J Emerg Med
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Randomized Controlled Trial
"Push as Hard as You Can" Instruction for Telephone Cardiopulmonary Resuscitation: A Randomized Simulation Study.
The medical priority dispatch system (MPDS®) assists lay rescuers in protocol-driven telephone-assisted cardiopulmonary resuscitation (CPR). ⋯ There is no difference in compression depth, quality of CPR, or physical strain on lay rescuers using the initial instruction "push as hard as you can" vs. the standard MPDS(®) instruction "push down firmly 5 cm."
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Review Case Reports
Streptococcal Necrotizing Myositis: A Case Report and Clinical Review.
Streptococcal necrotizing myositis, also known as gangrenous myositis, is a very rare and severe soft tissue infection that predominately involves skeletal muscle and, eventually, superficial fascia and surrounding tissues. The presentation is often nonspecific until the rapidly progressing clinical course becomes apparent. A high morbidity and mortality rate has been reported in the small number of cases since 1900. Despite several attempts to better define the different entities causing necrotizing myositis, no single definitive causal relationship has been defined. ⋯ A high level of suspicion for necrotizing myositis must be maintained for a patient with unexplained severe muscle pain and soft tissue swelling accompanied by systemic inflammatory response syndrome.
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Review Case Reports
Acute Respiratory Failure during Routine Blood Transfusion: A Case Report and Review of the Literature.
Transfusion medicine is a common practice in the emergency department (ED) and other outpatient settings, and may be complicated by a low rate of potentially fatal transfusion-related reactions. ⋯ TRALI is a clinical diagnosis with presentation similar to that of ARDS. Prompt differentiation from other transfusion reactions and initiation of appropriate treatment is crucial in minimizing the morbidity and mortality associated with this syndrome.
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A 26-year-old arena football lineman participating in a "bull in the ring" blocking and tackling drill was blindsided by an opposing teammate. He sustained a direct helmet-to-helmet blow to the right temporal area. ⋯ The tympanic membrane (TM) is a highly vascular membrane that is very sensitive to variations of atmospheric pressure. Overpressure can enter the external auditory canal, stretching and displacing the TM medially and causing injury to the tympanic membrane secondary to barotrauma. This concussed football player was never able to return to play due to his postconcussive symptoms. He had no residual hearing or ear problems.