Annals of emergency medicine
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This study was conducted to determine whether hospital emergency department (ED) use has been affected by the presence of freestanding emergency centers (FECs) in hospitals' service areas. A sample of FECs was drawn and hospitals in their service areas identified. ED visits to those hospitals from 1970 to 1980 were compared with those of a comparison group of hospitals not studied. ⋯ Because of the relative newness of FEC development, future studies of this type should be conducted. This study could not answer the question of whether FECs caused the growth of hospital ED visits to slow. It did not attempt to measure the impact FECs have on private medical practices or determine whether FECs attract currently underserved patient groups.
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A case of cyanide poisoning from laetrile ingestion is presented as an illustration of the recognition and treatment of cyanide intoxication. The pharmacology of laetrile, of cyanide, and of antidotes to cyanide intoxication are discussed as they relate to the acute management and successful treatment of this patient after this highly lethal ingestion.
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Increasing cerebral vascular resistance and brain perfusion failure occur within 90 minutes following cardiac arrest and resuscitation. This study followed cortical perfusion for 18 hours after a 15-minute cardiac arrest. Six dogs were anesthetized with ketamine and gallamine and then mechanically ventilated. ⋯ Determinations of rCCBF from 6 to 18 hours in post-arrest animals were 7% to 14% of pre-arrest values. We conclude that the post-resuscitation perfusion failure in the cortex is prolonged. Any potential for neuronal recovery, unless perfusion is protected, would not be realized given this phenomenon.