Articles: emergency-department.
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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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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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Pediatric emergency care · Jul 2014
Children in the United States Make Close to 200,000 Emergency Department Visits Due to Poisoning Each Year.
The aim of this study was to provide nationally representative hospital-based emergency department (ED) estimate visits in children (aged ≤ 18 y) attributed to poisoning in the United States in 2008. ⋯ The current study provides nationally representative estimates of ED visits attributed to poisoning among children in the United States. High-risk groups and economics associated with treating these injuries are estimated.
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Pediatric emergency care · Jul 2014
Point-of-Care Ultrasonography for the Identification of 2 Children With Optic Disc Drusen Mimicking Papilledema.
We present 2 cases of asymptomatic patients who were found to have raised and blurred optic discs on physical examination, suggestive of papilledema. Evaluation in the emergency department revealed 2 well-appearing children with normal vital signs and neurologic evaluation results, without symptoms of increased intracranial pressure. ⋯ Optic disc drusen is caused by the deposition of calcified axonal debris and is often buried within the optic disc in pediatric patients. It can cause some changes in visual acuity and visual fields, but patients who are otherwise asymptomatic can be easily diagnosed through point-of-care ultrasound, thereby sparing patients an aggressive workup if their clinical picture is otherwise reassuring.
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The ED and Behavioral Health (BH) department developed a behaviorally-based alcohol intoxication scale (AIS) to assess when patients can be transferred to the BH unit from the ED rather than using blood alcohol levels. The purpose of this study was to determine the reliability and validity of the scale. A secondary purpose was to determine whether there was any correlation between blood alcohol level and the alcohol intoxication scale. ⋯ This study showed preliminary support for using a behaviorally-based assessment as a basis for transferring patients to the BH unit. More studies are needed to further substantiate the reliability and validity of this measure as a tool to accurately assess stability for transfer to a BH unit.