Emergency medicine journal : EMJ
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A 37 year old man was found in his garden cold with no signs of life. Pupils were fixed and dilated. Electrocardiography showed asystole initially. ⋯ Cardiopulmonary resuscitation was continued for three hours before rewarming using partial cardiopulmonary bypass. He eventually regained spontaneous cardiac output and made a full neurological recovery. Hypothermic patients with no evidence of life cannot be assumed to be dead as there is a chance of full recovery when fully warmed.
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A short cut review was carried out to establish whether methylpyrazole is better than ethanol and/or haemodialysis in the treatment of ethylene glycol poisoning. Altogether 524 papers were found using the reported search, of which none presented any evidence to answer the clinical question. Two papers reported relevant case series. The author, date, and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these papers are tabulated.
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The incidence of anaphylaxis is under-reported. Children with asthma are frequently atopic and prone to allergic reactions. ⋯ Survivors of "acute asphyxic asthma" should be screened for reactions to common allergens that provoke anaphylactic reactions. Even if no provoking factor is identified, the asthma management plan of children who survive an episode of acute asphyxic asthma should include intramuscular adrenaline (epinephrine) in addition to conventional bronchodilators.
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A short cut review was carried out to establish whether a period of bed rest reduces the incidence of headache or other complications in patients undergoing diagnostic lumbar puncture. Altogether 85 papers were found using the reported search, of which five presented the best evidence to answer the clinical question. The author, date, and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these best papers are tabulated. A clinical bottom line is stated.