The American journal of emergency medicine
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Comparative Study
Injury characteristics and hemodynamics associated with guideline-compliant CPR in a pediatric porcine cardiac arrest model.
Guidelines for depth of chest compressions in pediatric cardiopulmonary resuscitation (CPR) are based on sparse evidence. ⋯ In this pediatric model of cardiac arrest, chest compressions to 1/3APd were more harmful without a concurrent benefit for resuscitation outcomes compared to the 1.5 in. compression group.
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Observational Study
Impact of COVID-19 lockdown on self-harm and violence among patients presenting to the emergency department.
Considering the resurgence of COVID19 and the rapid spread of new and deadlier strains across the globe understanding the incidence and pattern of violence and self harm tendencies during this period might help in formulating better contingency plans for future lockdowns. A deeper look at the available data shows that there is a significant dearth of research into self-harm & violence during the COVID-19 pandemic. ⋯ Increase in the incidence of cases of self-harm and violence reported to the ED was noted during the lockdown period. Upgradation of health-care and law enforcement infrastructure maybe needed to deal with similar circumstances in a more efficient manner.
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Case Reports
Needle decompression of the eye! Emergent management of a vision threatening surgical complication.
Acute angle-closure glaucoma (AACG) is a medical emergency that can cause permanent visual deficits without prompt recognition. From 2006 to 2011, nearly 12 million visits to emergency departments (ED) in the United States were ophthalmologic in nature, making it crucial for emergency physicians to be familiar with the diagnosis and treatment of ophthalmologic emergencies. AACG can be precipitated by several mechanisms including pupillary block, anticholinergic medications, and sympathomimetic medications. We present a rare case of angle-closure glaucoma status post pneumatic retinopexy with cryotherapy due to migration of an intravitreal gas bubble into the anterior chamber with emphasis on understanding how retinal surgery types lead to significant differences in management.
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The Covid-19 pandemic has had dramatic consequences on the progression of numerous pathologies, especially neoplastic ones. The orientation of hospital activities toward the care of patients with SARS-Cov2 infection has caused significant delays in the diagnosis and therapy of many other pathologies. What about severe hypercalcemia? The aim of this work was to determine the clinical and biological presentation, etiologies, mortality, and the impact of the Covid-19 pandemic on severe hypercalcemia. ⋯ The Covid-19 pandemic caused an increase in both the incidence and severity of hypercalcemia and the hemodialysis practiced in this context remains efficient and safe.
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The Mortality Probability Model (MPM) is used in research and quality improvement to adjust for severity of illness and can also inform triage decisions. However, a limitation for its automated use or application is that it includes the variable "intracranial mass effect" (IME), which requires human engagement with the electronic health record (EHR). We developed and tested a natural language processing (NLP) algorithm to identify IME from CT head reports. ⋯ NLP can accurately identify IME from free-text reports of head CTs in approximately 80% of records, adequate to allow automatic calculation of MPM based on EHR data for many applications.