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Emergency department pain

E Castagno, A F Urbino, R L Mancusi, F Benini
Pain is a major cause of admissions to pediatric emergency departments, but is often inappropriately managed (1). The findings of the Pain Practice in Italian Pediatric Emergency Departments on the appropriate use of paracetamol and ibuprofen have previously been reported (1,2). This multicentre, retrospective study evaluated the prescription of opioids given to patients up to the age of 14 with acute non-procedural pain by 18 Italian emergency departments between October 2014 and January 2015. This article is protected by copyright...
December 8, 2018: Acta Paediatrica
Pablo San Juan M, Angélica Pérez J, Cornelio Barrientos A
BACKGROUND: Peritonitis is the most important and frequent complication of peritoneal dialysis (PD). Bacterial infections are responsible in most cases, with characteristic symptoms. AIM: To determine the most frequent pathogens in peritonitis associated with PD in patients with chronic renal failure (CRF). Methodos: Retrospective, descriptive, cross-sectional and observational study of patients with peritonitis in PD with CRF of the emergency department, between July 2012 and June 2013...
2018: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
Aynur Sahin, Vildan Ozer, Fatih Akkaya, Sahin Kaplan
We report a case of prolonged and successful resuscitation following cardiotoxicity-related arrest occurring after inhaling toluene and Skunk , which is an increasingly popular synthetic cannabinoid (SC). Following presentation to the emergency department because of lethargy, nausea and chest pain, a 28-year-old male user of Skunk and toluene suffered from cardiac arrest due to ventricular fibrillation (VF). Cardiogenic shock, severe metabolic acidosis and regular wide QRS tachycardia were observed in the patient, and he developed VF every 5-10 minutes over the course of 10 hours...
December 2018: Turkish Journal of Emergency Medicine
Kwame Ofori Affram, Tanya Luke Reddy, Kofi M Osei
BACKGROUND Thyrotoxic periodic paralysis (TPP) is a rare cause of acute paralysis, which if not promptly recognized and treated, can lead to significant morbidity and mortality. TPP can be precipitated by several factors, including a high carbohydrate diet and exercise. This report is of a rare case of TPP after epidural steroid injection in a young man, with a review of the literature of previous cases. CASE REPORT A 36-year-old Asian man presented to the emergency department with sudden onset of paralysis of all his limbs following epidural steroid injection for traumatic low back pain...
December 8, 2018: American Journal of Case Reports
Abdelilah El Barzouhi, Marjolijn van Buren, Cees van Nieuwkoop
BACKGROUND This is a case report of a male patient who presented with a history of right flank pain based on renal infarction. Initially the symptoms were misdiagnosed as acute pyelonephritis. CASE REPORT A 47-year-old male with a history of familial hypercholesterolemia and cerebral infarction presented at the Emergency Department with a 3-day history of acute right-sided flank pain. Physical examination revealed hypertension, subfebrile temperature, and costovertebral angle tenderness. Blood tests were unremarkable except for renal impairment, a high C-reactive protein level of 215 mg/L (normal <8 mg/dL) and an elevated lactate dehydrogenase (LDH) of 1289 U/L (normal <248 U/L)...
December 10, 2018: American Journal of Case Reports
Carlos Guillén Astete, Sara Rodrigo González, Desiree Alfonso Pérez, Mónica Luque Alarcón, Roberto Penedo Alonso, María Jesús Estévez Rueda
For the purpose of assessing the impact of ultrasound in patients with acute shoulder pain, we conducted an analysis of quality health care indicators: need for reevaluation of the pain, rate of referral to specialized medicine and length of time in the emergency department. We reviewed the 1,433 records of patients attended to between 2015 and 2016. Thirty days after the first examination, 90 patients (10.1%) had returned to the control group (56 through the emergency department and 34 because of the), whereas, in the ultrasound (US) group, 14 (2...
December 5, 2018: Reumatología Clinica
James J Brown, James M Gray, Mark G Roback, Usha Sethuraman, Ahmad Farooqi, Nirupama Kannikeswaran
BACKGROUND AND OBJECTIVES: Children with autism spectrum disorder (ASD) present more frequently to the emergency department (ED) than children with normal development, and frequently have injuries requiring procedural sedation. Our objective was to describe sedation practice and outcomes in children with ASD in the ED. METHODS: We performed a retrospective chart review of children with ASD who underwent sedation at two tertiary care EDs between January 2009-December 2016...
October 16, 2018: American Journal of Emergency Medicine
Brit Long, Jennifer Robertson, Alex Koyfman
BACKGROUND: Small bowel obstruction (SBO) is a commonly diagnosed disease in the emergency department (ED). Recent literature has evaluated the ED investigation and management of SBO. OBJECTIVE: This review evaluates the ED investigation and management of adult SBO based on the current literature. DISCUSSION: SBO is most commonly due to occlusion of the small intestine, resulting in fluid and gas accumulation. This may progress to mucosal ischemia, necrosis, and perforation...
December 6, 2018: Journal of Emergency Medicine
Qi Jin, Qin Luo, Zhihui Zhao, Qing Zhao, Xue Yu, Lu Yan, Liu Gao, Zhihong Liu
BACKGROUND: Takotsubo syndrome (TTS) is an acute cardiac condition with reversible heart failure which is often triggered by psychological and physical stressful events. Although pulmonary embolism (PE) was reported as a trigger for TTS, the concurrence of TTS and PE has been rarely reported, let alone that triggered by PE. Here we describe a case of a postmenopausal female presenting with symptoms similar to myocardial ischemia, which may be caused by PE, and review the available literature that may help clinicians with their practice to similar situations since no published guidelines are available...
December 10, 2018: BMC Cardiovascular Disorders
Selman Yeniocak, Özgür Karcıoğlu, Asım Kalkan, Fatma Saraç, Gökçe Akgül Karadana, Zehra Zeynep Keklikkıran, Alper Gümüş, Macit Koldaş, Semih Korkut
BACKGROUND: The aim of this study was to investigate the prognostic value of irisin by examining the serum level of this smooth muscle protein in patients presenting at the emergency department (ED) with acute abdominal pain. METHODS: This research was performed as a single-center, prospective, cross-sectional study. In all, 213 adult patients presenting at the ED with acute abdominal pain and 140 healthy controls were enrolled. The serum irisin level was correlated with the leukocyte, C-reactive protein, amylase, and creatine kinase values...
November 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Leslie K Lee, Andrew T Reisner, William D Binder, Atif Zaheer, Martin L Gunn, Ken F Linnau, Chad M Miller, Maurice S Herring, Angela C Tramontano, Avinash Kambadakone, Onofrio A Catalano, Mukesh Harisinghani, Elkan F Halpern, Karen Donelan, G Scott Gazelle, Pari V Pandharipande
OBJECTIVE: The purpose of this study is to determine both the frequency of repeat CT performed within 1 month after a patient visits the emergency department (ED) and undergoes CT evaluation for abdominal pain and the frequency of worsened or new CT-based diagnoses. SUBJECTS AND METHODS: Secondary analysis was performed on data collected during a prospective multicenter study. The parent study included patients who underwent CT in the ED for abdominal pain between 2012 and 2014, and these patients constituted the study group of the present analysis...
December 4, 2018: AJR. American Journal of Roentgenology
Gustav Valentin Blichfeldt Sørensen, Jacob Stegger, Jørgen Møller Munkhof, Erika Frischknecht Christensen
INTRODUCTION: Pain is a frequent symptom in patients attending emergency departments (EDs), but it remains unknown whether all patients with pain want pain-relieving treatment. The primary aim of this study was to investigate the frequency and intensity of pain. The secondary aim was to establish the proportion of patients wanting pain-relieving treatment. METHODS: A cross-sectional study was performed at Aalborg University Hospital, Denmark. We interviewed all patients attending the ED using a structured questionnaire to evaluate patient and pain characteristics as well as pain management in the ED...
December 2018: Danish Medical Journal
Mohamed Abuzakouk, Nada AlMahmeed, Esat Memisoglu, Martine McManus, Aydamir Alrakawi
A 27-year-old Emirate man presented to Cleveland Clinic Abu Dhabi emergency department with a 4 year history of recurrent episodes of severe swellings affecting different parts of his body. He used to get 2 swelling episodes every week affecting either his face, hands, feet or scrotum and severe abdominal pain twice a week. Abdominal CT scan and a colonoscopy showed bowel wall oedema. There was no family history of similar complaint or of hereditary angioedema (HAE). Complement studies confirmed the diagnosis of HAE type II...
2018: Case Reports in Immunology
Asma Sriha Belguith, Kaouthar Beltaief, Mohamed Amine Msolli, Wahid Bouida, Hela Abroug, Manel Ben Fredj, Imen Zemni, Mohamed Habib Grissa, Hamdi Boubaker, Mohamed Hsairi, Samir Nouira
BACKGROUND: We aimed to describe diagnosed acute coronary syndrome (ACS) and its care management and outcomes in emergency departments (EDs) and to determine related cardiovascular risk factors (CVRFs). METHODS: We conducted a cross sectional multicenter study that included 1173 adults admitted to EDs for acute chest pain (ACP) in 2015 at 14 sites in Tunisia. Data included patients' baseline characteristics, diagnosis, treatment and output. RESULTS: ACS represented 49...
December 3, 2018: BMC Emergency Medicine
Hyun-Min Oh, Tae-Woo Nam, Ju-Hyun Kim, Tae-Du Jung
RATIONALE: Spontaneous intramedullary spinal cord hemorrhage (hematomyelia) is a rare disease and most cases have specific etiologies such as cavernous malformations and tumor. Most reported cases are about surgical treatment of intramedullary spinal cord hemorrhage, but there are no reports of rehabilitation effectiveness reported. This case reports the first case with positive effect of rehabilitation on a patient with intramedullary spinal cord hemorrhage, who did not undergo surgery...
November 2018: Medicine (Baltimore)
Matthew C Mauck, JunMei Hu, Christopher Sefton, Robert A Swor, David A Peak, Jeffrey S Jones, Niels K Rathlev, David C Lee, Robert M Domeier, Phyllis L Hendry, Samuel A McLean
Obesity has been found to increase the risk of musculoskeletal pain (MSP) in other settings, but to our knowledge the influence of increased body mass index on pain outcomes after common trauma exposures such as motor vehicle collision (MVC) has not been assessed. In addition, obesity results in biomechanical changes, as well as physiologic changes including reduced hypothalamic pituitary adrenal (HPA) axis negative feedback inhibition, but mechanisms by which obesity may result in worse post-traumatic outcomes remain poorly understood...
November 29, 2018: Pain
Mauricio Gonzalez Urquijo, Mario Rodarte-Shade, Raul Rangel-Rangel, Jorge A Castillo-Meraz, Jaime R Rodriguez-Tejeda, Gerardo Gil-Galindo
Introduction: Splenic hamartoma is a primary benign tumor of the spleen, with approximately 150 cases documented in the literature to date, with only a few cases associated with symptoms and hematologic disorders. Presentation of case: A 49-year-old female with no past medical history, presented to the emergency department complaining of a three-month history of intermittent abdominal pain and 12 kg of weight loss. Physical examination revealed abdominal distension and a big palpable and painless mass on the left side of her abdomen measuring 14 cm...
December 2018: Annals of Medicine and Surgery
Ting-Yuan Ni, Fu-Yuan Siao, Chun-Wen Chiu, Hsu-Heng Yen
Refractory ventricular fibrillation with cardiac arrest caused by occlusion of the left main coronary artery may rapidly become fatal. In this report, we describe the case of a 70-year-old male who presented to emergency department with chest pain. Electrocardiogram showed ST-segment elevation in leads aVR and aVL and ST-segment depression in leads v3, v4, v5, v6, 2, 3, and aVF. Occlusion of the left main coronary artery was suspected. While waiting for percutaneous coronary intervention, the patient experienced sudden refractory ventricular fibrillation with cardiac arrest...
November 16, 2018: American Journal of Emergency Medicine
Takaaki Mori, Osamu Nomura, Takateru Ihara
Although ultrasound-guided peripheral nerve block (UGPNB) has recently been introduced into pediatric emergency departments (EDs), knowledge of its use is still limited among pediatric emergency physicians. Ultrasound-guided ulnar nerve block (UGUNB) is a form of peripheral nerve block available for controlling the pain caused by phalangeal injuries, but studies of its use in pediatric patients are still scarce. The aim of this case series was to describe the experience of UGUNB use for pediatric phalangeal fractures in a pediatric ED setting...
November 24, 2018: American Journal of Emergency Medicine
Helena Estirado-Fugarolas, Maribel Maldonado-Meléndez
Stroke is a cerebrovascular disease caused by a decrease or abrupt obstruction of blood flow to the brain. Nerve cells do not receive oxygen and there is a transient or permanent alteration of the function of a certain region of the brain. It causes high morbidity and mortality resulting in disabilities with a large economic cost to society. The Stroke Code was established at the Mollet Hospital in 2015. A protocol, action guideline and registry were created. The Mollet Hospital does not have a specialist unit so people who suffer thrombolysis and / or who require specific care are transferred to the referral centre...
November 28, 2018: Enfermería Clínica
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