The American journal of emergency medicine
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Cardiac transplant is an effective long-term management option for several severe cardiac diseases. These cardiac transplant patients may present to the emergency department with a range of issues involving the cardiac transplantation, including complications due to their transplant as well as altered presentations of disease resulting from their transplant. ⋯ An understanding of the presentations and various complications that may affect patients with cardiac transplant will assist emergency clinicians in the care of these patients.
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Review Case Reports
Mycoplasma pneumonia and atypical acute hemorrhagic edema of infancy.
Acute hemorrhagic edema of infancy is a benign rare presentation of leukocytoclastic vasculitis that affects children between 4 and 24 months of age. It usually involves the distal extremities, face, and ears. ⋯ The rash resolved spontaneously within two weeks. Herein we present a case of Mycoplasma induced AHEI with an atypical clinical presentation followed by a review of the literature.
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Barrier enclosure devices were introduced to protect against infectious disease transmission during aerosol generating medical procedures (AGMP). Recent discussion in the medical community has led to new designs and adoption despite limited evidence. A scoping review was conducted to characterize devices being used and their performance. ⋯ While use of various barrier enclosure devices has become widespread during this pandemic, objective data of efficacy, efficiency, and usability is limited. Further controlled studies are required before adoption into routine clinical practice.
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Case Reports
Role of hydrogen peroxide injection for penetrating abdominal injury in creating CT Tractogram.
Penetrating abdominal trauma is responsible for approximately 35% of patients admitted to urban trauma centers, and up to 12% of those admitted in suburban or rural centers in the United States. Current protocol relies heavily on CT imaging as the diagnostic tool in evaluating for peritoneal violation in hemodynamically stable patients, however it is associated with false negative rates. In addition, visualization of the fascia of the rectus abdominis, the transversalis fascia, and the peritoneum cannot be reliably identified with CT. ⋯ We propose hydrogen peroxide as an alternative method to liquid contrast in reestablishing the stab wound tract. This method creates a negative contrast level to augment the ability of CT imaging to determine peritoneal penetration. Key Words: Penetrating Abdominal Injury, CT Tractography, Abdominal Trauma, Hydrogen Peroxide, Trauma Management.
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Double (or dual) external defibrillation (DED) has increasingly been used in the last few years by a number of emergency medical services (EMS) as a last resort to terminate ventricular fibrillation and pulseless ventricular tachycardia in adult patients who remain refractory to standard defibrillation. However, no randomized controlled trials comparing DED with standard defibrillation focusing on patient-oriented outcomes as the primary objective have been published to date. Selection criteria, procedure techniques, and protocol are not clearly defined and vary across observational studies. ⋯ The present paper provides a brief overview of the background, procedure techniques, pad placement, and factors affecting how DED is delivered. A further objective of this paper is to offer a proposal for a uniform nomenclature and a standardized protocol in the form of a flowchart for EMS agencies to guide further clinical trials and best practices. This paper should not only help give background on novel definitions and clarify nomenclature for this practice, but more importantly should help institutions lay the groundwork for performing EMS-based large trials to further investigate the effectiveness of DED.