J Emerg Med
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The therapeutic use of oxygen was pioneered in the early 20(th) century by the respiratory physiologist John Scott Haldane. His work followed Claude Bernard's description of the toxic effects of carbon monoxide. Haldane, having also observed the effects of carbon monoxide poisoning, became aware of the therapeutic benefits of oxygen in this condition. ⋯ Mayow's work was largely overlooked during his lifetime, and his insight was subsequently eclipsed by the phlogiston theory, an erroneous concept widely believed for nearly a century after his death. This theory was ultimately disproved by Joseph Priestley in 1774. Although the point of primacy is somewhat contentious, Priestley shares the distinction of discovering elemental oxygen with Antoine-Laurent Lavoisier, the French chemist, and Carl Wilhelm Scheele, the Swedish apothecary.
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This article reports the case of a 73-year-old man with hypocalcemia-induced heart failure secondary to primary idiopathic hypoparathyroidism. Total calcium at the time of presentation was 5.36 mg/dL (1.34 mmol/L). ⋯ However, hypocalcemia is reported as a reversible cause of cardiac failure. Hypocalcemia should be considered in patients with heart failure and prolonged QT intervals, particularly those with signs and symptoms such as paresthesias, as it is readily reversible.
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A collaborative partnership between the Johns Hopkins Hospital, Chaoyang Red Cross Hospital and Chinese Ministry of Health has been established to initiate Emergency Medicine (EM) administrative training in Beijing, China. The Emergency Medical Education and Training Center (EMETC) at Chaoyang Red Cross Hospital was opened as a training facility to foster EM administrative curriculum development and training nationwide. A six-step approach with problem identification, needs assessment, goals and objectives, educational strategies, implementation and evaluation was used to form a locally adapted curriculum. ⋯ Since its inception, the EMETC has trained 95 persons from throughout China in EM administration. An EM administration curriculum has been developed and refined. In conclusion, an international partnership between academic hospitals, supported by the local Ministry of Health, to develop a national training facility using this six-step approach may be an attractive strategy for dissemination of EM administration principles.
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To describe the prevalence and types of distracting injuries associated with vertebral injuries at all levels of the spine in blunt trauma patients. A prospective cohort study was conducted at an urban Level I trauma center. All patients undergoing radiographic evaluation of the cervical, thoracic, or lumbar vertebrae after blunt trauma were enrolled. ⋯ Distracting injuries in those patients without vertebral injuries included bony fractures (333), lacerations (63), soft tissue contusions (62), head injuries (15), bony dislocations (12), abrasions (11), visceral injuries (8), dental injuries (5), burns (3), ligamentous injuries (3), amputation (1), and compartment syndrome (1). In conclusion, in patients with distracting injuries, bony fractures of any type were important for identifying patients with vertebral injuries. Other types of distracting injuries did not contribute to the sensitivity of the clinical screening criteria in the detection of patients with vertebral injuries.
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We sought to describe the implementation of the Hospital Emergency Incident Command System (HEICS) at National Cheng Kung University Hospital (NCKUH) in Taiwan, ROC during the outbreak of severe acute respiratory syndrome (SARS) in early 2003. We administered a 14-question survey via structured interviews to individuals occupying activated HEICS leadership positions at NCKUH to identify the organization, structure, and function of the HEICS units and subunits they led and the job actions they performed from 25 March to 16 June 2003 Thirty-three of 38 persons (87%) occupying 39 of 44 (89%) activated HEICS leadership positions directly participated in the survey. The participants collectively reported: 1) the creation of four new HEICS unit leader positions and corresponding units during the outbreak, including the infection control officer (administrative section) and SARS assessment, isolation, and critical care unit leaders (operations section); 2) the creation of six new HEICS subunits, including functional areas for fever screening, SARS assessment, and resuscitation outside the hospital, and SARS patient care, SARS critical care, and employee isolation inside the hospital; and 3) the performance of new job actions related to infection control by all HEICS unit leaders. HEICS provides a flexible framework that seems to have assisted NCKUH in the organization of its emergency response to the SARS outbreak in Taiwan, ROC.