Pub Date : 2024-01-11DOI: 10.1016/j.jemrpt.2024.100071
Natalie T. Truong , Patrick B. Hinfey
Background
Point-of-care transthoracic echocardiography can be useful in diagnosing a pulmonary embolism in patients with hemodynamic instability and facilitate with their management in the emergency department.
Case report
A 64 year-old man presented to the ED with several days of worsening exertional dyspnea associated with left-sided chest pain who was hemodynamically unstable. Point-of-care ultrasound revealed a clot in the right atrium, which led to further assessment of the right heart function to detect signs of acute right heart strain when a pulmonary embolism is highly suspected.
Why should an emergency physician be aware of this?
Point-of-care ultrasound (POCUS) was utilized to evaluate characteristic findings that will predict a higher risk of deterioration from a pulmonary embolism. Rarely, a mobile clot can be seen within the right atrium which is highly specific for imminent pulmonary embolism and is associated with higher risk of decompensation. Bedside transthoracic echocardiogram allowed for rapid diagnostic assessment that guided decision making and early management of pulmonary embolism, which can improve the patient's outcome.
{"title":"Pulmonary embolism: Thrombus-in-transit","authors":"Natalie T. Truong , Patrick B. Hinfey","doi":"10.1016/j.jemrpt.2024.100071","DOIUrl":"https://doi.org/10.1016/j.jemrpt.2024.100071","url":null,"abstract":"<div><h3>Background</h3><p>Point-of-care transthoracic echocardiography can be useful in diagnosing a pulmonary embolism in patients with hemodynamic instability and facilitate with their management in the emergency department.</p></div><div><h3>Case report</h3><p>A 64 year-old man presented to the ED with several days of worsening exertional dyspnea associated with left-sided chest pain who was hemodynamically unstable. Point-of-care ultrasound revealed a clot in the right atrium, which led to further assessment of the right heart function to detect signs of acute right heart strain when a pulmonary embolism is highly suspected.</p></div><div><h3>Why should an emergency physician be aware of this?</h3><p>Point-of-care ultrasound (POCUS) was utilized to evaluate characteristic findings that will predict a higher risk of deterioration from a pulmonary embolism. Rarely, a mobile clot can be seen within the right atrium which is highly specific for imminent pulmonary embolism and is associated with higher risk of decompensation. Bedside transthoracic echocardiogram allowed for rapid diagnostic assessment that guided decision making and early management of pulmonary embolism, which can improve the patient's outcome.</p></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773232024000014/pdfft?md5=02648de60f441a205d70ebb2abc127a2&pid=1-s2.0-S2773232024000014-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139479953","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}
Pub Date : 2024-01-09DOI: 10.1016/j.jemrpt.2024.100075
Katherine A. Pollard , Thomas Lardaro , Carl Pafford , Julia Vaizer , Christian C. Strachan , Steven K. Roumpf , Megan R. Crittendon , Karen N. Crevier , Benton R. Hunter
Background
Computed Tomography (CT) use is common during emergency department (ED) visits, and ED clinicians may order CTs for myriad reasons, including desire to improve patient satisfaction.
Objectives
To determine if greater CT use by ED clinicians is associated with increased average patient satisfaction scores for those providers.
Methods
The study took part across 15 non-pediatric hospitals in a regional healthcare system. We compared clinician CT use rate for adult patients discharged from the ED with Net Promotor Score (NPS) for that clinician. NPS is a patient satisfaction metric with a possible range of scores from −100 to +100. We included ED clinicians (physicians and non-physician providers (NPPs)) with at least 500 adult patient encounters resulting in ED discharge from July 2020 through June 2022. We assessed for an association between CT use and clinician NPS using univariate and multivariate regression models.
Results
Across the 15 hospitals, 166 physicians and 74 NPPs were included in the study. The median CT rate was 25.7 % (range 7.1 %–48.9 %). In both models, there was a statistical association between CT utilization and NPS such that every absolute increase in CT use by 10 % resulted in a 3-point improvement in provider NPS on the 200-point scale. When examined in a sensitivity analysis, none of the hospitals individually showed this same association.
Conclusions
We found a 26 % rate of CT use by clinicians for adults discharged from the ED, with wide variation in utilization between clinicians. There was a small and inconsistent association between CT utilization and clinician specific NPS scores.
{"title":"Association between emergency department computed tomography utilization rate and patient satisfaction: A clinician level analysis across a regional healthcare system","authors":"Katherine A. Pollard , Thomas Lardaro , Carl Pafford , Julia Vaizer , Christian C. Strachan , Steven K. Roumpf , Megan R. Crittendon , Karen N. Crevier , Benton R. Hunter","doi":"10.1016/j.jemrpt.2024.100075","DOIUrl":"https://doi.org/10.1016/j.jemrpt.2024.100075","url":null,"abstract":"<div><h3>Background</h3><p>Computed Tomography (CT) use is common during emergency department (ED) visits, and ED clinicians may order CTs for myriad reasons, including desire to improve patient satisfaction.</p></div><div><h3>Objectives</h3><p>To determine if greater CT use by ED clinicians is associated with increased average patient satisfaction scores for those providers.</p></div><div><h3>Methods</h3><p>The study took part across 15 non-pediatric hospitals in a regional healthcare system. We compared clinician CT use rate for adult patients discharged from the ED with Net Promotor Score (NPS) for that clinician. NPS is a patient satisfaction metric with a possible range of scores from −100 to +100. We included ED clinicians (physicians and non-physician providers (NPPs)) with at least 500 adult patient encounters resulting in ED discharge from July 2020 through June 2022. We assessed for an association between CT use and clinician NPS using univariate and multivariate regression models.</p></div><div><h3>Results</h3><p>Across the 15 hospitals, 166 physicians and 74 NPPs were included in the study. The median CT rate was 25.7 % (range 7.1 %–48.9 %). In both models, there was a statistical association between CT utilization and NPS such that every absolute increase in CT use by 10 % resulted in a 3-point improvement in provider NPS on the 200-point scale. When examined in a sensitivity analysis, none of the hospitals individually showed this same association.</p></div><div><h3>Conclusions</h3><p>We found a 26 % rate of CT use by clinicians for adults discharged from the ED, with wide variation in utilization between clinicians. There was a small and inconsistent association between CT utilization and clinician specific NPS scores.</p></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773232024000051/pdfft?md5=b8567c1eed03f69a6ebef491073ef86a&pid=1-s2.0-S2773232024000051-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139433740","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}
Pub Date : 2024-01-01DOI: 10.1016/j.jemrpt.2024.100074
Abhay Kant, Mingwei Ng, Ming Jing Elizabeth Tan, Ponampalam R
{"title":"Successful use of haemato-polyvalent anti-venom cross-neutralisation in the clinical management of Rhabdophis subminiatus (Rhabdophis keelback) envenomation","authors":"Abhay Kant, Mingwei Ng, Ming Jing Elizabeth Tan, Ponampalam R","doi":"10.1016/j.jemrpt.2024.100074","DOIUrl":"https://doi.org/10.1016/j.jemrpt.2024.100074","url":null,"abstract":"","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139540696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-10DOI: 10.1016/j.jemrpt.2023.100070
T Andrew Windsor , Jade J. Wong-You-Cheong , Daniel B. Gingold , J David Gatz
{"title":"A woman with right upper extremity paralysis","authors":"T Andrew Windsor , Jade J. Wong-You-Cheong , Daniel B. Gingold , J David Gatz","doi":"10.1016/j.jemrpt.2023.100070","DOIUrl":"10.1016/j.jemrpt.2023.100070","url":null,"abstract":"","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773232023000664/pdfft?md5=e8701f307e9eb4f9ee2e2593800b97e0&pid=1-s2.0-S2773232023000664-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138612461","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}
Pub Date : 2023-12-02DOI: 10.1016/j.jemrpt.2023.100063
Khalid Zahalka , Tabea Haas-Heger , Ben Balogun-Ojuri
Background
Interventional management for primary spontaneous pneumothoraces (PSPs) appears to have become the norm, with conservative management having been pushed into the background over the past few decades. In the UK, management of PSPs is guided by the British Thoracic Society (BTS) Guidelines. While original guidance, dating back to 2011, favoured interventional management, the newly released updated BTS algorithm has given the conservative approach greater visibility.
Case report
A teenager presented to the Emergency Department after having developed sudden onset chest discomfort. A chest x-ray confirmed a PSP. He was admitted and initially treated conservatively. After 24 hours of observation, a chest drain was inserted on the basis of a lack of radiologic improvement. On discharge after chest drain removal, he was found to have a recurrence of his pneumothorax when reviewed at the outpatient respiratory clinic. He was again managed conservatively, this time successfully.
Why should the emergency physician be aware of this?
This case raised several questions regarding the management of stable patients presenting with PSP. The body of evidence supporting conservative management as a safe and feasible option has been growing. It is therefore important for physicians to reconsider its role and value. While the newly released BTS guidelines are a step in the right direction, there are a number of important questions to address in order to both effectively guide emergency physicians and for conservative management to be used in a more standardised and routine way.
{"title":"Reconsidering conservative treatment of primary spontaneous pneumothoraces: A case report","authors":"Khalid Zahalka , Tabea Haas-Heger , Ben Balogun-Ojuri","doi":"10.1016/j.jemrpt.2023.100063","DOIUrl":"https://doi.org/10.1016/j.jemrpt.2023.100063","url":null,"abstract":"<div><h3>Background</h3><p>Interventional management for primary spontaneous pneumothoraces (PSPs) appears to have become the norm, with conservative management having been pushed into the background over the past few decades. In the UK, management of PSPs is guided by the British Thoracic Society (BTS) Guidelines. While original guidance, dating back to 2011, favoured interventional management, the newly released updated BTS algorithm has given the conservative approach greater visibility.</p></div><div><h3>Case report</h3><p>A teenager presented to the Emergency Department after having developed sudden onset chest discomfort. A chest x-ray confirmed a PSP. He was admitted and initially treated conservatively. After 24 hours of observation, a chest drain was inserted on the basis of a lack of radiologic improvement. On discharge after chest drain removal, he was found to have a recurrence of his pneumothorax when reviewed at the outpatient respiratory clinic. He was again managed conservatively, this time successfully.</p></div><div><h3>Why should the emergency physician be aware of this?</h3><p>This case raised several questions regarding the management of stable patients presenting with PSP. The body of evidence supporting conservative management as a safe and feasible option has been growing. It is therefore important for physicians to reconsider its role and value. While the newly released BTS guidelines are a step in the right direction, there are a number of important questions to address in order to both effectively guide emergency physicians and for conservative management to be used in a more standardised and routine way.</p></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773232023000597/pdfft?md5=39a3406a5f86d44353fd9a0aa90c8f29&pid=1-s2.0-S2773232023000597-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138549202","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}
Pub Date : 2023-11-27DOI: 10.1016/j.jemrpt.2023.100066
Mary Rometti, Ashley Keifer, Grant Wei, Christopher Bryczkowski
Background
Patients with hip fractures frequently present to the emergency department (ED). Traditional methods of pain control often include the use of opioid pain medication. Fascia iliaca nerve blocks offer an alternative method to acute pain management in the ED for hip fractures. At the time of this publication, there are no readily available, cost-effective gelatin models of the surrounding fascia iliaca anatomy.
Objectives
The objective was to design an accurate and cost-effective model to simulate fascia iliaca nerve block models for training emergency medicine clinicians.
Discussion
A gelatin model was created to simulate the anatomy of the inguinal region in order to perform a fascia iliaca block. This fascia iliaca nerve block model aided in training of residents and attendings to become familiar with the anatomy and techniques necessary to perform this nerve block. Clinicians were able to practice ultrasound guided in-plane approach into the fascia iliaca space where they could then hydrodissect and distill anesthetic. Each model could be used several times allowing trainees multiple attempts.
Conclusion
A method to create a fascia iliaca nerve block model using readily available supplies was designed to aid training of emergency medicine clinicians. We hope to improve the technique and clinician comfort-level when performing the fascia iliaca nerve block using this model.
{"title":"Ultrasound-guided fascia iliaca nerve block gelatin model","authors":"Mary Rometti, Ashley Keifer, Grant Wei, Christopher Bryczkowski","doi":"10.1016/j.jemrpt.2023.100066","DOIUrl":"https://doi.org/10.1016/j.jemrpt.2023.100066","url":null,"abstract":"<div><h3>Background</h3><p>Patients with hip fractures frequently present to the emergency department (ED). Traditional methods of pain control often include the use of opioid pain medication. Fascia iliaca nerve blocks offer an alternative method to acute pain management in the ED for hip fractures. At the time of this publication, there are no readily available, cost-effective gelatin models of the surrounding fascia iliaca anatomy.</p></div><div><h3>Objectives</h3><p>The objective was to design an accurate and cost-effective model to simulate fascia iliaca nerve block models for training emergency medicine clinicians.</p></div><div><h3>Discussion</h3><p>A gelatin model was created to simulate the anatomy of the inguinal region in order to perform a fascia iliaca block. This fascia iliaca nerve block model aided in training of residents and attendings to become familiar with the anatomy and techniques necessary to perform this nerve block. Clinicians were able to practice ultrasound guided in-plane approach into the fascia iliaca space where they could then hydrodissect and distill anesthetic. Each model could be used several times allowing trainees multiple attempts.</p></div><div><h3>Conclusion</h3><p>A method to create a fascia iliaca nerve block model using readily available supplies was designed to aid training of emergency medicine clinicians. We hope to improve the technique and clinician comfort-level when performing the fascia iliaca nerve block using this model.</p></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773232023000627/pdfft?md5=0143e913b9c8ea79a88de83e0e648664&pid=1-s2.0-S2773232023000627-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138472576","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}
Pub Date : 2023-11-27DOI: 10.1016/S2773-2320(23)00065-2
{"title":"Aims and Scope","authors":"","doi":"10.1016/S2773-2320(23)00065-2","DOIUrl":"https://doi.org/10.1016/S2773-2320(23)00065-2","url":null,"abstract":"","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773232023000652/pdfft?md5=bcaa9530bfcfcac99981f49aa52d433e&pid=1-s2.0-S2773232023000652-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138448296","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}
Pub Date : 2023-11-26DOI: 10.1016/j.jemrpt.2023.100059
Rebekah Riordan
Background
Burnout, mental health issues, and sleep disorders continue to be a problem among emergency medicine physicians, affecting patient care, personal well-being, and retention of the specialty.
Case report
A 35-year-old female emergency medicine intern is brought in by her assistant program directors for altered mental status and ataxia, concerning for alcohol or drug intoxication. It was noted that she was confused, oriented only to self, and seemed to be experiencing auditory hallucinations. Also noted was she was tremulous and exhibited an ataxic gait. However, lab testing was inconsistent with drug or alcohol intoxication. During her hospital admission, it was discovered she had been awake over 80 hours after gaining collateral from friends and family. With the administration of a large amount of trazodone, she eventually fell asleep and was later diagnosed with four different sleep disorders and successfully treated by sleep specialists. This case is discussed here to bring more awareness to the poor state of wellness in the emergency medicine specialty and to suggest practical ways to address these multifactorial issues.
{"title":"An EM Intern's Misadventure and Lessons in Sleep and Wellness","authors":"Rebekah Riordan","doi":"10.1016/j.jemrpt.2023.100059","DOIUrl":"https://doi.org/10.1016/j.jemrpt.2023.100059","url":null,"abstract":"<div><h3>Background</h3><p>Burnout, mental health issues, and sleep disorders continue to be a problem among emergency medicine physicians, affecting patient care, personal well-being, and retention of the specialty.</p></div><div><h3>Case report</h3><p>A 35-year-old female emergency medicine intern is brought in by her assistant program directors for altered mental status and ataxia, concerning for alcohol or drug intoxication. It was noted that she was confused, oriented only to self, and seemed to be experiencing auditory hallucinations. Also noted was she was tremulous and exhibited an ataxic gait. However, lab testing was inconsistent with drug or alcohol intoxication. During her hospital admission, it was discovered she had been awake over 80 hours after gaining collateral from friends and family. With the administration of a large amount of trazodone, she eventually fell asleep and was later diagnosed with four different sleep disorders and successfully treated by sleep specialists. This case is discussed here to bring more awareness to the poor state of wellness in the emergency medicine specialty and to suggest practical ways to address these multifactorial issues.</p></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S277323202300055X/pdfft?md5=e4d85a70420d4defb8ed1039ffe27c11&pid=1-s2.0-S277323202300055X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138656560","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}
Pub Date : 2023-11-25DOI: 10.1016/j.jemrpt.2023.100058
Laura Sofoulis , Blake Dawson , Tuan Pham
Background
Acute epiglottitis is a life-threatening condition usually caused by streptococcal or staphylococcal species. It is rarely caused by Pasteurella multocida, which is an oropharyngeal commensal in cats and dogs, and is usually responsible for human skin infections following inoculation by bite or scratch.
Case report
We report a case of a 50-year-old female who presented to the emergency department with acute epiglottitis due to Pasteurella multocida. The patient suffered rapid deterioration and subsequent hypoxic cardiac arrest requiring advanced life support measures and intubation. She recovered well following a course of penicillin-based intravenous antibiotics and airway support in the intensive care unit. Infection was likely acquired after close contact with her pet dog.
Why an emergency physician should be aware of this
Pasteurella multocida can cause a variety of atypical infections, including acute epiglottitis, and should be considered a possible causal organism in those with a history of animal exposure. While it is important to take a careful exposure history, the nature of a patient's presentation may necessitate a reliance on collateral history when there is unexpected and rapid patient deterioration. As is demonstrated in this case, the diagnosis, management, and treatment of adult-onset epiglottitis is multidisciplinary in nature and reliant on careful patient assessment that correlates pertinent historical findings with relevant laboratory results.
{"title":"Pasteurella multocida epiglottitis: A case report","authors":"Laura Sofoulis , Blake Dawson , Tuan Pham","doi":"10.1016/j.jemrpt.2023.100058","DOIUrl":"https://doi.org/10.1016/j.jemrpt.2023.100058","url":null,"abstract":"<div><h3>Background</h3><p>Acute epiglottitis is a life-threatening condition usually caused by streptococcal or staphylococcal species. It is rarely caused by <em>Pasteurella multocida</em>, which is an oropharyngeal commensal in cats and dogs, and is usually responsible for human skin infections following inoculation by bite or scratch.</p></div><div><h3>Case report</h3><p>We report a case of a 50-year-old female who presented to the emergency department with acute epiglottitis due to <em>Pasteurella multocida</em>. The patient suffered rapid deterioration and subsequent hypoxic cardiac arrest requiring advanced life support measures and intubation. She recovered well following a course of penicillin-based intravenous antibiotics and airway support in the intensive care unit. Infection was likely acquired after close contact with her pet dog.</p></div><div><h3>Why an emergency physician should be aware of this</h3><p><em>Pasteurella multocida</em> can cause a variety of atypical infections, including acute epiglottitis, and should be considered a possible causal organism in those with a history of animal exposure. While it is important to take a careful exposure history, the nature of a patient's presentation may necessitate a reliance on collateral history when there is unexpected and rapid patient deterioration. As is demonstrated in this case, the diagnosis, management, and treatment of adult-onset epiglottitis is multidisciplinary in nature and reliant on careful patient assessment that correlates pertinent historical findings with relevant laboratory results.</p></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2773232023000548/pdfft?md5=f1a97ed40c037ea28f3e47b0ab0a1c89&pid=1-s2.0-S2773232023000548-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138474526","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}
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