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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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.
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We describe three patients with myasthenia gravis who presented to the emergency department - one with a previously established diagnosis and two others who were newly diagnosed as a result of workup initiated in the emergency department. Differential diagnosis of conditions causing neuromuscular weakness is broad; however, a key aspect of myasthenia gravis is fluctuating muscle weakness that increases with repeated use and improves with rest. ⋯ The third patient presented with a potentially life-threatening myasthenic crisis. Key points of discussion include: bedside tests to diagnose myasthenia gravis; distinction between cholinergic versus myasthenic crisis; and emergency department considerations when intubating a myasthenia gravis patient becomes necessary.
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To establish the level of medical care provided in the emergency department of general hospitals to the victims of the Volendam café fire on 1 January 2001. ⋯ Treatment and triage of the burn casualties after the Volendam café fire was adequate. The documentation rate was low. Not all steps in diagnosis and treatment may be of equal importance in disaster circumstances.
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It can be difficult to determine the exact mechanism of injury in infants and babies aged 24 months and under. Falls are the most common mechanism of injury in children. The purpose of this study is to identify the relationship between reported height of fall and long bone fracture. ⋯ Height of fall is only one factor that must be considered in dealing with fracture injury in children aged 24 months or under. However, significant injury presenting with falls from less than 50 cm should be critically evaluated.