J Emerg Med
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Biatrial thrombus is a rare condition that is typically associated with a patent foramen ovale (PFO). ⋯ This is a case of a 75-year-old man with history of heavy alcohol use found down with altered sensorium. He was hypothermic and in atrial fibrillation with rapid ventricular rate and was subsequently found to have a biatrial thrombus with no evidence of PFO. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Biatrial thrombus presents the unique danger of progressing to both pulmonary embolus and acute embolic disease (including stroke); both are life-threatening diagnoses that can be prevented by means of identifying and treating this rare and dangerous condition.
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Reducing the time between onset of cerebral infarction and treatment with tissue plasminogen activator improves the prognosis of patients with cerebral infarction. Diverse dosing protocols have been developed with the aim of reducing the time to bolus injection; however, only a few studies have investigated the methods and effects of the interrupted time between bolus and post-bolus infusion. ⋯ Because of the short half-life of alteplase, even a short delay in initiating post-bolus infusion can cause a significant reduction in serum alteplase concentration.
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Randomized Controlled Trial
Pediatric Chest Compression Improvement Via Augmented Reality Cardiopulmonary Resuscitation Feedback in Community General Emergency Departments: A Mixed-Methods Simulation-Based Pilot Study.
Yearly, more than 20,000 children experience a cardiac arrest. High-quality pediatric cardiopulmonary resuscitation (CPR) is generally challenging for community hospital teams, where pediatric cardiac arrest is infrequent. Current feedback systems are insufficient. Therefore, we developed an augmented reality (AR) CPR feedback system for use in many settings. ⋯ The novel CPR feedback system, AR-CPR, significantly changed the CC performance in community hospital non-pediatric-specialized general EDs from 18-21% to 87-90% of CC epochs at goal. This study offers preliminary evidence suggesting AR-CPR improves CC quality in community hospital settings.