J Emerg Med
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Most cases of pediatric epistaxis are spontaneous and self-resolve. However, a subset of children may experience significant bleeding and require procedural or medical intervention. ⋯ Epistaxis severity is associated with certain risk factors. However, most cases of pediatric epistaxis are mild and do not require intervention or ED evaluation.
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Calcific tendinitis is classically a painful condition that most commonly affects the rotator cuff, but may infrequently involve other tendons. ⋯ We discuss a 57-year-old man who presented to the emergency department with a 4-day history of right hip pain, described as the "worst pain in (his) life." The pain was first noticed at night and had progressively worsened. History, physical examination, and initial laboratory workup indicated an inflammatory vs. infectious process. Continued investigations with imaging techniques revealed the source of pain as calcific tendinitis involving the gluteus maximus tendon. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Symptoms of musculoskeletal pain in the emergency department are ubiquitous. In the proper clinical context, the diagnosis of calcific tendinitis, although uncommon, should be considered once emergent conditions are ruled out. Proper imaging techniques will facilitate accurate diagnosis, expedited pain management, and proper outpatient follow-up.
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Randomized Controlled Trial
Effects of Intravenous Lipid Emulsion Administration in Acute Tramadol Poisoning: A Randomized Controlled Trial.
As the prevalence of tramadol toxicity is increasing, managing these patients with the aim of treatment and complete recovery has become a major challenge for health care professionals. ⋯ In the setting of tramadol poisoning with a decreased level of consciousness and based on our study's findings, administration of ILE is suggested to help manage patients in hospital emergency departments. However, larger trials might be needed to confirm these findings before entering the guidelines.
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The adoption of point-of-care ultrasound (POCUS) has greatly improved the ability to rapidly evaluate unstable emergency department (ED) patients at the bedside. One major use of POCUS is to obtain echocardiograms to assess cardiac function. ⋯ EchoNet-POCUS can be applied to bedside echocardiogram videos in real time using commodity hardware, as we demonstrate in a prospective pilot study.