The American journal of emergency medicine
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Case Reports
Arterial emboli of the upper extremity presenting as ischemic heart disease: case report and review.
A case of brachial artery embolism presenting as ischemic coronary artery disease is presented. The patient presented with sudden onset of left arm pain, shortness of breath, nausea, vomiting, and diaphoresis. Initial relief with sublingual nitroglycerin was seen. ⋯ Delay in diagnosis and treatment can lead to substantial morbidity, including gangrene and amputation. Misdiagnosis is common, as it is seen in the same patients at risk for ischemic heart disease, stroke, and other vascular abnormalities. An awareness of this problem is important among those who initially evaluate patients in emergency departments.
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To determine whether aluminum foreign bodies located in the soft tissues of small body parts are radiopaque, six pieces of aluminum (0.5 mm x 0.5 mm x 1 mm; 0.5 mm x 0.5 mm x 2 mm; 0.5 mm x 0.5 mm x 4 mm; 1 mm x 1 mm x 1 mm; 1 mm x 1 mm x 2 mm; and 1 mm x 1 mm x 4 mm in size) were placed in a chicken wing model and anteroposterior and lateral radiographs of the preparation were obtained. Aluminum fragments (of all sizes used) were easily discernible when projected away from bone. The authors conclude that aluminum foreign bodies located in the soft tissues of small body parts are radiopaque.
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To demonstrate the use of the computer as a tool for information storage and analysis in the emergency department (ED) with the objective of improving ED efficiency, the authors conducted a prospective study from April through September 1991. Information from charts of patients who came into the medical emergency department (MED) and surgical emergency department (SED) were checked and input into the computer. This information included triage classification, registration time, time seen, disposition, disposition time, physician's impression as well as the reasons for delayed disposition. ⋯ A commitment to providing quality care in the ED sometimes results in unreasonable waiting times for triage 3 and 4 patients, causing patient dissatisfaction. Readjustment of staffing and space use is needed. Equipping the ED with facilities to provide sonography and computed tomography would enhance patient flow; this needs further study to evaluate cost effectiveness.(ABSTRACT TRUNCATED AT 250 WORDS)