An Observational Study to Determine Whether Routinely Sending Patients Home With a 24-Hour Supply of Topical Tetracaine From the Emergency Department for Simple Corneal Abrasion Pain Is Potentially Safe.

Study Objective: To determine if the number of emergency department (ED) rechecks, persistent fluorescein uptake, ophthalmology referrals, or complications would be affected by the prescription of topical tetracaine for pain relief from simple corneal abrasions (SCAs).

Methods: This retrospective cohort study was conducted in an ED where policy change allowed physicians to use topical tetracaine hydrochloride 1% eye drops for 24 hours for pain treatment for patients with corneal abrasions. Outcomes were compared between patients who did or did not received tetracaine (adjusting for the propensity for treatment).

Topical tetracaine used for 24 hours is safe and rated highly effective by patients for the treatment of pain caused by corneal abrasions: a double-blind, randomized clinical trial.

Objectives: The objective of this study was to test the hypothesis that topical tetracaine would be safe to use for 24 hours and would not affect corneal healing, that patients would experience more pain relief, and that patients would perceive tetracaine to be more effective than saline eye drops for the treatment of pain caused by corneal abrasions.

Methods: The study was a 12-month, prospective, double-blind, randomized trial of tetracaine versus saline set in the emergency department (ED) of a regional tertiary care teaching hospital. A total of 116 patients presenting with uncomplicated corneal abrasions were included in this study.

Seizure caused by dermal application of over-the-counter eucalyptus oil head lice preparation.

Natural plant oils such as eucalyptus are common worldwide in non-prescription natural health products. Oral ingestion of eucalyptus oil is well known to produce neurological symptoms and seizures; however, its dermal use is presumed to be safe. We describe a brief, self-limited, tonic-clonic seizure in a healthy 4-year-old girl following dermal exposure to eucalyptus oil as directed for treatment of head lice.

Unstable cervical spine without spinal cord injury in penetrating neck trauma.

Cervical spine instability in the neurologically intact patient following penetrating neck trauma has been considered rare or non-existent. We present a case of a woman with an unstable C5 fracture without spinal cord injury after a gunshot wound to the neck. Considerations regarding the risk of cervical spine instability are discussed, as well as suggestions for a prudent approach to such patients.

The diagnosis of acute mountain sickness in preverbal children.

Objective: To establish diagnostic criteria for acute mountain sickness (AMS) in preverbal children.

Design: Nonrandomized control trial.

Setting: Ambulatory.

Can patients with minor head injuries be safely discharged home?

To identify all patients with serious intracranial injury, current treatment strategies include admission and/or computed tomographic evaluation of all patients with head injuries. However, the majority of patients with head injuries who are awake do not require subsequent intervention. A review of 407 consecutive patients with head injuries treated at an adult regional trauma center identified 310 patients with Glasgow Coma Scores of 15 in the emergency department, all of whom were admitted.