The American journal of emergency medicine
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Hyperbaric oxygen (HBO) is widely accepted as a treatment for air or gas embolism, carbon monoxide (CO) poisoning, clostridial myonecrosis, crush injuries, and thermal burns. To the best of our knowledge, after HBO therapy, atrial fibrillation (AF) has not been reported in the literature yet. We herein describe a case of AF that occurred in a woman who had taken HBO therapy for CO poisoning. ⋯ After the HBO therapy, ECG showed AF. Her rhythm returned to the normal sinus rhythm after amiodarone treatment. Physicians should keep in mind that HBO treatment could contribute to AF, and all patients' ECG should be monitored before and after HBO therapy.
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Mediastinal hematoma is an uncommon finding in blunt chest trauma. It may be caused by aortic injury, by mediastinal vascular injury such as aortic injury, and by fractures of the sternum and vertebral column. A huge mediastinal hematoma can result in extrapericardial cardiac tamponade by compressing the adjacent organs. ⋯ The subxiphoid view of FAST can easily miss a mediastinal hematoma. For trauma patients with probable mediastinal injuries, we suggest doing an extended FAST with parasternal long-axis view. Alternatively, one should consider lowering the threshold of thoracic computed tomographic scan in patients with persistent symptoms because a missed mediastinal hematoma could be insidious and fatal.
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Energy drinks are popular among young individuals and marketed to college students, athletes, and active individuals between the ages of 21 and 35 years. We report a case that had ischemic stroke and epileptic seizure after intake of energy drink with alcohol. To the best of our knowledge, the following case is the first report of ischemic stroke after intake of energy drink. ⋯ In cranial diffusion magnetic resonance imaging, there were hyperintense signal changes in bilateral occipital area (more pronounced in the left occipital lobe), right temporal lobe, frontal lobe, and posterior parietal lobe. All tests associated with possible etiologic causes of ischemic stroke in young patients were negative. Herein, we want to attract attention to adverse effect of energy drink usage.
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Randomized Controlled Trial
Head position angles to open the upper airway differ less with the head positioned on a support.
The aim of the study was to assess the effects of positioning the head on a support on "head position angles" to optimally open the upper airway during bag-valve mask ventilation. ⋯ In the head-with-a-support group, when compared with the head-without-a-support group, head position angles differed less, indicating a decreased potential for failure during bag-valve mask ventilation with the head on a support. Moreover, in the head-with-a-support group, ventilation parameters differed less between head positions, and ventilation improved. These findings suggest a potential benefit of positioning the head on a support during bag-valve mask ventilation.
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Comparative Study
Anterior-posterior compression pelvic fracture increases the probability of requirement of bilateral embolization.
Transarterial embolization has become an effective method in the management of pelvic fracture-related retroperitoneal hemorrhage. However, the selection of bilateral embolization or selective unilateral embolization remains controversial. The anterior-posterior compression (APC) pelvic fracture creates a complete diastasis of the anterior pelvis, which might be associated with bilateral sacroiliac joint injuries and further bilateral arterial injuries. In the current study, we evaluated the correlation between APC pelvic fracture and the need for bilateral internal iliac artery (IIA) embolization. ⋯ In the management of APC pelvic fracture, more attention should be paid to the higher probability of bilateral hemorrhage. Bilateral IIA embolization should be considered in patients with APC pelvic fracture.