Annals of emergency medicine
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A tracheal-esophageal airway for field or hospital use is described. The airway consists of a clear plastic mask and endotracheal low pressure cuffed tube with a Murphy tip. ⋯ The endotracheal tube is attached to the mask by a tubular coupler and easily disconnected by removing a metal clip in the event of tracheal insertion of the tube. Our four-year experience with the tracheal-esophageal airway in 400 cardiac arrests has shown it to be safe, simple, and useful.
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The retention of knowledge and skill proficiency was evaluated for emergency care attendants (ECAs), emergency medical technicians (EMT-As) and paramedics (EMT-Ps). The sample represented 4.1% of the total number of individuals trained and certified in these positions in Texas. The average loss of didactic knowledge did not exceed 10% over a two-year period. ⋯ Participants in continuing education programs experienced an 11% better retention average for skill than did nonparticipants. The employees of privately operated ambulance services retained their basic skills better than did members of other types of services. The rate of knowledge deterioration for the sample evaluated was not correlated (R = 0.08) to the original written score.
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Photography is a rapid, relatively simple, and inexpensive means of documenting patient care and enhancing medical education. Because of its use in medical records, photography affords the physician added defense against claims of medical malpractice. The emergency physician should have ready access to a photographic system as well as a basic knowledge of camera operation, filming procedures, picture composition, and medico-legal implications. These topics are discussed and specific recommendations are offered concerning the purchase of essential photographic equipment.