The American journal of emergency medicine
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Dental fracture is a complication of laryngoscopy and endotracheal intubation. ⋯ Based on the dental fracture models studied, plastic laryngoscope blades have a lower potential for dental fracture compared with metal blades. Plastic laryngoscope blades would be best suited for trainees performing routine intubations under direct supervision. Metal blades would be more advantageous in difficult intubations preferably done by experienced intubators.
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Comparative Study
Canadian Headache Society criteria for the diagnosis of acute migraine headache in the ED--do our patients meet these criteria?
We previously reported that many patients who present to the ED with "migraine" headache do not meet the International Headache Society criteria (IHSC) for the diagnosis of acute migraine. Objective The aim of the study was to compare the frequency for which ED patients with migraine headache meet the Canadian Headache Society criteria (CHSC) vs the IHSC. ⋯ In our study population, only a minority of patients with headache who have prior diagnosis and/or ED diagnosis of migraine headache met CHSC. The utility of CHSC and/or IHSC to standardize ED patients for headache research may be limited.
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Comparative Study
Intubation without premedication may worsen outcome for unconsciousness patients with intracranial hemorrhage.
To clarify the influence of an intubation maneuver with or without premedication for an intracranial hemorrhage in an unconsciousness patient, we retrospectively analyzed 70 patients who had received intubation for unconsciousness and in whom a nontraumatic intracranial hemorrhage was found by CT over a 6-year period. They were divided into 2 groups, consisting of a drug group (n=15), wherein drugs were used before intubation, and control group (n=55), wherein no drugs were used before were intubation. ⋯ The GOS in the control group was significantly higher than in the drug group (P<.001). In cases of intubation for unconscious patients who may have intracranial hemorrhaging, premedication is considered associated with a more favorable outcome.
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Preeclampsia is a complication of pregnancy associated with hypertension and proteinuria. Preeclampsia may be associated with grand mal seizures and is termed eclampsia. Historically, eclampsia occurring more than 48 hours after delivery, known as late postpartum eclampsia, was thought to be uncommon; however, recent evidence suggests that its incidence is increasing. ⋯ This contributes to difficulty in diagnosing late postpartum preeclampsia-eclampsia in an emergency department setting. We report 2 cases of late postpartum eclampsia presenting 8 days after delivery, which highlight the unique features of this disorder and discuss some of the difficulties in managing these patients. Greater awareness and knowledge of this disorder by ED physicians should improve outcomes in these potentially life-threatening cases.