The American journal of emergency medicine
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To establish a clinical pathway for outpatient enoxaparin therapy in deep venous thrombosis (DVT) and then characterize its implementation and barriers to use. ⋯ The establishment of an organized DVT pathway for outpatient enoxaparin may facilitate home therapy; however, there will remain reasons that make hospital admission unavoidable in some patients.
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Case Reports
Life-threatening presentation of mediastinal neoplasms: report on 7 consecutive pediatric patients.
Cases of respiratory failure at presentation in children with anterior mediastinal malignancies can be very challenging for clinicians. Seven consecutive children presenting with superior mediastinal syndrome are reported needing urgent critical care approach. ⋯ Critical or extreme presentation of mediastinal neoplasms does not preclude a good clinical outcome: an intensive care approach is essential to allow patient recovery and effective antineoplastic therapy administration.
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Comparative Study
Can ruptured appendicitis be detected preoperatively in the ED?
The purpose of this study is to determine which clinical symptoms/signs and computed tomography (CT) signs can help in distinguishing ruptured from simple appendicitis. ⋯ Besides some clinical findings, CT scan can accurately determine appendiceal rupture in acute appendicitis and can further demonstrate the presence of local inflammatory mass, facilitating management decision in the emergency department (ED).
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Comparative Study
Effectiveness of mouth-to-mouth resuscitation performed by young adolescents on a mannequin.
Bystanders are reluctant to perform basic life support (BLS) because of fear of failure and of infection, especially with mouth-to-mouth resuscitation (MTM). A possibility to enhance willingness could be the giving of MTM or BLS instructions at a very early age to the potential rescuers. The study aimed to investigate the effectiveness of MTM with respect to ventilation and the time needed for performing 5 ventilations. ⋯ Ten-year-old children have already developed sufficient motor skills for MTM with no significant time differences compared with the 14-year-olds. However, physical demands may be rather high at this age. Further long-term studies are needed to investigate clinical benefits of early teaching of MTM or BLS that may lead to international guidelines with low age limits.
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Detecting and monitoring blood loss in trauma patients can often be challenging when an obvious source of hemorrhage is not readily seen. ⋯ Our data indicates that the measurement of the IVC diameter is a reliable indicator of blood loss, even in small amounts of 450 mL. On average, there was about a 5-mm decrease in both the IVCe and IVCi after donation of 450 mL of blood. The measurement of the IVCe may be an important addition to the ultrasonographic evaluation of trauma and other potentially volume-depleted patients.