J Emerg Med
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Superficial abscesses are commonly seen in the emergency department. In most cases, they can be adequately treated by the emergency physician without hospital admission. Treatment consists of surgical drainage with the addition of antibiotics in selected cases. ⋯ Staphylococcus aureus accounts for less than half of all cutaneous abscesses. Anaerobic bacteria are common etiologic agents in the perineum and account for the majority of all cutaneous abscesses. Abscesses at specific locations involve special consideration for diagnosis and treatment and may require specialty consultation.
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Near-drowning is defined as survival for at least some period of time after suffocation from submersion in a liquid. This article is a comprehensive review of the demography, pathophysiology, treatment, and prevention of near-drowning, an accident that affects approximately 6,000 to 7,000 Americans per year. Forty percent of these victims are children younger than 5 years. ⋯ The hypothermic patient requires special considerations. The role of aggressive cerebral resuscitation has not been elucidated. Prevention of the circumstances that lead to near-drowning must be stressed as a public service.
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There is growing concern in academic emergency medicine as to the appropriateness of 24-hour faculty coverage in the teaching emergency department. We surveyed 170 teaching emergency departments, 49 of which had approved emergency medicine residencies, asking for information regarding 24-hour faculty coverage. We were able to separate each department into one of 15 profiles based on the two variables of average ED yearly census and hospital type. Seventy-three percent of university teaching hospital EDs and 65% of those with emergency medicine residencies have 24-hour faculty coverage; 83% of private teaching hospital EDs and 100% of those with emergency medicine residencies have 24-hour faculty coverage; and 79% of city/county teaching hospital EDs and 80% of those with emergency medicine residencies have 24-hour faculty coverage.
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The effective teaching of clinical emergency medicine to medical students requires efficiency in the management of both student and faculty time. Presented is a course outline that makes use of the following elements to structure and augment clinical time in the emergency department (ED): Videotape to present a 19.7-hour series of faculty-produced lectures covering a "core" emergency medicine curriculum. A microcomputer to facilitate staggered scheduling of clinical time. ⋯ Once established, this program can be administered with fewer than five faculty hours per month assisted by a part-time (25% full-time equivalent) clerical coordinator. The total cost for the instructional program is $86.37 per student using the new technologies, and $144.15 per student when presenting the same program using traditional teaching techniques. The use of new technologies in student teaching will therefore result in significant savings.
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The management in the emergency department of febrile infants less than 2 months of age is influenced by the standard of practice in the community. We sought to determine if uniform practices existed across the United States. Individual academically based faculty from 154 (61%) United States pediatric residency programs responding to a questionnaire on the emergency department management of febrile infants less than 2 months of age showed great variability. ⋯ Respondents differed on the number and types of tests used and on antibiotic administration. University affiliation, type of population served, or presence of advanced training programs in ambulatory pediatrics were not related to the type of policy. The care of the young febrile infant varies greatly.