The American journal of emergency medicine
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Alteplase is the standard of care for early pharmacologic thrombolysis after acute ischemic stroke (AIS). Alteplase is also considered a high-alert medication and is fraught with potential for error. We sought to describe the difference in medication error rates in in patients receiving alteplase for acute ischemic stroke from regional hospitals compared to patients receiving alteplase at the Comprehensive Stroke Center. ⋯ The error rate of alteplase infusion for ischemic stroke is high, particularly in patients from referring centers. Errors may be associated with adverse events. Further education and administration safeguards should be implemented to decrease the risk of medication errors.
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Randomized Controlled Trial
The effect of oral magnesium supplementation on acute non-specific low back pain: Prospective randomized clinical trial.
We aimed to investigate the effect of oral magnesium supplementation for acute low back pain. ⋯ Level I, prospective randomized controlled study.
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Review Case Reports
Acute myocardial infarction from embolization of Lambl's excrescences: A case report.
While coronary artery embolism remains an infrequent cause of myocardial infarction (MI), it may present in patients at otherwise low risk for coronary artery disease. When clinicians apply typical risk stratification in these cases, they may be led away from a full evaluation for acute coronary syndrome (ACS). A diagnosis of MI in an otherwise healthy patient should prompt consideration of embolic sources, including Lambl's excrescences (LEs), and echocardiographic evaluation may be necessary to make a final diagnosis. We present a case of LEs in an otherwise healthy 43-year-old male presenting with chest pain and elevated cardiac enzymes, and also review the cases of this rare event found in the literature.
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Out-of-hospital cardiac arrest (OHCA) is a critical condition with poor outcomes. Although the survival rate increases in those who undergo defibrillation, the utility of on-time defibrillation among bystanders remained low. An evaluation of the deployment strategy for public access defibrillators (PADs) is necessary to increase their use and accessibility. This study was to conduct a systematic review for deployment strategies of PADs. ⋯ Three deployment strategies were presented. Although the optimal method could not be fully identified, a more efficient PAD deployment could benefit the population in terms of OHCA coverage and survival among patients with OHCA.
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During the early phase of the coronavirus disease 2019 (COVID-19) outbreak, many emergency departments (EDs) were exposed to COVID-19 and were temporarily closed according to national protocol of Korea. We aimed to evaluate the effect of concurrent and recurrent temporary closures of EDs on the clinical outcomes of patients who visited EDs during the COVID-19 outbreak. ⋯ The temporary closures of EDs due to the unpredicted COVID-19 exposure resulted in an increase in emergency patients' in-hospital mortality rates irrespective of whether they used EMS. Preparing regional EMS systems to cope with new outbreaks is essential to protect the safety of all citizens.