J Emerg Med
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Use of methohexital as an agent for moderate procedural sedation in the Emergency Department (ED) recently has increased. As a barbiturate, potential complications include respiratory and myocardial depression. We conducted a retrospective review of medical records and procedural flow charts for all use of methohexital in our ED during a 31-month period. ⋯ Complications occurred in 20.2% of patients and included oxygen desaturation, hypotension, hypoventilation, vomiting, tremor, and airway obstruction. All complications were transient and managed without sequelae. Use of concurrent parenteral opioid medications had no significant impact on success or complications.
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Infarction of the posterior cerebral artery may present only with signs of agitated delirium and an acute confusional state. In the absence of other prominent neurological deficits, this can be easily mistaken for toxic-metabolic encephalopathy, head trauma, post-ictal confusion, or a psychiatric disorder. Appropriate head imaging studies are important to detect an illness that might otherwise be missed and left untreated.
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To survey parents regarding use of child restraint devices (CRD) and knowledge of CRD recommendations, parents of children < or = 14 years of age presenting to an emergency department (ED) provided demographic data and answered questions regarding the family's restraint use and their understanding of CRD recommendations. Three hundred thirteen adults completed surveys, providing data on 541 children. Decreasing restraint use was reported with advancing child age. ⋯ No variables were associated with correct answers. In conclusion, CRD use decreases with increasing child age. In this study, many parents were unaware of CRD recommendations.
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Chylothorax is a rare entity with both traumatic and non-traumatic etiologies. Chyle depletion has significant nutritional, metabolic and immunologic consequences. We present a case of a patient with chylothorax who presented to the Emergency Department on numerous occasions with complications related to his chylothorax.