The American journal of emergency medicine
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Organophosphorus (OP) compound poisoning with suicidal intent is common. It is one of the frequent cause for admission to hospital Emergencies and intensive care units in our region. We describe here a case of 19-year old girl who presented to the Emergency Department with atypical features of OP poisoning. ⋯ Based on history and clinical suspicion of nicotinic receptor mediated effect of OP, she was given intravenous atropine along with other supportive treatment. Patient got completely recovered from fasciculations and her motor weakness improved after 6 h of atropine therapy. Emergency physician should keep a high index of suspicion of isolated nicotinic and ganglionic mediated effect of OP and a trial of atropine should be given to the patient.
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Randomized Controlled Trial
Variation in the accuracy of ultrasound for the detection of intubation by endotracheal tube size.
Rapid and accurate confirmation of endotracheal tube (ETT) placement is a fundamental step in definitive airway management. Multiple techniques with different limitations have been reported. Recent studies have evaluated the accuracy, time to performance, and physician confidence for ultrasound in both cadaveric models and live patients. However, no study to date has measured the effect of ETT size. Our study is the first to measure the accuracy of ultrasound for ETT confirmation based on ETT size. ⋯ The diagnostic accuracy of ultrasound for ETT confirmation did not vary with the use of different ETT sizes. Further studies are needed to determine if the accuracy would change with more novice providers or in specific patient populations.
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Research showed that the mortality of upper gastrointestinal hemorrhage (UGH) complicated with acute coronary syndrome (ACS) was higher than single UGH in elderly patients. This study aimed to determine the risk factors that associated with an increased risk of ACS occurrence after UGH. ⋯ History of diabetes, vasopressin or terlipressin use, smoking, liver cirrhosis, hemoglobin level and history of ACS are risk factors to develop ACS in elderly patients with UGH. Importantly, diabetes, smoking and lower hemoglobin level are key variables for mortality.