Articles: emergency-medicine.
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Case Reports
Complications from bariatric medical tourism: Lessons for the emergency physician from selected case reports.
Each year, increasing numbers of Americans travel abroad to undergo bariatric surgery. When postoperative complications arise, these patients often present to domestic emergency departments for care. ⋯ The presentation of patients with complications from bariatric surgery abroad at emergency departments, particularly those located near ports of entry, is likely to become more frequent. Emergency physicians should familiarize themselves with the clinical and operational challenges they may face when caring for this population.
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Emerg Med Australas · Nov 2024
Impact of the Astra Zeneca COVID-19 vaccine on an emergency department.
To assess the impact of the AstraZeneca (AZ) vaccine roll-out on an ED. Primary outcomes are ED length of stay (LOS), investigation ordering and costs. Secondary measures are compliance with the Thrombosis and Haemostasis Society of Australia and New Zealand (THANZ) Vaccine-Induced Thrombotic Thrombocytopaenia Syndrome (VITT) guidelines. ⋯ A high number of young, low acuity patients presented to the ED with AZ vaccine concerns and were associated with financial and workload implications. The quantity of ED presentations appears to be associated with vaccine administration rates. There was poor compliance with the THANZ guidelines, and they appear to have contributed to the high volume of investigations.
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Climate change is widely recognised as a critical public health challenge. ⋯ Geographical position and country risk index influence risk perception among focus groups more than income economy, with vector-borne diseases, extreme weather events and food shortages being the threats with the most variability. The most important actions identified to mitigate Climate Change effects are educational and strategic plans.
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Currently, there is uncertainty about which frailty scale is most appropriate and valid for use in the emergency department. The objective of this study was to compare the most commonly used frailty scales in triage and evaluate their performance. ⋯ The findings of this study suggest that the Triage Frailty and Comorbidity tool is a valid instrument for assessing frailty in the emergency department. Moreover, among the scales used, it is the only 1 that considers the entire adult population, not just those aged >65 years, making it more inclusive for a setting such as the emergency department.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2024
Review[The Penny's Dropped - "Aha" Moments in Emergency Medicine Diagnostics].
Hardly any other speciality is as fraught with tension as emergency medicine. In addition to the need to have a broad spectrum of knowledge about illnesses and injuries, the time factor is particularly important. Emergency physicians have to quickly gain an overview of their patients' condition. ⋯ A detective-like approach is sometimes required here, particularly in order to confirm suspected diagnoses and rule out differential diagnoses by using focussed diagnostics. Clinical experience, training and the odd "trick" lay the foundation for skillfully using the diagnostic options at the right time for the right patient - i.e. point-of-care - and finding the right diagnosis. Aha!