The American journal of emergency medicine
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The objective of this study is to review the mortality after discharge in clinically stable infants admitted with a first apparent life-threatening event. ⋯ The risk of subsequent mortality in infants admitted from our pediatric ED with an ALTE is substantial. Emergency physicians should consider routine admission for patients with ALTE.
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The purpose was to determine the proportion of alcohol-positive (AlcPos) trauma patients in different age groups and any association with mortality using the National Trauma Data Bank. ⋯ Trauma patients of all ages may be AlcPos. Being AlcPos is a marker for greater injury in all age groups. After controlling for ISSs, trauma patients 40 years and older who were AlcPos have increased mortality. This study suggests a role for alcohol testing in all age groups.
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Non-heart-beating donors (NHBDs) have to meet the predefined criteria for organ donation including death from irreversible cessation of the beating heart. The Maastricht conference defined 4 NHBD categories to differentiate their viability and ethical-legal support. In Spain, NHBDs who originate from an out-of-hospital setting correspond to type II donors. ⋯ Thirty days after transplantation, 2 recipients died, 1 died of stroke associated with bilateral pneumonia and 1 died of hypovolemic shock resulting from hemothorax. The remaining 18 patients were progressing well at 30 days. Our data suggest that lung transplantation from patients after extrahospitalary cardiac death is feasible.
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Spontaneous urine extravasation from the pelvicalyceal system into the perinephric space is an uncommon condition. It is most commonly seen in the setting of obstructive ureteric calculus. Other rare causes include neoplasms, trauma, and iatrogenic procedures. ⋯ We present a short series of 3 cases of spontaneous pelvis rupture, each with a different etiology. Diagnosis was confirmed by computed tomography. The follow-up and therapeutic approaches are discussed with a short review of literature.
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Identifying the cause of acute dyspnea in the emergency department is often challenging, even for the most experienced provider. Distinguishing chronic obstructive pulmonary disease from acute decompensated heart failure in the acutely dyspneic patient who presents in respiratory distress is often difficult. ⋯ A rapid 3-view sonographic evaluation of the heart, lungs, and inferior vena cava or “Triple Scan” may be a useful tool in identifying the cause of acute dyspnea and may aid the clinician in the initial management of the critically ill dyspneic patient. We present a case where a 3-view ultrasound examination, the “Triple Scan,” allowed for detection of new onset congestive heart failure and initiation of appropriate medical therapy without waiting for further standard diagnostic testing.