Articles: emergency-department.
-
The incidence of infection in open tibial shaft injuries varies with the severity of the injury with rates ranging from roughly 2% for Gustilo-Anderson type I to nearly 43% for type IIIB fractures. As with all fractures, timely antibiotics administration in the emergency department (ED) is an essential component of fracture management and infection prevention. This study identifies factors associated with the expedient administration of antibiotics for open tibial shaft fractures. ⋯ Earlier antibiotic delivery is associated with non-overnight arrival at the ED, arrival via EMS, and a coordinated trauma activation. Our findings indicate that in cases where administering antibiotics is critical to achieving positive outcomes, it is advisable to initiate a coordinated trauma response. Furthermore, hospital personnel should be attentive to the need for rapid administration of antibiotics to patients with open fractures who arrive via walk-in or during late-night hours.
-
Pediatric emergency care · Aug 2024
POCUS for Infectious Enteritis-A Retrospective Case Series Analysis.
The abdominal pain associated with diarrhea can be difficult to distinguish from appendicitis. We present a case series of all children found on pediatric emergency department point-of-care ultrasound (POCUS) to have right-sided bowel wall edema. ⋯ Enteritis can initially be difficult to distinguish on clinical grounds from acute appendicitis. Bowel wall edema on POCUS in a child without sonographic signs of appendicitis strongly suggests bacterial enteritis. Early POCUS demonstrating enteritis without signs of appendicitis may decrease hospital resource usage.
-
To assess the emergency department practice context and identify strategies to improve outcomes of patients with acute pain. ⋯ Achieving impactful change in clinical practice to improve patient outcomes should start with the application of implementation methods that enable comprehensive analysis of the local practice context. The assessment should begin with collaboration with local clinicians that persist throughout the life of the study to ensure change is sustainable.
-
Pediatric emergency care · Aug 2024
Case ReportsOrbital Mass Identified With Point-of-Care Ultrasound in a Child Presenting With Eyelid Swelling.
Point-of-care ultrasound was used in a child presenting to the emergency department with progressively worsening left eyelid swelling. The early use of ultrasound was helpful in detecting a soft tissue mass that is exhibiting pressure effect on the eyeball. Point-of-care ultrasound helped expedite advanced imaging and consultation with the specialist. The patient eventually had a biopsy and was diagnosed with idiopathic orbital inflammation.
-
Animal-related injuries are among the major causes of morbidity and mortality all over the world, especially in rural areas. This study aims to determine the characteristic features of animal-related injury cases presented to the emergency department and to evaluate their temporal trends and relationships with climatic factors. ⋯ This study revealed that animal-related injuries were commonly seen in children and young middle-aged adult groups and during warmer seasons. Based on the results of the study, we suggest several strategies to reduce the public health impact of animal-induced injuries, such as region-specific intervention programs adapted to animal species and seasonal changes, educational campaigns targeting children during the warmer seasons, and improved data recording systems for the cases.