J Emerg Med
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Emergency departments (EDs) face increasing patient volumes and economic pressures. These problems have been attributed to the Emergency Medical Treatment and Labor Act (EMTALA). ⋯ Many patients know that the law requires hospitals to provide care. This knowledge is associated with more frequent ED use. EMTALA changes might reduce ED use, but broader policy implications should be considered.
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Review Case Reports
Amatoxin poisoning: case reports and review of current therapies.
Diagnosis and management of Amanita mushroom poisoning is a challenging problem for physicians across the United States. With 5902 mushroom exposures and two resultant deaths directly linked to Amanita ingestion in 2009, it is difficult for physicians to determine which patients are at risk for lethal toxicity. Identification of amatoxin poisoning can prove to be difficult due to delay in onset of symptoms and difficulty with identification of mushrooms. Consequently, it is difficult for the Emergency Physician to determine proper disposition. Further, treatment options are controversial. ⋯ We present the successful treatment of 2 patients who ingested what we believe to be an Amanita species never before identified in the northeastern United States.
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Case Reports
Bilateral simultaneous traumatic upper arm compartment syndromes associated with anabolic steroids.
Acute compartment syndrome, a surgical emergency, is defined as increased pressure in an osseofascial space. The resulting reduction of capillary perfusion to that compartment requires prompt fasciotomy. Treatment delay has a poor prognosis, and is associated with muscle and nerve ischemia, resultant infarction, and late-onset contractures. ⋯ We suggest consideration of a history of anabolic steroid use when evaluating patients with extremity trauma.
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Review Case Reports
Bilateral anterior dislocation of the shoulder: review of seventy cases and proposal of a new etiological-mechanical classification.
Although anterior shoulder dislocation is common in everyday practice in Emergency Departments, bilateral presentation is a rare entity. ⋯ The bilateral anterior shoulder dislocation may not be as rare as previously thought and must be taken into account in emergency services. The authors propose a new etiological-mechanical classification. Also, the importance of radiologic diagnosis must be highlighted.
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Review Case Reports
Spontaneous compartment syndrome of the upper arm in a patient receiving anticoagulation therapy.
Compartment syndrome is a condition in which elevated pressures within an osseofascial compartment cause vascular compromise, leading to ischemia and possible necrosis. It commonly occurs after a traumatic event (e.g., fracture, crush, burn); however, compartment syndrome can happen spontaneously and in any compartment of the body. The objective of this case study is to present the signs and symptoms of upper arm compartment syndrome along with a review of the diagnosis and treatment. ⋯ Although uncommon, spontaneous compartment syndrome can occur, and prompt recognition and intervention are limb- and possibly life-saving.