European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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A 24-year-old male presented to the emergency department with hyperadrenergic manifestations of fenfluramine-phentermine overdose: tachycardia, mydriasis, fever, diaphoresis, hyperventilation, and combativeness. Sedatives, neuromuscular paralytics, adrenergic antagonists, and mechanical ventilation were required to care for the patient. ⋯ He was discharged after a 26-day hospital stay. We are unaware of any previously reported cases of fenfluramine-phentermine overdose with such profound degree of sympathetic storm.
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We report the case of a 83-year-old man who presented to the emergency department with hypoglycaemia resembling a cerebrovascular accident. Hypoglycaemic hemiparesis is an under-recognized manifestation of hypoglycaemia. If not recognized and treated promptly, hypoglycaemia may cause irreversible central nervous system injury; it rarely results in death. It is imperative that emergency physicians consider hypoglycaemia in all patients with coma in spite of focal neurological deficit even when the findings seem to be explained initially by other aetiologies.
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The medical aspects of disaster management, also referred to as disaster medicine, is a relatively new medical specialty, the roots of which are to be found in war surgery and traumatology. The main content of disaster medicine is based on empiricism. ⋯ This modelling of medical disaster management is important not only in the preparedness phase, but also during the disaster itself and its evaluation. This may in turn result in a decrease in mortality, morbidity and disability amongst disaster casualties.
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Multicenter Study Comparative Study
Equestrian injuries in the paediatric age group: a two centre study.
This study's objective was to examine the nature, cause and frequency of injury resulting from equestrian sport in paediatric patients attending two accident and emergency departments. We recorded the attendances of patients aged less than 16 years with equestrian-related trauma in 1 year. Demographic details, injury, mechanism of injury, rider experience and use of protective equipment were noted. ⋯ The majority of equestrian-related trauma was minor in this study. The possibility of severe trauma exists. Emergency physicians working in areas where equestrian sport is popular should be aware of the likely injuries and their treatment.
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A prospective study was undertaken to describe the pattern of utilization of an observation ward in an emergency department (ED). During a 1-month study period, the following data were collected for all patients admitted to the observation ward: (1) patient demographics, (2) purpose of observation, (3) interventions at the observation ward, (4) disposal destinations, (5) disposal diagnosis, (6) outcome categories, and (7) duration of stay. A total of 12188 patients attended our ED and 1042 (8.51%) patients were admitted into the observation ward. ⋯ The percentage of patients admitted to the hospital was 23%. There were 42 chest pain and 46 trauma patients. The impact of an observation ward on the service in ED was discussed.