The American journal of emergency medicine
-
Multicenter Study
Correlation of history and physical examination with imaging in traumatic near-shore aquatic head and spinal injury.
It remains unclear whether clinicians can rely on specific symptoms and signs to detect or exclude serious head and spinal injury sustained during near-shore aquatic activities. Our study investigated patients' history of present illness (HPI) and physical examination (PE) for their utility in detecting serious head and spinal injury. ⋯ We identified several components of the clinical evaluation that had clinically significant association with spinal injuries from beach-related trauma. While prospective studies are needed to confirm our observations, clinicians may consider these high-risk features in patients with beach-related trauma and adjust testing and level of care appropriately.
-
Inhalation of noble and other gases after cardiac arrest (CA) might improve neurological and cardiac outcomes. This article discusses up-to-date information on this novel therapeutic intervention. ⋯ Inhalation of certain gases after CPR appears promising in mitigating neurological and cardiac damage and may become the next successful neuroprotective and cardiotonic interventions.
-
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emerging viral pathogen that causes the novel coronavirus disease of 2019 (COVID-19) and may result in hypoxemic respiratory failure necessitating invasive mechanical ventilation in the most severe cases. ⋯ This review provides evidence-based recommendations for the treatment of COVID-19 related respiratory failure requiring invasive mechanical ventilation.
-
Acute chloroquine and hydroxychloroquine toxicity is characterized by a combination of direct cardiovascular effects and electrolyte derangements with resultant dysrhythmias and is associated with significant morbidity and mortality. ⋯ An understanding of the pathophysiology of acute chloroquine and hydroxychloroquine toxicity and available emergency treatments can assist emergency clinicians in reducing the immediate morbidity and mortality associated with this disease.
-
Clostridioides difficile infection (CDI), characterized primarily by diffuse diarrhea in the setting of recent healthcare and antibiotic exposure, maintains significantly high rates of diagnosis in the U.S., even in the emergency department (ED). Recent updates in the literature concerning CDI should be considered for effective clinical practice in the ED setting. ⋯ CDI cause significant illness throughout the U.S. Successful CDI diagnosis and management in the ED require current knowledge of risk, presentation, diagnosis, and proper antibiotic treatment.