J Emerg Med
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Focused assessment with sonography in trauma (FAST) is widely used and endorsed by guidelines, but little evidence exists regarding the utility of the cardiac portion in blunt trauma. The traditional FAST includes the routine performance of cardiac sonography, regardless of risk for hemopericardium. ⋯ Blunt hemopericardium is rare. High-acuity variables may help guide the selective use of echocardiography in blunt trauma.
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Case Reports
An unusual case of hypotension after fibrinolysis resulting from mediastinal hemorrhage.
Although bleeding complications may occur after fibrinolysis, mediastinal hemorrhage is extremely rare. ⋯ As fibrinolysis remains a common means of establishing reperfusion in patients with acute MI, emergency physicians should be aware of such unusual complications secondary to fibrinolysis. An orderly clinical approach with an individualized management protocol is essential in such situations so that undue instrumentation and invasive procedures with their attendant risks in a thrombolysed patient are avoided.
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Case Reports
Small bowel obstruction from potato and broccoli phytobezoar mimicking mesenteric ischemia.
Bezoars are concretions of undigested foreign material that form in the gastrointestinal tract. Rare in humans, they are nonetheless a well-documented cause of intraluminal bowel obstruction. ⋯ Although rare in humans, bezoars are a documented cause of small bowel obstruction, and should be considered when intraluminal bowel obstruction occurs. Bezoars causing small bowel obstruction require surgical treatment.
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Although debate exists about the treatment of sepsis, few disagree about the benefits of early, appropriately targeted antibiotic administration. ⋯ This study confirms the need for more rapid and accurate laboratory methods for bloodstream pathogen identification.
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The Emergency Department (ED) has been shown to be a valuable location to screen for family violence. ⋯ This study investigates the victim profile of a large cohort of a Chinese population, providing a unique data set not previously released in this cultural or medical system. The findings give insights to early identification of victims of family violence in the EDs and suggest that screening techniques focused on multiple forms of family violence would improve identification of violence cases. Multidisciplinary collaboration between health, legal, and social service professionals is also warranted to meet the various needs of victims and to reduce hospital readmissions.