Annals of emergency medicine
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All adult patients (102 cases) presenting to Bellevue Hospital Medical Center over a calendar year (1978) with core temperatures less than 35 C were studied. Statistically significant correlations between hypothermia and mortality were identified according to mental status, hypoxia, hypotension, hyperamylasemia, duration and severity of hypothermia, and history of exposure and alcohol ingestion. Mortality could not be predicted on the basis of season, age (if greater than 40 years old), sex, presence of infection, or presenting temperature (if greater than 26 C). ⋯ Prolonged hypothermia was uniformly associated with profound underlying medical disease. In patients presenting with temperatures less than 26 C, 50% of deaths resulted from temperature-induced ventricular arrhythmias. Alcoholics hypothermic from exposure had excellent prognoses; however, temperatures less than 26 C were associated with a marked and statistically significant incidence of death.
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The charts of 33 consecutive patients undergoing emergency department thoracotomies between July 1, 1979 and June 30, 1980 were reviewed. Thoracotomies were performed in victims of both blunt and penetrating trauma who had suffered cardiopulmonary arrest and were refractory to the usual methods of resuscitation. ⋯ There were no survivors from blunt trauma or penetrating wounds below the diaphragm. In patients with penetrating wounds above the diaphragm, emergency thoracotomy may be considerable benefit as demonstrated in our study by a 66.6% salvage rate.