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ABSTRACT: Thirty-two dogs undergoing operations to repair a torn cranial cruciate ligament or a fractured long bone were randomly allocated to one of two treatment groups in a study on postoperative pain. Sixteen of the dogs were given 4 mg/kg carprofen and the other 16 were given 0.2 mg/kg meloxicam subcutaneously before the operation. The signs of pain shown by the animals were assessed for 24 hours on a visual analogue scale, a discontinuous scoring system, and a score based on five behavioural and physiological variables. The dogs' heart and respiratory rates and their mean arterial blood pressures were also measured non-invasively at each assessment. Blood samples were taken before the surgery and 24 hours after it, and the concentrations of urea and creatinine were measured in plasma. Both drugs were effective in relieving the signs of pain for up to 24 hours in all the dogs. There were no significant changes in the concentrations of urea and creatinine, and no adverse effects were reported during the postoperative period.
The Veterinary record 12/2004; 155(21):667-71. · 1.25 Impact Factor
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ABSTRACT: Six adult female chimpanzees (Pan troglodytes) were anaesthetised for the placement of intrauterine contraceptive devices, microchips for identification, routine blood sampling, and physical measurements. Anaesthesia was induced with medetomidine in combination with ketamine administered by intramuscular injection with a projectile syringe. Induction was smooth and rapid, but five of the animals were insufficiently relaxed for orotracheal intubation. The plane of anaesthesia was deepened by administering isoflurane delivered in oxygen and nitrous oxide, and general anaesthesia was maintained for up to 74 minutes. The action of medetomidine was reversed at the end of each procedure with atipamezole, and the animals recovered smoothly and uneventfully.
The Veterinary record 02/2003; 152(1):18-20. · 1.25 Impact Factor
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ABSTRACT: Medetomidine at doses of 10, 20 or 30 microg/kg was administered along with 10 microg/kg buprenorphine intramuscularly to 48 dogs requiring sedation for various diagnostic or therapeutic procedures. The heart rate, respiratory rate and degree of sedation were recorded before and 30 minutes after administration of the drugs. Heart rate fell by a mean of 55 per cent and respiratory rate by a mean of 62 per cent. Mean sedation scores were increased in all groups. Administration of atipamezole at the end of the period of sedation produced rapid recoveries, with a mean time to standing of 12 minutes. Animals that were anaesthetised required much less thiopentone than the 10 mg/kg recommended after premedication with acepromazine maleate.
Journal of Small Animal Practice 10/2001; 42(9):444-7. · 1.00 Impact Factor
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ABSTRACT: Twenty-five years have passed since the introduction of the first civilian hospital-based air medical helicopter service. This study reviews the impact of a single air medical service during a decade of service on the survival of severely injured trauma patients.
A retrospective database analysis was performed to determine program demographics and obtain outcome data. The outcomes of trauma patients were compared to mortality derived from a national database utilizing physiologic indices of severity.
Outcome analysis demonstrated an overall 13% reduction in mortality for air transported patients when compared to controls. Stratification based upon Trauma Score demonstrated a 35% reduction in mortality for victims transported directly from the scene with scene scores between four and 13, and essentially no difference in outcome for patients at Trauma Score extremes.
Rapid utilization of helicopter air medical transport can have a dramatic impact upon patient outcome, especially within a select group of scene transported trauma patients with Trauma Scores ranging from four to 13.
Connecticut medicine 12/1999; 63(11):677-82.
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ABSTRACT: Maintaining cricothyrotomy skills is difficult for air medical crewmembers because the procedure is performed infrequently. The purposes of this study were to review our program's experience with cricothyrotomies and use this pilot study to guide an industry-wide study.
We conducted a retrospective review of all cricothyrotomies performed by our flight crew during the past 12 years. The flight logs were reviewed for patient demographics, scene information, clinical data, and procedure data.
During this period, 8833 patients were transported: 1589 required intubation (18%), and eight of the 1589 required a cricothyrotomy (0.5%). Five nurses (14% of the total employed during the study) and one physician attempted this procedure. All patients had at least one intubation attempt before the cricothyrotomy (average 3.6, range 1-6 attempts). Six (75%) patients had airway edema, four (50%) had an unstable trachea, and one patient (12.5%) had an airway obstruction. Five (62.5%) of the cricothyrotomy attempts were successful. The remaining three patients were managed with bag-valve mask ventilation. Three patients arrived at the receiving hospital with a perfusing rhythm.
Cricothyrotomy, rarely performed by our flight crews, is successful in 62.5% of cases. These preliminary data suggest current training practices should be re-evaluated. An industrywide survey is planned to determine the optimal training program.
AirMed 20(6):27-30.
