The American journal of emergency medicine
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This study evaluates the effectiveness of CHOKAI and STONE scores in patients presenting to the emergency department with ureteral stones. ⋯ In the functioning of the emergency department, it is important to make the differential diagnosis of patients quickly and provide effective treatment. The use of diagnostic scoring systems saves time for the emergency physician in the differential diagnosis phase and guides in terms of applying for possible additional imaging methods.
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Acute myeloid leukemia (AML) accounts for 16% of all leukemias in children. Prognosis in the pediatric population is better than that of older populations, with a younger age at diagnosis being a favorable prognostic factor [1]. Diplopia is a rare first presenting sign of AML. ⋯ Peripheral smear showed increased blast cells >10%. This patient was ultimately diagnosed with AML. This case demonstrates an atypical presentation of AML and urges a thorough work up for patients presenting with unexplained diplopia.
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To recognize and validate the predictor of risk factors for ICU patients with QTc intervals ≥500 ms. ⋯ For critically ill patients, congestive heart failure, number of combined LQTS-inducing medications and APACHE II score are proved as risk factors associated with QTc > 500 ms.
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This study aims to compare the composite outcome of progression to septic shock between 30 mL/kg/ideal body weight (IBW) versus 30 mL/kg/non-IBW fluid resuscitation dosing strategies in obese patients with severe sepsis. ⋯ Our study results suggest that in obese septic patients, fluid administration using an IBW-dosing strategy did not affect the progression to septic shock.
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Many trusted organizations recommend a particular set of gear for hikers. Termed the "10 essentials," the importance of these items to wilderness preparedness has not been critically evaluated. We sought to better understand the value of these items in day hiker preparedness by assessing the association between carried items, the occurrence of adverse events, and satisfaction. ⋯ Carrying more items did not translate into improved satisfaction for day hikers, but was associated with fewer events for which the hiker was unprepared. Other than adverse events related to hunger, thirst, weather, and minor medical events, adverse events were unlikely during this day hike. Nutrition, hydration, and insulation were the items reported as most often needed, followed by a kit to treat minor medical events, while the remaining 6 items were infrequently used.