is infrequent in fire fatalities, and when present it is associated with significant carboxyhemoglobinemia. Cyanide can be both produced and degraded in blood and tissue, making interpretation of blood levels difficult. In survivors of fire, detoxification of cyanide can occur without specific antidotes with the use of aggressive supportive care. Specific assay and treatment for cyanide poisoning is rarely necessary in the treatment of victims of smoke and fire.

Adult↗
PubMedDate not supplied

Substance abuse in victims of fire.

Ethanol or drug use may increase the risk of fire-related injury or death. This study was performed to quantify the role of substance abuse in fatal fires occurring in New Jersey over a 7-year period. Records of all the fatalities of fire reported to the State Medical Examiners Office between 1985 and 1991 were retrospectively examined. Blood assay results for ethanol were positive in 215 of the 727 (29.5%) fatalities of fire tested. For this group, the mean blood-ethanol level was 193.9 mg/dl. Blood or urine assay results for substances of abuse were positive in 78 of the 534 (14.6%) fatalities tested. The most commonly detected illicit substances were cocaine, benzodiazepines, barbiturates, and cannabinoids. The test results were positive for both ethanol and drug use in 36 victims. Forty percent of all the fatalities of fire were aged younger than 11 or older than 70. In contradistinction, 75% of drug-positive fatalities of fire and 58% of ethanol-positive fatalities of fire were between the ages of 21 and 50, suggesting that inebriation may impair the ability to escape from fire. Substance abusers in middle life are a previously unrecognized group at higher risk of injury or death in a fire.

Adolescent↗
PubMedDate not supplied

Organizational support of the clinical nurse specialist role: a nursing research and professional development directorate.

Administrative support is essential for optimal utilization of the Clinical Nurse Specialist (CNS) resource. It has been linked to successful role implementation, role efficacy and job satisfaction. The article addresses how a Nursing Research and Professional Development Directorate (NRPD) provides administrative support of the CNS role. The impact of the directorate on the role functions of practitioner, consultant, educator and researcher is delineated. Specific challenges to the CNS role and organizational benefits are described. A model of organizational support of the CNS, based on the concepts of collaboration and peer mentorship, is proposed. The model emphasizes mutual goal setting to achieve both organizational and professional objectives.

Humans↗