The American journal of emergency medicine
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The epidemiology, pathophysiology, and clinical presentation of herpes zoster ophthalmicus in the emergency department is discussed with an emphasis on the identification of the numerous potential ocular complications. Emergency physicians need to be able to recognize the clinical features of herpes zoster ophthalmicus and initiate appropriate therapy and referral.
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Case Reports
The "gastric fluid" sign: an unrecognized false-positive finding during focused assessment for trauma examinations.
The FAST exam has become the current standard for free intraperitoneal fluid determination in most emergency departments. Knowledge of false negative and false positive findings is imperative to improve accuracy. We detail a case in which an important false positive findings previously not discussed in the medical literature was noted. The ability of the physician to recognize the "gastric fluid" sign and make the adjustments accordingly could improve the specificity of the FAST exam, preventing non-therapeutic laparotomies.
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Complete fracture-dislocation of thoracolumbar spine without significant neurologic deficits is a rare entity. The possible mechanism may result from the spontaneous decompressive fractures of the spinal elements with sparing of the spinal cord. Here, we report a case of a healthy 50-year-old man who presented with complete fracture-dislocation of T12 through L1 vertebrae without paraplegia. Early diagnosis and early surgery with decompression, reduction, and stabilization is the best policy in management of this unstable spine injury.
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During summer, near drowning is a common accident in Taiwan. It may lead to multiple organ damages in cases where severe hypothermia and hypoxemia occur. We present a case of myocardial infarction after near drowning. ⋯ The initial level of cardiac enzymes was within normal limit but elevated in troponin I on the second day after hospitalization. We presumed that the possibility of myocardial infarction resulted from near drowning-related hypoxemia. To our knowledge, this is the first case describing myocardial injury with electrocardiogram changes after near drowning.
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The aim of the present study was to assess whether a beta-adrenergic blocking agent such as atenolol, administered during cardiopulmonary resuscitation, would improve initial resuscitation success. ⋯ A beta-adrenergic blocking agent, when administered during cardiopulmonary resuscitation, significantly improves initial resuscitation success and increases blood and coronary perfusion pressures during cardiopulmonary resuscitation.