Connecticut medicine
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Heparin-induced thrombocytopenia and thrombosis can occur with both low-dose and high-dose heparin. Clinicians should be aware of this syndrome, and platelet counts should be monitored prior to initiating heparin and during the course of therapy. The treatment of heparin-induced thrombocytopenia is variable depending on the use of heparin in each individual patient. ⋯ Aspirin given with dipyridamole or Iloprost have both been reported to be successful in managing this group of patients. Heparin is a commonly used drug in all areas of medicine. The early recognition and treatment of heparin-induced thrombocytopenia and thrombosis has resulted in a reduction in the morbidity associated with this syndrome.
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Connecticut medicine · Jan 1990
Connecticut emergency department physicians survey. Implications for graduate medical education.
A survey conducted in mid-1989 of 36 Connecticut hospital emergency departments sought to determine the nature of physician staffing and the volume and the acuteness of patient problems. Overall, only 31% of emergency department staffing is provided by board certified emergency physicians in the state of Connecticut. In addition to emphasizing the lack of board certified emergency physicians available in the state, this survey also indicated a relative deficiency in emergency department physician staffing in general with approximately 20% of all positions currently unfilled statewide. The implications of these findings for graduate medical education in Connecticut are discussed.
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Trauma patients requiring intubation at the scene of the accident were entered into a study from June 1985 to June 1987 to determine: 1) the success rate of intubation by flight crews and 2) factors important in managing the difficult airway at the scene. One hundred thirty-six patients were reviewed. The success rate of trauma patients intubated in the field was 92.6%. ⋯ An aeromedical crew (MD, RN, RT) can successfully intubate trauma patients at the scene of the accident. Severe facial injuries with vomiting and blood in the oropharynx are factors in intubation failure. The use of muscle relaxants and sedatives facilitates difficult intubations.
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Connecticut medicine · May 1989
Pain therapy for pancreatic carcinoma with neurolytic celiac plexus block.
The past year's experience of the Pain and Regional Anesthesia Service at Hartford Hospital with neurolytic celiac plexus blockade for pancreatic cancer has been reviewed. The series includes eight patients with intractable pain from pancreatic cancer as well as two patients with pain from other abdominal malignancies. ⋯ The only complication noted was one episode of mild, transient hypotension. Neurolytic celiac plexus blockade is a safe and effective means to relieve the terminal pain associated with not only pancreatic cancer but also other abdominal malignancies.