The American journal of emergency medicine
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Comparative Study
Performance comparison of lung ultrasound and chest x-ray for the diagnosis of pneumonia in the ED.
The aim of our study was to assess the potential of bedside lung ultrasound examination by the attending emergency physician in the diagnosis of acute pneumonia. ⋯ These results exhort to promote the use of thoracic ultrasound in the first-line diagnosis of pneumonia.
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To determine the ability of prehospital end-tidal carbon dioxide (ETCO₂) to predict in-hospital mortality compared to conventional vital signs. ⋯ Of all prehospital vital signs, ETCO₂ was the most predictive and consistent for mortality, which may be related to an association with metabolic acidosis.
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Case Reports
Massive cerebrovascular air embolism during posttraumatic cardiopulmonary resuscitation.
Air embolism is known to be a complicating factor in several clinical settings, including thoracic, cardiovascular, and neurosurgical operations; central line placement; and penetrating thoracic and cranial trauma. There are, however, only few case descriptions for cardiopulmonary resuscitation massive cerebral air embolism, and the frequency of this supposedly rare complication is unknown. Computed tomography is useful for showing cerebral air embolism. In this report, we present a 16-year-old adolescent girl with cerebrovascular air embolism on computed tomographic examination after a posttraumatic cardiopulmonary resuscitation and discuss the reasonable mechanisms of cerebrovascular air embolism.
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Musculoskeletal ultrasonography is a technique that is becoming more popular in diagnosing injuries of emergency department (ED) patients especially for the diagnosis of fractures. In this study, we determined the reliability of ultrasonography for the diagnosis of fractures of the fifth metatarsal. ⋯ Ultrasonography is a reliable diagnostic tool for acute fifth metatarsal fractures.
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Acquired factor VIII deficiency is a rare disease that has high rates of mortality and morbidity. Although this bleeding disorder has a classic presentation, its infrequency can make it difficult to identify. We present a case report of an elderly woman who came to an emergency department with spontaneous bilateral lower extremity compartment syndrome. ⋯ She underwent bilateral fasciotomies and had a postoperative course that was complicated by significant incisional bleeding. She was ultimately found to have acquired factor VIII deficiency. Emergency physicians must be familiar with this rare entity because its recognition can avoid serious complications, particularly in those requiring operative management.