European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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To assess whether the introduction of the National Emergency X-ray Utilization Study guidelines in a UK emergency department reduced the number of patients having cervical spine radiographs and altered the accuracy of diagnosis of cervical spine injury. ⋯ Introduction of the National Emergency X-ray Utilization Study guidelines to a UK emergency department did not reduce the number of patients having cervical spine radiographs after neck trauma and had no effect on the pick-up rate for cervical spine injuries.
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Screening studies of healthy volunteers have determined that coeliac disease affects 1% of the European population. Despite this the majority of cases are unrecognized. ⋯ This review provides an update of the published data on coeliac disease. We discuss the relationship between coeliac disease and abdominal pain and ways in which this may change emergency physicians practice.
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Field trauma triage systems currently used by emergency responders at mass casualty incidents and disasters do not adequately account for the possibility of contamination of patients with chemical, biological, radiological, or nuclear material. Following a discussion of background issues regarding mass casualty triage schemes, this paper proposes chemical, biological, radiological, or nuclear-compatible trauma triage algorithms, based on a review of the literature and the input of recognized content experts. ⋯ This template is then modified for use in chemical, biological, and radiation/nuclear situations in which the exposed or contaminated victims have also sustained conventional trauma. The proposed algorithms will need further refinement and testing.
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We present and discuss the case of a man admitted to our emergency room because of severe hypercalcemia and renal failure with maintained diuresis. We diagnosed a relapse of sarcoidosis, manifesting as hypercalcemia and renal failure, based on a history of lung sarcoidosis. This is a rare complication of sarcoidosis, due to granulomatous production of vitamin D. ⋯ The initial treatment of the patient was directed towards lowering the circulating calcium level through hyperhydration and forced diuresis, with secondary control of granulomatous activity using corticosteroid therapy. The patient was discharged after 7 days with normal levels of serum calcium, urinary calcium excretion and serum creatinine. Recognition of this rare cause of hypercalcemia is a challenge for the emergency physician.