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Cardiac arrest emergency department

Ting-Yuan Ni, Fu-Yuan Siao, Chun-Wen Chiu, Hsu-Heng Yen
Refractory ventricular fibrillation with cardiac arrest caused by occlusion of the left main coronary artery may rapidly become fatal. In this report, we describe the case of a 70-year-old male who presented to emergency department with chest pain. Electrocardiogram showed ST-segment elevation in leads aVR and aVL and ST-segment depression in leads v3, v4, v5, v6, 2, 3, and aVF. Occlusion of the left main coronary artery was suspected. While waiting for percutaneous coronary intervention, the patient experienced sudden refractory ventricular fibrillation with cardiac arrest...
November 16, 2018: American Journal of Emergency Medicine
Abdul Q Alarhayem, Stephen M Cohn, Oliver Cantu-Nunez, Brian J Eastridge, Todd E Rasmussen
BACKGROUND: Six hours has long been considered the threshold of ischemia after peripheral artery injury. However, there is a paucity of evidence regarding the impact of operative delays on morbidity and mortality in patients with lower extremity arterial injuries. METHODS: We analyzed the records of 3,441,259 injured patients entered into the National Trauma Data Bank Research Dataset from 2012 to 2015. Patients (≥16 years) with lower extremity arterial injuries were identified by International Classification of Diseases, Ninth Revision injury and procedure codes...
November 26, 2018: Journal of Vascular Surgery
A Pol, M Carter, S Bouchoucha
INTRODUCTION: Violence in healthcare settings is a concern for healthcare professionals and patients. Media reports, and debate within the healthcare profession, and the academic literature infer that workplaces such as intensive care units are becoming exposed to increasing violence. Increases in the incidence of violent behaviour are sometimes attributed to the increased pressure on emergency departments to accelerate the throughput of patients to meet targets. To ensure the wellbeing of patients and staff, there is a need to evaluate the impact of such targets...
November 19, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Giselle Volney, Habiba Wada, Michael Tatusov
Apical hypertrophic cardiomyopathy (AHCM) is a rare form of non-obstructive hypertrophic cardiomyopathy. It is rarely reported in African American patients, and more commonly reported in Japanese patients. AHCM involves hypertrophy of the apex of the left ventricle. It is considered to have a benign prognosis in terms of cardiovascular mortality, however arrhythmias and sudden cardiac death have been reported. We report a case of a 49-year-old African American male with a history of hypertension, who presented to the emergency department after in field defibrillation for ventricular fibrillation cardiac arrest with return of spontaneous circulation after 10 minutes of cardiopulmonary resuscitation...
September 7, 2018: Curēus
Ikuto Takeuchi, Hiroki Nagasawa, Kei Jitsuiki, Akihiko Kondo, Hiromichi Ohsaka, Youichi Yanagawa
Context/Aims: We retrospectively analyzed the characteristics of prehospital care for cardiopulmonary arrest (CPA) to identify the predictors of a good recovery (GR) among the recent changes in the management of Japanese prehospital care. Settings and Design: This study was a retrospective medical chart review. Subjects and Methods: We reviewed the transportation records written by emergency medical technicians and the characteristics of prehospital management of out-of-hospital (oh) CPA described by the Sunto-Izu Fire Department from April 2016 to March 2017...
July 2018: Journal of Emergencies, Trauma, and Shock
Mehmet Ali Ceyhan, Gültekin Günhan Demir, Gamze Babur Güler
BACKGROUND: Political parties in Turkey execute political public meetings (PPMs) during their election campaign for members of the parliament (MoP). A great number of people attend these meetings. No guidelines exist regarding preparation and organization of health care services provided during these meetings. Furthermore, there is no study evaluating health care problems encountered in previous PPMs. OBJECTIVE: Political parties arranged PPMs in 2015 during the election campaign for general election of MoP...
November 15, 2018: Prehospital and Disaster Medicine
Douglas Robinson, Gregory Hand, Jason Ausman, Anthony Hackett
BACKGROUND: Brugada pattern is a well-known pathological finding on electrocardiogram (ECG) which increases the likelihood of cardiac arrest due to ventricular arrhythmia. These cases generally present in younger patients without evidence of an electrolyte abnormality, structural heart disease, or cardiac ischemia. In many instances, this pattern is either hidden on initial presentation or presents as an incidental finding on an EKG. Often times the Brugada syndrome leads to sudden cardiac death or more rarely can be unmasked with a class 1A or 1C anti-arrhythmic agent...
October 23, 2018: American Journal of Emergency Medicine
A Almojuela, M Hasen, F A Zeiler
BACKGROUND: The Full Outline of UnResponsivness (FOUR) score is a neurological assessment score. Its theoretical benefit over preexisting scores is its evaluation of brainstem reflexes and respiratory pattern which may allow better assessment of patients with severe neurologic impairment. OBJECTIVE: Our goal was to perform a scoping systematic review on the available literature for FOUR score and outcome prediction in critically ill patients. The primary outcome of interest was patient global outcome, as assessed by any of: mortality, modified Rankin Score, Glasgow Outcome Score, or any other functional or neuropsychiatric outcome...
November 8, 2018: Neurocritical Care
Glenn Goodwin, Dyana Picache, Nicholas Gaeto, Brian J Louie, Tarik Zeid, Paxton P Aung, Sonu Sahni
Background Despite advances in resuscitation science and public health, out-of-hospital cardiac arrest (OOHCA) has an average survival rate of only 12% nationwide, compared to 24.8% of patients who suffer from cardiac arrest while in hospital. Additionally, gender is an important element of human health, and there is a clear pattern for gender-specific survivability in cardiac arrest. This study examined differences in presentations, treatment, management, and outcomes. Aim The primary focus of this study was to shed light on differences in presentations, treatments, and outcomes between men and women suffering from an out-of-hospital cardiac arrest and the accompanying contributing factors...
August 30, 2018: Curēus
Jason M Hardwick, Sean D Murnan, Daphne P Morrison-Ponce, John J Devlin
IntroductionEmergency physicians are using bolus-dose vasopressors to temporize hypotensive patients until more definitive blood pressure support can be established. Despite a paucity of clinical outcome data, emergency department applications are expanding into the prehospital setting. This series presents two cases of field expedient vasopressor use by emergency medicine providers for preflight stabilization during aeromedical evacuation to a hospital ship as part of the United States Navy disaster response in Puerto Rico...
November 9, 2018: Prehospital and Disaster Medicine
Hiroshi Okamoto, Tadahiro Goto, Zoie S Y Wong, Yusuke Hagiwara, Hiroko Watase, Kohei Hasegawa
AIM: To compare the tracheal intubation performance between video laryngoscopy (VL) and direct laryngoscopy (DL) in patients with cardiac arrest in the ED. METHODS: This is an analysis of the data from a prospective, multicentre study of 15 EDs in Japan. We included consecutive adult patients with cardiac arrest who underwent intubation with VL or DL from 2012 through 2016. The primary outcome was first-attempt success. The secondary outcomes were glottic visualisation assessed with Cormack grade (1 vs...
October 29, 2018: Resuscitation
Shoji Yokobori, Kevin K K Wang, Zhihui Yang, Tian Zhu, Joseph A Tyndall, Stefania Mondello, Yasushi Shibata, Naoki Tominaga, Takahiro Kanaya, Toru Takiguchi, Yutaka Igarashi, Jun Hagiwara, Ryuta Nakae, Hidetaka Onda, Tomohiko Masuno, Akira Fuse, Hiroyuki Yokota
This study aimed to identify neurological and pathophysiological factors that predicted return of spontaneous circulation (ROSC) among patients with out-of-hospital cardiac arrest (OHCA). This prospective 1-year observational study evaluated patients with cardiogenic OHCA who were admitted to a tertiary medical center, Nippon Medical School Hospital. Physiological and neurological examinations were performed at admission for quantitative infrared pupillometry (measured with NPi-200, NeurOptics, CA, USA), arterial blood gas, and blood chemistry...
October 29, 2018: Scientific Reports
Yasuhiro Oda, Kunihiro Ishioka, Takayasu Ohtake, Shuku Sato, Yotaro Tamai, Rikako Oki, Kenji Matsui, Yasuhiro Mochida, Hidekazu Moriya, Sumi Hidaka, Shuzo Kobayashi
BACKGROUND: Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of extranodal diffuse large B-cell lymphoma characterized by proliferation of B cells within small vessels. Herein, we report a case of a 77-year-old man who presented with IVLBCL and massive tumor formation on the aortic wall who was previously diagnosed with sarcoidosis and focal segmental glomerulosclerosis (FSGS). To our knowledge, this is the first reported case of an IVLBCL with aortic tumor formation. CASE PRESENTATION: A 77-year-old ambulatory man with sarcoidosis and FSGS had neurological symptoms for nine months...
October 29, 2018: BMC Nephrology
Robin Hohsfield, Christine Archer-Chicko, Traci Housten, Stephanie Harris Nolley
Pulmonary hypertension (PH) complicates common diseases and can lead to worsening symptoms and increased mortality. A specific group of PH, pulmonary arterial hypertension (PAH), World Health Organization Group 1, may present to the emergency department (ED). We review common ED presentations of patients with PAH such as cardiac arrest/sudden death, right ventricular failure, syncope, hypoxemic respiratory failure, arrhythmias, hemoptysis, pulmonary embolism, chest pain/left main compression syndrome, infection, and considerations for PAH medication administration...
October 2018: Advanced Emergency Nursing Journal
Omar Abdulfattah, Ebad Ur Rahman, Zainab Alnafoosi, Frances Schmidt
Introduction : Unhealthy use of alcohol can be associated with serious adverse events. Patients with alcoholism and malnutrition are at high risk for electrolyte disturbances, commonly hypokalemia. Here in we describe a case of alcohol use disorder presented with weakness and subsequently developed cardiac arrest secondary to severe hypokalemia. Case description : A 51-year-old lady presented to our emergency department because of generalized body ache and marked weakness in both lower extremities for two days duration...
2018: Journal of Community Hospital Internal Medicine Perspectives
V Spagnoli, M Diefenbronn, B Merat, D Logeart, G Sideris, P Henry, S Manzo-Silberman, L Drouet, J G Dillinger
BACKGROUND: Coronary lesions characteristics as well as patient thrombogenicity can explain coronary events manifestation. In young patient, local conditions are usually less important and thrombogenicity could play a significant role. Assessing thrombophilia could be justified in young patients and may induce an adapted therapeutic management. PURPOSE: We aimed to assess the prevalence of thrombophilia and therapeutic modification in young adults aged≤55 years admitted in our department for ST elevation myocardial infarction (STEMI)...
October 17, 2018: Annales de Cardiologie et D'angéiologie
Tomoya Nishino, Shinjirou Wakai, Hiromichi Aoki, Sadaki Inokuchi
Case: A 45-year-old man presented to our emergency department with disturbance of consciousness; he had mentioned to his family earlier about a drug overdose. When first responders arrived, he suffered cardiac arrest. Cardiac arrest due to drug overdose was diagnosed.The patient was supported with venoarterial extracorporeal membrane oxygenation. Arterial blood gas showed mixed acidosis, and electrocardiogram showed junctional rhythm and complete right bundle branch block. Outcome: The patient's blood pressure gradually decreased, and he died on the third day of hospitalization...
October 2018: Acute Medicine & Surgery
Yutaka Igarashi, Shoji Yokobori, Hidetoshi Yamana, Kosuke Nagakura, Jun Hagiwara, Tomohiko Masuno, Hiroyuki Yokota
Aim: In Japan, standard prehospital care is provided by emergency medical services teams. Doctor-staffed ambulances play a role in facilitating the immediate treatment of critically ill patients to increase the survival rates. However, little is known about their activities. We revealed the present situation of doctor-staffed ambulances in Japan. Methods: First, we surveyed all the fire departments in Japan and determined whether a doctor-staffed ambulance was present within their district boundary...
October 2018: Acute Medicine & Surgery
Justyna Swol, Jan Belohlávek, Daniel Brodie, Joseph Bellezzo, Scott D Weingart, Zachary Shinar, Andreas Schober, Matthew Bachetta, Jonathan W Haft, Shingo Ichiba, Tetsuya Sakamoto, Giles J Peek, Roberto Lorusso, Steven A Conrad
BACKGROUND: Extracorporeal life support (ECLS) describes the use of blood perfusion devices to provide advanced cardiac or respiratory support. Advances in percutaneous vascular cannula insertion, centrifugal pump technologies, and the miniaturization of extracorporeal devices have simplified ECLS. The intention of this discussion is to review the role of ECLS as a potential rescue method for emergency department (ED) clinicians in critical clinical scenarios and to focus on the prerequisites for managing an ECLS program in an ED setting...
December 2018: Resuscitation
David P Fitzgerald, Srikant Das, Matthew P Malone, B Shane Holland, Stephen M Schexnayder
Sudden cardiac arrest of cardiac etiology is rare in children and adolescents and most often occurs with exertion. Conversely, syncope is a common pediatric emergency department complaint but rarely is associated with a serious underlying cardiac disorder. This report describes a case of the channelopathy Brugada syndrome (BrS) as a cause of sudden cardiac arrest in a febrile preadolescent child taking medications known to affect cardiac conduction. The patient received cardiopulmonary resuscitation and was successfully defibrillated...
October 17, 2018: Pediatric Emergency Care
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