Emergency department pain

Esophageal foreign bodies (FBs) are one of the common emergencies in otolaryngology, usually involving objects accidentally swallowed, and generally do not result in severe respiratory distress. This article presents an extremely rare case of an esophageal FB, where a 44-year-old man accidentally ingested an entire mantis shrimp while sucking its flavored tail, and was sent to the emergency department for severe throat pain and difficulty breathing. We immediately performed a laryngoscopy that revealed the FB that obstructs the entrance of the esophagus, obstructing the glottis due to the long shape of the shrimp...

BACKGROUND: Nonspecific discharge diagnoses after acute hospital courses represent patients discharged without an established cause of their complaints. These patients should have a low risk of adverse outcomes as serious conditions should have been ruled out. We aimed to investigate the mortality and readmissions following nonspecific discharge diagnoses compared to disease-specific diagnoses and assessed different nonspecific subgroups. METHODS: Register-based cohort study including hospital courses beginning in emergency departments across 3 regions of Denmark during March 2019-February 2020...

BACKGROUND: Non-bacterial thrombotic endocarditis (NBTE) is a rare condition marked by sterile vegetations on cardiac valves, often linked to rheumatologic diseases, autoimmune disorders, and advanced solid malignancies. An early diagnosis and treatment of the associated clinical condition are mandatory, although they do not usually eliminate valvular vegetations, making anticoagulation essential to prevent embolic events. Despite variability, the prognosis of NBTE is usually unfavorable due to recurrent embolic events and the severity of the primary condition, typically advanced cancer...

BACKGROUND: Distal radius fractures are a common presentation in emergency departments. Synthesis of qualitative research of treatment, care and rehabilitation this fracture presents from the patient perspective could improve clinical practice and care. The purpose of this systematic review was to synthesize the qualitative literature on patient experiences after sustaining a distal radius fracture. METHODS: We searched Embase, MEDLINE, CINAHL, Psycinfo and CINAHL to identify qualitative studies published from database conception to May 2023...

Ketamine has been in use since its development as a dissociative anesthetic in the 1960s, but it was largely confined to the operating theater or austere environments until used by emergency physicians to facilitate painful procedures in children. As the unique effects of ketamine across its dose-response curve were understood, new applications emerged. In low doses, ketamine has found an important role alongside or instead of opioids in the management of severe pain, and methods to slow its absorption allow higher, more effective doses while attenuating psychoperceptual effects...

BACKGROUND: For the majority of patients with atrial fibrillation (AF), disease management has improved in recent years. However, there are still populations underrepresented or excluded in current registries and randomized controlled trials. HERA-FIB (Heidelberg Registry of Atrial Fibrillation) was planned to assess real-world evidence for the prevalence, demographic characteristics and management of patients with the diagnosis of AF presenting consecutively to a chest pain unit. METHODS AND RESULTS: HERA-FIB is a retrospective, observational, single-center study on patients with a diagnosis of AF presenting to a chest pain unit from June 2009 until March 2020...

Penetrating aortic ulcer (PAU) is a component of acute aortic syndromes (AASs), encompassing a range of potentially life-threatening aortic conditions such as dissection, intramural hematoma (IMH), and PAU itself. Ruptured PAU constitutes an emergency requiring surgical intervention. Here, we present a case involving a 47-year-old male patient admitted to our emergency department due to severe abdominal pain, malaise, and tenderness of the abdominal wall, which commenced abruptly several hours prior. An emergency CT scan revealed a large pseudoaneurysm of the infrarenal abdominal aorta, which was found with moderate atherosclerosis and no evidence of other dilated or aneurysmal segments...

INTRODUCTION: Alleviating pain and anxiety of patients during procedures is an essential skill for an Emergency Physician (EP). Several sedatives and dissociative agents are used for PSA (Procedural Sedation and Analgesia). In this study, we aimed to compare two drugs that is, ketamine and fentanyl for procedural sedation in adults with isolated limb injuries in the Emergency Department (ED). MATERIALS AND METHODS: In this prospective, randomised controlled interventional trial, patients aged between 18 to 65 years with isolated extremity injury requiring PSA in the ED were recruited...

Currently, clinically available coronary CT angiography (CCTA) derived fractional flow reserve (CT-FFR) is time-consuming and complex. We propose a novel artificial intelligence-based fully-automated, on-site CT-FFR technology, which combines the automated coronary plaque segmentation and luminal extraction model with reduced order 3 dimentional (3D) computational fluid dynamics. A total of 463 consecutive patients with 600 vessels from the updated China CT-FFR study in Cohort 1 undergoing both CCTA and invasive fractional flow reserve (FFR) within 90 d were collected for diagnostic performance evaluation...

BACKGROUND: Coronary functional testing to formally diagnose coronary microvascular dysfunction (CMD) reduces cardiovascular events and alleviates angina. This study aims to investigate the extensive and complex journey that patients with CMD undergo, from the onset of chest pain to eventual diagnosis. METHODS: Data from the Coronary Microvascular Disease Registry (CMDR) were analyzed, including information on the date of first documentation of chest pain, number of non-invasive and invasive tests the patient underwent, emergency department visits, and hospitalizations...

INTRODUCTION: Pain affects all children, and in hospitals across North America, this pain is often undertreated. Children who visit the emergency department (ED) experience similar undertreatment, and they will often experience a painful procedure as part of their diagnostic journey. Further, children and their caregivers who experience social injustices through marginalization are more likely to experience healthcare disparities in their pain management. Still, most of our knowledge about children's pain management comes from research focused on well-educated, white children and caregivers from a middle- or upper-class background...

BACKGROUND: The objective of this study was to assess the efficacy of Kinesio Tape (KT) application as a complementary treatment for patients with acute ankle sprain (AAS) in an Emergency Department (ED) setting. METHODS: A prospective, quasi-randomized controlled trial was conducted in a tertiary care ED. Adult patients diagnosed with isolated, stable Grade 1 and Grade 2 AAS were included. Patients were divided into two groups: the KT group, where KT was applied in addition to conventional treatment, and the control group, receiving only conventional treatment...

In this case report, we present an unusual complication linked to a hydrogel explant in a 72-year-old male presenting to the emergency department with persistent left eye pain, redness, and discharge for one month. The patient had a history of retinal detachment in 1989, which was managed with scleral buckle surgery and gas injection. Initial examination revealed an extruding scleral buckle in the superior temporal region, along with signs of an infection. CT scans revealed a 1.9 × 1.2 × 3.8 cm abscess accompanied by preseptal cellulitis...

OBJECTIVES: Our research aimed to examine the characteristics of palliative oncology patients hospitalised through an emergency to look for the symptom profile, characteristics of dyselectrolytemia and blood investigations, and possible associations with mortality. MATERIALS AND METHODS: After institutional review board approval, a retrospective, observational study of patients hospitalised in our tertiary care specialty oncology hospital was undertaken. Records of hospitalised cancer patients admitted from the emergency department under palliative care from January 2019 to October 2021 were examined...

INTRODUCTION: Heterotopic pregnancy is a rare form of pregnancy, defined by the coexistence of an ectopic and an intrauterine pregnancy. The diagnosis of heterotopic pregnancy remains one of the greatest challenges of the gynecological-obstetrical emergencies. CASE PRESENTATION: We report a rare case of spontaneous heterotopic pregnancy of a 28-year-old woman, diagnosed with a heterotopic pregnancy by ultrasound and treated by laparotomy in emergency obstetrical department of Ibn Rochd University Hospital of Casablanca...

INTRODUCTION: Gastric outlet obstruction presents with a range of symptoms which include abdominal pain, early satiety, weight loss and vomiting caused obstruction secondary to tumors from outside the gastrointestinal tract or due to motility disorders. Bladder cancer is rarely associated with Gastric outlet obstruction. It usually presents with painless hematuria and urinary symptoms. Squamous cell carcinoma is a subtype of bladder malignancies that tends to present at a later stage and is associated with poorer prognosis in terms of metastasis and survival...

Introduction . Strongyloides stercoralis causes a helminthic infection that occurs via penetration of the skin with migration to the bloodstream, tracheobronchial tree, and gastrointestinal system. Pulmonary manifestations are rare and are typically seen in immunosuppressed patients who have Strongyloides stercoralis hyperinfection syndrome. Eosinophilic pleural effusions are rare in strongyloidiasis and only cited in a few case reports. Case Presentation . A 45-year-old male with a past medical history of diabetes mellitus, alcoholic cirrhosis, and end-stage renal disease presented to the emergency department with abdominal pain and dyspnea...

OBJECTIVE: This study aimed to assess and determine the presentation, risk factors, and outcomes of pediatric patients who were admitted for cardiac-related chest pain. BACKGROUND: Although chest pain is common in children, most cases are due to non-cardiac etiology. The risk of misdiagnosis and the pressure of potentially adverse outcomes can lead to unnecessary diagnostic testing and overall poorer patient experiences. Additionally, this can lead to a depletion of resources that could be better allocated towards patients who are truly suffering from cardiac-related pathology...

PURPOSE/AIMS: To explore cancer patients' perceptions of factors that influence hospital readmissions. DESIGN: A cross-sectional, prospective design was employed utilizing a 1-time survey and brief interviews to measure patients' perceptions and unplanned hospital admissions. METHODS AND VARIABLES: The principal investigator collected data from medical record review, the Hospital Admission Survey, and interviews to measure patient characteristics and perceptions of influencing factors that contributed to an unplanned hospital admission upon admission...

BACKGROUND: Literature comparing different alternatives for pain control in the immediate postoperative period of pediatric acute appendicitis (PAA) is scarce. MATERIALS AND METHODS: We prospectively compared the analgesic and emetogenic profile of intravenous ibuprofen and metamizole in the immediate postoperative period of PAA. For this purpose, we used a sample of patients operated on in 2021 in our center. Participants were recruited on arrival at the Emergency Department and histopathological confirmation of the diagnosis was obtained in all of them...