EM3M: envisioning the future of emergency medicine.
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Biomedical subjects
Publications and source records attributed to J F Waeckerle.
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The ED of the future will require the effective integration of information technologies into clinical care. This article proposes strategies for improving information management in emergency medicine to facilitate patient care, public health surveillance, clinical research, medical education, and health care management.
The emergency department of the future will require the effective integration of information technologies into clinical care. This article proposes strategies for improving information management in emergency medicine to facilitate patient care, public health surveillance, clinical research, medical education, and health care management. Cordell WH, Overhage JM, Waeckerle JF, for the Information Management Work Group: Strategies for improving information management in emergency medicine to meet clinical, research, and administrative needs.
Annals' 25th anniversary is a cause for celebration, but the future imposes a new set of ethical questions and moral dilemmas for emergency physicians. Each physician will need to make personal choices consistent with the courage, judgment, integrity, and dedication of past leaders when dealing with the moral dilemmas of the future.
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The topical anesthetic TAC (tetracaine 0.5%, adrenaline 0.05%, cocaine 11.8%) has been reported to be effective in pain control for local procedures. However, it has the potential for cocaine toxicity by absorption through an open wound. A study was undertaken to assess the systemic absorption of cocaine and its metabolites when TAC is used as a local anesthetic. Fifty-one children, 1 to 14 years of age, were enrolled in the study. Plasma for cocaine and/or its metabolite levels was available from 46 children and obtained 20 to 40 minutes after the topical anesthetic was applied. No plasma sample had detectable parent cocaine levels; however, 26 (56.5%) had cocaine metabolite levels. Ecgonine methylester levels were detected in plasma from six children and ranged from 59 to 985 ng/mL. Benzoylecgonine levels were detected in none of 19 specimens not preserved with sodium fluoride, and in 23 of 27 specimens to which sodium fluoride had been added. Benzoylecgonine levels ranged from 40 to more than 600 ng/mL. No clinical sign of cocaine toxicity was observed in any child.