The American journal of emergency medicine
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The severity of handlebar injuries can be overlooked due to subtle signs and wide range of associated internal injuries. Our objective was to describe thoracoabdominal injuries due to bicycle handlebars and their outcomes in children. ⋯ Bicycle handlebars can cause significant thoracoabdominal injuries. Presence of abdominal pain, vomiting, fever or a circular imprint on the chest or abdomen should prompt further workup. Future studies on diagnostic modalities and best practices are needed to lower the chance of missed injuries.
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Administering large volumes of crystalloids to trauma patients has been shown to exacerbate metabolic complications of hemorrhage including dilutional coagulopathy and worsening acidosis The aim of this study was to evaluate crystalloid administration volumes in trauma patients after replacing 1 L IV containers with 500 mL IV containers in the emergency department trauma resuscitation bay. ⋯ Due to reduced mortality, expanding literature and guidelines clearly support minimizing IV crystalloid resuscitation. Institutions must now work to minimize use of IV crystalloids to hemorrhaging trauma patients and a simple solution of using smaller IV fluid bags was shown to improve adherence to this practice.
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In emergency medical services (EMS), response time is a key factor that shows the performance of the system. This factor is composed of two parts including activation time and travel time. The activation time of an emergency call is the time a call center spends on taking an incoming call for EMS and decides whether an ambulance should be dispatched or the emergency can be resolved by giving some medical advices. ⋯ This work is an example of the tremendous positive impact that the application of queuing theory and mathematical modeling can have. The proposed framework can significantly decrease the cycle time and increase the ambulance coverage level. The findings of this study help the policy makers of EMS centers with evaluating the performance of their systems and determining the optimal number of operators and locations of ambulances in a way that enhances the quality of emergency services.
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Acute flank pain associated with hematuria and unilateral hydronephrosis is a classic presentation for an obstructing ureteral stone. However, in the setting of hemorrhagic cystitis, blood can acutely obstruct the distal ureter and infrequently result in hydronephrosis. ⋯ Her symptoms resolved, urine cultures showed no growth, and her outpatient follow-up was unremarkable. We suspect given the acute onset of right obstructive uropathy, an unremarkable CT just hours earlier, and the brief nature of her symptoms, that blood obstructed her distal UVJ leading to acute and transient obstructive uropathy.
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The aim of this study is to compare the diameter of the inferior vena cava with tricuspid annular plane systolic excursion (TAPSE) measurement in order to determine the volume loss before and after blood donation in healthy volunteers. ⋯ Our study revealed that, low IVC and TAPSE values correlated in determining blood loss after blood donation. TAPSE may be useful to predict blood loss in early stages of hypovolemic shock.