Early recognition of airway compromise following a retropharyngeal abscess in the emergency department

2022 ◽  
Vol 26 ◽  
pp. 101231
Author(s):  
Adebayo Da'osta ◽  
Ayokunle Osonuga ◽  
Theodore Howard ◽  
Christopher Johnston ◽  
Adewoyin Osonuga ◽  
...  
Keyword(s):  
Emergency Department ◽  
Early Recognition ◽  
Retropharyngeal Abscess ◽  
Airway Compromise

Asthma

2020 ◽  
Author(s):  
Haitham Nsour ◽  
Anne E. Dixon
Keyword(s):  
Emergency Department ◽  
Inhaled Corticosteroids ◽  
Early Recognition ◽  
Allergic Bronchopulmonary Aspergillosis ◽  
Significant Proportion ◽  
The United States ◽  
Asthma Prevalence ◽  
Public Health Burden ◽  
Asthma Exacerbations ◽  
Oral Corticosteroids

Asthma is one of the most common diseases in developed nations. A pathognomonic feature of asthma is episodic aggravations of the disease; these exacerbations can be life-threatening and contribute to a significant proportion of the public health burden of asthma. In the emergency department, successful management of asthma exacerbations requires early recognition and intervention before they become severe and potentially fatal. This review summarizes the pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes for asthma. Figures show the management of asthma exacerbations in the emergency department and hospital, pooled odds ratio comparing inhaled corticosteroids and oral corticosteroids with oral corticosteroids alone following emergency department discharge, and an asthma discharge plan at the emergency department. Tables list current asthma prevalence among selected demographic groups in the United States, risk factors for fatal asthma exacerbations, differential diagnosis of asthma exacerbations, and dosages of drugs for asthma exacerbations. This review contains 3 figures, 16 tables, and 88 references. Key Words: Asthma, allergic bronchopulmonary aspergillosis, gastroesophageal reflux disease, sinus disease, breathlessness, shortness of breath  

scholarly journals Meningococcemia Presenting as a Myocardial Infarction

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Daniel Lachant ◽  
David Trawick
Keyword(s):  
Myocardial Infarction ◽  
Emergency Department ◽  
Chest Pain ◽  
Cardiogenic Shock ◽  
Neisseria Meningitidis ◽  
Early Recognition ◽  
Myocardial Dysfunction ◽  
Shortness Of Breath ◽  
Gram Negative ◽  
St Elevation

Neisseria meningitidisis an encapsulated gram negative diplococcus that colonizes the nasopharynx and is transmitted by aerosol or secretions with the majority of cases occurring in infants and adolescents. Meningococcemia carries a high mortality which is in part due to myocarditis. Early recognition and prompt use of antibiotics improve morbidity and mortality. We report a 55-year-old male presenting to the emergency department with chest pain, shortness of breath, and electrocardiogram changes suggestive of ST elevation MI who developed cardiogenic shock and multisystem organ failure fromN. meningitidis. We present this case to highlight the unique presentation of meningococcemia, the association with myocardial dysfunction, and the importance of early recognition and prompt use of antibiotics.

Sneezing, Wheezing, Having Trouble Breathing

2020 ◽  
pp. 179-188
Author(s):  
Renee Quarrie
Keyword(s):  
Emergency Department ◽  
Respiratory Distress ◽  
Emergency Management ◽  
Pediatric Patient ◽  
Childhood Asthma ◽  
Early Recognition ◽  
Current Treatment ◽  
Treatment Modalities ◽  
Key Points ◽  
Routine Chest

This chapter deals with one of the most common chronic diseases of childhood—asthma. It reviews the diagnosis of this disease and the acute emergency management of a pediatric patient who presents to the emergency department in respiratory distress from asthma. The current treatment modalities and indications for their use are discussed. Key points include that asthma diagnosis in the pediatric patient is largely clinical; early recognition and intervention are critical for successful management of asthma exacerbations; early administration of corticosteroids is important as it has been shown to reduce the rate of hospitalization; and routine chest radiographs do not play a part in the management of asthma.

scholarly journals Evaluation of prognostic value of MEDS, MEWS, and CURB-65 criteria and sepsis I and sepsis III criteria in patients with community-acquired infection in emergency department

2019 ◽  
Vol 27 (5) ◽  
pp. 277-285
Author(s):  
Maruf Beğenen ◽  
Vahide Aslihan Durak ◽  
Halis Akalın ◽  
Erol Armağan
Keyword(s):  
Emergency Department ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Sofa Score ◽  
Early Recognition ◽  
Scoring Systems ◽  
Similar Efficacy ◽  
Early Mortality ◽  
Systemic Inflammatory Response ◽  
Sepsis Score

Background: Early and effective treatment of patients with sepsis requires early recognition in emergency department and understanding the severity of the disease. Many studies have been conducted for this purpose, and many of scoring systems have been developed that provide early recognition of these patients and show their severity. Objectives: The aim of this study is to evaluate the efficacy of the scoring systems used to determine the mortality of patients with infections admitted in emergency department. Methods: In all, 400 patients who admitted to Uludağ University Hospital Emergency Department were prospectively included in this study. In addition to Systemic Inflammatory Response Syndrome score, Quick SOFA score, Mortality in Emergency Department Sepsis score, Modified Early Warning Score, and Charlson Comorbidity Index score in all patients, CURB-65 score was calculated in the patients diagnosed with pneumonia. It has been aimed to determine the power of these scores’ predictive mortality rates and their superiority to each other. Results: It was found that Mortality in Emergency Department Sepsis score and Quick SOFA score could be used with similar efficacy (respectively p = 0.761 and p = 0.073) in determining early mortality in emergency department (5th and 14th days) and that MEDS score was more effective (p < 0.001) in predicting the 28th-day mortality. While these recommendations were valid in patients diagnosed with pneumonia, it was determined that CURB-65 score could also be used to estimate 5th-, 14th-, and 28th-day mortalities (respectively, for the 5th day, p = 0.894 and p = 0.256; for the 14th day, p = 0.425 and p = 0.098; and for the 28th day, p = 0.095 and p = 0.158). The power of Systemic Inflammatory Response Syndrome score, previously used to identify sepsis, in predicting mortality was detected to be lower. Conclusion: Mortality in Emergency Department Sepsis score and Quick SOFA score could be used with similar efficacy in determining early mortality in emergency department. However, if you want to predict 28th-day mortality rate, it can be better to use Mortality in Emergency Department Sepsis score or CURB-65 (in patients diagnosed with pneumonia).

scholarly journals A Retrospective Review of Patients with Necrotizing Fasciitis Presenting to an Emergency Department in Hong Kong

2002 ◽  
Vol 9 (1) ◽  
pp. 10-17 ◽  
Author(s):  
Fp Sin ◽  
Mc Yuen ◽  
Kw Lam ◽  
Cw Wu ◽  
Wk Tung
Keyword(s):  
Emergency Department ◽  
Necrotizing Fasciitis ◽  
Early Recognition ◽  
High Dose ◽  
Accident And Emergency ◽  
Patients With Diabetes ◽  
Wrong Diagnosis ◽  
Radical Debridement ◽  
Accident And Emergency Department ◽  
Clinical Records

Background Necrotizing fasciitis is a soft tissue gangrenous infection that require early diagnosis, radical debridement and broad-spectrum antibiotics. Aim To review the clinical spectrum and outcome of necrotizing fasciitis in Kwong Wah Hospital during a period of 18 months. Method Cases of necrotizing fasciitis were identified from discharge statistics for the period January 1999 to June 2000. Accident and Emergency Department (AED) notes and clinical records after admission were reviewed for clinical features, predisposing factors, microbiology, histology, treatment and outcome. Results Fifteen cases of necrotizing fasciitis were found but two of them had wrong diagnosis made. Of the thirteen cases, ten were male and three were female. The average age was 61.7 years old. Most of them presented with different combinations of swelling, pain, erythema and fever. They attended the emergency department with an interval of 3.5 days from the onset of symptoms. Risk factors were identified in 64% of patients, with diabetes mellitis (DM) and hypertension (HT) being the most common. Monomicrobial and polymicrobial infections were equally common in our study. Streptococcus pyogene was the most common pathogen. Only two NF (18%) were diagnosed in AED. Six patients were admitted to either surgical or orthopaedic wards and all of them underwent operations within 24 hours although two of them died. Other five patients were managed in medical ward and four of these patients underwent delayed operations but survived whilst one of them died despite of early surgical intervention. Overall mortality was 23%. Conclusions This condition affects a wide age group and have associated morbidities. It is often a fatal disease. Early recognition, high dose antibiotics and surgical debridement are important in its management.

Carbon Monoxide Poisoning: Implications for Patient and Family Care in the Emergency Department

2008 ◽  
Vol 1 (1) ◽  
pp. 46-49 ◽  
Author(s):  
Courtney E. Reinisch
Keyword(s):  
Emergency Department ◽  
Carbon Monoxide ◽  
Practice Nurse ◽  
Early Recognition ◽  
Carbon Monoxide Poisoning ◽  
Family Care ◽  
The United States ◽  
Emergency Department Visits ◽  
Advanced Practice ◽  
Co Poisoning

Carbon monoxide (CO) is a colorless, odorless gas that can produce a constellation of noxious symptoms and potentially death when it reaches certain levels. Exposure to CO can be intentional (suicidal) or unintentional (accidental). CO poisoning is responsible for up to 40,000 to 50,000 emergency department visits and 5,000 to 6,000 deaths per year, making it one of the leading causes of poisoning death in the United States. When patients present to the emergency department with a constellation of symptoms, the advanced practice nurse should include environmental exposure in the differential diagnosis. This is especially important when family members present with similar complaints, such as headache or euphoria. Early recognition of CO poisoning is vital to identify individuals in need of prompt treatment and to prevent harmful and potential deadly exposure to others. Since patients often present with constitutional symptoms, including headache (most common), malaise, nausea, and dizziness, providers need to be cautious not to misdiagnose patients as having acute viral syndromes where CO poisoning could be the cause. Vigilance is needed during the winter months in cold climates when unintended poisoning is most common.

scholarly journals Frontal Mucocele following Previous Facial Trauma with Hardware Reconstruction

2016 ◽  
Vol 2016 ◽  
pp. 1-2
Author(s):  
Megan EuDaly ◽  
Chadd K. Kraus
Keyword(s):  
Emergency Department ◽  
Motor Vehicle ◽  
Bone Fractures ◽  
Early Recognition ◽  
Interdisciplinary Approach ◽  
Motor Vehicle Crash ◽  
Facial Trauma ◽  
Facial Bone ◽  
Vehicle Crash ◽  
Frontal Sinuses

Mucoceles are cysts that can develop after facial bone fractures, especially those involving the frontal sinuses. Despite being rare, mucoceles can result in serious delayed sequelae. We present a case of a frontal mucocele that developed two years after extensive facial trauma following a motor vehicle crash (MVC) and review the emergency department (ED) evaluation and treatment of mucocele. Early recognition, appropriate imaging, and an interdisciplinary approach are essential for managing these rare sequelae of facial trauma.

Traumatic Retropharyngeal Abscess of Insidious Onset -a case report and literature review (Preprint)

2018 ◽  
Author(s):  
Shuaib Kayode Aremu
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Retropharyngeal Abscess ◽  
Airway Compromise ◽  
Neck Trauma ◽  
Anterior Neck ◽  
Insidious Onset ◽  
Life Threatening

UNSTRUCTURED Retropharyngeal abscess is an abscess of the deep spaces in the neck which if not treated urgently can be life-threatening as a result of airway compromise. It is important to detect and treat very early. It may arise in pediatrics from direct neck trauma which is not very common and fishbone impaction. Direct anterior neck trauma resulting in insidious retropharyngeal abscess has not been widely reported.

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