The American journal of emergency medicine
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We report a case of absolute vitamin K deficiency (VKD) diagnosed by measuring serum VK levels in an elderly woman undergoing warfarin therapy. A 78-year-old woman was admitted to our hospital because of dyspnea and sore throat diagnosed as pharyngitis 1 week before admission. On admission, the sore throat had exacerbated and dyspnea developed. ⋯ Warfarin was suspected to have caused absolute VKD. Severe coagulopathy in patients undergoing warfarin therapy is primarily caused by, relative VKD. However, the possibility of warfarin-related absolute VKD should be suspected when INRis not sufficiently improved by intravenous VK administration.
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Case Reports
Continuous chest compression pediatric cardiopulmonary resuscitation after witnessed electrocution.
Electrical injury is a relatively infrequent but potentially devastating multisystem injury with high morbidity and mortality. We describe the case of an 11-year-old boy who suffered loss of his consciousness after touching an electrical cable.
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Multicenter Study
Pulmonary Embolism Rule-out Criteria vs D-dimer testing in low-risk patients for the diagnosis of pulmonary embolism: a retrospective study in Paris, France.
The Pulmonary Embolism Rule-out Criteria (PERC) score has shown excellent negative predictive value; however, its use in the European population with high prevalence of PE is controversial. In Europe, PERC is not part of routine practice. For low-risk patients, guidelines recommend D-dimer testing, followed if positive by imaging study. We aimed to study the rate of diagnosis of PE after D-dimer testing in PERC-negative patients that could have been discharged if PERC was applied. ⋯ D-dimer testing in PERC-negative patients led to a diagnosis of PE in 0.5% of them, with 15% of patients undergoing unnecessary irradiative imaging studies.