European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Case Reports
Renal colic as the first symptom of acute renal vein thrombosis, resulting in the diagnosis of nephrotic syndrome.
Renal vein thrombosis is a well-known complication of nephrotic syndrome, but rarely its first or only symptom. We describe a 26-year-old patient presenting with flank pain suggestive of renal colic. A computed tomography scan showed acute renal vein thrombosis, the only sign of a later diagnosed nephrotic syndrome. This is a rare presentation of a renal vein thrombosis caused by nephrotic syndrome, and easily misdiagnosed as renal calculi especially in young and otherwise asymptomatic patients.
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Subdural haematomas can result from bridging vein rupture. Rotational acceleration in the sagittal plane and in a forward direction, as in falls, is very likely the 'mechanical' cause of subdural haematoma, as shown in cadaveric studies. ⋯ We report a case of chronic subdural haemorrhage in a male teenager without precipitating factors and no history of head trauma. This case shows the value of good history-taking in medical diagnosis and that one should be aware of the risks of violent sports or dancing and the minimal clinical signs encountered.
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Utilization of hospital emergency departments (EDs) is continuously increasing. Though nurses and physicians are ultimately responsible for the definite triage decisions, initial ED patient triage is frequently performed by hospital admission staff. This study analyzes the quality of assessment of the severity of emergencies and the choice of treatment unit made by hospital admission staff. ⋯ Triage quality regarding the choice of treatment unit was found to be excellent, whereas the quality of the assessment of the severity of the emergency by nonmedical ED admission staff was acceptable. ED patients have to be assessed by medical staff early after admission to ensure adequate and timely interventions.
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Adult epiglottitis is a relatively rare but potentially lethal disease. It seems to be increasing in incidence in other countries. The objective of this study was to examine the common presentations and clinical course of adult epiglottitis in Hong Kong. ⋯ A high index of suspicion is required for making the diagnosis of adult epiglottitis. Proper airway assessment and close monitoring are of the utmost importance in patient management. Flexible laryngoscopy is the key investigation of choice in the emergency department.
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Witnessed resuscitation is the process of resuscitation in the presence of family members. ⋯ Our data locally revealed that most of the participants in this survey would like to witness CPR conducted on their family members who presented to our emergency department.