JACEP
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Randomized Controlled Trial Comparative Study Clinical Trial
Shock and resuscitation. II: Volume repletion with minimal edema using the "HALFD"(Hypertonic Albuminated Fluid Demand) regimen.
A hypertonic albuminated fluid demand regimen (HALFD) for resuscitation has been used in burn patients since January 1, 1976. The effects of the HALFD method were compared with hypertonic fluid and Ringer's lactate resuscitation. ⋯ Patients treated with the HALFD method fared significantly better clinically, needed less fluid, had less weight gain and plasma leak, and experienced slower plasma volume repletion than those treated more traditionally. We conclude that the HALFD method is a physically and physiologically appropriate paradigm for resuscitating the volume-depleted patient.
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Two patients presented to the emergency department with acute onset of fever and myalgia after injecting heroin reclaimed from previously used cotton filters. Their histories and clinical courses are illustrative of the symptom complex known to drug users as "cotton fever." Although the causative mechanisms are unknown, the syndrome does appear to have a benign, self-limiting course.
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This study evaluated the regional burn health care system of the Commonwealth of Virginia using the criteria for optimal care of the burn patient designated by the American Burn Association. The data base for this evaluation was hospital records of seven hospitals in Virginia. ⋯ Using the criteria designated by the American Burn Association, a large number of minor burn injuries were judged erroneously to be major burn injuries. A modification of the American Burn Association's injury severity grading system is proposed which more precisely identifies the minor burn injury.