The American journal of emergency medicine
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Intraoral evaluation with ultrasound has been shown to be an ideal method for differentiating between peritonsillar abscess (PTA) and peritonsillar cellulitis. Unfortunately, many patients experience significant trismus and are unable to tolerate the intracavitary probe. ⋯ We present a case of a 30 year old male patient with severe throat pain and trismus. Ultrasound evaluation of the submandibular space with a linear transducer demonstrated a clear peritonsillar abscess and allowed for successful aspiration of 5 mLs of purulent material.
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Early radiologic evaluations including noncontrast computed tomographic (CT) scan of the brain have been reported to be useful in the diagnosis and management of the intoxicated patients. Changes in the brain CT scan of the acute opium overdose patients have little been studied to date. This study aimed to evaluate changes of the brain CT scans in the acute opium overdose patients. ⋯ Abnormal brain CT findings are detected in about 20% of the acute opium overdose patients who are ill enough to warrant performance of the brain CT scan and associate with a poor prognosis in this group of the patients.
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During the influenza season patients are labeled as having an influenza-like illness (ILI) which may be either a viral or bacterial infection. We hypothesize that C-reactive protein (CRP) levels among patients with ILI diagnosed with a bacterial infection will be higher than patients diagnosed with an influenza or another viral infection. ⋯ C-reactive protein is both a sensitive and specific marker for bacterial infection in patients presenting with ILI during the influenza season.
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Endovascular cooling using the femoral cooling catheter is widely practiced. Central venous pressure (CVP) monitoring in patients undergoing femoral endovascular cooling may require the placement of another catheter near the right atrium (RA). We sought to estimate the agreement between the CVP recorded from catheters placed in the superior vena caval pressure (SVCP) and the inferior vena caval pressure (IVCP) recorded from the femoral cooling catheter in patients undergoing femoral endovascular cooling. ⋯ Inferior vena caval pressure measured via the femoral cooling catheter showed excellent agreement with CVP recorded from catheters placed in the SVC, which indicates that the femoral cooling catheter can be used for monitoring CVP.
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Hypothermia increases clotting time, which is known as hypothermic coagulopathy. However, prothrombin time and activated partial thromboplastin time prolongation associated with therapeutic hypothermia is usually mild and thus, hypothermic coagulopathy is not considered to cause clinically significant bleeding. ⋯ Serious bleeding complications of therapeutic hypothermia has not been reported previously. Herein, we introduce a case of spontaneous brain stem hemorrhage as a complication of therapeutic hypothermia-induced coagulopathy.