The American journal of emergency medicine
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Case Reports
Successful treatment of propafenone-induced cardiac arrest by calcium gluconate: A case report.
Propafenone is prescribed for the control of cardiac ventricular arrhythmias. Poisoning from propafenone intoxication is rare, but the survival rate of patients is low. We present a case of a 37-year-old man who developed cardiac arrest due to propafenone intoxication. ⋯ After repeated administrations of calcium gluconate, the patient achieved a full recovery. To the best of our knowledge, this is the first case report in which a full recovery from cardiac arrest was achieved by administration of calcium gluconate. We recommend that for patients poisoned by propafenone, close monitoring for decreased blood calcium is important.
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Spontaneous pneumomediastinum is defined as the presence of free air in the mediastinum without any apparent concomitant factors or disease. It is uncommon but usually benign and self-limiting. Generally, patients with spontaneous pneumomediastinum are admitted to hospital, and occasionally, prophylactic antibiotics are administered to prevent mediastinitis. The purpose of this study was to describe practices concerning the feasibility of outpatient treatment and follow-up of spontaneous pneumomediastinum and the necessity of prophylactic antibiotics. ⋯ Spontaneous pneumomediastinum is a benign condition presenting primarily in young adults, with an uneventful recovery. Therefore, patients may recover from this condition without admission or the need for prophylactic antibiotics.
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The hydraulic height control systems of hospital beds provide convenience and shock absorption. However, movements in a hydraulic bed may reduce the effectiveness of chest compressions. This study investigated the effects of hydraulic bed movement on chest compressions. ⋯ These results indicate that the movements in our hydraulic bed were associated with a non-statistically significant trend towards lower-quality chest compressions.
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Comparative Study
The impact of prolonged waiting time for coronary care unit admission on patients with non ST-elevation acute coronary syndrome.
The boarding of patients in the emergency department consumes nursing and physician resources, and may delay the evaluation of new patients. It may also contribute to poor cardiovascular outcomes in patients with acute coronary syndrome (ACS). This study analyzed the relationship between the delay in coronary care unit (CCU) admission and the clinical outcomes of patients with ACS with non-ST-segment elevation (NSTE-ACS). ⋯ There was no significant difference in the clinical outcomes of NSTE-ACS patients without profound shock between those with CCU waiting times of <12 and >12h. If necessary, CCU admission should be prioritized for patients whose hemodynamic instability or respiratory failure.
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Comparative Study
Comparison of modified Kampala trauma score with trauma mortality prediction model and trauma-injury severity score: A National Trauma Data Bank Study.
Mortality prediction of trauma patients relies on anatomical, physiological or combined scores. The purpose of this study is to compare the diagnostic accuracy of the modified Kampala Trauma Score (M-KTS) with the Trauma Mortality Prediction Model (TMPM), and Trauma-Injury Severity Score (TRISS) using data from a large dataset from a developed registry, the National Trauma Data Bank (NTDB). ⋯ M-KTS performed worse than TRISS although its' main advantage is simple use in resource-limited settings.