The American journal of emergency medicine
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A 22-year-old man was brought in by EMS for coma and respiratory failure. The initial diagnosis was an opioid overdose but the patient did not respond to naloxone. ⋯ Despite neurosurgical and ICU care, the patient did not recover. Cerebellitis is a seldom-discussed complication of opioid use which may become more common as the opioid and fentanyl epidemic evolves.
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The COVID pandemic, which has caused high mortality rates worldwide, has mainly affected the working environment of healthcare workers. Metabolic and respiratory changes occur in healthcare workers working with surgical masks. ⋯ Regular and long-term use of surgical masks does not harm the body metabolically and respiratorily.
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Medical encounters require an efficient and focused history of present illness (HPI) to create differential diagnoses and guide diagnostic testing and treatment. Our aim was to compare the HPI of notes created by an automated digital intake tool versus standard medical notes created by clinicians. ⋯ Digitally generated clinical notes had moderate agreement compared to standard clinical notes and within the one point clinically significant difference except for the conciseness attribute. Digital notes more reliably documented billing components of severity. The use of automated notes should be further explored to evaluate its utility in facilitating documentation of patient encounters.
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Observational Study
The incidence of self-harm ingestions in adolescents and young adults at a tertiary care center between January 2019-March 2022.
There has been an increasing incidence of self-harm attempts in recent years in the United States. Particularly concerning, there has been a growing trend of self-harm in the adolescent and young adult population. In order to inform initiatives to address this trend, risk factors and substances used for self-harm need to be clarified. ⋯ There was a persistent increase in self-harm attempts via poisoning throughout the study period with a particularly vulnerable period in the adolescent age group.
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To assess the effectiveness of non-rebreather mask combined with low-flow nasal cannula (NRB + NC) compared to high-flow nasal cannula (HFNC) in improving oxygenation in patients with COVID-19-related hypoxemic respiratory failure (HRF). ⋯ HFNC may be beneficial in COVID-19 HRF. NRB + NC is a viable alternative, especially in resource-limited settings, given similar improvement in oxygenation at two hours, and no significant differences in long-term outcomes. The effectiveness of NRB + NC needs to be investigated by a powered randomized controlled trial.