The American journal of emergency medicine
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Octylcyanoacrylate (Dermabond) is approved by the Food and Drug Administration for laceration closure. International studies have shown its utility in wound closure and have shown it to be as good or better than suture closure for speed, patient preference, and cosmesis, with no difference in the rate of dehiscence or infection. We sought to determine whether it retains its tensile strength, durability, and skin apposition when an athlete is allowed to reenter competition, where it is subject to recurrent stress, moisture, and trauma. ⋯ Of the 32 lacerations, 31 (97.6%) had good results at the conclusion of the game. Of these 31, all had good results at 7 days following repair. Dermabond retained its strength, durability, and skin apposition when the athlete was allowed to reenter competition following wound repair.
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The transportation of critically ill patients requiring mechanical ventilation is recognized as a high-risk and expensive procedure. Approaches have included using manual bag-type valve resuscitators and expensive portable transport ventilators. This study evaluated the effectiveness of the inexpensive portable RespirTech PRO (RTP) gas-powered automatic resuscitator during intrahospital transport of critically ill mechanically ventilated patients. ⋯ This study showed that the portable pressure-cycled RTP also allows safe transportation of mechanically ventilated ICU patients. By analogy, the RTP is potentially useful as an automatic resuscitator for emergency medical care. This RTP is a disposable resuscitator/ventilator device that provides an inexpensive alternative for transporting ventilator-dependent patients.
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The objective of this study was to examine current practice patterns of analgesia administration among emergency physicians (EPs) when caring for a patient with an acute abdomen. Cross sectional data were acquired by a survey mailed in October 1997 to 1,000 American College of Emergency Physicians (ACEP) members from a purchased ACEP mailing list which contained 1,000 randomized ACEP members. A repeat survey was sent to nonresponders 2 months later and a random subset of recurrent nonresponders were telephoned. ⋯ Although eighty-five percent felt that the conservative administration of pain medication did not change important physical findings on the physical examination, 76% choose not to give an opiate analgesic until after the examination by a surgeon. Twenty-five percent of patients did not receive any pain medication in the department. In conclusion, although EPs report that the judicious administration of pain medication does not mask important examination findings, the majority wait until after the surgeon has evaluated the patient to deliver analgesics.
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The Republic of the Seychelles enjoys a sophisticated health care system by developing country standards. Basic food, water, sanitation, and preventative health care needs have been addressed and the Seychelles Ministry of Health has recently focused on the need to improve the country's emergency medical services (EMS). ⋯ This report profiles the current health care system in the Seychelles, with special emphasis on EMS. It also describes an international collaborative effort between the Seychelles Ministry of Health and the UCLA Center for International Emergency Medicine designed to improve existing EMS.