Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
-
To ascertain the status of journal club within emergency medicine (EM) residency programs and to describe 3 currently used formats. ⋯ Journal clubs associated with EM residencies vary in format and perceived success. The 3 representative journal clubs illustrate different format options.
-
Review Case Reports
Management of nontraumatic subarachnoid hemorrhage in a patient with sickle-cell disease: a case report.
Subarachnoid hemorrhage (SAH) due to sickle-cell anemia is rare, but potentially devastating. However, with early recognition of SAH, aggressive support with exchange transfusion, cerebral angiography, and neurosurgical intervention, a positive outcome may be achieved. A case report of SAH managed in this fashion is reported. Based on similar cases in the literature, a suggested treatment protocol is provided for the management of nontraumatic SAH in sickle-cell patients presenting to the ED.
-
To determine the frequency of delayed diagnosis of major thoracolumbar vertebral fractures (T-L Fxs) in ED multiple-trauma patients, and to determine the differences between cases of delayed and nondelayed diagnoses of T-L Fx. ⋯ A delay in the diagnosis of T-L Fx in hospitalized trauma patients is frequently associated with an unstable patient condition that necessitates higher-priority procedures than ED T-L spine radiographs. Such patients should receive spinal precautions until more complete evaluation can be performed. The decision to selectively radiograph T-L spines in multiple-trauma patients should consider the mechanism of injury, the presence of possible confounders to physical examination, and clinical signs and symptoms of back injury.
-
To assess the usefulness of the complete blood count (CBC) and the reticulocyte count in the evaluation of adult patients with acute vasoocclusive sickle-cell crisis (SCC) presenting to the ED. ⋯ Determination of the Hb level and the reticulocyte count do not appear useful in the evaluation of acute SCC in the ED. Admission decisions appear associated with elevations in the WBC count. Further study is required to determine the true value of the WBC count in such decisions.
-
Case Reports
Blood cultures in adult patients released from an urban emergency department: a 15-month experience.
To determine the frequency of positive blood cultures obtained from adult patients with potential occult bacteremia released from an urban ED and how often these positive cultures alter the subsequent patient course or management. ⋯ The prevalence of bacteremia was 1.8% among the released patients who had blood cultures obtained in the ED. Furthermore, only 0.52% of the patients had positive blood cultures that potentially affected their medical management. Further study is warranted to identify specific criteria for selecting ambulatory patients for whom the use of blood cultures may be cost-effective.