Can J Emerg Med
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Review Case Reports
Lateral medullary syndrome: a diagnostic approach illustrated through case presentation and literature review.
Patients with lateral medullary syndrome classically present with crossed hemisensory disturbance, ipsilateral Horner syndrome, and cerebellar signs, all of which are attributable to infarction of the lateral medulla. However, variability in the presentation of this syndrome is the rule, as illustrated in this case presentation and literature review. ⋯ The importance of recognition of this condition in the emergency department is underscored by the association between lateral medullary infarction and vertebral artery dissection. With optimal therapy, the prognosis for recovery from lateral medullary syndrome is good.
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Multicenter Study
Cohort study on the prevalence and risk factors for delayed pulmonary complications in adults following minor blunt thoracic trauma.
The objectives of this study are to determine the prevalence, risk factors, and time to onset of delayed hemothorax and pneumothorax in adults who experienced a minor blunt thoracic trauma. ⋯ The presence of at least one rib fracture between the third and ninth rib on the x-ray of the hemithorax is a significant risk factor for delayed hemothorax and pneumothorax.
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Computerized interpretation of the prehospital electrocardiogram (ECG) is increasingly being used in the basic life support (BLS) ambulance setting to reduce delays to treatment for patients suspected of ST segment elevation myocardial infarction (STEMI). ⋯ The predictive values of the computerized prehospital ECG interpretation appear to be adequate for diversion programs that direct patients with a positive result to hospitals with angioplasty facilities. The estimated 26.0% chance that a positive interpretation is false is likely too high for activation of a catheterization laboratory from the field. Acquiring prehospital ECGs does not substantially increase on-scene time in the BLS setting.
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Does epinephrine (adrenaline) used in the context of out-of-hospital cardiac arrest improve outcomes? ⋯ To determine the effect of epinephrine in out-of-hospital cardiac arrest on patient survival to hospital discharge, prehospital return of spontaneous circulation, and neurologic outcomes.
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There is a question of whether a single assessment tool can assess the key competencies of residents as mandated by the Royal College of Physicians and Surgeons of Canada CanMEDS roles framework. ⋯ Further research is needed to develop and test ITER items that will differentiate each CanMEDS role exclusively.