The American journal of emergency medicine
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Each year millions of children seek care in emergency departments, many of whom are from marginalized and minoritized groups who lack access to primary and preventive care. Law enforcement personnel are also commonly present in pediatric and adult emergency departments serving in a range of roles. Therefore, pediatric emergency departments sit at the nexus of the health system and the legal system for many vulnerable youth and families. ⋯ Pediatric clinicians, highly trained professionals in the medical and social care of youth and children, are often unaware of legal rules and procedures that guide law enforcement interaction with youth. This lack of knowledge may result in unknowing and unwitting violations of patients' rights while also compromising the quality of health care provided. Therefore, it is imperative that clinicians are educated on their roles and their institutions' roles in safeguarding patients' privacy and autonomy while still promoting effective collaboration with law enforcement.
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Marchiafava Bignami Disease (MBD) is a reversible neurological disorder with can be difficult to diagnose initially due to variable neurological presentations that can be seen in patients. Physicians need to consider this diagnosis as the readily available treatment of thiamine can help reverse symptoms and prevent long lasting effects. We present the case of a 52-year-old man with a history of alcohol use disorder who presented with concerns for a cerebrovascular accident. ⋯ MRI revealed restricted diffusion in the corpus callosum which helped confirm the diagnosis of MBD. Treatment with thiamine helped the patient get back to their usual state of health with no new neurological deficits. This case emphasizes that MBD is a rare neurological disorder that must be considered in patients with alcohol use disorder who present with varying neurological symptoms as early thiamine treatment can reverse symptoms.
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Opioid overdoses have increased at a concerning rate in recent years. Middle-aged individuals have been reported as an age group of high concern for opioid overdoses. The purpose of this study was to assess trends in opioid overdose 911 dispatches between Q1 2018 and Q3 2023 among different age groups. It was hypothesized that the steepest increase in dispatches would be among middle-aged individuals. ⋯ Middle-aged individuals experienced significant increases in opioid-related 911 dispatches between Q1 2018 and Q2 2021, and had the steepest increase compared to the other age groups. Conversely, younger-aged individuals have experienced a recent decrease in dispatches. These findings support previous indications that middle-aged individuals are at significant risk for opioid overdose. Additional research is necessary to identify geographic and demographic factors that may affect these trends.