Biomedical subjects

Richard D Zane

Publications and source records attributed to Richard D Zane.

4 recordsLinked to original sources

PubMed2006

Comminuted femur fracture secondary to stress during the Boston marathon.

We report a case of a comminuted femur fracture secondary to repetitive stress in a healthy marathon runner. Stress fractures are common orthopedic injuries that result from normal muscular activity on deficient bone ("insufficiency fractures") or excessive, repetitive stresses on normal bone ("fatigue fractures"). Of recreational and professional sports, running accounts for a higher incidence of stress fractures, which have been reported to cause up to 15% of all injuries to runners. We report a case of a sub-trochanteric comminuted femoral stress fracture in a female marathon runner.

Female↗

PubMed2004

Lightning injuries.

Lightning is persistently one of the leading causes of death caused by environmental or natural disaster. To understand the pathophysiology and treatment of lightning injuries one must first discount the innumerable myths, superstitions, and misconceptions surrounding lightning. The fundamental difference between high voltage electrical injury and lightning is the duration of exposure to current. Reverse triage should be instituted in lightning strike victims because victims in cardiopulmonary arrest might gain the greatest benefit from resuscitation efforts, although there is no good evidence suggesting that lightning strike victims might benefit from longer than usual resuscitation times. Many of the injuries suffered by lightning strike victims are unique to lightning, and long-term sequelae should be anticipated and addressed in the lightning victim.

Burns, Electric↗

PubMed2003

Panic disorder and emergency services utilization.

OBJECTIVES: The characteristics of patients with panic disorder in emergency department (ED) patient populations are unknown. This study compares demographic information and emergency care use among patients identified as having a high likelihood of having panic disorder with that of patients who tested negative on the screening test for panic disorder. METHODS: Prospective cross-sectional study of a convenience sample of patients presenting to an urban ED. Patients were excluded if they were aged 18 years or younger, were unstable, or could not speak English or Spanish. Of 968 patients, 813 agreed to participate. Over a period of 23 days, patients were administered a Diagnostic and Statistical Manual (DSM)-IV screening questionnaire (PRIME-MD) for panic disorder along with a survey assessing their use of medical services during the prior year. RESULTS: One hundred patients (12.3%) met PRIME-MD criteria for having a high likelihood of panic disorder. Patients with Medicare were 2.84 times more likely to have a positive result on the screening test than those without insurance. Patients who had four to seven ED visits or eight or more ED visits in one year were 2.63 and 3.10 times more likely to screen positive on the PRIME-MD, respectively, compared with those who had one to three visits. Patients who activated 911 two to ten times or 11 or more times in one year were 2.02 and 4.99 times more likely to screen positive for panic disorder, respectively, compared with those who had never activated 911. CONCLUSIONS: Patients who screen positive for panic disorder use emergency medical services and ED services more frequently. In addition, the overall prevalence of screening positive for panic disorder in an ED is higher than previously reported.

Adult↗

PubMedDate not supplied

Implementing the Hospital Emergency Incident Command System: an integrated delivery system's experience.

INTRODUCTION: Hospital disaster manuals and response plans often lack formal command structure; instead, they rely on the presence of key individuals who are familiar with hospital operations, or who are in leadership positions during routine, day-to-day operations. Although this structure occasionally may prove to be successful, it is unreliable, as this leadership may be unavailable at the time of the crisis, and may not be sustainable during a prolonged event. The Hospital Emergency Incident Command System (HEICS) provides a command structure that does not rely on specific individuals, is flexible and expandable, and is ubiquitous in the fire service, emergency medical services, military, and police agencies, thus allowing for ease of communication during event management. METHODS: A descriptive report of the implementation of the HEICS throughout a large healthcare network is reviewed. RESULTS AND CONCLUSIONS: Implementation of the HEICS provides a consistent command structure for hospitals that enables consistency and commonality with other hospitals and disaster response entities.

Delivery of Health Care, Integrated↗