The American journal of emergency medicine
-
Esophageal perforation due to blunt trauma is a rare clinical condition, and the diagnosis is often difficult because patients have few specific symptoms. Delayed diagnosis may result in a fatal clinical course due to mediastinitis and subsequent sepsis. ⋯ Therefore, the patient developed septic shock due to mediastinitis. However, his subsequent clinical course was good because of prompt combined therapy involving surgical repair and medical treatment after the diagnosis.
-
The aim of this study was to evaluate factors of digoxin use and its relation to mortality in ED patients with atrial fibrillation (AF). ⋯ In ED patients with AF, digoxin was more frequently assigned to vulnerable patients with concomitant HF or valvular heart disease, and digoxin use was not related to a significantly increased risk of mortality.
-
The use of ultrasonography for the investigation of pneumomediastinum is limited by the presence of air artifacts. Air accumulation in the mediastinum obscures the heart, sometimes leading to misinterpretation as lung tissue. ⋯ We named this dynamic finding, the "disco spotlight" sign. This finding may be useful to confirm the diagnosis of pneumomediastinum.
-
It is unclear whether scene time interval (STI) is associated with better neurological recovery in the emergency medical service (EMS) system with intermediate service level. ⋯ The middle STI (4-7min) was associated with the highest odds of neurological recovery for patients who could not be restored in the field. The STI may be a clinically useful predictor of good neurology outcome in victims of cardiac arrest.
-
Kohler's disease is rare cause of foot pain and limping in the pediatric population. The exact etiology of Kohler's disease is unknown. ⋯ The patient was eventually diagnosed with Kohler's disease (avascular necrosis of the navicular bone). Although Kohler's disease is not very common, it should be considered in the differential diagnosis of foot pain in the pediatric population, as it may prevent unnecessary tests and treatments.