The American journal of emergency medicine
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Carbon monoxide (CO) poisoning is known to increase thrombotic tendency, and the risk of deep vein thrombosis in individuals who have experienced CO poisoning is higher than in the general population. However, there are a few reports describing cases of pulmonary thromboembolisms (PTE) secondary to CO poisoning. ⋯ To date, the causal relationship between PTE and CO poisoning is unclear. However, PTE should be considered in patients with CO poisoning as a differential diagnosis when unexplained hypoxemia or shock are observed. Further studies on the association between CO poisoning and PTE are warranted.
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Emergency Department (ED) leaders are increasingly confronted with large amounts of data with the potential to inform and guide operational decisions. Routine use of advanced analytic methods may provide additional insights. ⋯ In this study regarding the use of advanced analytics in daily ED operations, time series analysis provided multiple useful insights into boarding and its impact on performance metrics.
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Carbon monoxide (CO) is a leading cause of morbidity and mortality. Treatment focuses on the rapid elimination of CO and management of hypoxia. Oxygen is the cornerstone of therapy, and usually applied via a reservoir face mask. ⋯ One patient was treated by non-invasive CPAP-ventilation support with a FiO2 of 100%, whereas the other was treated by conventional oxygen inhalation. In the patient treated by CPAP, COHb-levels fell quickly to 6% within one hour, and reached 3% after 90 min, whereas it took six hours to reach the same levels in the patient with conventional treatment. This vividly illustrates the potential of CPAP therapy as an alternative to conventional oxygen inhalation in the treatment of CO poisoning.
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We had previously experienced a case involving prolonged cardiopulmonary resuscitation (CPR) on Mt. Fuji (3776 m), demanding strenuous work by the rescuers. The objective of this study was to compare the effect of compression-only and conventional CPR on oxygen saturation of rescuers in a hypoxemic environment. ⋯ Prolonged CPR at high altitude exerts a significant physical effect upon the condition of rescuers. Compression-only CPR at high altitude may deteriorate rescuer oxygenation, whereas CPR with breaths might ameliorate such deterioration.
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Thrombus burden in pulmonary embolism (PE) is associated with higher D-Dimer-levels and poorer prognosis. We aimed to investigate i) the influence of right ventricular dysfunction (RVD), deep venous thrombosis (DVT), and high-risk PE-status on D-Dimer-levels and ii) effectiveness of D-Dimer to predict RVD in normotensive PE patients. ⋯ Thrombus burden in PE is related to elevated D-Dimer levels, and D-Dimer values >1.18 mg/l were predictive for RVD in normotensive patients. D-Dimer levels were influenced by DVT, but not by cancer, pneumonia, age, or renal impairment.