The American journal of emergency medicine
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The objective of this study is to determine whether creatine kinase-MB (CK-MB) index (CK-MBi) is useful in the evaluation of acute myocardial infarction (AMI) in patients with indeterminate troponin (Tn) in the emergency department (ED). ⋯ Initial results identify rare cases of AMI where CK-MBi is positive in the setting of indeterminate Tn. However, most patients with indeterminate Tn and positive CK-MBi were not judged to be having AMI. In most cases, CK-MBi is not positive with indeterminate Tn and when positive more commonly confuses the picture. This suggests CK-MBi could be eliminated in patients with indeterminate Tns.
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The objective of this study is to describe the use of emergent head computed tomography (CT) in young children and ask in which circumstances scans contributed to immediate management. ⋯ Every child in this sample who required emergency intervention had red flags on history and physical examination. The 35% of CT scans performed in young children without red flags did not contribute usefully to their acute management.
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Medicalized high sea rescue is very different from prehospital medical evacuation. It requires specifically trained medical teams because the difficulties are marine, aerial, and medically related. The French Navy provides medical evacuations by helicopter on the Atlantic coast, up to 320 km offshore and under all weather conditions. ⋯ The most common prehospital diagnosis was coronary chest pain in 23 patients (64%), including 11 patients with acute coronary syndrome with ST-segment elevation. Thirty-two patients were airlifted by helicopter. All patients benefited from monitoring, electrocardiogram, peripheral venous catheter, and medical management as soon as the technical conditions allowed it.
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Hiatus hernia (HH) is a frequent condition and is asymptomatic most of the time. Common symptoms can include epigastric pain, postprandial fullness, and nausea. We report a case of postprandial acute right and left heart failure caused by an intrathoracic stomach in a previously asymptomatic woman. ⋯ To the best of our knowledge, ours is the first report of both acute right and left heart failure due to an HH. The prompt placement of a nasogastric tube was lifesaving. We believe that the diagnosis of HH ought to be taken into consideration by emergency physicians and included in the differential diagnosis for acute postprandial heart failure.
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In recent years, significant growth has been seen in the field of emergency medicine. However, the national productivity to the field of emergency medicine remains unknown. This study aimed to reveal the national contributions in the field of emergency medicine. ⋯ United States is the most productive country in the field of emergency medicine.