PubMed Health⌕ Search

Biomedical subjects

R M Walls

Publications and source records attributed to R M Walls.

At least 19 recordsLinked to original sources
PubMed1992

Airway management in the blunt trauma patient: how important is the cervical spine?

Emergency airway management in the patient with blunt trauma is a clinical dilemma. Many of these patients require immediate airway management, but each method carries its own set of risks and benefits. At the heart of the issue is the long-standing belief that oral intubation is hazardous in the presence of an unstable injury to the cervical spine. In this article, the issues surrounding selection of an appropriate technique for airway management are reviewed critically. Recommendations are made for management of the airway in this high-risk group of patients with injury to the cervical spine.

Airway Obstruction↗
PubMed1988

Evidence of increased class I MHC expression on human peripheral blood lymphocytes during acute ethanol intoxication.

Certain ethanol-related diseases in humans have been linked to disorders of immunity. Although humoral and cellular immunity have been studied, the precise mechanisms whereby ethanol use leads to tissue damage remain unknown. In order to explore the hypothesis that ethanol may lead to alteration in expression of tissue Class I major histocompatibility antigen causing an autoimmune phenomenon, a population of acutely ethanol-intoxicated patients was studied. Measurement of Class I major histocompatibility antigen on peripheral blood lymphocytes in this population showed a highly significant (p less than 0.01) increase over controls. The role that this increased antigenicity may play in the evolution of clinical disease is discussed.

Adult↗
PubMed1988

Cricothyroidotomy.

Cricothyroidotomy is a technique used to gain emergency access to the airway through the cricothyroid membrane. Although its use should be reserved for specific circumstances, the procedure is safe and can be performed rapidly. Knowledge of the anatomy of the anterior neck and a specific sequence for performing the cricothyroidotomy generally will result in a good success rate and acceptable complications.

Airway Obstruction↗
PubMed1987

Case report: Brown-Séquard's syndrome associated with histiocytic lymphoma.

Brown-Séquard's syndrome is a rare spinal cord lesion usually produced by penetrating injuries in which ipsilateral hemiparesis and loss of position sense is associated with loss of pain and temperature sensation on the opposite side of the body. Reported here is an unusual cause of the syndrome, and a review of the pathophysiology of the syndrome is presented.

Adult↗
PubMed1987

Stab wounds to the abdomen: failure of blunt probing to predict peritoneal penetration.

A study was conducted to examine the usefulness of blunt probing for evaluation of penetrating abdominal trauma. Ten anesthetized adult beagles weighing 8 to 17 kg were sacrificed by ventricular fibrillation following a standardized resuscitation protocol. Immediately thereafter, the abdomen was shaved and ten stab wounds were placed in the abdomen of each dog with #11 blade. A separate individual probed the wounds sequentially with a cotton swab and predicted on the basis of this examination whether the wound penetrated the parietal peritoneum (deep) or not (superficial). The abdomen then was opened and reflected, by a midline incision, and peritoneal penetration was verified visually by two observers. Statistical analysis of data was performed using the z test for binomial proportions. Fifty-nine of the 100 wounds were found to penetrate the parietal peritoneum. Examiners predicted 35 correctly, but called 24 of 59 superficial. Thirty-eight of 41 superficial wounds were identified correctly; three were incorrectly called deep. Sensitivity was .59 (z = 1.432, P greater than .5); specificity was .93 (z = 5.466, P less than .001). Blunt probing may be a useful technique if peritoneal penetration is determined, but it is inaccurate in predicting peritoneal nonpenetration. If violation of the peritoneum is not determined with this technique, other methods must be used.

Abdominal Injuries↗
PubMed1986

Hyperkalemia: ECG manifestations and clinical considerations.

Hyperkalemia is a common cause of electrolyte induced cardiac conduction disturbance. A well-defined series of changes at the cellular level leads to characteristic evolutionary changes in the surface electrocardiogram. Initial high T waves and shortened intervals give way to prolongation of conduction and lethal dysrhythmias as the serum potassium level rises. The patterns of electrocardiographic changes associated with hyperkalemia are reviewed and an outline of appropriate therapeutic interventions.

Aged↗
PubMed1985

Acute pericarditis.

There are many causes of acute pericarditis (inflammation of the pericardium) and diagnosis is often difficult owing to the dynamic nature of the disease. History and physical examination, augmented by radiographic and ECG studies, will allow the diagnosis to be made in the majority of cases. The ECG typically undergoes a four-stage evolution, and frequent reassessment of the patient is essential. Outpatient treatment is usually successful, although a subgroup of these patients require hospitalization.

Acute Disease↗
PubMed1985

QT interval prolongation.

The QT interval is a function of ventricular repolarization time and is measured from the onset of the QRS complex to the end of the T wave. The length of this interval is inversely related to heart rate. A prolonged QT interval is most often secondary to the use of Type I antidysrhythmic medications (quinidine, procainamide). It is also associated with phenothiazines, organophosphates, hypocalcemia, liquid protein diets and the congenital long QT syndromes. QT prolongation is associated with a variety of ventricular dysrhythmias, most characteristically Torsades des pointes. Treatment consists of correction of the underlying metabolic disorder or discontinuation of the offending medication.

Adrenergic beta-Antagonists↗
PubMed1984

Traumatic dislocation of the knee.

Traumatic dislocation of the knee is an uncommon orthopedic injury affecting primarily young males who have been subjected to major trauma. The presentation may be subtle and the diagnosis is frequently overlooked. The high frequency of associated limb-threatening vascular injury mandates careful search for and aggressive treatment of this entity, as misdiagnosis of the knee injury or failure to pursue evaluation of the vascular status of the limb will result in a large number of potentially avoidable amputations.

Emergencies↗
PubMed1984

Case report: common femoral artery occlusion following blunt trauma in a child.

Vascular injury from blunt trauma is infrequently seen in children unless associated with major trauma. This case report is an example of a significant vascular injury in the setting of minor trauma. The consequences of missing such an injury as well as some of the difficulties encountered in establishing the diagnosis are discussed.

Child, Preschool↗