Clinical Associate Professor, Emergency Medicine
Current Research and Scholarly Interests
Ignorance of Hepatitis A Among Travelers (writing up data)
Travelers Neglecting to Seek Pre Travel Medicine Advice (writing up data)
Fluoroquinolones in the Treatment of Complicated Urinary Tract Infections (new ED study)
Verification of endotracheal tube placement by prehospital providers: is a portable fiberoptic bronchoscope of value?
Air medical journal
2006; 25 (2): 74-78
This study was designed to examine whether a handheld, battery-operated fiberoptic bronchoscope (FOB) used to verify endotracheal tube (ETT) placement would be as sensitive and specific as other modes and whether a combination of multiple modes would further enhance the sensitivity and specificity of ETT placement verification.An academic hospital-based air medical program.This was a prospective, randomized study examining surgical patients undergoing general endotracheal anesthesia. Eighteen critical care transport (CCT) nurses, previously unfamiliar with FOB, were asked to identify intratracheal and intraesophageal ETTs by using misting, end-tidal carbon dioxide concentration (ETCO(2)), and FOB alone or with a combination of all three modes. The sensitivity and specificity of single and multimode verification were calculated and compared.Comparison of ETT verification by single mode alone revealed a rank order of sensitivity with ETCO(2) (0.97) > FOB (0.87) > misting (0.84), whereas all three modes had similar specificities (0.93-0.94). However, the use of the three-mode combination revealed a sensitivity and specificity of 1.0.As a single mode for ETT verification, use of a handheld, battery-operated FOB device allowed for direct visualization and had an 87% sensitivity and 93% specificity. When combined with misting and ETCO(2), FOB allowed 100% successful verification of ETT placement.
View details for PubMedID 16516118
Topics in international and travel medicine.
The California journal of emergency medicine / California Chapter of the American Academy of Emergency Medicine
2005; 6 (4): 74-75
View details for PubMedID 20847870
Famotidine in the treatment of acute urticaria
American-College-of-Emergency-Physicians Research Forum
BLACKWELL PUBLISHING. 2000: 186–89
Recent studies suggest that histamine H2-receptor antagonists may be useful in the treatment of urticaria. This study was conducted to determine whether famotidine, a H2 antagonist, is effective in the treatment of acute urticaria and compare its effect with that of the H1 antagonist diphenhydramine. In this prospective, double-blind, controlled trial, 25 patients with urticaria of less than 72 h duration were randomized to receive a single dose of either famotidine 20 mg i.m. or diphenhydramine 50 mg i.m. Prior to treatment and 30 min after treatment, patients rated pruritus and sedation using visual analogue scales, while physicians evaluated intensity of urticaria and percentage of body surface area involved by urticaria. Famotidine was found to reduce pruritus associated with acute urticaria, intensity of urticaria, and body surface area affected by urticaria without causing sedation. Famotidine was comparable to diphenhydramine in efficacy; however, there was a (nonsignificant) trend for diphenhydramine to be more effective than famotidine in the treatment of pruritus, and for famotidine to be more effective in the reduction of surface area of involvement. It is concluded that famotidine merits further investigation as a potential medication for treatment of urticaria.
View details for Web of Science ID 000087227800004
View details for PubMedID 10844490
- Flight Attendants and Hepatitis A American Public Health Association, Washington DC, 1998 (poster) 1998
- Ignorance of Hepatitis A Among Travelers to Southeast Asia 5th Conference of Int'l Society of Travel Medicine, Geneva, 1997 (poster) 1997