Annals of emergency medicine
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To survey emergency care providers about their stethoscope-cleaning measures and to determine the correlation between these measures and the extent of Staphylococcus carriage. ⋯ Our results confirm that stethoscopes used in emergency practice are often contaminated with staphylococci and are therefore a potential vector of infection. This contamination is greatly reduced by frequent cleaning with alcohol or nonionic detergent.
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The recent increase in tuberculosis (TB) cases may have an important effect on emergency department infection-control measures. We describe infection-control interventions for TB patients admitted through the ED and hypothesize that ED suspicion of TB is associated with more rapid isolation and treatment. ⋯ Among patients with active pulmonary TB in the ED, TB is often unsuspected and isolation measures are often not used. ED suspicion of TB is associated with more rapid isolation and treatment.
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To compare CPR with chest compressions plus ventilatory support (CC+V) and chest compressions alone (CC). ⋯ In this experimental model of bystander CPR, we could not detect a difference in hemodynamics, 48-hour survival, or neurologic outcome when CPR was applied with and without ventilatory support.
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To characterize fatigue-induced deterioration in the adequacy of closed-chest compressions performed over a period of 5 minutes and to determine whether CPR providers can recognize the effects of fatigue on compression adequacy. ⋯ Although compression rate was maintained over time, chest compression quality declined significantly over the study period. Because CPR providers could not recognize their inability to provide proper compressions, cardiac arrest team leaders should carefully monitor compression adequacy during CPR to assure maximally effective care for patients receiving CPR.
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To analyze the emergency medicine system in a developing country and identify areas of need and potential collaboration. ⋯ The ED and prehospital systems provide high-volume and often high-acuteness care. Barriers to improved care include limited specialized training and lack of medical records.