Annals of emergency medicine
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Although the rate of new cases of HIV infection has been relatively stable during the past decade, it remains unacceptably high, with 40,000 individuals newly infected each year. In 2001, the Centers for Disease Control and Prevention (CDC) issued revised guidelines for HIV counseling, testing, and referral directed toward promoting further reduction of HIV acquisition and transmission. ⋯ Despite the time and practical limitations inherent in ED practice, many studies suggest that routine HIV counseling, testing, and referral in the ED may be feasible and effective. This article reviews those studies in the context of the most up-to-date CDC HIV counseling, testing, and referral guidelines.
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Influenza has been linked to emergency department (ED) crowding, yet few studies have examined this association. We describe the relationship between ED crowding and influenza outbreaks. ⋯ Influenza seasons are associated with increased ED ambulance diversion. The impact is substantial but brief because there is little or no influenza activity most of each year.
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Editorial Guideline
"Do not attempt resuscitation" (DNAR) in the out-of-hospital setting.