J Emerg Med
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Phlegmasia cerulea dolens is a rare complication of deep venous thromboembolism that can have life-threatening consequences. It is more commonly reported in the adult population, and rarely in the pediatric population, especially in a healthy child. ⋯ We report a case of a healthy 7-year-old girl who presented with right leg pain and fever, found to have a thrombus involving her inferior vena cava and right lower extremity. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case illustrates the importance of early recognition and a multimodal approach to treatment of phlegmasia cerulea dolens.
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Randomized Controlled Trial
Providers with Limited Experience Perform Better in Advanced Life Support with Assistance Using an Interactive Device with an Automated External Defibrillator Linked to a Ventilator.
Medical teams with limited experience in performing advanced life support (ALS) or with a low frequency of cardiopulmonary resuscitation (CPR) while on duty, often have difficulty complying with CPR guidelines. ⋯ The assist device increased the rescuers' CPR quality. CPR providers with limited experience or a limited frequency of CPR performance (i.e., rural Emergency Medical Services crew) may potentially benefit from this assist device.
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Emergency department (ED) discharge is safe when croup-related stridor has resolved after corticosteroids and a single dose of racemic epinephrine (RE). Little evidence supports the traditional practice of hospital admission after ≥ 2 doses of RE. ⋯ Inpatient interventions after ≥ 2 ED doses of RE for croup were infrequent, most commonly RE administration. Most patients asymptomatic upon admission require 0-1 inpatient RE doses and may be candidates for outpatient management.
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There have been several studies published regarding family-witnessed resuscitation (FWR), but fewer studies regarding its effectiveness. In FWR, family members are invited to be present during resuscitation efforts of a loved one. This practice is recognized and approved by the Emergency Nurses Association. ⋯ This article represents my professional opinion on the implication and professional recommendation of instituting FWR as standard of care. Education regarding the positive aspects of FWR is urgently needed to improve staff acceptance and promote policies to incorporate the procedure into practice.