Emergency medicine journal : EMJ
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The case history is presented of a healthy 25-year-old man who was admitted to hospital after two syncopal episodes caused by carbon monoxide poisoning after smoking narghile. Clinicians should be aware of this association when they evaluate syncope in the emergency department, especially in narghile users.
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The epidemiology of aortic transection is changing with improvements in road safety and the use of endovascular stents. This research investigates the profile of cases and outcomes of traumatic thoracic aortic transection in Victoria, Australia. ⋯ Aortic transection was generally secondary to traffic-related injury affecting young men, with a mortality rate of over 90%. There has been a trend towards endovascular treatment over open repair in Victorian trauma centres.
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To explore the nature of interruptions that occur during clinical practice in the emergency department (ED). We determined the frequency, duration and type of interruptions that occurred. We then determined the impact on patient satisfaction of those interruptions occurring at the bedside. ⋯ Interruptions occur commonly during all clinical activities in the ED, and are frequently generated by providers themselves. These have a negative impact on patient satisfaction. The direct impact on medical errors or on provider satisfaction has not been determined.
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Methanol is generally known to cause visual impairment and various systemic manifestations. There are a few reported specific findings for methanol intoxication on magnetic resonance imaging (MRI) of the brain. ⋯ The optic nerve and extraocular muscles (superior rectus, medial rectus, inferior rectus and inferior oblique muscle) were enhanced by gadolinium-DTPA on MRI of the orbit. This is the first case report of permanent monocular blindness with confirmed unilateral damage of the retina and optic nerve, combined with third cranial nerve palsy after methanol ingestion.