Review, clinical update, and practice guidelines for excited delirium syndrome.

Excited delirium syndrome (ExDS) is a term used to describe patients experiencing a clinical condition characterized by bizarre and aggressive behavior, often in association with the use of chronic sympathomimetic drug abuse. The agitated and disruptive behavior of persons with ExDS often results in a call to police resulting in an arrest for disorderly conduct. The suspect's inability to comply with police commands during the arrest frequently results in a struggle and the use of physical or chemical control measures, including the use of conductive energy weapons (CEWs).

Clinical encounters in tactical medicine: a mission-specific analysis of the Maryland State Police experience.

Introduction: The Maryland State Police (MSP) Tactical Medical Unit (TMU) provides tactical emergency medical support (TEMS) through the deployment of specially trained state trooper tactical paramedics. The MSP TMU maintains an operational database of all mission related medical activity. This information constitutes a robust dataset derived from real world operational medicine experiences.

Methicillin-resistant staphylococcus aureus nasal colonization prevalence among Emergency Medical Services personnel.

Introduction: The prevalence of Methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization among Emergency Medical Services (EMS) personnel is not well studied. Methicillin-resistant Staphylococcus aureus colonization can be a health hazard for both EMS personnel and patients. The aim of this study was to quantify the prevalence of MRSA colonization among EMS personnel.

A public health enforcement initiative to combat underage drinking using Emergency Medical Services call data.

Objective: The objective of this study was to determine whether Emergency Medical Services (EMS) records can identify bars that serve a disproportionate number of minors, and if government officials will use this data to direct underage drinker enforcement efforts.

Methods: Emergency Medical Services call logs to all bars in the study area were cross-referenced with a local hospital's records. The records of patients with alcohol-related complaints were analyzed.

Bacterial pathogens in ambulances: results of unannounced sample collection.

Unlabelled: The concern that the health care environment may harbor a substantial reservoir of infectious agents has been vigorously examined by microbiology and infectious disease experts. Although universal precautions and disposable equipment reduces risks to patients and providers, the ambulance remains vulnerable to bacterial contamination from biological secretions. Additionally, the nature of emergency medical services creates pressures on prehospital care providers.

Community-acquired pneumonia in casualty: etiology, clinical features, diagnosis, and management (or a look at the "new" in pneumonia since 2002).

Purpose Of Review: Community-acquired pneumonia, because of its substantial treatment costs, incidence, and mortality, is an aggressively researched diagnosis. In this review, we highlight new developments in the diagnosis, etiology, pathophysiology, treatment, and prevention of community-acquired pneumonia published since April 2002.

Recent Findings: The combined end points of improved patient care and conservation of health care resources have prompted several studies examining current professional society community-acquired pneumonia guidelines.

Effect of lunar cycle on temporal variation in cardiopulmonary arrest in seven emergency departments during 11 years.

Objective: To determine the effect of the phase of the full and new moon on the variation in the number of daily cardiopulmonary resuscitations.

Design: A retrospective analysis of a computerized billing database of emergency department visits in a cohort of seven northern New Jersey (USA) emergency departments.

Participants: Consecutive patients seen by emergency department physicians over an 11-year period (1 January 1988 to 31 December 1998).

Effects on local emergency departments of large-scale urban chemical fire with hazardous materials spill.

Introduction: On 18 July 2001, a train hauling hazardous materials, including hydrochloric acid, hydrofluoric acid, and acetic acid, derailed in the city of Baltimore, Maryland, resulting in a fire that burned under a downtown street for five days. Firefighters were stymied in their efforts to extinguish the fire, and the city was subjected to thick smoke for several days.

Objectives: To determine whether an urban chemical fire with a hazardous materials spill resulted in a detectable public health impact, and to demographically describe the at-risk population for potential smoke and chemical exposure.

Ambulance snatching: how vulnerable are we?

Out of concern that ambulances might be targeted for hijack for terrorism purposes, we observed security-related behaviors of a cross-section of ambulance crews and their vehicles in Emergency Department ambulance bays. We sent observers to a convenience sample of trauma and suburban Emergency Department ambulance entrances in several states. We observed 151 total ambulance arrivals.