The American journal of emergency medicine
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Hypovolemic shock is an important cause of death in the emergency department (ED). We sought to conduct a meta-analysis to quantify existing evidence on sonographic measurement of inferior vena cava (IVC) diameter in assessing of volume status adult ED patients. ⋯ Moderate level of evidence suggests that the IVC diameter is consistently low in hypovolemic status when compared with euvolemic. Further blinded studies are needed before it could be used in the ED with confidence.
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Intracranial complications of pediatric sinusitis are rare but potentially life threatening. These complications include cavernous sinus thrombosis, orbital infection, meningitis, and subdural empyema. Children with these complications may experience significant morbidity from their infection. ⋯ Emergency physicians, pediatricians, and otolaryngologists should maintain a high index of suspicion for this complication of disease when treating patients with sinusitis in the emergency department or outpatient clinic. Early and accurate diagnosis of subdural empyema will lead to prompt treatment and a favorable outcome for the patient. We report a case of subdural empyema secondary to frontal sinusitis in an otherwise healthy immunocompetent adolescent boy.
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Comparative Study
Bedside ultrasound performed by novices for the detection of abscess in ED patients with soft tissue infections.
The objective was to compare bedside ultrasound (US) to clinical examination for the detection of abscess. ⋯ Novice ED sonographers can identify abscesses with only minimal US training. Identification of abscess on US may change management of cutaneous abscesses.
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The aim of this study was to investigate whether emergency department (ED) patients who were newly diagnosed with atrial fibrillation (AF) displayed risk factors for incident AF on prior ED visits. ⋯ Nearly 40% of patients diagnosed with new AF had previous ED visits and displayed validated risk factors for incident AF. The ED provides an opportunity to identify and educate these patients as well as refer them for primary prevention interventions.