The American journal of emergency medicine
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The use of the automatic external defibrillator (AED) can significantly reduce the time to defibrillation in patients with sudden cardiac death. This early defibrillation via the AED can also improve patient outcome, including survival and neurologic status among survivors. ⋯ In our design of the system, we found little useful information to guide us in the development and construction our system. This article is a review of the process of public access defibrillation AED system development such that other medical and academic leaders at similar institutions can more easily develop such systems.
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Emergency physicians, specialists, and primary care doctors across the health care delivery spectrum remain actively engaged in the provision of medical oversight for emergency medical services (EMS) systems, a vital link in the medical continuum of care. Practicing emergency physicians, regardless of their level of formal EMS training, interface with EMS system components and providers on a regular basis. It is important to remain aware of trends and practice patterns that have the potential to affect the care of emergency patients. ⋯ Like a single 12-lead electrocardiographic (ECG) tracing, this review represents a “snapshot” of current discussions in the EMS community. Prehospital medicine is a dynamic discipline, and its practice patterns are not identical to those found in a hospital emergency department (ED). The purpose of this literature review is to familiarize emergency physicians with some of the ongoing discussions in the prehospital literature.
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The aim of this study was to measure sublingual perfused capillary density (PCD) to assess sublingual microvascular perfusion during emergency department (ED) treatment of acute decompensated heart failure (ADHF). ⋯ Sublingual tissue perfusion is diminished in ADHF but increases with treatment. It may represent a quantitative way to evaluate ADHF in the ED setting.
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A 19-year-old man presented with a 1-month history of progressive 4-limb numbness and gait imbalance. Physical examination revealed mild general muscular weakness, areflexia, and wide-based, ataxic, steppage gait. Sensory tests showed diminished superficial sensation below the level of the cervical-thoracic junction and a glove-and-stocking pattern of sensory loss at the 4 extremities. ⋯ The numbness resolved after the first week, but there remained a mild sensory ataxic gait. The patient recovered fully after 2 months of treatment and nitrous oxide abstinence. We recommend an investigation of the patient's history of nitrous oxide exposure in cases where an individual presents to the emergency department or outpatient department with acute numbness characterized by megaloblastic red blood cells and symmetric neurologic deficits.