The American journal of emergency medicine
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The aim of the study was to determine whether C-reactive protein (CRP), procalcitonin (PCT), and d-dimer (DD) are markers of mortality in patients admitted to the emergency department (ED) with suspected infection and sepsis. ⋯ Our results suggest that high levels of DD are associated with 28-day mortality in patients with infection or sepsis identified in the emergency department.
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Thirty-year-old woman with history of AIDS and anxiety presented with palpitations. Although clinically euvolemic, she was aggressively fluid resuscitated in lieu of sinus tachycardia. ⋯ Given her normal cardiac, renal, and liver status, she spontaneously cleared the extra fluid, and the pulmonary edema resolved. This case highlights the importance of recognizing transient unilateral pulmonary edema and need for early radiographs to document clearance and prevent unnecessary testing.
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Symptoms are compared among patients with coronary artery disease (CAD) admitted to the emergency department with or without acute coronary syndrome (ACS). Sex and age are also assessed. ⋯ In patients with CAD, shortness of breath and dizziness are more common in non-ACS, whereas prior percutaneous coronary intervention and chest or arm pain are important factors to include during ACS triage.
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Knee dislocations are rare injuries typically associated with severe traumatic mechanisms. We report 2 cases of morbidly obese patients who had complete knee dislocations after falls from standing height. Both cases resulted in significant morbidity secondary to popliteal artery injury. Emergency physicians need to maintain a high index of suspicion for knee dislocations and should be aware of atypical presentations from minor trauma in the obese population.
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Case Reports
Lung ultrasound associated to capnography to verify correct endotracheal tube positioning in prehospital.
Endotracheal intubation is the “gold standard” of the control of airway patency but is associated with nonnegligible morbidity rates. A rapid detection of esophageal intubation is essential. Capnography is considered the reference technique for correct endotracheal tube (ETT) positioning confirmation. ⋯ During cardiopulmonary resuscitation, there was a sudden absence of end-tidal CO2 capnographic detection. Correct tube positioning could not be ascertained by auscultation because the environment had become extremely noisy. However, TM-mode (Time Motion--mode) lung ultrasound revealed bilateral pleural sliding during insufflation with the self-filling balloon, thus confirming correct ETT positioning.