J Emerg Med
-
Observational Study
The effect of tropical cyclones (typhoons) on emergency department visits.
Case reports have indicated that a tropical cyclone may increase Emergency Department (ED) visits significantly. ⋯ During tropical cyclones, emergency services were under increased demand in selected time periods and areas. Health care authorities should collect information to build local models to optimize their resources allocation in preparation.
-
Antihypertensive medications, including β-blockers, are widely used in patients with chronic kidney disease. Unlike most β-blockers, atenolol is excreted primarily by the kidney, and its clearance by peritoneal dialysis is poor. These pharmacokinetic factors may predispose patients to gradual accumulation of the drug over time. ⋯ The unique pharmacokinetics of long-term medications must be considered in patients with impaired clearance, such as this patient with end-stage renal disease treated by peritoneal dialysis. Medications may gradually accumulate to supratherapeutic levels, which over time may lead to symptoms of significant toxicity.
-
Despite the publication of recent guidelines for anaphylaxis management, many studies show that physicians are still not at ease with the management of anaphylaxis. ⋯ Medication errors in the management of anaphylaxis were frequent. Use of an SOF significantly reduced the rate of dosage errors.
-
Bedbug infestations are increasing across North America and Europe, with more people presenting to Emergency Departments for treatment. Physicians cannot provide substantive treatment for people affected by bedbugs. ⋯ It may be possible that ivermectin could help eradicate, suppress, or prevent a bedbug infestation.
-
High-dose corticosteroid therapy is used to treat several severe autoimmune diseases. Despite a common knowledge in the medical community of the adverse effects of chronic corticosteroid use, there is much less awareness of the affects that can occur after very high doses are administered in a relatively short period of time. ⋯ More patients with autoimmune diseases may be placed on outpatient-based treatment regimens of high-dose corticosteroids in the future. It is important for emergency physicians to be aware of bradycardia as a possible adverse effect, as many of these patients may present to the emergency department for evaluation.