The American journal of emergency medicine
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Multicenter Study Comparative Study
Outcome of insulin-treated diabetics receiving epinephrine during cardiac arrest.
The purpose of this study was to determine the effects of epinephrine in insulin-treated diabetics (DM) compared with nondiabetic (ND) controls during cardiopulmonary resuscitation (CPR). A retrospective analysis from a multicenter study of out-of-hospital cardiac arrest included 62 DM and 1,151 ND. Outcome parameters included return of spontaneous circulation (ROSC), blood pressure (BP), emergency department admissions (EDA), hospital admissions (HA), and hospital discharge (DC). ⋯ However, none of the DM given HDE (n = 24) were discharged from the hospital. These results suggest that DM may have improved resuscitation rates with SDE and may be adversely affected with HDE. Larger prospective studies are needed to confirm these findings.
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There is little experience with overdose of the relatively new antidepressant bupropion. The case of an 18-year-old healthy adult female patient after an intentional ingestion of 9 g of bupropion is presented. Her hospital course was significant for grand mal seizures, sinus tachycardia without conduction abnormality, and complete neurological recovery. The first pure bupropion overdose in the emergency medicine literature is presented, and the literature pertinent to emergent management of this new antidepressant is reviewed.
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New research has shown that the incidence of success of replanted avulsed teeth can be greatly increased by differentially diagnosing and treating them according to the length of extraoral time and the physiological width of the apical foramen. A specific treatment regimen has been presented that will give the physician the information necessary to maximize the success of replanted avulsed teeth that may be seen.
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Comparative Study
Facial trauma in motor vehicle accidents: etiological factors.
The effects of seat belts and the use of alcohol and drugs have been studied as etiological factors in facial trauma to occupants of motor vehicle accidents (MVAs). During a 15-month period, 461 patients were admitted to a regional trauma center as a result of injuries sustained in MVAs. Two hundred thirty-seven (51%) of these patients had facial trauma. ⋯ Head injuries and blunt chest trauma were most commonly associated injuries in these patients. This study suggests that use of alcohol and drugs in occupants of the motor vehicle had a major effect on the etiology of facial trauma. Also it supports the data that suggests that the use of seat belts prevents a wide range of injuries including facial trauma in MVAs.