Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Dizziness is a common clinical presentation that incurs huge financial costs. It is frequently misdiagnosed due to a wide differential involving both benign (inner ear disease) and serious (stroke) disorders. ⋯ This Clinical Progress Note reviews the literature on acute dizziness evaluation in adult patients and presents an evidence-based framework for hospitalists to diagnose the majority of undifferentiated dizzy patients at the bedside. Future research should assess the validity of this approach with hospitalists' ability to accurately diagnose dizzy patients, and its impact on patient care and healthcare outcomes.
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An improved understanding of patient-related violent events toward healthcare workers (HCWs) is a critical step in mitigating patient violence in the pediatric medical hospital setting. Therefore, we sought to describe the timing/setting, potential antecedents to, and management of pediatric patient-related violence toward HCW. Using our electronic health record (EHR), we performed a retrospective study of patient-related physical violent events from 2017 to 2022 among youth hospitalized at our free-standing children's hospital. ⋯ Most (66.7%) events occurred after a youth was medically cleared for discharge, and most (55%) events were preceded by an aversive experience the youth was trying to avoid. Most (77.1%) youth received medications for de-escalation, and nearly one-half (47.9%) experienced mechanical restraints. Our results highlight the challenges hospitals face while caring for youth at risk for behavioral escalations and support the need for both comprehensive in-patient behavioral health teams.