J Emerg Med
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Multicenter Study
One-week survey of pain intensity on admission to and discharge from the emergency department: a pilot study.
The purpose of this pilot study was to determine the incidence and severity of pain intensity in patients 4 years of age and older presenting to the noncritical ward of the emergency department (ED). All patients presenting to the ED of two university hospitals (one general, one pediatric) who were triaged to the noncritical ward during 12 h/day for 1 week were asked to report their pain intensity on admission and again asked just prior to discharge home. The chromatic analogue scale with a range of 0-10 was used as the measure of pain intensity. ⋯ It thus appears that pain is a problem for the majority of patients presenting to the ED. An important percentage of patients leave the ED with more pain than when they arrived. Further investigation is warranted to determine factors predicting poor pain resolution during an ED visit.
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Patients exposed to pressurized liquids or gases present unique diagnostic and treatment challenges to the Emergency Physician. The potential for injury depends upon the properties of the chemical in addition to the thermodynamic effects from exposure to a pressurized substance. We present two cases of exposure to pressurized ammonia during an industrial accident. One patient's symptoms were consistent with an ammonia alkali burn, whereas the other patient's symptoms were more characteristic of a significant thermal injury caused by the rapid expansion and evaporation of a pressurized liquid.
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Seizures are generally regarded as a manifestation of extreme, generally near-fatal carbon monoxide poisoning. A case is described in which a seizure attributable to carbon monoxide poisoning occurred in a small child at a level not thought to be associated with serious neurologic toxicity. A literature review of the occurrence of seizures in carbon monoxide poisoning found that no particular degree of carboxyhemoglobin was correlated with the presence of seizures. A seizure with no other apparent cause occurring in circumstances in which carbon monoxide toxicity would be suspected can be attributed to carbon monoxide poisoning.