The American journal of emergency medicine
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To determine current practices regarding security measures in the emergency department (ED), a random sample of 250 hospitals with EDs was surveyed by telephone. Security issues addressed included personnel (in-house security, contract guards, or police), hours of staffing in the ED, how security is armed, whether ED doors are locked at off-hours, and whether alarm buttons, direct phone lines, a paging code, closed circuit surveillance, metal detectors, and seclusion rooms are used. This information was stratified according to hospital size, ED census, rural/suburban/urban setting, teaching/nonteaching status, and region. ⋯ Small, rural hospitals are more likely to lock the ED doors at off-hours, whereas the use of security codes does not clearly follow demographic trends. Larger hospitals in suburban and urban settings and having a teaching status are more likely to have secure/detention rooms and closed circuit surveillance. The use of alarm buttons and/or direct telephone lines varies widely, but is generally more common in larger, teaching hospitals, located in urban and suburban settings.
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The use of organs from poisoned victims for the purpose of transplantation has been poorly studied; criteria for organ donation is virtually non-existent in such cases. To further elucidate these indications, a retrospective review of all organ transplantation donated by poisoned victims in Northern and Central Illinois was undertaken. From January 1988 to December 1993, 17 poisoned victims were identified as having donated organs to 41 recipients. ⋯ Thirty-two kidneys were transplanted with 28 having good 10-day postoperative function, three having fair postoperative function, and one (cocaine donor) having poor postoperative function. One kidney transplanted from a cocaine donor had a thrombosed graft 5 days postoperatively. Deaths involving toxins in general does not seem to be a contraindication to donation of liver and kidney for transplantation.
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Letter Review Case Reports
Tibial fracture: a complication of intraosseous infusion.
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To determine if wound excision and superoxide dismutase (SOD) treatment prevent ongoing lipid peroxidation after burn injury, the plasma, kidney, and lung lipid peroxide (LPO) levels in 25% total body surface area (TBSA) burned rats was studied. The animals were given intraperitoneal bovine copper-, zinc-SOD (Cu/Zn-SOD) (50,000 U/kg dissolved in saline) or saline immediately after burns and were operated by wound debridement and allograft 2 hours after the burn. ⋯ The combination of wound excision and Cu/Zn-SOD treatment markedly inhibited the increase in both plasma and tissue LPO levels after the burn, but did not prevent the increase in Mn-SOD. Wound excision in conjunction with SOD-treatment might be therapeutic in the management of severe burns.