European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Field trauma triage systems currently used by emergency responders at mass casualty incidents and disasters do not adequately account for the possibility of contamination of patients with chemical, biological, radiological, or nuclear material. Following a discussion of background issues regarding mass casualty triage schemes, this paper proposes chemical, biological, radiological, or nuclear-compatible trauma triage algorithms, based on a review of the literature and the input of recognized content experts. ⋯ This template is then modified for use in chemical, biological, and radiation/nuclear situations in which the exposed or contaminated victims have also sustained conventional trauma. The proposed algorithms will need further refinement and testing.
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Review Case Reports
Keep off the grass: marijuana use and acute cardiovascular events.
Marijuana is one of the most widely used recreational substances in the world, considered by many consumers as a relatively safe drug with few significant side-effects. We report the case of a 21-year-old man who suffered an acute myocardial infarction following the use of marijuana, despite having no other identifiable risk factors for an acute cardiovascular event. We review the published medical literature regarding acute cardiovascular events following marijuana use and postulate a possible mechanism for this unusual pathological consequence of marijuana use.
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Staff in the emergency departments of hospitals are reported as being negative or ambivalent toward suicidal or self-harming individuals. According to the literature, these patients are subjected to stigmatization and lack of empathy. ⋯ In this paper, evidence suggesting staff attitudes toward suicidal and self-harming patients is reviewed. An overview of related issues such as clinical judgment, the use of scales and nurses' role is also included in this report.
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Review Case Reports
A teenager with angiographically normal epicardial coronary arteries and acute myocardial infarction after butane inhalation.
The most common cause of death among volatile substance abusers is sudden cardiac death. To the best of our knowledge, butane-induced myocardial infarction is a rare presentation among teenagers. We report on a 14-year-old male student who sustained cardiopulmonary arrest after sniffing seven canisters of butane. ⋯ Cardiac catheterization revealed patent coronary arteries with severe anterolateral and apical left ventricular wall hypokinesia. We assume that cardiac complications after butane inhalations may partly be secondary to intense coronary artery spasm on the basis of the clinical and laboratory findings. This assumption may have major therapeutic implications in this patient population.
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Review Case Reports
Rupture of axillary artery and neuropraxis as complications of recurrent traumatic shoulder dislocation: case report.
Gleno-humeral dislocations are frequent, but associated complete transection of the axillary artery has only been reported sporadically. We present a case of complete rupture of the axillary artery associated with recurrent anterior dislocation of the shoulder, followed by a discussion of the likely mechanisms and the key learning points.