Can J Emerg Med
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Somatization is a common phenomenon that can severely complicate youths' functioning and health. The burden of somatization on pediatric acute care settings is currently unclear; better understanding it may address challenges clinicians experience in effectively caring for somatizing patients. In this study, we estimate the prevalence of somatization in a pediatric emergency department (ED). ⋯ A considerable proportion of non-mental health-related visits may involve a somatizing component, indicating the burden of mental health concerns on the ED may be underestimated. A higher index of suspicion for the possibility of somatization may support clinicians in managing somatizing patients.
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To determine the incidence, risk, and timing of mortality (unnatural and natural causes) among youth seen in a pediatric emergency department (ED) for mental health concerns, compared with matched non-mental health ED controls. ⋯ While youth seeking emergency mental health care are at increased risk of death by unnatural causes, their overall mortality risk is lower than non-mental health controls. The protracted duration from initial presentation to suicide highlights the need for long-term surveillance and preventative care for youth seen in the ED for all mental health concerns.
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One in four cases of acute aortic syndrome are missed. This national survey examined Canadian Emergency physicians' opinion on risk stratification, the need for a clinical decision aid to risk stratify patients, and the required sensitivity of such a tool. ⋯ Our national survey determined that emergency physicians would use a highly sensitive clinical decision aid to determine which patients are at low, medium, or high-risk for acute aortic syndrome. The majority of clinicians have a low threshold (<1%) for investigating for acute aortic syndrome, but accept that a zero miss-rate is not feasible.
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A 67-year-old male presents to the emergency department (ED) with a 10-minute history of right upper extremity and right facial weakness, which came on suddenly. His symptoms spontaneously remitted. He has never experienced symptoms like this before. ⋯ Reflexes, coordination, and gait are all within normal limits. Cardiac and respiratory examination are also unremarkable. His electrocardiogram shows normal sinus rhythm.
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The aim of this study was to describe the clinical and laboratory characteristics of invasive group A streptococcal infections in a geographic area that sees a high volume of cases. ⋯ Invasive group A streptococcal infections often present insidiously in adult patients with mild tachycardia and tachypnea at triage. The CRP was the most consistently abnormal laboratory investigation.