The American journal of emergency medicine
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Prompt identification of cardiac arrest by emergency dispatchers can save valuable time and increase the likelihood of successful resuscitation. The authors reviewed 516 cardiac and 146 non-cardiac calls to identify features of a probable cardiac arrest call. ⋯ When the patient is over 50 years old and the caller is emotional, the possibility of cardiac arrest is high, suggesting that questions about consciousness and breathing should be asked immediately. Additional information can be obtained or telephone cardiopulmonary resuscitation (CPR) instructions can be given after dispatch of an emergency vehicle.
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Computer-aided teaching in the emergency department offers an important adjunct to traditional lectures and bedside clinical teaching. Using an integrated software system, lessons and patient simulations were created for the emergency department. ⋯ Acceptance and usage rates are high and remain so even after the initial novelty of the system declined. To be useful, such a system should be accessible over extended hours, and lessons should be brief and simple to execute.
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A 64-year-old man presented to an emergency department with a two-week history of intermittent, bilateral lower extremity paralysis without associated chest, abdominal, or back pain. He subsequently deteriorated and died as a result of a thoracic aortic dissection. This unusual case is reported, and the pathophysiology, diagnosis, and management of aortic dissection are discussed.
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A case of accidental oral poisoning with hydrofluoric acid in an adult is presented. The patient ingested the product from a drinking glass, mistaking it for water, and died approximately 90 minutes after the exposure. Severe acidemia and hypocalcemia were present, which resulted in refractory asystole. A plasma fluoride determination showed an extremely high fluoride level.