The American journal of emergency medicine
-
Review Meta Analysis
Prevalence of pulmonary embolism in patients presenting with syncope. A systematic review and meta-analysis.
Syncope is a common clinical presentation and establishing an etiology is often challenging. Pulmonary embolism (PE) has been thought to be an uncommon cause but a recent report suggested otherwise. ⋯ The estimated prevalence of PE in patients presenting with syncope is low. The Prandoni et al. estimates are significantly higher, suggesting a possible site effect, accrual bias, or investigation strategy. These and the prognostic impact of higher PE prevalence require understanding before changes in practice.
-
To investigate the characteristics of stair-related injuries among individuals of all ages and estimate national injury frequencies and rates using a representative sample of patients treated in United States emergency departments. ⋯ Stairs are a common source of injury among individuals of all ages and the frequency and rate of stair-related injuries are increasing. This underscores the need for increased prevention efforts, particularly those related to stair design and construction.
-
It is estimated that as many as 1 in 10 individuals who complete suicide had been seen in emergency departments within the prior 2months. However, very little evidence underlies the current recommendations on managing patients with suicidal ideation presenting to the emergency department. The American College of Emergency Physicians (ACEP) and Veterans Affairs/Department of Defense (VA/DoD) have developed clinical practice guidelines for the screening and treatment of patients with suicidal ideation who present to emergency departments. In this study we investigated the extent to which new and ongoing studies are being conducted to address the current limitations in suicide screening in emergency departments. ⋯ Little research is being done to improve suicide risk assessment tools in the emergency department. Further research in this area may decrease health care costs, improve patient care, and save the lives of those at risk of dying by suicide.
-
Measurement of optic nerve sheath diameter (ONSD) using point of care ultrasound has been used to indirectly assess the intracranial pressure (ICP) particularly in conditions where it is raised. Direct pressure measurements using probes reaching the ventricle system correlated with ONSD using ultrasound. Attempts were made to measure the ONSD pre and post lumbar puncture (LP) after draining cerebrospinal fluid (CSF) as well as post ventricular shunt placement. We report ONSD measurement and demonstrate dynamic changes during LP in a patient with known idiopathic intracranial hypertension (IIH).
-
Case Reports
Is topical tranexamic acid a better alternative for selected cases of anterior epistaxis management in the ED?
Epistaxis is a well-known problem that is mostly self-limited. In certain cases it requires packing or cauterization. Tranexamic acid has been tried and has shown promising results. Here we report a case of prolonged epistaxis in a patient on dual anti-platelet agent therapy.