The American journal of emergency medicine
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Multicenter Study
Prognostic factors for patients with accidental hypothermia: A multi-institutional retrospective cohort study.
In cases of severe accidental hypothermia (AH) in urban areas, the prognostic factors are unknown. We identified factors associated with in-hospital mortality in patients with moderate-to-severe AH in urban areas of Japan. ⋯ The independent prognostic factors associated with in-hospital mortality of patients with moderate-to-severe AH in urban areas of Japan were age ≥ 75 years, need for assistance with ADL, hemodynamic instability, and hyperkalemia.
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The aim of this study is to determine the accuracy of pre-hospital trauma notifications and the effects of inaccurate information on trauma triage. ⋯ EMS crews frequently provide inaccurate pre-hospital information or do not provide any pre-hospital notification at all, which results in over/under triage of trauma patients.
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The density ratio of gray matter (GM) to white matter (WM) on brain computed tomography (CT) (gray-to-white matter ratio, GWR) helps predict the prognosis of comatose patients after cardiac arrest. However, Hounsfield units (HU) are not an absolute value and can change based on imaging parameters and CT scanners. We compared the density of brain GM and WM and the GWR by using images scanned with different types of CT machines. ⋯ In this study, the HU values of GM and WM in the normal adult brain differed up to 23% among scanners. Unfortunately, the GWR may not compensate for the HU difference between GM and WM occurring between scanners. Therefore, rather than applying consistent GWR cut-offs, the protocol or manufacturer differences between imaging scanners should be considered.
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Case Reports
Priapism following erector spinae plane block for the treatment of a complex regional pain syndrome.
Erector spinae plane block (ESPB) is a novel block where local anesthetic is deposited between the erector spinae muscle and the underlying transverse process. Safety of this technique is emphasized in the majority of reports, but with a continued increase of its use, the number of related complications and side effects is likely to expand. We report the case of a patient treated with ESPB for a complex regional pain syndrome, complicated by the development of a priapism.