Annals of emergency medicine
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Randomized Controlled Trial Clinical Trial
Efficacy of rectal midazolam for the sedation of preschool children undergoing laceration repair.
To determine the efficacy of rectal midazolam as sedation for laceration repair in preschool children in the pediatric emergency department. ⋯ Rectal midazolam is an effective method of sedation for facilitating uncomplicated laceration repair in preschool children. However, physicians must be aware of the possibility of paradoxical reactions when using midazolam in children.
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Emergency department patients who leave without seeing a physician: the Toronto Hospital experience.
To determine why emergency department patients leave without being seen by a physician and whether they receive alternate medical care. ⋯ The majority of survey respondents had a low acuity rating and left because of prolonged waiting times. Most of these patients sought alternate medical care through their personal physician or other EDs.
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To determine the rate and cause of death of patients who were evaluated in the emergency department and discharged and how the cause of death related to the ED visit. ⋯ Death after discharge from the ED is uncommon. The most common cause of unexpected, directly related death is ruptured aortic aneurysm.
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Fractures of the hip following seizure are uncommon but may have devastating consequences if allowed to go unrecognized. The presence of groin pain suggests hip pathology, but the ability to ambulate does not necessarily rule out fracture. ⋯ Given the powerful contractions that occur with convulsions, musculoskeletal pain following seizure should not be dismissed until fractures or dislocations have been ruled out. We report the case of a young man with bilateral hip fractures following seizure, illustrating the violent muscular forces possible.
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Wound botulism is a rare infectious and toxicologic complication of trauma and i.v. drug abuse. Only 39 cases have been reported in detail in the English literature. ⋯ Although his history and physical examination were consistent with wound botulism, diagnosis and therapy were delayed because this rare disease was not considered initially in the differential diagnosis. Wound botulism should be considered in trauma patients and i.v. drug abusers who present with cranial nerve palsies and descending paresis.