In-flight medical emergencies: one year of experience with the enhanced medical kit
Article Abstract:
During the past 50 years of aviation the health and safety of passengers has been a prime concern. Medical supplies available on airplanes remained essentially the same until 1986 when the Federal Aviation Administration (FAA) instituted new regulations requiring all flights with more than 30 passengers to carry an enhanced medical kit. Because previous concerns about changing the medical kit had focused on the incidence and severity of in-flight medical emergencies, data was collected on United Airlines passengers who received medical care and those who provided care during the first year of the new FAA regulations. The documentation that is required whenever the enhanced medical kit is used was also reviewed. Health care providers responded that the new kit was useful in more than 80 percent of emergencies and was occasionally life-saving. The most common medical emergencies were: fainting, heart attack or chest pain, asthma or breathing problems and allergic reactions. In-flight emergencies are often related to alcohol use, psychological stress, and physiological challenges of flight. Current illness, medications being taken, eating foods to which one is known to be allergic, and seasonal illness such as colds and flu, also affect rates and patterns of medical emergencies. With 450 million domestic airline passengers per year, the data estimates 3,000 emergencies. The enhanced medical kit has proved to be beneficial, but it is recommended that a bronchodilator medication with an inhalation device be added to the kit. Limitations of the data are discussed.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1989
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Cytopathological interpretation and medical consultation
Article Abstract:
Since the introduction of the Papanicolaou classification of cervical (neck of the uterus) and vaginal cell smears (Pap test) there has been increased interest in neoplasms (tumors) of these areas. This original system has outlived its usefulness and many problems of classification and difficulties relating to the ability to communicate the tissue diagnosis to the referring physician are intrinsic to the Papanicolaou system. Obviously a new standard with clear unambiguous terminology is required. Participants in a workshop on terminology of cervical and vaginal cytology (the study of cells) have developed a new more concise, clear and uniform classification system. One goal of the workshop was to define the cytopathologic report as a medical consultation. However, the representatives of the American College of Obstetricians and Gynecologists strongly objected to this definition. In the context of modern medical practice, the College (and the author) interprets a medical consultation as having available a complete patient history and physical examination. Without this knowledge and interaction with the patient any recommendation could be dangerous.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1989
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Enhancement of Clinicians' Diagnostic Reasoning by Computer-Based Consultation: A Multisite Study of 2 Systems
Article Abstract:
Computer-based diagnostic decision support systems (DSSs) can be helpful to some doctors and medical students. A total of 215 doctors, residents, and fourth-year medical students used two DSSs called ILIAD and Quick Medical Reference to analyze 36 cases based on actual patients. The cases were analyzed before and after consulting the programs. The programs increased the correct diagnosis from 39% of the cases to 45%. Students were especially likely to arrive at the correct diagnosis after using the programs. These programs could be used to train medical students.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1999
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