Annals of emergency medicine
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Garter snake bites are generally innocuous to human beings. We report a case of human envenomation from the Wandering Garter snake (Thamnophis elegans vagrans). The patient, who was bitten on his right third fingertip, rapidly developed local edema, ecchymosis, and hemorrhagic vesicles. ⋯ The clinical picture was similar to that in three previous patients with Thamnophis envenomation in that clinical signs followed a prolonged bite. Thamnophis species have Duvernoy's glands, which may be analogous to venom glands in Crotalidae (pit viper) species. The progressive local effects produced by secretions of these glands may be confused with early Crotalidae envenomation.
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Review Case Reports
Bilateral spontaneous pneumothoraces, pneumopericardium, pneumomediastinum, and subcutaneous emphysema: a rare presentation of paraquat intoxication.
Pneumothorax, subcutaneous emphysema, and pneumomediastinum occur frequently in critically ill patients in association with blunt or penetrating injuries or other conditions while performing Valsalva-like maneuvers. We present the case of a patient with bilateral pneumothoraces, pneumomediastinum, pneumopericardium, and subcutaneous emphysema after acute paraquat intoxication.
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To examine the rate and source of funding of research articles published in the emergency medicine literature. ⋯ The majority of research articles published in the three journals during the two years did not list a source of funding. This is in contrast to other specialties, in which the majority of published research is funded. The emergency medicine literature relies more heavily on private industry funding than does the literature of other specialties.
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Comparative Study
Work-related stress and depression among practicing emergency physicians: an international study.
To compare the levels of work-related stress and depression reported by practicing emergency physicians in three survey sites and to determine the effects of gender and marital status on the stress and depression experienced by these physicians. ⋯ Statistical differences among practicing emergency physicians from the United States, Australasia, and the United Kingdom were observed, but the actual levels of work-related stress and depression were similar and did not appear severe. Marriage was associated with lower levels of depressive symptomatology.
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To characterize the role of emergency medicine residency programs in determining emergency medicine career choice among medical students. ⋯ An emergency medicine residency program that is closely affiliated with a medical school is strongly and independently associated with a quantitatively and statistically significant increase in the proportion of students from that school who choose a career in emergency medicine. These data support the proposition that, if emergency medicine is to meet national manpower shortage needs by attracting students to the specialty, it must establish residency programs within the primary teaching hospital(s) of medical schools. Such a configuration does not currently exist in the majority of schools.