Browsing by Author "McNamara, John"

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    Applied Human Anatomy
    Nolan, Michael F.; McNamara, John (Virginia Tech Publishing, 2022)

    The structure of the human body is usually considered in courses in gross anatomy. These courses typically consist of lectures by the faculty, readings in assigned textbooks and the study of photographs and illustrations in human anatomy atlases. However, as student’s progress through the curriculum and move into the more clinical or practice oriented phases, many discover that the anatomical knowledge they actually need is somewhat different from the kind they possess. What many encounter is difficulty in applying their knowledge to a clinical setting. Applied Human Anatomy was created to better integrate material that is more often than not treated separately in contemporary health care curricula. It is hoped that through this integration students will develop a deeper and more lasting knowledge and understanding of human anatomy as they are likely to need it in the evaluation and management of patients. A print version is available for purchase on Amazon.
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    Evaluation of Dyspnea through Education and Implementation of the Bedside Lung Ultrasound in Emergency (BLUE) Protocol by Prehospital Paramedics
    Brookeman, Harrison; Stolarchuk, Christina; McNamara, John; Rose-Inman, Hayley; Bernier, Carol (2023-01-12)
    BACKGROUND: It has been demonstrated that emergency medical service (EMS) providers have very poor sensitivity for identifying patients who present with dyspnea due to congestive heart failure versus other causes such as asthma or chronic obstructive pulmonary disease (COPD)1. Prior research has shown that focused lung ultrasound has high accuracy for differentiating respiratory distress in various clinical settings2. Paramedics have the requisite background to obtain adequate prehospital lung ultrasound images3. OBJECTIVES: The goal of this study was to demonstrate that paramedic-performed and paramedic-interpreted lung ultrasound is an accurate diagnostic tool for prehospital advanced life support providers in order to differentiate the etiology of respiratory distress. METHODS: This study was a randomized trial utilizing 911 paramedics to perform both ultrasound and standard, non-ultrasound clinical diagnostics on patients experiencing respiratory distress. Paramedics were trained in ultrasonography and randomized on a per-shift basis to perform ultrasound diagnostics or traditional diagnostics while assessing respiratory patients in the prehospital setting. The primary outcome was the accuracy of the paramedics’ two diagnostic methods compared to the clinical diagnoses determined by in-hospital providers after discharge from either the emergency department or in-patient care. RESULTS: Paramedics from four different EMS agencies (urban, suburban, and rural ground EMS, helicopter EMS) were trained in lung ultrasonography by study personnel. There were 53 patients who underwent focused lung ultrasound by paramedics and 109 patients who had non-ultrasound clinical diagnoses obtained. Paramedics’ diagnoses in both cases were compared to hospital diagnoses. Paramedic ultrasound for dyspnea had an overall accuracy of 79.2% compared to the non-ultrasound diagnostics accuracy of 63.3%. Ultrasound improved the diagnostic accuracy of the paramedics by 15.9% (95% CI [1.8%, 30.1%, p=0.028) compared to traditional protocols and skills. CONCLUSIONS/FUTURE WORK: Ultrasound has been shown to provide statistically significant increase in paramedic diagnostic accuracy for undifferentiated respiratory distress. Further research into improvement in patient outcomes from the application of prehospital ultrasound would likely show benefit from more accurate and precise prehospital interventions.
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    Pioneers in Human Anatomy
    Nolan, Michael; McNamara, John (Virginia Tech Publishing, 2023-02-24)

    Pioneers in Human Anatomy provides an opportunity for those who may be interested in those pioneers in anatomy or who may have learned (or forgotten) some eponymonic descriptions in the past, to test their knowledge (or memory) of these historical designations or to link particular individuals to anatomical structures and features previously unknown. While students and teachers of anatomy may might have a professional interest in knowing who, in the history of anatomy, has been associated with a particular structure, others including medical historians, biographers and medical artist might also find this information of interest. This collection of free-answer quiz questions is divided into three sections. In the first section a brief description of an anatomical structure, feature, tissue, cell or pathway is presented followed by a blank line in which the reader may insert the name(s) of the individual(s) commonly associated with that structure, feature, tissue or pathway. The descriptions and individuals included here are limited to those associated with the four traditional sub-disciplines of anatomy: gross anatomy, neuroanatomy, microscopic anatomy and developmental anatomy. Within these major anatomical subdisciplines, the descriptions are further categorized to better organize the material. Some eponyms have come into the literature because that individual was the first to report on a particular topic (aqueduct of Sylvius) or may have provided the most definitive description of the topic (Parkinson disease). Others recognize the committed effort or discovery of a single individual (islets of Langerhan) while others signify the combined or collaborative efforts of two or more dedicated persons (Marchiafava-Bignami disease). Some refer to normal structures (Hunter’s canal) or functions (Starling’s law), while many others relate to abnormal observations (Babinski sign). Countless numbers are associated with diseases (Tay-Sachs disease) or injuries (Colle’s fracture), procedures for evaluating functions (McMurray’s test) or techniques for treating specific disease or injuries (Epply maneuver). Eponymonic designations are used to identify tools and surgical instruments invented for particular purposes (Kerrison Rongeur) and surgical procedures (Whipple procedure). Some eponyms are associated with other, frequently more descriptive terms (Poupart’s ligament / inguinal ligament) while others indicate structures, processes or procedures for which no other name exists (McBurney’s point). As can be appreciated from this brief synopsis, eponyms are well ingrained into almost all facets of medicine.