The American journal of emergency medicine
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Multicenter Study
Impact of hypotension after return of spontaneous circulation on survival in patients of out-of-hospital cardiac arrest.
To investigate the relationship between hypotension in the first 3h after return of spontaneous circulation (ROSC) in patients with out-of-hospital cardiac arrest. ⋯ Among the patients who experienced ROSC after OHCA, post-ROSC hypotension was an independent predictor of survival.
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Multicenter Study
Association of recent major psychological stress with cardiac arrest: A case-control study.
We hypothesized that major psychological stress can be a risk factor for cardiac arrest and that effects are modified by elapsed time from specific stressful events. ⋯ MLEs were associated with cardiac arrest occurrence, and the effect was modified by the elapsed time from the MLEs.
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Observational Study
A brief assessment of capacity to consent instrument in acutely intoxicated emergency department patients.
The aim of this study was to determine to what extent acute alcohol intoxication effects capacity to assent, consent, or refuse research participation. ⋯ While intoxicated emergency department patients are able to complete the questionnaire, the majority do not possess capacity to provide informed consent to research. A minority of participants remember involvement once they have achieved sobriety, exception from informed consent protocols are needed to perform emergency research in this population.
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Case Reports
Nonepileptic seizure provoked by cardiac dysrhythmia: A case of ST elevation myocardial infarction.
Acute seizures represent 1% of all visits to emergency departments in the United States. While many acute seizures are correctly attributable to underlying epilepsy, approximately one-third of acute seizures are provoked by underlying and potentially life-threatening acute conditions. ⋯ Cardiac dysrhythmias are known causes of acute seizure-like activity and, if transient and not captured by electrocardiogram tracings during acute episodes, may be incorrectly diagnosed as epileptic seizures. We report a case of acute ST-segment elevation myocardial infarction presenting with acute symptomatic seizure due to occult transient cardiac dysrhythmia.
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Review Meta Analysis Comparative Study
Comparison of the loop technique with incision and drainage for soft tissue abscesses: A systematic review and meta-analysis.
Skin and soft tissue infections are a common presentation to the emergency department. Traditional management of abscesses involves a linear incision through the center of the abscess with packing placed. The loop drainage technique (LDT) is an alternate approach that may reduce pain and scarring, as well as decrease the number of follow up visits needed. This systematic review and meta-analysis aimed to compare the efficacy of the LDT with conventional incision and drainage (CID) in the treatment of soft tissue abscesses. ⋯ The existing literature suggests that LDT is associated with a lower failure rate than CID. However, the data is limited by small sample sizes and predominantly retrospective study designs. Given the potential for less pain, decreased scarring, and lower associated healthcare costs, this technique should be considered for the treatment of skin and soft tissue abscesses in the ED setting, but further studies are needed.