The American journal of emergency medicine
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In-hospital cardiac arrests (IHCAs) are often preceded by abnormal vital signs. Preceding abnormal vital signs might lower the physiological reserve capacity and therefore decrease survival after an IHCA. ⋯ The NEWS can be a probable proxy for estimating physiological reserve capacity since high NEWS is associated to high change of death in case of an IHCA. This information can be used when discussing prognosis with patients and relatives. But even more importantly, it stresses the need for better preventive strategies in IHCAs. STRENGTHENS AND LIMITATIONS WITH THIS STUDY.
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Diffuse axonal injury is usually caused by head trauma, and patients have significant clinical symptoms during admission to the emergency department. In our case, we present a five-year-old patient who was involved in a car accident. During admission to the emergency department, the patient had no symptoms of trauma. ⋯ In some studies, it has been reported that diffuse axonal injury is permanent in accelerated and decelerated head traumas without accompanying loss of consciousness. Neurological sequels have occurred in the recovery phase of some patients with diffuse axonal damage. In this study, we present a delayed diffuse axonal injury case accompanying a head trauma.
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To evaluate occurrence of cerebellar stroke in Emergency Department (ED) presentations of isolated dizziness (dizziness with a normal exam and negative neurological review of systems). ⋯ Though there was preselection bias for stroke risk factors, our study suggests an important proportion of cerebellar stroke among ED patients with isolated dizziness, considering how common this complaint is.
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Stanford type A aortic dissection (TAAD) may lead to coronary artery occlusion and malfunction. However, TAAD manifesting as acute ST-segment elevation myocardial infarction (STEMI) has not been studied. In the present study, we reported 8 TAAD cases with STEMI as the primary presentation, and analyzed their clinical characteristics and outcome. ⋯ TAAD presenting as STEMI was a rare condition that predominantly involved RCA. A quick and correct clinical diagnosis of STEMI caused by TAAD prior to invasive procedure would be important. Urgent CAG without awareness of TAAD could provide important information for a timely diagnosis. High level of suspicion and awareness is the key to establishing the diagnosis and achieving optimal clinical outcome.