John M C Howell

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This clinical policy from the American College of Emergency Physicians is an update of a 2000 clinical policy on the evaluation and management of patients presenting with nontraumatic acute abdominal pain.1 A writing subcommittee reviewed the literature to derive evidence-based recommendations to help clinicians answer the following critical questions:(More)
OBJECTIVE To identify factors in exposures to beta blockers (beta-adrenergic receptor antagonists) that are associated with the development of cardiovascular morbidity and contribute to disposition decisions from the emergency department. METHODS Prospective cohort of 280 beta blocker exposures reported to 2 regional poison centers. Multiple logistic(More)
We studied the effects of closing lacerations with suture or cyanoacrylate tissue adhesive on staphylococcal counts in inoculated guinea pig lacerations. Wounds closed with adhesive alone had lower counts than wounds containing suture material (P < 0.05). The results of a time-kill study were consistent with a bacteriostatic adhesive effect of the adhesive(More)
STUDY OBJECTIVE To sample the practice styles of emergency physicians caring for acute traumatic wounds. DESIGN Written survey. SETTING US emergency departments obtained from the American College of Emergency Physicians mailing list. SUBJECTS Randomly selected ACEP members. MAIN RESULTS One hundred fifty-one of 285 (53%) survey mailings were(More)
Nine cases of symptomatic bradycardia are presented in which treatment with intravenous glucagon was administered when atropine failed to improve the patient's condition significantly. Although the cause often was not obvious at presentation, all nine subjects took oral medications that could have contributed to the development of symptomatic bradycardia.(More)
Clonidine and the imidazolines, commonly found in topical ophthalmic and nasal decongestants, are chemically related drugs that have been responsible for many pediatric poisonings. These medications can cause significant morbidity in small doses. A review of the available literature reveals that young children have exhibited severe signs and symptoms after(More)
Xiphodynia is an uncommon musculoskeletal disorder that mimics a number of common abdominal and thoracic diseases. We report three cases of xiphodynia. The diagnosis is suggested when a given patient's chest or abdominal discomfort is completely or almost completely reproduced with light pressure on the xiphoid process. Local injection with an(More)
Urinary retention resulting from urethral obstruction by a retroverted, gravid uterus is an uncommon disorder that is reported only once in the Emergency Medicine literature. Yet these patients may present in extreme distress and precipitate considerable confusion regarding the cause of and solution to this problem. No study evaluating outcome, risk of(More)
BACKGROUND Concussions are commonly diagnosed in pediatric patients presenting to the emergency department (ED). The primary objective of this study was to evaluate compliance with ED discharge instructions for concussion management. METHODS A prospective cohort study was conducted from November 2011 to November 2012 in a pediatric ED at a regional Level(More)
  • J M Howell
  • Emergency medicine clinics of North America
  • 1992
New adjuncts to outpatient wound care focus on diminishing infection rates and improving the speed and effectiveness of laceration repair. This article provides an overview of growth factors, proteolytic enzymes, topical antimicrobial agents, and new materials that facilitate wound closure. Also, the pathophysiology of surface wound repair is summarized.