Articles: emergency-department.
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To describe the demographic characteristics and incidence of unintentional fall-related fractures among older adults treated in the US hospital emergency departments (EDs). ⋯ The oldest old, women and lower trunk fractures account for the majority of fall-related fractures among persons aged 65 years or older treated in US hospital EDs. Increasing ED visits and hospitalisations for fall-related fracture among older adults deserve further research.
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ABSTRACTObjectives:Requests for specialty consultation are common in emergency departments (EDs) and often contribute to delays in throughput. Our objectives were to describe the contribution of the consultation process to total ED length of stay (LOS) through novel metrics and illustrate causes of delay. Methods:We conducted a prospective cross-sectional study at three Canadian tertiary care centres. ⋯ Conclusion:The consultation process is highly variable and has an important impact on ED LOS. We describe novel measures related to consultation performance and provide an analysis of what causes delays. These results can be used to seek improvements in the consulting process.
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ABSTRACTTraumatic dislocation of the elbow is rare in children and can most often be managed in the emergency department using procedural sedation and closed reduction with good functional outcome. Radiographs must be evaluated for associated avulsions and fractures around the elbow. We present the case of a 14-year-old girl who sustained a fracture of the radial neck subsequent to repeated attempts at closed reduction of a pure posterior elbow dislocation that was missed on postreduction radiographs. Careful use of reduction techniques and avoidance of repeated forceful manipulations is emphasized.
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ABSTRACTObjectives:To describe pediatric emergency medicine (PEM) physicians' reported pain management practices across Canada and explore factors that facilitate or hinder pain management. Methods:This study was a prospective survey of Canadian pediatric emergency physicians. The Pediatric Emergency Research Canada physician database was used to identify participants, and a modified Dillman's Total Design Survey Method was used for recruitment. ⋯ Conclusions:When analgesia was reported as provided, ibuprofen and acetaminophen were most commonly used. Both procedural and presenting pain remained suboptimally managed. There is a substantial evidence practice gap in children's ED pain management, highlighting the need for further knowledge translation strategies and policies to support optimal treatment.
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ABSTRACTTrimethoprim/sulfamethoxazole (TMP/SMX), also known as Septra, is a commonly encountered and prescribed antibiotic in emergency department patients. The side effects associated with TMP/SMX are generally mild and self-limited, but serious side effects, including Stevens-Johnson syndrome and drug-induced aseptic meningitis, have been reported. We discuss the case of a 33-year-old woman who presented to our emergency department with the signs and symptoms of meningeal inflammation after being prescribed TMP/SMX 3 days earlier for an abscess with cellulitis.