The American journal of emergency medicine
-
Among patients of out-of-hospital cardiopulmonary arrest (OHCPA), only 6% resume their pre-OHCPA social life. The prediction of neurological outcome immediately after the return of spontaneous circulation (ROSC) is urgently needed in OHCPA patients. Novel biomarkers, biological antioxidant potential (BAP), and diacron-reactive oxygen metabolites (d-ROM) are potential predictors of neurological outcome after OHCPA. This study was conducted to evaluate the utility of BAP and d-ROM in the prediction of patient outcomes after OHCPA. ⋯ Oxidative stress, indicated by BAP on admission, strongly correlated with the neurological outcome after OHCPA.
-
Observational Study
Prehospital end-tidal CO2 as an early marker for transfusion requirement in trauma patients.
Below normal end-tidal carbon dioxide measurement (ETCO2) is associated with worse outcomes in sepsis and trauma patients as compared to patients with normal ETCO2. We sought to determine if ETCO2 can be used in the prehospital setting to predict transfusion requirement, operative hemorrhage control, or mortality in the first 24 h after admission for trauma. ⋯ Below normal ETCO2 values were associated with increase need for transfusion, operative intervention, and death. Further study is warranted to determine if ETCO2 outperforms other predictors of severe trauma.
-
After a traumatic injury, the provision of appropriate, timely care to pregnant women jury is crucial for the health of both the mother and fetus. The aim of this study was to identify risk factors predicting post-traumatic obstetric complications in pregnant women who presented to the emergency department (ED) with traumatic injuries. ⋯ Among pregnant patients who present to the ED after a traumatic injury, advanced maternal age, trauma in the third trimester, and abnormal obstetric ultrasonography findings should alert physicians to the possibility of post-traumatic complications (within the first 24 h after trauma) and the need for close monitoring.
-
Despite the COVID-19 pandemic, cardiovascular disease is still the main cause of death in developed countries. Of these deaths, acute coronary syndromes (ACS) account for a substantial percentage of deaths. Improvement in ACS outcomes, are achieved by reducing the time from symptom onset until reperfusion or total ischemic time (TIT). Nevertheless, due to the overwhelming reality at the beginning of the pandemic, acute coronary syndrome (ACS) care may have been compromised. ⋯ During the pandemic a reduction in ACS admissions occurred in our hospital that accompanied with longer in-hospital TIT due to additional tests, triage, protocols to protect and prevent infection within hospital staff, and maintenance of adequate standards of care. However, door-to-balloon time was maintained under 90 min.