The American journal of emergency medicine
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Acute myocardial damage is detected in a significant portion of patients with coronavirus 2019 disease (COVID-19) infection, with a reported prevalence of 7-28%. The aim of this study was to investigate the relationship between electrocardiographic findings and the indicators of the severity of COVID-19 detected on electrocardiography (ECG). ⋯ ST depression, T-wave inversion, ST-T changes, and the presence of fQRS on admission ECG are closely associated with the severity of COVID-19 infection.
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Envenoming syndrome induced by massive Vespa basalis stings is a critical condition. Severe systemic reaction may present with hemolytic activity and rhabdomyolysis, leading diffuse alveolar hemorrhage, adult respiratory distress syndrome, coagulopathy, and multiple organs failure. ⋯ Here, we provide a case presented with pulmonary hemorrhage due to multiple Vespa basalis stings tried to rescue by veno-arterial extracorporeal membrane oxygenation. We also highlight that early recognition of venom-induced disseminated intravascular coagulation by checking coagulation profile in high risk patients may prevent from poor outcome.
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Hollow adrenal gland sign on dual-phase contrast-enhanced CT in critically ill patients with sepsis.
We aimed to describe the clinical manifestations of patients with sepsis who had the hollow adrenal gland sign (HAGS) during the acute phase of resuscitation and evaluated its value in predicting in-hospital mortality. ⋯ Patients with sepsis who showed the HAGS had more severe illness than those who did not, and had an increased need for organ-supportive interventions. Presence of the HAGS was independently associated with in-hospital mortality.
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Children are increasingly diagnosed with mental illnesses and self-harm behaviors. They present frequently to the emergency department (ED) for evaluation. The aim of this study is to describe the youngest children in the ED with psychiatric issues. ⋯ The number of young children with psychiatric complaints presenting to the ED has increased. However, a large number are found to be stable for discharge home. Increase in urgent outpatient psychiatric resources could help decrease ED utilization.