The American journal of emergency medicine
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Lactic acidosis is a marker of tissue hypoperfusion and impairs oxygen delivery. High lactate levels are associated with altered systemic hemodynamics, tissue hypoperfusion, and altered cellular metabolism. Increased lactate levels have also been reported as a complication of β-adrenergic agents administered during asthma therapy. ⋯ Previous studies have suggested that administration of β agonists can lead to lactic acidemia in the absence of hypoxia or shock, but it is the highest level of lactate that we found in the literature. In sepsis and shock, lactic acidosis is used as a marker of disease severity. In this case, it is not necessarily the sign of an immediate gravity.
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Hospitals implement electronic medical record systems (EMRSs) that are intended to support medical and nursing staff in their daily work. Evolution toward more computerization seems inescapable. Nevertheless, this evolution introduced new problems of organization. ⋯ In the satisfaction questionnaire, clinicians reported minimal satisfaction but refused to return to handwritten records. The increase in door-to-FMC time may be explained by the improved quantity/quality of data and by the many interruptions due to the software. Medical reorganization was requested after the installation of the EMRS.
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The purpose was to compare head kinematics between the Eject Helmet Removal System and manual football helmet removal. ⋯ Although the Eject system created more motion at the head, removing a helmet manually resulted in more sudden perturbations as identified by resultant velocity and acceleration of the head. The implications of these findings relate to the care of all cervical spine-injured patients in emergency medical settings, particularly in scenarios where helmet removal is necessary.
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We aimed to describe clinical and radiologic features of acute renal infarction (RI). ⋯ Renal infarction should be considered in the differential diagnosis of a patient presented to the emergency department with abdominal or flank pain. Laboratory workup should include lactate dehydrogenase levels. After ruling out stone disease, contrast-enhanced CT examination is essential for the diagnosis.
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The aim of this study was to determine the rates of laboratory confirmed gonorrhea (GC) and chlamydia (CT) in emergency department (ED) patients with pelvic inflammatory disease (PID) and cervicitis who were diagnosed clinically and treated empirically. A secondary goal examines which clinical criteria were present in patients with PID testing positive for GC/CT. ⋯ There is a generally low prevalence of GC and CT in this patient population diagnosed with cervicitis or PID. There is a very low prevalence of coinfection.