Articles: emergency-department.
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Pediatric emergency care · Nov 2013
Case ReportsThyrotoxicosis after a massive levothyroxine ingestion in a 3-year-old patient.
Most children with exploratory levothyroxine ingestions remain asymptomatic or suffer only minor effects, and most patients can be managed in the home or with supportive care in the hospital. We present a case of a 3-year-old girl who was found after a witnessed massive ingestion of levothyroxine. The patient was initially seen in an emergency department and discharged in stable condition, only to return 4 days after ingestion with thyrotoxicosis, hypertension, tachycardia, 24 hours of persistent vomiting, and clinical and laboratory evidence of dehydration. ⋯ The patient was followed up until 2 months after ingestion and remained asymptomatic. Although most exploratory levothyroxine ingestions suffer little to no clinical effects, serious symptoms can occur. Because serious symptoms can occur in a delayed fashion, it is important for clinicians to give proper anticipatory guidance regarding home symptom monitoring, follow-up, and reasons to return to the emergency department when patients present for medical evaluation.
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The National Health Service (NHS) depends on a highly skilled workforce. Anything threatening the well-being of that workforce threatens the delivery of healthcare. Violence and aggression directed towards healthcare professionals is a longstanding problem within the NHS, and is particularly acute in the Emergency Department (ED). This study examined ED staff perceptions and experiences of violent behaviour directed towards them within the ED. ⋯ This study adds to current evidence regarding how staff perceive and experience violence in the ED. Given the variation in reporting behaviour, national figures on violence within the NHS are likely to be underestimated. More research is needed to understand the true prevalence of violence occurring in the ED.
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(1) Determine the difference in pre-test and post-test knowledge scores for attendees of a train-the-trainer workshop and (2) determine the number of attendees who disseminated the content within 6 months of attending the workshop. ⋯ A train-the-trainer workshop specifically designed for emergency physicians and nurses that discussed the broad spectrum of SCD was well attended, and 6 months later, 99 additional providers received training.