J Emerg Med
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A pilot study was conducted to enumerate the most common evaluations done in the emergency department (ED) of a community hospital in assessing patients presenting with a first episode of syncope and to determine the feasibility of defining a clinically useful set of investigations to identify the subset of syncopal patients that can be safely discharged from the ED. The study was conducted as a retrospective chart review of patients seen during an 8 week period. In the course of the study, 33 consecutive adult patients presenting to the ED with first episodes of syncope were identified. ⋯ In this small study, few patients presenting with new onset syncope required admission. The number and types of investigations performed on these patients was inconsistent. Further study is needed to determine whether syncopal patients requiring admission can be identified in the ED with a small number of standard inexpensive laboratory investigations.
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Case Reports
Successful treatment of severe hypothermia and prolonged cardiac arrest with closed thoracic cavity lavage.
This case report describes the resuscitation of a 19-year-old man who had been immersed in ice water for 14 h and presented with a rectal temperature of 22 degrees C and no pulses. It reports the successful use of prolonged cardiac massage (3.5 h) and closed thoracic cavity lavage in the treatment of severe hypothermia. It also confirms that victims of severe hypothermia can be effectively treated in peripheral hospitals not equipped for cardiopulmonary bypass.