The American journal of emergency medicine
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Spontaneous ruptures of the inferior vena cava (IVC) are rare. The mortality rate is high associated with all IVC injuries despite prompt resuscitation or operation. We present a case of 68-year-old women with spontaneous IVC dissection, presented as acute chest pain. ⋯ After resuscitation, abdomen CT angiography was taken to find bleeding focus. Second CT demonstrated massive contrast extravasation to pericardial space due to rupture of IVC. Patient expired due to multi-organ failure.
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Case Reports
Diagnosing acute aortic dissection with aneurysmal degeneration with point of care ultrasound.
To present a case with visual images of an aortic dissection with aneurysmal degeneration. ⋯ An aortic dissection was detected rapidly by emergency physician preformed bedside ultrasound. This led to rapid identification and treatment CONCLUSION: Rapid bedside emergency ultrasound can quickly and accurately diagnosis an aortic dissection and lead to rapid treatment.
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There is widespread geographic variation in healthcare quality, but we often lack clear strategies for improving quality in underserved areas. This study characterized geographic disparities in stroke care quality to assess whether improved access to neurological services has the potential to bridge the care quality gap, particularly in terms of alteplase (rt-PA) administration. ⋯ The large quality gap in stroke care between metropolitan and non-metropolitan areas could be at least partly addressed through improved procedural efforts by stroke center certification increasing the supply of neurological services, (i.e. through training and hiring new neurologists) or by adopting decision support systems such as telemedicine.
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This is a case of a 19-year-old male who presented to the medical tent at an outdoor electronic dance music festival (EDMF) due to an altered mental state in the setting of acute 3,4-methylenedioxymethamphetamine (MDMA) intoxication. He was noted to be in severe respiratory distress, required endotracheal intubation in the field and subsequently developed Acute Respiratory Distress Syndrome (ARDS) without other acute organ dysfunction. He was hospitalized for 5days requiring endotracheal intubation and mechanical ventilation. By presenting this case, we will explore and discuss the cardiopulmonary effects of MDMA intoxication that can lead to a rare, deleterious complication of MDMA intoxication other than previously reported adverse outcomes.