Articles: emergency-department.
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Pediatric emergency care · Jul 2014
Point-of-Care Ultrasonography for the Identification of 2 Children With Optic Disc Drusen Mimicking Papilledema.
We present 2 cases of asymptomatic patients who were found to have raised and blurred optic discs on physical examination, suggestive of papilledema. Evaluation in the emergency department revealed 2 well-appearing children with normal vital signs and neurologic evaluation results, without symptoms of increased intracranial pressure. ⋯ Optic disc drusen is caused by the deposition of calcified axonal debris and is often buried within the optic disc in pediatric patients. It can cause some changes in visual acuity and visual fields, but patients who are otherwise asymptomatic can be easily diagnosed through point-of-care ultrasound, thereby sparing patients an aggressive workup if their clinical picture is otherwise reassuring.
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In emergency department patients with symptoms suggestive of acute myocardial infarction, is the absolute or relative change of cardiac troponin assays (either high sensitivity or ultrasenstive) more accurate in diagnosing acute myocardial infarction at 1 to 2 hours postpresentation? ⋯ To evaluate the accuracy of new troponin assays in diagnosing acute myocardial events.
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The ED and Behavioral Health (BH) department developed a behaviorally-based alcohol intoxication scale (AIS) to assess when patients can be transferred to the BH unit from the ED rather than using blood alcohol levels. The purpose of this study was to determine the reliability and validity of the scale. A secondary purpose was to determine whether there was any correlation between blood alcohol level and the alcohol intoxication scale. ⋯ This study showed preliminary support for using a behaviorally-based assessment as a basis for transferring patients to the BH unit. More studies are needed to further substantiate the reliability and validity of this measure as a tool to accurately assess stability for transfer to a BH unit.