Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
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To describe cases of violence related to weapons in a university hospital and urban county ED and to provide related recommendations for ED staff security. ⋯ Emergency department staff should prepare for the possibility of violence by 1) recognizing the danger, 2) rehearsing response mechanisms, and 3) debriefing after incidents. In particular, plans must be made and practiced for the time when external violence follows the surviving victims of gang activity through the "sacrosanct" hospital doors. Protection of patients and ED personnel must be ensured. In many urban settings, appropriately armed security guards must be immediately accessible to the ED staff. Other suggestions for ED protection are given.
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Randomized Controlled Trial Comparative Study Clinical Trial
Prospective evaluation of topical antibiotics for preventing infections in uncomplicated soft-tissue wounds repaired in the ED.
To determine differences in infection rates among uncomplicated, repaired wounds managed with: topical bacitracin zinc (BAC); neomycin sulfate, bacitracin zinc, and polymyxin B sulfate combination (NEO); silver sulfadiazine (SIL); and petrolatum (PTR). ⋯ The use of topical antibiotics resulted in significantly lower infection rates than did the use of a petrolatum control. BAC and NEO had the lowest wound infection rates.
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To report cardiac arrest demographics and assess whether arrest rate is associated with differences in intracity regional population densities, incomes, or race distributions. ⋯ The association of lower income with cardiac arrest suggests that cardiac health promotion and EMS intervention measures, including CPR instruction, should be targeted to lower-income neighborhoods. These findings may help explain previous studies suggesting a racial or population density association with cardiac arrest rates.
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To determine whether a certain distance measurement on the oral endotracheal tube (ETT) at the corner of the mouth could reasonably ensure proper depth of placement in critically ill patients, without the immediate need for a confirming chest x-ray (CXR). ⋯ Proper depth of ETT placement in the critically ill adult patient can be estimated by the technique of this study. In this adult patient population, corner-of-the-mouth placement of the ETT using the 21-cm tube mark for the women and the 23-cm mark for the men would have led to proper placement for most patients.