Annals of emergency medicine
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Multicenter Study
Prevalence of Staphylococcus aureus nasal colonization in emergency department personnel.
Nasal colonization with Staphylococcus aureus and methicillin-resistant Staphylococcus aureus (MRSA) can precede infection in patients and contacts. Although general population S aureus/MRSA rates are well described, the prevalence of S aureus and MRSA nasal colonization in emergency department health care workers is not defined. We seek to determine the prevalence of S aureus and MRSA nasal colonization among ED health care workers without evidence of an active site of staphylococcal infection and identify variables associated with colonization. ⋯ In this urban ED health care worker population, the prevalence of S aureus is similar but MRSA nasal colonization is higher than previously reported estimates in the general population of the United States. Physicians and nonpatient contact ED health care workers did not have MRSA colonization.
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Multicenter Study
A descriptive study of an outbreak of clenbuterol-containing heroin.
Illicit drugs may be adulterated with substances other than the sought-after substance of abuse. Although the true incidence and clinical effects of this practice are unknown, geographically disparate outbreaks of clinically significant adulteration continue to occur. We report on a recent outbreak of clenbuterol-adulterated heroin occurring along the East Coast of the United States. ⋯ The adulteration of heroin by clenbuterol was associated with sympathomimetic effects, metabolic acidosis, and myocardial injury. The report also highlights how collaborative efforts among poison centers using the Centers for Disease Control and Prevention's Epi-X system rapidly identified a disease outbreak.
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Managers use timestamps from computerized tracking systems to evaluate emergency department (ED) processes. This study was designed to determine how accurately these timestamps reflect the actual ED events they purport to represent. ⋯ The timestamps recorded by both active and passive tracking systems contain systematic errors and nonnormal distributions. The active system had much lower precision than the passive system but similar accuracy when large numbers of active system observations were used. Medians should be used to represent timestamp and interval data for reporting purposes. Site-specific data validation should be performed before use of data in high-profile situations.
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We assess the effect of emergency physicians' clinical experience on the propensity to commit a patient care error. ⋯ Emergency physicians with less than 1.5 years of clinical experience may be more likely to commit errors than more experienced emergency physicians.