The American journal of emergency medicine
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In the Emergency Department (ED) setting, clinicians commonly treat severely elevated blood pressure (BP) despite the absence of evidence supporting this practice. We sought to determine if this rapid reduction of severely elevated BP in the ED has negative cerebrovascular effects. ⋯ While this small cohort did not find an overall substantial change in cerebral blood flow, it demonstrated adverse cerebrovascular effects from rapid BP reduction in the emergency setting.
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Observational Study
Clinical characteristics of elderly drowning patients.
Drowning is one of the major causes of traumatic death. The impact of drowning in the elderly and patients who were not elderly will be different because of physiological differences. We wanted to analyze the clinical differences such as mortality, incidence rate of complications, degree of hypothermia and rate of cardiac arrest between elderly and adult drowning patients. ⋯ Elderly drowning patients accounted for approximately 1/10 of all drowning cases and were more likely to experience a cardiac arrest, hypothermia, mortality, and ICU admission.
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Both aortic dissection and tension pneumothorax are conditions that require urgent treatments. However, the diagnosis of these emergencies is sometimes challenging because of various symptoms and difficulty obtaining their medical history due to severe conditions. Here, we present the case of a patient with type A aortic dissection associated with tension pneumothorax. ⋯ Contrast-enhanced computed tomography revealed type A thrombosed aortic dissection with bullae in the upper lobe of the left lung. Therefore, the patient was admitted to the intensive care unit, conservatively treated, and discharged without any complications. In conclusion, type A aortic dissection may be associated with tension pneumothorax and should be considered if the patient's vital signs do not improve even after decompression of the tension pneumothorax.
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To characterize the clinical presentation and hospital course of patients with reported synthetic cannabinoid (SC) exposure requiring Intensive Care Unit (ICU) admission. ⋯ Patients admitted to ICU after SC exposure exhibit significant organ dysfunction, particularly neurologic and respiratory. Prognosis is good with supportive care.