Google is goodish: An information literacy course designed to teach users why google may not always be the best place to search for evidence

This article describes a course that was developed in response to health sector and local authority workers being reliant on Google and using it for their information needs regardless of whether it was the best place to search. The methodology for developing and structuring the course is explored, including details of the content included. The author concludes by asserting that teaching users about the effective use of Google is an important part of user education. D.I.

Helicopter transport of patients to tertiary care centers after cardiac arrest

Air transport is commonly used to transfer survivors of cardiac arrest from rural hospitals to large tertiary-care centers, presumably to improve outcome. To examine this issue, a retrospective review of patients stabilized after a cardiac arrest was conducted; 157 transports were reviewed. The mean age of patients was 37.9 +/- 27.8 yrs, with a male to female ratio of 2.2:1. Survivors were significantly older than nonsurvivors. Thirty-one of 69 patients (45%) with primary cardiac disease were discharged alive from the hospital, 75% without neurological sequelae. Only a minority of patients with noncardiac medical illness (7%), electrical injury (33%), suffocation (15%), near-drowning (15%), and inhalation (0%) were discharged alive from the hospital. Outcomes for cardiac arrest in adult patients older than 65 years (32.3% survival) were similar to those for adult patients younger than 65 years (36.2% survival) (P = .887). These results show that survivors of a primary cardiac event have a favorable outcome when transferred by air to tertiary centers when compared with historical controls that were transported by ground. On the other hand, cardiac arrests from noncardiac medical illness, suffocation, near-drowning, and inhalation have a grim prognosis. Prospective studies should clarify the role of air transport in these patients.

Air medical transport for the trauma patient requiring cardiopulmonary resuscitation: a 10-year experience

INTRODUCTION

Air medical response and transport for the injured patient in cardiopulmonary arrest remain controversial. This study is a large, single-program experience.

METHODS

A retrospective chart review and descriptive study of all injured patients requiring cardiopulmonary resuscitation (CPR) immediately before or during air medical transport. The crew functioned under advanced cardiac life support/advanced trauma life support protocols.

SETTING

The patients, when transported, went to a variety of facilities, with the majority of patients transported to a level-I trauma center. The service area was primarily rural.

RESULTS

During 1985 to 1994, inclusive, there were 12,518 completed missions. A total of 320 injured patients required CPR (284 with blunt injury and 36 with penetrating injury), six of the 320 patients (1.9%) survived. Survivors and nonsurvivors did not differ significantly in age, mechanism of injury, time from initiation of CPR to arrival in the emergency department (ED), year of injury or initial cardiac rhythm. All survivors did, however, present to the ED in normal sinus rhythm with a palpable blood pressure.

CONCLUSION

Air medical transport for the injured patient without signs of life following prehospital intervention appears futile.

Recording and analysis of uterine activity in pregnant guinea-pigs

Guinea-pigs are of considerable interest for the study of the physiology of parturition in view of their lack of placental 17-alpha hydroxylase, a property which they share with Man and monkeys. To allow long-term analysis of uterine activity, a chronic guinea pig model was developed carrying a uterine electromyogram (EMG) electrode array, intrauterine and intraabdominal balloon catheters and vascular catheters. Operative procedures and the characteristics of the hardware and software are described and evaluated. Quantitative analysis of uterine activity relies on the quasi-integrated EMG signal which is highly correlated with the raw EMG signal. Under optimal conditions of intrauterine pressure recording, the area of the quasi-integrated EMG signal is highly correlated with the area of the intrauterine pressure increment. The preparation is stable for at least four weeks, measurements are reproducible, and biologically meaningful results are obtained from the recordings.

Comparison of the maternal and fetal effects associated with intermittent or continuous infusion of extradural analgesia

Eighty normal primigravidae received an extradural dose of 0.25% bupivacaine and were then allocated randomly to receive "top-ups" of 0.25% bupivacaine (group A) or an infusion of 0.125% bupivacaine (group B). Group B received supplementary top-ups if required. Group A required more top-ups (147 vs 80) (P < 0.01). No maternal advantage was demonstrated from each regimen. Fetal state was assessed by analysis of the cardiotocograph during labour and the condition of the fetus at delivery. Three different patterns of late deceleratory episodes were identified (grades 1-3). Total numbers of episodes per group were similar (group A, 71; group B, 69). More episodes in group A were related to top-ups (42/71 vs 18/69; P < 0.01) but the incidence of episodes after a top-up was similar (group A, 42/147 (28.6%); group B, 18/80 (22.5%)). In group A, 31/42 events (73.8%) were transient compared with 11/18 persistent episodes (61.1%) (> 10 min duration) in group B. However, the difference in the deceleratory patterns did not influence the condition of the fetuses at delivery.

Human alloantibodies detecting a red cell antigen apparently identical to MER2

Three examples of an antibody were found to be detecting a red cell polymorphism probably identical to MER2. The antibodies were made by Jews originating from India and living in Israel. Two of them were sibs and the third was unrelated. All 3 had kidney disease requiring renal dialysis and regular blood transfusion. In 2 cases the antibodies were detected before dialysis was started and before the patients had been transfused. The human antibodies reacted with red cells of 90% of Israeli blood donors tested. In tests on selected blood donors, 82 English and 56 Israeli, one of the human antibodies gave almost identical reactions to those given by monoclonal anti-MER2. Anomalous reactions were probably due to anti-Bga. Two of the human antibodies completely blocked, and one partially blocked, the reaction of monoclonal anti-MER2 with MER2+ red cells.