The American journal of emergency medicine
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An emergency physician (EP) is often the first provider to evaluate, resuscitate, and manage a critically ill patient. Over the past two decades, the annual hours of critical care delivered in emergency departments across the United States has dramatically increased. During the period from 2006 to 2014, the extent of critical care provided in the emergency department (ED) to critically ill patients increased approximately 80%. ⋯ As a result, it is imperative for the EP to be knowledgeable about recent developments in resuscitation and critical care medicine, so that the critically ill ED patient care receive current evidence-based care. These articles have been selected based on the authors review of key critical care, resuscitation, emergency medicine, and medicine journals and their opinion of the importance of study findings as it pertains to the care of the critically ill ED patient. Topics covered in this article include cardiac arrest, post-cardiac arrest care, rapid sequence intubation, mechanical ventilation, fluid resuscitation, cardiogenic shock, transfusions, and sepsis.
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Spontaneous bladder rupture, while rare, carries a high risk of morbidity and mortality if left untreated. Here, we describe a case report of spontaneous bladder rupture in a patient initially presenting with foley malfunction. Despite foley replacement, the patient continued to endorse abdominal pain and clinically deteriorate, thus raising our suspicion for possible bladder rupture. Recognizing and understanding the different variations of spontaneous bladder rupture is paramount for timely appropriate intervention.
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The COVID pandemic, which has caused high mortality rates worldwide, has mainly affected the working environment of healthcare workers. Metabolic and respiratory changes occur in healthcare workers working with surgical masks. ⋯ Regular and long-term use of surgical masks does not harm the body metabolically and respiratorily.
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Case Reports
Keep shocking: A case report of double sequential defibrillation for refractory ventricular fibrillation.
Double sequential defibrillation is proposed as a novel modality of managing refractory ventricular fibrillation (VF). However, existing evidence has not been enough to support this. Here, we report an interesting case of a 54-year-old male who suffered from cardiac arrest with VF rhythm. ⋯ He had another episode of VF unresponsive to thirty minutes of standard defibrillation on his way to the catheterization laboratory. Again, the VF was terminated by double sequential defibrillation. Five days later, the patient was discharged home without neurological sequels.