J Emerg Med
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Compartment syndrome is a limb-threatening complication associated with extremity trauma. The existence of compartment syndrome involving the thenar space is considered controversial and has not been reported in association with blunt traumatic injury of the hand. ⋯ Compartment syndrome of the thenar space may be more common than previously reported. Given the limited time frame after which permanent damage occurs, clinicians should consider measurement of thenar compartment pressures in high-risk injuries.
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Boarding of inpatients in the Emergency Department (ED) has been widely recognized as a major contributor to ED crowding and a cause of adverse outcomes. We hypothesize that these deleterious effects extend to those patients who are discharged from the ED by increasing their length of stay (LOS). ⋯ In this retrospective study, increasing boarder burden was associated with increasing LOS of patients discharged from the ED, with the greatest effect between 11:00 a.m. and 11:00 p.m. on medium-acuity patients. This relationship between LOS and ED capacity limitation by inpatient boarders has important implications, as ED and hospital leadership increasingly focus on ED LOS as a measure of efficiency and throughput.
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Injuries caused by the TASER(®) (TASER International, Inc., Scottsdale, AZ) have been well documented, and both direct and indirect ocular injuries have been reported. We present a case of severe perforating injury to the globe from a TASER dart with central cornea penetration. ⋯ This is a case of a severe TASER-related ocular injury resulting in significant vision loss. Although mechanical trauma seemed to be the main etiology for vision loss, electrical shock injury may also be contributory. Direct injury to the eye from a TASER dart is similar to other perforating projectile injuries and can have a devastating visual outcome.
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Comparative Study
Emergency ultrasound of the gall bladder: comparison of a concentrated elective experience vs. longitudinal exposure during residency.
It is unknown how an intensive emergency ultrasound (EUS) experience compares with comparable exposure done over the course of residency training. ⋯ Physicians who participated in a 2-week, semi-structured EUS elective demonstrated EUS accuracy for biliary disease that was comparable with those who performed the same number of examinations over a longer period of time.
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Although cardiac dysrhythmia is common in patients with thyrotoxic periodic paralysis (TPP), high-degree atrioventricular (AV) block complicated by cardiogenic shock, even under KCl supplementation, is rarely described. ⋯ A paradoxical fall in serum K(+) concentration with potentially life-threatening complication is still underappreciated in patients with TPP on KCl supplementation. Early recognition and prompt therapy prevent untoward consequences.