Annals of emergency medicine
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Review Case Reports
Bilateral spontaneous pneumothoraces, pneumopericardium, pneumomediastinum, and subcutaneous emphysema: a rare presentation of paraquat intoxication.
Pneumothorax, subcutaneous emphysema, and pneumomediastinum occur frequently in critically ill patients in association with blunt or penetrating injuries or other conditions while performing Valsalva-like maneuvers. We present the case of a patient with bilateral pneumothoraces, pneumomediastinum, pneumopericardium, and subcutaneous emphysema after acute paraquat intoxication.
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To examine the rate and source of funding of research articles published in the emergency medicine literature. ⋯ The majority of research articles published in the three journals during the two years did not list a source of funding. This is in contrast to other specialties, in which the majority of published research is funded. The emergency medicine literature relies more heavily on private industry funding than does the literature of other specialties.
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Hospital disaster planning should encompass events that affect the safety of the hospital environment and address those measures that ensure the availability of necessary services. Although most of the emphasis has been placed on general disaster planning, there is little written about disasters occurring within a hospital. In recent years, several incidents at our medical center involving fire, flood, and power failure resulted in a reevaluation of our preparedness to handle such situations. These experiences prompted this discussion and literature review of internal disaster plan because it is likely that at some time an internal emergency may occur.
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Sedation and analgesia are essential components of the ED management of pediatric patients. Used appropriately, there are a number of medications and techniques that can be used safely in the emergency care of infants and children. Emergency physicians should be competent in the use of multiple sedatives and analgesics. Adequate equipment and monitoring, staff training, discharge instructions and continuous quality management should be an integral part of the ED use of these agents.
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Sepsis and septic shock are among the most frequent life-threatening infectious disease problems encountered in emergency medicine practice. This review summarizes the extensive research into the pathophysiology of sepsis, with emphasis on Gram-negative infection. ⋯ It also critically evaluates new preparations developed to blunt the actions of the exogenous and endogenous mediators responsible for the clinical manifestations comprising this syndrome. Clinical signs likely to be associated with Gram-negative infection are also reviewed, and guidelines are considered for the potential use of newly developed anti-endotoxin antibodies and other biological response modifiers in the treatment of patients with Gram-negative sepsis.