Articles: emergency-department.
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Determining the appropriate disposition of emergency department (ED) syncope patients is challenging. Previously developed decision tools have poor diagnostic test characteristics and methodological flaws in their derivation that preclude their use. We sought to develop a scale to risk-stratify adult ED syncope patients at risk for serious adverse events (SAEs) within 30 days. ⋯ We derived a risk scale that accurately predicts SAEs within 30 days in ED syncope patients. If validated, this will be a potentially useful clinical decision tool for emergency physicians, may allow judicious use of health care resources, and may improve patient care and safety.
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Pediatric emergency care · Mar 2014
Mobile and web-based education: delivering emergency department discharge and aftercare instructions.
Prior research has identified deficiencies in the standard process of providing instructions for care at discharge from the emergency department (ED). Patients typically receive a brief verbal instruction, along with preformatted written discharge documents. Studies have found that understanding and retention of such information by families are very poor, leading to nonadherence in follow-up care, unnecessary return visit to the ED, and poor health outcomes. ⋯ Information can also be delivered both synchronously and asynchronously, enabling the health care providers to deliver health education to the patients electronically to their home, where health care occurs. Furthermore, the providers can track information access by patients, customize content to the individual patients, and reach other caregivers who may not be present during the ED visit. Further research is needed to develop the systems and best practices for incorporating mobile health in the ED setting.
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Thoracic aortic aneurysms (TAAs) are less prevalent than abdominal aortic aneurysms. Symptomatic TAAs need to be identified quickly by the emergency physician (EP) since mortality rates increase dramatically once complications such as rupture or dissection occur. Compared with validated EP-performed ultrasound of the abdominal aorta, EP-performed focused cardiac ultrasound that includes evaluation of the thoracic aorta is relatively unreported. ⋯ EPs performing focused cardiac ultrasound can visualize regions of the thoracic aorta that may reveal an aneurysm, particularly in the parasternal long axis view.
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Pediatric emergency care · Mar 2014
Comparative StudySeasonal variation of presentation for headache in a pediatric emergency department.
Headache is a common pediatric complaint. Our experience indicated that there was a seasonal variation in children seeking emergency department (ED) care for headache. We hypothesized that visits to the ED would be more common during the school year compared with that during the summer months. ⋯ Visits to the ED for headache were less common in May and June and more common during the fall. This remained true across headache type, age, sex, and racial groups.
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Pediatric emergency care · Mar 2014
Case ReportsSurfactant for acute respiratory distress syndrome caused by near drowning in a newborn.
Near drowning is the term for survival after suffocation caused by submersion in water or another fluid. Pulmonary insufficiency may develop insidiously or suddenly because of near drowning. ⋯ This case report describes a rapid and persistent improvement after 2 doses of surfactant in acute respiratory distress syndrome with severe oxygenation failure caused by near drowning in a newborn.