Can J Emerg Med
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Cardiopulmonary resuscitation (CPR) is an inherently traumatic procedure. Successful resuscitations are often complicated by iatrogenic injuries to structures of the neck, thorax, or abdomen. ⋯ We describe a novel case of CPR-associated right ventricular rupture in a woman with acute-on-chronic pulmonary embolism and no known pre-existing cardiac disease. We propose that chest compressions in the setting of elevated right ventricular pressure resulted in cardiac rupture, in this case.
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Over the past few decades, point-of-care ultrasound (PoCUS) has come to play a major role in the practice of emergency medicine. Despite its numerous benefits, there has been a slow uptake of PoCUS use in rural emergency departments. ⋯ Potential solutions include expanding residency training in ultrasound skills, extending funding for PoCUS training to rural physicians in practice, moving PoCUS training courses to rural sites, and creating telesonography training for rural physicians. With these barriers identified and solutions proposed, corrective measures must be taken so that the benefits of PoCUS are extended to patients in rural Canada where, arguably, it has the greatest potential for benefit when access to advanced imaging is not readily available.
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Randomized Controlled Trial
Comparison of naproxen with cyclobenzaprine, oxycodone-acetaminophen, and placebo for the treatment of acute low back pain.
Clinical Question Does the addition of cyclobenzaprine or oxycodone with acetaminophen to naproxen result in improved functional outcomes at one week when compared to placebo in patients with acute low back pain? Article Chosen Friedman B, Dym A, Davitt, M, et al. Naproxen with cyclobenzaprine, oxycodone/acetaminophen, or placebo for treating acute low back pain: a randomized clinical trial. JAMA 2015:20;314(15):1572-80. Study Objective The primary objective of this study was to compare functional outcomes at one week and three months after emergency department (ED) presentation for acute low back pain among patients prescribed naproxen plus one of the following: (1) oxycodone/acetaminophen; (2) cyclobenzaprine; or (3) placebo.