Articles: emergency-department.
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Emergency department (ED) presentation of pulmonary tuberculosis (TB) can be highly atypical and an ED visit might be the only health care interaction for high-risk patients. ⋯ Patients with atypical presentations, as well as those who were unresponsive or reported a history of homelessness and substance abuse, were at greater risk for nondiagnosis of TB during an infectious ED visit.
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The Japan Advanced Trauma Evaluation and Care (JATEC) education program was introduced in 2002. To examine its effect on the survival of trauma patients, we investigated changes in trauma mortality in Japan in the years after JATEC was introduced. ⋯ Since 2007, mortality has decreased in patients with mild trauma injury; however, mortality was significantly worse for severely injured patients or patients requiring surgical procedures. These findings suggest that definitive trauma care in Japan should be strengthened.
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To determine the diagnostic accuracy of copeptin in patients with suspected acute coronary syndrome (ACS) and its correlation with obstructive coronary artery disease (CAD) on coronary CT angiography (CTA). ⋯ Copeptin seems to be elevated in patients with ACS while there is no strong correlation with obstructive coronary disease on CTA.
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Pediatric emergency care · Nov 2013
Case ReportsThyrotoxicosis after a massive levothyroxine ingestion in a 3-year-old patient.
Most children with exploratory levothyroxine ingestions remain asymptomatic or suffer only minor effects, and most patients can be managed in the home or with supportive care in the hospital. We present a case of a 3-year-old girl who was found after a witnessed massive ingestion of levothyroxine. The patient was initially seen in an emergency department and discharged in stable condition, only to return 4 days after ingestion with thyrotoxicosis, hypertension, tachycardia, 24 hours of persistent vomiting, and clinical and laboratory evidence of dehydration. ⋯ The patient was followed up until 2 months after ingestion and remained asymptomatic. Although most exploratory levothyroxine ingestions suffer little to no clinical effects, serious symptoms can occur. Because serious symptoms can occur in a delayed fashion, it is important for clinicians to give proper anticipatory guidance regarding home symptom monitoring, follow-up, and reasons to return to the emergency department when patients present for medical evaluation.
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(1) Determine the difference in pre-test and post-test knowledge scores for attendees of a train-the-trainer workshop and (2) determine the number of attendees who disseminated the content within 6 months of attending the workshop. ⋯ A train-the-trainer workshop specifically designed for emergency physicians and nurses that discussed the broad spectrum of SCD was well attended, and 6 months later, 99 additional providers received training.