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Biomedical subjects

T G Price

Publications and source records attributed to T G Price.

7 recordsLinked to original sources
PubMed2001

Emergency department management of occupational exposures: cost analysis of rapid HIV test.

OBJECTIVE: To compare costs for evaluation and treatment of a healthcare worker (HCW) experiencing an occupational exposure, using a rapid human immunodeficiency virus (HIV) test versus a standard enzyme-linked immunosorbent assay (ELISA) HIV test. DESIGN: Retrospective chart review of all HCWs presenting to the emergency department (ED) for care of an occupational exposure over a 13-month period. SETTING: A 404-bed university-based level 1 trauma center with an annual ED census of approximately 35,000. PARTICIPANTS: All HCWs experiencing an occupational exposure treated in the ED using a rapid HIV protocol were included in the analysis. METHODS: A calculation of selected costs of the initial evaluation and treatment of patients whose evaluation included a rapid HIV test on the source patient were performed. A similar calculation was then made for these patients, had the standard ELISA test been used. Evaluated costs included laboratory tests, postexposure prophylactic medications, and estimated lost work time. Other costs were constant and were not included in the evaluation. RESULTS: Total evaluated cost using the rapid HIV test as part of the evaluation and treatment protocol was $465.80 for 17 patients. Had the ELISA test been used instead of the rapid test, the total evaluated cost for the 17 patients would have been $5,965.81. CONCLUSIONS: When used as part of the evaluation and treatment of the HCW with an occupational exposure, the rapid HIV test results in substantial cost savings over the ELISA test .

AIDS Serodiagnosis↗
PubMed2000

Infant hypernatremia: a case report.

A 7-month-old infant presented to the emergency department with diarrhea, vomiting, and decreased activity. The infant was febrile, tachycardic, tachypneic, lethargic, and had a prolonged capillary refill. Initial serum sodium was 197 mmol/L. Ultimately, the infant was diagnosed with central diabetes insipidus complicated by severe dehydration secondary to rotavirus infection. A brief review of infant hypernatremia and its evaluation and treatment in the emergency department follows.

Dehydration↗
PubMedDate not supplied

Changes in hearing acuity in ambulance personnel.

OBJECTIVES: To determine whether emergency medical technicians (EMTs) and paramedics suffer excessive hearing loss as a result of occupational noise exposure. A secondary objective was to determine noise levels in a modern ambulance. METHODS: This retrospective study reviewed audiograms for EMTs and paramedics currently employed by the Louisville Emergency Medical Services. The age-adjusted threshold shift was calculated for the right and left ears at 1,000, 2,000, and 4,000 Hz in 81 of these individuals. Seventy-four of the subjects also had measurements that allowed similar calculations at 3,000 Hz in both ears. The age-adjusted threshold shift was then correlated with the elapsed time. Second, noise levels were measured inside an ambulance at several times during an eight-hour shift. RESULTS: The correlation coefficient of age-adjusted threshold shifts and elapsed time was greatest at 2,000 Hz in the left ear but was still not significant at -0.2692. The noise levels in the ambulance ranged from 58 dBA in the patient compartment while stationary to 84 dBA in the forward cab with the windows down and the siren in use. CONCLUSION: There was no significant correlation between the number of months elapsed between audiograms and the age-adjusted threshold shift at any frequency in either ear. There appears to be no excessive loss of hearing acuity in ambulance personnel. The noise levels in the study ambulance stayed well below the Occupational Safety and Health Administration (OSHA) guidelines.

Adult↗
PubMedDate not supplied

The effectiveness of lights and siren use during ambulance transport by paramedics.

OBJECTIVES: To determine whether lights and siren (L&S) use during transport in the authors' EMS system results in reduced transport time to the hospital. Second, to determine whether L&S use results in any emergency department critical interventions in the time saved. METHOD: A convenience sample of transport times were measured for 75 ambulances traveling to the hospital with L&S and compared with measured simultaneous transport times for a personal observer vehicle traveling the same route as the ambulance. Upon hospital arrival, the driver of the observer vehicle proceeded to the patients' locations and noted the medical interventions accomplished at the hospital prior to his arrival. Interventions were reviewed to identify time-critical interventions that would have been delayed without L&S use. RESULTS: The mean ambulance transit time was 666 seconds and the mean observer transit time was 896 seconds. The mean difference in ambulance (L&S) transit time and the observer (no L&S) transit time was 230 seconds (3 min, 50 sec). There was a statistically significant correlation between transit time difference and number of stoplights encountered, traffic intensity, and distance traveled. Of the 75 patients transported, four patients were felt to have benefited clinically by the time saved. CONCLUSIONS: Use of L&S significantly shortens transport time. In this series of patients transported under the care of a paramedic, the time saved by the use of L&S was not usually associated with immediately apparent clinical significance.

Ambulances↗