The American journal of emergency medicine
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Randomized Controlled Trial
Stay and play eFAST or scoop and run eFAST? That is the question!
The concept that ultrasonography could be interesting in the prehospital setting and during the transfer of traumatized patients is not new. Paradoxically, there is a lack of description of routine use of ultrasonography in emergency ambulances. The aim of this study was to compare the feasibility and efficiency of an extended focused assessment sonography for trauma (eFAST) examination performed on-site, during the patient's transfer, or both. ⋯ The eFAST examination can provide reliable and important information in the initial evaluation of traumatized patients. It can be completed either on-site or during patient transfer. Its feasibility and efficiency are similar to that done in intensive units, especially if the examination is repeated.
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Most patients at low to intermediate risk for an acute coronary syndrome (ACS) receive a 12- to 24-hour "rule out." Recently, trials have found that a coronary computed tomographic angiography-based strategy is more efficient. If stress testing were performed within the same time frame as coronary computed tomographic angiography, the 2 strategies would be more similar. We tested the hypothesis that stress testing can safely be performed within several hours of presentation. ⋯ Patients who present to the ED with potential ACS can safely undergo a rapid diagnostic protocol with stress testing.
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Cardiac arrest is a daunting medical emergency. The aim of the present study was to assess whether the combination of adrenaline and glucagon would improve initial resuscitation success, 48-hour survival, and neurologic outcome compared with adrenaline alone in a porcine model of ventricular fibrillation. ⋯ In this porcine model of prolonged ventricular fibrillation, the addition of glucagon to adrenaline improves hemodynamics during resuscitation and early postresuscitation period and may increase survival.
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Stanozolol is a popular androgenic anabolic steroid, used by body builders and athletes for physical performance enhancement. There are few data on its potential adverse effects and no documented cases of it causing severe electrolyte imbalance. Here, we report a patient presenting to a tertiary care emergency department with reduced conscious level, profound hypokalemia, and severe metabolic alkalosis, resulting from stanozolol misuse. This is the first such case reported.
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Case Reports
Cerebral venous thrombosis and "Dense Triangle Sign" on unenhanced head computed tomographic scan.
This case report describes a 21-year-old man with headache who was ultimately diagnosed as having cerebral venous thrombosis(CVT), a rare cause of headache in the emergency department that is sometimes lethal. However, correct diagnosis of CVT is often quite difficult because of a lack of findings in imaging studies. ⋯ This finding disappeared after anticoagulation therapy. Emergency physicians must know about this finding to diagnose this rare condition correctly.