Articles: emergency-department.
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Pediatric emergency care · Jun 2014
Case ReportsHemoperitoneum: an unusual presentation of chronic granulocytic leukemia in a pediatric patient.
Chronic granulocytic leukemia (CGL) is a rare hematologic disease in pediatric patients. It usually presents with insidious symptoms. However, some cases may have an atypical presentation. ⋯ Pathology revealed a CGL-infiltrated ovary. The patient is currently stable, has finished adjuvant chemotherapy, and is at 24 months of follow-up. To our knowledge, this is the first report of such a case.
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Participation of hospital clinical pharmacists in the care of inpatients is widespread, often encouraged by the dicta promulgated by regulatory bodies. For years, clinical pharmacists have ventured out of the pharmacy to participate in rounds and, otherwise, in the care of patients on hospital floors and in intensive care units. In fact, it has been well documented in many research studies published in the last 20 years that having pharmacists prospectively involved with orders generates significant cost savings for the hospital and benefit to patients. ⋯ The potential benefits were recognized, but the pace and costs seemed prohibitive. The addition of pharmacists in the ED has reduced medication errors and provided numerous other benefits that will be discussed in this article. We will show that recent data indicate that using an ED clinical pharmacist promotes patient safety and is cost-effective.
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Observational Study
Prescription opioid misuse among ED patients discharged with opioids.
The purposes of this study were to determine the prevalence of prescription opioid misuse in a cohort of discharged emergency department (ED) patients who received prescription opioids and to examine factors predictive of misuse. ⋯ Prescription opioid misuse was prevalent among this cohort of ED patients. A heterogeneous mixture of behaviors was captured. Future research should focus on the etiologies of misuse with directed screening and interventions to decrease misuse.
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Massive wasp envenomation can cause not only severe immediate allergic reactions and anaphylaxis but also severe delayed toxin-mediated systemic reactions, including hemolysis, coagulopathy, rhabdomyolysis, acute renal failure, and hepatotoxicity. However, reports of the latter type of reactions are rare. The subject of this case report, a 66-year-old man, was stung more than 30 times during an attack by wasps. ⋯ Immediately after diagnosis, an emergency laparotomy was performed. Nonocclusive mesenteric ischemia was finally diagnosed via a histologic examination of the resected small bowel. We present the first case report of nonocclusive mesenteric ischemia consequent to wasp stings.