Ching-Chi Lee, Nan-Yao Lee, Ming-Che Chuang, Po-Lin Chen, Chia-Ming Chang, Wen-Chien Ko
DOI: http://dx.doi.org/10.1016/j.ajem.2011.05.026
Published online: December 14 2011
xThis study aims to determine the risk factors associated with the bacterial contamination of blood cultures among adults visiting the emergency department (ED).
Jacquelyn H. Clower, Neil B. Hampson, Shahed Iqbal, Fuyuen Y. Yip
DOI: http://dx.doi.org/10.1016/j.ajem.2011.05.028
Published online: August 22 2011
xUnintentional carbon monoxide poisoning is preventable. Severe cases are often referred for hyperbaric oxygen treatment. To guide prevention efforts and treatment practices, this study provides some of the most detailed current information about patients with carbon monoxide poisoning who have been treated at hyperbaric facilities across the United States and the circumstances surrounding their exposures. This study can help improve efforts to prevent carbon monoxide poisoning and enhance treatment practices.
Ching-Chi Lee, Chung-Hsun Lee, Ming-Yuan Hong
DOI: http://dx.doi.org/10.1016/j.ajem.2011.05.029
Published online: August 22 2011
xThe aim of this study was to determine the clinical characteristics of, antibiotic therapy for, and clinical outcome of Pseudomonas aeruginosa infection among bacteremic adults who visit the emergency department (ED).
Patrick J. Crocker, Eric Higginbotham, Benjamin T. King, Diane Taylor, Truman J. Milling Jr.
DOI: http://dx.doi.org/10.1016/j.ajem.2011.05.030
Published online: October 26 2011
xHistorically, pain has been poorly managed in the pediatric emergency department (ED) (PED), resulting in measurable psychosocial issues both acute and delayed.
Christopher J. Hogan, Kevin R. Ward, Douglas S. Franzen, Bipin Rajendran, Leroy R. Thacker
DOI: http://dx.doi.org/10.1016/j.ajem.2011.06.005
Published online: August 26 2011
xThe aim of this study was to measure sublingual perfused capillary density (PCD) to assess sublingual microvascular perfusion during emergency department (ED) treatment of acute decompensated heart failure (ADHF).
Rishi Sikka, Laura H. Tommaso, Carleen Kaucky, Erik B. Kulstad
DOI: http://dx.doi.org/10.1016/j.ajem.2011.06.006
Published online: August 22 2011
xIn 2007, the Centers for Medicare and Medicaid Services created a measure known as “diagnostic uncertainty” in emergency department (ED) pneumonia admissions. This documentation excludes the antibiotic timing measure, as pressure to quickly diagnose pneumonia may serve to reduce overall accuracy.
Bruce M. Lo, Catherine M. Visintainer, Heidi A. Best, Hind A. Beydoun
DOI: http://dx.doi.org/10.1016/j.ajem.2011.06.008
Published online: August 22 2011
xThe aim of the study was to evaluate the risk of Friday the 13th on hospital admission rates and emergency department (ED) visits.
Anthony Napoli, Esther K. Choo
DOI: http://dx.doi.org/10.1016/j.ajem.2011.06.009
Published online: September 12 2011
xWomen with acute coronary syndrome appear to be treated less aggressively than men. However, little is known about potential sex biases in the evaluation of patients with low-risk chest pain admitted to emergency department (ED) chest pain units.
Peter McCanny, Kath Bennett, Paul Staunton, Geraldine McMahon
DOI: http://dx.doi.org/10.1016/j.ajem.2011.06.011
Published online: September 12 2011
xThe purpose of this study was to investigate the clinical correlation between arterial and venous blood gas (VBG) values in patients presenting to the emergency department (ED) with acute exacerbation of chronic obstructive pulmonary disease.
Eichi Narimatsu, Tomohisa Niiya, Kazunobu Takahashi, Masanori Yamauchi, Michiaki Yamakage
DOI: http://dx.doi.org/10.1016/j.ajem.2011.06.013
Published online: August 26 2011
xThe composite effects of organophosphorus (OP)–cholinesterase (ChE) inhibitors and oximes on the actions of nondepolarizing neuromuscular blockers in acute OP-ChE inhibitor intoxication have not been evaluated in detail. We investigated the effects of paraoxon (Pox) (an OP-ChE inhibitor) and pralidoxime (PAM) (an oxime) on the nondepolarizing neuromuscular blocking action of rocuronium.
Ali Zorlu, Hasan Yucel, Gokhan Bektasoglu, Kenan Ahmet Turkdogan, Umut Eryigit, Savas Sarikaya, Meltem Refiker Ege, Izzet Tandogan, Mehmet Birhan Yilmaz
DOI: http://dx.doi.org/10.1016/j.ajem.2011.12.040
Published online: March 2 2012
xIncreased γ-glutamyl transferase (GGT) level is associated with increased oxidative stress, all-cause mortality, the development of cardiovascular disease, and metabolic syndrome. However, its role in acute pulmonary embolism (PE) is unknown. In this study, we aimed to investigate the relationship between GGT and early mortality in patients with acute PE.
Kristen E. Nordenholz
DOI: http://dx.doi.org/10.1016/j.ajem.2012.03.001
Published online: June 4 2012
xRisk stratification of acute pulmonary embolism (PE) is an increasingly exciting, timely, and interesting topic as growing evidence supports outpatient management of low-risk acute PE [1]. Prognostic information is also critical for guiding acute PE management decisions such as the administration of thrombolytic therapy and level of monitoring. Thus, the article published in this issue of American Journal of Emergency Medicine, “Increased gamma glutamyl transferase (GGT) levels predict early mortality in patients with acute pulmonary embolism” [2] is of interest to researchers and practitioners alike.
I-Ming Kuo, Chien-Hung Liao, Ming-Che Hsin, Shih-Ching Kang, Shang-Yu Wang, Chun-Hsiang Ooyang, Jen-Feng Fang
DOI: http://dx.doi.org/10.1016/j.ajem.2011.03.014
Published online: June 6 2011
xDelayed diagnosis of blunt traumatic diaphragmatic rupture (BDR) is not uncommon in the emergency department (ED) despite improvement in investigative techniques. We reviewed a large case series of patients diagnosed with blunt traumatic diaphragmatic rupture in order to report demographics, clinical features, and mechanisms of injury of this important but challenging entity.
Bruno Schneider de Araujo, Roberta Reichert, Diego André Eifer, Stephan A. Soder, Manoel B. Schmiedel dos Santos, Nadine Clausell, Luís Beck-da-Silva
DOI: http://dx.doi.org/10.1016/j.ajem.2011.04.013
Published online: June 13 2011
xPhysicians often overlook trepopnea as a symptom, and its prevalence and clinical repercussions are not usually described. We propose that trepopnea is a common symptom in heart failure (HF) and, because of patient avoidance of left lateral decubitus position, contributes to the greater prevalence of right-sided pleural effusion in patients with HF. Accordingly, this study aimed to determine trepopnea prevalence and to evaluate the association of trepopnea and the laterality of pleural effusion in decompensated HF.
Vytautas Vaicys, Antone Eason, Jay D. Schieber, Erik B. Kulstad
DOI: http://dx.doi.org/10.1016/j.ajem.2011.04.026
Published online: June 13 2011
xMild therapeutic hypothermia has been shown to improve outcomes after adult cardiac arrest but remains underused. Development of easier methods than currently exist to induce therapeutic hypothermia may help increase use of this treatment. We developed a mathematical model to evaluate the potential to induce mild therapeutic hypothermia through the esophagus.
Bertrand Prunet, Yves Asencio, Guillaume Lacroix, Ambroise Montcriol, Arnaud Dagain, Jean Cotte, Pierre Esnault, Henry Boret, Eric Meaudre, Eric Kaiser
DOI: http://dx.doi.org/10.1016/j.ajem.2011.05.005
Published online: June 13 2011
xThe aim of this study is to prospectively compare the accuracies of transcranial color-coded sonography (TCCS) and transcranial Doppler (TCD) in the diagnosis of elevated intracranial pressure.
Shannon E. Moffett, Bradley W. Frazee, John C. Stein, Bahar Navab, Judy Maselli, Sukhjit S. Takhar, Ralph Gonzales
DOI: http://dx.doi.org/10.1016/j.ajem.2011.05.008
Published online: August 1 2011
xIncreased trimethoprim/sulfamethoxazole (TMP/SMX) resistance has led to changes in empiric treatment of female urinary tract infections (UTI) in the emergency department (ED), particularly increased use of fluoroquinolones (Acad Emerg Med.2009;16(6):500-507). Whether prescribing changes have affected susceptibility in uropathogens is unclear. Using narrow-spectrum agents and therapy tailored to local susceptibilities remain important goals.
Jon B. Cole, Samuel J. Stellpflug, Heather Ellsworth, Carson R. Harris
DOI: http://dx.doi.org/10.1016/j.ajem.2011.05.015
Published online: August 1 2011
xQuetiapine overdose is a clinical entity commonly encountered in emergency departments. Quetiapine is a drug with many mechanisms, including antimuscarinic effects. Traditionally, treatment of quetiapine toxicity has been primarily supportive care. Case reports exist documenting improvement in mental status in these patients after administration of physostigmine, a carbamate capable of reversing antimuscarinic toxicity. In this descriptive case series, 3 patients with quetiapine toxicity treated with physostigmine are reported.
Richard M. Nowak, Ayan Sen, Audwin J. Garcia, Heidi Wilkie, James J. Yang, Michael R. Nowak, Michele L. Moyer
DOI: http://dx.doi.org/10.1016/j.ajem.2011.05.021
Published online: August 1 2011
xEmergency physicians (EPs) estimate the underlying hemodynamics of acutely ill patients and use them to help both diagnose and formulate a treatment plan. This trial compared the EP clinically derived estimates of cardiac output (CO) and systemic vascular resistance (SVR) to those measured noninvasively.
Michal Filip, Petr Linzer, Filip Šámal, Jiří Tesař, Roman Herzig, David Školoudík
DOI: http://dx.doi.org/10.1016/j.ajem.2011.05.007
Published online: July 28 2011
xThe transmission of medical images and other data over mobile phone networks may facilitate remote medical consultations between neurosurgeons and regional hospitals treating spinal injury patients. The aim of this study was to compare the efficacy of mobile phone consultations with standard hospital workstation consultations in spinal injury patients.
Benjamin J. Lawner, Jose Victor Nable, William J. Brady
DOI: http://dx.doi.org/10.1016/j.ajem.2011.05.031
Published online: December 14 2011
Eric J. Nilles, Paul M. Arguin
DOI: http://dx.doi.org/10.1016/j.ajem.2011.06.016
Published online: September 12 2011
xEvidence suggests that imported malaria is a diagnostic challenge with initial misdiagnosis rates of 40% or greater. Given that prompt diagnosis and appropriate treatment are the only intervention proven to prevent progression to severe malaria and death, these figures are concerning. The purpose of this clinical review is to provide the most up-to-date and practical information on the diagnosis and treatment of imported malaria for the emergency health care provider. We highlight common pitfalls, errors, and mistakes in arriving at the correct diagnosis.
W. Frank Peacock IV, Daniel E. Hilleman, Phillip D. Levy, Denise H. Rhoney, Joseph Varon
DOI: http://dx.doi.org/10.1016/j.ajem.2011.06.040
Published online: September 12 2011
xHypertensive emergencies are acute elevations in blood pressure (BP) that occur in the presence of progressive end-organ damage. Hypertensive urgencies, defined as elevated BP without acute end-organ damage, can often be treated with oral agents, whereas hypertensive emergencies are best treated with intravenous titratable agents. However, a lack of head-to-head studies has made it difficult to establish which intravenous drug is most effective in treating hypertensive crises. This systematic review presents a synthesis of published studies that compare the antihypertensive agents nicardipine and labetalol in patients experiencing acute hypertensive crises.
Jacob R. Hennings, Francis M. Fesmire
DOI: http://dx.doi.org/10.1016/j.ajem.2011.04.025
Published online: June 24 2011
xThe benefit of emergency reperfusion therapy with fibrinolytics or primary percutaneous coronary intervention in patients with ST-segment elevation (STE) acute myocardial infarction (MI) is well known. However, what is not well known are which subgroups of MI patients with ST-segment depression (STD) on the 12-lead electrocardiogram (ECG) may benefit from emergent reperfusion therapy. Current clinical guidelines recommend against administering emergent reperfusion therapy to MI patients with STD on the ECG unless a true posterior MI is suspected.
Narat Srivali, Saeed Ahmed, Wisit Cheungpasitporn, Daych Chongnarungsin
DOI: http://dx.doi.org/10.1016/j.ajem.2012.03.006
Published online: May 4 2012
xWe thank Camp-Rogers et al [1] for their excellent case study “Therapeutic hypothermia after profound accidental hypothermia and cardiac arrest.” This was a very interesting case report as usual for the American Journal of Emergency Medicine. The successful therapeutic hypothermia after cardiac arrest in humans was first described in the late 1950s [2]. This therapy has subsequently been recommended by the Advanced Life Support Task Force of the International Liaison Committee on Resuscitation and the American Heart Association as one of the mainstay treatment after cardiac arrest [3].
Iván Ortega Deballon, David Rodríguez-Arias Vailhen, Edurne de la Plaza Horche
DOI: http://dx.doi.org/10.1016/j.ajem.2012.03.007
Published online: May 25 2012
xIn recent years, the number of programs for organ donation after unexpected cardiac arrest (uncontrolled donation after circulatory determination of death [uDCDD]) has increased. Potential uDCDD donors have died of an unexpected loss of circulation mostly because of sudden cardiac arrest. Because circulation is lost before death is determined and long before organ procurement could begin, organs will die unless they are quickly preserved. In Spain alone, there are 7 active programs in 6 different regions and at least as many advanced projects [1].
Gheshlaghi Farzad
DOI: http://dx.doi.org/10.1016/j.ajem.2012.03.015
Published online: May 25 2012
xI read with interest the study conducted by McAllister et al [1] titled “Lipid 20% emulsion ameliorates the symptoms of olanzapine toxicity in a 4-year-old,” which is in press in your journal. In the article, the authors mentioned that because of the low morbidity associated with lipid therapy, early consideration of lipid therapy should be considered in adults and children who have toxicity of lipid-soluble medications.
Goran P. Koracevic
DOI: http://dx.doi.org/10.1016/j.ajem.2012.03.016
Published online: May 25 2012
xModeling suggests that more than 900 000 incident or recurrent venous thromboembolism (VTE) events occur annually in the United States, of which approximately one third are fatal; 30-day pulmonary thromboembolism (PTE) survival is 59.1% [1]. Drawbacks of the current PTE protocol were pointed out recently [2]. Contemporary guidelines for initial anticoagulants in PTE are based on only 2 relatively old (>20 years) studies: one in DVT and the other in VTE patients (some of them having PTE) [2-4]. It is questionable if half of the single, old study in PTE is enough to make generalization to all PTE patients today.
Ingrid Millot, David Plancade, Julien Nadaud, Sophie Cottez, Elodie Schaeffer, Nicolas Gagnon, Jean-Christophe Favier, Christian Landy
DOI: http://dx.doi.org/10.1016/j.ajem.2012.03.019
Published online: May 25 2012
xWe considered the critical situations using transversus abdominis plane block (TAP) for analgesia described by Herring et al [1]. We used TAP in an original indication: hyperalgesic, opiate-resistant acetabular fracture analgesia.
Goran P. Koracevic
DOI: http://dx.doi.org/10.1016/j.ajem.2012.03.023
Published online: May 25 2012
xPulmonary thromboembolism (PTE) is commonly unsuspected in the emergency department (>50% of PTE patients go unrecognized) [1] because symptoms are often not specific enough (they are “typically atypical”), because many diagnostic methods do not have the specificity we want, and because death may come very quickly, before the results of diagnostic procedures. For example, sudden death is the initial clinical presentation of 25% of PTE patients [2]. Moreover, in PTE, up to 80% of deaths occur within 2.5 hours into the admission [3].
Gheshlaghi Farzad
DOI: http://dx.doi.org/10.1016/j.ajem.2012.03.039
Published online: May 25 2012
xI have recently read the interesting case report entitled “Hyperacute rejection from a donor who died of carbamate intoxication” presented by Chan et al [1] in press in your journal. Despite the hyperacute rejection of transplanted heart, the authors concluded that heart from carbamate intoxication donors after adequate detoxification and elimination may be considered as another “suboptimal” choice. However, because of the condition of the patient, serum cholinesterase level, and final result of transplantation, the following points should be considered:
Yi-Hsin Chan, Pao-Hsien Chu
DOI: http://dx.doi.org/10.1016/j.ajem.2012.03.038
Published online: May 25 2012
xWe thank the author and colleagues for their interest in and comments on our case report of the hyperacute rejection from a donor who died of carbamate intoxication [1]. Indeed, there are more reports about the feasibility of successful organ transplantation from donors poisoned with carbamate insecticide.
Nancy Lutwak, Curt Dill
DOI: http://dx.doi.org/10.1016/j.ajem.2011.02.020
Published online: December 14 2011
xEmergency department (ED) physicians frequently evaluate women with first trimester vaginal bleeding. Etiologies include spontaneous abortion, ectopic pregnancy, and, rarely, gestational trophoblastic disease. The clinical assessment may be difficult, but the use of transvaginal sonograms and serum quantitative β human chorionic gonadotropin levels is helpful. Pregnant women previously treated for gestational trophoblastic disease may present to EDs with vaginal bleeding. We describe gestational trophoblastic disease and its treatment and discuss the evaluation of a patient with previous history of molar pregnancy presenting to the ED with abdominal pain and vaginal bleeding during a subsequent pregnancy.
Ken-Hing Tan, Shih-Yu Ko, Sun-Li Chou
DOI: http://dx.doi.org/10.1016/j.ajem.2011.03.023
Published online: June 6 2011
xA 72-year-old man was brought to our emergency department (ED) because of upper abdominal pain. Initial vitals at the triage station were significant only for high blood pressure. Computed tomography (CT) of the abdomen with contrast enhancement revealed an intimal flap over his descending aorta, the infrarenal part. The flap was found throughout the descending aorta until its bifurcation. Stanford type B dissection was initially suspected. However, a reconstructed CT discovered an interesting feature of the aorta.
Russell K. McAllister, Carrie D. Tutt, Christopher S. Colvin
DOI: http://dx.doi.org/10.1016/j.ajem.2011.03.025
Published online: June 6 2011
xOlanzapine (Zyprexa; Eli Lilly, Indianapolis, IN) is an antipsychotic medication that has been useful in the treatment of psychiatric disorders. In cases of overdose, cardiovascular and neurologic changes are seen. Lipid emulsion has proven successful in relieving the toxicity associated with overdose of lipid-soluble drugs. We present a case report of a 4-year-old child who presented with tachycardia and agitation, followed by somnolence after presumed accidental olanzapine ingestion. Treatment with lipid emulsion resulted in amelioration of the symptoms.
Shyh-Shyong Sim, Hao-Chang Chou, Juin-Wei Chen, Matthew Huei-Ming Ma
DOI: http://dx.doi.org/10.1016/j.ajem.2011.03.030
Published online: June 6 2011
xVery few cases of the use of extracorporeal membrane oxygenation (ECMO) in pregnant women have been reported to date. We report the first case of the use of ECMO for the treatment of cardiac arrhythmia with cardiogenic shock in a pregnant woman. A 28-year-old pregnant woman at 26 weeks of gestation presented with supraventricular tachycardia complicated with cardiogenic shock and fetal distress that was refractory to medication and electrical cardioversion. ECMO was applied, and it facilitated successful radiofrequency ablation.
Casimir J. Fitzgerald, Thomas V. Pranikoff, Gregory A. Ross, Steven Mou, Laurence B. Givner, Avinash K. Shetty
DOI: http://dx.doi.org/10.1016/j.ajem.2011.03.032
Published online: June 6 2011
xSepsis-induced purpura fulminans is a rare but life-threatening condition characterized by rapidly progressive hemorrhagic infarction of the skin due to dermal vascular thrombosis resulting in tissue loss and severe scarring. Although most commonly related to meningococcal or invasive group A streptococcal disease, it may also be caused by several other bacterial or viral pathogens including Pneumococcus and Varicella. Purpura fulminans associated with Staphylococcus aureus sepsis is rare but has been reported in adults.
Giuseppina Patrizia Dognini, Gianluca Cadeo, Luigi Dolcino, Lodovico Gilardoni, Enrico Stringhi, Franco Forloni
DOI: http://dx.doi.org/10.1016/j.ajem.2011.04.003
Published online: June 6 2011
xAtypical presentation of emergency abdominal aortic aneurysm comprises a wide spectrum of symptoms. Lower limbs' involvement is infrequent, usually monolateral and with clear vascular features. We report the case of a 58-year-old patient who complained exclusively about symmetric lower limb myalgias without vascular features, after having repeatedly climbed the stairs of the school he worked in. The surprising final diagnosis was of rupturing abdominal aortic aneurysm; the patient was sent to emergency surgery and survived.
Jae Hee Lee, Koo Young Jung
DOI: http://dx.doi.org/10.1016/j.ajem.2011.04.004
Published online: June 15 2011
xInstantaneous rigor as muscle stiffening occurring in the moment of death (or cardiac arrest) can be confused with rigor mortis. If trismus is caused by instantaneous rigor, orotracheal intubation is impossible and a surgical airway should be secured. Here, we report 2 patients who had emergency cricothyrotomy for trismus caused by instantaneous rigor. This case report aims to help physicians understand instantaneous rigor and to emphasize the importance of securing a surgical airway quickly on the occurrence of trismus.
Massimo Bonacchi, Gabriella Di Lascio, Guy Harmelin, Andrea Pasquini, Adriano Peris, Guido Sani
DOI: http://dx.doi.org/10.1016/j.ajem.2011.04.011
Published online: June 13 2011
xWe report our first experience of treating an immunocompetent adult patient with acute respiratory distress syndrome (ARDS) due to type 1 herpes simplex (HSV1) pneumonitis, using extracorporeal membrane oxygenation (ECMO). Similar cases reported in literature are reviewed as well. The therapeutic options for this particular complication are discussed. Pneumonia caused by HSV1 is a rare finding in immunocompetent individuals; it occurs more often in immunosuppressed and ventilated patients. It is a severe illness; therefore, early diagnosis and initiation of treatment are imperative.
Hichem Chenaitia, Marc Fournier, Jean Paul Brun, Pierre Michelet, Jean Pierre Auffray
DOI: http://dx.doi.org/10.1016/j.ajem.2011.04.016
Published online: June 24 2011
xPulmonary embolism (PE) is a common cause of sudden death; the use of prehospital thrombolysis is currently a last-resort option and requires a prolonged cardiopulmonary resuscitation (CPR). Novel mechanical devices have recently been introduced that provides automatic mechanical chest compression (AMCC) according to the guidelines and continually without decrease efficiency throughout prolonged resuscitation.
Andrei D. Margulescu, Alan G. Fraser
DOI: http://dx.doi.org/10.1016/j.ajem.2011.04.018
Published online: June 13 2011
xA 49-year-old man was admitted with high-risk left ventricular thrombosis and systemic embolization. Prompt and complete resolution of the thrombus was achieved under intravenous lepirudin administration but not under full-dose heparin treatment. Medical physicians, including emergency medicine physicians, cardiologists, cardiac surgeons, and hematologists, should become more aware of these alternative anticoagulant treatments, especially in cases when other therapeutic options (such as thrombolysis or cardiac surgery) may be associated with high morbidity or mortality.
Matthew J. Pirotte, James Saucedo, Danielle McCarthy
DOI: http://dx.doi.org/10.1016/j.ajem.2011.04.021
Published online: June 13 2011
xDislocations and subluxations at the metacarpal-phalangeal joint are rare and volar or palmar subluxations represent a small fraction of these. A 54-year-old man presented with an injury to his right hand; he had heard a pop while putting down a weight. He had normal vital signs, and his examination revealed a deformity at the third metacarpal-phalangeal joint. Plain radiographs did not reveal a fracture. The diagnosis of volar subluxation was made after consultation with a hand surgeon. Attempts at closed reduction in the emergency department were unsuccessful, and he was splinted with plans for follow-up.
Chih-kang Hsu, Yue-quen Chen, Vei-zen Lung, Sheng-Chuan His, Huan-Chu Lo, Hann-Yeh Shyu
DOI: http://dx.doi.org/10.1016/j.ajem.2011.05.001
Published online: December 14 2011
xA 19-year-old man presented with a 1-month history of progressive 4-limb numbness and gait imbalance. Physical examination revealed mild general muscular weakness, areflexia, and wide-based, ataxic, steppage gait. Sensory tests showed diminished superficial sensation below the level of the cervical-thoracic junction and a glove-and-stocking pattern of sensory loss at the 4 extremities. An initial magnetic resonance imaging examination of the cervical spine revealed an increased bilateral signal from the posterior and anterior columns on T2-weighted images.
Ghassam Sojod, Michele Diana, James Wall, Jacopo D'Agostino, Didier Mutter, Jacques Marescaux
DOI: http://dx.doi.org/10.1016/j.ajem.2011.05.006
Published online: July 11 2011
xThe aim of this study is to report the case of a catecholamine-induced cardiogenic shock bridged to curative adrenalectomy using extracorporeal membrane oxygenation (ECMO) and medical management. A 37-year-old woman presented an acute cardiogenic shock due to a left-sided pheochromocytoma. Echocardiography revealed a severe global hypokinesia with a left ventricular ejection fraction of 15%. Despite maximal ionotropic support, adequate perfusion could not be achieved; and ECMO was used to bridge the patient during medical management with calcium-channel blockers.
Randall N. Willard, Antonio E. Muñiz, Francis Chuidian
DOI: http://dx.doi.org/10.1016/j.ajem.2011.05.009
Published online: August 1 2011
xEnoxaparin (Lovenox) is a low–molecular weight heparin used to prevent deep venous thrombosis in patients undergoing total hip or knee arthroplasty.
Peter Whitney-Cashio, Melissa Sartin, William J. Brady, Kelly Williamson, Kostas Alibertis, Gilbert Somers, Robert E. O'Connor
DOI: http://dx.doi.org/10.1016/j.ajem.2011.07.005
Published online: September 12 2011
xThe use of the automatic external defibrillator (AED) can significantly reduce the time to defibrillation in patients with sudden cardiac death. This early defibrillation via the AED can also improve patient outcome, including survival and neurologic status among survivors. We undertook the addition of a public access defibrillation program at a large mid-Atlantic university. In our design of the system, we found little useful information to guide us in the development and construction our system.
DOI: http://dx.doi.org/10.1016/S0735-6757(12)00272-0
Published in issue: July 2012
DOI: http://dx.doi.org/10.1016/S0735-6757(12)00273-2
Published in issue: July 2012
DOI: http://dx.doi.org/10.1016/S0735-6757(12)00274-4
Published in issue: July 2012
