Robert Hood, Kenneth M Shermock, Charles Emerman
DOI: http://dx.doi.org/10.1016/j.ajem.2003.09.009
Published in issue: January 2004
xLittle data exists comparing the safety and efficacy of triple antibiotic ointment (TAO) and mupirocin for prevention of uncomplicated soft tissue wound infections. The purpose of this investigation was to conduct a pilot study of the relative safety, efficacy, and cost effectiveness of the 2 preparations. This was a randomized, prospective, interventional study to determine the difference in infection rates of uncomplicated soft tissue wounds between subjects treated with TAO and mupirocin ointment after standard wound care and suturing.
Werner Rabitsch, Ajsa Nikolic, Peter Schellongowski, Julia Kofler, Peter Kraft, Claus G Krenn, Thomas Staudinger, Gottfried J Locker, Paul Knöbl, Roland Hofbauer, Michael Frass
DOI: http://dx.doi.org/10.1016/j.ajem.2003.09.008
Published in issue: January 2004
xEvaluation of tube position is important after in-hospital and prehospital emergency intubation. Colorimetric breath indicators are devices for immediate control of tube positioning by showing a color change according to end-tidal CO2 (ETCO2) concentrations. We hypothesized that colorimetric breath indicators can yield reliable results for confirmation of tube position. The aim of this study was to evaluate the effectivity and safety of a new colorimetric breath indicator (Colibri, ICOR AB, Bromma, Sweden) in 147 patients during general anesthesia, in critically ill patients, during transport to in-hospital interventions, and in a study design after insertion of a second tube into the esophagus in long-term ventilated patients.
Joshua Broder, David Jerrard, Jonathan Olshaker, Michael Witting
DOI: http://dx.doi.org/10.1016/j.ajem.2003.09.004
Published in issue: January 2004
xTo assess the need for antibiotics in low-risk human bite wounds, a prospective, double-blind, placebo-controlled study involving 127 patients presenting with low-risk human bite wounds over 2 years to a 40,000 visit per year major academic ED was performed. Low-risk bites penetrated only the epidermis and did not involve hands, feet, skin, overlying joints, or cartilaginous structures. Exclusion criteria included age less than 18 years, puncture wounds, immunocompromise, allergy to penicillin or related compound, or bites greater than 24 hours old.
Marc Cohen, Heidar Arjomand, Charles V Pollack Jr
DOI: http://dx.doi.org/10.1016/j.ajem.2003.09.001
Published in issue: January 2004
xAcute ST-segment elevation myocardial infarction continues to be associated with substantial mortality rates. Despite much advancement in care, current treatments have also failed to eliminate the significant risk of morbidity, including reinfarction, reocclusion of the infarct-related artery, and thromboembolic stroke. The potential benefit of early thrombolytic therapy in reducing mortality was first established in 1986. Further benefits of conjunctive therapy with aspirin were demonstrated soon thereafter.
Ron Ben-Abraham, Avi A Weinbroum
DOI: http://dx.doi.org/10.1016/j.ajem.2003.09.006
Published in issue: January 2004
xThe purpose of this study was to evaluate the rates of successful airway control using endotracheal tubes (ETs) or laryngeal mask airways (LMAs) and compare them between anesthetists and non-anesthetists wearing full antichemical protective gear. Anesthetists and non-anesthetists (n = 10 per group) twice attempted inserting ETs and LMAs on a mannequin model of airway management in a crossover, prospective manner. Times to successful insertion and failure rates were recorded. Non-anesthetists had a slightly higher failure rate inserting ETs compared with anesthetists (P = not significant).
Michael Mullins, Krista Van Zwieten, Jeffrey R Blunt
DOI: http://dx.doi.org/10.1016/j.ajem.2003.09.003
Published in issue: January 2004
xIn December 2001, the FDA required a “black box warning” suggesting that unexpected cardiovascular deaths could occur at normal therapeutic doses of droperidol. We reviewed data from 270 MedWatch reports, including 99 reports of death, submitted between November 1, 1997, and January 10, 2002. We further reviewed primary reports of deaths and cardiovascular adverse events associated with ≤10 mg of droperidol. There were 99 death reports representing 89 patients, with a specified dose in 66 cases.
Richard M Nowak, Charles L Emerman, Kendyl Schaefer, Rachel L DiSantostefano, Louis Vaickus, James M Roach
DOI: http://dx.doi.org/10.1016/j.ajem.2003.11.001
Published in issue: January 2004
xThis was a prospective, open-label, nonrandomized pilot study to evaluate efficacy and tolerability of levalbuterol (LEV) in acute asthma. Asthmatics (forced expiratory volume in 1 second [FEV1], 20–55% predicted) were sequentially enrolled into cohorts of 12 to 14 and received 0.63, 1.25, 2.5, 3.75, or 5.0 mg LEV or 2.5 or 5.0 mg racemic albuterol (RAC) every 20 minutes × 3. After the first dose, FEV1 changes were 56% (0.6 L) for 1.25 mg LEV and 6% (0.07 L) and 14% (0.21 L) for 2.5 and 5 mg RAC respectively.
Slava V Gaufberg, Tom P Workman
DOI: http://dx.doi.org/10.1016/j.ajem.2003.09.002
Published in issue: January 2004
xWe propose a simple and flexible connection setup for needle cricothyroidotomy. Needle cricothyroidotomy is a life-saving procedure. It is technically easy to perform, but it cannot provide adequate ventilation for a long period of time. The standard recommended ventilation equipment for needle cricothyroidotomy consists of a jet insuflator connected to a source of oxygen with 50 psi pressure. Such a setup is not always available in emergency situations. Alternative setups using ventilation with a bag-valve had been proposed.
Douglas D Brunette
DOI: http://dx.doi.org/10.1016/S0735-6757(02)42250-4
Published in issue: January 2004
xObesity is a major health care problem in the United States. The body mass index (BMI) is the standard measure of obesity. A BMI >25 kg/m2 is defined as overweight and obesity as a BMI >30 kg/m2. Recent surveys indicate that 54% of adults, or roughly 97 million people, are overweight.1,2 Given the incidence of obesity in the general population, it is likely that EM physicians will be involved in the emergency care of critically ill or injured obese patients. The objective of this article is to present the clinical problems associated with the resuscitation of the critically ill or injured obese patient and their potential solutions.
Charles A Perrott
DOI: http://dx.doi.org/10.1016/j.ajem.2003.09.007
Published in issue: January 2004
xInguinal hernias are a common problem but often present with diagnostic dilemmas, in part as a result of the complex anatomy of the region. A simplified analogy is put forward in the hope of increasing the understanding of the anatomy and some guidance given in an endeavor to differentiate direct and indirect hernias, with significance to their possible complication rates.
Barth Wilsey, Scott Fishman, John S Rose, Jennifer Papazian
DOI: http://dx.doi.org/10.1016/j.ajem.2003.09.005
Published in issue: January 2004
xRecent regulatory and legal scrutiny has raised concerns about the over- and undertreatment of pain in the hospital. This debate stems from either the overly aggressive approach to the management of pain with opioids or, alternatively, to the barriers preventing the appropriate prescribing of these medications. The media attention on diversion of controlled substances for illicit purposes has intensified this debate, highlighting the possible overuse of these medications in the treatment of nonmalignant pain.
Douglas S. Ander, Katherine L. Heilpern, Constance S. Parramore
DOI: http://dx.doi.org/10.1016/j.ajem.2003.09.012
Published in issue: January 2004
Armand H. Dorian, Fredrick M. Abrahamian
DOI: http://dx.doi.org/10.1016/j.ajem.2003.09.016
Published in issue: January 2004
Katarzyna Ferraro, Merrill A. Cohen
DOI: http://dx.doi.org/10.1016/j.ajem.2003.09.010
Published in issue: January 2004
Jeanne L. Jacoby, Jessica Fulton, David Pronchik, John Patterson, James Reed, Michael B. Heller
DOI: http://dx.doi.org/10.1016/j.ajem.2003.09.013
Published in issue: January 2004
Vincenzo Marafioti, Andrea Variola
DOI: http://dx.doi.org/10.1016/j.ajem.2003.09.014
Published in issue: January 2004
Atsunobu Tsunoda, Akio Hatanaka, Nanae Watabiki, Tatsuya Ishige, Makoto Okamoto, Takaaki Yamashita
DOI: http://dx.doi.org/10.1016/j.ajem.2003.08.020
Published in issue: January 2004
DOI: http://dx.doi.org/10.1016/S0735-6757(03)00271-7
Published in issue: January 2004
DOI: http://dx.doi.org/10.1016/S0735-6757(03)00272-9
Published in issue: January 2004
DOI: http://dx.doi.org/10.1016/S0735-6757(03)00273-0
Published in issue: January 2004
