Articles: emergency-department.
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Observational Study
[Children with minor head injury in the emergency department: Is skull radiography necessary for children under 2 years?].
Current guidelines on the management of mild head trauma (traumatic brain injury/TBI) do not include the presence of a skull fracture in determining the risk of intracranial injury. However, in our setting cranial radiography is still performed frequently to rule out the presence of skull fracture. ⋯ Children younger than two years of age with mild TBI have low prevalence of ciTBI. Consequently, it is possible to monitor children younger than two years with a TBI without performing skull radiography.
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Case Reports
Unnecessary shock from an implantable cardioverter-defibrillator following transcutaneous pacing.
As the population ages and cardiovascular disease becomes more prevalent, an increasing number of patients are receiving implantable cardioverter-defibrillators (ICDs). When these patients present to the emergency department, it is imperative that physicians are not only aware of the possible underlying medical issues that may have precipitated their admission but should also have a good understanding of the potential interactions that any medical intervention may have on the patient's device. We discuss a case in which a patient known to have an ICD in situ was transcutaneously paced for the management of bradycardia, leading to an unnecessary shock.
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Comput Methods Programs Biomed · Jul 2014
Emergency department utilization can indicate early diagnosis of digestive tract cancers: A population-based study in Taiwan.
Patients who visit emergency department (ED) may have symptoms of occult cancers. ⋯ The health system could identify high risk patients early by real-time review of their ED utilization before the diagnosis of digestive tract cancers. We proposed a follow-up methodology for daily screening of patients with high risk of digestive tract cancer by informatics system in the ED.
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To identify issues, from the emergency department clinicians' viewpoint, with the management of patients presenting to the emergency department with a mental illness. ⋯ Although initiatives have been implemented, there needs to be a greater focus on educating the staff in emergency departments in relation to the policies and strategies which aim to improve the care and management of patients presenting with a mental health problem.
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We assessed an early notification system using smartphones to reduce door-to-balloon times (DTBT) in ST-elevation myocardial infarction (STEMI). Text page alarms were sent to cardiologists for all patients presenting with chest pain or an equivalent in the emergency department before acquisition of an electrocardiogram (ECG). A total of 210 patients (with mean age of 59 years) were investigated (109 in the intervention group and 101 in a control group from the previous two-year period). ⋯ In a secondary analysis, the length of hospital stay was also significantly less. However, there was no significant improvement in all-cause one-year mortality. Early text page alarms using smartphones were effective in reducing the DTBT, but had a limited effect on clinical outcome.