The American journal of emergency medicine
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There is limited information directly comparing andexanet alfa (AA) versus four-factor prothrombin complex concentrate (4F-PCC) in intracranial hemorrhage (ICH) on apixaban or rivaroxaban. ⋯ This study found no significant differences in good or excellent ICH hemostasis within 24-h or new thrombotic events within 14-days in a cohort given AA or 4F-PCC for ICH while on apixaban or rivaroxaban. However, this single-center analysis is underpowered due to sample size constraints, therefore further high-quality research comparing AA safety and effectiveness versus 4F-PCC is needed.
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Foreign body in the eye is a relatively common emergency department (ED) chief complaint which does not usually lead to ophthalmologic intervention. We report a case of a 35-year-old male with a history of developmental delay who presented to our ED for evaluation of ocular foreign body. His reported foreign body was removed, and subsequently identified as an Ahmed Valve, a device used in the management of glaucoma. ⋯ Even patient presentations for seemingly simple, straightforward chief complaints deserve critical appraisal by emergency clinicians. When suspicions are raised or there is any doubt, specialty consultation should be obtained to ensure patients receive appropriate care and necessary follow up. This is especially true when history and exam are limited by other factors such as developmental delay, incomplete medical history, or altered mental status.
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Violence and aggressive behaviors among youth are a leading cause of Emergency Department (ED) mental health (MH) encounters. A consistent method is needed for public health research, to identify ED encounters associated with aggression. The aim of this study was to develop such a screening procedure. ⋯ This paper presents a screening method for identifying ED encounters related to aggression. A replication study will be necessary to validate the method prior to applying to large claims data. If validated, it will support future research on this important population.
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Trends in upper extremity injuries presenting to emergency departments during the COVID-19 pandemic.
During the emergence of the SARS-CoV-2 (COVID-19) pandemic, there were substantial changes in United States (U.S.) emergency department (ED) volumes and acuity of patient presentation compared to more recent years. Thus, the purpose of this study was to characterize the incidence of specific upper extremity (UE) injuries presenting to U.S. EDs during the COVID-19 pandemic and analyze trends across age groups and rates of hospital admission compared to years prior. ⋯ Level III - Retrospective Cohort Study.
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Tranexamic acid (TXA) is an antifibrinolytic agent which reduces bradykinin production through its blockade of the conversion of plasminogen to plasmin and subsequently pre-kallikrein to kallikrein. It has been utilized in angiotensin converting enzyme (ACE) inhibitor-induced angioedema (ACEi-AE) in small case reports and series however overall data is limited. This report describes a patient who historically received TXA for ACEi-AE and represented with ACEi-AE after an accidental exposure and was successfully treated with TXA again. This case suggests TXA may be a safe and effective treatment option for ACEi-AE.