Emergency medicine Australasia : EMA
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Emerg Med Australas · Jun 2012
Case ReportsEmergency presentation of emboli to multiple sites from an atrial myxoma.
A middle aged man presented to our ED with back pain and confusion, had evidence of acute arterial insufficiency to his lower limbs and myocardial infarction on initial ECG. His workup included an urgent CT, which revealed a filling defect in his dilated left atrium, renal and splenic infarcts, and an embolism in his left internal iliac artery. Urgent embolectomy and fasciotomy could not save his left lower limb, and emergency cardiac surgery was required to excise an atrial myxoma. A brief narrative review of the literature is also presented, with this case being unusual in causing such widespread concurrent multiple organ damage, including stroke and myocardial infarct.
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Emerg Med Australas · Jun 2012
Case ReportsEcstasy-induced acute coronary syndrome: something to rave about.
Ecstasy or 3,4-methylenedioxymethamphetamine is a commonly used illicit recreational drug, enjoying popularity for its stimulant effects. Although acute coronary syndrome is recognized after cocaine and methamphetamine use, association with Ecstasy use has rarely been reported. We report three cases of significantly delayed acute coronary syndrome and ST elevation myocardial infarction related to ingestion of Ecstasy.
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Emerg Med Australas · Jun 2012
Effect on emergency department efficiency of an accelerated diagnostic pathway for the evaluation of chest pain.
To compare ED efficiency measures between a trial period using an accelerated diagnostic pathway (ADP) for chest pain evaluation, and a control period using a traditional diagnostic pathway (TDP). ⋯ The ADP utilizing point-of-care multimarkers led to significantly shorter ED LOS for both discharged and admitted chest pain patients. This was associated with increased cardiac cubicle throughput, but improvements in other whole ED performance indicators were not demonstrated.
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Emerg Med Australas · Jun 2012
Editorial CommentDisaster triage: evidence, consistency and standard practice.