Annals of emergency medicine
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Case Reports
Cardiac Arrest Caused by an Acute Intrathoracic Gastric Volvulus Treated With Percutaneous Gastrostomy.
During cardiopulmonary resuscitation, one of the first priorities after establishing basic and advanced life support is to identify the cause of the arrest. We present a rare case of cardiac arrest due to a decreased venous return from mediastinal shift caused by a paraesophageal hernia with an incarcerated thoracic gastric volvulus, which was treated by percutaneous gastrostomy.
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We evaluate the effect of implementing the out-of-hospital pediatric traumatic brain injury guidelines on outcomes in children with major traumatic brain injury. ⋯ Implementation of the pediatric out-of-hospital traumatic brain injury guidelines was not associated with improved survival when the entire spectrum of severity was analyzed as a whole (moderate, severe, and critical). However, both adjusted survival to hospital admission and discharge improved in children with severe traumatic brain injury, indicating a potential severity-based interventional opportunity for guideline effectiveness. These findings support the widespread implementation of the out-of-hospital pediatric traumatic brain injury guidelines.