J Emerg Med
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Childhood trauma is an important public health problem with financial, physical health, and mental health repercussions. Emergency departments (EDs) are often the first point of contact for many young children affected by emotionally or psychologically traumatic events (e.g., neglect, separation from primary caregiver, maltreatment, witness to domestic violence within the family, natural disasters). ⋯ Preventing recurrent trauma or recognizing early trauma exposure is difficult, but essential if long-term negative consequences are to be mitigated or prevented. Within EDs, there are missed opportunities for identification and intervention for trauma-exposed children, as well as great potential for expanding primary and secondary prevention of maltreatment-associated illness, injury, and mortality.
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New residents enter emergency medicine (EM) residency programs with varying EM experiences, which makes residency orientation programs challenging to design. There is a paucity of literature to support best practices. ⋯ The Kern Model was a relevant and useful method for redesigning a new-resident orientation curriculum.
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Acute gastric dilatation is a rare but severe complication of anorexia nervosa. Gastric dilatation causing abdominal compartment syndrome with lower-limb ischemia is even less common. This case report illustrates the importance of a holistic clinical approach of every patient presenting to the emergency department (ED), even when the reason for admittance is organ specific. ⋯ This case report underscores the importance of a thorough clinical examination in every patient admitted to the ED. Early diagnosis and treatment are mandatory in preventing fatal complications.
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Tubular gauze dressings are commonly used, but have potential to cause iatrogenic finger ischemia. ⋯ It is important that circumferential digital dressings are applied correctly. Vascular insufficiency from an occlusive dressing is an iatrogenic and avoidable complication. Successful operative decompression may be indicated to minimize tissue loss and improve circulation.
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Several studies have attempted to support or dispel the teaching of appendix movement away from the right lower quadrant (RLQ) during pregnancy with contradictory results. ⋯ The appendix in the gravid patient was not found in the RLR with increasing frequency as pregnancy progressed.