Annals of emergency medicine
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To determine the reasons patients with suspected acute myocardial infarction (AMI) delay seeking medical care or do not call 911. ⋯ Maximal benefit from thrombolytic therapy is not realized in a substantial proportion of patients with AMI because of delays in seeking medical care. Knowledge of the reasons patients delay or do not call 911 can help focus efforts on achieving more rapid treatment of patients with AMI.
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To determine whether triage and stabilization of severely injured rural trauma victims in outlying Level III emergency departments before transfer to Level I trauma centers results in outcomes similar to national normative data. ⋯ Triage and stabilization of severely injured rural trauma victims at Level III EDs before Level I transfer provide outcomes similar to national results. Unexpected death of severely injured trauma victims remains a problem in rural Level III EDs.
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To determine whether nonemergency patients can be prospectively identified by triage nurses and safely triaged out of the emergency department without treatment. ⋯ A subset of patients with nonemergency problems can be prospectively identified and triaged out of the ED without significant adverse outcomes provided there is community support for follow-up care.
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We report the case of a 3-month-old girl with tetralogy of Fallot who was resuscitated from a near-fatal hypercyanotic episode (Tet spell). While tetralogy of Fallot is rare (1 in 10,000 live births), failures of diagnosis or management may result in catastrophic outcomes for an eminently survivable condition. An understanding of the pathophysiology of hypercyanotic spells will allow the emergency specialist to understand and apply a treatment option--compression of the abdominal aorta--not previously reported in the emergency medicine literature.
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Blunt trauma to the anterior neck has been known to cause upper-airway obstruction requiring emergency tracheostomy. We report the case of a 26-year-old man who sustained blunt trauma to the anterior neck in whom upper-airway obstruction developed. ⋯ Emergency tracheostomy was performed, and the patient recovered uneventfully. A Medline search of the literature for the past 3 years failed to identify any individual case reports of bilateral vocal cord paralysis secondary to blunt anterior neck trauma.