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Domestic violence is a serious problem that, unfortunately, is seen all too commonly in our emergency departments. Statistics show, however, that physicians, including emergency physicians, are not good at identifying victims of domestic violence.
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In a child who is critically injured there is the potential for many serious or life-threatening injuries. The initial focus must always be to stabilize the child's airway and breathing and, then, rapidly identify shock and aggressively correct volume deficits.
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Everyone who provides care for patients in emergency departments is well aware of the annual winter-spring spike in patient volume due to influenza disease and its complications.
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In North America, rotavirus gastroenteritis is a predictable winter epidemic every year--young children presenting to emergency departments and outpatient clinics with fever, vomiting, diarrhea, and varying degrees of dehydration.
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In this randomized-controlled trial, Koeman and associates wanted to determine the effect of two oral decontaminating gels, chlorhexidine 2% (CHX) or chlorhexidine 2% plus colistin 2% (CHX/COL), compared to a placebo, on the development of ventilator-associated pneumonia (VAP) in patients requiring more than 48 hours of mechanical ventilation.
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In this prospective observational study, Kollef and associates enrolled patients with ventilator-associated pneumonia (VAP) in 20 ICUs across the United States in order to characterize the patients and the antimicrobial regimens used in treating them, as well as their mortality and lengths of stay.
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In the early 2000s, substantial evidenced-based interventions were added to the care of critically ill patients that significantly reduced mortalityincluding low tidal volume ventilatory support for acute respiratory distress syndrome (ARDS), protocolized sedation with daily awakening, Drotrecogin-alpha for severe sepsis, tight glycemic control, corticosteroids for refractory septic shock and preventative strategies for ventilator associated pneumonia.
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TNF Blockers: Should You Be Concerned?; FDA Actions
