Articles: emergency-department.
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The indications for neuroimaging in emergency department (ED) patients presenting with seizures have not been clearly defined. In this study, we aimed to investigate the findings that may influence the emergency management of patients with seizures undergoing brain computed tomography (CT) and the factors that influence these findings. ⋯ CT scanning of patients presenting to the ED with seizures has a limited impact on emergency patient management. Clinical decision-making guidelines for emergency CT scanning of patients with seizures need to be reviewed and improved to identify zero/near-zero risk patients for whom imaging can be deferred.
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One of the means of easing increased pressure on emergency care worldwide has been the development of advanced musculoskeletal physiotherapy practice in the emergency department setting. This model of care is in its infancy in Ireland. ⋯ The findings of this study indicate that an advanced practice physiotherapist can provide a timely, effective, and safe service for patients attending the emergency department with musculoskeletal complaints in Ireland.
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The use of potentially inappropriate medications (PIMs) is considered an important quality indicator for older adults seen in the ambulatory care setting. ⋯ We found that younger age and lower immediacy were associated with increased prescriptions of PIMs for older adults seen, while dementia and Northeastern rural region was associated with reduced use of PIMs seen and discharged from EDs in United States.
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Pediatric emergency care · Jun 2024
Emergency Department Usage Patterns Among Pediatric Victims of Gun Violence and Physical Assault.
Violent injuries are a common reason for pediatric emergency department (ED) visits, with gun violence being the leading cause of violent death among children. The objective of this study was to assess for patterns of pediatric ED usage that are associated with future ED visits for violent injuries. ⋯ Emergency department visits due to interpersonal violence, mental/behavioral health, sexual/reproductive health, and sexual assault are associated with recurrent ED visits for violent injuries. Awareness of patterns of ED usage may aid in identifying patients at high risk for violence and increase opportunities for preventative interventions.
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A 49-year-old male with history of intravenous drug use presented to the Emergency Department with localized right arm swelling that has been slowly growing for months. On physical exam, there was a golf ball sized mass in the right antecubital fossa without overlying skin changes and no neurovascular deficits in the distal extremity. Point-of-care ultrasound (POCUS) was performed utilizing a water bath with visualization of bidirectional swirling in a round cavity adjacent to the brachial artery. ⋯ On color doppler ultrasound, pseudoaneurysm is characterized by the pathognomonic "yin-yang" sign. In the case of the 49-year-old male with a right antecubital mass and history of IVDU, the proposed mechanism of injury was trauma to the arterial wall secondary to auto-injection. POCUS has been found to improve identification of abscesses and its incorporation in patient evaluation can guide clinical management, prevent unwanted iatrogenic exsanguination, and determine whether there is a need for urgent vascular surgery intervention, particularly in high-risk patients.