Annals of emergency medicine
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Case Reports
Avulsion fracture of the anterior superior iliac spine presenting as acute-onset meralgia paresthetica.
Avulsion fracture of the anterior superior iliac spine is rare. Most cases occur in adolescents involved in competitive sports or vigorous exercise in which the sartorius and tensor fascia lata muscles are contracted strongly and suddenly against a hyperextended trunk. ⋯ We describe a patient with avulsion of the anterior superior iliac spine who presented with meralgia paresthetica. The symptoms resolved with conservative treatment.
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Randomized Controlled Trial Comparative Study Clinical Trial
Simplification of emergency department discharge instructions improves patient comprehension.
Emergency department patients have been shown to have difficulty understanding written discharge instructions. We attempted to determine whether improvements in comprehension can be achieved by simplification of available materials. ⋯ Simplified written materials may help patients who do not understand current standard materials. Health care providers should simplify written materials to make them understandable to the greatest number of patients.
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Randomized Controlled Trial Comparative Study Clinical Trial
Nebulized dexamethasone versus oral prednisone in the emergency treatment of asthmatic children.
To compare nebulized dexamethasone with oral prednisone in the treatment of children with asthma. ⋯ Nebulized dexamethasone was as effective as oral prednisone in the ED treatment of moderately ill children with acute asthma and was associated with more rapid clinical improvement, more reliable drug delivery, and fewer relapses.
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Comparative Study
Gender-associated differences in emergency department pain management.
To determine whether patient or provider gender is associated with the number, type, and strength of medications received by emergency department patients with headache, neck pain, or back pain. ⋯ Female patients with headache, neck pain, or back pain describe more pain and are perceived by providers to have more pain than male patients in the ED. Female patients also receive more medications and stronger analgesics. In this study, severity of patient pain rather than gender stereotyping appeared to correlate most with pain-management practices.
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To determine the spectrum of disorders in children younger than 6 years with upper-extremity injury or immobility and to identify clinical findings associated with specific disorders. ⋯ Most children with arm injury or immobility have bony or soft-tissue trauma, the majority being RHS. Clinical findings varied between diagnoses and may aid the clinician in deciding whether attempted reduction of RHS is indicated or whether radiographs are warranted first. Nontrauma diagnoses are unusual but should be considered, particularly in the child younger than 6 months old. Appropriate immobilization and follow-up are important for the management of children without a clear diagnosis at the initial evaluation.