Articles: emergency-department.
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Nitrous oxide myelopathy is rare in children. We report a 16-year-old girl who presented at the pediatric emergency department with progressive ascending numbness in 4 limbs for 1 week and sensory ataxia for 4 days. The patient had frequently inhaled nitrous oxide for recreation over the preceding 3 months. Her serum vitamin B12, homocysteine, and folate levels were within normal ranges. Magnetic resonance imaging of the spinal cord T2-weighted images series showed hyperintensities in the central and dorsal cervical spinal cord section over C1 to C6 and suspicious of hyperintensities in the thoracic spinal section over T7 and T8. ⋯ Myelopathy due to nitrous oxide should be considered in a differential diagnosis when adolescents develop neurologic symptoms after nitrous oxide inhalation abuse.
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Critically ill patients can be subject to prolonged stays in the emergency department following receipt of an order to admit to an intensive care unit. The purpose of this study was to explore patient and organizational influences on the duration of boarding times for intensive care bound patients. ⋯ The study results provide a profile that may assist clinicians in understanding the complex and site-specific interplay of variables contributing to boarding of critically ill patients.
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Drug Alcohol Depend · Apr 2014
Randomized Controlled TrialDoes beverage type and drinking context matter in an alcohol-related injury? Evidence from emergency department patients in Latin America.
Previous studies have already substantiated alcohol's causal role in injuries. Yet the role that alcoholic beverage preferences and the drinking context play in the risk for injury is still under-investigated. In this study, a cross-national comparison of the association between alcohol and injury focusing on beverage type preference and the drinking context is reported. ⋯ A similar beverage-specific association with alcohol-related injury was found across LAC countries, mainly attributed to beer consumption, and spirits drinkers seem to have a greater chance of becoming involved in injury events. Future prevention strategies should inform the public about harms from drinking associated with the context in which drinking takes place.
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The hemodynamic profile of patients presenting to the emergency department (ED) with acutely decompensated heart failure (ADHF) provides the basis for initial management. We characterized the hemodynamic profiles of patients presenting to the ED with ADHF and their association with treatments and outcomes. ⋯ Of HTN ADHF patients, less than half received vasodilators, and approximately one-third did not receive diuretics, in the ED. The development of stratified protocols for therapy based on these profiles should be considered.
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To classify older adults in the emergency department (ED) according to healthcare use and to examine associations between group membership and future ED visits and hospital admissions. ⋯ In older adults released from an ED, group membership was associated with future health services use. Classification of individuals using readily available previous visit data may improve targeting of interventions to improve outcomes.