European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Unilateral re-expansion pulmonary oedema is a rare threatening complication of the treatment of lung atelectasis, pleural effusion or pneumothorax, the pathogenesis of which is not completely known. The clinical picture varies considerably from asymptomatic radiological findings to dramatic respiratory failure with circulatory shock. ⋯ The diagnosis of unilateral re-expansion pulmonary oedema was made and he was successfully treated with non-invasive continuous positive airway pressure. Literature data about the aetiological and pathogenetic factors of the condition are also considered.
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Comparative Study
Urinary acetoacetate or capillary beta-hydroxybutyrate for the diagnosis of ketoacidosis in the Emergency Department setting.
We compared the semiquantitative measurement of acetoacetate using urinary dipsticks with the bedside quantitative fingerprick measurement of the principal ketone bodies 3-beta-hydroxybutyrate, for the diagnosis of ketoacidosis. ⋯ The measurement of 3-beta-hydroxybutyrate in capillary blood is faster and more effective than the use of dipsticks in the urine to detect ketoacidosis in the Emergency Department setting.
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The objective of this case report was to document a rare case of isolated myocardial contusion in the setting of blunt thoracic trauma. Although demonstrated by electrocardiogram and myocardium-specific enzymes, the trauma had no clinical relevance and the patient was discharged uneventfully from the intensive care unit. The clinical significance of blunt myocardial contusion is then discussed.
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Comparative Study
A description of emergency department-related malpractice claims in The Netherlands: closed claims study 1993-2001.
The aim of this study was to assess the quality of care provided at emergency departments (ED) in the Netherlands by analysing medical liability insurance claims. ⋯ The number of medical liability claims is low compared with the number of patients treated in ED in the Netherlands. Claims primarily concerned alleged mistakes in diagnosis and the treatment of minor trauma. Residents were involved in the majority of the claims. More resident supervision is needed, as are specific training programmes for emergency physicians.
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Comparative Study
Predicting the result of our X-rays, a way to identify overuse? the Ulster Hospital Dundonald.
The objectives of the study were to identify areas of the unnecessary use of diagnostic plain X-rays in the emergency department. Requests for inappropriate plain X-ray investigations have resource, radiation and overcrowding implications for the emergency department. ⋯ The training of emergency medicine staff should include education about clinical indications from guidelines and recommendations about X-ray use, information on the dose of radiation exposure, implications of resources and overcrowding of departments.