The American journal of emergency medicine
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The objectives of this study are to validate a set of clinical variables to identify patients with pelvic fractures and to determine the sensitivity of anteroposterior (AP) pelvic radiographs in patients with pelvic fractures. ⋯ Previously identified high-risk variables for pelvic fracture identify most but not all patients with pelvic fractures. However, these high-risk variables identify all patients undergoing surgery and may be implemented as screening criteria for pelvic radiography. Anteroposterior pelvic radiographs fail to demonstrate a fracture in a substantial number of patients with pelvic fracture including patients who undergo surgery.
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A 46-year-old man presented to the emergency department after being injured with a press machine from his left hand 30 minutes before admission. Subungual hematoma was diagnosed in his index finger, although the nail plate was intact. Emergency physicians could identify nail bed injury with bedside ultrasonography examination. This noninvasive, inexpensive, and repeatable diagnostic modality could preserve patients from a complex, invasive nail removal procedure.
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The incidence of ceftriaxone-related hypersensitivity skin reactions is between 1% and 3%, whereas anaphylaxis is rare. To the best of our knowledge, the following case is the first report of asystole after the administration of single-dose ceftriaxone. A 55-year-old man was admitted to our emergency department because of high fever, abdominal pain, dysuria, and weakness. ⋯ The time of onset was suggestive of ceftriaxone-induced anaphylaxis. The patient was discharged in good clinical condition on the 10th day of admission. Emergency physicians should be mindful of the possibility of anaphylaxis and asystole that could occur with the first dose of ceftriaxone and should also make sure to offer receiving detailed informed patient consent, too.
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This study aims to evaluate clinical values and determine the function of a pediatric observation unit (POU) as an alternative to inpatient unit admission for children with newly onset seizures. ⋯ The POU may be an alternative to immediate admission in selected cases of first seizures. Related information such as age, use of anticonvulsants in the ED, serum C-reactive protein value, and clinical diagnosis of febrile seizure are important factors for determining whether pediatric patients with first seizure attack should be admitted or discharged.