J Emerg Med
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The physical properties of lightning are given, including a description of the different observed lightning forms. The wide variety of effects of lightning on humans is reviewed. ⋯ Recommendations for emergency department evaluation, treatment, and disposition are given. Guidelines to prevent humans from being struck by lightning are discussed.
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Near-drowning is defined as survival for at least some period of time after suffocation from submersion in a liquid. This article is a comprehensive review of the demography, pathophysiology, treatment, and prevention of near-drowning, an accident that affects approximately 6,000 to 7,000 Americans per year. Forty percent of these victims are children younger than 5 years. ⋯ The hypothermic patient requires special considerations. The role of aggressive cerebral resuscitation has not been elucidated. Prevention of the circumstances that lead to near-drowning must be stressed as a public service.
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Superficial abscesses are commonly seen in the emergency department. In most cases, they can be adequately treated by the emergency physician without hospital admission. Treatment consists of surgical drainage with the addition of antibiotics in selected cases. ⋯ Staphylococcus aureus accounts for less than half of all cutaneous abscesses. Anaerobic bacteria are common etiologic agents in the perineum and account for the majority of all cutaneous abscesses. Abscesses at specific locations involve special consideration for diagnosis and treatment and may require specialty consultation.
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The management in the emergency department of febrile infants less than 2 months of age is influenced by the standard of practice in the community. We sought to determine if uniform practices existed across the United States. Individual academically based faculty from 154 (61%) United States pediatric residency programs responding to a questionnaire on the emergency department management of febrile infants less than 2 months of age showed great variability. ⋯ Respondents differed on the number and types of tests used and on antibiotic administration. University affiliation, type of population served, or presence of advanced training programs in ambulatory pediatrics were not related to the type of policy. The care of the young febrile infant varies greatly.
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Since Henry Heimlich's description of a method for relieving food choking was presented, the management of foreign body upper airway obstruction has been enveloped in controversy. The major point of contention has been the approval by the American Red Cross and American Heart Association of the chest thrust and back blows, techniques that Heimlich considered inferior and dangerous. ⋯ Most studies have found airway pressures generated by back blows to be higher than those produced by chest or abdominal thrusts. However, chest and abdominal thrusts produce their effects over a more sustained time period.