Articles: emergency-services.
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Case Reports
Point-of-Care Ultrasound Diagnosis of Pyocele: A Rare Complication of Testicular Infection.
Epididymo-orchitis is one of the common causes of acute scrotal pain that requires an accurate diagnosis as delayed management can result in complications such as pyocele, abscess, or testicular infarction. Point-of-care ultrasound (PoCUS) has emerged as a valuable diagnostic tool in the management of testicular emergencies in the emergency department (ED) including testicular infections CASE REPORT: Here we report a case of an elderly man who presented to the ED with a complaint of right-sided testicular pain and swelling. ⋯ WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case underscores the important role of PoCUS in the timely and accurate diagnosis of pyocele. The prompt identification of pyocele enabled early referral to urology services, highlighting the significance of integrating PoCUS into the management of testicular emergencies in the ED.
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Observational Study
Door-in-Door-Out Times at Referring Hospitals and Outcomes of Hemorrhagic Stroke.
Interhospital transfer is often required in the care of patients with hemorrhagic stroke. Guidelines recommend a door-in-door-out (DIDO) time of ≤120 minutes at the transferring emergency department (ED); however, it is unknown whether DIDO times are related to clinical outcomes of hemorrhagic stroke. ⋯ These findings suggest that EDs currently expedite the transfer of the sickest patients; however, prospective studies and more granular data are needed to understand the impact of early treatment and timing of transfer for patients with hemorrhagic stroke.
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Emerg Med Australas · Feb 2025
Multicenter Study Observational StudyHospitalisations for non-specific low back pain in people presenting to South Australian public hospital emergency departments.
The present study sought to investigate predictors of hospitalisation in adults diagnosed with non-specific low back pain (LBP) and/or sciatica from an ED. ⋯ Certain patient characteristics and ED clinical activity are associated with hospitalisations for LBP. Understanding these factors will better inform the design and delivery of appropriate high-quality care.
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Pediatric emergency care · Feb 2025
ReviewCurrent Evidence on the Care of Young Infants With Hypothermia in the Emergency Department.
The presence of hypothermia among young infants in the emergency department may be a sign of serious or invasive bacterial infections, or invasive herpes simplex viral infection. However, hypothermia may also occur due to a variety of other infectious and noninfectious conditions or environmental exposure. In some settings, hypothermia may represent a protective, energy-conserving response to illness. ⋯ Risk factors for serious bacterial infections in infants with hypothermia, as identified in single-center and multicenter retrospective studies, include lower temperatures, older age, and abnormalities in blood and urine testing. Given the absence of clear guidelines, management of infants with hypothermia relies heavily on clinician judgment and shared decision making, guided by individual patient assessments and risk factors. This review article summarizes existing evidence and identifies gaps in the management of infants (<90 days) with hypothermia in the emergency department.
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Multicenter Study
The effects of the 2022 computed tomography IV contrast shortage on the emergency department diagnosis of abdominal pathology.
A COVID-19 lockdown in China resulted in a global disruption in IV contrast media production, which resulted in a hospital system advisory limiting contrast studies. The purpose of this study was to describe the effects of the IV contrast shortage on the ED diagnosis of emergent abdominopelvic pathology. ⋯ We did not identify differences in diagnoses during the contrast shortage period compared to the control period, and did not identify any missed important diagnoses as a consequence of the IV contrast shortage.