Emergency radiology
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Emergency radiology · Apr 2014
Case ReportsCerebrovascular accident (CVA) in association with a Taser-induced electrical injury.
Various adverse outcomes related to the use of electrical weapons such as the stun gun or the Taser have been described in the literature over the years. Examples include cardiac arrhythmias, blunt and penetrating injuries, seizure activity, and altered mental status. ⋯ However, imaging findings and pathophysiology of electrical injuries that result in significant neurological events remain largely unexplored. We report the case of a patient who developed an ischemic stroke following Taser discharge, raising the possibility of association between the electrical injury and the ischemic stroke.
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Emergency radiology · Apr 2014
Comparative StudyComputed tomography of blunt and penetrating diaphragmatic injury: sensitivity and inter-observer agreement of CT Signs.
Diaphragmatic injury is an uncommon but clinically important entity in the setting of trauma. Computed tomography (CT) is widely used to evaluate hemodynamically stable trauma patients. While prior studies have identified CT signs of diaphragm injury in blunt or penetrating trauma, no study has directly compared signs across these two types of injuries. ⋯ Inter-observer reliability of these signs is also high (κ > 0.65). Penetrating diaphragm injuries present a different spectrum of imaging findings from those in blunt trauma and are underdiagnosed at CT; looking for a wound tract traversing the diaphragm is highly sensitive for diaphragm injury in these cases. Signs of organ or diaphragm fragment displacement are sensitive for blunt diaphragm injuries, consistent with these injuries being caused by increased intra-abdominal pressure.
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Emergency radiology · Apr 2014
The yield of CT pulmonary angiograms to exclude acute pulmonary embolism.
There is accumulating evidence regarding the overuse of computed tomography pulmonary angiography (CTPA) to exclude pulmonary embolism (PE). We evaluated the yield of CTPA studies performed at our tertiary care hospital between April 2008 and March 2010 for emergency patients (ED), inpatients (INPT), and intensive care unit inpatients (ICU). For each patient group, we also compared CTPA positivity rates among the following: daytime and on-call studies, 1 year before and after institution of an Emergency Radiology division, interpreting thoracic and non-thoracic radiologists, and individual emergency physicians. ⋯ For individual emergency physicians, the mean CTPA positivity rate was 15.4 % but varied considerably (σ = 8.5 %, range, 0-38.5 %). In comparison to other recent studies, our yield of ED CTPA is relatively high but varied widely among individual emergency physicians. While the reasons for such differences require further investigation, our results reinforce the importance of a strong clinical assessment in the work-up of suspected PE.
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Emergency radiology · Apr 2014
Historical ArticleLooking back, moving forward: 1988-2013. The first 25 years of the American Society of Emergency Radiology.
The American Society of Emergency Radiology (ASER) was founded in 1988 and is celebrating its 25th Anniversary. ASER is thriving and emergency radiology has never enjoyed greater popularity than at present. ⋯ It is based on the recollections and personal files of the authors, one Founder and both former ASER Presidents and Gold Medalists, the ASER archives, and interviews and correspondence with many ASER members. It is hoped that this brief review will be interesting to the reader, provide some insight into ASER evolution over the years, and hold some lessons moving forward.