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This meta-analysis of published trials comparing HMEs and heated humidifiers found a significant reduction in VAP when they were used, particularly among patients who required more than 7 days in the ICU.
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Recent epidemiologic studies indicate that nearly 4% of Americans are afflicted with food allergies. The spectrum of food allergy ranges from atopic dermatitis or other cutaneous manifestations hours after eating the problem food, to life-threatening events occurring shortly after ingestion. As well, some individuals experience allergic symptoms only if the food is eaten before physical stimuli such as vigorous physical exercise.
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Burn injuries frequently present to the emergency department. In the majority of cases, the burns are minor, yet they require a careful assessment, cleaning, dressing, and careful follow-up. Patients with more severe burn injuries, especially those associated with house fires or explosions, should be assessed carefully for multiple trauma, and care should be taken to protect the spine until injury can be excluded clinically or radiographically. The authors review the diagnosis, classification, and management of patients with sustained burns.
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Dermatologic complaints commonly are seen in emergency medicine and may pose a diagnostic dilemma for the clinician. Although a detailed understanding of all dermatologic conditions is beyond the scope of practice of emergency physicians, recognition of categories of disease, particularly emergent conditions, is essential. Knowledge of basic disease lesions, patterns, diagnostic tests, and emergent management is crucial to the appropriate treatment of patients with cutaneous disease. This article presents an organized approach to the diagnosis and management of cutaneous conditions, including brief discussions of selected dermatologic complaints.
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This study found no evidence that the use of narcotics or benzodiazepines to treat discomfort after the withdrawal of life support hastens death in critically ill patients at our center. Clinicians should strive to control patient symptoms in this setting and should document the rationale for escalating drug doses.
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The Department of Health and Human Services (HHS) has placed a draft influenza preparedness and response plan on its web site. This detailed document provides useful advice about health care system guidance on staffing, infection control, and strategies to limit transmission of infection within health care institutions.
