The American journal of emergency medicine
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Comparative Study
A comparison between evacuation from the scene and interhospital transportation using a helicopter for subarachnoid hemorrhage.
We investigated the changes in the vital signs and the final outcomes subarachnoid hemorrhage (SAH) patients who were evacuated from the scene using the doctor-helicopter (Dr. Heli) service and those who only underwent interhospital transportation using the doctor-helicopter Dr. Heli service to investigate safety of this system. ⋯ The present study indirectly suggests the safety of using a Dr. Heli to evacuate SAH patients from the scene.
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Puncture wounds are common injuries treated in the emergency department (ED). Prior studies have shown that toothbrushes are common reservoirs for oral flora, especially in regions near the head of the toothbrush near the bristles. ED providers must be aware of the danger associated with bacterial contamination of the associated wound and should be familiar with different pathogens and options for treatment. We present a unique case of a 30-year-old male with non-intraoral injury who presented to the ED after puncturing his left palm with the metal post of an electric toothbrush.
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Acute dyspnea affects a large heterogeneous patient group with high mortality and readmission rates. ⋯ A score of tPA, PRL, FAS and CCL3 predicts 6-month death and readmission in patients hospitalized for acute dyspnea and may prove useful to optimize length of stay and follow-up. Although the BRS outweighs dyspnea severity in prediction of the endpoint, its prognostic role is strongest in mild-moderate dyspnea.
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Takayasu arteritis is a form of vasculitis that involves the aorta, its major branches, and the pulmonary arteries. Coronary artery involvement is not uncommon, and most frequently includes the ostia and proximal segments. ⋯ However, recent advances in imaging modalities-including magnetic resonance angiography, computed tomography (CT), sonography, and fluoro-deoxyglucose positron emission tomography (FDG-PET)/CT Isobe (2013) [2]-have facilitated earlier and more accurate diagnoses of this condition. Here we report a case in which imaging revealed stenosis in the ostia of the coronary artery.
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Case Reports
A case of cardiac arrest that occurred on a high mountain in which a favorable outcome was obtained.
A 36-year-old man started to climb Mount Fuji (3776m above sea level: ASL), from the Gotemba new fifth station (2400m ASL). He had no significant medical history, and this was his first attempt to climb such a high mountain. He began feeling chest discomfort but continued to climb. ⋯ A chest computed tomography angiogram indicated triple-vessel disease. He was discharged without any neurological deficits after undergoing bypass surgery. In high mountains that can be easily accessed by amateur climbers who may have cardiac disease, the placement of AED devices and the establishment of the chain of survival from the scene to the intensive care unit are essential for obtaining a favorable outcome when a climber suffers cardiac arrest.