The American journal of emergency medicine
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Case Reports
Sevoflurane administration initiated out of the ED for life-threatening status asthmaticus.
Status asthmaticus is both a common and dangerous cause of acute dyspnea in the emergency department (ED) setting. Although most cases respond favorably to standard treatment, there are rare cases in which therapy beyond traditional treatment is needed. One of these treatment modalities includes inhalational anesthesia. ⋯ To our knowledge, this is only the second case to report the use of inhaled anesthetics initiated out of the ED for status asthmaticus and is the first report of its kind to thoroughly detail the respiratory response noted while inhalation anesthesia was being implemented. A brief review of other case reports involving the use of sevoflurane for asthma is included. This case, as well as the others reviewed, illustrates the significant beneficial effect inhaled anesthetics can have on asthma, making this a treatment modality that must be recognized and appreciated by all emergency medicine providers.
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Case Reports
Acute myocardial infarction due to marijuana smoking in a young man: guilty should not be underestimated.
Marijuana (cannabis) is a frequently used recreational drug that potentially imposes serious health problems. We present a case of acute myocardial infarction with chronic total occlusion of left main coronary artery due to marijuana smoking in a 27-year-old man, which was not previously reported. This case illustrate that marijuana abuse can lead to serious cardiovascular events.
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Emergency medical services (EMS) preparedness is essential to reduce morbidity and mortality from mass casualty incidents (MCIs). ⋯ Advanced EMS interventions are not frequent during MCIs in the United States. Emergency medical services systems with other types of providers or MCI response patterns might report different findings.
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Case Reports
Successful cardiopulmonary cerebral resuscitation in patient with severe acute pancreatitis.
Severe acute pancreatitis (SAP) is a critical illness in clinical practice, which is characterized by intensive inflammatory response in the early phase and infected pancreatic necrosis in the later phase. Despite the knowledge of SAP and critical care support technology got significant progress in recent years, SAP still carries approximately 30%mortality rate. Some SAP patients also have many other kinds of underlying disease such as hyperlipidemia, hypertension, coronary atherosclerotic heart disease, and heart rhythm abnormalities, which are related to cardiopulmonary arrest to some extent. ⋯ We would not start CRRT for the complexity of operation and additional loss of blood. This time, we used CRRT to regulate electrolyte and acid-base imbalance and implement hypothermia brain protection, which played an important role in the patient that we report here. We strongly recommended a prolonged cardiopulmonary cerebral resuscitation in some not quite old SAP patients and continue to use existing CRRT but not remove it.
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Our objective was to identify trends and examine the characteristics of the top 100 cited articles in emergency medicine (EM) journals. ⋯ The top-cited articles published in EM journals help us recognize the quality of the works, discoveries, and trends steering EM. Our analysis provides an insight to the prevalent areas of study being cited within our field of practice.