The American journal of emergency medicine
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Mechanical bull-riding has become a popular form of entertainment in the United States (US) over the last few decades. While mechanical bull-riding may result in injuries, the literature on such injuries is limited. This study characterized mechanical bull-riding injuries treated at US emergency departments (EDs). ⋯ The highest proportion of mechanical bull-riding injuries involved patients age 20-29 years. The majority of injuries involved the patient falling or being thrown from the mechanical bull. The most frequently reported diagnosis among mechanical bull-riding injuries was sprain or strain followed by fracture and contusion or abrasion.
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The purpose of this study was to analyze the prevalence and significance of incidental findings on computed tomography pulmonary angiography (CTPA) studies and to assess the diagnostic yield of CTPA in identifying an alternate diagnosis to pulmonary embolism (PE) on PE negative exams. ⋯ CTPA may suggest an alternative diagnosis to pulmonary embolism in approximately 40% of the patients with a negative study. The probability of finding an alternate diagnosis (type 1 incidental) is higher in elderly patients and in patients referred from ICU and inpatient units.
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The Covid19 pandemic has reignited debates and discussions around healthcare systems' biosecurity vulnerabilities and cast a spotlight on the potential weaponization of biological agents. Terrorist and violent extremist groups have already attempted to incite the intentional spread of Covid19 and to use it as an improvised form of a biological weapon. This study aims to provide an epidemiological description of all terrorism-related attacks using biological agents sustained between 1970 and 2019. ⋯ The reported use of biological agents as a terrorist weapon is extremely rare and accounts for 0.02% of all historic terrorist attacks. Despite its apparent rarity, however, bioterrorism has the ability to inflict mass injuries unmatched by conventional weapons. Anthrax has been the most commonly used in previous bioterrorism events with the vast majority of reported attacks occurring in the United States by a single suspected perpetrator. Counter-Terrorism Medicine (CTM) and Disaster Medicine (DM) specialists need to be proactive in delivering ongoing educational sessions on biological events to first responder communities, and anticipate emerging novel biotechnology threats.
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Randomized Controlled Trial
Performance comparison of intraosseous devices and setups for infusion of whole blood in a cadaveric swine bone model.
Intraosseous (IO) access can provide a critical bridge for blood product infusion when peripheral venous access is not obtainable. Successful pressurized IO infusion requires flow rates sufficient to preserve life, but with infusion pressures low enough to avoid clinical complications (e.g., hemolysis, bone damage, fat emboli). However, the optimal method for pressured IO delivery of blood was unknown. ⋯ Some pressured IO infusion methods can achieve flow rates adequate to serve as a resuscitative bridge in the massively hemorrhaged trauma victim, but flow rates and pressures vary greatly across IO pressurized infusion methods. Manual Rapid Infuser and push-pull methods conferred high flow rates but also relatively high pressures, highlighting the importance of using in vivo models in future research to assess the possible clinical complications of using these promising methods. Combined, present findings highlight the importance of studying pressurized IO methods towards preserving the life of the critically injured trauma victim.