J Emerg Med
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Alcohol intoxication often affects patient management in the emergency department. ⋯ Both genders can estimate their impaired ability to drive while drinking, but women are better at assessing their capacity to drive after drinking cessation.
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Patients leaving the emergency department (ED) before treatment completion (LBTC) is a common universal occurrence. We hypothesized that the characteristics of the Israeli health care system, as well as its policy, intended to reduce the burden of nonurgent ED visits, may have an impact on factors associated with LBTC. ⋯ These findings reflect the strengths of the Israeli health care system. Despite the policy intended to reduce the burden of nonurgent ED visits, there are possible shortcomings in the system that should be addressed.
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Background Although commonly used inside hospitals, no previous case report has been published on high-flow nasal oxygen (HFNO) therapy in an adult in the prehospital setting. Case Report A 46-year-old nonsmoking man presented with a cough and fever. He deteriorated suddenly 5 days later. ⋯ It was therefore decided to start HFNO therapy. The patient was transferred to an intensive care unit, where HFNO was continued. Why Should an Emergency Physician Be Aware of This? As the trend in emergency medical services may move toward prehospital HFNO, this case report is an opportunity to question the feasibility of HFNO therapy in the prehospital setting.
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Case Reports
Migratory Fish Bone Presented With Extensive Surgical Subcutaneous Emphysema: A Case Report.
Fishbone ingestion represents a common cause for emergency department (ED) referral. In the majority of cases, an observed fishbone can be easily retrieved in the clinic setting. An impacted fishbone in the throat, albeit uncommon, carries potential risks of life-threatening events. Unusual complications caused by a migrated fishbone, including deep neck abscess, airway obstruction, and major vessels injury, are greatly influenced by the type of ingested fishbone and time between onset and presentation. ⋯ Here we report an unusual case of surgical subcutaneous emphysema after multiple attempts of purging to remove an ingested fishbone. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Fishbone foreign body is a common presentation to the ED. A thorough history and examination for the migratory foreign body is essential, as the complications are consequential.
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Babesiosis, a tick-borne illness spread by Ixodes scapularis, is an emerging infectious disease in the Northeastern and upper Midwestern United States. Infection can present as a flu-like illness with anemia, thrombocytopenia, and jaundice. This disease can even be fatal in the immunocompromised or highly infected patient. Co-infection with other tick-borne illnesses is common, and prompt treatment with antiprotozoal agents and antibiotics is indicated to prevent adverse outcomes. ⋯ We describe a patient who presented to the emergency department with flu-like symptoms, but had history concerning for environmental exposure to babesiosis. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Early detection is important to prevent severe sequalae of the disease. This is a disease that can imitate a viral syndrome but should be considered in the differential for a patient with a concerning history.