European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Acute dislocations of the elbow complicated by brachial artery involvement are rare but serious injuries. Rapid assessment and a high index of suspicion are essential to facilitate prompt treatment, as delay in diagnosis is associated with a poorer outcome. We present two cases of brachial artery transection after closed and open dislocation of the elbow, and discuss the appropriate management of such patients.
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We present the case of a liver abscess caused by a swallowed chicken bone in an elderly man successfully treated with laparotomy. This report illustrates the difficulties of obtaining a preoperative diagnosis. The prolonged time course of the illness, the lack of history of the ingestion of a foreign body, the relatively non-specific symptoms and signs and the non-specific results obtained by conventional radiography resulted in a delayed recognition of this possibly fatal disease. This rare condition should be kept in mind when dealing with cases of hepatic abscess or even septic shock of unknown origin.
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The objectives of the present study were to examine the degree and the sources of mental distress and the coping strategies adopted by healthcare workers (HCW) of emergency departments (ED) in Hong Kong during the outbreak of severe acute respiratory syndrome (SARS). ⋯ SARS had caused a significant level of distress among ED staff. The distress level was highest for nurses, followed by doctors and HCA. The three most important variables that could account for the distress level were loss of control/vulnerability, fear for self-health and spread of the virus. Overall, the more frequently adopted coping strategies were acceptance, active coping, and positive framing.
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Ecstasy is a very popular and widely used party drug with known complications such as agitation, hyperpyrexia, rhabdomyolysis or renal failure. A 16-year-old boy was admitted to our Emergency Department with a spontaneous pneumomediastinum (SPM) after Ecstasy ingestion, complicated by myocarditis. To our knowledge this is the first case described with the combination of Ecstasy ingestion, SPM and myocarditis. ⋯ The course is usually benign, with spontaneous resorption. Emergency physicians should be aware of the risk, especially if a drug user presents with neck emphysema, difficulty in swallowing, and precordial crepitations or thoracic pain. Ecstasy, similarly to cocaine, can induce cardiac symptoms.
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Frequent emergency department (ED) users are a nebulous group of patients. A high degree of psychiatric problems and higher than expected mortality from medical illness have been reported in this population. ⋯ These data show that there is a high incidence of medical problems in frequent ED users and a high incidence of mortality in patients with heavy ED use.