JEM reports最新文献_第2页

Bilateral true vocal fold avulsion following trampoline accident: A case report

JEM reports Pub Date : 2025-01-27 DOI: 10.1016/j.jemrpt.2025.100146

Allison Epstein , Alexandra Welschmeyer , Temitope Adeyeni , Jamil Hayden , Matthew Gropler , Jay Shah , Nelson Scott Howard

{"title":"Bilateral true vocal fold avulsion following trampoline accident: A case report","authors":"Allison Epstein , Alexandra Welschmeyer , Temitope Adeyeni , Jamil Hayden , Matthew Gropler , Jay Shah , Nelson Scott Howard","doi":"10.1016/j.jemrpt.2025.100146","DOIUrl":"10.1016/j.jemrpt.2025.100146","url":null,"abstract":"<div><h3>Background</h3><div>Vocal cord avulsion is a rare and potentially devastating injury which may result from blunt laryngotracheal trauma. While there are cases of unilateral vocal cord avulsion, we present a pediatric patient with bilateral vocal cord avulsion from blunt trauma to the anterior neck following a trampoline accident.</div></div><div><h3>Case report</h3><div>This 10-year-old female presented with dysphonia and dysphagia and was found to have bilateral vocal cord avulsion effecting the superior vocal fold with a noticeable height mismatch and exposed cartilage seen only on diagnostic direct laryngoscopy, corresponding to a Schaeffer Grade 3 laryngeal injury. Distal chip laryngoscopy was not as useful in providing a comprehensive examination of the patient due to muscle tension with arytenoid prolapse. Primary endoscopic repair was performed with subsequent improved vocal cord position, voice quality, and tolerance of oral intake.</div></div><div><h3>Why should an emergency physician be aware of this?</h3><div>Laryngeal trauma in children is rare, and early detection is critical to optimize long term outcomes. To date, no universal protocol for diagnosis and management of these injuries in the pediatric population exists. A low index of suspicion of endolaryngeal injury must be maintained for children with these injuries given their smaller airway diameter and increased propensity to develop acute airway compromise in the absence of obvious warning signs or symptoms. We highlight our endoscopic repair technique and excellent postoperative course with improvements in voice, swallow, and overall quality of life.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"4 1","pages":"Article 100146"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Unveiling Wunderlich syndrome: Diagnosis and management of a rare spontaneous renal hematoma

JEM reports Pub Date : 2025-01-27 DOI: 10.1016/j.jemrpt.2025.100144

Rebecca Merrill , Pete Jordanides , Jessica Krizo , Erin L. Simon

{"title":"Unveiling Wunderlich syndrome: Diagnosis and management of a rare spontaneous renal hematoma","authors":"Rebecca Merrill , Pete Jordanides , Jessica Krizo , Erin L. Simon","doi":"10.1016/j.jemrpt.2025.100144","DOIUrl":"10.1016/j.jemrpt.2025.100144","url":null,"abstract":"<div><h3>Background</h3><div>Wunderlich syndrome (WS) is a rare condition that is described as an atraumatic, spontaneous renal hemorrhage in the perirenal space. Symptoms typically present as nondescript flank pain, but a flank mass and hypovolemic shock are also possible. Computed tomography (CT) imaging with intravenous contrast should be the modality of choice to diagnose WS, with recent studies highlighting the efficacy of transcatheter arterial embolization (TAE) as the preferred treatment over surgery. WS is often secondary to conditions such as renal neoplasms, vascular diseases, and infections, necessitating adequate follow up to determine the etiology.</div></div><div><h3>Case report</h3><div>We present the case of a 79-year-old woman presenting to the emergency department (ED) with left flank pain. Computed tomography with angiography revealed a large left renal subcapsular hematoma with perinephric and retroperitoneal extension with active extravasation, characteristic of Wunderlich syndrome. The patient was treated emergently with transcatheter arterial embolization of the lower polar branch of her left renal artery. In the ED, WS can present with a variety of non-specific symptoms, making the diagnosis challenging for emergency physicians.</div></div><div><h3>Why should an emergency physician be aware of this?</h3><div>Wunderlich syndrome is a rare, sudden, and life-threatening emergency that requires prompt diagnosis, as the hematoma can spread to the perinephric space leading to massive internal hemorrhage. Causes and presenting symptoms are variable, with flank pain being a common symptom. CT or MRI imaging is necessary for diagnosis, and embolization is often the treatment of choice to avoid further complications.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"4 1","pages":"Article 100144"},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hypoglycaemia and monitoring practices following insulin-dextrose therapy for hyperkalaemia

JEM reports Pub Date : 2025-01-25 DOI: 10.1016/j.jemrpt.2025.100142

Samuel Ford , Julian Williams , Ian Coombes , Adam La Caze

{"title":"Hypoglycaemia and monitoring practices following insulin-dextrose therapy for hyperkalaemia","authors":"Samuel Ford , Julian Williams , Ian Coombes , Adam La Caze","doi":"10.1016/j.jemrpt.2025.100142","DOIUrl":"10.1016/j.jemrpt.2025.100142","url":null,"abstract":"<div><h3>Background</h3><div>Hypoglycaemia is commonly encountered following insulin-dextrose therapy (IDT) for hyperkalaemia. This retrospective study aimed to assess the local incidence of hypoglycaemia following IDT for hyperkalaemia in the Emergency Department (ED).</div></div><div><h3>Objectives</h3><div>Describe the local incidence of hypoglycaemia and BGL monitoring practices following IDT for hyperkalaemia in the ED.</div></div><div><h3>Methods</h3><div>Adult patients with hyperkalaemia (>5.5 mmol/L) who received IDT in a large metropolitan ED were included. The primary outcome was the incidence of hypoglycaemia, defined as a BGL less than 70 mg/dL (3.9 mmol/L), within 5 h post-administration. Secondary outcomes included hypoglycaemia severity, time to hypoglycaemia, risk factors for hypoglycaemia, blood glucose and potassium monitoring. Data collection spanned January 1, 2019 to May 1, 2020.</div></div><div><h3>Results</h3><div>Among 90 patients, 51 % were receiving chronic renal replacement therapies and the incidence of hypoglycaemia and severe hypoglycaemia was 30 % and 6.7 % respectively. Risk factors for hypoglycaemia were lower pre-treatment blood glucose (p=<0.001), absence of diabetes (p=<0.001) and not being prescribed insulin prior to presentation (p = 0.0026). Approximately 50 % of patients received ≤2 blood glucose measurements within 5 h post IDT. Only 44 % of patients had a potassium sample taken in the 1st hour post IDT and 24 % in hour 3.</div></div><div><h3>Conclusions</h3><div>This study demonstrates a higher incidence of hypoglycaemia post-IDT for hyperkalaemia than reported in the general population and estimates the incidence of severe hypoglycaemia in an Australian population. Monitoring of both blood glucose levels (BGL) and potassium was suboptimal. Strategies to improve BGL monitoring and prospective studies to define the optimal dose of insulin-glucose for hyperkalaemia are needed.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"4 1","pages":"Article 100142"},"PeriodicalIF":0.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143157424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Patient acceptance of emergency department-initiated buprenorphine and reasons for declining

JEM reports Pub Date : 2025-01-18 DOI: 10.1016/j.jemrpt.2025.100141

Lindsey K. Jennings , Allison Smith , Angela Moreland , Ralph Ward , Sarah Gainey , Suzanne Lane , Olivia Holodnik , Katherine Scarpino , Karen Hartwell , Louise Haynes , Kathleen T. Brady , Kelly Barth

{"title":"Patient acceptance of emergency department-initiated buprenorphine and reasons for declining","authors":"Lindsey K. Jennings , Allison Smith , Angela Moreland , Ralph Ward , Sarah Gainey , Suzanne Lane , Olivia Holodnik , Katherine Scarpino , Karen Hartwell , Louise Haynes , Kathleen T. Brady , Kelly Barth","doi":"10.1016/j.jemrpt.2025.100141","DOIUrl":"10.1016/j.jemrpt.2025.100141","url":null,"abstract":"<div><h3>Background</h3><div>Medication for Opioid Use Disorder (MOUD) reduces morbidity and mortality for patients with opioid use disorder (OUD). Emergency department-initiated buprenorphine (EDIB) doubles retention in treatment at 30 days compared to outpatient referral alone. Little is known about acceptance rates of EDIB and reasons why patients decline this life-saving intervention.</div></div><div><h3>Objectives</h3><div>The aim of this study was to quantify the number of patients who initiate and decline buprenorphine in the ED and determine reasons for declination.</div></div><div><h3>Methods</h3><div>Seven SC EDs implemented EDIB programs that included ED-based peer recovery specialists (PRSs) to provide a brief intervention and assist with referral to outpatient treatment. The PRSs recorded patient interactions in a database including medical eligibility, if EDIB was provided, and the reason(s) why eligible patients declined EDIB. All eligible EDIB patients were entered in the PRS database and included in the study. Reasons for declining buprenorphine in eligible patients were analyzed with both fixed and free-text response options.</div></div><div><h3>Results</h3><div>A total of 2205 patients were eligible for EDIB. Of those, 963 (43.6 %) patients accepted buprenorphine and 1242 (56.3 %) declined. The most common reasons for declination were 1) the “patient preferring non-MOUD treatment” (53.4 %), 2) “Not ready/would like to think about it and/or check with other treatment providers or case workers” (16.7 %).</div></div><div><h3>Conclusions</h3><div>Over half of patients with OUD who were eligible for EDIB declined treatment, with the most common reason being preference for non-MOUD treatment. Given the success of MOUD for treatment of OUD, this topic requires further exploration.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"4 1","pages":"Article 100141"},"PeriodicalIF":0.0,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ketamine for rapid control of hyperactive delirium with severe agitation. A retrospective comparison study

JEM reports Pub Date : 2025-01-18 DOI: 10.1016/j.jemrpt.2025.100138

Beatrice Borreani , Annalisa Belluti , Francescopaolo D'Adamo , Luca Acquarone , Cristina Cocino , Paolo Canepa , Francesco Quaglia , Martina D'Antoni , Andrea Alienda , Alessandro Riccardi

{"title":"Ketamine for rapid control of hyperactive delirium with severe agitation. A retrospective comparison study","authors":"Beatrice Borreani , Annalisa Belluti , Francescopaolo D'Adamo , Luca Acquarone , Cristina Cocino , Paolo Canepa , Francesco Quaglia , Martina D'Antoni , Andrea Alienda , Alessandro Riccardi","doi":"10.1016/j.jemrpt.2025.100138","DOIUrl":"10.1016/j.jemrpt.2025.100138","url":null,"abstract":"<div><h3>Background</h3><div>The agitated patient represents a very large clinical problem for the work of the emergency department. The therapeutic goal is rapid symptom control while ensuring maximum patient safety. Hyperactive delirium constitutes a true clinical emergency, and some sedatives carry inherent risks. Ketamine has already demonstrated remarkable safety in this setting. OBJECTIVES This study aims to indentify an effective and safe option for the rapid control of severe psychomotor agitation METHODS Our retrospective study analyzes the comparison of ketamine alone, ketamine with droperidol, and midazolam with haloperidol. RESULTS During the period of January 2022 and September 2023 we identified 66 patients with severe psychomotor agitation (13–76 years), and we demonstrated a faster and more effective response in patients treated with ketamine, and a reduction in adverse events in patients treated with ketamine and droperidol. CONCLUSIONS Our data show that patients treated with ketamine exhibit a significantly faster response, with immediate patient control, with greater safety than patients treated with midazolam. The combination with droperidol increases clinical efficacy compared with ketamine alone.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"4 1","pages":"Article 100138"},"PeriodicalIF":0.0,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Acute pancreatitis and euglycemic non-diabetic ketoacidosis caused by an intentional semaglutide overdose

JEM reports Pub Date : 2025-01-17 DOI: 10.1016/j.jemrpt.2025.100139

Anthony Acosta , Ashley Fanco , Hataitaya Rohan , Zane Elfessi

{"title":"Acute pancreatitis and euglycemic non-diabetic ketoacidosis caused by an intentional semaglutide overdose","authors":"Anthony Acosta , Ashley Fanco , Hataitaya Rohan , Zane Elfessi","doi":"10.1016/j.jemrpt.2025.100139","DOIUrl":"10.1016/j.jemrpt.2025.100139","url":null,"abstract":"<div><h3>Background</h3><div>Glucagon-like peptide-1 (GLP-1) receptor agonists, such as semaglutide, have been approved for weight loss and have gained popularity for its efficacy and a once-weekly administration. The FDA approved max dose of 2.4 mg per week resulted in a 10 % reduction in weight over a 6-month period. GLP receptors are expressed in islet and exocrine duct cells of the pancreas. Case reports of pancreatitis and diabetic ketoacidosis have been reported in patients who have hypertriglyceridemia or carry a diagnosis of diabetes.</div></div><div><h3>Case report</h3><div>We report a first-of-its kind case of an intentional overdose of semaglutide leading to pancreatitis and ultimately euglycemic non-diabetic ketoacidosis (EnDKA). Overstimulation by GLP-1 agonists, like semaglutide, can lead to hyperplasia and resulting pancreatitis. Acute pancreatitis can induce a systemic inflammatory response and may be responsible for dysfunction of beta cells and subsequent insulin deficiency, resulting in diabetic ketoacidosis.</div><div>Why should an EM Physician be aware of this?</div><div>Acute pancreatitis and euglycemic non-diabetic ketoacidosis are both life threatening emergencies. As the use of weight-management drugs become increasingly popular, the incidence of these emergencies may be on the rise as well.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"4 1","pages":"Article 100139"},"PeriodicalIF":0.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Curious case of a frozen pupil – Orbital apex syndrome

JEM reports Pub Date : 2025-01-13 DOI: 10.1016/j.jemrpt.2025.100140

Sophia Aguirre, Rahul Nene

引用次数: 0

Hydrogen peroxide toxicity of a lower lip piercing: A case report

JEM reports Pub Date : 2025-01-11 DOI: 10.1016/j.jemrpt.2025.100137

Monique Graf , Craig Reece Brockman II , Kara Pretzlaff

{"title":"Hydrogen peroxide toxicity of a lower lip piercing: A case report","authors":"Monique Graf , Craig Reece Brockman II , Kara Pretzlaff","doi":"10.1016/j.jemrpt.2025.100137","DOIUrl":"10.1016/j.jemrpt.2025.100137","url":null,"abstract":"<div><h3>Background</h3><div>Hydrogen peroxide, a well-known cleaning product, is responsible for a large number of emergency department visits each year. The current literature contains only few case reports of these exposures, and our case report provides an example of what can happen from direct hydrogen exposure and how it is managed from the emergency department.</div></div><div><h3>Case report</h3><div>A 26-year-old female presented to the emergency department with lower lip swelling and overlying skin changes. Vital signs were within normal limits and the remainder of her exam was within normal limits. It was elicited with further questioning that the patient had irrigated her lip piercing the night before with hydrogen peroxide. With this information, the correct diagnosis of hydrogen peroxide toxicity was made and with the help of oral and maxillofacial surgery, the patient was treated appropriately for this condition.</div></div><div><h3>Why should emergency medicine physicians be aware of this</h3><div>Toxic exposures, whether via direct contact, inhalation, or ingestion, are commonly seen in the emergency department and require expeditious diagnosis and treatment. Based on physical exam alone, lip swelling suggests a variety of diagnoses. In this case, as in many others, accurate history taking is crucial in making the correct diagnoses.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"4 1","pages":"Article 100137"},"PeriodicalIF":0.0,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143157426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

High dose intravenous ascorbic acid masking hypoglycemia in a patient presenting with stroke-like symptoms: A case report

JEM reports Pub Date : 2024-12-26 DOI: 10.1016/j.jemrpt.2024.100136

John Seaser , Brooke Sherman

{"title":"High dose intravenous ascorbic acid masking hypoglycemia in a patient presenting with stroke-like symptoms: A case report","authors":"John Seaser , Brooke Sherman","doi":"10.1016/j.jemrpt.2024.100136","DOIUrl":"10.1016/j.jemrpt.2024.100136","url":null,"abstract":"<div><h3>Background</h3><div>Point of care glucometers are commonly used in the emergency setting on patients presenting with stroke-like symptoms to rule out abnormal glucose levels as a cause. High doses of intravenous (IV) ascorbic acid have been shown to interfere with the accuracy of point of care glucose readings and some continuous glucose monitors (CGM). This interaction can cause falsely elevated point of care glucose readings which can mask true hypoglycemia.</div></div><div><h3>Case report</h3><div>A 65-year-old female with a past medical history of leukemia and type 1 diabetes mellitus on an insulin pump presented with stroke-like symptoms after receiving an IV infusion of high dose ascorbic acid as an adjunctive cancer treatment. Point of care glucose upon emergency department arrival was 127 mg/dL, however, serum glucose resulted as 36 mg/dL. The serum glucose was thought to be an error when a repeated point of care glucose was 128 mg/dL. The patient was considered for thrombolytic therapy, but it was ultimately held. A repeat serum glucose was again critically low at 37 mg/dL, and around this time the drug-device interaction was discovered. The patient was given IV dextrose with immediate resolution of her symptoms.</div></div><div><h3>Why should an emergency physician be aware of this?</h3><div>Symptoms of hypoglycemia can mimic stroke, and not recognizing hypoglycemia could result in inappropriate thrombolytic administration or delayed correction of glucose. As outpatient vitamin and hydration clinics are becoming more prevalent, providers should be aware of the drug-device interaction between IV ascorbic acid and glucose meters that could negatively impact care.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"4 1","pages":"Article 100136"},"PeriodicalIF":0.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143157425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Procedural pain management in an academic emergency department, a pilot study

JEM reports Pub Date : 2024-12-19 DOI: 10.1016/j.jemrpt.2024.100134

Irvan J. Bubic , Sidra L. Speaker , Christopher J. Coyne , Jessica C. Oswald

{"title":"Procedural pain management in an academic emergency department, a pilot study","authors":"Irvan J. Bubic , Sidra L. Speaker , Christopher J. Coyne , Jessica C. Oswald","doi":"10.1016/j.jemrpt.2024.100134","DOIUrl":"10.1016/j.jemrpt.2024.100134","url":null,"abstract":"<div><h3>Background</h3><div>Pain is the leading cause of Emergency Department (ED) visits and untreated acute pain can frequently transition to chronic pain. (1,2) A 2020 pilot study showed that an ED-physician-led procedural pain management program reduced pain. (3)</div></div><div><h3>Objectives</h3><div>Our objective was to determine the feasibility and usefulness of a Mobile ED (MED) Pain Management program led by a dual-trained Pain Management and Emergency physician.</div></div><div><h3>Methods</h3><div>We included adult patients who visited the ED at a large academic hospital between October 26th and November 17th, 2020. Patients had a variety of types of pain and were treated with bedside nerve blocks. We recorded procedure indication, demographic data, and pre-and-post Visual Analog Scale (VAS) pain scores. We also captured patient and provider satisfaction, and billing data.</div></div><div><h3>Results</h3><div>The MED team was available for a total of 30 h and performed 14 procedures on 12 patients and 4 consults without procedures on 4 additional patients. VAS 30-min score reductions ranged from 20 % (intercostal nerve blocks) to 100 % erector spinae plane block (ESPB). The average VAS pain reduction was 58 %. The most common procedure performed was the ESPB with mean VAS pain reduction of 74 %. The procedures and consults produced 50.13 RVUs total and work Relative Value Units (wRVUs) of 29.4. Average RVU was 3.13 (1.84 wRVU) per patient and 1.67 RVU (0.98 wRVU) per hour.</div></div><div><h3>Conclusions</h3><div>These preliminary data suggest that although implementation of a dedicated ED pain could potentially lead to improved pain relief, it may not be financially feasible in this setting.</div></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":"4 1","pages":"Article 100134"},"PeriodicalIF":0.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143100753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0