The American journal of emergency medicine
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Acute asthma exacerbations (AAE) account for many Pediatric Emergency Department (PED) visits. Chest radiography (CXR) is often performed in these patients to identify practice-changing findings such as pneumonia (PNA). Limited knowledge exists to balance the cost and radiation dose of CXR with expected yield of clinically meaningful information. ⋯ CXR infrequently adds valuable information in children with AAE. Patients treated with antibiotic within 7days are more likely to have PNA identified on CXR and receive antibiotics. A larger study is needed to examine potential significance of hypoxia and crackles.
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Emergency and transport ventilators use in the prehospital field is not well described. This study examines trends of ventilator use by EMS agencies during 911 calls in the United States and identifies factors associated with this use. ⋯ Providers at different EMS levels use ventilators during 911 scene calls in the US. Training of prehospital providers on ventilation technology is needed. The benefit and effectiveness of this intervention remain to be assessed.
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Fibrinogen plays an important role in hemostasis and thrombosis and is proven to have prognostic significance in patients with cardiovascular disease. We examined the utility of fibrinogen as a prognostic indicator for patients with type A acute aortic dissection (AAD). ⋯ Low fibrinogen level on admission is an independent predictor of in-hospital mortality in patients with type A AAD.
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Case Reports
An incidental image of a patient with chest pain after fall from a tree: Swyer-James-MacLeod syndrome?
Unilateral hyperlucent lung was firstly described by Swyer and James 1950s. After that, some patients with same disease were detected by Macleod. Then this syndrome was named as Swyer- James-Macleod syndrome (SJMS), and this syndrome includes a smaller or normal sized unilateral hyperlucent lung. ⋯ In his computed tomography no rib fracture, pneumothorax and hemothorax. But an abnormal image (5.5 cm hyperlucent area) was seen in his left lung. This report aims to present one of incidentally diagnosed rare case of SJMS.