The American journal of emergency medicine
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Emergency department (ED) crowding is a recognized issue and it has been suggested that it can affect clinician decision-making. ⋯ Increased ED occupancy was found to be associated with more patients being classified as higher acuity as well as higher hospital admission rates. As an example, for a commonly observed patient category, our model predicts that as the ED occupancy increases from 25 to 75 patients, the probability of a patient being triaged as high acuity increases by about 50% and the probability of a patient being categorized as admit increases by around 25%.
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Case Reports
A knack for "NAC": Treatment for heat stroke induced acute liver injury: A case report.
Heat stroke occurs when the body's core temperature becomes elevated above 40 °C, which may impact multiple organ systems. We present a case of heat stroke resulting in acute liver injury (ALI) successfully treated with intravenous N-acetylcysteine (NAC). ⋯ Hepatocellular injury is one of the most serious complications of heat stroke. We discuss the incidence and outcomes for patients who develop acute liver injury secondary to heat stroke and the use of NAC as an early potential therapeutic option.
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To the majority of health care professionals, burns present as a challenging and potentially distracting diagnosis. Because of their perceived complexity, they often eclipse other medical problems which can often be life threatening. Pressure related injuries, in rare instances can mimic and be mistaken for full thickness burns. Long lies may cause pressure necrosis of decubitus areas and compartment syndrome of vulnerable areas. Compartment syndrome, is a surgical emergency requiring prompt diagnosis and intervention. It may be missed in the context of a long lie after a collapse and maybe detrimental to patients' prognosis. ⋯ Pattern analysis and recognition are very important diagnostic tools in medicine. Detailed history taking and examination cannot be emphasised enough. Training both emergency departments and plastic surgeons in recognising long lie related injuries will decrease possible associated dangers such as missing a compartment syndrome.
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Spontaneous lung herniation is a rare finding, most often the result of forceful coughing. Risk factors include obesity, male gender, tobacco use, and steroid use. Surgical repair is recommended due to increasing size of herniation and pain control. Life style modification, such as smoking cessation, is recommended in this patient population.