The American journal of emergency medicine
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Although the clinical findings of scorpion stings are often mild, they may lead to multiorgan failure and even cardiogenic shock. The toxin has both local and systemic effects. ⋯ The toxins have been implicated in a number of cardiac arrhythmias, including torsade de pointes, long QT syndrome, and atrial fibrillation. Here, we present a 90-year-old woman with no history of drug use or complaints due to dysrhythmias who developed atrial fibrillation after being stung by a scorpion.
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Comparative Study
Comparing patients who leave the ED prematurely, before vs after medical evaluation: a National Hospital Ambulatory Medical Care Survey analysis.
Many patients leave the Emergency Department (ED) before beginning or completing medical evaluation. Some of these patients may be at higher medical risk depending on their timing of leaving the ED. ⋯ When comparing all patients who left the ED before completion of care, those who left after versus before medical provider evaluation differed in their patient, hospital, and visit characteristics and may represent a high risk patient group.
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Comparative Study
A 5-year comparison of ED visits by homeless and nonhomeless patients.
A 2005 study examined emergency department (ED) utilization by homeless patients in the United States. Within the following 5 years, unemployment increased by 5%. ⋯ The number of visits by homeless patients in the ED increased proportionally to an overall increase in ED visits between 2005 and 2010.
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Plasma lactate concentration is known to increase after alcohol intake. However, this increase has rarely been analyzed quantitatively in emergency department (ED) settings. Evaluating plasma lactate elevation in ED patients after alcohol intake is important because it can affect patients' evaluation based on the plasma lactate level. ⋯ Analyses show that plasma lactate concentration is significantly higher in ED patients after alcohol intake and to a greater degree than previously reported, even in patients without previously known alcohol-related diseases. Emergency department physicians must be careful when interpreting the lactate level of the patients with alcohol intake.
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Limited data suggest that heroin worsens asthma severity, but little is known about heroin-dependent patients who seek emergency department (ED) care for asthma. ⋯ Patients with heroin dependence frequently use the ED for their health care needs related to asthma. Most do not have other health care providers, most have limited health literacy, and all would benefit from referral to a primary care provider and substance abuse resources.