The American journal of emergency medicine
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To perform serial electrocardiogram (ECG) analyses in patients with subtle ECG changes in the anterior leads and evaluate the performance of the four-variable formula in detecting left anterior descending (LAD) coronary artery occlusion. ⋯ The four-variable formula was found to be a valid method for the differentiation of STEMI and BV-STE in patients with subtle ECG changes. While managing this patient group, using serial ECGs rather than a single ECG to evaluate the clinical status of patients can help clinicians make more accurate decisions.
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Foreign body aspiration accounts for 7% of accidental deaths in children under age 4 (4). Children between the ages of 6 months and 3 years of age, adolescent boys and children with mental health issues are at the highest risk of foreign body ingestion. Coins are the most commonly swallowed foreign body in the United States (US) and in other countries those related food such as fish bones are most common (10). ⋯ The most common complication is esophageal obstruction particularly at the thoracic inlet. However, the object can become lodged anywhere in the gastrointestinal tract. We present an unusual case of small bowel obstruction and bowel ischemia secondary to superabsorbent polymer water bead ingestion in a pediatric patient.