Annals of emergency medicine
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Physician service time varies with patient service category, length of stay, and intensity of service. ⋯ Case mix of patient services affects emergency physician workload and should be considered in planning departmental staffing needs.
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We report a case of an iliac apophyseal fracture in a 15-year-old boy, sustained while swinging a baseball bat. He presented with right hip pain one hour after the injury occurred. ⋯ The iliac crest is an unusual site of injury for this avulsion fracture. Only one other well-described case of an acute, noncontact fracture of the iliac apophysis with a similar mechanism of injury has been reported.
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To establish the frequency of use of pediatric emergency departments by adult patients and the spectrum of disease with which they present. ⋯ Adults frequently present to pediatric EDs for both minor and serious illnesses. Training in adult emergency medicine should be a part of all pediatric emergency medicine fellowship programs.
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In two separate incidents, two toddlers with no previous history of respiratory ailments presented to the emergency department of a children's hospital with progressive respiratory distress. Both children had unilateral lung findings on auscultation and initial chest radiographs that were consistent with a pneumothorax. ⋯ Nasogastric tube insertion relieved the respiratory distress of these two children. Recognition of the "acquired" congenital diaphragmatic hernia in the setting of extreme aerophagia or mild abdominal trauma may prevent unnecessary procedures during the resuscitation of children with acute respiratory distress and unilateral lung findings.
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Comparative Study
Does nasotracheal intubation increase complications in patients with skull base fractures?
To determine if the complications associated with skull base fractures are increased when nasotracheal intubation is performed in the field. ⋯ Patients with skull base fracture have a significant complication rate (25%). The complications associated with skull base fractures are not markedly increased by attempts at nasotracheal intubation in the field.