The American journal of emergency medicine
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Cycas revoluta (sago cycad or palm) is a popular ornamental plant in the United States. All parts of the plant contain toxins such cycasin and beta-methylamino-l-alanine, the ingestion of which can be harmful to humans and animals. The objective of this study was to characterize C. revoluta exposures reported to poison centers. ⋯ Most of the C. revoluta exposures tended to be unintentional and occurred at home. Although most of the C. revoluta exposures involved ingestion, 35% were dermal, and the most frequently reported clinical effects were dermal followed by gastrointestinal. Most of the exposures were not serious and were managed outside of a healthcare facility.
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The clinical therapy for severe 2019 coronavirus disease (i.e., COVID-19) sufferers is relatively challenging. Herein, the processes involving salvage of a critical COVID-19 patient were retrospectively analyzed. The condition of an obese female critical COVID-19 sufferer progressively worsened in the initial period after admission. ⋯ In the later therapeutic phase, however, sedative and analgesic dosages were gradually reduced, and psychological and rehabilitative therapies were conducted, concomitantly with enhancement of airway care to facilitate sputum expectoration. Eventually, the endotracheal tube was feasibly removed after intubation for 18 days and subsequently replaced with noninvasive ventilation and a high-flow nasal cannula oxygen therapy. Intensive airway care alongside psychological and rehabilitative therapies can shorten the mechanical ventilation time and improve the prognosis of COVID-19 sufferers.
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Malignant otitis externa (MOE) is a progressive infection of the external auditory canal (EAC). This disease is rare but has severe morbidity and mortality. ⋯ MOE is a rare, yet deadly diagnosis that must be suspected when patients with immunocompromise, diabetes, or advanced age present with severe otalgia. Rapid diagnosis and treatment may prevent complications and improve outcomes.
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Demographic shifts and care delivery system evolution affect the number of Emergency Department (ED) visits and associated costs. Recent aggregate trends in ED visit rates and charges between 2010 and 2016 have not been evaluated. ⋯ The rate of ED visits per 1000 persons and the mean charge per ED visit increased significantly between 2010 and 2016. Mean charges increased for both high- and low-acuity clinical categories. Visits for the 5 most common clinical categories comprise about 30% of ED visits, and may represent focus areas for increasing the value of ED care.