The American journal of emergency medicine
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Syncope is a common emergency department (ED) chief complaint, with many known but also unknown causes. Here we present a novel ED presentation of a young woman with new-onset hyperthyroidism that masqueraded as a syncopal event with head trauma. ⋯ Persistent tachycardia during her ED course after an unremarkable full trauma evaluation prompted ordering of additional lab testing, which revealed evidence of thyrotoxicosis. Here we consider the possibility of thyroid dysfunction resulting in syncope.
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Multicenter Study Observational Study
QTc prolongation as a marker of 30-day serious outcomes in older patients with syncope presenting to the Emergency Department.
Syncope is a common chief complaint in the ED, and the electrocardiogram (ECG) is a routine diagnostic tool in the evaluation of syncope. We assessed whether increasingly prolonged QTc intervals are associated with composite 30-day serious outcomes in older adults presenting to the ED with syncope. ⋯ In a cohort of older patients presenting with syncope, increased QTc interval was a marker of but was not independently predictive of composite 30-day serious outcomes.
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Organophosphorus (OP) compound poisoning with suicidal intent is common. It is one of the frequent cause for admission to hospital Emergencies and intensive care units in our region. We describe here a case of 19-year old girl who presented to the Emergency Department with atypical features of OP poisoning. ⋯ Based on history and clinical suspicion of nicotinic receptor mediated effect of OP, she was given intravenous atropine along with other supportive treatment. Patient got completely recovered from fasciculations and her motor weakness improved after 6 h of atropine therapy. Emergency physician should keep a high index of suspicion of isolated nicotinic and ganglionic mediated effect of OP and a trial of atropine should be given to the patient.
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Observational Study
Role of ED crowding relative to trauma quality care in a Level 1 Trauma Center.
Trauma Quality Improvement Program participation among all trauma centers has shown to improve patient outcomes. We aim to identify trauma quality events occurring during the Emergency Department (ED) phase of care. ⋯ Provider related issues are a common contributor to undesirable outcomes in trauma care. ED crowding lacks significant association with poor trauma quality care. Prolonged ED LOS (≥2 h) appears to be linked with unfavorable outcomes in ED trauma care.