Articles: emergency-services.
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A new limp or refusal to weight-bear are common symptoms in children presenting to the pediatric emergency department (ED). This poses a diagnostic challenge, particularly among toddlers and nonverbal patients. Point-of-care ultrasound (PoCUS) used by pediatric emergency medicine physicians may detect hip effusion, which dramatically aids diagnostic workup and management. There is limited literature regarding the accuracy of hip PoCUS conducted by pediatric emergency medicine physicians. This study aims to assess the diagnostic performance of pediatric emergency medicine physician-performed PoCUS in identifying hip effusion. ⋯ PoCUS performed by pediatric emergency medicine physicians has reasonably high sensitivity and specificity for diagnosing hip effusion among pediatric patients presenting to the pediatric ED with a limp or leg pain. This practice may potentially expedite both diagnosis and treatment within this patient population.
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Pediatric emergency care · Dec 2024
Utility of a Smart Device Infrared Camera in Localizing Acute Pediatric Long Bone Fractures: A Pilot Study.
Musculoskeletal injuries are one of the top 10 reasons children present to the emergency department (ED). Infrared thermal imaging (IRT) is a noninvasive and nonradiating imaging modality that can detect subtle temperature differences. IRT may be used to detect the presence of musculoskeletal injury. ⋯ This pilot study shows that the use of smart device infrared camera attachments is feasible and has promising results in fracture localization. This could allow for a decrease in radiographs and be particularly useful in resource-limited areas.
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Heart failure (HF) is a common condition prompting presentation to the Emergency Department (ED) and is associated with significant morbidity and mortality. However, there is limited recent large-scale, robust data available on the admission rates, evaluation, and treatment of HF in the ED setting. ⋯ HF represents a common reason for ED presentation, with the majority of patients being admitted. All patients received diuresis in the ED, with the majority receiving intravenous diuresis with furosemide. Approximately one-quarter received nitroglycerin with the sublingual/oral route being most common. These findings can help inform health policy initiatives, including admission decisions and evidence-based medication administration.
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Delayed intracranial hemorrhage (ICH) after head injury in older patients taking anticoagulants has been reported to be as high as 7.2%. Other studies suggest much lower rates. Its incidence and clinical management are controversial, with some recommending observation and repeat head imaging at 24 h. ⋯ The incidence of delayed ICH is very low in older ED head trauma patients on prescribed pre-injury anticoagulants. Our data have important clinical implications for the management of blunt head trauma among older ED patients on anticoagulants.
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The Pulmonary Embolism Rule-Out Criteria (PERC), developed to minimize unnecessary testing in low-risk pulmonary embolism (PE) cases, lacks clear validation in the context of COVID-19. ⋯ The study demonstrates that the sensitivity and negative predictive value of the PERC are comparable in COVID-19 positive and negative patients. Furthermore, the incidence of PE among patients presenting to the emergency department did not significantly differ based on COVID-19 status. While this study highlights the relevance of the PERC in clinical decision-making, caution is advised as the PERC may not always provide reliable results when used as the sole diagnostic test.