The American journal of emergency medicine
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Cerebral infarction associated with myocardial hypertrabeculation is a rare condition that requires optimal management to reduce the risk of thromboembolism and stroke. As intravenous thrombolysis (IVT) is a standard treatment for acute ischemic stroke, it is important to investigate whether it is safe and effective in patients with this rare condition. ⋯ This case report provides evidence that IVT is safe and effective in the treatment of cerebral infarction associated with myocardial hypertrabeculation in adults.
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Traumatic Brain Injury (TBI) remains a significant global health concern with significant impact on morbidity and mortality. This narrative review explores adjunctive pharmacologic agents to be employed by emergency medicine clinicians during Advanced Trauma Life Support (ATLS) in patients presenting with a TBI. Pharmacologic agents are commonly employed for the management of rapid sequence intubation and post-intubation analgosedation, hemodynamics, intracranial pressure, coagulopathy, seizure prophylaxis, and infection. This narrative review discusses current evidence and controversies to optimize adjunct pharmacotherapies during the acute management of TBI within the emergency department.
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A glial fibrillary acidic protein (GFAP) and ubiquitin carboxyl-terminal hydrolase L1 (UCH-L1) blood biomarker panel can reliably eliminate the need to perform a head computed tomography (CT) scan in selected patients with traumatic brain injury (TBI). Currently, this FDA cleared panel can be run both on a core laboratory platform or a hand-held single-sample point of care platform. This study examined test characteristics of the panel as analyzed on a core lab-based fast high-throughput platform. ⋯ The biomarker panel, measured on this core lab-based fast high-throughput platform, had high sensitivity and negative predictive values. The core laboratory platform has the advantage of speed and the ability to analyze multiple samples simultaneously suggesting additional utility when there is high need for CT imaging such as mass casualty or emergency department volume overload situations.
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Patients with cancer face complex challenges that often lead them to seek care in emergency departments (EDs) for acute symptoms and complications. While previous studies have examined preventable ED visits by patients with cancer, less attention has focused on frequent ED use in this population. This study aimed to explore the temporal visit patterns of frequent ED users with cancer. ⋯ Frequent ED visits by oncology patients are more likely to be for similar reasons compared to non-cancer frequent users. These findings highlight the need for targeted care coordination for oncology patients who frequently visit the ED, potentially reducing repeat visits through improved outpatient management. Understanding the distinct patterns of ED utilization among cancer patients could help prioritize resource allocation and care pathways.