The American journal of emergency medicine
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Observational Study
The NACA score as a predictor of ventricular cardiac arrhythmias - A retrospective six-year study.
Helicopter Emergency Medical Service (HEMS) conducts the evaluation of a patient's condition using NACA score before transporting the patient to hospital. The conditions inside the rescue helicopter limit or even make it impossible to conduct some medical procedures. An appropriate classification of the patient may lead to a lower possibility of occurrence of adverse events during the flight. The aim of the research was to evaluate the correlation of NACA score with the cardiac arrhythmia that may be life threatening. ⋯ NACA score allows to predict the risk of occurrence of ventricular arrhythmia of the myocardium as well as cardiac arrest. The possibility of occurrence of a life-threatening rhythm is significantly higher in patients classified as NACA IV or higher.
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Case Reports
Bodybuilding supplements leading to copper toxicity, encephalopathy, fulminant hepatic failure and rhabdomyolysis.
Millions of people worldwide use nutritional and dietary supplements, such as vitamins and minerals. These and other performance-enhancing substances are also used by high school, college, and professional athletes, bodybuilders, and amateur sports enthusiasts. ⋯ Emergency physicians and nurses should be aware of these potential deleterious effects and inquire about supplement use by patients with unexplained multiorgan failure. Family, friends, or acquaintances should be asked to bring the actual products to the hospital for analysis.
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Observational Study
Rapid correction of hyperkalemia is associated with reduced mortality in ED patients.
Hyperkalemia (HK) is common and associated with mortality. Our purpose was to determine if the rapid correction of elevated serum potassium level (K+) was associated with reduced mortality in emergency department (ED) patients. ⋯ Normalization of K+ during the ED stay in patients with HK is associated with a 50% mortality reduction. Efforts to rapidly identify and treat HK in the ED are needed.
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In toxicology literature, snake bites were the second toxicology-relevant cause mimicking brain death. A 57-year-old woman with history of cobra snake bite. On examination, the brain stem reflexes were absent with Glasgow coma score of 3. ⋯ Thus, intensivist should exclude neuroparalytic effect of snakebite before considering withdrawal of ventilatory support or organ donation. Also, the life-threatening presentation of cobra envenomation mandates the use of higher doses of PSA to reverse the neuroparalytic toxicity. We should consider the rule of anticholinesterase as an adjunctive therapy to PSA in severe cobra envenomation.
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Low-acuity outpatients constitute the majority of emergency department (ED) patients, and these patients often experience an unpredictable length of stay (LOS). Effective LOS prediction might improve the quality of ED care and reduce ED crowding. ⋯ NLP-based models can be used as an early short-term prediction of LOS and have the potential for mixed-type clinical data analysis. The proposed models would likely aid ED physicians' decision-making processes and improve ED quality of care.