J Emerg Med
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How patients fare once they leave the emergency department (ED) against medical advice (AMA), and the extent of illness burden that accompanies them, remains unstudied. ⋯ Patients who leave the ED AMA have significant pathology.
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An inner-city emergency department (ED) visit provides an opportunity for contact with high-risk adolescents to promote injury prevention. ⋯ Adolescents seeking care in an inner-city ED, regardless of the reason for seeking care, report an elevated prevalence of recent injury, including violence. Future injury screening and prevention efforts should consider universal screening of all youth seeking ED care.
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Patients with acute and chronic pain syndromes such as migraine headache, fibromyalgia, and sickle cell disease represent a significant portion of emergency department (ED) visits. Certain patients may have tolerance to opioid analgesics and often require large doses and prolonged time in the ED to achieve satisfactory pain mitigation. Droperidol is a unique drug that has been successfully used not only as an analgesic adjuvant for the past 30 years, but also for treatment of nausea/vomiting, psychosis, agitation, sedation, and vertigo. ⋯ Droperidol is an important adjuvant for patients who are tolerant to opioid analgesics. The FDA black box warning does not apply to doses below 2.5 mg.
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The difficulties with gum elastic bougie (GEB) use in the emergency department (ED) have never been studied prospectively. ⋯ The GEB is a helpful rescue airway device, but emergency care providers should be aware that failure rates are relatively high at a teaching institution.
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Community emergency physicians (EPs) are often required to respond to unstable patients outside of their department during off-hours. ⋯ Many community EPs are responsible for covering critically ill patients outside of their ED. Further investigation is required to determine the impact on patient care.