Articles: emergency-department.
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Review Meta Analysis
Efficacy of Prescribed Opioids for Acute Pain after Being Discharged from the Emergency Department: A Systematic Review and Meta-Analysis.
Opioids are often prescribed for acute pain to patients discharged from the emergency department (ED), but there is a paucity of data on their short-term use. The purpose of this study was to synthesize the evidence regarding the efficacy of prescribed opioids compared to nonopioid analgesics for acute pain relief in ED-discharged patients. ⋯ For ED-discharged patients with acute musculoskeletal pain, opioids do not seem to be more effective than nonopioid analgesics. However, this absence of efficacy seems to be driven by codeine, as opioids other than codeine are more effective than nonopioids (mostly NSAIDs). Further prospective studies on the efficacy of short-term opioid use after ED discharge (excluding codeine), measuring patient-centered outcomes, adverse events, and potential misuse, are needed.
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The aim of this study was to examine the epidemiology of alcohol-associated fall injuries among older adults aged ≥65 years in the United States. ⋯ Our findings highlight the rising rates of ED visits for alcohol-associated falls among older adults during the study period. Health care providers in the ED can screen older adults for fall risk and assess for modifiable risk factors such as alcohol use to help identify those who could benefit from interventions to reduce their risk.
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Computed tomography (CT) is routinely used in the emergency department (ED) due to its ease of access and its ability to rapidly rule in or out many serious conditions. Freestanding emergency departments (FSEDs) have become increasingly used as an alternative to hospital-based emergency departments (HBEDs). The objective of this study was to investigate if the utilization rate of CT differs between FSEDs and HBEDs for chest pain. ⋯ CT scans of the chest are utilized less frequently at FSEDs compared to HBEDs for patient presenting with chest pain.
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There are multiple reported injuries associated with cardiopulmonary resuscitation, most of them caused by the force of compressions, like sternal and rib fractures, abdominal organ injuries like splenic rupture, liver lacerations, and injuries to the upper airway and skin. Injuries related to defibrillation and cardioversion are rare, mostly related to skin and muscle injuries on where the defibrillation paddles were placed. ⋯ A 52-year-old man presented to the Emergency Department with crushing chest pain. The patient was suffering from a myocardial infarction, and during percutaneous coronary intervention, had to be defibrillated on the angioplasty table. This resulted in fracture-dislocations on both shoulders. The patient was transferred to our orthopedics clinic and was operated on within 5 days of angioplasty. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Early diagnosis and treatment are important, and can prevent long-term morbidity. However, cardiopulmonary resuscitation and defibrillation are acts that are most commonly performed in the emergency department. Injury prevention by controlling the patient's position, in this case, positions of the shoulders, is an important factor that emergency physicians can control and effect.