Pub Date : 1979-11-01DOI: 10.1016/S0361-1124(79)80061-1
MD Donald R. Kamens, MD Robert L. Wears, MD Cleve Trimble
Prompt blood-gas analysis consisting of pH, PCO2, and PO2 is now almost universally accessible. PCO2 directly conveys the role of the respiratory mechanism in any acid-base disturbance. The metabolic condition, however, is hidden in a relationship between pH and PCO2 that is most faithfully expressed by the cumbersome Henderson-Hasselbalch equation (HHE). Two methods of quickly determining metabolic status from pH and PCO2, without resorting to the HHE, are discussed. The first method is well known and adjusts pH to represent only metabolic state by quantitatively cancelling the influence of hyper- or hypoventilation. The second method, not previously reported, uses measured pH to estimate the ratio HCO3−/PCO2, which, when multiplied by PCO2, equals bicarbonate ion concentration.
{"title":"Circumventing the Henderson-Hasselbalch equation","authors":"MD Donald R. Kamens, MD Robert L. Wears, MD Cleve Trimble","doi":"10.1016/S0361-1124(79)80061-1","DOIUrl":"10.1016/S0361-1124(79)80061-1","url":null,"abstract":"<div><p>Prompt blood-gas analysis consisting of pH, PCO<sub>2</sub>, and PO<sub>2</sub> is now almost universally accessible. PCO<sub>2</sub> directly conveys the role of the respiratory mechanism in any acid-base disturbance. The metabolic condition, however, is hidden in a relationship between pH and PCO<sub>2</sub> that is most faithfully expressed by the cumbersome Henderson-Hasselbalch equation (HHE). Two methods of quickly determining metabolic status from pH and PCO<sub>2</sub>, without resorting to the HHE, are discussed. The first method is well known and adjusts pH to represent only metabolic state by quantitatively cancelling the influence of hyper- or hypoventilation. The second method, not previously reported, uses measured pH to estimate the ratio HCO<sub>3</sub><sup>−</sup>/PCO<sub>2</sub>, which, when multiplied by PCO<sub>2</sub>, equals bicarbonate ion concentration.</p></div>","PeriodicalId":75959,"journal":{"name":"JACEP","volume":"8 11","pages":"Pages 462-466"},"PeriodicalIF":0.0,"publicationDate":"1979-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0361-1124(79)80061-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11263301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1979-11-01DOI: 10.1016/S0361-1124(79)80066-0
MD Roy A.M. Myers, PhD Steven E. Linberg, MD R Adams Cowley
{"title":"Carbon monoxide poisoning: The injury and its treatment","authors":"MD Roy A.M. Myers, PhD Steven E. Linberg, MD R Adams Cowley","doi":"10.1016/S0361-1124(79)80066-0","DOIUrl":"10.1016/S0361-1124(79)80066-0","url":null,"abstract":"","PeriodicalId":75959,"journal":{"name":"JACEP","volume":"8 11","pages":"Pages 479-484"},"PeriodicalIF":0.0,"publicationDate":"1979-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0361-1124(79)80066-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11595410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1979-11-01DOI: 10.1016/S0361-1124(79)80073-8
MD Ronald A. Hellstern
{"title":"National contract groups","authors":"MD Ronald A. Hellstern","doi":"10.1016/S0361-1124(79)80073-8","DOIUrl":"10.1016/S0361-1124(79)80073-8","url":null,"abstract":"","PeriodicalId":75959,"journal":{"name":"JACEP","volume":"8 11","pages":"Pages 493-495"},"PeriodicalIF":0.0,"publicationDate":"1979-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0361-1124(79)80073-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"56617079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1979-11-01DOI: 10.1016/S0361-1124(79)80059-3
MD An-Shih Lee
Thirty-two cases of drug-induced dystonic reaction were treated by the author with diphenhydramine or benztropine mesylate, intramuscularly or intravenously, in a prospective, nonrandomized fashion. Recovery time with the two drugs was compared. Benztropine mesylate lessened recovery time in this case series. An epidemiological study of drug-induced dystonic reactions found that most of the patients were drug abusers. The commonest offensive agent in this case series was haloperidol. The most common dystonic reactions seen were buccolingual and torticollic.
{"title":"Treatment of drug-induced dystonic reactions","authors":"MD An-Shih Lee","doi":"10.1016/S0361-1124(79)80059-3","DOIUrl":"10.1016/S0361-1124(79)80059-3","url":null,"abstract":"<div><p>Thirty-two cases of drug-induced dystonic reaction were treated by the author with diphenhydramine or benztropine mesylate, intramuscularly or intravenously, in a prospective, nonrandomized fashion. Recovery time with the two drugs was compared. Benztropine mesylate lessened recovery time in this case series. An epidemiological study of drug-induced dystonic reactions found that most of the patients were drug abusers. The commonest offensive agent in this case series was haloperidol. The most common dystonic reactions seen were buccolingual and torticollic.</p></div>","PeriodicalId":75959,"journal":{"name":"JACEP","volume":"8 11","pages":"Pages 453-457"},"PeriodicalIF":0.0,"publicationDate":"1979-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0361-1124(79)80059-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11707866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1979-11-01DOI: 10.1016/S0361-1124(79)80069-6
MD John P. McDade (President)
{"title":"What is past is prologue","authors":"MD John P. McDade (President)","doi":"10.1016/S0361-1124(79)80069-6","DOIUrl":"10.1016/S0361-1124(79)80069-6","url":null,"abstract":"","PeriodicalId":75959,"journal":{"name":"JACEP","volume":"8 11","pages":"Pages 490-491"},"PeriodicalIF":0.0,"publicationDate":"1979-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0361-1124(79)80069-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11707872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1979-11-01DOI: 10.1016/S0361-1124(79)80058-1
MD Daniel C. Brown (Research Fellow) , MD A. James Lewis , MD J. Michael Criley
Parasympathetic tone may be high during ventricular asystole because of reflex vagal stimulation from a number of sources. Eight patients in cardiac arrest were treated with cardiopulmonary resuscitation. All eight patients had ventricular asystole as the initial rhythm or as the result of defibrillation. Six patients failed to respond to 5 cc to 20 cc of 1:10,000 epinephrine intravenously (IV). In all eight cases a regular rhythm (sinus in seven, idioventricular in one) appeared within 30 seconds of administration of the last dose of atropine (1 mg to 2 mg IV). Five patients (62.5%) lived 12 hours, three (37.5%) were discharged from the hospital. These results suggest that atropine may be of value in the treatment of ventricular asystole.
{"title":"Asystole and its treatment: The possible role of the parasympathetic nervous system in cardiac arrest","authors":"MD Daniel C. Brown (Research Fellow) , MD A. James Lewis , MD J. Michael Criley","doi":"10.1016/S0361-1124(79)80058-1","DOIUrl":"10.1016/S0361-1124(79)80058-1","url":null,"abstract":"<div><p>Parasympathetic tone may be high during ventricular asystole because of reflex vagal stimulation from a number of sources. Eight patients in cardiac arrest were treated with cardiopulmonary resuscitation. All eight patients had ventricular asystole as the initial rhythm or as the result of defibrillation. Six patients failed to respond to 5 cc to 20 cc of 1:10,000 epinephrine intravenously (IV). In all eight cases a regular rhythm (sinus in seven, idioventricular in one) appeared within 30 seconds of administration of the last dose of atropine (1 mg to 2 mg IV). Five patients (62.5%) lived 12 hours, three (37.5%) were discharged from the hospital. These results suggest that atropine may be of value in the treatment of ventricular asystole.</p></div>","PeriodicalId":75959,"journal":{"name":"JACEP","volume":"8 11","pages":"Pages 448-452"},"PeriodicalIF":0.0,"publicationDate":"1979-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0361-1124(79)80058-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11595409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1979-11-01DOI: 10.1016/S0361-1124(79)80062-3
MD William F. Bobzien III
Suicide attempts using hypoglycemic agents are uncommon but are associated with a high level of morbidity and mortality. Their recognition is sometimes difficult and the duration of hypoglycemic effect is often prolonged. Two cases that illustrate the difficulties encountered in recognition and therapy are described. Effective therapy depends on adequate glucose supplementation to maintain euglycemia. Therapeutic intervention often must be maintained for several days. Glucocorticoids may be useful in difficult cases. Other modes of therapy, including glucagon, are unproven or controversial.
{"title":"Suicidal overdoses with hypoglycemic agents","authors":"MD William F. Bobzien III","doi":"10.1016/S0361-1124(79)80062-3","DOIUrl":"10.1016/S0361-1124(79)80062-3","url":null,"abstract":"<div><p>Suicide attempts using hypoglycemic agents are uncommon but are associated with a high level of morbidity and mortality. Their recognition is sometimes difficult and the duration of hypoglycemic effect is often prolonged. Two cases that illustrate the difficulties encountered in recognition and therapy are described. Effective therapy depends on adequate glucose supplementation to maintain euglycemia. Therapeutic intervention often must be maintained for several days. Glucocorticoids may be useful in difficult cases. Other modes of therapy, including glucagon, are unproven or controversial.</p></div>","PeriodicalId":75959,"journal":{"name":"JACEP","volume":"8 11","pages":"Pages 467-470"},"PeriodicalIF":0.0,"publicationDate":"1979-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0361-1124(79)80062-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11707868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1979-11-01DOI: 10.1016/S0361-1124(79)80072-6
MD Thomas A. Kelley Jr (Medical Director)
{"title":"Emergency case recognition of spinal cord injuries","authors":"MD Thomas A. Kelley Jr (Medical Director)","doi":"10.1016/S0361-1124(79)80072-6","DOIUrl":"10.1016/S0361-1124(79)80072-6","url":null,"abstract":"","PeriodicalId":75959,"journal":{"name":"JACEP","volume":"8 11","pages":"Page 493"},"PeriodicalIF":0.0,"publicationDate":"1979-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S0361-1124(79)80072-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"11707874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号