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Biomedical subjects

R S Erickson

Publications and source records attributed to R S Erickson.

14 recordsLinked to original sources
PubMed1996

Using pressure to decrease the pain of intramuscular injections.

The purpose of this study was to determine if applying pressure to the site for 10 sec prior to an intramuscular injection would reduce injection pain, an approach suggested by anecdotal observation and the gate control theory. The subjects were 93 patients who had dorsogluteal intramuscular injections of immune globulin at a county health department. Forty-eight received the pressure treatment and 45 received a standard injection in which no pressure was applied. Mean pain intensity on a 100-mm visual analogue scale, adjusted for differences in injection volume, was 13.6 mm for the experimental group and 21.5 mm for the control group (P = 0.03). The findings suggest that simple manual pressure applied to the site is a useful technique to decrease injection pain.

Adolescent↗
PubMed1996

Accuracy of chemical dot thermometers in critically ill adults and young children.

Chemical dot thermometers are used widely, but their clinical accuracy is not well documented. Temperature measurements with chemical dot and electronic thermometers were compared at the oral site in 27 adults and the axillary site in 44 adults and 34 young children in critical care units. In adults, mean readings with chemical dot thermometers were lower by -0.4 degrees C orally, but higher by 0.4 degrees C in the axilla. Axillary readings in children did not differ significantly with the two methods, although individual differences of +/- 0.4 degrees C or more were common. Chemical dot thermometers provided rough temperature estimates, performing differently at the oral and axillary sites and in the two age groups.

Adult↗
PubMed1996

Effectiveness of a jet injection system in administering morphine and heparin to healthy adults.

BACKGROUND: Jet injection eliminates the risk of contaminated needlestick injuries when giving intramuscular or subcutaneous medications. Clinical efficacy of the Biojector System was equivalent to that of needle and syringe injection in unpublished trials with vaccines, but had not been studied using other drugs. OBJECTIVE: To compare the effectiveness of the Biojector with conventional needle and syringe injection in administering intramuscular morphine and subcutaneous heparin to healthy adults, as measured by plasma drug concentration. METHODS: Intramuscular injections of morphine 8 mg (5 mg if weight < or = 65 kg) were given 24 hours apart with the jet injector and with a needle and syringe to 30 subjects at the deltoid site and 10 subjects at the dorsogluteal site. Blood samples for plasma concentrations of free morphine were drawn at 15, 30, 45, 60, 120, and 240 minutes and were analyzed using radioimmunoassay. Abdominal subcutaneous injections of heparin 3500 U were given every 8 hours for 5 days with both injection methods to 29 subjects, with 48 hours between the two series. Daily blood samples for plasma heparin were analyzed by colorimetric assay for antifactor Xa activity. RESULTS: Mean free morphine concentration, peak value, and area under the curve did not differ significantly between the deltoid and dorsogluteal sites or between the jet injector and needle and syringe. Values of mean daily heparin concentrations and area under the curve were low and did not differ between the two injection methods. CONCLUSION: Plasma drug concentrations provided by the Biojector were equivalent to those provided by conventional needle and syringe when administering intramuscular morphine and low-dose subcutaneous heparin.

Adult↗
PubMed1995

Effect of cerumen on infrared ear temperature measurement.

This pilot study examined whether the occlusion of one ear canal with cerumen affected the usual temperature difference between the ears as measured with an infrared thermometer. Ear-based temperature measurements were made in 14 elderly nursing home residents before and 3 to 4 days after irrigation to clear cerumen from the occluded ear. The presence of cerumen tended to lower the temperature reading, with a mean change of -0.24 +/- 0.47 degrees F (-0.13 +/- 0.47 degrees C, p = 0.08) and individual differences ranging from -0.9 to 0.4 degrees F (-0.5 to 0.2 degrees C), 43% of subjects (6/14) had values lower by -0.5 degrees F (-0.3 degrees C) or more. The advantage of removing impacted cerumen before making infrared ear temperature measurements may be offset by the time and inconvenience of the irrigation procedure. Improved hearing may be a more important outcome of cerumen removal, with secondary benefit for temperature measurement.

Aged↗
PubMed1994

Accuracy of infrared ear thermometry and other temperature methods in adults.

OBJECTIVE: To compare the accuracy of infrared ear-based temperature measurement in relation to thermometer, ear position, and other temperature methods, with pulmonary artery temperature as the reference. METHODS: Ear-based temperature measurements were made with four infrared thermometers, three in the core mode and two in the unadjusted mode, each with tug and no-tug techniques. Pulmonary artery, bladder (n = 21), and axillary temperatures were read after each ear-based measurement and oral temperature was measured once when possible (n = 32). Subjects consisted of a convenience sample of 50 patients with pulmonary artery catheters who were in adult critical care units of a university teaching hospital. RESULTS: Ear-based measurements correlated well with pulmonary artery temperature (r = .87 to .91), although closeness of agreement differed among thermometer-mode combinations (mean offsets = -0.7 to 0.5 degree C) and had moderately high variability between subjects (SD = +/- 0.5 degree C) with all instruments. Use of an ear tug either made no difference or resulted in slightly lower readings. Bladder temperature was nearly identical to pulmonary artery temperature values (r = .99, offset = 0.0 +/- 0.2 degree C). Oral readings were slightly lower (r = .78, offset = -0.2 degree C) and axillary readings much more so (r = .80 to .82, offset = -0.7 degree C); both were highly variable (SD = +/- 0.6 degree C) and affected by external factors. CONCLUSIONS: Infrared ear thermometry is useful for clinical temperature measurement as long as moderately high variability between patients is acceptable. Readings differ among thermometers, although several instruments provide values close to pulmonary artery temperature in adults. Readings are not higher with an ear tug. Bladder temperature substitutes well for pulmonary artery temperature, whereas oral and axillary values may be influenced by external factors in the critical care setting.

Adult↗
PubMed1993

Comparison of ear-based, bladder, oral, and axillary methods for core temperature measurement.

OBJECTIVE: To determine the accuracy and repeatability of ear-based, bladder, oral, and axillary temperature methods. DESIGN: Prospective, descriptive comparison of the accuracy of four temperature methods in relation to pulmonary artery temperature and the repeatability of each method. SETTING: Critical care units of a university teaching hospital. PATIENTS: Convenience sample of 38 adult patients with indwelling pulmonary artery thermistor catheters. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Ear-based estimates of core temperature with an infrared thermometer and pulmonary artery, bladder, oral, and axillary temperatures with thermistor-based instruments were made every 20 mins for 4 hrs. Mean offsets (+/- SD) from pulmonary artery temperature for each method were as follows: ear-based 0.07 +/- 0.41 degrees C; bladder 0.03 +/- 0.23 degrees C; oral 0.05 +/- 0.26 degrees C; and axillary -0.68 +/- 0.57 degrees C. The accuracy of each method varied with the level of pulmonary artery temperature. Repeated measurements with all four methods had mean SD values within +/- 0.2 degrees C. CONCLUSIONS: Infrared ear thermometry provided a relatively close estimate of pulmonary artery core temperature, although with more variability than bladder or oral methods, while axillary readings were substantially lower than the pulmonary artery temperature and highly variable.

Adult↗
PubMed1991

Effect of aluminized covers on body temperature in patients having abdominal surgery.

An unintended fall in body temperature is commonly associated with surgery. One promising strategy to help conserve body heat is use of covers made of aluminum-coated plastic. We compared the effect of three combinations of the covers (head cover, body covers, both) and a control condition on tympanic temperature in 60 adults having major abdominal surgery under general anesthesia. The covers were applied from the time of transport to the operating room until exit from the postanesthesia care unit (PACU). Tympanic temperature was measured with an infrared thermometer. Between transport and PACU entry, the four groups had mean temperature decreases ranging from 1.6 degrees to 2.3 degrees F (0.9 degree to 1.3 degrees C). After controlling for background variables affecting body temperature, adjusted PACU entry temperature was higher in the two groups with aluminized body covers. Regression analysis showed that use of the body covers accounted for 7% of the temperature variance at PACU entry and predicted a 0.9 degree F (0.5 degree C) higher temperature at that time. These findings indicate that aluminized body covers help to reduce heat loss in patients having major abdominal surgery.

Abdomen↗
PubMedDate not supplied

Comparison of tympanic and oral temperatures in surgical patients.

The purpose of this study was to compare tympanic and oral temperatures at four times during the perioperative period in 60 adults having major abdominal surgery. Tympanic temperature was measured with an infrared thermometer and oral temperature with a predictive thermistor thermometer. Measurements at the two sites were similar in pattern and moderately well correlated. Tympanic temperature was somewhat more sensitive to the effects of an intervention influencing body temperature. The tympanic-oral temperature offset was relatively stable over time, with tympanic readings having a smaller range of values at each measurement. Tympanic temperature measurement variation was fairly small, with 92% of readings reproducible within 0.5 degree F (0.3 degree C); comparable oral data were not available. The findings suggest that the tympanic site offers some advantage, but that either tympanic or oral readings would be satisfactory for routine intermittent monitoring of body temperature during the perioperative period.

Adult↗
PubMedDate not supplied

Accuracy of infrared ear thermometry and traditional temperature methods in young children.

OBJECTIVE: To compare the accuracy of ear-based, rectal, and axillary temperature measurements in comparison to bladder temperature as a core reference. DESIGN: Repeated-measures comparison study. SETTINGS: Pediatric critical care settings in two tertiary care hospitals. PATIENTS: Thirty children, 1 to 45 months old (mean 16.6 months), who required bladder catheters for their care. OUTCOME MEASURES: Correlation and agreement (mean offset +/- SD) of ear-based, rectal, and axillary temperature measurements with bladder temperature. PROCEDURE: Ear-based measurements were made with three infrared thermometers in the core mode, both with and without an ear tug. All six readings were made in the same ear in randomized order. Bladder, rectal, and axillary temperatures were read from continuous digital displays immediately after each ear-based measurement. RESULTS: Ear-based readings correlated relatively well with bladder temperature (r = 0.80 to 0.87), but were lower by means of -0.3 degrees to -0.7 degrees C with moderately high variation (SD = 0.4 degrees to 0.5 degrees C) between children. Use of an ear tug did not affect the readings. Rectal temperature correlated well with bladder values (r = 0.93 to 0.97) and was usually slightly higher (mean offset = 0.2 +/- 0.2 [SD] degrees C), while axillary temperature correlated rather poorly (r = 0.59 to 0.64), with much lower and more variable readings (mean offset = 0.9 degrees +/- 0.6 degrees C). In regard to sensitivity, specificity, and predictive value in screening for fever, rectal readings performed very well, ear-based readings moderately well with some variation, and axillary readings poorly. CONCLUSIONS: The findings suggest that the additive core-mode adjustments in infrared ear thermometers are too low for young children, an ear tug is not an essential part of measurement technique, rectal temperature closely reflects bladder temperature, and axillary temperature is low and highly variable.

Age Factors↗