J Emerg Med
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Emergency departments (EDs) need to be prepared to manage crises and disasters in both the short term and the long term. The coronavirus disease 2019 (COVID-19) pandemic has necessitated a rapid overhaul of several aspects of ED operations in preparation for a sustained response. ⋯ A crisis like the COVID-19 pandemic requires careful planning to facilitate urgent restructuring of many aspects of an ED. By sharing our departments' responses to the COVID-19 pandemic, we hope other departments can better prepare for this crisis and the next.
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Helicopter Emergency Medical Services (HEMS) dispatch currently depends on predefined protocols, on first responders' initial assessment, or on medical direction decision in some states. National guidelines do not provide recommendations concerning prehospital time criteria. ⋯ In adult patients with blunt trauma, HEMS transport was associated with overall improved survival rates mainly in the first 30 min after injury. GEMS transport, however, had a survival advantage in the 61- to 90-min total prehospital time interval.
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Case Reports
Laryngeal Edema, Metabolic Acidosis, and Acute Kidney Injury Associated with Large-Volume Kohrsolin TH® Ingestion.
Glutaraldehyde is a commonly used disinfectant in most hospitals. It is known to be an irritating agent to the airway. With the exception of one small-quantity (75 mL) ingestion, no large-volume ingestion has been previously reported. ⋯ A 59-year-old man presented with history of large-volume (500 mL) consumption of a solution containing 10% glutaraldehyde and developed respiratory distress, as well as gastrointestinal and kidney injury. His ingestion necessitated a feeding jejunostomy tube placement and tracheostomy. His condition improved with supportive care and he was discharged after 1 month with no long-term sequelae. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Ingestion of this easily accessible agent, which may initially seem clinically benign, warrants close observation. Emergent airway stabilization and supportive care is crucial to the survival of the patient.