This issue might be subtitled "What will they think of next?" Getting high does not always require the purchase of illegal drugs, and all substances that alter sensorium, such as nutmeg, cannot be regulated. However, the emergency physician must remain aware of the latest fads of drug abuse, and should be able to recognize the symptoms they cause.
In recent months, Escherichia coli O104:H4 has infected more than 4,000 people and caused 880 cases of hemolytic uremic syndrome (HUS) in Europe, with the majority of cases reported in Germany and with more recent outbreaks in France and Switzerland. Travelers should implement food hygiene precautions to prevent infection when visiting Europe.
Using an algorithm based on score and chest X-ray when appropriate, the overall sensitivity for the detection of aortic dissection was 96%.
This randomized study of low-tidal-volume ventilation during and after cardiac surgery, in comparison to ventilation with tidal volumes of 10 mL/kg predicted body weight, showed no differences in median ventilation time but higher rates of extubation by 6 and 8 hours postoperatively and fewer reintubations in the low-tidal-volume group.
