Articles: patients.
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I had one of the most rewarding nights of my medical career tonight. I delivered the baby of a woman whom I treated for an eating disorder 7 years ago. I remember the day her parents first brought her to see me, the sports medicine specialist. ⋯ The patient told me she'd eaten nothing for 3 days before her visit, and that I couldn't make her eat. It's intimidating even when a 15-year-old is yelling at you at the top of her lungs. Yet I stood my ground, related the treatment plan, had my nurse draw her blood, and told the girl to come back in a week.
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Several neuromuscular blocking (NMB) agents are available for clinical use in anesthesia. The present study was performed in order to identify preferences and behaviors of anesthesiologists for using vecuronium, rocuronium or other NMB agents in their clinical practice. MATERIAL AND ⋯ Vecuronium was preferred for most clinical situations, and the decision for this choice was not based on costs. Storage of unused drugs without refrigeration in a single syringe for purpose of future use in several patients represented a dangerous common practice.
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Reducing the number of unnecessary antibiotic prescriptions given for common respiratory infections has been recommended as a way to limit bacterial resistance. This study assessed the validity of a clinical sore throat score in 2 community emergency departments (EDs) and its impact on antibiotic prescribing. We also attempted to improve on this approach by using a rapid streptococcal antigen test. ⋯ An explicit clinical score approach to the management of GAS pharyngitis is valid in a community ED setting and could improve the pattern of antibiotic prescribing. While the addition of a rapid streptococcal antigen test significantly decreased the sensitivity of detecting GAS infections, a combined approach consisting of the clinical score and throat culture for patients with negative results on the rapid test would decrease antibiotic prescribing and telephone follow-up without decreasing the sensitivity of detecting GAS infection.
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Aeromedical transport in northern areas may be associated with hypothermia. The objective of this study was to determine whether significant hypothermia (core temperature <35 masculineC) occurs in severely injured or ill intubated patients during transport by rotary wing aircraft. ⋯ During brief (<225 km) rotary wing aeromedical transport of severely injured or ill patients, significant hypothermia is uncommon and body temperature is generally well maintained with the use of simple passive measures. These findings do not justify recommendations for more aggressive core temperature monitoring during this type of aeromedical transport.