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Biomedical subjects

R Marlin

Publications and source records attributed to R Marlin.

5 recordsLinked to original sources

Bacteriological sampling of postmortem rooms.

Thirty hospital and coroners' postmortem rooms in the West Midlands were visited over two years. The design, environmental facilities, and hygienic practices were investigated and air exchange rates were measured. Microbiological samples were taken from the environment and from gloves, hands, and protective clothing of staff. Glove punctures were also recorded and a plastic isolator evaluated. Bacterial counts in the air were low and related more to the number of people in the room than to the air exchange rate. There was little evidence of the production of aerosol containing bacteria, although splashing occurred while intestines were being washed out. Surfaces often remained contaminated with Gram negative bacilli after cleaning but numbers were considerably reduced on drying. Decontamination of instruments was satisfactory. A wide range of disinfectants and concentrations was used, but none showed evidence of contamination. Gloves were heavily contaminated after use, and occasionally the hands of the wearer after removal of the gloves. Washing the hands effectively removed residual transient organisms, irrespective of the agent used. The incidence of glove punctures was higher among technicians (38%) than pathologists (12%). The plastic isolator reduced smells and limited environmental contamination but visibility and acceptability were poor. The results of the study suggest that there is little evidence of risk of infection to staff, providing basic hygienic precautions are taken, but consideration should be given to the prevention of glove punctures.

Air Microbiology↗

Prehospital care at a major international airport.

Medical emergencies at a major metropolitan airport have a significant impact on prehospital care capabilities for the rest of the community in which the airport is located. Stapleton International Airport in Denver, Colorado, is a facility that in 1985 had 14.4 million passengers and a static employee population of 12,000 to 15,000. In 1981, there were 1,182 ambulance trips to the airport, 40.4% of which did not result in the transport of a patient. The expense of sending an ambulance and fire engine out on such calls was great, and paramedics were out of service for approximately 300 hours on these nontransport cases. In order to improve prehospital services to the airport and the city, a paramedic has been stationed in the concourse at the airport 16 hours a day since 1982. The records for airport paramedic services for the 12 months ending September 1985 were reviewed. Paramedic services were requested for 1,952 patients. Of these, 696 (35.7%) were transported to hospital by ambulance; 115 (5.9%) went by private car; 284 (14.6%) refused any paramedic care or transport; and 857 (43.9%) were released, after base station contact, with instructions to seek definitive care at the final destination. Presenting complaints were classified into 55 categories and the frequencies and dispositions are described. The most common presentations resulting in transport were chest pain, 110 (5.6%); syncope, 60 (3.1%); psychiatric, 57 (2.9%); abdominal pain, 49 (2.5%); seizure, 36 (1.8%); fracture, 31 (1.6%); and cardiac arrest, 29 (1.5%).(ABSTRACT TRUNCATED AT 250 WORDS)

Ambulances↗

Contingently faded heart rate biofeedback: attempted replication of large-magnitude decreases.

McKinney et al. (1980) reported large-magnitude reductions in heart rate (HR) from resting baseline levels, employing shaping and fading techniques and a reinforcement program in which a secondary reinforcer was awarded both contingently and immediately during training. The four male subjects in this group showed significantly greater HR decreases than a group of four males receiving beat-by-beat analogue HR feedback. The present study compared decreases in HR in 20 male subjects receiving the contingently faded biofeedback procedure to those shown by 10 male subjects for whom reinforcement was contingent on vigilant observation of a visual display, and independent of HR. The former group showed significantly greater decreases in HR that could not be attributed to elevated baseline levels. However, the decreases in HR were not as large as those reported by McKinney et al. (1980). It is argued that future research should assess variables contributing to individual differences in performance.

Adolescent↗

The field instructor program: quality control of prehospital care, the first step.

Orientation and evaluation of the new paramedic employee are areas that are frequently overlooked or not performed in a consistent manner. In order to evaluate skills of new employees in a standardized fashion and provide a formal structured orientation, the field instructor program was instituted. Since 1978, 78 people have gone through the program. Sixty-nine (88.5%) successfully completed the course. All of those released in "poor standing" were subsequently dismissed from the paramedic division because of poor medical performance. This program has provided orientation of new paramedics and identified those with serious deficiencies in their practice.

Allied Health Personnel↗