European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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The objective of this study was to determine if supportive care without endotracheal intubation in the emergency department (ED) was safe in the absence of complications in gamma-hydroxybutyrate (GHB)/gamma-butyrolactone (GBL) intoxicated patients with a decreased Glasgow Coma Scale (GCS) score. ⋯ Our study suggests that conservative airway management for patients with a decreased GCS due to suspected GHB intoxication may be safe. Major adverse events were present in 2.4% of patients, only 1.4% of patients required intubation. All minor adverse events were managed effectively with conservative treatment.
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A large proportion of patients affected with hypertension go undetected. A systematic review was conducted to assess the performance of a screening strategy in adults using blood pressure measurement at the time of an emergency department consultation. A systematic literature search on Embase, CINHAL and Medline was carried out. ⋯ For diagnostic confirmation, four studies used a blood pressure measurement method based on the reported guidelines. Half of the patients (50.2%) with elevated blood pressure during the emergency department visit had blood pressure corresponding to uncontrolled elevated blood pressure at follow-up measurement. The contribution of emergency department to the screening for hypertension, by recognizing the presence of elevated blood pressure and then making a referral for diagnostic confirmation, could provide an opportunity to detect a large number of people with hypertension.
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Case Reports
Prevalence of myocardial injury requiring percutaneous coronary intervention after acute carbon monoxide poisoning.
More than one-third of patients with moderate to severe acute carbon monoxide (CO) poisoning had myocardial injury. However, the ratio of acute CO patients necessitating percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) remains unknown. This study aimed to examine the prevalence of myocardial injury requiring PCI or CABG in patients with CO poisoning. ⋯ The present study reported a low prevalence of myocardial injury requiring PCI in acute CO poisoning patients. Although myocardial injury due to coronary artery occlusion would be a very rare presentation in the setting of acute CO poisoning, coronary occlusion should be taken into consideration for elderly patients and/or patients who have coronary risk factors.