The Erector Spinae Plane Block as Novel Therapy for Renal Colic: A Case Series.

We present a 10-patient case series supporting the use of the erector spinae plane block (ESPB) as a novel approach for the treatment of acute pain from renal colic. An in-plane needle approach was used with either transverse or longitudinal orientation of the ultrasound probe on the affected side, in either seated or prone patient position. These cases showed significant improvement in patient reported pain; suggesting that the ESPB can be used safely and effectively for either primary or adjunctive treatment of acute pain due to renal colic in the emergency department.

Differentials and trends in emergency department visits due to alcohol intoxication and co-occurring conditions among students in a U.S. public university.

BACKGROUND: Few studies have explored the epidemiology of students presenting to the emergency department (ED) as a consequence of hazardous drinking. This study examined differentials and trends in ED visits following alcohol intoxication and co-occurring conditions among students presenting to a major U.S. university health system. METHODS: The ED electronic medical records from academic years 2010-2015 were queried for student visits and their records were linked to the university's student admission datasets. Student alcohol-related visits were identified based on ICD-9 codes. Student characteristics and trends in the rate of alcohol intoxication per 100 ED student visits were analyzed. A random sample of 600 student clinical records were reviewed to validate diagnostic codes. RESULTS: There were 9616 student ED visits (48% males) to the ED of which 1001 (10.4%) visits involved alcohol intoxication. Two thirds of ED visits with alcohol intoxication had a co-occurring diagnosis, with injuries (24%) being the most common condition. The rate of alcohol intoxication varied greatly by student demographics and campus-related factors. There was a linear increase in the rate of alcohol intoxication from 7.9% in 2009-10 to 12.3% in 2014-15 (p<0.01). The increase was greater among female students, students below 20 years of age, Asian students, and student athletes. In the sample reviewed, only two thirds of ED visits with alcohol intoxication were recorded by diagnostic codes. CONCLUSION: The rate of ED visits following alcohol intoxication varied by student demographic characteristics and campus-related factors with a rising trend over the study period.