Annals of emergency medicine
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Evaluate the utility of routine rescanning of older, mild head trauma patients with an initial negative brain computed tomography (CT), who is on a preinjury antithrombotic (AT) agent by assessing the rate of delayed intracranial hemorrhage (dICH), need for surgery, and attributable mortality. ⋯ In older patients with an initial Glasgow Coma Scale of 14 to 15 and a negative initial brain CT scan, the dICH rate is low (<1%) and of minimal clinical consequence, regardless of AT use. In addition, no patient had operative neurosurgical intervention. Therefore, routine rescanning is not supported based on the results of this study.
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Centers for Disease Control and Prevention conducts case surveillance through the National Notifiable Diseases Surveillance System (NNDSS). This study aimed to provide surveillance report of unintentional carbon monoxide poisoning across multiple data sources to provide baseline data for the new NNDSS carbon monoxide poisoning surveillance. ⋯ The crude rates in non-fire-related carbon monoxide poisonings from hospitalizations, and mortality significantly decreased over the study period (ie, 2005 to 2018). This surveillance report provides trends and characteristics of unintentional carbon monoxide poisoning and the baseline morbidities and mortality data for the Centers for Disease Control and Prevention national surveillance system of carbon monoxide poisoning.
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The Southern Pacific rattlesnake (Crotalus helleri) is commonly encountered throughout Southern California. Typical toxicity includes tissue injury and hematologic toxicity. ⋯ In this case series, 7 patients envenomated by the Southern Pacific rattlesnake with significant neurotoxicity, including dysarthria, ataxia, and myokymia, are presented. Clinicians practicing in this region should be aware of evolving patterns of toxicity associated with the Southern Pacific rattlesnake.