The American journal of emergency medicine
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The recovery of cardiac arrest patients with pulmonary embolism who are given an ultra-long duration of cardiopulmonary resuscitation(CPR) with manual chest compressions is very rare. We reported a 52-year-old woman who came to the hospital because of paroxysmal dyspnea. She experienced in hospital cardiac arrest and underwent prolonged CPR with manual chest compressions for 160 minutes. ⋯ Sixty minutes later, her sinus rhythm was restored. After the continuous renal replacement therapy for renal failure was administered and other conservative treatments were given for the complications after the CPR with thrombolytic therapy, she finally recovered and was discharged. This case report supports the use of persistent ongoing CPR efforts and the use of thrombolytic therapy.
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Review Case Reports
Cervical necrotizing fasciitis of nonodontogenic origin: Case report and review of literature.
Cervical necrotizing fasciitis (CNF) is a potentially fatal infection characterized by generalized necrosis of the cervical fascia that progresses rapidly. The incidence of this entity corresponds to 2.6% of all infections of the head and neck. The most frequent primary origin is dental infection, although other causes exist that should be evaluated. ⋯ Early detection and adequate emergency treatment are critical in the management of these patients and may reduce morbimortality and improve survival. The emergency services should be prepared to manage such cases efficiently, through a multidisciplinary treatment by coordinating emergency surgery with critical support and clinical stabilization of patients. We present a case of CNF of non odontogenic origin managed in our hospital.
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Review Case Reports
ST-segment elevation after direct current shock mimicking acute myocardial infarction: a case report and review of the literature.
External direct current (DC) shocks are and have long been commonly used for electrical cardioversion/defibrillation of atrial or ventricular arrhythmias. ST-segment elevation after cardio version with DC is an easily ignored phenomenon, occurring acutely and resolving during the first few minutes postshock. Here, we describe electrocardiographic findings of widespread ST-segment elevation lasting at least 1 hour after DC cardioversion for ventricular defibrillation due to Brugada syndrome and mimicking acute myocardial infarction (AMI). This case of ST-segment elevation without a dynamic and evolving AMI underscores the need to consider other causes of ST-segment elevation.
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The objectives of this study are to estimate the prevalence of weakness and fatigue visits in older emergency department (ED) patients, to compare demographics and resource use in these patients with those without these complaints, and to determine their ED diagnoses and disposition. ⋯ Weakness and fatigue are common in older ED patients. These patients undergo more tests and procedures, and most are admitted.