J Emerg Med
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Acute psychiatric presentations account for a significant number of emergency department (ED) visits. These patients require assessment by the emergency physician and often need further evaluation by a psychiatrist, who may request routine laboratory evaluation and an electrocardiogram (ECG). ⋯ Based upon the available literature, routine laboratory analysis and ECG for all patients presenting with a psychiatric complaint are not recommended. Clinicians should consider the individual patient, clinical situation, and comorbidities when deciding to obtain further studies such as laboratory analysis. © 2022 Elsevier Inc.
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Pain management is critical to the management of patients in the emergency department (ED). The clinical decision-making process for prescribing medications is complicated by its subjective nature. Historically, racial and ethnic minority groups and women have not had their pain managed as aggressively as White and male patients. ⋯ Although differences in pain management practices have been explored previously, this study provided a large, updated, multifacility assessment that confirmed that race- and sex-based differences in pain management persist, specifically in the decision to treat with narcotics. Further investigation is warranted to determine the root causes of these differences.
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There are concerns that emergency health care workers are exposed to ionizing radiation as the result of frequent portable radiographs obtained in the emergency department (ED) during active patient care. ⋯ The level of radiation exposure to ED staff found in this study was well below the recommended allowable occupational exposure of 50 mSv/y. Radiation exposure is not a significant occupational hazard in a busy ED level I trauma center. Existing precautions should adequately protect staff from occupational exposure, and use of further protective gear, or the need for individual monitoring using dosimeters, appears unwarranted.