Staff Augmentation during Disaster Response.

This article outlines a disaster medicine team response to the Texas-Mexico border during a coronavirus disease 2019 (COVID-19) surge. The team consisted of emergency medicine attending providers, as well as a nurse practitioner and a physician assistant, who were asked to work in the intensive care unit (ICU) under the guidance of an intensivist. The article highlights the medicolegal and ethical implications of providers working outside of their designated scope of practice. A framework for future staff augmentation during a disaster is explained.

Cannabis and acute myocardial infarction.

Marijuana is one of the most commonly consumed psychotropic drugs in the world. It has been associated with adverse cardiovascular reactions including acute coronary syndrome, but this information is not widely known among emergency medicine clinicians. This article describes cannabis use as a contributing factor to acute myocardial infarction in a young woman with chest pain.

Treatment data using a topical povidone-iodine antiseptic in patients with superficial skin abscesses.

The standard treatment of cutaneous abscesses in the emergency department is incision and drainage (I&D). The purpose of this investigation is to determine the feasibility of using a povodine-iodine topical antiseptic solution (PVP-I) as a clinical adjunct in the treatment of superficial skin abscesses after I&D, and the data is related to "Pilot Study to Evaluate the Adjunct Use of a Povidone-Iodine Topical Antiseptic in Patients with Soft Tissue Abscesses" [Olson et al., 2019]. The data aims to determine if the daily application of PVP-I in the wound cavity and as an antiseptic hand wash would confer any benefit over I&D alone. The primary outcome was clinical cure 7-10 days after I&D. The secondary outcomes were rate of new abscess development and spread of infection in household contacts (HC) within 30 days.

Pilot Study to Evaluate the Adjunct Use of a Povidone-Iodine Topical Antiseptic in Patients with Soft Tissue Abscesses.

BACKGROUND: Povidone-iodine (PVP-I) antiseptic solutions have been shown to be effective against methicillin-resistant Staphylococcal aureus, a common cause of superficial skin abscesses. OBJECTIVES: Our objective was to study the feasibility of using PVP-I as a treatment adjunct in patients with superficial skin abscesses and determine if it confers any benefit over incision and drainage (I&D) alone. METHODS: This was a randomized controlled pilot study of adult patients with an uncomplicated skin abscess. Patients were randomized to PVP-I or standard treatment. All patients had I&D and abscess packing. Patients randomized to PVP-I were instructed on daily application of the agent to hands, wound, and surrounding skin with dressing changes. Subjects returned at 48-72 h and 7-10 days and followed-up by phone at 30 days. The primary outcome was clinical cure 7-10 days after I&D. The secondary outcomes were rate of development of new skin lesions and spread in household contacts within 30 days. RESULTS: Clinical cure occurred in 91.3% of patients in the standard group vs. 88.2% of patients in the PVP-I group (difference, 3.1%; 95% confidence interval [CI] -10.7 to 16.8; p = 0.53). There was a significantly higher adverse event rate in the group who received PVP-I (59.6%) vs. standard care (26.5%) (difference 33.1%, 95% CI 13.2-50.2; p < 0.001). CONCLUSIONS: There was no difference in clinical cure rates among patients using PVP-I (88.2%) vs. standard care (91.3%) after I&D. There were no major adverse events, but the addition of PVP-I was commonly associated with local skin irritation.