The American journal of emergency medicine
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Pediatric mental health presentations continue to increase across the US. These patients often board for significant periods of time and may require more resources than other acute non-mental health patients. This has important implications for the overall function of the emergency department (ED) as well as care of all ED patients. ⋯ A hospital policy allowing mental health patients to be admitted to the inpatient hospital once stabilized has the potential to improve ED flow and functionality.
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The literature indicates that youth with intellectual/developmental disabilities (IDD) have poor health and that access to health services decreases as they transition from pediatric to adult services. At the same time their use of emergency department services increases. The objective of this study was to compare use of emergency department services by youth with IDD to youth without IDD, with particular emphasis on the transition period from pediatric to adult health care services. ⋯ The findings from this study indicate that youth with IDD have higher odds of using emergency services than youth without IDD although these increased odds appear to be largely driven by mental illness. In addition, use of emergency services increases as the youth age and transition from pediatric to adult health services. Better treatment of mental health issues within this population may reduce their use of emergency services.
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When weighing the costs and benefits of "choosing wisely," in a healthcare climate that continues to stress cost-saving practices, it is difficult to argue with approaching low-risk patients with conservative approaches and treatments. In defense of liberal and broad approaches to patient workups, however, one must also weigh the bounce-back emergency department (ED) visit, which may represent either a failure of initial evaluation or a success of appropriate return precautions. ⋯ Magnetic Resonance Imaging (MRI) of the brain and spine demonstrated extensive and multifocal areas of signal abnormalities consistent with active demyelination concerning for acute disseminated encephalomyelitis (ADEM). Additional lab workup demonstrated seropositive myelin oligodendrocyte glycoprotein (MOG) antibodies, further supporting the diagnosis of ADEM, an immune-mediated disorder which can lead to rapid multifocal neurologic dysfunction.
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Smart watches, which are a rapidly developing technology that can record and store personal health data such as heart rate, oxygen saturation, ECG, and sports activities. We presented a patient who applied to the emergency department due to palpitation and he recorded an ECG output with a smart watch before admission. In this case, we emphasized that the use of smart watches in the prehospital period can help the diagnosis process of dysrhythmias in the hospital setting.