The American journal of emergency medicine
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Observational Study
Effect of predischarge blood pressure on follow-up outcomes in patients with severe hypertension in the ED.
Although emergency department (ED) patients with asymptomatic severe hypertension (ASH) generally have no serious short-term hypertension-related adverse events, it is unclear whether persistently high discharge blood pressure (BP) affects the outcome due to the dynamic nature of BP. ⋯ Predischarge BP value is not associated with immediate serious adverse events and does not affect short-term BP control in ED patients with ASH. Further study on the need to lower BP during the ED stay and on antihypertensive prescriptions for these patients is required.
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Clinical Trial
Influence of caudal traction of ipsilateral arm on ultrasound image for supraclavicular central venous catheterization.
The first step for successful ultrasound (US)-guided subclavian vein (SCV) catheterization using a supraclavicular approach is to obtain a good longitudinal image of SCV for in-plane needle placement. We evaluated the efficacy of caudal traction of ipsilateral arm on the exposure of the SCV. ⋯ The caudal traction of ipsilateral arm toward to the knee improves the longitudinal US view of SCV for the supraclavicular approach, without reducing its size. Proper caudal traction of the arm might ensure the high success rate with safe needle insertion technique. Abduction should be avoided during US-guided supraclavicular SCV catheterization.
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There are several studies evaluating the cardiac effects of carbon monoxide (CO) poisoning during the acute period; however, the number of studies evaluating the long-term cardiac effects is limited. ⋯ In patients presenting to the ED with CO poisoning, COHb levels can be helpful for risk stratification in the long-term development of AMI.