The American journal of emergency medicine
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The objective of this study was to describe consultation and referral patterns from a military emergency department (ED). The design of the study consisted of a prospective analysis of consultations and referrals from Madigan Army Medical Center ED during April 1990, an Army Medical Center with multiple residencies, including emergency medicine (EM). Patient population included active and retired military personnel, their families, and civilian emergency medical system-transported patients. ⋯ ED patients frequently are referred to or result in consultations with non-EM physicians. Differences in consultation by level of training and the impact of consultation on consulting services both deserve further investigation. Review of EM resident use of consultation and referral may focus evaluation of ED care in teaching hospitals.
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Emergency medicine has not yet appropriated "humanism" as a term of its own. Medical humanism needs to be interpreted in a way that is consistent with the practical goals of emergency medicine. In this essay, humanism in emergency medicine is defined by identifying the dehumanizing aspects of sudden illness and exploring of ways for sustaining the humanity of emergency department patients. Excerpts from Dr Oliver Sacks' autobiographical work A Leg to Stand On give voice to the human needs created by sudden illness and its treatment.
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Advanced cardiac life support drugs undergo a wide range of temperature exposures in the prehospital setting. Although manufacturers place temperature restrictions for drug stability on their products, it has been shown that these limits are often exceeded in the prehospital environment. ⋯ This information has obvious implications in making further recommendations for drug storage. More work to determine bioactivity of temperature-exposed drugs may show results with implications for success in prehospital cardiac resuscitation.
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Randomized Controlled Trial Comparative Study Clinical Trial
The shorthand vertical mattress stitch: evaluation of a new suture technique.
The shorthand vertical mattress suture is a new suture technique that provides the same amount of wound eversion in less time than the classic method. A randomized, prospective clinical trial was designed to test this hypothesis in a University-affiliated community hospital. Thirty patients who presented to the emergency department with traumatic lacerations requiring primary closure were eligible for this study. ⋯ The shorthand stitch provided the same amount of wound eversion in half the time as the classic technique. No infectious complications, delayed wound healing, or cosmetic problems were observed with the shorthand technique. The shorthand vertical mattress stitch described is an efficient, alternative method for laceration repair without compromising wound eversion or cosmetic results.