The American journal of emergency medicine
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The recent arrival of the target-specific oral anticoagulants (TSOACs) offers potential advantages in the field of anticoagulation. However, there are no rapid and accurate and routinely available laboratory assays to evaluate their contribution to clinical bleeding. With the expanding clinical indications for the TSOACs, and the arrival of newer reversal agents on the market, the emergency clinician will need to be familiar with drug specifics as well as methods for anticoagulation reversal. This review offers a summary of the literature and some practical strategies for the approach to the patient taking TSOACs and the management of bleeding in these cases.
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To determine the ability of emergency physicians to detect complex abnormalities on point-of-care (POC) echocardiograms. ⋯ Our study results suggest that with increased experience, emergency physicians can accurately identify most of complex echocardiographic abnormalities.
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The hemodynamic profile of patients presenting to the emergency department (ED) with acutely decompensated heart failure (ADHF) provides the basis for initial management. We characterized the hemodynamic profiles of patients presenting to the ED with ADHF and their association with treatments and outcomes. ⋯ Of HTN ADHF patients, less than half received vasodilators, and approximately one-third did not receive diuretics, in the ED. The development of stratified protocols for therapy based on these profiles should be considered.
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Prehospital delay is the most critical factor to prognosis of ST-elevation myocardial infarction (STEMI). Few study had examined a series of predictors of prehospital delay by multivariate analysis of sociodemographic and clinical characteristics, onset features, and symptom condition of STEMI in China. ⋯ Multivariate analysis results found that symptom onset-related variables strongly influenced PDT. Onset-related status of STEMI needed to be combined into interventions of participants, and more emergency education should be recommended to both participants and their relatives. Most importantly, more efforts should be taken to educate the public about the symptoms and signs to increase the recognition of STEMI.
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Case Reports
The evaluation of acute vision loss: a case report of central serous chorioretinopathy.
Acute vision loss is frightening to patients and may represent serious pathology that is irreversible if not intervened upon quickly. We present a case of a 36-year-old man with sudden onset of unilateral painless central visual disturbance described as flashes of light. ⋯ Although there is no proven treatment regimen for acute disease, vision problems usually resolve. Some patients have recurrent episodes that can lead to permanent visual loss