Articles: emergency-department.
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Pediatric emergency care · Apr 2014
Case ReportsBedside hip ultrasonography in the pediatric emergency department: a tool to guide management in patients presenting with limp.
We present a case of a 3-year-old girl brought to the emergency department for evaluation of limp after falling off the monkey bars 1 day prior. X-rays of the entire left lower extremity were normal with no evidence of fracture, dislocation, or effusion. Point-of-care ultrasound of the left hip demonstrated a hip effusion, which prompted further imaging, ultimately revealing an occult fracture of the left proximal femoral metaphysis. This case demonstrates the ability of point-of-care ultrasound to guide the management of patients presenting to the pediatric emergency department with musculoskeletal complaints.
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ABSTRACTObjective:Postdischarge emergency department (ED) communication with family physicians is often suboptimal and negatively impacts patient care. We designed and piloted an online notification system that electronically alerts family physicians of patient ED visits and provides access to visit-specific laboratory and diagnostic information. ⋯ Introduction of a web-based ED visit communication tool improved ED-family physician communication. The impact of this system on improved continuity of care, timeliness of follow-up, and reduced duplication of investigations and referrals requires additional study.
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Pulmonary embolism (PE) is a common emergency department (ED) diagnosis with a wide range in mortality rates. Methods to identify and risk-stratify PE, including measuring right ventricular strain (RVS) by echocardiography (echo), are essential in providing effective and efficient care. A limited echo examination aims to expedite and increase availability of RVS determination through assessment at the bedside by the ED provider. ⋯ In this retrospective cohort study, limited echo demonstrated moderate agreement with consultative echo for RVd. Right ventricular dilation on limited echo was highly specific for RVS but had low sensitivity.
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Focussed assessment with sonography in trauma (FAST) has assumed a key role in the rapid non-invasive assessment of thoracoabdominal trauma and assists in decreasing disposition time. This study evaluates FAST's efficacy with respect to haemodynamic stability in a South African emergency department (ED). ⋯ This study showed a valuable role for FAST in all traumas, particularly in haemodynamic compromise. As an addition to the physician's repertoire of bedside assessment tools, it improves diagnostic capabilities in comparison with simple haemodynamic assessments alone.