Emergency laser vaporization and helium-oxygen administration for acute malignant tracheobronchial obstruction Massimo Torre, Bruno Amari, Barbara Barbieri, Mario Merli, Pierangelo Belloni
DOI: http://dx.doi.org/10.1016/0735-6757(89)90173-3
The American Journal of Emergency Medicine , Vol. 7 , Issue 3 ,
Published in issue: May 1989
x Two patients with malignant airway obstruction and acute respiratory insufficiency were given emergency treatment with yttrium aluminum garnet (YAG) laser tissue vaporization under local anesthesia only. A mixture of oxygen and helium was administered to reduce the respiratory distress. This case emphasizes the rapidity and effectiveness of YAG laser treatment via fiberoptic bronchoscopy under local anesthesia in the management of acute malignant airway obstructions.
Persistent hiccups followed by acute respiratory failure Yu-Ren Lin, Chang-Chih Shih, Hsiang-Cheng Chen, Sy-Jou Chen
DOI: http://dx.doi.org/10.1016/j.ajem.2015.10.042
Publication stage: In Press Corrected Proof
The American Journal of Emergency Medicine
Published online: October 26 2015
x A 19-year-old woman presented with symptoms of persistent and relapsing hiccups for 2 months, followed by a swallowing dysfunction that deteriorated to acute respiratory failure. Brain magnetic resonance imaging showed hyperintense areas in the posterior medulla and left inferior cerebellar peduncle in a T2-weighted image, suggesting demyelinating lesions. Sjogren syndrome was diagnosed based on subsequent positive tests of antinuclear and anti-Ro antibodies as well as salivary scintigraphy examinations.
Noninvasive bilevel positive pressure ventilation in severe acute pulmonary edema Dennis L Newberry III, Kenneth E Noblett, Lynnette Kolhouse
DOI: http://dx.doi.org/10.1016/0735-6757(95)90143-4
The American Journal of Emergency Medicine , Vol. 13 , Issue 4 ,
Published in issue: July 1995
x Severe acute pulmonary edema is a medical emergency that requires immediate action on the part of the health care provider. Endotracheal intubation and mechanical ventilation remain the primary method of respiratory support in the most severe cases when respiratory failure ensues. Two cases of respiratory failure resulting from severe acute pulmonary edema are presented in which mechanical ventilation was indicated but the patients were treated instead with noninvasive bilevel positive pressure ventilation, which subsequently reversed their inspiratory failure.
Death from a rattlesnake bite Steven C. Curry, Donald B. Kunkel
DOI: http://dx.doi.org/10.1016/0735-6757(85)90095-6
The American Journal of Emergency Medicine , Vol. 3 , Issue 3 ,
Published in issue: May 1985
Prearrest signs of shock and respiratory insufficiency in out-of-hospital cardiac arrests witnessed by crew of the emergency medical service Markus B. Skrifvars, James Boyd, Markku Kuisma
DOI: http://dx.doi.org/10.1016/j.ajem.2008.03.027
The American Journal of Emergency Medicine , Vol. 27 , Issue 4 ,
Published in issue: May 2009
x The objective of this study is to determine whether prearrest shock and respiratory insufficiency influence outcome in patients with emergency medical service–witnessed out-of-hospital cardiac arrest.
Can Differential Regional Ventilation Protect the Spared Lung In Acute Respiratory Distress Syndrome? Kapil Dev Soni, Devi Prasad Dash, Richa Aggrawal, Narendra Kumar, Niraj Kumar
DOI: http://dx.doi.org/10.1016/j.ajem.2015.01.009
The American Journal of Emergency Medicine , Vol. 33 , Issue 8 ,
Published online: January 16 2015
x Acute respiratory distress syndrome (ARDS) is a common clinical problem prevalent in intensive care settings. It can complicate many critical illnesses. The general treatment is mainly supportive. Mechanical ventilation, low tidal volume strategy, and control of plateau pressure form the basis of current management. No specific treatment exists for ARDS. Various interventions have been tested for the lethal condition including steroids, fluid restriction, statins, high-frequency ventilation, nitric oxide, and prone ventilation strategy.
Field airway management of the trauma patient: The efficacy of bag mask ventilation Kenneth J. Rhee, Robert J. O'Malley, James E. Turner, Richard E. Ward
DOI: http://dx.doi.org/10.1016/0735-6757(88)90150-7
The American Journal of Emergency Medicine , Vol. 6 , Issue 4 ,
Published in issue: July 1988
x There is no consensus on what constitutes appropriate field airway management in the seriously injured semiconscious patient. The respiratory complications in a selected group of patients who were transported from the scene of an accident by a helicopter service whose policy was to perform endotracheal intubation on only deeply obtunded patients and manage others with bag mask ventilation are reported. Respiratory compromise was defined as follows: partial pressure of oxygen <65 torr on initial hospital arterial blood gases, partial pressure of carbon dioxide >45 torr on initial hospital arterial blood gases, or radiographic and clinical evidence of aspiration pneumonitis within 5 days of admission to the hospital.
Three-view bedside ultrasound for the differentiation of acute respiratory distress syndrome from cardiogenic pulmonary edema Daniel Mantuani, Arun Nagdev, Michael Stone
DOI: http://dx.doi.org/10.1016/j.ajem.2011.06.028
The American Journal of Emergency Medicine , Vol. 30 , Issue 7 ,
Published online: August 26 2011
x Bedside ultrasound is being increasingly used by emergency physicians (EPs) for the differentiation of acute dyspnea in critically ill patients [1]. Lung ultrasound is emerging as a highly sensitive tool in diagnosing alveolar interstitial edema with the presence of diffuse “B-lines” arising from the pleural line [2]. However, when used independently, lung ultrasound is unable to differentiate between cardiogenic and noncardiogenic causes of pulmonary edema [3]. This case report describes a rapid 3-view or “triple scan” sonographic examination to differentiate acute respiratory distress syndrome (ARDS) from cardiogenic pulmonary edema.
Acute respiratory distress syndrome in a young soccer player: search obturator internus primary pyomyositis. A reverse Lemierre syndrome Aude Gibelin, Damien Contou, Vincent Labbé, Antoine Parrot, Michel Djibré, Muriel Fartoukh
DOI: http://dx.doi.org/10.1016/j.ajem.2014.11.033
The American Journal of Emergency Medicine , Vol. 33 , Issue 5 ,
Published online: November 28 2014
x Pyomyositis of the obturator internus muscle is a rare condition, usually affecting children after trauma or muscular effort. Diagnosis is often delayed and may lead to severe infectious complications. We discuss hereafter the case of a 24-year-old patient who presented a primary pyomyositis of the right obturator internus muscle complicated by a thrombosis of the adjacent internal iliac vein and septic pulmonary emboli and acute respiratory distress syndrome.
How safe is the prone position in acute respiratory distress syndrome at late pregnancy? Sukhen Samanta, Sujay Samanta, Jyotsna Wig, A.K. Baronia
DOI: http://dx.doi.org/10.1016/j.ajem.2013.12.021
The American Journal of Emergency Medicine , Vol. 32 , Issue 6 ,
Published online: December 16 2013
x We encountered a case of severe acute respiratory distress syndrome in late pregnancy due to influenza (H1N1) with refractory hypoxemia to conventional mechanical ventilation. Ventilation in prone position rescued this patient by maintaining oxygenation and sustaining improvement thereafter. Here, we discuss the mechanism of prone ventilation with special references to safety management of acute respiratory distress syndrome in the third trimester of pregnancy. It requires frequent monitoring of possible complications due to prone position and highly dedicated supporting staffs.
Acute severe respiratory distress secondary to misuse of an N -acetylcysteine effervescent tablet Selman Yeniocak, Ozgur Tatli, Aysegul Cansu, Engin Erturk, Mehmet Muharrem Erol, Suleyman Turedi
DOI: http://dx.doi.org/10.1016/j.ajem.2009.11.013
The American Journal of Emergency Medicine , Vol. 28 , Issue 7 ,
Published online: April 5 2010
x Anaphylactoid reactions have generally been reported in 3% to 6% of patients using N -acetylcysteine (NAC). Predisposing factors for anaphylactoid reactions to NAC are a history of atopy, asthma, drug allergy, low plasma acetaminophen concentrations, and incorrect high-dose intravenous use. We present a case, the first in the literature, of inadvertent direct swallowing of a 1200-mg NAC effervescent tablet that should have been entirely dissolved in water but which became stuck and aspirated in the subglottic region, the patient subsequently developing severe respiratory distress accompanied by subglottic edema, tachycardia, and widespread wheezing.
Airway edema following household bleach ingestion Franz E Babl, Sigmund Kharsch, Alan Woolf
DOI: http://dx.doi.org/10.1016/S0735-6757(98)90006-7
The American Journal of Emergency Medicine , Vol. 16 , Issue 5 ,
Published in issue: September 1998
x Household bleach is a frequent nonpharmaceutical childhood ingestion in the US. It is regarded as a benign ingestion. A rare presentation is reported of poisoning by low-concentration hypochlorite household bleach in a toddler that led to severe respiratory sequelae. The literature on respiratory and nonrespiratory sequelae of liquid household bleach ingestion is reviewed.
Descending necrotizing mediastinitis from upper respiratory infection Kuang-Jui Chang, Wen-Jone Chen, Shey-Ying Chen, Kuang-Chau Tsai, Ang Yuan
DOI: http://dx.doi.org/10.1016/j.ajem.2003.12.016
The American Journal of Emergency Medicine , Vol. 22 , Issue 2 ,
Published in issue: March 2004
Repeated ambulance use by patients with acute alcohol intoxication, seizure disorder, and respiratory illness Jennifer Brokaw, Lenora Olson, Lynne Fullerton, Dan Tandberg, David Sklar
DOI: http://dx.doi.org/10.1016/S0735-6757(98)90031-6
The American Journal of Emergency Medicine , Vol. 16 , Issue 2 ,
Published in issue: March 1998
x Three chronic conditions were examined—acute alcohol intoxication, seizure disorder, and respiratory illness—to quantify the extent of repetitive emergency medical services (EMS) use in a defined population. Urban EMS system ambulance data from 1992 to 1994 were analyzed for the three designated conditions with respect to transports by condition and individual patient. Analysis by χ 2 was used for comparing proportions. Analysis of variance after square root transformation was used to evaluate differences among means.
Supine chest compression: alternative to prone ventilation in acute respiratory distress syndrome Sukhen Samanta, Sujay Samanta, Kapil Dev Soni
DOI: http://dx.doi.org/10.1016/j.ajem.2013.11.014
The American Journal of Emergency Medicine , Vol. 32 , Issue 5 ,
Published online: November 18 2013
x Prone ventilation is usually used for severe acute respiratory distress syndrome. We applied an alternative method to prone position. We described 2 cases of trauma where prone position could not be done. Chest wall compression was performed by 2-kg weight in front of the chest wall bilaterally while the patient was in a supine position. Respiratory mechanics work to improve oxygenation almost as same as the mechanism proposed for prone position without any major adverse effects and serious complications.
Aspiration of nortriptyline David R. Johnson, David Yew
DOI: http://dx.doi.org/10.1016/0735-6757(94)90154-6
The American Journal of Emergency Medicine , Vol. 12 , Issue 3 ,
Published in issue: May 1994
x Unintentional aspiration of medication capsules is a rare event. A case report of a neurologically impaired 23-year-old woman who aspirated a 50-mg nortriptyline capsule is presented. This resulted in progressive respiratory distress necessitating ventilatory support. Bronchoscopy showed severe airway inflammation and edema.
A test of syndromic surveillance using a severe acute respiratory syndrome model David J. Wallace, Bonnie Arquilla, Richard Heffernan, Martin Kramer, Todd Anderson, David Bernstein, Michael Augenbraun
DOI: http://dx.doi.org/10.1016/j.ajem.2008.03.020
The American Journal of Emergency Medicine , Vol. 27 , Issue 4 ,
Published in issue: May 2009
x We describe a field simulation that was conducted using volunteers to assess the ability of 3 hospitals in a network to manage a large influx of patients with a potentially communicable disease. This drill provided the opportunity to evaluate the ability of the New York City Department of Health and Mental Hygiene's (NYC-DOHMH) emergency department chief complaint syndromic surveillance system to detect a cluster of patients with febrile respiratory illness.
Acid-base interpretation can be the predictor of outcome among patients with acute organophosphate poisoning before hospitalization Jiung-Hsiun Liu, Che-Yi Chou, Yao-Lung Liu, Pen-Yuan Liao, Po-Wen Lin, Hsin-Hung Lin, Ya-Fei Yang
DOI: http://dx.doi.org/10.1016/j.ajem.2007.03.017
The American Journal of Emergency Medicine , Vol. 26 , Issue 1 ,
Published in issue: January 2008
x Acute organophosphate (OP) poisoning causing alteration in acid-base equilibrium was reported before. Hence, different acid-base statuses may present in patients with acute poisoning due to OP exposure. This study aims to determine the impact of acid-base interpretation in patients with acute OP poisoning before hospitalization in medical care units and to describe the pattern of mortality with different acid-base statuses.
An observational study of noninvasive positive pressure ventilation in an out-of-hospital setting Phillipe Bruge, Patricia Jabre, Michel Dru, Chadi Jbeili, Eric Lecarpentier, Mohamed Khalid, Alain Margenet, Jean Marty, and others
DOI: http://dx.doi.org/10.1016/j.ajem.2007.04.022
The American Journal of Emergency Medicine , Vol. 26 , Issue 2 ,
Published in issue: February 2008
x Out-of-hospital clinical experience with noninvasive bilevel positive airway pressure (BiPAP) ventilation is extremely limited compared to inhospital management. The aims of this study were to assess the feasibility of out-of-hospital BiPAP ventilation in patients with acute respiratory distress of various origins, and to look for specific factors associated with failure of this respiratory support.
Adult respiratory distress syndrome from organophosphate poisoning Richard Kass, Gurpreet Kochar, Michael Lippman
DOI: http://dx.doi.org/10.1016/0735-6757(91)90009-9
The American Journal of Emergency Medicine , Vol. 9 , Issue 1 ,
Published in issue: January 1991
x A 46-year-old man after an accidental exposure to organophosphates developed florid adult resplratory distress syndrome (ARDS). A markedly suppressed level of pseudocholinestrase and red blood cell cholinestrase with profuse salivation and sweating confirmed the diagnosis of organophosphate poisoning. Within 48 hours, patient developed respiratory distress needing intubation. Despite maximum ventilatory support and positive end-expiratory prossure, hypoxia persisted, Swan Ganz (Baxter Healthcare Inc, Irvine, CA) pressures showed low pulmonary capllary wedge pressure and patient died on the third hospital day.
