J Emerg Med
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Heart failure (HF) emergency department (ED) visits are commonly due to HF self-care nonadherence. ⋯ Patients seeking ED care for decompensated HF had inaccurate HF beliefs and poor self-care adherence. Lack of association between HF beliefs and self care (and trend of an inverse relationship) reflects a need for predischarge HF education, including an explanation of what HF means and how it can be better controlled through self-care behaviors.
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Chest pain accounts for a significant number of visits to the Emergency Department. Lung herniation is an uncommon cause of chest pain, but one that is easily treated. Patients may complain of pain or present with ecchymosis or a visible bulge in the chest wall. Most lung herniations are located anteriorly or at the thoracic inlet, due to the lack of musculature in these areas. We present a unique case of a right lateral lung herniation and subsequent development of a spontaneous right-sided transdiaphragmatic hernia. ⋯ To our knowledge, this is the first reported case of a patient presenting with spontaneous right-sided lateral lung herniation and spontaneous right-sided transdiaphragmatic hernia. This case is unusual given the location of the hernias, and is unique in the spontaneous development of the hernias without any inciting history of trauma.
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Randomized Controlled Trial Comparative Study
Randomized Trial of Bilevel versus Continuous Positive Airway Pressure for Acute Pulmonary Edema.
Studies have shown different clinical outcomes of noninvasive positive pressure ventilation (NPPV) from those of continuous positive airway pressure (CPAP). ⋯ Compared to CPAP to treat APE, BPAP more rapidly improves oxygenation and dyspnea scores, and reduces the need for ICU admission. Further, BPAP does not increase MI rate compared to CPAP.
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Clinical Trial
Successful Discharge of Children with Gastroenteritis Requiring Intravenous Rehydration.
Emergency Department (ED) revisits are very common in children with gastroenteritis administered intravenous rehydration. ⋯ Lower serum bicarbonate values at the time of intravenous rehydration are not associated with unfavorable outcomes after discharge.