The American journal of emergency medicine
-
Nitroglycerin (NTG) is a vasodilator used in the prehospital setting with chest pain patients. Potential adverse effects include hypotension, bradycardia or tachycardia, and mental status change. However, it is unclear which factors, if any, are associated with patients having an adverse event after receiving NTG. The objective of this study was to determine demographic and clinical factors associated with adverse events after prehospital NTG administration. ⋯ Adverse events following prehospital NTG administration were rare, especially in patients with an SBP > 110 and a HR < 100, and less frequent in those with existing IV access. Demographics were not found to be clinically significant.
-
To investigate the effect of lactate/albumin (L/A) ratio on survival to discharge in patients who have had out-of-hospital cardiac arrest (OHCA). ⋯ The L/A ratio is more valuable than the lactate or albumin levels alone in predicting survival to discharge. Our findings indicate that a combination of these parameters might increase the predictability of survival to discharge in OHCA patients.
-
Long-term consequences of electrical injury without initial signs of severity: The AFTER-ELEC study.
There is no specificity of emergency or long-term management of benign electrical injuries (EI). The main objective of our work was to describe the occurrence of long-term complications of EI considered as benign. ⋯ all health professionals involved in the care of victims of a EI must be made widely aware of the occurrence of these long-term complications, particularly neuropsychological ones, in order to improve the long-term patient care.
-
Targeted temperature management is a class I indication in comatose patients after a cardiac arrest. While the literature has primarily focused on innovative methods to achieve target temperatures, pharmacologic therapy has received little attention. We sought to examine whether pharmacologic therapy using antipyretics is effective in maintaining normothermia in post cardiac arrest patients. ⋯ Among patients undergoing targeted temperature management, relying solely on as needed use of antipyretics is not sufficient to maintain temperatures <38 °C. However, antipyretics could be used as an initial strategy if given regularly and/or in conjunction with more aggressive cooling techniques.
-
In order to determine if time from onset to treatment time (OTT) to alteplase (tPA) administration is associated with improved outcomes in acute ischemic stroke, we performed a retrospective analysis of all acute ischemic stroke patients who received tPA at our hospital. ⋯ Our small, retrospective data shows no association between OTT and either hemorrhagic conversion or mRS at 90 days. This data lends support that time may not be the ideal indicator for identifying patients who will benefit from tPA administration.