J Emerg Med
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We report a rare event of acute hemorrhage into a thyroid adenoma after blunt trauma and causing respiratory distress. A 65-year-old woman fell and hit the left side of her anterior neck without any other injuries. The next day, she suffered from severe dyspnea and respiratory distress, and visited a community hospital. ⋯ The patient was referred to our hospital because the diagnosis of malignant thyroid tumor was not completely ruled out. She successfully underwent left lobectomy of the thyroid gland without sternotomy. The pathological examination revealed follicular adenoma of the thyroid gland with massive intratumor bleeding.
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The objective of this study was to determine if the implementation of bedside registration would affect patient throughput times in an urban, academic emergency department. This was a before-and-after interventional study. An 8-month period before initiating bedside registration in November 2001 was compared to three subsequent 4-month intervals. ⋯ Bedside registration decreased triage-to-room times for non-urgent patients and urgent patients initially, but this was not sustained at the end of 1 year. It had no effect on emergent patients who are routinely taken into the patient care area immediately. The sustainable effects of bedside registration were during the morning time when emergency department beds were available.