The American journal of emergency medicine
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The objective was to evaluate whether passive leg raising during cardiopulmonary resuscitation in a porcine model of prolonged ventricular fibrillation improves hemodynamics, return of spontaneous circulation, 24-hour survival, and neurological outcome. ⋯ Passive leg raising during cardiopulmonary resuscitation significantly increased coronary perfusion pressure in the minute prior to the first shock. Return of spontaneous circulation and 24-hour survival rate were comparable between groups. However, the animals in the passive leg raising group exhibited significantly higher neurological scores.
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A 44-year-old male patient was admitted to our emergency department (ED) with an episode of severe anaphylaxis displaying generalized urticaria and dyspnea 1 hour after consuming a kiwifruit. Initially, the patient reported discrete itching of his abdominal skin and was in moderate respiratory distress. The patient's wheal response and itch were attenuated 30 minutes after emergency treatment with intravenous antianaphylaxis drugs. ⋯ Cases of patients with anaphylactic reaction to kiwifruit and dragon fruit have not been reported yet. In the ED, it is easy to overlook the prolonged exposure to allergen in patients with oral allergy syndrome. If the patient has consumed much food or drugs to cause the allergic reaction, self-induced vomiting or gastric lavage to clean allergen may be useful.
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Review Meta Analysis
The use of pleural fluid procalcitonin and C-reactive protein in the diagnosis of parapneumonic pleural effusions: a systemic review and meta-analysis.
We aimed to perform a systematic review and meta-analysis of the diagnostic performance of pleural fluid procalcitonin (PCT) or C-reactive protein (CRP) in differentiating parapneumonic effusion in patients with pleural effusion. ⋯ The existing literature suggests that both pleural fluid and serum PCT tests have low sensitivity and specificity for differentiating parapneumonic effusion from other etiologies of pleural effusion. Compared with PCT, serum CRP has higher specificity and a higher positive likelihood ratio, and thus, it has a higher rule-in value than PCT.