The American journal of emergency medicine
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Refractory ventricular fibrillation occurs when there are three or more episodes of ventricular fibrillation within a 24-hour period. We report the first case of a 35-year-old woman without prior medical or family cardiac history who sustained refractory ventricular fibrillation while taking Lamictal for bipolar depression. ⋯ The patient received a Subcutaneous Implantable Cardio-Defibrillator and was discharged home. There was no identifiable cardiac or medical cause of her ventricular fibrillation and the electrophysiologist suspected Lamictal caused her refractory ventricular fibrillation.
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This study is to present the diagnostic values of the novel sonographic visualization of the inferoposterior thoracic wall (VIP) and boomerang signs in detecting right pleural effusion by sonologists with little to no experience in ultrasound. ⋯ Despite inexperience in sonography, the novel VIP and boomerang signs show high diagnostic values in detecting right pleural effusion compared to the traditional methods.
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New paradigm shifts in trauma resuscitation recommend that early reconstitution of whole blood ratios with massive transfusion protocols (MTP) may be associated with improved survival. We performed a preliminary study on the efficacy of MTP at an urban, Level 1 trauma center and its impact on resuscitation goals. ⋯ MTP resulted in clinically significant improvements in transfusion times and volumes. Further larger and randomized studies are warranted to validate these findings to optimize MTP protocols.
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Compression ultrasonography (CUS) is a validated technique for the diagnosis of deep venous thrombosis (DVT), but has never been studied with pocket-sized ultrasound device (PUD). The main objective of this study was to assess the diagnostic performance of CUS made by emergency physicians (EPs) using a PUD. ⋯ CUS-PUD performed with a pocket-sized ultrasound appears to be feasible in emergency practice for the diagnosis of proximal DVT. A study with a larger sample size will have to describe the accuracy.
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Bacterial meningitis is a relatively uncommon condition encountered in the emergency department and the constellation of symptoms varies. Hearing loss has been well documented in the literature as a complication of the disease process, but not as the presenting complaint. ⋯ Even with advances in therapy, bacterial meningitis still carries a significant mortality rate. Early diagnosis and treatment is critical to achieving good outcomes.