The American journal of emergency medicine
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The current recommendations for body-packers are based on packet content, the presence of drug toxicity, or of bowel obstruction. Asymptomatic patients are usually treated with activated charcoal and whole bowel irrigation (WBI). ⋯ However, we report 2 body-packers who show the limitations of this technique. These cases show the importance of confirming the absence of drug packets in the gastrointestinal (GI) tract as the definitive end-point in the treatment of body-packers.
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Comparative Study
Ethnic differences in the ST segment of the electrocardiogram: a comparative study among six ethnic groups.
Deviation of the ST segment of the electrocardiogram (ECG) may signify infarction or ischemia. Prior studies suggest that normal ECG patterns may differ among ethnic groups. We retrospectively reviewed the first thousand medical files of a multiethnic community, where all individuals shared similar living conditions. ⋯ Significant ST segment elevation is common in normal healthy men but may not fulfill criteria for early repolarization; it has no ethnic predilection. ST segment elevation is uncommon in normal women. ST segment depression is a rare finding in healthy adults regardless of ethnic origin.
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A major drawback of submission of so-called incident reports for medical institutions is that such reports may be able to be obtained on request by patients and to be used as evidence in malpractice lawsuits. In Japan, there are no established rules concerning the use of accident reports in medical lawsuits. More debate is needed for voluntary report systems to become established in medical institutions throughout Japan.
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The objective of the study was to evaluate the effectiveness of triage, treatment, and transfer interventions on multiple burn casualties managed in a high volume ED that does not have a verified in-hospital burn unit. The charts of 11 male patients injured in a 1999 foundry explosion and brought to Baystate Medical Center (BMC), a level I trauma center, were reviewed. All patients sustained deep partial and full thickness burns. ⋯ The resources and expertise of a high volume ED without an in-hospital burn unit can be effectively used in the initial resuscitation and treatment of multiple burn casualties. Coordinated responses among emergency medicine, trauma, anesthesia, and nursing personnel are instrumental to the rapid triage, resuscitation, and treatment of critically injured burn patients. Future disaster planning should incorporate a clearly demarcated, ED command center led by an easily identifiable "captain of the ship," as well as more accurate patient identification systems and improved communications with family members.