J Emerg Med
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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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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.
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Pediatric emergency department (PED) visits among children and adolescents with acute mental health needs have increased over the past decade with long wait times in the PED awaiting disposition. ⋯ The use of a dedicated child psychiatrist and mental health social worker to the PED results in significantly decreased LOS and need for admission without any change in return visit rate. Larger, multicenter studies are needed to confirm these findings.
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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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One-fifth of patients with severe facial trauma suffer ophthalmic injury. Currently, patients presenting with mid-face injury to the emergency department (ED) undergo visual examination and then further assessment by ophthalmologists and with computed tomography (CT) scanning. The utility of the initial visual examination in the ED, performed by nonophthalmologists, remains unclear. ⋯ We identified no significant difference between a comprehensive visual examination performed by nonophthalmologists in the ED, and improved ophthalmic outcomes. Physicians assessing patients with mid-face trauma in the ED should rule out eye emergencies, including retrobulbar hemorrhage and penetrating globe injury, and initiate expeditious CT scan and assessment by specialist ophthalmologists.