J Emerg Med
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Fishhook injuries are an uncommon trauma, and removing a penetrating fishhook is a complicated maneuver, especially if the wound involves delicate anatomical structures like the ocular region. ⋯ Emergency physicians should be aware of all the possible approaches to fishhook penetrating injuries. If the fishhook does not involve the globe and an ophthalmologist is not available, the injury may be managed in the emergency department.
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Ureteral stones are a common diagnosis in the emergency department (ED) setting, often found with computed tomography (CT). The high frequency of phleboliths can confound ureteral stone diagnosis on CT imaging. ⋯ Phleboliths are a common finding on CT imaging. Radiological findings of rim sign and comet tail sign may help to differentiate phleboliths and ureteral stones; however, their low sensitivity and inconsistent presentation should prompt greater reliance on other signs of ureteral obstruction to aid in diagnosis of undifferentiated pelvic calcifications.
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Left ventricular assist devices (LVADs) can be used as a bridging therapy for myocardial recovery or cardiac transplant, as well as a destination therapy for long-term support in patients with advanced heart failure. Patients with LVADs can present to the emergency department (ED) for acute deterioration and emergency physicians (EPs) must be equipped with the necessary knowledge and skill to treat this unique population. ⋯ Patients with LVADs have altered anatomy and physiology. Therefore, an understanding of key modifications to standard POCUS views is necessary so that EPs can use POCUS effectively in their evaluation of these patients.
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Infants are often brought to an emergency department (ED) for medical evaluation upon surrender or abandonment. However, no specific guidelines exist for the care of surrendered or abandoned children. We describe the case of an abandoned infant who was brought to a pediatric quaternary care hospital as a model for evaluation and management. ⋯ A 3-day-old abandoned female was brought to a quaternary care pediatric hospital ED. Given limitations in history, upon physical examination and in consultation with specialists, our team completed an extensive laboratory workup to guide initial management and treatment. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Abandoned and surrendered infants frequently enter the medical system via the ED, and emergency physicians must be aware of best practices to evaluate and manage these patients. While each infant presentation is unique, commonalities exist. Our care may serve as a starting point by which others may base their own management. © 2022 Elsevier Inc.
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An accurate estimation of fetal gestational age is essential for the management of pregnant patients who present to the emergency department (ED). Point-of-care-ultrasound (POCUS) is an integral part of emergency medicine training and includes measurement of fetal gestational age by the biparietal diameter (BPD) method. ⋯ This study shows that EP-performed BPD measurements for gestational age are quantitatively accurate, with 91% of estimates within 14 days of a standard radiological or obstetrical estimation.