J Emerg Med
-
Randomized Controlled Trial
Management of Benign Paroxysmal Positional Vertigo: A Randomized Controlled Trial.
Benign paroxysmal positional vertigo (BPPV) is a common presenting problem. ⋯ This pilot study shows promise, and would suggest that there is no difference in symptomatic resolution, ED length of stay, or patient satisfaction between standard medical care and canalith repositioning maneuver. Physicians should consider the canalith repositioning maneuver as a treatment option.
-
Case Reports
Migrating Sternal Rod: Ultrasound Identification of an Unusual Soft Tissue Foreign Body.
Sternal hardware migration from its original site of implantation is a rare entity. Bedside ultrasound may identify migrated hardware if the site of migration is the subcutaneous tissue. ⋯ Sternal hardware migration is uncommon, but in patients who have undergone surgery involving sternal fixation, this diagnosis should be considered as a cause for unusual symptoms.
-
Case Reports
Intragastric Balloon in the Emergency Department: An Unusual Cause of Gastric Outlet Obstruction.
Obesity has become a worldwide epidemic and is associated with significant morbidity and mortality. Many strategies to promote weight loss, including medications and surgical techniques, have been developed; however, few have proven effective. As the rates of obesity and associated complications continue to climb, there is growing pressure on the medical community to develop less invasive procedures that can provide lasting weight loss results. ⋯ With an increasingly mobile and obese global population, emergency physicians should be aware of weight loss procedures such as the IGB and appropriate time-sensitive management of high-risk complications.
-
Computed tomography (CT) scan, the largest medical source of ionizing radiation in the United States, is used to test for failure of ventricular peritoneal shunts. ⋯ Patients with ventricular peritoneal shunts underwent many cranial CT scans each year. None of the signs or symptoms included on the clinical pathway was predictive of changes on CT scan.
-
Patient satisfaction is a common parameter tracked by health care systems, and likely influences patient provider choice and may impact insurer payment. Achieving high satisfaction in an academic emergency department (ED) can be a daunting task due to variable volumes, acuity, and overcrowding. ⋯ In the study institution, patients that are called back are much more likely to have a favorable impression of the visit as assessed by likelihood to recommend regardless of WT, LOS, or TC. These data support "call back" as an effective strategy to improve ED patient satisfaction.