The American journal of emergency medicine
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Stroke has been rarely associated with carbon monoxide (CO) intoxication. We report a symptomatic internal carotid artery (ICA) thrombosis in a patient with acute CO intoxication.
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Cardiogenic shock (CS) is a predictor of poor prognosis in patients with acute pulmonary embolism (APE). ⋯ In patients with APE, low QRS voltage, RBBB, and ST-segment elevation in lead V1 were associated with CS.
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Intramedullary pressure changes during intraosseous (IO) procedures have been implicated in the intravasation of bone marrow fat and with pain in conscious patients. The objective of this study was to demonstrate inter-provider variability in pressures generated during initial flush procedures. ⋯ The IO compartment pressures generated by physicians demonstrated significant interoperator variability with greater than 35-fold difference in flush forces, and an inverse relationship between intraosseous pressure and flush duration. It may be prudent practice for providers to extend the flush over several seconds, thus limiting maximal pressures.
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Nebulized particles must have diameters between 1 to 5 μm (optimal particle size range [OPSR]) to be deposited in the lower respiratory tract. The purpose of this study is to determine factors that affect the particle size distributions of nebulized albuterol. ⋯ Single-use disposable nebulizers do not degrade with use, but their performance is highly dependent on gas flow rates. At the flow rate achieved by the home pump, the semipermanent nebulizer performs better than the SUD nebulizer.
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Transcatheter arterial embolization (TAE) is usually necessary in the management of hemodynamically unstable patients with concomitant pelvic fractures. Given the critical conditions of such patients, TAE is at times performed only according to the results of a primary evaluation without computed tomographic (CT) imaging. Therefore, the evaluation of associated intra-abdominal injuries (IAIs) might be insufficient. Clinically, some patients have required post-TAE laparotomy due to further deterioration. In this study, we attempted to determine a feasible protocol for post-TAE observation. ⋯ In the management of hemodynamically unstable patients with concomitant pelvic fractures, greater attention should be paid to associated IAIs. Early CT imaging is encouraged after the patient's hemodynamic status is stabilized with TAE.