J Emerg Med
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Randomized Controlled Trial
Impact of Video Discharge Instructions for Pediatric Fever and Closed Head Injury from the Emergency Department.
Lack of understanding of diagnosis and disease process remains a major complaint of caregivers who bring their children to the pediatric emergency department (PED). Misunderstanding of diagnosis and discharge instructions can lead to unnecessary return visits and health disparities. ⋯ For caregivers with children who presented to the PED with fever and CHI, video discharge instructions improved caregiver comprehension of the child's diagnosis and disease process when added to verbal and written instructions.
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Subglottic secretion drainage endotracheal tubes (SSD ETTs) have been shown to decrease ventilator-associated pneumonia and are recommended for patients intubated > 48 h or 72 h. However, it is difficult to determine which patients will be intubated > 48 h or 72 h at the time of intubation. ⋯ Nonoperative intubation, emergent intubation, history of dementia, admission to NCCU and AKI all appear to be independently associated with increased RRs for either ≥ 48 h or 72 h of ventilation.
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Elder abuse is under-recognized by emergency department (ED) providers, largely due to challenges distinguishing between abuse and accidental trauma. ⋯ Victims of physical elder abuse commonly have injuries on the upper extremities, head, and neck. Suspicious circumstances and injury patterns may be identified and are commonly present when victims of physical elder abuse present with purportedly accidental injuries.
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One of the common emergencies presenting to the emergency department is a child who has inserted a foreign body into their nose. Of the various things that children insert accidently, the most dangerous are button batteries. ⋯ We followed up 11 cases of children with history of button battery insertion in the nose for 1 year. We found that all of the patients had developed a septal perforation; other sequelae included nasal adhesions and saddle nose. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Button batteries in the nose are dangerous and can lead to early complications with long-term consequences for the patients. Early diagnosis is required so that they can be removed as soon as possible to prevent the development of complications and long-term sequelae.
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Despite patients' increasing use of urgent care centers (UCC), little is known about how urgent care clinicians communicate with the emergency department (ED). ⋯ Our findings highlight variation in communication from UCCs to EDs, indicating a need to improve communication standards and practices. We identify several potential ways to improve this clinical information hand-off.