ACEP News, October 2009

October 2009 ACEP News in full digital format
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Serving as the executive director for the American College of Emergency Physicians, Mr. Wilkerson debuted at an impressive number 37 on Modern Healthcare magazine's annual "100 Most Powerful People in Healthcare" list.

As hospitals prepare for a potential surge in cases of the pandemic (A)H1N1 influenza virus this fall, physicians must make decisions about protective measures based on limited evidence about the virus's transmission and severity.

New prediction rules derived in a large prospective study of children and adolescents could identify which head trauma patients are at very low risk of serious traumatic brain injuries and thus do not routinely need a CT scan.

A new scoring system for categorizing patients who present with chest pain to the emergency department--called the HEART score--proved to be a strong discriminator of acute coronary syndrome and the risk of major adverse cardiac events within the next 6 weeks in a Dutch multicenter validation study.

The recommended antiviral therapy during the coming influenza season will depend on whether a patient has laboratory-confirmed pandemic influenza A(H1N1).

Hospitals should require all health care workers with direct patient contact to be vaccinated against both seasonal influenza and the pandemic A(H1N1) flu, the Association for Professionals in Infection Control and Epidemiology has said.

I knew that our relationship would be difficult. You told me you would be demanding and difficult and unpredictable. 

Physicians should use oseltamivir to treat patients with severe or progressive cases of infection with the pandemic influenza A(H1N1) virus. If that drug is unavailable or if the virus demonstrates resistance to it, treat with zanamivir, international public health officials said.

Using basic infection-control practices may be the best approach when caring for patients hospitalized with the pandemic influenza A(H1N1) virus, in contrast to more stringent measures such as the use of respirators.

The treatment success rate for metronidazole in C. difficile - associated disease has definitely dropped off, compared with that of vancomycin, since the disease epidemiology changed around the year 2000, but the drug nevertheless retains a highly useful role for this infection.

Eighty-five percent of typhoid fever cases in the United States are related to foreign travel, particularly travel in the Indian subcontinent, investigators reported in JAMA.

The common practice of discontinuing beta-blocker therapy during hospitalization for an acute exacerbation of heart failure is counterproductive, according to a French randomized trial.

Two retrospective studies reveal trends in acute myo- cardial infarction and mortality associated with cardiogenic shock in hospitalized patients.

The use of bivalirudin during primary percutaneous coronary intervention yielded superior outcomes as long as 1 year later, compared with the use of standard anticoagulant therapy, according to a report published in Lancet.

Thirty-day mortality among patients hospitalized with acute myocardial infarction markedly decreased in the United States between 1995 and 2006, according to a report in JAMA.

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