Articles: emergency-department.
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J Stroke Cerebrovasc Dis · Jan 2005
Painless acute aortic dissection with a left hemiparesis: a case report.
We report a patient with completely painless acute aortic dissection who presented with transient left hemiparesis. A 59-year-old male presented to our Emergency Department with left-sided weakness of sudden onset. We therefore suspected cerebrovascular accident. ⋯ The cycle of symptom appearance and recovery recurred 3 times over a period of a few minutes. The final diagnosis was acute aortic dissection (DeBakey type II Stanford type A). Completely painless acute aortic dissection who presented with only neurologic symptoms, which made the diagnosis of acute aortic dissection extremely difficult.
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Patient satisfaction most be a priority in emergency departments (EDs). The care provided by residents forms much of the patient contact in academic EDs. ⋯ Incentives are a novel idea to improve patient satisfaction, but did not foster overall Press-Ganey score improvement. We did find a trend toward improvement for doctor-patient interaction scores. Confounding variables, such as increasing patient census, could account for inability to demonstrate a positive effect.
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Our objective was to document and compare the views obtained at laryngoscopy during emergency department (ED) rapid sequence intubation (RSI) by anesthetists and emergency physicians of varying seniority and experience. ⋯ Anesthetic trainees obtain better laryngoscopic views than emergency medicine trainees, but these differences disappear with increasing emergency physician seniority, suggesting a training and experience effect. Emergency medicine trainees may benefit from additional focus on laryngoscopic visualization techniques early in their training period.
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The objective of this study was to evaluate the utility of circumferential casting in the emergency department (ED), orthopedic follow-up visits, and radiographic follow-up in the management of children with wrist buckle fractures. ⋯ Orthopedic follow-up visits and radiographic follow-up may have minimal utility in the treatment of pediatric wrist buckle fractures. ED casting may pose more risk than benefit for these children. Splinting in the ED with primary care follow-up appears to be a reasonable management strategy for these fractures. A prospective study comparing ED splinting and casting for pediatric wrist buckle fractures is needed.