We conducted a retrospective review of the medical records of women requesting emergency contraception (EC) at our emergency department over a 9-year period (1994-2002). EC accounted for 5.9% of all visits (n = 95,288) and increased from 1.26% in 1994 to 9.82% in 2002 (p < 0.001). Reasons for EC ...

As we approach the 21st century, there is an increasing worldwide awareness and threat regarding the use of biological warfare agents both for war and terrorist attack. Biological agents include microorganisms or biological toxins that are used to produce death in humans, animals and plants. They are characterized by low ...

It is likely that the first responder to a medical emergency in space will be a nonphysician. Terrestrial experience has shown that even under optimal conditions experienced clinicians can have difficulty establishing an airway. Establishing and maintaining a patent airway is essential to ensuring a successful outcome from cardiopulmonary resuscitation ...

STUDY OBJECTIVE: We characterize communication in an urban, academic medical center emergency department (ED) with regard to the timing and nature of the medical history survey and physical examination and discharge instructions. METHODS: Audiotaping and coding of 93 ED encounters (62 medical history surveys and physical examinations, 31 discharges) with ...

Cesarean section, initially described as an emergency operative procedure for delivering moribund parturients, is now advocated by many as a routine technique with major advantages over vagi-nal delivery. In fact, it has been suggested that labor and vaginal delivery are no longer the desired consequence of pregnancy, a conclusion that ...

AIMS: To determine the relevance of lymphopenia to the diagnosis of bacteraemia in patients admitted with medical emergencies, relative to peripheral blood white cell count and neutrophilia. PATIENTS/METHODS: A two year cohort study carried out in a teaching hospital in Oxford, UK of 21,495 consecutive adult emergency admissions to general ...

Travellers to malaria-endemic destinations are at risk of significant disease and, sometimes, death. Current malaria protection strategies, including chemoprophylaxis, can never be completely effective. In some cases, protective measures are discontinued or misapplied while the risk of infection still exists. In others, suboptimal measures are used, or even no measures ...

BACKGROUND: Medical emergency team (MET) responses have been implemented to reduce inpatient mortality, but data on their efficacy are sparse and there have been no reports to date from US hospitals. OBJECTIVES: To determine how the incidence and outcomes of cardiac arrests have changed following increased use of MET. METHODS: ...

The use of ultrasound technology in the emergency department(ED) is a recent and fast-growing phenomenon. Ultrasound is an extremely valuable tool for the evaluation of gallbladder (GB) dis-ease in the ED for several reasons: this disease is a common medical problem, cholecystitis can present in different ways clinically,the nature of ...

BACKGROUND: Cancellation of operations increases theatre costs and decreases efficiency. We examined the causes of theatre cancellations in general surgery. METHODS: The Beaumont hospital database (ORSUS system) and theatre records were examined retrospectively between April 1997 and March 2002. The number and causes of theatre cancellations, the number of emergency ...

In this thesis, a low-cost system, called Mobile Ambulance, is designed and implemented that provides patient’s medical data collection and transmission from a moving ambulance. The aim of the system is to decrease the waiting time for critical care patients to be seen at the emergency department (ED) at the ...

Prior to the terrorist attacks of September 11, 2001 and the subsequent anthrax attacks, the Strategic National Stockpile (SNS), known as the National Pharmaceutical Stockpile until March 2003, was an important component of the national medical response to a crisis, but one that had not yet been tested in a ...

There is a heightened awareness of terrorism in this country. There always remains the possibility of nonterrorist disasters at sporting venues. The team physician will be among the first medical responders to a disaster at a sporting venue. By being involved in the creation of an emergency action plan, learning ...

Since September 11, 2001, government agencies on all levels have focused on planning and preparing to respond to another possible terrorist attack. In addition to emergency and medical issues, these agencies must be concerned about the public's behavior and psychological response when they plan the management of a bioterrorist event. ...

Physicians and surgeons in the United States have become increasingly aware of the requirement for an organized response to mass casualty and disaster situations. This has not always been the case. The terrorist acts in Oklahoma City in 1995 and at the World Trade Center in 1993 and 2001 showed ...

Alpine search and rescue teams must perform each incident response safely. To do so requires experience, organizational skills, technical training, and ability. In addition, teams should interface with emergency medical control advisors who are familiar with local terrain, mountain rescue operations, and the evacuation techniques employed. To facilitate safety and ...

Tracheal intubation (ETI) is considered the method of choice for securing the airway and for providing effective ventilation during cardiac arrest. However, ETI requires skills which are difficult to maintain especially if practised infrequently. The laryngeal tube (LT) has been successfully tested and used in anaesthesia and in simulated cardiac ...

The Health Insurance Portability and Accountability Act (HIPAA) seems to be as useful as is capitalism to the medically uninsured (or perhaps, as necessary as another leukotriene inhibitor for asthma). Is the emergency medical community doing enough? Can we improve on HIPAA to increase privacy in the emergency department? HIPAA ...

Pediatric rapid sequence intubation is a skill of great importance to emergency medicine physicians. Developing a systematic strategy for approaching an emergent airway aids in the proper handling of this event. This paper is a review of the current recommendations for pediatric rapid sequence intubation including current medications and surgical ...

The Emergency Medical Treatment and Labor Act (EMTALA) still may apply once a patient's initial emergency medical condition has been resolved. Another emergency that arises while the patient still is in your ED could trigger another EMTALA obligation. Emergency physicians are not necessarily obligated to conduct another exam every time ...

OBJECTIVE: Use of ambulances for nonemergency and routine transportation is thought to be a serious and growing problem. Third-party payers frequently refuse payment when ambulance use is deemed inappropriate. The authors attempted to determine whether cases in which ambulance transport was denied were done appropriately. METHODS: Consecutive ambulance run forms ...

Cereal leaf beetle, Oulema melanopus (L.), invaded northern Alabama and Georgia more than a decade ago and since has become an economic pest of winter wheat and other cereal crops in the southeastern United States. A series of trials was conducted beginning in 1995 to determine optimal rate and timing ...

The Federal Emergency Medical Treatment and Labor Act (EMTALA) is one of the most difficult laws to interpret and the easiest to violate. This federal law was enacted to ensure that all individuals presenting to an emergency department of any Medicare- or Medicaid-participating facility for evaluation and treatment of a ...

Tinnitus is tolerated by most patients, but in others it is enough of a problem that they seek medical attention. Results of treatment have been mixed. On occasion, a patient is so distressed by tinnitus that he or she is incapacitated and seeks help in an emergency department. We describe ...

We present a case with angioedema of the tongue, following 1 dose of an angiotensin-converting enzyme (ACE) inhibitor ingestion. A gradual progression of angioedema required tracheotomy despite aggressive medical treatment and illustrates the severity of this adverse reaction. Although ACE inhibitors are considered safe, emergency physicians should be alert for ...

The United States Pharmacopeia (USP) National Formulary prescribes the packaging, storage, and distribution of medications. Most of the medications commonly used by emergency medical services (EMS) are intended for storage at "controlled room temperature." The USP definition of controlled room temperature is multifaceted and complex, and cannot be easily described ...

The primary goal of the Neely Conference project is to work toward defining a set of research criteria for medical necessity in emergency medical services (EMS). This paper reviews the extant literature on triage and nontransport decisions made in the field by EMS personnel, with emphasis on the methodologies that ...

Civilian populations are at risk from exposure to toxic materials as a result of accidental or deliberate exposure. In addition to industrial hazards, toxic agents designed for use in warfare now are a potential hazard in everyday life through terrorist action. Civil emergency medical responders should be able to adapt ...

The emergence of less common but medically important fungal pathogens contributes to the rate of morbidity and mortality, especially in the increasingly expanding population of immunocompromised patients. These pathogens include septate filamentous fungi (e.g., Fusarium spp., Scedosporium spp., Trichoderma spp.), nonseptate Zygomycetes, the endemic dimorphic pathogen Penicillium marneffei, and non-Cryptococcus, ...

We report a 4-year-old child who developed systemic anaphylactic reaction to lidocaine hydrochloride within 15 minutes after a dental procedure. Hypersensitivity to local anesthetics is not common; however, if anaphylaxis did happen, it required emergent and immediate resuscitation. To prevent such complications, complete medical history including drug allergy should be ...

Medical emergencies in dental clinics are atypical however they do occur with potentially serious consequences. A postal questionnaire survey of all seventy-seven dentists in Fiji regarding occurrence of medical emergencies, their possession of emergency drugs and equipment and whether further training was required in the management of medical emergencies was ...

Most complications of pregnancy allow time for transfer to specialized obstetric ultrasound units, but many women present to the emergency room or the labor and delivery unit with signs and symptoms suggesting genuine acute medical emergencies, where successful outcome depends on prompt diagnosis of the disorder and rapid appropriate medical ...

Mortality in the Accident and Emergency (A&E) department is a good indicator of the quality of care as well as facilities available. Between 1st of July 1996 and 30th of June 2000 a total of 3583 patients were registered at the accident and emergency unit of Nnamdi Azikiwe University Teaching ...

OBJECTIVES: We investigated the impact of an emergency medical services call on the management of acute myocardial infarction, considering time intervals for intervention and revascularization procedures. METHODS: Data were prospectively collected from January 2001 to October 2002 from 531 patients hospitalized for myocardial infarction with ST segment elevation and a ...

Every patient presenting to a hospital emergency department must have a medical screening examination to determine whether an emergency medical condition exists. If there is no emergency medical condition, the Act does not apply. Any patient who is found to have an emergency medical condition must be stabilized. If necessary. ...

Precise documentation of medical treatment in emergency medical missions and for resuscitation is essential from a medical, legal and quality assurance point of view [Anästhesiologie und Intensivmedizin, 41 (2000) 737]. All conventional methods of time recording are either too inaccurate or elaborate for routine application. Automated speech recognition may offer ...

A modified design for ovate pontics is proposed to achieve the esthetic, functional, and hygienic requirements for fixed partial dentures. This design should aid the clinician in preparing the edentulous area, thus resulting in less discomfort for the patient because little to no ridge augmentation is required. The same emergence ...

Tiana Lee's article provides an overview and update on the latest in the Emergency Medical Treatment and Active Labor Act (EMTALA). Reviewing the history of the statute, explaining some of the relevant regulations, and exploring government enforcements efforts to date, Ms. Lee highlights the benefits and drawbacks of the statute ...

We are describing a heretofore untold narrative description of the emergency medical plan that saved the life of President Reagan on March 30th 1981. In 1976, Dr. Richard Edlich, director of the Emergency Medical Services at the University of Virginia Medical Center, wrote an editorial on the need for an ...

Chemical warfare agents are toxic weapons and emergency prehospital medical care providers should be well prepared, trained, and equipped to give response. Personnel need to be aware of the following medical issues regarding prehospital management of a chemical attack, event recognition, incident medical command and control, safety and protection, decontamination, ...

This essay identifies the bias that institutional sponsorship of medical mediation introduces and the probability that such bias undermines the ability of such mediation programs to generate trust by patients in physicians and health care institutions. Based on data from an emerging medical trust movement in the U.S., the essay ...

STUDY OBJECTIVE: This is an attempt to present an analysis of the literature examining objective information concerning the likelihood of medicolegal errors as it applies to current medical practice. Hopefully this information will be synthesized to generate a cogent approach to manage risk in emergency medicine. METHODS: Articles were obtained ...

One of the goals of this manuscript is to celebrate the influential and productive careers of three leaders in Emergency Medical Systems: Drs. James Mills, R Adams Cowley, and David Boyd. Through his courageous efforts, Dr. James Mills established the specialty of emergency medicine, with its own educational training programs, ...

OBJECTIVES: To describe the patient demographic characteristics and organisational factors that influence length of stay (LOS) among emergency medical admissions. Also, to describe differences in investigation practice among consultant physicians and to examine the impact of these on LOS. DESIGN: Prospective observational study. SETTING: General medicine department of a teaching ...

Setting clear priorities for the sequence and importance of actions during cardiopulmonary resuscitation (CPR) is of utmost importance for future guidelines. Unless performed under the rare condition of hypoxic arrest, combined compression and ventilation is usually not necessary in one-rescuer resuscitation of adults. After notifying the emergency medical services (EMS), ...

Emergency Medicine (EM) has evolved since 1950s--in the Czech Republic as well as abroad--from Anaesthesiology and Resuscitation in parallel with the Burn Medicine which has separated from Plastic Surgery. EM creates a link between the laymen first aid and the specialized hospital care, which is realized by the Emergency Medical ...

Dusting powders were first applied to gloves to facilitate donning. After 1980, manufacturers devised innovative techniques to manufacture gloves without dusting powders. It has been well documented that the powders on gloves present a health hazard to patients, as well as healthcare workers. First, these powders elicit tissue toxicity in ...

The major causes of deaths all over the world are circulatory system diseases, neoplasms and injuries. Each man can become a participant of the event which results in life-threatening emergencies and the most immediate possible actions are essential. The period of time for starting efficient life-restoration actions is very short, ...

The Emergency Medical Treatment and Active Labor Act (EMTALA), enacted in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act of 1985, aims to prevent "patient dumping" by requiring hospitals to screen and stabilize patients who come to an emergency room seeking medical attention. For many reasons, recovery under ...

We have designed and developed a novel data communications network targeted at the provision of Emergency Medical Care in disaster situations over wide areas. The network nodes can transmit essential biosignals and in addition, support video and diagnostic quality sound (auscultation) broadcasting for teleconsultation purposes, by using a variety of ...