ABSTRACT
The Union Cycliste Internationale (UCI) Mountain Bike World Cup in 2019 provided unique challenges for effective prehospital care. While on-site medical care has demonstrated improved outcomes along with reduced emergency department and emergency medical services (EMS) utilization, this aspect has not been well documented in the literature with respect to rural mass gathering events (MGEs). Conducted at a large mass gathering event in a geographically isolated area, this study aimed to assess the medical needs at this specific event and will hopefully assist in future coordination of similar events. All patients who were treated at the event clinic were included in the analysis. Primary investigators collected and recorded data while providing care. We believe the on-site clinic was successful in reducing barriers to healthcare by improving access, streamlining the treatment process, and optimizing resource utilization. This benefit extended to race participants, support staff, spectators, and the local EMS system.
ABSTRACT
Takotsubo cardiomyopathy (TCM) is an important condition for the emergency physician to consider in patients with cardiovascular symptoms. A 70-year-old woman presented with chest pain and nausea following emotional trauma. She had an elevated troponin and a normal electrocardiogram with no history of previous cardiac disease. Point-of-care focused cardiac ultrasound (FOCUS) showed reduced left ventricular systolic function with mid to apical hypokinesis. Cardiac catheterization revealed clean coronary arteries and confirmed the suspected diagnosis of TCM. Few reports emphasize the importance of FOCUS in the diagnosis and management of TCM in the emergency department. We detail FOCUS findings that assisted with diagnosis of TCM and describe how this quick, noninvasive imaging modality can be used to assess and manage emergent conditions.
ABSTRACT
BACKGROUND: Work-related injuries are commonly seen in the emergency department (ED). This study sought to analyze characteristics of ED patient visits that were billed under workers' compensation. METHODS: This was a retrospective chart review of visits during 2015 that were billed under workers' compensation at an academic ED. The following variables were collected: age, gender, mechanism of injury/exposure, diagnoses, imaging performed, specialty consultation, operative requirement, follow-up specialty, and ED disposition. RESULTS: In 2015, 377 patients presented to the ED for work-related injuries. The most common mechanism of injury was fall. Frequent diagnoses included lower extremity injuries and hand/finger injuries. The most common consulting service was orthopedics. Only five patients were referred to occupational medicine for follow up. CONCLUSION: Knowledge of the types of occupational injuries and subsequent care required may help guide both workers and employers how to best triage patients within the healthcare system. Alternative settings such as occupational medicine or primary care services may be appropriate for some patients.
