The American journal of emergency medicine
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Four to ten percent of patients evaluated in emergency departments (ED) present with altered mental status (AMS). The prevalence of non-convulsive seizure (NCS) and other electroencephalographic (EEG) abnormalities in this population is unknown. ⋯ The prevalence of EEG abnormalities in ED patients with undifferentiated AMS is significant. ED physicians should consider EEG in the evaluation of patients with AMS and a high suspicion of NCS/NCSE.
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Foot and ankle injuries that result in sprains or fractures are commonly encountered at the emergency department. The purpose of the present study is to find out the accuracy of ultrasound (US) scanning in injuries in the aforementioned areas. ⋯ Ultrasound imaging permits the evaluation of foot and ankle fractures. Because it is a highly sensitive technique, US can be performed in the emergency department with confidence.
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This study aimed to determine whether routine urinalysis may serve as a tool in discriminating between acute appendicitis and perforated appendicitis in children. ⋯ Routine urinalysis may serve to aid in discriminating between simple and perforated appendicitis. Clinically, we believe that these urine parameters may aid primary emergency physicians with decision making in patients with clinically suspected appendicitis.
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Case Reports
Prolonged cardiac arrest: successful resuscitation with extracorporeal membrane oxygenation.
Extracorporeal membrane oxygenation support can extend the duration of cardiopulmonary resuscitation (CPR), but prolonged CPR may develop multiple organ failure, and neurologic death is a major complication. We present a case of a 35-year-old woman with fulminant myocarditis secondary to H1N1 influenza A infection, in which cardiac arrest was refractory to prolonged conventional CPR. Extracorporeal membrane oxygenation was initiated 250 minutes after prolonged CPR. Extracorporeal membrane oxygenation provided cardiopulmonary life support for prolonged CPR, achieving a sustained return of spontaneous circulation, which allowed further treatment and made a good recovery with intact cerebral performance.
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Household stoves are a common source of injury in the United States. ⋯ This is the first comprehensive study of stove-related injuries in the United States using a nationally representative sample. Strategies to prevent stove-related injuries should address the multiple mechanisms of injury.