J Emerg Med
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Commonly used abortion agents carry potentially serious side effects for the mother. It is important for emergency physicians to be aware of the medications used in elective abortions from the late first trimester to term. If digoxin is used as an abortifacient, it is injected intrafetally or intraplacentally. With this method there is a chance of extraplacental injection, resulting in maternal systemic digoxin toxicity and serious morbidity or death. ⋯ It is important for emergency physicians to be aware of the various late first-trimester to term abortifacient agents and procedures being used in obstetrical/gynecological practice, and the potential risks of these interventions. Digoxin toxicity or hyperkalemia should be suspected when a patient presents with severe weakness and respiratory distress after an attempted abortion.
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Ultrasound-guided invasive procedures, such as central venous catheter insertion, soft-tissue abscess drainage, and foreign-body removal are essential competencies for Emergency Physicians. Such competencies can be trained using ultrasound phantoms. ⋯ The elements required to construct homemade reusable ultrasound phantoms are inexpensive and can be easily obtained.
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Focused, proximal compression ultrasound (FPCUS) is a commonly used point-of-care study in the Emergency Department (ED). Pelvic vein deep venous thrombosis (DVT) is a rare presentation, and Emergency Physicians need to be aware of the limitations and pitfalls of FPCUS. ⋯ Emergency physicians using FPCUS in the evaluation of lower-extremity pain or swelling need to be aware of the pitfalls, limitations, and advanced techniques to avoid misdiagnosis while evaluating for DVT.
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Effective communication is important for the delivery of quality care. The Emergency Department (ED) environment poses significant challenges to effective communication. ⋯ The patients in this study perceived that the ED teams were respectful and allowed them to talk without interruptions; however, lower ratings were given for items related to actively engaging the patient in decision-making and asking questions.