The American journal of emergency medicine
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Pediatric patients comprise 13% of emergency medical services (EMS) transports, and most are transported to general emergency departments (ED). EMS transport destination policies may guide when to transport patients to a children's hospital, especially for medical complaints. Factors that influence EMS providers 'decisions about where to transport children are unknown. Our objective was to evaluate the factors associated with pediatric EMS transports to children's hospitals for medical complaints. ⋯ We found that younger patient age, EMS protocol requirements, and paramedic scene response may influence pediatric patient transport to both children's and community hospitals. Socioeconomic factors, ED proximity, diversion status, respiratory rate, chief complaints, and communication barriers may also be contributing factors. Further studies are needed to determine the generalizability of these findings to other EMS systems.
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To investigate how the total prehospital time (TPT), Abbreviated Injury Scale (AIS), Injury Severity Score (ISS), and Trauma Score-Injury Severity Score (TRISS) affect the outcome of plane crash victims from anatomical, physiological and psychological perspectives. The accuracy or strength of these scores and TPT in predicting hospitalization and surgery, sequelae development and psychiatric complications [permanent temporary disability (PoTDs)] and PTSD can allow medical professionals to direct and prioritize management efforts of the victims of mass casualties in general. ⋯ It is expected that everyone who practices medicine be equipped to handle multiple casualties. As the number of people involved in mass casualties increases, diagnostic tools, workups such as laboratory and radiological studies, and prognostic markers such as trauma scores should be simpler and more user-friendly.
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Poisonings resulting from the abuse of drugs currently represent a serious problem for public health. Among the main agents involved, cocaine stands out. It became one of the most abused drugs around the world, and one of the main reasons for visits to the emergency department due to the use of illicit substances. The use of cocaine is primarily in combination with alcoholic beverages. There are few studies that correlate cocaine blood concentration and the severity of clinical manifestations in patients evaluated at Emergency Department. The aim of the present study was to verify the possible relationship between the blood concentration of cocaine and cocaethylene (product of the interaction of cocaine with ethanol) with the severity of the clinical manifestations presented by patients with cocaine intoxication. ⋯ The application of the SIS score proved to be an important alternative capable of predicting the severity of the patients due to cocaine intoxication in a fast and simplified way.
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Lung cancer is one of the leading causes of cancer related mortality worldwide. Currently, it is the third most common cancer behind prostate and breast cancer. Approximately 85% of all lung cancers are non-small-cell lung cancers (NSCLC). ⋯ Multiple case reports have been reported with ocular metastases, such as the choroid, iris and retina. We present a 87-year-old women whose initial emergency department presentation of squamous cell type lung cancer was an intraocular mass. To our knowledge this is the first reported case of this presentation and diagnosis within the emergency department setting.
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The primary goals of emergency department (ED) clinicians when dealing with a pediatric patient experiencing a seizure are to control the seizure and prevent seizure-related complications. After stabilizing the patient, the clinician should determine whether the patient is likely to have recurrent seizures that may need treatment such as antiepileptic drugs (AEDs). The early identification of pediatric seizure patients at high risk for recurrence can be of great help in consulting with their parents. This study aimed to identify predictors of seizure recurrence in pediatric patients who visited the ED for first-onset afebrile seizure. ⋯ Age at onset ≥11 years, a longer seizure duration, acidosis, and hyperglycemia were predictors of seizure recurrence in children who had experienced first-onset afebrile seizure.