The American journal of emergency medicine
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Emergency medical services (EMS) facilitate out of hospital care in a wide variety of settings on a daily basis. Stretcher-related adverse events and long term musculoskeletal injuries are commonly reported. Novel stretcher mechanisms may facilitate enhanced movement of patients and reduce workload for EMS personnel. ⋯ A structured methodology may be used for testing the exertion levels experienced while using different stretcher systems. The use of supporting stretcher system mechanisms may reduce perceived exertion in EMS personnel mainly during transports down stairs and during loading into ambulance vehicles.
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Acute cardiopulmonary distress in pregnancy always carries exceptionally arduous challenge for physicians. Here we report a patient who sustained spontaneous chordae tendineae rupture complicated with severe mitral regurgitation and acute pulmonary edema during peripartum period. ⋯ However, certain physiological stress, including hormone changes related matrix remodeling, increased cardiac output during pregnancy or labor pain may precipitate to this condition. Literature reviews from previously reported cases showed that those who were diagnosed chordae tendineae rupture at very preterm period all had preterm delivery.
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Case Reports
Severe malaria presenting to the ED: A collaborative approach utilizing exchange transfusion and artesunate.
We describe the case of a previously healthy 33year-old male pilot recently arrived to the United States from Africa. The patient presented to our ED febrile and disoriented, with projectile coffee-ground emesis. ⋯ Within 48h his parasitic load was reduced from 42% to 0.4%. The following is an account of a collaborative effort that spans the specialties of emergency medicine, infectious disease, and critical care medicine.