The American journal of emergency medicine
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Case Reports
Thrombosis of external iliac and common femoral arteries secondary to blunt trauma due to handlebar injury.
Vascular injuries are uncommon following a bicycle handlebar injury in children. However, they are associated with an extremely high morbidity including limb loss and asymmetric limb growth. ⋯ In managing patients with blunt force trauma to the abdomen from handlebars, clinicians should have a high index of suspicion for vascular injuries even with low-risk mechanism of injury and superficial injuries noted on exam. Their assessment should include immediate examination of bilateral peripheral pulses of the lower extremities to evaluate for clinical findings associated with acute lower limb ischemia as well as bedside Doppler exams and early consideration of CTA to assess for occult vascular injury.
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Case Reports
Asymptomatic ventricular fibrillation in continuous flow left-ventricular assist device.
Left ventricular assist devices (LVADs) have increased survival for heart failure patients. Individuals with LVADs are a growing patient population with frequent complications and Emergency Department (ED) visits. A 50-year-old female presented to the ED due to a low flow alarm on her LVAD. ⋯ Amiodarone was continued as an outpatient. Patients with continuous flow LVADs can be in dysrhythmias including ventricular tachycardia and ventricular fibrillation and remain relatively asymptomatic. We present a rare case of a patient with an LVAD and ventricular fibrillation who was completely asymptomatic in the ED.
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Thyroid gland rupture in a child secondary to blunt trauma is an extremely rare occurrence. The number of published cases of thyroid gland injuries in children is very limited in the research literature. ⋯ This case highlights potential life-threatening complications and reviews management of thyroid gland injuries. Based on this case and other published pediatric case reports, conservative management may be a reasonable approach in thyroid gland injuries from blunt neck trauma in children.
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Observational Study
Evaluating the effect of SARS-Cov-2 infection on prognosis and mortality in patients with acute pancreatitis.
Acute pancreatitis (AP) is the leading cause of hospitalization among gastrointestinal disorders. The aim of our study is to compare the results between AP patients with and without COVID-19, and to reveal the effects of COVID-19 on the course, intensive care needs and mortality of AP patients. ⋯ The severity and mortality of AP increase in patients with both AP and COVID-19. This rate increases even more in the presence of COVID-19-associated pneumonia. We believe that new strategies should be developed for the follow-up and treatment of patients with both these conditions.
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We investigated the effectiveness of automated pupillometry on monitoring cardiopulmonary resuscitation (CPR) and predicting return of spontaneous circulation (ROSC) in a swine model of cardiac arrest (CA). ⋯ The automated pupillometry may serve as an effective surrogate method to monitor cardiopulmonary resuscitation efficacy and predict ROSC in a swine model of cardiac arrest.