Bio

Clinical Focus


  • International Emergency Medicine
  • Emergency Medicine
  • Trauma
  • Emergency Medical Services
  • Medical Education

Academic Appointments


Administrative Appointments


  • Associate Chief, Stanford Division of Emergency Medicine (2000 - 2012)
  • Medical Director, Stanford Univeristy Emergency Department (2000 - 2012)
  • Director, Stanford Emergency Medicine International, Stanford University School of Medicine (2000 - Present)
  • Director, Fellowship in International Emergency Medicine, Stanford University School of Medicine (2005 - Present)
  • Course Director, Surgery 313A, Medical Student Clerkship in Emergency Medicine, Stanford University School of Medicine (1999 - 2006)
  • Course Director, Surgery 220, Introduction to Emergency Medicine, Stanford University School of Medcine (2000 - 2008)
  • Director, International Visiting Scholar's Program, Stanford Emergency Medicine International (SEMI) (2000 - 2008)

Honors & Awards


  • 4th Lifeline-AAEMI Award for EMS (India), Lifeline, American Academy for Emergency Medicine in India (2013)
  • Save of the Month (July), Stanford University Emergency Department (2013)
  • SEMI Excellence Award, Emergency Medical Services, Society of Emergency Medicine in India (SEMI) (2012)
  • ACEP National Faculty Teaching Award, American College of Emergency Physicians (2012)
  • Arthur L. Bloomfield Award for Excellence in the Teaching of Clinical Medicine, Stanford University School of Medicine (2012)
  • Denise M. O"Leary Award for Excellence, Board of Directors, Stanford Hospital and Clinics (2012)
  • 2011 California EMS Authority: Team Award (International), California EMS Authority (2011)
  • CAL ACEP Education Award, California American College of Emergency Physicians (ACEP) (2011)
  • Stanford Biodesign Faculty Teaching Award, Stanford Biodesign (2008)
  • Award for Outstanding Community Service/Dedicated Leadership/ Contributions to Improving India's EMS, Osmania Gandhi Kakatiya Medical Alumni Assoc. (OGKMA) (2007)
  • ACEP 2006-2007 Honorable Mention Outstanding Speaker of the Year Award, American College of Emergency Physicians (ACEP) (2006-2007)
  • Winter Emergency Medicine Bedside Teaching Award, Stanford- Kaiser Emergency Medicine Residency Program (2007)
  • AMWA 2006 Book Award Winner: Physician's Category: An Introduction to Clinical Emergency Medicine, American Medical Writers Association (AMWA) (2006)
  • 50 Outstanding UC Riverside Students, 50th Anniversary of the UC Riverside Alumni Association (2006)
  • ACEP 2004-2005 Scientific Assembly Rookie Speaker of the Year Award, American College of Emergency Physicians (ACEP) (2004-2005)
  • Council of Residency Directors (CORD) Faculty Teaching Award, Council of Emergency Medicine Residency Directors (CORD) (2003)
  • Innovations in Emergency Medicine Exhibit (IEME) Award, Society for Academic Emergency Medicine (SAEM) (2003)
  • Fall Emergency Medicine Bedside Teaching Award, Stanford- Kaiser Emergency Medicine Residency Program (2003)
  • 2002-2003 Emergency Medicine Bedside Teaching Award, Stanford-Kaiser Emergency Medicine Residency (2002-2003)
  • Spring Emergency Medicine Bedside Teaching Award, Stanford- Kaiser Emergency Medicine Residency Program (2001)

Professional Education


  • Board Certification: Emergency Medicine, American Board of Emergency Medicine (1998)
  • Residency:Olive View - UCLA Medical Center (1996) CA
  • Internship:Harbor-UCLA Medical Center (1993) CA
  • Medical Education:UCLA School of Medicine (1992) CA
  • BS, UC Riverside, Biomedical Sciences (1988)
  • MD, UCLA School of Medicine, Medicine (1992)

Community and International Work


  • 2014 VPOL Course: Managing Emergencies: What Every Doctor Needs to Know, Uganda

    Partnering Organization(s)

    Makerere University

    Location

    International

    Ongoing Project

    Yes

    Opportunities for Student Involvement

    Yes

  • 2013-2014 Stanford Essential Prehospital Care Course, India

    Partnering Organization(s)

    EMRI

    Location

    International

    Ongoing Project

    Yes

    Opportunities for Student Involvement

    Yes

  • 2012-2013 Stanford-EMRI Pediatric District Hospital Course, India

    Topic

    Pediatric Emergency Medicine

    Partnering Organization(s)

    EMRI

    Location

    International

    Ongoing Project

    Yes

    Opportunities for Student Involvement

    No

  • 2011-2013 Stanford-URC Cambodia, Cambodia

    Topic

    Emergency medicine strengthening

    Partnering Organization(s)

    URC-CHS

    Populations Served

    http://www.urc-chs.com/country?countryID=17

    Location

    International

    Ongoing Project

    Yes

    Opportunities for Student Involvement

    Yes

  • 2010-2012 Iraq Regional Health Emergency Response Project (RHERP), Iraq

    Topic

    Emergency Medical Services

    Partnering Organization(s)

    World Bank

    Location

    International

    Ongoing Project

    Yes

    Opportunities for Student Involvement

    No

  • 2010-2011 Stanford-EMRI EMS Protocol Development, India

    Topic

    EMS Protocols

    Partnering Organization(s)

    GVK EMRI

    Location

    International

    Ongoing Project

    No

    Opportunities for Student Involvement

    No

  • 2009-2010 Stanford-EMRI District Hospital Course, India

    Topic

    Emergency Medicine at the District Hospital

    Location

    International

    Ongoing Project

    Yes

    Opportunities for Student Involvement

    No

  • 2009-2011 Stanford-EMRI International Research Insitute, India

    Partnering Organization(s)

    GVK EMRI

    Location

    International

    Ongoing Project

    Yes

    Opportunities for Student Involvement

    Yes

  • 2010 Nepal Ambulance Project, EMT-Education, Nepal

    Topic

    EMS development

    Partnering Organization(s)

    Nepal Ambulance Service

    Populations Served

    http://nepalambulanceservice.org/

    Location

    International

    Ongoing Project

    No

    Opportunities for Student Involvement

    No

  • 2007 Stanford-EMRI Post-Graduate Program in Emergency Care, Hyderabad, India

    Topic

    Emergency Medical Services

    Partnering Organization(s)

    Emergency Management and Research Institute (EMRI)

    Populations Served

    http://www.emri.in/

    Ongoing Project

    No

    Opportunities for Student Involvement

    No

  • 2006 Stanford-Apollo EMT-Intermediate Training Program, Hyderabad and Chennai, India

    Topic

    Emergency Medical Services

    Partnering Organization(s)

    Apollo Hospital India

    Location

    International

    Ongoing Project

    No

    Opportunities for Student Involvement

    No

  • 2005 United Nations handbook Landmine And

    Topic

    First Aid

    Partnering Organization(s)

    UCLA CIM, United Nations

    Location

    International

    Ongoing Project

    No

    Opportunities for Student Involvement

    No

  • 2004-2005 Fundamentals in Trauma Care, China

    Topic

    Trauma care

    Partnering Organization(s)

    UCLA CIM, Project Hope

    Location

    International

    Ongoing Project

    No

    Opportunities for Student Involvement

    No

  • 2003-2005 Fundamentals in Trauma Care, Egypt

    Topic

    Trauma care

    Partnering Organization(s)

    UCLA CIM, Project Hope

    Location

    International

    Ongoing Project

    No

    Opportunities for Student Involvement

    No

  • 2000-present Stanford Emergency Medicine International Visiting Scholar's Program, Stanford

    Topic

    International Emergency Medicine

    Location

    International

    Ongoing Project

    Yes

    Opportunities for Student Involvement

    No

  • On field volunteer emergency physician San Francisco 49ers

    Topic

    Emergency Medicine

    Partnering Organization(s)

    San Francisco 49ers

    Location

    Bay Area

    Ongoing Project

    Yes

    Opportunities for Student Involvement

    No

Teaching

2013-14 Courses


Publications

Journal Articles


  • INDIAN AND UNITED STATES PARAMEDIC STUDENTS: COMPARISON OF EXAMINATION PERFORMANCE FOR THE AMERICAN HEART ASSOCIATION ADVANCED CARDIOVASCULAR LIFE SUPPORT (ACLS) TRAINING JOURNAL OF EMERGENCY MEDICINE Goodwin, T., Delasobera, B. E., Strehlow, M., Camacho, J., Koskovich, M., D'Souza, P., Gilbert, G., Mahadevan, S. V. 2012; 43 (2): 298-302

    Abstract

    The American Heart Association (AHA) Advanced Cardiovascular Life Support (ACLS) course is taught worldwide. The ACLS course is designed for consistency, regardless of location; to our knowledge, no previous study has compared the cognitive performance of international ACLS students to those in the United States (US).As international health educational initiatives continue to expand, an assessment of their efficacy is essential. This study assesses the AHA ACLS curriculum in an international setting by comparing performance of a cohort of US and Indian paramedic students.First-year paramedic students at the Emergency Management and Research Institute, Hyderabad, India, and a cohort of first-year paramedic students from the United States comprised the study population. All study participants had successfully completed the standard 2-day ACLS course, taught in English. Each student was given a 40-question standardized AHA multiple-choice examination. Examination performance was calculated and compared for statistical significance.There were 117 Indian paramedic students and 43 US paramedic students enrolled in the study. The average score was 86% (± 11%) for the Indian students and 87% (± 6%) for the US students. The difference between the average examination scores was not statistically significant in an independent means t-test (p=0.508) and a Wilcoxon test (p=0.242).Indian paramedic students demonstrated excellent ACLS cognitive comprehension and performed at a level equivalent to their US counterparts on an AHA ACLS written examination. Based on the study results, the AHA ACLS course proved effective in an international setting despite being taught in a non-native language.

    View details for DOI 10.1016/j.jemermed.2011.05.096

    View details for Web of Science ID 000307920500016

    View details for PubMedID 22244286

  • PENETRATING CARDIAC INJURY FROM A WOODEN KNITTING NEEDLE JOURNAL OF EMERGENCY MEDICINE Hsia, R. Y., Mahadevan, S. V., Brundage, S. I. 2012; 43 (1): 116-119
  • Airway Management In Mahadevan S (Editor) & Garmel G (Co-editor): An Introduction to Clinical Emergency Medicine (2nd edition) Mahadevan S, Sovndal S 2012
  • Ear pain In Mahadevan S (Editor) & Garmel G (Co-editor): An Introduction to Clinical Emergency Medicine (2nd edition) Gilbert G, Mahadevan S 2012
  • An Introduction to Clinical Emergency Medicine (2nd Edition) Mahadevan SV, Garmel GM 2012
  • Abdominal Pain In Mahadevan S (Editor) & Garmel G (Co-editor): An Introduction to Clinical Emergency Medicine (2nd edition) Mahadevan S 2012
  • Low Back Pain In Mahadevan S (Editor) & Garmel G (Co-editor): An Introduction to Clinical Emergency Medicine (2nd edition) Herbert M, Lanctot-Herbert M, Mahadevan S 2012
  • Pediatric Cervical Spine Tutorial In Wang NE (Editor): Handbook of Pediatric Emergencies Mahadevan S 2011
  • Pediatric Cervical Spine Injuries In Wang NE (Editor): Handbook of Pediatric Emergencies Mewaldt K, Mahadevan S 2011
  • Emergency Airway Management In Auerbach PS (Editor): Wilderness Medicine (6th Edition) Mahadevan S 2011
  • Evaluating the efficacy of simulators and multimedia for refreshing ACLS skills in India RESUSCITATION Delasobera, B. E., Goodwin, T. L., Strehlow, M., Gilbert, G., D'Souza, P., Alok, A., Raje, P., Mahadevan, S. V. 2010; 81 (2): 217-223

    Abstract

    Data on the efficacy of the simulation and multimedia teaching modalities is limited, particularly in developing nations. This study evaluates the effectiveness of simulator and multimedia educational tools in India.Advanced Cardiac Life Support (ACLS) certified paramedic students in India were randomized to either Simulation, Multimedia, or Reading for a 3-h ACLS refresher course. Simulation students received a lecture and 10 simulator cases. The Multimedia group viewed the American Heart Association (AHA) ACLS video and played a computer game. The Reading group independently read with an instructor present. Students were tested prior to (pre-test), immediately after (post-test), and 3 weeks after (short-term retention test), their intervention. During each testing stage subjects completed a cognitive, multiple-choice test and two cardiac arrest scenarios. Changes in exam performance were analyzed for significance. A survey was conducted asking students' perceptions of their assigned modality.One hundred and seventeen students were randomized to Simulation (n=39), Multimedia (n=38), and Reading (n=40). Simulation demonstrated greater improvement managing cardiac arrest scenarios compared to both Multimedia and Reading on the post-test (9% versus 5% and 2%, respectively, p<0.05) and Reading on the short-term retention test (6% versus -1%, p<0.05). Multimedia showed significant improvement on cognitive, short-term retention testing compared to Simulation and Reading (5% versus 0% and 0%, respectively, p<0.05). On the survey, 95% of Simulation and 84% of Multimedia indicated they enjoyed their modality.Simulation and multimedia educational tools were effective and may provide significant additive benefit compared to reading alone. Indian students enjoyed learning via these modalities.

    View details for DOI 10.1016/j.resuscitation.2009.10.013

    View details for Web of Science ID 000274982500014

    View details for PubMedID 19926385

  • Maxillofacial and Neck Injury In Savitsky ES (editor): Combat Casualty Care: Lessons Learned in OEF & OIF Hale RG, Hayes DK, Orloff G, Peterson J, Powers D, Mahadevan S 2010
  • Development of a Self-Sustaining Paramedic Educational Program in India: The Stanford-GVK EMRI Partnership EMS India Mahadevan S, Strehlow M 2010
  • Cervical Spine Fractures In Wolfson AB (Editor): Harwood Nuss? Clinical Practice of Emergency Medicine (5th edition) Mower W, Hoffman JR, Mahadevan S 2009
  • Eye Medications In Wolfson AB (Editor): Harwood Nuss? Clinical Practice of Emergency Medicine (5th edition) Schertzer K, Mahadevan S 2009
  • Discordance rates between preliminary and final radiology reports on cross-sectional imaging studies at a level 1 trauma center ACADEMIC RADIOLOGY Stevens, K. J., Griffiths, K. L., Rosenberg, J., Mahadevan, S., Zatz, L. M., Leung, A. N. 2008; 15 (10): 1217-1226

    Abstract

    The goal was to determine discordance rates between preliminary radiology reports provided by on-call radiology house staff and final reports from attending radiologists on cross-sectional imaging studies requested by emergency department staff after hours.A triplicate carbon copy reporting form was developed to provide permanent records of preliminary radiology reports and to facilitate communication of discrepant results to the emergency department. Data were collected over 21 weeks to determine the number of discordant readings. Patients' medical records were reviewed to show whether discrepancies were significant or insignificant and to assess their impact on subsequent management and patient outcome.The emergency department requested 2830 cross-sectional imaging studies after hours and 2311 (82%) had a copy of the triplicate form stored in radiology archives. Discrepancies between the preliminary and final report were recorded in 47 (2.0%), with 37 (1.6%) considered significant: 14 patients needed no change, 13 needed a minor change, and 10 needed a major change in subsequent management. Ten (0.43%) of the discordant scans were considered insignificant. A random sample of 104 (20%) of the 519 scans without a paper triplicate form was examined. Seventy-one (68%) did have a scanned copy of the triplicate form in the electronic record, with a discrepancy recorded in 3 (4.2%), which was not statistically different from the main cohort (P = .18).Our study suggests a high level of concordance between preliminary reports from on-call radiology house staff and final reports by attending subspecialty radiologists on cross-sectional imaging studies requested by the emergency department.

    View details for DOI 10.1016/j.acra.2008.03.017

    View details for Web of Science ID 000259742400002

    View details for PubMedID 18790392

  • Internationalizing the Broselow tape: How reliable is weight estimation in Indian children ACADEMIC EMERGENCY MEDICINE Ramarajan, N., Krishnamoorthi, R., Strehlow, M., Quinn, J., Mahadevan, S. V. 2008; 15 (5): 431-436

    Abstract

    The Broselow pediatric emergency weight estimation tape is an accurate method of estimating children's weights based on height-weight correlations and determining standardized medication dosages and equipment sizes using color-coded zones. The study objective was to determine the accuracy of the Broselow tape in the Indian pediatric population.The authors conducted a 6-week prospective cross-sectional study of 548 children at a government pediatric hospital in Chennai, India, in three weight-based groups: < 10 kg (n = 175), 10-18 kg (n = 197), and > 18 kg (n = 176). Measured weight was compared to Broselow-predicted weight, and the percentage difference was calculated. Accuracy was defined as agreement on Broselow color-coded zones, as well as agreement within 10% between the measured and Broselow-predicted weights. A cross-validated correction factor was also derived.The mean percentage differences were -2.4, -11.3, and -12.9% for each weight-based group. The Broselow color-coded zone agreement was 70.8% in children weighing less than 10 kg, but only 56.3% in the 10- to 18-kg group and 37.5% in the > 18-kg group. Agreement within 10% was 52.6% for the < 10-kg group, but only 44.7% for the 10- to 18-kg group and 33.5% for the > 18-kg group. Application of a 10% weight-correction factor improved the percentages to 77.1% for the 10- to 18-kg group and 63.0% for the >18-kg group.The Broselow tape overestimates weight by more than 10% in Indian children > 10 kg. Weight overestimation increases the risk of medical errors due to incorrect dosing or equipment selection. Applying a 10% weight-correction factor may be advisable.

    View details for DOI 10.1111/j.1553-2712.2008.00081.x

    View details for Web of Science ID 000255285200005

    View details for PubMedID 18439198

  • Expedition Orthopedics In Bledsoe GH (Editor): Expedition Medicine Gianotti A, Mahadevan S 2008
  • Issues and Solutions in Introducing Western Systems to Prehospital Care Systems in Japan. WestJEM Suzuki T, Nishida M, Suzuki Y, Kobayashi K, Mahadevan S. 2008; 9: 166-170
  • Spine Trauma and Spinal Cord Injury In Adams J (Editor): Emergency Medicine: Expert Consult: Online and Print Lin M, Mahadevan S 2008
  • Effects of implementing a rapid admission policy in the ED AMERICAN JOURNAL OF EMERGENCY MEDICINE Quinn, J. V., Mahadevan, S. V., Eggers, G., Ouyang, H., Norris, R. 2007; 25 (5): 559-563

    Abstract

    The purpose of this study is to determine the impact of a new rapid admission policy (RAP) on emergency department (ED) length of stay (EDLOS) and time spent on ambulance diversion (AD).The RAP, instituted in January 2005, allows attending emergency physicians to send stable patients, requiring admission to the general medicine service, directly to available inpatient beds. The RAP thereby eliminates 2 conventional preadmission practices: having admitting physicians evaluate the patient in the ED and requiring all diagnostic testing to be complete before admission. We compared patient characteristics, percentage of patients leaving without being seen, EDLOS for admitted patients, time on AD, and total adjusted facility charge for a 3-month period after the RAP implementation to the same period of the prior year.There was a 1.1% increase in census with no difference in patient demographics, acuity, or disposition categories for the 2 periods. The EDLOS decreased on average by 10.1 minutes (95% confidence interval [CI], 3.3-17.0 minutes), resulting in an average of 4.2 hours of extra bed availability per day. Weekly minutes of AD decreased 169 minutes (95% CI, 29-310 minutes). There was also a 3.2% increase (95% CI, 3.1%-3.3%) in adjusted facility charge between these periods in 2005 compared with 2004.The RAP resulted in a small decrease in the EDLOS, which likely decreased AD time. The resulting small increase in ED volume and higher acuity ambulance patients significantly improved ED revenue. Wider implementation of the policy and more uniform use among emergency physicians may further improve these measures.

    View details for DOI 10.1016/j.ajem.2006.11.034

    View details for Web of Science ID 000247298800012

    View details for PubMedID 17543661

  • Annotated Bibliography of Blast Injury. Blast Injury Educational Curriculum for Healthcare providers in Egypt. Strehlow M, Mahadevan S, Savitsky E 2007
  • Clinical Assessment of Hypovolemia. Emergency Medicine Practice?s The 2007Lifelong Learning and Self-Assessment (LLSA) Study Guide. Strehlow M, Mahadevan S 2007
  • Emergency Airway Management In Auerbach PS (Editor): Wilderness Medicine (5th Edition) Mahadevan S 2007
  • Adolescent Violence, Sikh Religion and Hate Crimes Case Based Cultural Competency Curriculum in Emergency Medicine. Mahadevan S 2006
  • Ultrasound-Guided Procedural Training Using Emerging Technologies Acad Emerg Med Savitsky E, Mahadevan S 2006; 25: 559-63
  • Importance, Advances and Impact of an International Emergency Trauma Care Education Program. Indian Emergency Journal. Indian Emergency Journal Mahadevan S 2005; 1 (1)
  • Importance, Advances and Impact of an International Emergency Trauma Care Education Program. Indian Emergency Journal Mahadevan SV 2005; 1 (1): 12-15
  • Cervical Spine Fractures Harwood Nuss? Clinical Practice of Emergency Medicine (4th edition). Mower W, Hoffman JR, Mahadevan S: 2005
  • Ear pain In Mahadevan S (Editor) & Garmel G (Co-editor): An Introduction to Clinical Emergency Medicine Gilbert G, Mahadevan SV 2005
  • Airway Management In Mahadevan S (Editor) & Garmel G (Co-editor): An Introduction to Clinical Emergency Medicine Mahadevan SV, Sovndal S 2005
  • Abdominal Pain In Mahadevan S (Editor) & Garmel G (Co-editor): An Introduction to Clinical Emergency Medicine Mahadevan SV 2005
  • An Introduction to Clinical Emergency Medicine: Guide for Practitioners in the Emergency Department (First Edition) Mahadevan SV, Garmel GM 2005
  • Emergency department orientation utilizing web-based streaming video ACADEMIC EMERGENCY MEDICINE Mahadevan, S. V., Gisondi, M. A., Sovndal, S. S., Gilbert, G. H. 2004; 11 (8): 848-852

    Abstract

    To assure a smooth transition to their new work environment, rotating students and housestaff require detailed orientations to the physical layout and operations of the emergency department. Although such orientations are useful for new staff members, they represent a significant time commitment for the faculty members charged with this task. To address this issue, the authors developed a series of short instructional videos that provide a comprehensive and consistent method of emergency department orientation. The videos are viewed through Web-based streaming technology that allows learners to complete the orientation process from any computer with Internet access before their first shift. This report describes the stepwise process used to produce these videos and discusses the potential benefits of converting to an Internet-based orientation system.

    View details for DOI 10.1197/j.aem.2003.10.032

    View details for Web of Science ID 000223090900006

    View details for PubMedID 15289191

  • Evaluation and Clearance of the Cervical Spine in Adult Trauma Patients: Clinical Concepts, Controversies and Advances: Part 2 Trauma Reports Mahadevan SV, Navarro M 2004; 5 (5)
  • Evaluation and Clearance of the Cervical Spine in Adult Trauma Patients: Clinical Concepts, Controversies and Advances: Part 1 Trauma Reports Mahadevan SV, Navarro M 2004; 5 (4)
  • Cervical Spine Injury in Blunt Trauma Emergency Medicine Practice?s The 2004 Lifelong Learning and Self-Assessment (LLSA) Study Guide. Mahadevan SV 2003
  • Knee Injuries. Emergency Medicine Practice?s The 2004 Lifelong Learning and Self-Assessment (LLSA) Study Guide. Garza D, Mahadevan SV 2003
  • The outstanding medical student in emergency medicine ACADEMIC EMERGENCY MEDICINE Mahadevan, S., Garmel, G. M. 2001; 8 (4): 402-403

    View details for Web of Science ID 000168133100018

    View details for PubMedID 11282680

  • Ocular Trauma Trauma Reports Mahadevan SV, Savitsky E 2001; 2 (4)
  • Traumatic Ocular Injuries and Visual Loss Hospital Physician: Emergency Medicine Board Review Manuak Mahadevan SV 1999; 5 (1)
  • Interrater reliability of cervical spine injury criteria in patients with blunt trauma ANNALS OF EMERGENCY MEDICINE Mahadevan, S., Mower, W. R., Hoffman, J. R., Peeples, N., Goldberg, W., Sonner, R. 1998; 31 (2): 197-201

    Abstract

    To determine the interrater reliability of previously defined risk criteria for cervical spine injury.Two emergency physicians independently evaluated patients with blunt trauma to determine whether they exhibited any of four risk criteria: (1) altered neurologic function; (2) evidence of intoxication; (3) spinous process or posterior midline cervical tenderness; or (4) distracting painful injury. Each criterion was explicitly described on study data forms. Physician concordance was measured, and the kappa statistic was calculated, for the combined risk criteria (based on the presence of any individual criterion), and for each individual criterion.There were 122 patients evaluated. Physicians agreed on overall classifications for 107 patients (87.7%; kappa, .73; confidence interval [CI], .61 to .86). Agreement for individual criteria were as follows: (1) altered neurologic function--102 patients (83.6%; kappa, .58; CI, .41 to .74); (2) intoxication--118 patients (96.7%; kappa, .86; CI, .72 to .99); (3) posterior midline tenderness--109 patients (89.3%; kappa, .77; CI .65 to .89); (4) distracting injury--112 patients (91.8%; kappa.77; CI, .64 to .91).The combined cervical spine injury criteria have substantial interrater reliability. Individual criteria are slightly less reliable.

    View details for Web of Science ID 000071887900007

    View details for PubMedID 9472180

  • Nontraumatic Ocular Emergencies. Hospital Physician: Emergency Medicine Board Review Manuak Mahadevan SV 1998; 4 (3)
  • ADENOSINE FOR THE PREHOSPITAL TREATMENT OF PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA ANNALS OF EMERGENCY MEDICINE Gausche, M., Persse, D. E., SUGARMAN, T., Shea, S. R., PALMER, G. L., Lewis, R. J., BRUESKE, P. J., Mahadevan, S., Melio, F. R., KUWATA, J. H., Niemann, J. T. 1994; 24 (2): 183-189

    Abstract

    To determine the efficacy and feasibility of adenosine for the treatment of paroxysmal supraventricular tachycardia (PSVT) in the prehospital setting.Prospective case series.Large, urban, advanced life support emergency medical services system.One hundred twenty-nine adult patients with PSVT, as identified by paramedic personnel. Pregnant patients and those taking carbamazepine or dipyridamole were excluded.Dose of 12 mg adenosine by rapid i.v. push followed by a 5-mL saline flush and a repeat dose of 12 mg adenosine i.v. push if the patient's rhythm remained unchanged.Six-second lead II rhythm strips and vital signs were documented before and 2 minutes after the administration of adenosine. Demographic information, past medical history, medications, number of adenosine doses given, and complications were recorded by the paramedic on a case-report form. One hundred six of 129 (82%) of the case-report forms included the rhythm strips from before and after adenosine administration. Actual initial rhythms were determined by a consensus panel. The initial rhythms were PSVT in 79% (84 of 106) of patients, atrial fibrillation in 12% (13 of 106), sinus tachycardia in 5% (five of 106), atrial flutter in 2% (two of 106), and ventricular tachycardia in 2% (two of 106). Eighty-five percent (71 of 84) of patients in PSVT were successfully converted to sinus rhythms; four (5.6%) of these patients required a second 12-mg dose. One patient in atrial fibrillation spontaneously converted to normal sinus rhythm and one patient in ventricular tachycardia converted after adenosine. All other patients not initially in PSVT remained in their initial rhythm. Complications occurred in 12 of 129 patients and included chest pain (five), flushing (three), shortness of breath (two), nausea (one), anxiety (one), dizziness (one), headache (one), and seizure (one). All complications were transient and required no treatment. Prior history of PSVT was the only variable associated with a higher rate of conversion (P = .029).Paramedics are able to accurately identify PSVT using a single lead. Adenosine is safe and effective treatment for PSVT in the prehospital setting. This series is the largest prehospital study of adenosine use to date.

    View details for Web of Science ID A1994PA15600001

    View details for PubMedID 8037382

Conference Proceedings


  • Internationalizing the broselow tape: How reliable is weight estimation in Indian children? Ramaralan, N., Krishnamoorthi, R., Strehlow, M., Quinn, J., Mahadevan, S. MOSBY-ELSEVIER. 2008: 512-513

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