BACKGROUND: Cancer patients frequently visit the emergency department (ED) with various symptoms of cancer. The purpose of this study was to determine the clinical characteristics and 1-year survival rate of cancer patients in the ED of a university hospital. METHODS:We conducted a retrospective review of 408 cancer patients who visited the ED between January 2011 and December 2011. Patient information on demographics, chief complaints, fi ndings, and survival was gathered from the hospital registry and corresponding health administration. RESULTS:The study included 240 (58.8%) males and 168 (41.2%) females with a median age of 57.9 years (range 19-87). Regarding cancer staging, 266 patients (65.3%) had metastatic disease and 142 (34.7%) had local and loco-regional disease. The hospitalization rate was 59.6%. The most common symptoms were shortness of breath (23.2%), pain (17.8%), fever (14.2%), and nausea/vomiting (14.4%). The most common cancer sites were the lung (32.5%), gastrointestinal system (25.4%), and breast (9.3%). The initial evaluation determined progressive disease (42.4%), chemotherapy effects (20.7%), infections (17.2%), radiotherapy effects (4.7%), extravasation (1.8%), anemia (1.4%), and unknown (11.3%). During follow up, 191 (46.8%) patients died after admission to the ED. The 1-year overall survival of all patients was 7.3 months.CONCLUSIONS: Symptom management in cancer patients is a complex multifaceted concern for the emergency physician. Because of the increasing prevalence of cancer patients, emergency physicians should develop consensus algorithms in collaboration with the relevant disciplines to manage the commonly encountered problems.

Our findings suggest that sending the ECG images via a multimedia message service may be a practical and inexpensive telecardiology procedure.

Objective: Reports to legal authorities must be made for a variety of patients who present to emergency departments (EDs). This study summarises paediatric cases reported with a temporary legal form from our ED and reviews the literature on this topic with reasons and possibilities. Material and Methods: Charts were reviewed of all patients presenting to the university ED up to 18 years of age who were declared to hospital police as a legal case between January 1, 2008 and December 31, 2009. Demographic and clinical details were recorded. SPSS version 12 was used for statistical analysis. Results: During the study period, 889 paediatric cases (mean age 8±5 years, 58% male) were referred to the hospital police as cases requiring legal action. The categories of injuries/events to patients due to the chief complaint were as follows: poisonings in 28% (n=255), falls in 23% (n=208), and traffic accidents in 16% (n=144). Over half (55%) of patients were discharged home while 45% were admitted: 13% to paediatric surgery, 8% to neurosurgery, and 7% to paediatrics. Conclusion: Patients who were admitted to the emergency service due to falls could be reported to the legal authorities by doctors as a result of a suspicion of child abuse, neglect or any kind of physical violence instead of simple reasons due to the findings of the patients. It was observed that patients who had no significant physical findings or a history could not be reported.

Typical ultrasonographic findings of cardiac rupture were present in this patient, who presented in extremis with chest pain. Early bedside echocardiography can be helpful in directing the initial care of critically ill patients.

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