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"Trauma" AND "Emergency Department"

Alexander E St John, Jason C Newton, Erika J Martin, Bassem M Mohammed, Daniel Contaifer, Jessica L Saunders, Gretchen M Brophy, Bruce D Spiess, Kevin R Ward, Donald F Brophy, José A López, Nathan J White
BACKGROUND: Trauma-induced coagulopathy (TIC) is a common and deadly bleeding disorder. Platelet dysfunction is present during TIC, but its mechanisms remain unclear. Platelets are currently thought to become "exhausted", a state in which they have released their granule contents and can no longer aggregate or contract. METHODS: This prospective observational cohort study tested the hypothesis that platelet exhaustion is present during TIC and characterized the early time course of platelet dysfunction...
February 19, 2019: Journal of Thrombosis and Haemostasis: JTH
Kalaiarasi Raja, Sithananda-Kumar Venkatesan, Sivaraman Ganesan, Arun Alexander
Introduction:  Penetration injury to the neck constitutes 5-10% of all trauma cases. Penetration of a foreign body into the trachea with subsequent impaction into the tracheoesophageal party wall is extremely rare. We present a patient with an unusual penetrating injury of the neck caused by a metallic foreign body embedded into the tracheoesophageal party wall, and its management. Case Report: A 35-year-old male presented to the emergency department with a history of accidental penetrating injury on his neck, with severe pain and bleeding from the wound entry site...
January 2019: Iranian Journal of Otorhinolaryngology
Ithan D Peltan, Samuel M Brown, Joseph R Bledsoe, Jeffrey Sorensen, Matthew H Samore, Todd L Allen, Catherine L Hough
BACKGROUND: The impact of antibiotic timing on sepsis outcomes remains controversial due to conflicting results in prior studies. This study investigated the association of door-to-antibiotic time with long-term mortality in emergency department (ED) patients with sepsis. METHODS: This retrospective cohort study included non-trauma adult ED patients with clinical sepsis admitted to four hospitals from 2013 to 2017. Only patients' first eligible encounter was included...
February 16, 2019: Chest
Corrado Tagliati, Giulio Argalia, Gian Marco Giuseppetti
AIMS: To assess contrast enhanced ultrasound (CEUS) performance in the prediction of non-operatively managed blunt spleen injuries requiring only observation and monitoring during follow-up and to evaluate if CEUS accuracy was higher than conventional ultrasound (US) in this field. MATERIAL AND METHODS: In 112 hemodynamic stable blunt spleen trauma patients, CEUS was performed for follow-up after computed tomography evaluation in the emergency department. CEUS and US performance were assessed considering as true negative cases patients that had not underwent interventional or surgical treatment during follow-up and were assessed as negative for splenic complications respectively by CEUS or US examinations...
February 17, 2019: Medical Ultrasonography
Ashley D Palmer, Jodie Murphy-Oikonen
Often referred to as miscarriage, Early Pregnancy Loss (EPL) is the spontaneous death of a fetus experienced within the first 20 weeks of gestation and is the most common complication in pregnancy. Symptoms of an impending EPL are routinely managed in the Emergency Department (ED). EPL can have a substantial impact on women, potentially leading to psychological and emotional health issues and risks to future pregnancies. Despite the high prevalence of EPL, many women suffer in silence due to the common societal belief that EPL are insignificant...
February 18, 2019: Social Work in Health Care
Fernando Brandão Andrade-Silva, Renan Lyuji Takemura, Renato Tavares Bellato, Marcos de Camargo Leonhardt, Kodi Edson Kojima, Jorge Dos Santos Silva
Objectives: To describe the clinical utility of the Manchester triage scale adapted for orthopedic emergency departments and to evaluate its validity in identifying patients with the need for hospital care and its reliability when reproduced by different professionals. Methods: Five triage flowcharts were developed based on the Manchester scale for the following orthopedic disorders: traumatic injuries, joint pain, vertebral pain, postoperative disorders, and musculoskeletal infections...
January 2019: Acta Ortopedica Brasileira
Michael Mohseni, Theodore Szymanski
BACKGROUND Auricular hematomas are well-known among wrestlers and other contact sports participants, but spontaneous auricular hematomas are rare. The differential diagnosis for acute spontaneous auricular swelling is limited. In addition to infectious causes, antecedent trauma, and bleeding complications, angioedema should also be considered. Although rare, acute non-traumatic auricular hematomas need urgent surgical intervention if they are large. CASE REPORT A 37-year-old male presented to the Emergency Department (ED) with the complaint of acute pain and swelling to his left ear 30 minutes prior to arrival...
February 16, 2019: American Journal of Case Reports
Dayron Rodriguez, Kai Li, Michel Apoj, Ricardo Munarriz
INTRODUCTION: The epidemiology of penile fractures in the emergency setting is not well described. AIM: Examine the incidence, evaluation, management, risk factors predicting surgical repair or hospital transfer, and use of financial resources in patients presenting with penile fractures to the emergency departments (ED) nationwide in the Unites States. METHODS: ED visits with a primary diagnosis of penile fractures (International Classification of Diseases, Ninth Edition codes) between 2010-2014 were abstracted from the Nationwide Emergency Department Sample...
February 2019: Journal of Sexual Medicine
Philip A Sosa, Phillip Matar, Isabel T Gross
BACKGROUND: Extracranial carotid aneurysms in children are extremely rare but carry a high mortality and morbidity. For pediatric patients, they are often complications of pharyngeal infections and surgical trauma but can also arise from congenital and inflammatory diseases. They have a wide range of presentation from an asymptomatic mass to a rapidly fatal hemorrhage. CASE: A 10-year-old boy presented to the emergency department with complaints of a neck mass and residual cough from a recent upper respiratory infection...
February 13, 2019: Pediatric Emergency Care
Wei-Ting Wu, Hsiu-Yung Pan, Kuan-Han Wu, Yi-Syun Huang, Chien-Hung Wu, Fu-Jen Cheng
BACKGROUND: Subarachnoid hemorrhage (SAH) is a serious cause of headaches. The Ottawa subarachnoid hemorrhage (OSAH) rule helps identify SAH in patients with acute nontraumatic headache with high sensitivity, but provides limited information for identifying other intracranial pathology (ICP). OBJECTIVES: To assess the performance of the OSAH rule in emergency department (ED) headache patients and evaluate its impact on the diagnosis of intracranial hemorrhage (ICH) and other ICP...
February 7, 2019: American Journal of Emergency Medicine
Michael Bernhard, Sönke Nils Bax, Thomas Hartwig, Maryam Yahiaoui-Doktor, Sirak Petros, Sven Bercker, Alexandra Ramshorn-Zimmer, André Gries
BACKGROUND: Emergency airway management (AM) is a major key for successful resuscitation of critically ill non-traumatic (CINT) patients. Details of the AM of these patients in German emergency departments (ED) are unknown. This observational study describes epidemiology, airway techniques, success rates and complications of AM in CINT ED patients in the resuscitation room (RR). METHODS: Data was collected prospectively on adult CINT patients admitted to the RR of a single German university ED September 2014 to August 2015...
February 14, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Helen Fagerlind, Lara Harvey, Stefan Candefjord, Johan Davidsson, Julie Brown
BACKGROUND: Prehospital undertriage occurs when the required level of care for a major trauma patient is underestimated and the patient is transported to a lower-level emergency care facility. One possible reason is that the pattern of injuries exceeding a certain severity threshold is not easily recognizable in the field. The present study aims to examine whether the injury patterns of major road trauma patients are associated with trauma centre transport decisions in Sweden, controlling for the distance from the crash to the nearest trauma centre and other patient characteristics...
February 13, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
M Pape, G F Giannakópoulos, W P Zuidema, E S M de Lange-Klerk, E J Toor, M J R Edwards, M H J Verhofstad, T N Tromp, E M M van Lieshout, F W Bloemers, L M G Geeraedts
INTRODUCTION: Little evidence suggest that female gender is associated with a lower risk of mortality in severely injured patients, especially in premenopausal women. Previous clinical studies have shown contradictory results regarding protective effects of gender on outcome after severe trauma. The objective of this study was to determine the association between gender and outcome (mortality and Intensive Care Unit (ICU) admission) among severely injured patients in the Netherlands. METHODS: A retrospective multicentre study was performed including all polytrauma patients (Injury Severity Score (ISS) ≥16) admitted to the ED of three level 1 trauma centres, between January 1st, 2006 and December 31st, 2014...
February 13, 2019: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Gen Nakamura, Muneaki Abe, Hozumi Kumano
Acute compartment syndrome of the forearm secondary to hematoma without direct trauma has been reported rarely. We report a case of acute compartment syndrome of the forearm following a hematoma after playing golf. A 55-year-old man felt pain in his left forearm while playing golf that gradually worsened. He could not continue to play and visited the emergency department of our hospital. The radial side of his left forearm was markedly swollen on presentation, and he suffered severe pain that worsened with ulnar flexion of the wrist; no paralysis or hypesthesia was observed...
March 2019: Journal of Hand Surgery Asian-Pacific Volume
Alessandro Aprato, Alessandro Casiraghi, Giovanni Pesenti, Marco Bechis, Alessandro Samuelly, Claudio Galante, Dario Capitani, Alessandro Massè
BACKGROUND: In the last 10 years, the rate of femur fractures treated within 48 h from trauma has been introduced as a performance index for hospital management in Italy. Literature showed a significant indirect correlation between early treatment and mortality/comorbidity. The aims of early treatment are pain management and reduction of time to ambulation. The purpose of this study is to evaluate whether early treatment has reduced time to ambulation in femur fracture. MATERIALS AND METHODS: All patients admitted to two level I trauma centers with proximal femoral fracture between 1/1/2017 and 31/12/2017 were included in this study...
February 13, 2019: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
Jaclyn M Stoffel, Regan A Baum, Adam J Dugan, Abby M Bailey
Purpose: The purpose of this survey-based research project is to identify factors, including prior training, institution demographics, and pharmacist prioritization of services that may impact variability in practice among emergency medicine (EM) pharmacists. Methods: An electronic survey was available for 6 weeks. Participants were contacted through professional membership directories. Survey questions addressed EM pharmacist training and institution demographics...
February 8, 2019: American Journal of Health-system Pharmacy: AJHP
David Leo Jolley, Bryan Upham, Lynne Fullerton, Robert D Annett
OBJECTIVE: The objective of this study was to evaluate the effect of the Pediatric Emergency Care Applied Research Network (PECARN) blunt head trauma guidelines and implementation of urgent neurology follow-up (UNF) appointments on an observed decline in head computed tomography (CT) use for pediatric emergency department (PED) patients presenting with headache, seizure, and trauma. METHODS: Patients ages 0 to 18 years presenting to and discharged from an urban tertiary care PED with chief complaint of trauma, headache, and seizure between 2007 and 2013 were retrospectively included...
February 8, 2019: Pediatric Emergency Care
James E McKinley, Allen Perkins
Family physicians may be the first point of contact for adults with new-onset seizure. There are many etiologies of seizures in adults. Etiologies of provoked seizures include temporary metabolic disturbances, central nervous system infections, cerebrovascular disease, drug withdrawal, and traumatic brain injury. Stable or evolving cerebral conditions can cause unprovoked seizures. Nonorganic etiologies include nonepileptiform convulsions, such as a pseudoseizure, which are psychogenic. In the emergency department setting, computed tomography scan of the head should be considered for all patients with new-onset seizure...
February 2019: FP Essentials
C Joubert, S Gazzola, A Sellier, A Dagain
Acute spinal cord compression usually results from trauma, infection, or cancer. Spinal subdural hematoma is an uncommon cause of spinal cord compression that occurs after spine trauma or spinal invasive procedure, especially in context of coagulopathy. In the following reported case, an 82-year-old woman with a history of rapidly progressive paraparesis after a sudden middle back pain, with no previous trauma or coagulopathy, due to an acute spontaneous spinal subdural hematoma. In fact, the main difficulty was to determine, in an emergency situation, the right strategy to identify both the lesion and its cause to adapt therapeutics...
February 8, 2019: Neuro-Chirurgie
Brittany M Stopa, Stefano Amoroso, Luca Ronfani, Elena Neri, Egidio Barbi, Lois K Lee
BACKGROUND: Pediatric head trauma management varies between emergency departments globally. Here we aim to compare the pediatric minor head trauma management between a US and Italian hospital. METHODS: We conducted a retrospective chart review of children 0-18 years old presenting after minor head trauma (Glasgow Coma Scale 14-15) from two emergency departments, in Boston, Massachusetts, United States and Trieste, Italy, between January and December 2013. Frequencies of demographic, clinical, and management characteristic were calculated...
February 11, 2019: Italian Journal of Pediatrics
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