The American journal of emergency medicine
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Massive hemoptysis (MH) is a serious condition that carries with it a high rate of morbidity and mortality. ⋯ An understanding of MH can assist emergency clinicians in diagnosing and managing this dangerous disease. Providing a prompt evaluation, obtaining intravenous access, pursuing advanced imaging, providing reversal of coagulopathy, supporting hemodynamics, and appropriate consultation are key interventions in MH.
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Gabapentinoids increasingly utilized for neuropathic pain, possibly to curb opioid prescribing. At the same time, data suggest subsequent increases in misuse and overdose of gabapentinoids, often in mixed overdoses. We sought to determine national trends and characteristics of gabapentinoid prescribing, including co-use with opioids, from the emergency department (ED). ⋯ Despite an association of misuse and overdose, often associated with opioids, gabapentinoids were increasingly prescribed at ED discharge. While these agents may be safer alternatives to opioids, misuse may be an associated consequence of increased prescribing, which warrants further investigation.
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The use of acute hospital-level care at home (hospital-at-home) for patients who are chronically ill has led to decreased medical costs, amount of sedentary time, and hospital admissions. Our large integrated healthcare system identified the need to develop a mechanism through which to decrease emergency department (ED) visits in this patient population by creating a home acute care program called Urgent Dispatch. The primary objective of this study was to determine the medical condition for referral and seven and 30-day ED visit rates. ⋯ A home-based care model of healthcare delivery for patients with chronic medical conditions can provide effective care, with 80.2 % of patients avoiding an ED visit within seven days and 68.2 % avoiding an ED visit within 30 days.
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To analyze the clinical characteristics, surgical management decisions, and outcomes of Neonatal testicular torsion (NTT) in order to offer guidance for future clinical practice. ⋯ NTT primarily occurs prenatally with insidious manifestations, often leading to omission or misdiagnosis. The testicular salvage rate is extremely low. Physicians need to attach importance to neonatal testicular examination, improve the vigilance of NTT. Early bilateral exploration does not necessarily save the affected testes, but it is more important to prevent damage to the contralateral one.