The American journal of emergency medicine
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The objective was to compare neurological outcomes at 6 months in older patients with preinjury warfarin or clopidogrel use and mild traumatic intracranial hemorrhage with those without prior use of these medications. ⋯ Older adults with preinjury warfarin or clopidogrel use and mild traumatic intracranial hemorrhage may be at an increased risk for unfavorable long-term neurological outcomes compared with similar patients without preinjury use of these medications.
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The cardiac dipolar field is represented by the measured 12-lead electrocardiogram (ECG) and 3-lead vectorcardiogram (VCG). The objective is to derive the 12-lead ECG and 3-lead VCG from 3 measured leads acquired from only 5 electrodes. ⋯ The 12-lead ECG and 3-lead VCG can be derived accurately from 3 measured leads with high quantitative and qualitative correlations. These derived tracings can be acquired instantaneously and displayed in real time from a cardiac rhythm monitor. This will allow for immediate, on-demand, convenient, and cost-effective acquisition and analysis of the 12-lead ECG and 3-lead VCG in areas of acute patient care.
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The prevalence and impact of prehospital neurologic deterioration (PhND) in patients with traumatic brain injury (TBI) have not been investigated. We aimed to determine the prevalence of PhND during emergency medical service (EMS) transportation among patients with TBI and its impact on patient's outcome. ⋯ Prehospital neurologic deterioration occurs in 9% of patients with TBI. It is more prevalent in men and associated with lower EMS GCS level and higher ED ISS. Prehospital neurologic deterioration is an independent predictor of worse hospital outcome and higher resource use in patients with TBI.
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Heatstroke (HS) is a life-threatening condition, manifested by systemic inflammation and multiorgan failure. Rapid recognition and treatment are life saving. We report a laboratory-oriented characterization of HS by low plasma C-reactive protein (CRP) level and propose its usefulness in distinguishing this type of hyperpyrexia from central nervous system-associated high core temperature. ⋯ Low serum CRP levels characterize non-central nervous system-associated HS. This available laboratory test could identify noninfectious hyperthermic patients upon admission, saving precious time until treatment and avoiding unnecessary diagnostic tests.