J Emerg Med
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The benefits of Tactical Emergency Medical Support (TEMS) elements are providing injury prevention, immediate care of injuries, and medical augmentation of the success of dangerous law enforcement operations. TEMS is recognized by civilian Special Weapons and Tactics (SWAT) and various other law enforcement agencies around the country as a vital addition to such SWAT teams. The integration of specially trained TEMS personnel has become a key component of law enforcement special operations. ⋯ Physician involvement is an essential element of a successful TEMS program. There is a need for more physicians to become involved as TEMS personnel for specialized tactical teams to spread the time commitment and increase their availability to tactical units on a daily basis.
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Lumbar puncture (LP) is a commonly performed procedure in pediatrics. Accurate analysis of cerebrospinal fluid (CSF) profile is essential in diagnosing and managing a variety of infectious and inflammatory conditions involving the brain, meninges, and spinal cord. It can also provide useful diagnostic information in the evaluation of possible subarachnoid hemorrhage and demyelinating syndromes, and aid in the diagnosis and management of pseudotumor cerebri. ⋯ A thorough understanding of anatomic, physiologic, and pathologic considerations regarding performing lumbar puncture and CSF analysis can augment success in diagnosing a variety of potentially serious pediatric conditions.
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Review Case Reports
Emergency Cesarean Section Due to Acute Aortic Dissection Type A (Debakey I) without Marfan Syndrome: A Case Report and Review of the Literature.
Acute aortic dissection during pregnancy is an uncommon but important emergency due to its lethal risk to both mother and child. The dissection usually involves the ascending aorta or the aortic arch. Although additional affection of the descending aorta up to bifurcation is possible, further increasing the risk of organ malperfusion, full-length aortic dissection (DeBakey I) is known to be very rare. Dissection during pregnancy has been reported predominantly in combination with Marfan syndrome. Acute aortic dissection Stanford type A (AADA) DeBakey I during pregnancy without signs of Marfan syndrome as a warning signal is very uncommon in the current literature. ⋯ This alarming result of AADA (DeBakey I) in late pregnancy without obvious warnings such as Marfan syndrome illustrates the importance of performing early imaging in similar cases.