The American journal of emergency medicine
-
Sex disparities in out-of-hospital cardiac arrest (OHCA) care processes have been reported. This study aimed to investigate the association between sex and prehospital advanced cardiac life support (ACLS) interventions provided by emergency medical services in Japan. ⋯ Compared with males, females were less likely to receive prehospital ACLS. Emergency medical service staff must be made aware of this disparity, and off-the-job training on intravenous cannulation or AAM replacement must be conducted. Investigation of the impact of sex disparity on OHCA care processes can facilitate planning of future public health policies to improve survival outcomes.
-
Junctional hemorrhage remains a difficult source of bleeding to control with the groin being the most common location. FemoStop devices are a well established tool for achieving hemostasis in post cardiac catheterization femoral access site hemorrhage. Massive hemorrhage is a traumatic presentation well known to emergency physicians and trauma surgeons alike. We describe a case of traumatic proximal femoral artery injury with expanding hematoma and hemorrhage control with a FemoStop device applied in the emergency department.
-
Case Reports
Retrobulbar hemorrhage decompression with paracanthal "one-snip" method: Time to retire lateral canthotomy?
Orbital compartment syndrome is a rare but serious condition most commonly as a result of traumatic retrobulbar hemorrhage and must be treated quickly to avoid ischemic damage to the optic nerve and retina. While the previously accepted standard of care for management of this condition has been lateral canthotomy with inferior cantholysis, this procedure can be challenging for physicians to perform given the rarity of the condition and that patients are frequently in significant pain often with significant periocular edema. In this case, orbital compartment syndrome was effectively treated with a paracanthal "one-snip" incision quickly and efficiently in the ED. This procedure offers a more manageable alternative treatment which has been found to produce a satisfactory intraocular pressure reduction in both cadaver models and now a patient with confirmed retrobulbar hemorrhage and resultant orbital compartment syndrome.
-
to describe the clinical and safety outcomes between andexanet alfa (AA) and 4-factor prothrombin complex concentrate (4F-PCC) for the reversal of apixaban or rivaroxaban in the setting of an intracranial hemorrhage (ICH). ⋯ This study suggests that real-world clinical and safety outcomes between andexanet alfa and 4F-PCC for the reversal of factor Xa inhibitors in the setting of ICH are similar to ones reported in clinical trials.