The American journal of emergency medicine
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Massive hemoptysis (MH) is a serious condition that carries with it a high rate of morbidity and mortality. ⋯ An understanding of MH can assist emergency clinicians in diagnosing and managing this dangerous disease. Providing a prompt evaluation, obtaining intravenous access, pursuing advanced imaging, providing reversal of coagulopathy, supporting hemodynamics, and appropriate consultation are key interventions in MH.
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Case Reports
A ruptured bronchial artery aneurysm presenting with neurological symptoms: A case report.
A 72-year-old man visited the emergency department with chief complaints of dizziness and dysarthria. Initially, a stroke was strongly suspected and brain computed tomography (CT) and neck CT angiography were performed; however, a ruptured bronchial artery aneurysm (BAA) was observed. BAA is a rare disease and usually asymptomatic but can be life-threatening. Patients with a ruptured BAA may present with hypovolemic shock, causing symptoms such as suspected cerebrovascular disease due to decreased cerebral blood flow.
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Multicenter Study
A nationwide analysis of emergency medicine residents' CT interpretation in trauma: The Tract-EM study.
To evaluate the accuracy and determine the factors influencing trauma CT interpretation proficiency among emergency medicine (EM) residents in Turkey through the TraCT-EM study (Interpretation of Trauma CT by EMergency Physicians). ⋯ The TraCT-EM study highlighted a 65 % accuracy rate for senior EM residents in trauma CT interpretation, with specific predictors of failure identified. These findings suggest a need for tailored radiology education strategies to enhance training and competency in trauma CT interpretation for EM residents. Further optimization of educational programs could address these gaps, ultimately improving patient outcomes in trauma care.
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Case Reports
High homocysteine levels as potential indicators of subacute combined degeneration of the spinal cord.
Homocysteine (Hcy) is widely recognized as a significant risk factor for cardiovascular and cerebrovascular diseases. However, our research has uncovered a novel perspective, suggesting that elevated levels of Hcy could serve as an indicator for neurological diseases. This article presents a unique case of Subacute Combined Degeneration of the spinal cord(SCD), characterized by high homocysteine levels, yet normal vitamin B12 and imaging results. This discovery could facilitate early detection and ensure timely referral of patients to specialized departments for further treatment.
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Airway management is a key intervention during the resuscitation of critically ill trauma patients. Emergency surgical airway (ESA) placement is taught as a backup option when endotracheal intubation (ETI) fails. We sought to (1) describe the incidence of the emergency department (ED) ESA, (2) compare ESA versus ETI-only recipients, and (3) determine which factors were associated with receipt of an ESA. ⋯ ESA placement is a rarely performed procedure but frequently used as a primary airway intervention in this dataset. Penetrating mechanisms, and injuries to face were most associated with ESA placement. Our findings reinforce the need to maintain this critical airway skill for trauma management.