J Emerg Med
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Case Reports
Spontaneous spinal epidural hematoma causing Brown-Sequard syndrome: case report and review of the literature.
Spinal epidural hematoma is a rare clinical entity and has a varied etiology. Urgent surgical evacuation to prevent serious permanent neurologic deficits is generally indicated. ⋯ This diagnosis was initially overlooked, given the asymmetric pattern of deficit. He later underwent cervical laminectomy and had complete restoration of neurologic function.
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The purpose of this study was to examine whether the SAGE assessment survey could predict, within the Emergency Department setting, those youth at risk for engaging in violent behavior. It also examined whether those who test positive for engaging in high-risk violent behavior during the initial baseline SAGE survey were prone to continue this behavior 1 month later. This was an observation, convenience sample of young male and female patients, half of whom had injuries related to violence and half of whom had injuries unrelated to violence, who presented when a research fellow was available. ⋯ A set of four questions from the 12-question SAGE survey, however, was successful at tracking specific types of at-risk behaviors. This indicates that certain questions within the SAGE survey may be effective at tracking those who engage in high-risk violent behavior. These same questions were able to track those who continued to engage in high-risk violent behaviors 1 month later.
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The long-axis technique for ultrasound-guided vascular access may benefit users attempting deeper targets. The purpose of this study was to determine if a difference exists in the difficulty experienced by novice ultrasound users in obtaining vascular access in long axis with linear vs. curvilinear transducers. Subjects obtained access on simulated peripheral veins in a gel model. ⋯ The difference in time to cannulation with the linear and curvilinear transducers was not statistically significant. Novice ultrasound users found the curvilinear transducer easier to use for simulated vascular access in the long axis. Studies utilizing live patients and more experienced ultrasonographers could determine whether the preference for the curvilinear transducer amounts to clinically meaningful shorter times to needle entry and more successful first attempts.