Army Urban Augmentation Medical Task Forces for COVID-19: Part 2-Initial Utilization.

This article describes the utilization of a new ad hoc medical formation, named Urban Augmentation Medical Task Force for the Department of Defense response to the coronavirus disease 2019 pandemic in the Continental United States during the spring of 2020. Military medical personnel from these units were used to staff a variety of different mission assignments. We review the benefits and limitation of this type of formation and recommend future force allocation models.

Army Urban Augmentation Medical Task Forces for COVID-19: Part 1-Development.

This article describes how the U.S. Army developed a new ad hoc medical formation, named Urban Augmentation Medical Task Force for the Department of Defense (DoD) in response to the Coronavirus Disease 2019 pandemic in the Continental United States during the spring of 2020.

Omental liposarcoma presenting as chronic constipation.

Constipation is a common cause of pediatric abdominal pain seen in pediatric emergency departments (EDs). We present the case of an 11-year-old boy with a 4-month history of chronic constipation and abdominal pain who presented to the children's ED. He was found to have a large abdominal mass that was determined to be a myxoid liposarcoma.

A child with leukocoria.

Leukocoria, meaning "white pupil," describes the clinical finding of a white pupillary reflex on examination. It may be discovered through an asymmetric red reflex using direct ophthalmoscopy, or it may be seen incidentally on flash photography. It results from an abnormality of the eyeball that interferes with the normal reflective process.

Baclofen and ethanol ingestion: a case report.

The number of reported cases of skeletal muscle relaxant ingestion has been increasing in the United States, although fatalities are rare. A 30-year-old women ingested 300 mg of baclofen and ethanol. She was able to ambulate into the Emergency Department (ED) 50 min later, but within 30 min post-arrival had a Glasgow Coma Score of 3.

Emergency department impact of the Oklahoma City terrorist bombing.

Study Objective: To collect descriptive epidemiologic injury data on patients who suffered acute injuries after the April 19, 1995, Oklahoma City bombing and to describe the effect on metropolitan emergency departments.

Methods: A retrospective review of the medical records of victims seen for injury or illness related to the bombing at 1 of the 13 study hospitals from 9:02 AM to midnight April 19, 1995. Rescue workers and nontransported fatalities were excluded.

Comparison of arterial and venous blood gas values in the initial emergency department evaluation of patients with diabetic ketoacidosis.

Study Objective: To determine whether venous blood gas values can replace arterial gas values in the initial emergency department evaluation of patients with suspected diabetic ketoacidosis.

Methods: This prospective comparison was performed in an adult university teaching hospital ED. Samples for arterial and venous blood gas analysis were obtained during initial ED evaluations.

Vascular abdominal emergencies.

Vascular emergencies are an uncommon but significant cause of abdominal pain, back pain, hemorrhagic shock, and death in adults. This article reviews abdominal vascular anatomy, risk factors, signs and symptoms, abdominal vascular thrombosis, mesenteric ischemia and infarction, and abdominal vascular emboli and aneurysms.

A prospective survey of procedures performed by emergency medicine residents during a 36-month residency.

Future specialty training requirements for emergency medicine may include adequately documented records of procedures and resuscitations performed. A computer database was developed to track these data and to report the experience of one graduating class of nine emergency medicine residents. This study was a prospective survey conducted at a community hospital with a fully accredited (PGY 1-3) emergency medicine residency program.

Deposition of amphotericin B aerosols in pulmonary aspergilloma.

The aim of the present study was to characterize amphotericin B aerosols nebulized by ultrasonic and jet nebulizers and to study their deposition and pharmacokinetics in patients with pulmonary mycetoma. The aerodynamic behaviour and pulmonary deposition of amphotericin B particles were measured using a direct isotopic method based on stable labelling of the drug with 99mTc. Each nebulizer was bench tested for inhaled mass and particle size distribution.

Prospective evaluation of topical antibiotics for preventing infections in uncomplicated soft-tissue wounds repaired in the ED.

Objective: To determine differences in infection rates among uncomplicated, repaired wounds managed with: topical bacitracin zinc (BAC); neomycin sulfate, bacitracin zinc, and polymyxin B sulfate combination (NEO); silver sulfadiazine (SIL); and petrolatum (PTR).

Methods: This was a prospective, randomized, double-blind, placebo-controlled study conducted at a military community hospital with an emergency medicine residency program. Patients were enrolled if they: presented to the ED within 12 hours of injury and did not have puncture wounds, allergies to the agents used, or a history of immunocompromise; were not receiving antibiotics, chemotherapy, or steroids at the time of presentation; had not taken antibiotics within the preceding seven days; did not have an underlying fracture; and were not pregnant as determined by history.

A prospective evaluation of risk factors for infections from dog-bite wounds.

Objective: To define risk factors for infections from dog- bite wounds and to model the probability of wound infection in patients presenting without infection who are treated as outpatients.

Methods: A prospective survey of 769 consecutive dog-bite victims presenting over a two-year period to a community hospital emergency department (ED) with an emergency medicine residency program. A standardized wound-cleaning protocol was used, which included debridement and wound closure when indicated.

Double-blinded comparison of diphenhydramine versus lidocaine as a local anesthetic.

Study Objective: To evaluate the efficacy, onset of action, duration of action, and side effects of 1% diphenhydramine compared with 1% lidocaine when used as a local anesthetic agent.

Design: Prospective, double-blinded, cross-over study.

Setting: Emergency medicine residency program, research section.

Characterization of estrone sulfatase activity in human thrombocytes.

Estrone sulfatase is an important enzyme which catalyzes the production of estrone from estrone sulfate in a variety of human and animal tissues. We report, for the first time, on the presence of estrone sulfatase activity in thrombocytes from human blood. Incubation of [3H]estrone sulfate in the presence of human thrombocyte lysates resulted in the formation of [3H]estrone as assessed by two-dimensional TLC.

Comparison of intramuscular meperidine and promethazine with and without chlorpromazine: a randomized, prospective, double-blind trial.

Study Objectives: To compare the effectiveness of intramuscular meperidine (2 mg/kg) and promethazine (1 mg/kg) with chlorpromazine (MPC) or without chlorpromazine (MP) (1 mg/kg) for sedation of children undergoing emergency department procedures.

Design: Randomized, double-blind trial.

Setting: A community and university hospital ED.

Emergency management of dog and cat bite wounds.

Most dog and cat bite injuries are minor wounds that require only local wound care as well a patient evaluation for tetanus and rabies postexposure immunoprophylaxis. For larger wounds, primary or delayed primary closure can be performed safely where indicated. When antimicrobial agents are necessary, inexpensive penicillins or cephalosporins are adequate for initial therapy.

Cutaneous nocardiosis associated with insect bites.

We report the first case of cutaneous nocardiosis associated with insect bites. The patient received these insect bites while camping a few days before he presented to the emergency room. The patient was a healthy twenty-six-year-old man, who was asplenic as a result of a motor vehicle accident.

Prophylactic oral antibiotics for low-risk dog bite wounds.

The use of prophylactic antibiotics in the initial treatment of noninfected dog bite wounds is controversial. All patients with noninfected dog bite wounds who presented to our emergency department (ED) over a two-year period were considered for entry into a randomized prospective study. Patients were excluded from the study if they had any high-risk criteria for infection: puncture wounds, hand or foot wounds, wounds greater than 12 hours old, a history of immunocompromising disorders, or the use of immunosuppressive drugs.

Neurocysticercosis presenting to the emergency department as a pure motor hemiparesis.

We report the case of a 23-year-old male who presented to the emergency department (ED) with an isolated right-sided pure motor hemiparesis (PMH). An unenhanced computed tomography (CT scan) revealed a hypodensity in the area of the left parasagittal motor strip. The patient then experienced a Jacksonian type of seizure involving his right leg and was treated with intravenous phenytoin and dexamethasone.

Cat bite wounds: risk factors for infection.

Study Objective: In the last ten years, many emergency medicine specialists have studied animal bite wounds. The majority of these studies have addressed the controversies of prescribing prophylactic antibiotics or suturing wounds. This study was undertaken to determine risk factors for cat bite wound infections.

A prospective analysis of intramuscular meperidine, promethazine, and chlorpromazine in pediatric emergency department patients.

Study Objective: To examine physiologic responses and efficacy of 2, 1, and 1 mg/kg IM meperidine, promethazine, and chlorpromazine (MPC), respectively, in children.

Design: Prospective, unblinded trial.

Setting: A university and community emergency department.