A 27-year-old man with multiple stab wounds to the chest.

A 27-year-old man presented to a community emergency department (ED) after sustaining multiple stab wounds to the anterior and posterior chest and posterior neck after an altercation at a local bar. Shortly after arrival at the ED, the patient's mental status altered, and he increasingly became combative and confused. When the patient was assessed in the ED, staff found the patient hypoxic with oxygen saturations noted to be in the low 90s.

Changes in physical examination caused by use of spinal immobilization.

Unlabelled: The standard of care for patients following blunt trauma includes midline palpation of vertebrae to rule out fractures. Previous studies have demonstrated that spinal immobilization does cause discomfort.

Objective: To determine whether spinal immobilization causes changes in physical exam findings over time.

National prevalence of palliative care protocols in emergency medical services.

Objectives: There are approximately 500,000 hospice patients in the United States. While hospice patients may desire only palliative care, they often access the emergency medical services (EMS) system, unaware that many EMS systems do not have specific palliative care protocols. This study was undertaken to determine the prevalence of palliative care protocols among EMS agencies in the United States, and to estimate the percentage of the U.

An unusual case of clarithromycin associated ergotism.

A 41-year-old woman presented to the Emergency Department complaining of a 4-day history of worsening lower leg pain, pallor, and a sensation of coolness aggravated by exertion. Evaluation revealed severe lower extremity vasospasm. She recently had been prescribed clarithromycin for "flu-like" symptoms, and for many years had been taking a caffeine-ergotamine preparation for migraine headaches.

Comparison of staples vs suturing for securing central venous catheters.

Objective: To determine whether skin staples can be used to secure central venous catheters as effectively as does suturing.

Methods: A prospective, randomized trial of techniques to secure a central venous catheter was performed in a medical school human anatomy laboratory using human cadavers. Central lines were secured to the upper left thorax using either standard suture material (000 silk) or skin staples (5.