The American journal of emergency medicine
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Hyperbaric oxygen (HBO) is widely accepted as a treatment for air or gas embolism, carbon monoxide (CO) poisoning, clostridial myonecrosis, crush injuries, and thermal burns. To the best of our knowledge, after HBO therapy, atrial fibrillation (AF) has not been reported in the literature yet. We herein describe a case of AF that occurred in a woman who had taken HBO therapy for CO poisoning. ⋯ After the HBO therapy, ECG showed AF. Her rhythm returned to the normal sinus rhythm after amiodarone treatment. Physicians should keep in mind that HBO treatment could contribute to AF, and all patients' ECG should be monitored before and after HBO therapy.
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Comparative Study
Comparison of risk scoring systems in predicting clinical outcome at upper gastrointestinal bleeding patients in an emergency unit.
Admission Rockall score (RS), full RS, and Glasgow-Blatchford Bleeding Score (GBS) can all be used to stratify the risk in patients presenting with upper gastrointestinal bleeding (UGIB) in the emergency department (ED). The aim of our study was to compare both admission and full RS and GBS in predicting outcomes at UGIB patients in a Romanian ED. ⋯ The GBS can be used to predict need for intervention and transfusion in patients with UGIB in our ED, whereas full RS can be successfully used to stratify the mortality risk in these patients.
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Children with both headache and hypertension present a relatively rare condition with a broad range of differential diagnoses in pediatric emergency medicine. Some possible diagnoses are potentially life-threatening conditions and merit aggressive evaluation management. We report a case of a 14-year-old girl who presented with headache and hypertension. ⋯ Ophthalmic evaluation revealed bilateral Kayser-Fleischer rings. Finally, she was diagnosed with Wilson disease. This case emphasizes that children with headache and hypertension merit aggressive evaluation and management.
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The aim of the present study was to determine whether quick diagnosis units (QDUs) can safely and efficiently avoid emergency department (ED) visits and hospitalizations. ⋯ An increasing number of PC and ED patients were referred to the QDU. Hospitalizations might have been avoided in at least 84% of patients. Although QDU and hospitalization are similarly effective in reaching a diagnosis, the QDU model incurs fewer costs.
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The objective of this study was to determine factors that impact emergency department (ED) utilization among the most frequent ED users. ⋯ The top 1% of frequent users usually had adequate health insurance and primary care access but were burdened by chronic conditions and frequent hospital admissions. Such patients may require more extensive coordinated medical management to decrease ED utilization.