The American journal of emergency medicine
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Compartment syndrome usually occurs in the muscles of an extremity as a consequence of trauma or reperfusion. However, it can also occur from minor injuries with resulting hematoma. We reviewed the charts of 5 individuals who presented to the emergency department after minimal or no known trauma and were ultimately diagnosed with acute compartment syndrome. ⋯ Low-impact trauma can cause acute compartment syndrome in the lower extremities. These cases could be the result of muscle hemorrhage and subsequent hematoma formation, rather than muscle swelling itself. Anticoagulation therapy can increase the risk of hemorrhage.
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The present study was designed to evaluate the effects of ulinastatin (UTI) on cardiac dysfunction after cardiopulmonary resuscitation (CPR). ⋯ The progression of proinflammatory responses, oxidative stress, and myocardial injury have been linked to the reduced EF after VF/CPR, and the administration of UTI at a cardioprotective dosage preserved the cardiac function after VF/CPR.
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Case Reports
Cerebral venous sinus thrombosis as an initial manifestation of primary antiphospholipid syndrome.
Cerebral venous sinus thrombosis is a rare neurologic manifestation of antiphospholipid syndrome. We report a case of a 49-year-old woman who presented to the emergency department with recurrent episodes of transient clumsiness of the left upper extremity. ⋯ Thrombophilia screen disclosed positive lupus anticoagulant. In this case report, we aim to emphasize the significance of recognizing an unusual presentation of antiphospholipid syndrome.
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Shock index (SI), the ratio of heart rate to systolic blood pressure, has found to outperform conventional vital signs as a predictor of shock. Although age-specific vital sign norms are recommended in screening for shock, there are no reported age- or sex-specific norms for SI. Our primary goal was to report age- and sex-specific SI normal values for a nationally representative population 10 years and older by 5-year age groups. A secondary goal was to report SI normal values for children ages 8 to 19 years by 1-year age groups. ⋯ This first report of age- and sex-specific normal values for SI indicates that SI norms vary by age and sex. Just as age-specific vital sign norms are recommended in screening for shock, our findings suggest that age- and sex-specific SI norms may be more effective in screening for shock than a single-value threshold.
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Swimming is one of the most popular recreational activities in the United States. The objective of this study was to investigate the epidemiology of the complete spectrum of injuries associated with swimming and swimming pools treated in US hospital emergency departments. ⋯ The observed increase in injuries among individuals older than 7 years underscores the need for increased prevention efforts, including education about safe swimming practices, supervision, and environmental modifications.