The American journal of emergency medicine
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Existing data indicate that selenium supplementation may be beneficial in critically ill patients and in those with ischemic stroke. The purpose of this retrospective study was to explore the influence of early administration of selenium on neurological outcome after cardiopulmonary resuscitation (CPR). ⋯ This retrospective analysis leads to the hypothesis that early administration of selenium may improve neurological outcome after cardiac arrest.
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Takotsubo cardiomyopathy, or left ventricular apical ballooning syndrome, is a newly described disorder in which patients develop anginal symptoms, often times with acute congestive heart failure, during periods of stress. The electrocardiogram demonstrates ST-segment and/or T-wave abnormalities similar to those findings seen in acute coronary events; on occasion, serum markers can be abnormal. As an extreme, acute pulmonary edema with or without cardiogenic shock can also be encountered. ⋯ We compared 2 populations encountered in the emergency department (ED) population--Takotsubo cardiomyopathy and ST-segment elevation myocardial infarction. In the ED, features of the presentation and management were similar between the 2 groups with the exception of the presence of female sex and abnormal QT interval occurring more often in Takotsubo cardiomyopathy subgroup. These 2 cardiovascular maladies present in very similar fashion in the ED; distinction in the ED may not be possible.
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Comparative Study
Ultrasound-guidance vs. standard technique in difficult vascular access patients by ED technicians.
We evaluated the efficacy and safety of emergency department technicians' (EDT) use of ultrasound (US) guided peripheral intravenous (PIV) access compared to the traditional approach on a subset of patients with difficult IV access. ⋯ Following a brief US training for PIV access, EDTs showed similar success rates but US had significantly improved speed and patient satisfaction with fewer skin punctures and complications.
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The aim of this study is to investigate the use of multipolar radiofrequency (RF) ablation with internally cooled electrodes to control hemorrhage percutaneously from blunt liver trauma. ⋯ Multipolar RF ablation with internally cooled electrodes is effective in producing hemostasis percutaneously by direct treatment of injured parenchyma in blunt liver trauma.