The American journal of emergency medicine
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We assessed out-of-hospital cardiac arrest patients' cerebral oxygenation during cardiopulmonary resuscitation (CPR) using near infrared spectrophotometry (NIRS). We evaluated the relation between a rise in patients' cerebral saturation values between the start and end of CPR and return of spontaneous circulation. ⋯ Patients whose cerebral saturation values measured with NIRS rise during CPR have a higher post-resuscitation survival rate. Monitoring of patients during CPR with this non-invasive technique may be a good method for predicting return of spontaneous circulation.
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Cerebrospinal fluid (CSF) rhinorrhea is rarely seen in the emergency department (ED) and most often occurs after a traumatic event. Spontaneous CSF leaks are much less common and are often the result of benign intracranial hypertension. If not recognized early on, CSF infections are the most serious consequence of this condition and therefore its early diagnosis and treatment are essential. ⋯ This disease must be considered in the differential diagnosis of any patient who presents with persistent atraumatic unilateral rhinorrhea. Although CSF leaks have been portrayed in the literature, this case report is unique because it describes a rare manifestation of this condition and its diagnosis by emergency physicians. This article presents the case, discusses the incidence, potential causes, predisposing factors, diagnostic modalities and the course of treatment for this particular diagnosis.
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Clopidogrel is an adenosine diphosphate receptor antagonist. The risk of intracranial hemorrhage following minor head trauma in patients with pre-injury use of clopidogrel has not been fully determined. ⋯ The use of clopidogrel is associated with a significantly increased risk of developing intracranial hemorrhage following minor trauma.