Southern medical journal
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Southern medical journal · Jan 1993
Editorial CommentObstetric anesthesia: delivering quality care.
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Southern medical journal · Jan 1993
Practice Guideline GuidelineGuidelines for Regional Anesthesia in Obstetrics: potential impact on obstetric anesthesia services in rural Alabama.
When the American Society of Anesthesiologists published its Guidelines for Regional Anesthesia in Obstetrics, I did a survey to determine what impact a broadly implemented strict interpretation of those guidelines might have on obstetric anesthesia care in small rural Alabama hospitals. Thirty-six rural Alabama hospitals with fewer than 200 beds were included in the survey, with a response rate of 50%. Data included total deliveries, cesarean section rates, utilization rates of anesthesia services, personnel providing anesthesia care, and identification of physician personnel available during labor and cesarean section. ⋯ If these data also reflect the nonrespondent hospitals, statewide access could be limited for approximately 6000 parturients annually. The Guidelines should be interpreted with caution. Rather than conform to related policies, interpretation should allow implementation consistent with the capabilities of the individual institutions, while ensuring quality anesthesia care for the parturients.
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Southern medical journal · Dec 1992
Is the pediatric preoperative hematocrit determination necessary?
The usefulness of the preoperative hematocrit determination as a screening test before outpatient pediatric surgical procedures has been questioned. It has been suggested that a careful history and physical examination are of greater importance than routine laboratory tests in determining a child's fitness for surgery. We evaluated the utility of preoperative measurement of hematocrit as a screening test for surgical fitness in healthy children having a variety of elective outpatient surgical procedures.
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Southern medical journal · Nov 1992
Effect of aeromedical aircraft on care of trauma patients: evaluation using the Revised Trauma Score.
Rotor wing aircraft used in transport of the trauma victim have not been subject to objective means of evaluating their contribution to patient care. A retrospective evaluation of a Bell 206 L-1 and an Aerospatiale 365 N-1 using the Revised Trauma Score Triage (RTS) as an indicator of status in 98 patients transported from the scene of injury was conducted. Ground (GT), flight (FT), and total mission (TMT) times, as well as initial RTS, final RTS, and the difference between them (DRTS) were determined for all patients. ⋯ GT, FT, and TMT were significantly lower in patients transported by the 365 N-1. In more severely injured patients (RTS < or = 10), DRTS and final RTS were significantly higher in the 365 N-1; FT was significantly less. The contributions of various aeromedical aircraft to the care of the trauma victim may be assessed using objective indices of patient status.
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Southern medical journal · Oct 1992
Case ReportsRecurrence of neisserial meningococcemia due to deficiency of terminal complement component.
Recurrent infections with Neisseria meningitidis are attributed to deficiencies of terminal complement components. The serotype most commonly responsible for recurrent N meningitidis infections is serotype Y. We have reported a case of recurrent meningitis due to N meningitidis in a patient who was found to be deficient in the sixth component of complement. Complement deficiencies should be considered in any patient with recurrent infections caused by N meningitidis.