The American journal of emergency medicine
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Determine the incidence, management, and impact on patient disposition of allergic-like contrast reactions (ALCR) to intravenous iodinated contrast in the emergency department (ED). ⋯ ALCR among ED patients undergoing CECT are rare, generally of mild severity, respond well to pharmacologic management, and do not alter patient disposition in most cases. Familiarity with symptoms, management, and prevention strategies is increasingly relevant to the emergency physician given the ubiquity of CECT.
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The increased volume in demand worldwide in the present day has led to the need for the establishment of effective ambulance services. As call centers have become the primary contact point between patients and emergency service providers, the planning of the call center has become a key task for administrators. ⋯ This paper provides a basis for operation planning strategies of ambulance services by reconsidering the uncertainties of demand. The newsvendor model, which works well under parameter uncertainty, can be used in planning the capacities of health care services, especially when high service levels are required.
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Observational Study
A prospective study of ketamine as primary therapy for prehospital profound agitation.
We investigated the effectiveness of ketamine as a primary therapy for prehospital profound agitation. ⋯ In patients with prehospital profound agitation, ketamine provides rapid effective sedation when used as a primary therapy. Intubation was common but accompanied by a short duration of mechanical ventilation and appears to have been subject to individual physician practice variation.
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Case Reports
Dynamic variations in platelet counts may reflect the severity and prognosis of stingray injuries in the early phase.
There is often a delay in offering quality and prompt treatment after a stingray sting. We present 3 cases of stings and discuss the Poisoning Severity Score (PSS) and a simple tool to assess the severity of such injuries. A 34-year-old man, who worked as an aquarium keeper, presented a wound on the left fifth digit caused by a stingray. ⋯ We found that relatively high PSSs were associated with lower platelet counts that happen due to various adverse events. We suggest that dynamic changes in platelet counts may be associated with the severity of the injury. Furthermore, lower platelet counts in the normal or abnormal range may indicate poor prognoses.
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There is significant overlap between the symptoms of patients presenting with retinal detachment (RD) and posterior vitreous detachment (PVD). Urgency to obtain consultation and treatment are dependent on the ability to accurately distinguish these two conditions. The objective of this study was to determine the ability of emergency physicians to differentiate RDs from PVDs using point-of-care (POC) ocular ultrasound. ⋯ Emergency physicians were modestly accurate in distinguishing RD from PVD on POC ultrasound.