Can J Emerg Med
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Communication between emergency department (ED) staff and parents of children with asthma may play a role in asthma exacerbation management. We investigated the extent to which parents of children with asthma implement recommendations provided by the ED staff. ⋯ Improvements are urgently needed in developing strategies to manage pediatric asthma exacerbations related to URTIs, communication with parents at discharge in acute care, and using alternate acute care services for parents who continue to rely on EDs for the initial care of mild asthma exacerbations.
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A young woman presented with cardiac arrest following ingestion of yew tree leaves of the Taxus baccata species. The toxin in yew tree leaves has negative inotropic and dromotropic effects. The patient had a cardiac rhythm that alternated between pulseless electrical activity with a prolonged QRS interval and ventricular fibrillation. ⋯ After 36 hours of ECMO (including 12 hours of electrical asystole), the patient's electrocardiogram had normalized and the left ventricular ejection fraction was 50%. At this time, dobutamine and the ECMO were stopped. The patient had a full neurologic recovery and was discharged from the intensive care unit after 5 days and from the hospital 1 week later.
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Computed tomography (CT) use is increasing in the emergency department (ED). Many physicians are concerned about exposing patients to radiation from CT scanning, but estimates of radiation doses vary. This study's objective was to determine the radiation doses from CT scanning for common indications in a Canadian ED using modern multidetector CT scanners. ⋯ Approximately one in seven ED patients had a CT scan. Emergency physicians should be aware of typical radiation doses for the studies they order and how the dose varies by protocol and indication.
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What is the effect of family presence during cardiopulmonary resuscitation on family members and the medical team? ⋯ The authors sought to determine whether systematically offering relatives the option to be present during cardiopulmonary resuscitation increases the proportion of relatives with posttraumatic stress disorder-related symptoms after 90 days. Secondary outcomes included the presence of anxiety and depression symptoms in relatives, the effect of family presence on medical efforts at resuscitation, the well-being of the medical team, and the occurrence of medicolegal claims.