The American journal of emergency medicine
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Case Reports
More than meets the eye: Point-of-care ultrasound diagnosis of acute optic neuritis in the emergency department.
Optic neuritis (ON) is an inflammatory condition that causes demyelination and thickening of the optic nerve leading to acute/subacute vision loss. It is frequently associated with other conditions like multiple sclerosis, but is often misdiagnosed, which can lead to a suboptimal prognosis. Ultrasound is rarely utilized to help make this diagnosis, even though it can easily detect a thickened retrobulbar optic nerve sheath diameter. We describe four cases in which ultrasonographic measurement of the optic nerve sheath diameter aided in the diagnosis of ON.
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Drug overdoses are the most common cause of accidental death in the United States, with the majority being attributed to opioids. High per capita opioid prescribing is correlated with higher rates of opioid abuse and death. We aimed to determine the impact of sharing individual prescribing data on the rates of opioid prescriptions written for patients discharged from the emergency department (ED). ⋯ Our study demonstrates the sharing of individual opioid prescribing data was associated with a reduction in opioid prescribing at a single institution.
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Barriers to EMS care can result in suboptimal outcomes and preventable morbidity and mortality. Large EMS databases such as the National Emergency Medical Services Information System (NEMSIS) dataset provide valuable data on the relative incidence of such barriers to care. ⋯ Racially white patients and male patients have a statistically significant higher risk of encountering an EMS barrier to care in cases of violent trauma.
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Case Reports
Anterior wall ventricular pseudoaneurysm presenting as dizziness and syncope: A case report.
Ventricular pseudoaneurysm rupture is a rare finding in emergency departments in the era of percutaneous coronary intervention. It is an infrequent complication after acute myocardial infarction. We present a case of ventricular pseudoaneurysm rupture and examine current literature on the pathophysiology and imaging guidelines on the topic. ⋯ He was treated surgically. Ventricular pseudoaneurysm rupture is an uncommon finding in medicine and the emergency department. Point-of-care ultrasound is an important diagnostic modality to identify this critical complication and prompt surgical management.