Rib fractures are commonly seen in children due to many causes such as car accidents, falls, child abuse and direct blows to the chest.
Renew Your Subscription and List Your Practice for Free!Chronic pain sufferers are using our pain specialist directory to find pain specialists in your area.
Pain can be classified as nociceptive or neuropathic.3 Nociceptive pain results from stimulation at pain receptors, whereas neuropathic pain arises in the peripheral or central nervous system. Numerous clinical practice guidelines for the treatment of chronic pain have been developed by professional organizations.
The SNRI antidepressants that have been shown to be effective for chronic pain include venlafaxine, duloxetine, and milnacipran. Antidepressants are especially useful for fibromyalgia because they not only improve pain, but they also improve symptoms of depression, fatigue, and insomnia related to the disorder.14 In fact, duloxetine and milnacipran have been FDA-approved as a primary therapy for fibromyalgia. Skeletal muscle relaxants are a heterogeneous group of drugs used for a variety of musculoskeletal disorders.12,19 They are frequently used as adjunctive medication in the treatment of acute low back pain. Do you recommend using technology (smartphone apps, Fitbits, etc) to help your patients become more active? Vertical Health Media, LLC does not, by publication of the advertisements contained herein, express endorsement or verify the accuracy and effectiveness of the products and claims contained therein.
Practical Pain Management is sent without charge 10 times per year to pain management clinicians in the US. When patients make a visit to the emergency department (ED), there is a chance they may need to make a repeat visit.
A new study, published in the Annals of Internal Medicine, suggests patients return to ERs for the same complaint more often than you think, and they frequently end up at a different ER on the second visit.
The researchers examined data from the Agency for Healthcare Research, and Quality’s Healthcare Cost and Utilization Project database from 2006 to 2010. Electronic health records have made great strides in gaining popularity, but the healthcare system still has a big disconnect when it comes to cross communication in many areas. Previous studies have found that about 3% of patients make a revisit to the ER in the first three days. While creating a system to share information between emergency departments or with primary care providers may seem like an incredibly investment, it would actually save money in the long run. Hi,I too have EDS and have been suffering all my life fromit, although i was only recently diagnosed. Hi, I have never posted ( or read ) a blog, but knew when my 8 year old son was diagnosed with EDS 1 month ago that I had to reach out to understand better what this is all about.
I am 41 and I have EDS-HM, as well as Fibro, early osteoarthritis, rotator cuff tendinitis and Raynauds. There is a higher incidence of gall bladder disease in women of northern European descent and Ehlers-danlos is more common in those folks as well. I hope you're doing well and have found a wheelchair and a trained dog to help you and keep you company. I think it's important to understand that not every person with ED will fit every guideline for this disorder. In Pakistan, having few cardiac centres catering to major cities offering limited number of primary PCI, the majority of STEMI patients from rural and urban population are treated in emergency departments and coronary care unit (CCU) of general hospitals wherein timely delivery of thrombolytic treatment is hampered due to a number of reasons. Furthermore, emergency departments (EDs) of general care hospitals in Pakistan, like most of the developing countries, are not providing prompt fibrinolysis and, hence, door-to-needle time (DNT) is higher than recommended.10 The first chest pain unit (CPU) was developed in 1981,10 to evaluate patients with chest pain and it has been shown that CPU care can reduce admissions, re-attendances and outpatient followup, and improve the quality of life for selected low-risk patients who are suitable for CPU care. All consecutive STEMI patients presenting to the ED of Sheikh Zayed Hospital, Rahimyar Khan from January to October 2009 were included in the study. In the second phase, a CPU was established within the existing ED in a separate room fully equipped with monitoring system and resuscitation trolley, in addition to rescue 1122 services, to reduce DNT. TT was defined as time from the onset of symptoms to the start of treatment, and the DNT as the time from arrival at the facility to the start of the treatment. The patients who were brought in by EMS had a marked reduction in TT, which was reduced to almost half of the other modes of presentation.
The other important segment of our study is the establishment of CPUs in the ED of non-cardiac general hospitals. By combining Rescue 1122 and CPU, a total of 4hour and 8minutes were reduced in our study, having a remarkable improvement in managing STEMI patients.
To continue, in the third phase we plan to intervene at the community level by creating awareness regarding recognition of chest pain symptoms in population at large, train GPs and rescue personnel for proper diagnosis of STEMI, pre-hospital ECG by Rescue personnel and their ability to read and interpret limited ECG tracings and ensure fast communication between CPU and Rescue 1122, in order to get prompt thrombolytic treatment. Based on the findings of our study, we propose a model for the speedy delivery of thrombolytic treatment in Pakistan. By utilizing EMS, remarkable improvement in the timing of fibrinolytic treatment was noticed. This journal is a member of and subscribes to the principles of the Committee on Publication Ethics. ABCD sponsors treatment for those in need regardless of gender, race or creed, helping them to reach their full potential, to live life with dignity and to take their rightful place in their community. ABCD works through local Palestinian partners, the Bethlehem Arab Society for Rehabilitation (BASR) based in Beit Jala, The Sheepfold in Beit Sahour and two UNWRA Refugee Camps in Jalazone and Nour Shams. Funding is constantly needed for new projects and to update and refurbish existing facilities. Patient information: See related handout on cold sores, written by the authors of this article. Nongenital herpes simplex virus type 1 (HSV-1) is a common infection that most often involves the oral mucosa or lips (herpes labialis). A cross-sectional study of herpes simplex virus types 1 and 2 in college students: occurrence and determinants of infection. Longitudinal evaluation of herpes simplex virus DNA load during episodes of herpes labialis. The natural history of recurrent herpes simplex labialis: implications for antiviral therapy. Comparison of Chemicon SimulFluor direct fluorescent antibody staining with cell culture and shell vial direct immunoperoxidase staining for detection of herpes simplex virus and with cytospin direct immunofluorescence staining for detection of varicellazoster virus.
Acute herpetic gingivostomatitis in adults: a review of 13 cases, including diagnosis and management. Treatment of herpes simplex gingivostomatitis with aciclovir in children: a randomised double blind placebo controlled study.
Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer. Single-dose, patient-initiated famciclovir: a randomized, double-blind, placebo-controlled trial for episodic treatment of herpes labialis.
Valacyclovir and topical clobetasol gel for the episodic treatment of herpes labialis: a patient-initiated, double-blind, placebo-controlled pilot trial. Clinical efficacy of topical docosanol 10% cream for herpes simplex labialis: a multi-center, randomized, placebo-controlled trial.
In addition, a variety of medications that were originally developed for indications other than analgesia are emerging as effective agents for the treatment of pain. Venlafaxine was the initial agent in this drug class and was primarily developed for the treatment of depression. Duloxetine also recently received approval as a primary therapy for chronic muscoskelatal pain. Practice guidelines for chronic pain management: an updated report by the American Society of Anesthesiologists Task Force on Chronic Pain Management and the American Society of Regional Anesthesia and Pain Medicine.
Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Guideline for the management of fibromyalgia syndrome pain in adults and children, APS Clinical Practice Guidelines Series, No. Evidence-based guideline: treatment of painful diabetic neuropathy Report of the American Academy of Neurology, the American Association of Neuromuscular and Electrodiagnostic Medicine, and the American Academy of Physical Medicine and Rehabilitation [published online ahead of print April 11, 2011]. Recommendations for the pharmacological management of neuropathic pain: an overview and literature update. An update on the pharmacological management of post-herpetic neuralgia and painful diabetic neuropathy. A randomized, double-blind, placebo-controlled trial of pramipexole, a dopamine agonist, in patients with fibromyalgia receiving concomitant medications. Polyanalgesic Consensus Conference 2003: an update on the management of pain by intraspinal drug delivery—report of an expert panel. Vertical Health Media, LLC disclaims any liability for damages resulting from the use of any product advertised herein and suggests that readers fully investigate the products and claims prior to purchasing. The data included 58 million patients discharged from ERs in six states for which data was available on subsequent ER visits and admissions. Rising is part of a hospital telemedicine program that uses video calls to address patient concerns after they are discharged from the ER. Estimates were made using 2008 Medicare reimbursement rates, and the researchers found that in 19.8% of revisits within 30 days, the total costs exceeded the initial ER visit by 118%. This study, however, shows revisit rates are actually much higher because people seek care at different hospitals than the ones where they were initially treated. I have broken bones, bruised legs pain so bad that at one point i thought death would be better then living.
I´ve got the hypermobile version as well, and I am struggling with finding anyone in my region that knows anything about this disease.
I have had many dislocations, subluxations, fractures and live in constant pain and fatigue.


I am fourteen and have to walk around high school with a cane.I have been a figure skater since kindergarten and have been coached by a former Olympian since I was 11. He has had major back surgery and they didn't fix the problem but made it worse and it continues to keep getting worse !
I've been on numerous ED sides and found Wide variances between the treatment and diagnosis. I have type 3, have had extensive spinal surgery, shoulder surgery and am about to have my first hip operation, followed a few months later by the second hip.
Lack of awareness of symptom recognition by patients and their relatives, accurate appraisal by general practitioners (GPs), distance to facility and mode of transportation6 are among the most important factors leading to delay in presentation, thus prolonging total time (TT) to treatment, and resulting in worse outcome in a large number of the patients. There were two phases of the study: in the first phase, EMS of Rescue 1122 were utilised to reduce TT by removing transportation delay and ensuring speedy communication between cardiology services and Rescue 1122 ambulance staff.
A proforma describing patients' characteristics, demographics, TT, DNT, reperfusion criteria, immediate and delayed complications were filled in by the attending doctor. The DNT was significantly dropped in CPU compared to ED and CCU (P = There was reduction of 63 minutes in DNT at CPU versus CCU. Since there wasn't a major difference in DNT, decrease in TT portrayed a lower transportation time than other modes. Therefore, we want to emphasise on two important aspects in the management of STEMI patients. Emergency medical services should be contacted at the onset of chest pain and the patients sent directly to CPU for evaluation (Figure-2).Integrating these two not-so-difficult strategies, a great deal of time may be saved, and when fighting a battle where 'time is muscle,' 'time' could mean the difference between life and death. It is strongly recommended that CPUs be developed in EDs of all districts and tertiary care hospitals nationwide as a cost-effective facility with a great impact on morbidity and mortality related to STEMI. The primary oral infection may range from asymptomatic to very painful, leading to poor oral intake and dehydration. The virus travels from the skin during contact to the sensory dorsal root ganglion, where latency is established. The mouth lesions (herpetic gingivostomatitis) consist of painful vesicles on a red, swollen base that occur on the lips, gingiva, oral palate, or tongue. However, if the pattern of the lesions is not specific to HSV, its diagnosis can be made by viral culture, PCR, serology, direct fluorescent antibody testing, or Tzanck test.
In one randomized controlled trial (RCT), children receiving acyclovir had oral lesions for a shorter time than children receiving placebo (median of four versus 10 days). Medications such as anti-depressants and anticonvulsants are commonly considered adjuvant analgesics because traditionally they have been used in combination with opioid or non-opioid analgesics for the treatment of pain.1,2 More recently, however, these medications have become primary therapy for neuropathic pain, pain related to fibromyalgia, and chronic pain.
The medications included in this review (with the exception of skeletal muscle relaxants) are more effective for neuropathic pain, including diabetic neuropathy and postherpetic neuralgia.1 Many of these medications also are useful for fibromyalgia. Studies with duloxetine have focused on its use as a primary treatment of chronic muscoskelatal pain, neuropathic pain, and fibromyalgia, while milnacipran has been used to treat fibromyalgia. The purpose was to analyze revisit rates, variation in revisit rates by diagnosis and state, and associated costs. She discovered that fear played a big factor in their decisions, according to an ABC News report.
So the cost factor and burden on the healthcare system is also much higher than originally thought. I mean, I wish that the doctors telling me that I should take ibuprofen for my pain could live in my shoes for a week. The doubt though lays in the fact that I have high arches in my feet super wide as well, ( apparently normally with EDS you have flat feet). In 2012 before I was diagnosed with EDS I was offered a spinal cord Stim for what doctors then called failed back surgery. I thought it was my kidneys at first, had every test possible and they found ovarian cysts and thought it might be referred pain (it wasn't). The Punjab government has established emergency medical services (EMS) Rescue 1122 in all the major districts of the province.7 This is the first trained Emergency Rescue Medical Service established in Pakistan according to international training standards. Injection Streptokinase (SK) was instituted either in the general emergency department or CCU. All patients with STEMI were thrombolysed in CPU and shifted to the CCU after stabilisation.
This can be attributed to the fact that Rescue 1122 is an ever available emergency facility which ensures quick response to emergency calls and speedy delivery to hospitals.88 Both these advantages are not present when patients rely on home transportation alone. In our study, the utilisation of CPU reduced the DNT to 28 minutes, hence affecting TT as a whole. First, is the use of EMS, and the second is the establishment of CPU within the existing emergency setup. Besides, awareness must be created among population at large regarding the recognition of chest pain symptoms, and the benefits of utilising EMS. Implications and reasons for the lack of use of reperfusion therapy in patients with ST-segment elevation myocardial infarction: findings from the CRUSADE initiative. An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction.
Prehospital delay in patients hospitalized with acute myocardial infarction in the emergency unit of a North Indian tertiary care hospital.
Randomised controlled trial and economic evaluation of a chest pain observation unit compared with routine care.
Impact of time to treatment on morbidity after prehospital fibrinolysis or primary angioplasty: data from the CAP TIM randomized clinical trial.
Duration of, and temporal trends (1994-1997) in, prehospital delay in patients with acute myocardial infarction: the second National Registry of Myocardial Infarction. High prevalence of lack of knowledge of symptoms of acute myocardial infarction in Pakistan and its contribution to delayed presentation to the hospital.
Trends in prehospital delay time and use of emergency medical services for acute myocardial infarction: experience in 4 US communities from 1987-2000.
The diagnosis of an infection with herpes simplex virus type 1 is usually made by the appearance of the lesions (grouped vesicles or ulcers on an erythematous base) and patient history. Oral HSV-1 infections reactivate from the trigeminal sensory ganglia, affecting the facial, oral, labial, oropharyngeal, and ocular mucosa.Primary infection appears two to 20 days after contact with an infected person. This review, part 3 of a 3-part series on medications for chronic pain, will focus on medications used for pain that are neither opioid nor non-opioid analgesics.
They either couldn’t get an appointment with their primary care physician and were afraid to wait, or felt too sick to endure multiple visits for X-rays and lab work when the ER had it all right in one place. Because my husband is in the military and I constantly change doctors, it makes it very difficult to get consistent treatment. I was born in Latin America, but I live now in Europe where a genetic department diagnosed me with EDS few months ago. It took half an hour for the doc to believe me, and they drained three litres of fluid from under my kneecap.
The way he felt while holding him on my hip, very bendy and flexible etc, falling a lot, bruising easily. Unfortunate: since the physicians have no knowledge themselves they might go to only one source and be lacking in their understanding of the other aspects. In developed countries, emergency services are equipped with the devices that transmit patient information, and even electrocardiographs, to the nearest hospital.12 Hence, valuable time is not wasted in petty formalities, triage and initial assessments.
This is the one factor that played the most significant role and achieved the goal of 30-minute DNT laid down by global guidelines. Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Arteries.
However, if uncertain, the diagnosis of herpes labialis can be made by viral culture, polymerase chain reaction, serology, direct fluorescent antibody testing, or Tzanck test. The vesicle should be unroofed with a scalpel or sterile needle, and a swab should be used to soak up the fluid and to scrape the base. Anticonvulsants, antidepressants, skeletal muscle relaxants, pramipexole, topical agents, and intrathecal medications will be included in this review. I have hypermobile joints & basically was told it is hypermobility syndrome, which to me seems to be more like a symptom. I went to the doctor because my knees really hurts and I felt that my legs loose strength, so I got scared. Pre requisite arrangements can be made by the hospital and the patient can get immediate treatment. The time taken to transfer the patient to the CCU for thrombolysis may result in delayed treatment20 and a patient with chest pain may not receive the required attention in the overcrowded ED with other equally serious patients fighting for the attention of limited number of doctors and staffs attention. We suggest that our rescue teams be trained in symptom recognition, performing and interpretation of ECGs. Other nonoral herpes simplex virus type 1 infections include herpetic keratitis, herpetic whitlow, herpes gladiatorum, and herpetic sycosis of the beard area.
The swab should be sent in special viral transport media directly to the laboratory (or placed on ice if transport will be delayed). I have persistent knee pain without injury, persistent back pain from an injury about 13 years ago. It was a funny visit to the doctor because he saw my skin, my face, my ears, even how I take the pencil, and he deducted that I have EDS!
I live in Ontario and thank goodness I was ref to a great Rheum who at least believed me, and did all the right tests. Pre-hospital administration of thrombolytics has even been well advocated in EMS13,14 with favourable results.


In this situation, a CPU may be the most appropriate place, especially since increased DNT has been directly linked with increased mortality.21 We introduced the concept of utilizing CPUs as a venue for thrombolysis, wherein previously the major role of CPUs had mainly been in assessment and monitoring of chest pain patients. A system should be created for prior warning to hospitals and ECG sent to CPU by telemetry. The differential diagnosis of nongenital herpes simplex virus infection includes aphthous ulcers, acute paronychia, varicellazoster virus infection, herpangina, herpes gestationis (pemphigoid gestationis), pemphigus vulgaris, and BehA§et syndrome. There were more aborted lesions in the valacyclovirclobetasol group compared with the placebo-placebo group (50 versus 15.8 percent).
These patients undergo workup, usually radiography and CT to look for lesions of the scapula, clavicle or ribs. The doctor is treating me with Folic acid and the pain has improved at lot and I don't feel the lack of strength in my legs anymore.
I by passed the pediatrician and took him to a pediatric orthopedist that diagnosed him with hypermobility and fit him with UCVL's ( orthotics on steroids). When I do, I can't jump at all, and the pain is excruciating (imagine all that impact on the joints). The minimum TT was in Rescue 1122 patients, and the minimum DNT was among the referred patients (Table-1).
Low level of education, distance, lack of awareness regarding recognition of symptoms of MI are among the many factors which affect delayed presentation, hence increasing TT.15-17 In our study, the female gender, lack of education and rural residence had significant impact on prolonging TT. Furthermore, general awareness should be created in the public regarding the benefit of using Rescue 1122 over other modes of transportation.
Oral acyclovir suspension is an effective treatment for children with primary herpetic gingivostomatitis.
Usatine, MDFigure 2.Primary herpetic gingivostomatitis caused by herpes simplex virus type 1 shown in (A) a four-year-old girl with lower lip ulcers and crusting on the upper lip, and (B) a two-year-old girl with ulcers on the lower lip and tongue.
Direct fluorescent antibody testing may be performed from air-dried specimens, and can detect 80 percent of true HSV-positive cases compared with culture results.10 Immunoglobulin G antibodies that are type-specific to HSV develop the first several weeks after infection and persist indefinitely.
1 ankle, both knees, both hips, both shoulders and both sides of my jaw have subluxed multiple times. My heart has also a congenital problem, my fingers hurt even with the splints, i can walk, but not too long, and i cannot have any social life, I am looking for a wheelchair, but I have nobody to push me !
I learnt that at least in my country (Chile) about 40% of the population has some kind of EDS!
They are helping with finger splints, wrist splints, exercises to help strengthen my body in areas we can to help the areas that slip out or break.
I am also a serious flute student, but I can't play for more than ten minutes before all my fingers bend backward and lock, forcing me to stop. Secondly, our study proves the drastic improvement in timely delivery of thrombolytics with the use of CPU.
Oral acyclovir, valacyclovir, and famciclovir are effective in treating acute recurrence of herpes labialis (cold sores).
A Tzanck test is difficult to perform correctly without specific training in its use, but it may be done in the office setting by scraping the floor of the herpetic vesicle, staining the specimen, and looking for multinucleated giant cells.
Recurrences of herpes labialis may be diminished with daily oral acyclovir or valacyclovir. Usatine, MDIn recurrent herpes labialis, symptoms of tingling, pain, paresthesias, itching, and burning precede the lesions in 60 percent of persons.5 The lesions then appear as clusters of vesicles on the lip or vermilion border (Figure 1).
They applied penciclovir cream or placebo within one hour of the first sign or symptom of a recurrence, and then every two hours while awake for four days.
Patients may have an isolated incident that causes such symptoms, but often have repetitive overhead motions such as ball throwing or javelin hurling. I was ridiculed an made to feel like some kind of drug addict poster child.i would not recommend treatment for this medical condition .
I know that I may be wrong, but the more I read about this awful illness, the more my life makes sense.As far as my doctor is concerned, I have Fibromyalgia and very severe ME. As he grew he would complain when we went to amusement parks, on hikes , places that required a lot of walking etc. Of course, my teacher views this as an excuse even though I am in many selective ensembles, and the band director told me he thinks I'm capable of learning saxophone on top of that. Topical acyclovir, penciclovir, and docosanol are optional treatments for recurrent herpes labialis, but they are less effective than oral treatment. Resolution of symptoms occurred more rapidly in the penciclovir group regardless of whether the medication was applied in the early or late stage. The short of it is, I switched to a pediatrician that listened and referred us to a specialist which asked me if I had ever heard of "EDS"?
I still suffer, I wake up in great pain, my hands swell due to the raynauds, my toes go blue and I'm in danger of losing my digits if not careful. I'm sick of being told to deal with it, or that everybody has aches and pains sometimes.
I asked if they would like my help to move over there and they laughed and said honey you can't do a thing!
I just hope with all my heart that they never have to come to me with a dislocated joint of their own.I cope by crafting.
She examined me as well ( I am 43) and determined that I also have it and that the gene is usually passed from the mother. I suffer bouts of costochondritis (inflammation of the sternum and rib cage) which is agony when it happens and live with heating bags on my chest with ice on my swollen collarbone (tends to slip if I lean over, into the fridge usually), a tip is glucosamine and good quality fish oil for those issues.
I plopped first one leg and then the other down and moved myself over, to their stunned dismay. Usatine, MDFigure 3.(A) Ulcers that form after the vesicles break, as shown in an adult women with herpes labialis. Need for immediate data to treat patients may consequently lead to duplication of tests and imaging, ultimately resulting in increased downstream costs, often passed down to patients. I am now unable to work, the pain and fatigue wiped out my ability to think and work effectively.
I also suffer as many of you will from IBS symptoms, like we didn't have enough to deal with. Common symptoms are eye pain, light sensitivity, and discharge with gritty sensation in the eye.
Hell to the yeah!Be strong people, and find some meaning for yourself!Have a beautiful life and smile at our wonderful planet that we are so lucky to have!
Fluorescein stain with a ultraviolet light may show a classic dendritic ulcer on the cornea (Figure 47). I am putting my joint paint on the back burner as we all do as parents because our kids come first. Tracking the movement of patients who are reevaluated and potentially re-admitted to other hospitals was a distinguishing factor in the study design. Also to the person with high arches, I also have very high arches, but upon standing my feet fall and flatten the worst my chiro friend had seen.
He fitted me for orthotics at his own expense and they've helped me from breaking my feet so often.
Usatine, MDHerpetic whitlow is a vesicular lesion found on the hands or digits (Figures 68 and 7). It occurs in children who suck their thumbs or medical and dental workers exposed to HSV-1 while not wearing gloves.
Herpes gladiatorum is often seen in athletes who wrestle, which may put them in close physical contact with an infected person. Vesicular eruptions are often seen on the torso, but can occur in any location where skin-to-skin contact has occurred.
For example, in the first 30 days after initial ED visits, patients in Florida had revisit costs that were 17.7% higher than the combined costs of all patients’ index ED visit costs. Herpetic sycosis is a follicular infection with HSV that causes vesiculopapular lesions in the beard area.
Estimates for states other than Florida suggest that revisits could cost as much as 45% more than the total costs for all initial ED visits.
Usatine, MDHSV infection is one of the most common causes of erythema multiforme (Figure 8), which some patients have with a recurrent HSV infection.
Usatine, MDFigure 9.Vesicles on a red base of the wrist in a woman with herpes gestationis after the loss of a pregnancy. That being said, our study shows a third of those revisits are occurring at a different ED within 3 days, and improving the communication infrastructure across EDS can help improve care.” Communication, in theory, might also imply the ability of all medical providers to communicate and share medical information such as imaging (X-ray, CT, MRI) studies, blood test results, and clinical notes and impressions.
The reality is that there is a fragmented system of care that currently exists in the U.S, with information silos that are not accessible to the vast majority of medical providers as well as across healthcare systems.
Developing an initiative for development of a national EMR might be a step toward improving patient care while reducing costs associated with revisits.
The appropriate use of observation units may further help to triage patients with more complex medical conditions, versus those who can be safely discharged home after their initial ED visit. For example, Jefferson Hospital’s ED has been using telemedicine to check on patients after they are sent home and that’s just one strategy to better track patients (or have them self-track the relevant condition and send the data) following an ED visit,” added Topol.



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