Articles: emergency-department.
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Observational Study
Prospective, 10-year evaluation of the impact of Hispanic ethnicity on pain management practices in the ED.
Hispanic ethnicity has been reported as an independent risk factor for oligoanalgesia in the emergency department (ED). ⋯ White and Hispanic patients were similar in rates of initial morphine administration for pain-related complaints. These findings contrast with previous studies reporting lower rates of initial analgesia administration among Hispanic patients in the ED.
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To describe pediatric emergency medicine (PEM) physicians' reported pain management practices across Canada and explore factors that facilitate or hinder pain management. ⋯ When analgesia was reported as provided, ibuprofen and acetaminophen were most commonly used. Both procedural and presenting pain remained suboptimally managed. There is a substantial evidence practice gap in children's ED pain management, highlighting the need for further knowledge translation strategies and policies to support optimal treatment.
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Law enforcement restraint-related death is frequently associated with excited delirium syndrome (ExDS). Because such deaths are rare, the pathophysiology underlying ExDS deaths remains unknown, making identification of high-risk situations challenging. This study describes the medical conditions and situations surrounding restraint of individuals identified by law enforcement to be experiencing ExDS. ⋯ Officer-identified cases of ExDS infrequently involved individuals requiring extensive restraint or with medical conditions that objectively placed them at high risk for sudden death. The low specificity of this syndrome in predicting risk of sudden death may present a challenge to law enforcement and emergency physicians.
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Australian dental journal · Sep 2014
Dental emergencies presenting to a general hospital emergency department in Hobart, Australia.
Dental problems presenting to general hospital emergency departments (GHEDs) may create difficulties as there may not be appropriate facilities or personnel to manage them. The incidence and demographics of dental presentations to GHEDs in Tasmania are currently unexamined. This knowledge may be relevant in shaping dental service delivery. ⋯ Dental infections contribute a significant burden of ED dental presentations. Encouraging and facilitating patients to seek timely and appropriate primary care from dentists may decrease the number of presentations to ED, and the drain on time and resources. Additionally, this may spare patients from the unpleasant experience of an acute dental infection episode.
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Internal medicine journal · Sep 2014
Rapid rule out of myocardial infarction with the use of copeptin as a biomarker for cardiac injury.
Copeptin is a non-specific marker of an endogenous stress response. A dual biomarker marker approach involving the simultaneous use of troponin and copeptin assays may assist early exclusion of acute coronary syndrome in Australian emergency departments. The utility and limitations of this approach are discussed.