J Emerg Med
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Although most studies have found low rates of organic illness in patients with isolated psychiatric complaints, psychiatric patients are frequently brought to emergency departments (EDs) for medical clearance. ⋯ Few patients brought to the ED on an involuntary hold required a medical screen. Use of basic criteria in the prehospital setting to determine who required a medical screen (altered mental status, ingestion, hanging, traumatic injury, unrelated medical complaint, rape) could have led to significant savings.
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Observational Study
Adverse Drug Event Nonrecognition in Emergency Departments: An Exploratory Study on Factors Related to Patients and Drugs.
Many adverse drug events (ADEs) are not identified by emergency physicians. Research has been done to study risk factors for ADEs and help emergency physicians diagnose ADEs. However, no research has specifically examined the causes underlying a lack of attribution of ADEs to medications in emergency department (ED) patients. ⋯ Our results emphasize the importance of searching for ADEs in patients with daily polypharmacy or whose chief complaint does not seem to be drug related.
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Interest in global health and international electives is growing among Emergency Medicine (EM) residents in the United States (US). The majority of EM residency programs offer opportunities for international electives. The degree of participation among residents and type of support provided by the residency program, however, remains unclear. ⋯ The majority of EM residencies have residents participating in international electives. However, the programs report variable preparation, requirements, and resident supervision. These results suggest a need for an expanded and more structured approach to international electives undertaken by EM residents.
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Thyrotoxic periodic paralysis (TPP) is a potentially life-threatening complication of thyrotoxicosis, characterized by hypokalemia and muscle paralysis. ⋯ TPP should always be considered as a differential in patients, especially in young males of Asian descent with lower-limb paralysis or weakness. We present this case, followed by a review of the literature.
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Pediculosis capitis is a common parasitic infestation, whereas phthiriasis palpebrarum is an uncommon infection due to Phthirus pubis (pubic lice) inoculating the eyelashes and surrounding tissues of the eye. Emergency physicians should recognize the causes of this uncommon disease. Cases of phthiriasis palpebrarum should trigger the clinician to consider the potential for child abuse when suspected or when social history dictates the risk for abuse. ⋯ Pediatric phthiriasis palpebrarum can represent child abuse, and the origins of this infection need to be carefully discerned. A thorough history can provide information to assess whether further action is needed and, if in doubt, social services should be contacted to ensure child safety.