1/3. Pentaethylene-terephthalate (PET) bottles: a new device for autoerotic strangulation of the penis causing serious injury.Strangulation of the penis by application of constricting devices may present a challenge for the treating physician. Depending on the type of constricting material, special equipment is essential for successful removal of the foreign bodies. We report a new form of constricting device, the neck of a coca cola bottle made of Pentaethylene-terephthalate (PET). Particular difficulties were encountered upon removal. Technical details of this case are described. Prior literature on the treatment of penile strangulation is discussed.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/3. Does determining serum alcohol concentrations in emergency department patients influence physicians' civil suit liability?Emergency physicians may incur liability when impaired patients who have been treated and released are subsequently involved in traffic crashes. We surveyed attorneys to assess their perception of how serum alcohol determinations might influence their liability in civil suits. overall, 63.9% of the attorneys surveyed would advise patients that they received potentially negligent care if they were impaired following treatment in the emergency department and were involved in a traffic crashes. Perceived liability was altered by physician behavior as follows: 43.1% of attorneys would advise clients that they received potentially negligent care when impairment was documented by a test for serum alcohol concentration and no advice was given regarding drunk driving, and 17.3% of attorneys would give similar advice when impairment was not documented by a test for serum alcohol concentration and no advice was given regarding drunk driving. In contrast, only 3.5% of attorneys would suggest possible negligence when impairment was documented by a test for serum alcohol concentration and with advice subsequently given not to drive. The coupling of diagnosing impairment by the serum alcohol concentration and driving advice is medically sensible and might result in minimal civil liability.- - - - - - - - - - ranking = 6keywords = physician (Clic here for more details about this article) |
3/3. Special considerations in the poisoned pediatric patient.The incidence of serious pediatric morbidity and mortality has fortunately declined over the past two decades due to better prevention efforts, the development of regionalized poison information programs, and advances in the emergency management and critical care of poisoned patients. Still, children continue to explore and often ingest many substances they discover in their world. Some of these children will become patients who present to the emergency department, requiring a coordinated approach to the seriously or even critically ill poisoned child by physicians who can access specialized resources to manage a vast spectrum of potential toxins. This article summarized one such approach, emphasizing initial attention to life support priorities, followed by a detailed evaluation process using readily available clinical and laboratory data. Management strategies including decontamination, urgent antidotal therapy, initiation of excretion enhancement, and optimal supportive care were reviewed. Several specific intoxications were illustrated briefly in an attempt to facilitate pattern recognition of characteristic pediatric exposures.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |