Annals of emergency medicine
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Case Reports
Out-of-hospital quantitative monitoring of end-tidal carbon dioxide pressure during CPR.
To assess the feasibility and potential usefulness of quantitative measurement of end-tidal carbon dioxide pressure (PETCO2) during out-of-hospital cardiac arrest. ⋯ These preliminary pilot observations confirm the feasibility of quantitative capnography during out-of-hospital cardiac arrest and indicate that early institution of this noninvasive procedure may provide insight into pathophysiologic mechanisms such as pseudo-electromechanical dissociation and may also track changes in pulmonary blood flow during chest compressions or during spontaneous circulation.
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To study the prevalence, risk factors, and consequences of ambulance diversion. ⋯ Ambulance diversion is a common and increasing event that delays emergency medical care.
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To determine characteristics motivating physicians to choose careers in academic and nonacademic emergency medicine. ⋯ Factors influencing career decisions can be used to plan strategies to meet the future needs of academic emergency medicine.
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Case Reports
Pneumocephalus following an epidural blood patch procedure: an unusual cause of severe headache.
Pneumocephalus is a rare complication of anesthetic procedures involving the epidural space. We report the case of a 36-year-old woman who developed a severe headache due to pneumocephalus that occurred during an epidural blood patching procedure. This report reviews the blood patch procedure and its attendant complications. Emergency physicians should be aware of the potential complications of this commonly performed procedure and include iatrogenic pneumocephalus in the differential diagnosis of severe headache in the proper clinical scenario.
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Case Reports
Pacemaker-twiddler's syndrome: a rare cause of lead displacement and pacemaker malfunction.
Pacemaker-twiddler's syndrome is characterized by spontaneous, subconscious, inadvertent, or deliberate rotation of the pulse generator by the patient resulting in lead dislodgement and pacemaker malfunction. We present a case of pacemaker-twiddler's syndrome that involved an atrioventricular sequential pacemaker. It resulted in failure of atrial lead capture and phrenic nerve stimulation but without loss of ventricular lead capture. A search of the literature revealed only ten previous cases reported; none were in the emergency medicine literature, and none involved an atrioventricular sequential pacemaker.