European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Randomized Controlled Trial Comparative Study
Reliability and validity of two four-level emergency triage systems.
To measure and compare the reliability and predictive validity of a four-level triage system (I-4L) and the new four-level model triage emergency method (TEM). ⋯ The interrater and intrarater reliability for rating triage acuity and for accuracy in patient admission prediction was good with both models. Performance with the new model was similar to that of I-4L despite the nurses' short experience. The new TEM model has the advantage of predicting utilization of emergency department resources.
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Comparative Study Clinical Trial
Minor head trauma and linear skull fracture in infants: cranial ultrasound or computed tomography?
To determine the clinical evolution of children with skull fractures as a result of a minor head trauma from a witnessed accidental fall that have been studied by transfontanellar ultrasound (TFUS). ⋯ TFUS is a valid and reliable alternative to CT for minor head trauma in infants with skull fractures. Its innocuousness and cost-effectiveness in comparison with CT makes it a good choice in this situation.
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To assess the characteristics of the patients admitted to a home hospitalization unit (HHU) after a first emergency department (ED) visit. ⋯ A HHU proved to be effective and safe for acutely ill individuals who required hospitalization.
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Review Case Reports
Torsion of the ovary: a known but frequently missed diagnosis.
Torsion of the ovary or fallopian tube is a rare acute gynaecological disorder, seen by different medical specialists. The diverse clinical presentation is one of the main reasons this diagnosis is frequently missed at first presentation. For the preservation of ovarian function it is of utmost importance to diagnose an ovarian torsion at an early stage. ⋯ Although every specialist is familiar with the disorder, the diagnosis in acute presentation is frequently missed. To bring this entity and its great variability in clinical presentation into focus once again, we will highlight three patients out of a series of 13. Furthermore, we will discuss the possible causes of the disorder and present a proposition for treatment.
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Spider bites are an uncommon presenting complaint to Irish emergency services. We describe the case report of a patient diagnosed with a spider bite, thought due to an Australian (White-Tailed) spider unintentionally imported in a traveller's luggage. Her lesions were consistent with those caused by White-Tailed Spiders, and her clinical course and management is described. ⋯ The ascription of various clinical effects to particular spiders is problematic because of poor case definition and a lack of confirmed scientific evidence. However, spider bite enquiries are now the single most common reason for calls to Australian poisons centres. The diagnosis and treatment of spider bites is discussed with reference to the use of antibiotics, steroids and antivenoms, as featured in the recent literature.