The American journal of emergency medicine
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Review
Ventricular assist device in the emergency department: Evaluation and management considerations.
Ventricular assist devices (VAD) are being used at increasing rates in patients with severe, end-stage heart failure. Specific indications include VAD placement as a bridge to cardiac function recovery, a bridge to cardiac transplantation, or destination therapy (long-term support for patients ineligible for transplant). The assessment and management of the VAD patient is rather complex, requiring a basic knowledge of device structure and function. This article reviews the basic structure and function, discusses the approach to the VAD patient in the ED, and reviews the more common presentations and complications encountered in these technology-complex patients who are critically ill at baseline.
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Multicenter Study
Emergency department boarding and adverse hospitalization outcomes among patients admitted to a general medical service.
Overcrowding in the emergency department (ED) has been associated with patient harm, yet little is known about the association between ED boarding and adverse hospitalization outcomes. We sought to examine the association between ED boarding and three common adverse hospitalization outcomes: rapid response team activation (RRT), escalation in care, and mortality. ⋯ Within the first 24h of hospital admission to a general medicine service, adverse hospitalization outcomes are rare and not associated with ED boarding.
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Multicenter Study Observational Study
Emergency department length of stay for ethanol intoxication encounters.
Emergency Department (ED) encounters for ethanol intoxication are becoming increasingly common. The purpose of this study was to explore factors associated with ED length of stay (LOS) for ethanol intoxication encounters. ⋯ Variables such as diagnostic testing, treatments, and hour of arrival may influence ED LOS in patients with acute ethanol intoxication. Identification and further exploration of these factors may assist in developing hospital and community based improvements to modify LOS in this population.
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Case Reports
Chemotherapy patient with Stevens-Johnson Syndrome presents to the Emergency Department: A case report.
Stevens-Johnson syndrome (SJS) is part of a continuum of severe mucocutaneous reactions, commonly thought to be triggered by certain medications. The syndrome itself is characterized by diffuse necrosis and detachment of the epidermis. ⋯ While Stevens-Johnson syndrome has been a rare toxicity, it is potentially fatal. The emergency physician should pay special attention cancer patients presenting with suspicious rashes and carefully review their medications.
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This study is to present the diagnostic values of the novel sonographic visualization of the inferoposterior thoracic wall (VIP) and boomerang signs in detecting right pleural effusion by sonologists with little to no experience in ultrasound. ⋯ Despite inexperience in sonography, the novel VIP and boomerang signs show high diagnostic values in detecting right pleural effusion compared to the traditional methods.