The American journal of emergency medicine
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Early recognition and management of hemorrhage, damage control resuscitation, and blood product administration have optimized management of severe trauma. Recent data suggest hypocalcemia exacerbates the ensuing effects of coagulopathy in trauma. ⋯ Calcium is a key component of trauma resuscitation and the coagulation cascade. Recent data portray the intricate physiologic reverberations of hypocalcemia in the traumatically injured patient; however, future research is needed to further guide the management of these patients.
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Supraventricular tachycardia is a common cardiac arrhytmia with recurrent episodes. The rapid resolution of supraventricular tachycardia remains a challenge. Vagal manoeuvres are simple and non-invasive but yield positive results in less than half the cases. ⋯ We report in this series 11 cases of supraventricular tachycardia, 10 of which were effectively reduced after the completion of the reverse Valsava manoeuvre. The very encouraging results of this series of cases will have to be quickly evaluated by a randomised controlled trial. This new technique, which is simple to learn and carry out, could be easily taught throughout the world, including in regions with few health-care resources.
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Review pediatric electrocardiogram (ECG) result severity classification and describe the utilization of ECG testing, and rate of clinically significant results, in the pediatric emergency department (PED). ⋯ In this study, we provided a valuable review of ECG result severity classification in the pediatric population. We found that chest pain and syncope represented over half of all ECGs performed. We found that clinically significant results are rare in the pediatric population at 12.7% of all ECGs performed, and very few (2.0%) have severe abnormalities that would require immediate intervention. Those with increased odds of a clinically significant ECG include young patients ≤1 year of age, male patients, and certain ECG indications.
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Review Case Reports
Mycoplasma pneumonia and atypical acute hemorrhagic edema of infancy.
Acute hemorrhagic edema of infancy is a benign rare presentation of leukocytoclastic vasculitis that affects children between 4 and 24 months of age. It usually involves the distal extremities, face, and ears. ⋯ The rash resolved spontaneously within two weeks. Herein we present a case of Mycoplasma induced AHEI with an atypical clinical presentation followed by a review of the literature.