ABSTRACT
This year marks the 20th anniversary of the Primary Trauma Care Foundation (PTC), which provides a course aimed at providing a systematic approach to trauma and the unwell patient in low- and middle-income countries. The course is based on the original 36-page PTC manual and a key ethos of being appropriate to the target audience, affordable to those who need it, adaptable to the needs of each local area and sustainable to perpetuate itself. The concept is simple: a two-day course for candidates, followed by a one-day instructor course, and finally a first course delivered to local healthcare staff by the first cohort. Now in its 20th year, its reach spans 76 countries, is ingrained in the syllabus of many healthcare systems and continues to reach new territories with a programme shown to produce a measurable improvement in the care delivered.
Subject(s)
Primary Health Care/methods , Wounds and Injuries/therapy , Cohort Studies , Delivery of Health Care/organization & administration , Developing Countries , Global Health , HumansSubject(s)
Clinical Competence , Emergency Medicine/education , Internship and Residency , Patient Simulation , Humans , OhioABSTRACT
Two data bases have been developed by toxicologists from the Department of Scientific and Industrial Research in New Zealand. The data bases are designed to store and retrieve postmortem drug and poison levels (TOXFILE) and methods used in drug and poison determinations (TOXMETH). TOXFILE contains a list of all the analytical results determined in toxicological cases received by the three laboratories. This method of storing the data has been found superior to the previously used card systems. The file also contains a reference to the analytical method which is very important for the interpretation of the results. TOXMETH contains a list of the analytical methods which have been developed and are in use in one or more of the three Chemistry Division toxicology laboratories. Methods can be added, modified and superseded as approaches change. A Chemistry Division Report (Pannell, L.K. et al., Chemistry Division Report No. CD: 2195, 1983) has been published containing all the programs and instructions. Copies of this are available from the authors on request. Computer magnetic tapes of the programs, the report and the data are also available. The names of the deceased on the TOXFILE data file are encrypted to provide increased security of the information. The TOXFILE data file which will be supplied on magnetic tape to overseas laboratories will have the name file on all records changed to 'CD' to provide complete confidentiality.
Subject(s)
Autopsy , Computers , Toxicology/methods , Forensic Medicine , Humans , Pharmaceutical Preparations/analysis , Poisons/analysisABSTRACT
A discussion of the methods reported for the analysis of orphenadrine is given. The drug levels in biological specimens and the methods reported vary widely. The stability and extractability of orphenadrine is investigated and a method suggested, which uses subtilisin digestion of tissue followed by extraction with 1-chlorobutane. Body fluids are extracted directly by 1-chlorobutane after pH adjustment. Analysis is performed by gas chromatography with a nitrogen selective detector and no interferences are observed from bland specimens. The following levels are results from a case of a 19-year-old male who was found dead 2.5 hours after last being seen alive. This laboratory analysed the case using diphenhydramine as an internal standard: blood 18.1 micrograms/mL, liver 242 micrograms/g, urine 7.0 micrograms/mL, stomach contents 1452 mg.
Subject(s)
Liver/analysis , Orphenadrine/poisoning , Stomach/analysis , Adult , Chromatography, Gas , Humans , Male , Orphenadrine/blood , Orphenadrine/urineABSTRACT
A case report involving low levels of labetalol is presented. Samples of post mortem stomach contents, liver, kidney, urine, and blood were flocculated with aluminium hydroxide before the labetalol was extracted by using Sep-pakTM C18 cartridges. Quantification of the extracts was performed by HPLC with an ultraviolet detector. The significant of relatively low drug levels found in a patient suffering from a respiratory disease is discussed.
Subject(s)
Chromatography, High Pressure Liquid , Ethanolamines/analysis , Labetalol/analysis , Aged , Cadaver , Humans , Labetalol/toxicity , MaleABSTRACT
A simple spectrophotometric method is given for the determination of carbon monoxide in postmortem bloods. Duplicate determinations take about 15 minutes and are shown to be unaffected by the presence of methemoglobin. The method is therefore particularly suitable for use in a forensic laboratory. The results obtained are compared to those from the method of Commins and Lawther.
