European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Body thermoregulation can be violently offset by drugs capable of altering the balance between heat production and dissipation. Such events may rapidly become fatal. The drugs that are involved in the eruption of such syndromes include inhalation anaesthetics, sympathomimetic agents, serotonin antagonists, antipsychotic agents and compounds that exhibit anticholinergic properties. ⋯ Prompt life-saving procedures include aggressive body temperature reduction. Patients with a suspected drug (or non-drug) hypermetabolic reaction should be admitted into an intensive care area for close monitoring and system-oriented supportive treatment. We present six conditions, in decreasing order of gravity and potential lethality, in which hyperthermia plays an essential role, and suggest a clinical approach in such conditions.
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Review Case Reports
Pulmonary oedema in SCUBA divers: pathophysiology and computed risk analysis.
SCUBA diving has become a popular sport, with an increasing number of people participating in it. Although it is an essentially very safe activity, several specific medical problems are associated with diving. The present paper addresses diving-related pulmonary oedema, which is a rarely reported condition. ⋯ Consequently, we could design and construct a bio-mechanical computer model of the alveolar septa to explore the pathophysiology of diving-related pulmonary oedema and the vulnerability of individual divers as they relate to some mechanical characteristics of their lung structure. The physiological mechanisms of diving-related pulmonary oedema and the results provided by the computational model successfully delineated the process. The model predicted that the risk of injury is significantly increased in individuals who have a stiffer lung parenchyma or lower lung compliance values.
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Review Case Reports
Portal vein air embolization after blunt abdominal trauma: a case report and review of the literature.
Gas in the portal vein is a rare and often fatal condition in surgical patients. However, the presence of gas in the mesenteric and portal veins in association with abdominal trauma is a transient incidental finding that resolves spontaneously. ⋯ The condition was clinically benign and resolved spontaneously. The pathogenesis is discussed and a review of the literature is provided.
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Patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) commonly present to the emergency department for treatment. Some of them, despite appropriate therapy become more dyspnoeic with increasing acute respiratory failure. The requirement for intubation and mechanical ventilation is for these patients often associated with a prolonged and complicated intensive care unit stay and has been associated with morbidity and mortality rates in excess. ⋯ There are few published data on the question whether NIV could or should be started earlier and initiated in the emergency department. It seems that NIV treatment could be an effective addition to standard treatment especially for acute exacerbation of COPD. A more extensive and routine use of non-invasive ventilation in the emergency department requires further study.