Can J Emerg Med
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Introduction The International Federation for Emergency Medicine (IFEM) Ultrasound Special Interest Group (USIG) was tasked with development of a hierarchical consensus approach to the use of point of care ultrasound (PoCUS) in patients with hypotension and cardiac arrest.
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Observational Study
A comprehensive regional clinical and educational ECPR protocol decreases time to ECMO in patients with refractory out-of-hospital cardiac arrest.
Extracorporeal membrane oxygenation within CPR (ECPR) may improve survival for refractory out-of-hospital cardiac arrest (OHCA). We developed a prehospital, emergency department (ED), and hospital-based clinical and educational protocol to improve the key variable of time-to-ECPR (TTE). ⋯ An organized clinical and educational protocol to initiate ECPR for patients with OHCA is feasible and significantly reduces the key benchmark of time-to-ECPR flows.
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Tetanus is a life-threatening clinical syndrome that commonly presents with muscular spasms, rigidity, and autonomic instability. It is considered rare in industrialized countries, and tetanus occurring secondary to dental abscesses, procedures, or infections has been infrequently reported. We describe the case of a patient inadequately immunized for tetanus, who presented to the emergency department with muscular spasms, rigidity, and autonomic instability in the setting of an odontogenic infection. A clinical diagnosis of tetanus was made and subsequently managed successfully.
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We present the case of a 23 year-old male who sustained an anterior tibial artery pseudoaneurysm after an apparently innocuous soccer injury. The patient presented with sudden onset severe pain and swelling one week after the injury. The diagnosis was made using duplex ultrasound, and confirmed with CT angiography. ⋯ One year later, the patient is asymptomatic and remains active. A review of the epidemiology, diagnosis, and treatment of arterial pseudoaneurysm is presented. Bedside ultrasound in the emergency department may be a useful adjunct in the early identification of pseudoaneurysms.