British medical journal (Clinical research ed.)
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Br Med J (Clin Res Ed) · Jan 1987
Early emergency care study: the potential and benefits of advanced prehospital care.
Of 26358 patients taken by ambulance to the accident and emergency departments of two large hospitals, 1185 were admitted to resuscitation areas. The scope for ambulance staff to employ a range of advanced techniques at the scene of incidents was assessed by using information relating to the condition of patients when they were picked up by the ambulance and on admission, time in transit, details from hospital records, and outcome at three months. ⋯ The results of the assessment of benefit were compared with estimates of benefit from other studies. In cases of cardiopulmonary arrest the potential to save lives was less optimistic than earlier estimates, and in cases of trauma the potential to save lives was negligible.
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Br Med J (Clin Res Ed) · Jan 1987
Case ReportsLife threatening sickle chest syndrome treated with extracorporeal membrane oxygenation.
A young West Indian woman with established sickle cell disease developed a severe episode of sickle chest syndrome. Conventional treatment including exchange transfusions and mechanical ventilation was to no avail, and an infusion of epoprostenol also failed to halt her worsening condition. ⋯ The patient recovered and six months later showed a transfer factor close to the predicted range and normal spirometric values. Extracorporeal membrane oxygenation should be considered for severe sickle chest syndrome when conventional methods of artificial ventilation fail.
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Br Med J (Clin Res Ed) · Jan 1987
Randomized Controlled Trial Clinical TrialTranexamic acid as an aid to reducing blood transfusion requirements in gastric and duodenal bleeding.
A prospective randomised double blind study examined the effect of the antifibrinolytic drug tranexamic acid compared with placebo in 154 patients bleeding from verified benign lesions in the stomach or duodenum or both. Three out of 72 patients receiving tranexamic acid underwent emergency surgery compared with 15 out of 82 given placebo (p = 0.010). ⋯ Side effects occurred in six patients, of which an uncomplicated deep venous thrombosis was the most severe. Tranexamic acid reduces the blood transfusion requirement and need for emergency surgery in patients bleeding from a benign gastric or duodenal lesion.
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Br Med J (Clin Res Ed) · Nov 1986
Childhood respiratory infection and adult chronic bronchitis in England and Wales.
The high mortality from chronic bronchitis in England and Wales and the excess of urban over rural mortality are unexplained. On dividing England and Wales into 212 local authority areas a strong geographical relation was found between death rates from chronic bronchitis and emphysema in 1959-78 and infant mortality from bronchitis and pneumonia during 1921-5. ⋯ National time trends reflected the influence of both factors. Chronic air pollution in adult life may be less important a cause of chronic bronchitis than previously supposed.