J Emerg Med
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Hand sanitizing, although often a "forgotten" practice, has been demonstrated to be a leading factor in preventing infectious disease transmission in health care environments. Previous studies have looked at hand-sanitization rates in hospital settings, but we are aware of very few describing this in the prehospital setting. Because emergency medical services (EMS) providers are potential vectors of infectious disease spread, it is important to know if their hand-sanitization practices are sufficient. ⋯ Hand-sanitization events were noted in this convenience sample group a majority of times in association with patient contact. However, there appears to be substantial room for improvement. This suggests that EMS services should work to improve hand-sanitization compliance. Increased instruction, education, or access to hygiene equipment should be investigated as avenues to improve future compliance.
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Frequent and unnecessary utilization of the emergency department (ED) is often a sign of serious latent patient issues, and the associated costs are shared by many. Helping these patients get the care they need in the appropriate setting is difficult given their complexity, and their tendency to visit multiple EDs. ⋯ When examined as a whole, research on the program suggests that expanding it would be an efficient allocation of hospital, and possibly societal, resources.
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Anaphylaxis is the quintessential critical illness in emergency medicine. Symptoms are rapid in onset and death can occur within minutes. Approximately 1500 patients die annually in the United States from this deadly disorder. It is imperative, therefore, that emergency care providers be able to diagnose and appropriately treat patients with anaphylaxis. Any delays in recognition or initiation of therapy can result in unnecessary increases in patient morbidity and mortality. ⋯ For patients with anaphylaxis, rapid and appropriate administration of epinephrine is critical for survival. Additional therapy, such as supplemental oxygen, intravenous fluids, antihistamines, and corticosteroids should not delay the administration of epinephrine.