The American journal of emergency medicine
-
Randomized Controlled Trial
Effectiveness of therapeutic plasma exchange in patients with intermediate syndrome due to organophosphate intoxication.
We aimed to determine effectiveness of therapeutic plasma exchange (TPE) in patients with intermediate syndrome (IMS) due to organophosphate (OP) intoxication. ⋯ In our study, it was observed that a significant decrease in the level of blood plasma OP and a significant increase in the level of PChE were achieved with TPE process in the early period of IMS due to OP poisoning. This study indicates that TPE is one of the effective treatment options for IMS due to OP intoxication.
-
Filtering the cardiopulmonary resuscitation (CPR) artifact has been a major approach to minimizing interruptions to CPR for rhythm analysis. However, the effects of these filters on interruptions to CPR have not been evaluated. This study presents the first methodology for directly quantifying the effects of filtering on the uninterrupted CPR time. ⋯ Filtering reduces the frequency of CPR interruptions for rhythm analysis in less than 60% of nonshockable rhythms. New strategies to increase the probability of prolonging CPR for nonshockable rhythms should be defined and evaluated using the methodology proposed in this study.
-
The referred pain of angina to upper half of the body is well known. However, isolated pain in the thigh as a presenting symptom in myocardial infarction is neither considered nor discussed at all. ⋯ After thrombolysis, the thigh pain improved. The probable mechanism for this is attributable to radiation of pain via sensory cardiac fibers that is present in the lumbar sympathetic ganglia, which resulted in pain.
-
We report a case where an emergency physician using bedside ocular ultrasound was able to diagnose vitreous hemorrhage and lens dislocation in an elderly patient. Bedside ultrasound performed by a physician trained in this imaging modality can diagnose ocular emergencies, facilitating appropriate consultation and treatment.
-
A 58-year-old man presented to the emergency department with a persistent left-sided sore throat of 2-month duration. The sore throat had not responded to antibiotic therapy. Over the past week, the soreness had increased and was aggravated by opening the mouth. ⋯ In the upper left neck, a 3-cm, firm, nontender, lymph node was palpated anterior to the sternocleidomastoid muscle. A computed tomography of the neck with contrast revealed an enhancing tonsillar mass as well as enlarged lymph nodes bilaterally. A transoral biopsy returned squamous cell carcinoma.