The American journal of emergency medicine
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Otalgia with mastoiditis is an infrequently encountered complication of acute otitis media (Pfaff and Moore, 2018). Even more rare is the development of infected jugular venous thrombosis, Lemierre's disease. ⋯ The true prevalence of Lemierre's from mastoiditis is difficult to discern. This clinical case highlights the importance of the consideration of these pathologies by the emergency physician.
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The aim of this study was to compare hypothermia patients with and without an Osborn wave (OW) in terms of physical examination findings, laboratory results, and clinical survival. ⋯ Although there is a relationship between the decrease in bicarbonate levels, changes in kidney functions that cause acidosis, and the presence of OW, it has no effect on mortality. The presence of OW in hypothermic patients is insufficient to make a decision regarding mortality.
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Emergency department (ED) visits for dental pain and low back pain (LBP) are common. Many such patients have severe pain and receive opioids. Increased opioid-related deaths has led to efforts to reduce opioid prescriptions. We compared recent trends in use of analgesics and opioids in the ED and at discharge among patients with dental or LBP. ⋯ Prescription of opioids decreased for ED dental patients. While less likely to receive analgesics and opioids in the ED, patients with dental pain were more likely to be prescribed analgesics and opioids at the time of ED discharge than those with LBP.
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Observational Study
Variability in opioid prescribing in veterans affairs emergency departments and urgent cares.
The Veterans Health Administration (VHA) is the largest integrated health care system in the U.S., serving approximately 2.5 million Veterans in the Emergency Department/Urgent Care Centers (ED/UCC) each year. Variation in opioid prescribing by ED/UCC providers in the VHA is described. ⋯ ED/UCC providers in the VHA system nationally vary considerably in rates of opioid prescribing. A focused initiative tailored for ED/UCC providers is needed to decrease opioid prescribing variability.