The American journal of emergency medicine
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The optimum chest compression site with regard to heart failure demonstrated by computed tomography.
To determine the optimum chest compression site during cardiopulmonary resuscitation (CPR) with regard to heart failure (HF) by applying three-dimensional (3D) coordinates on computed tomography (CT). ⋯ The lowest possible sternum just above the xiphisternal joint should be compressed especially for HF patients during CPR.
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Comparative Study
How can lifeguards recover better? A cross-over study comparing resting, running, and foam rolling.
The aim of this study is to compare the effectiveness of active recovery in form of running or foam rolling on clearing blood lactate compared to remain sitting after a water rescue. ⋯ We found that surf lifesavers clear out blood lactate more efficient when performing an active recovery protocol. Foam rolling is an effective method of increasing the rate of blood lactate clearance. These two recovery methods are also adequate for surf lifeguards as they do not interfere with the surveillance aspect of their job.
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We describe a patient with pneumocephalus following an epidural steroid injection (ESI) who presented with altered mental status, headache, focal neurologic findings and seizures. Pneumocephalus has rarely been described following ESI. A 34-year-old female presented with an altered level of consciousness worsening over approximately 18h following an ESI for lumbar back pain. ⋯ Case reports noting complications associated with this technique have been reported; rarely including pneumocephalus. Complications from the pneumocephalus are even less commonly reported. Though rare following an ESI and generally self-limited without complication, pneumocephalus should be considered in the differential diagnosis when evaluating a patient with neurologic deficits after instrumentation.
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Case Reports
Acute intractable headache and oculomotor nerve palsy associated with nicorandil: A case report.
Acute non-traumatic headaches with neurological deficits alarm emergency department (ED) physicians. Typically, a sudden headache with oculomotor nerve palsy involving a pupil indicates the possibility of a subarachnoid hemorrhage (SAH) due to an aneurysm originating from the posterior communicating artery. For the ED physician, thinking beyond the possibility of an SAH can be crucial. ⋯ Cerebrospinal fluid analysis was also unremarkable. The patient's headache and oculomotor nerve palsy improved completely after discontinuation of nicorandil for 3 days. To the best of our knowledge, this is the first case report on side effects of nicorandil presenting as a severe headache with reversible oculomotor nerve palsy involving a pupil, symptoms which mimicked a possible SAH due to aneurysm.