J Emerg Med
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Acute coagulopathy associated with trauma has been recognized for decades and is a constituent of the "triad of death" together with hypothermia and acidosis. ⋯ Acute coagulopathy is present on admission to the ED and is associated with injury severity and significantly higher mortality.
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Adolescent patients comprise the highest rate of Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) in the United States. These patients often initially present to the emergency department (ED) with vague symptoms. ⋯ The majority of adolescent women found to have GC or CT or both in the ED were not treated at presentation.
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Review Case Reports
Accidental Acute Alcohol Intoxication in Infants: Review and Case Report.
Acute alcohol intoxication in children younger than 18 months old is both rarely documented and rarely fatal. Previous case reports suggest hypoglycemia and faster than normal rates of alcohol elimination found in children with acute alcohol intoxication compared with adults, but data are lacking. ⋯ A 2-month-old infant presented with a decreased mental status after accidental ingestion of alcohol. He was diagnosed with acute alcohol intoxication, with a blood alcohol level of 330 mg/dL and was hyperglycemic (167 mg/dL). Alcohol elimination rate was calculated to be 21.6 mg/dL/h, similar to that in adults. To our knowledge, this case is the second youngest documented patient with accidental alcohol intoxication via ingestion in the United States. We present a rare case report of acute alcohol intoxication in an infant and a review of the literature. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Although rare in the literature, poison control data suggests that alcohol poisoning in very young children is not rare. Emergency physicians should be prepared for the management of infants with alcohol poisoning. This case report and review brings attention to this subject and briefly discusses ethanol metabolism in infants.
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Observational Study
Septic Shock and Adequacy of Early Empiric Antibiotics in the Emergency Department.
Antibiotic resistance is an increasing concern for Emergency Physicians. ⋯ In this population of ED patients with septic shock, empiric antibiotic coverage was inadequate in a small group of uroseptic patients with recent health care exposure. Current guidelines for UTI treatment do not consider health care setting exposure. A larger, prospective study is needed to further define this risk category and determine optimal empiric antibiotic therapy for patients.