David A. Della-Giustina

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Ectopic pregnancy is a high-risk diagnosis that is increasing in frequency and is still commonly missed in the emergency department. The emergency physician needs a high index of suspicion and must understand that the history, physical examination, and a single quantitative beta-hCG level cannot reliably rule out an ectopic pregnancy. Most pregnant patients(More)
Babesiosis is a tick-borne illness endemic to the coastal areas of southern New England. Despite the enormous safety measures that transfusion and blood bank services perform for each product, transfusion of blood products is not without risk. The majority of transfusion-related reactions and complications are recognized soon after transfusion. We report a(More)
Orthopedic injuries in children are unique in terms of the mechanisms of injury, pathophysiology, and healing. This article reviews the pediatric fracture patterns and common pediatric injuries or complaints seen in the emergency department, with an emphasis on management in the emergency department. Additionally, the approach to pediatric cervical spine(More)
INTRODUCTION The Masimo Radical-7 Pulse CO-Oximeter is a medical device recently approved by the US Food and Drug Administration that performs noninvasive oximetry and estimated venous or arterial hemoglobin measurements. A portable, noninvasive device that rapidly measures hemoglobin concentration could be useful in both austere and modern hospital(More)
Patients with back pain commonly present in the emergency department for evaluation and treatment. Because it is a common syndrome with a generally benign origin, the examiner may overlook markers of serious disease. This article reviews the important historical and physical factors to consider, with an emphasis on the red flags of serious disease. This(More)
Auricular foreign bodies are usually presented to the emergency department in an easily recognizable fashion. We report the case of a 16-year-old male who presented to the emergency department with complaints of unilateral tinnitus and dysgeusia. He denied any history of injury except for falling from his bike in the woods earlier that day. On examination,(More)
This study describes deep sedations performed for painful procedures completed in the emergency department at an academic tertiary care hospital during an 18-month period. One hundred consecutive cases were retrospectively reviewed to describe indications, complications, procedural lengths, medication dosing, and safety of these sedations. Propofol and(More)
We present the case of a 45-year-old female who presented multiple times to the emergency department with acute low back pain and was subsequently diagnosed with bilateral psoas muscle abscess. Psoas abscess is an uncommon cause of acute low back pain that is associated with high morbidity and mortality. The onset of symptoms is frequently insidious and the(More)