The American journal of emergency medicine
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Review Meta Analysis Comparative Study
Comparison of the loop technique with incision and drainage for soft tissue abscesses: A systematic review and meta-analysis.
Skin and soft tissue infections are a common presentation to the emergency department. Traditional management of abscesses involves a linear incision through the center of the abscess with packing placed. The loop drainage technique (LDT) is an alternate approach that may reduce pain and scarring, as well as decrease the number of follow up visits needed. This systematic review and meta-analysis aimed to compare the efficacy of the LDT with conventional incision and drainage (CID) in the treatment of soft tissue abscesses. ⋯ The existing literature suggests that LDT is associated with a lower failure rate than CID. However, the data is limited by small sample sizes and predominantly retrospective study designs. Given the potential for less pain, decreased scarring, and lower associated healthcare costs, this technique should be considered for the treatment of skin and soft tissue abscesses in the ED setting, but further studies are needed.
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Acute upper gastrointestinal bleeding (UGIB) is a potentially life-threatening condition that requires rapid assessment in the emergency department (ED). We aimed to compare the performance of the AIMS65, Glasgow-Blatchford (Blatchford), preendoscopic Rockall (pre-Rockall), and preendoscopic Baylor bleeding (pre-Baylor) scores in predicting 30-day mortality in patients with acute UGIB in the ED setting. ⋯ In patients with acute UGIB in the ED, the AIMS65 and Glasgow-Blatchford scores are clinically more useful for predicting 30-day mortality than the preendoscopic Rockall and preendoscopic Baylor scores. The AIMS65 score might be more ideal for risk stratification in the ED setting.
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Blunt chest injury is a common presentation to the emergency department. However, a delayed hemothorax after blunt trauma is rare; current literature reports a delay of up to 30days. We present a case of 44-day delay in hemothorax which has not been previously reported in current literature. ⋯ Delayed hemothorax after blunt trauma is a rare clinical occurrence but associated with significant morbidity and mortality. The management of delayed hemothorax includes draining the hemothorax and controlling the bleeding. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians should be vigilant and weary that hemothorax could be a possibility after a chest injury despite a delay in presentation. A knowledge of delayed hemothorax will prompt physicians in providing important advice, warning signs and information to patients after a chest injury to avoid a delay in seeking medical attention.