The American journal of emergency medicine
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There are few clinical problem of spermatic vein thrombosis were reported. Spontaneous spermatic vein thrombosis is a particularly rare diseases which can lead to acute or chronic testicular pain and testicular swelling. We report a case in which ultrasonography (US) discovered hypoechoic mass of left spermatic vein and contrast-enhanced ultrasonography (CEUS) revealed thrombus formation of left spermatic vein in a patient who had underwent a continuous driving for eight hours twenty days ago.
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Early and reliable prediction of neurological outcome remains a challenge for comatose survivors of cardiac arrest (CA). The purpose of this study was to evaluate the predictive ability of EEG, heart rate variability (HRV) features and the combination of them for outcome prognostication in CA model of rats. ⋯ Earlier post-resuscitation HRV provided prognostic information complementary to quantitative EEG in the CA model of rats. The combination of EEG and HRV features leads to improving performance of outcome prognostication compared to either EEG or HRV based features alone.
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Case Reports
Multimodal analgesia in crotalid snakebite envenomation: A novel use of femoral nerve block.
Snakebite envenomations occur throughout the United States, with most envenomations resulting from Crotalid bites. These envenomations can result in severe pain despite aggressive analgesia due to effects of venom toxins. We report a case in which we treated a 44- year-old man who sustained a Copperhead (Agkistrodon contortrix) bite to his left hallux with progressive local toxicity, including severe pain radiating into his upper leg, without evidence of compartment syndrome or coagulopathy. ⋯ We performed a fascia iliaca compartment femoral nerve block under dynamic ultrasound guidance with 20 mL of 0.25% bupivacaine, which provided substantial pain relief in his upper leg. To our knowledge, this is a novel application of regional anesthesia with peripheral nerve block. We demonstrate fascia iliaca compartment femoral nerve block may be a safe, beneficial technique for emergency physicians to utilize in providing multimodal analgesia in Crotalid envenomation.
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Observational Study
Effect of regional cerebral oximetry to estimate neurologic prognostic outcomes in patients administered targeted temperature management.
The aim of our study is to research the role and efficacy of cerebral oximetry in predicting neurologic prognosis when applied during TTM to patients experiencing coma after CA. ⋯ There is no significant correlation between rSO2 values and neurologic outcomes. Multimodal monitoring methods may be useful and further studies with a larger patient population are necessary in this area.
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Letter Randomized Controlled Trial
Impact of a CPRMeter feedback device on chest compression quality performer by nurses: A randomized crossover study.