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Practical Summaries in Acute Care Archives – June 1, 2005

June 1, 2005

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  • MRI Finds Hip or Pelvic Fractures After Initial Negative Plain X-rays

    The purpose of this study was to evaluate the incidence of hip fractures presenting to the emergency department with negative initial radiographs.
  • GIK Infusion Ineffective in Acute MI

    In this study, investigators conducted a large, international, randomized controlled clinical trial (as a part of the CREATE trial) to determine the effect of glucose-insulin-potassium infusion on mortality in patients presenting with acute ST-segment elevation MI.
  • Prehospital Intubation with Neuromuscular Blockade: The Pendulum Swings Again?

    This is a retrospective study of consecutive head injury patients admitted to a single Level 1 trauma center.
  • The Clostridial Connection

    Public health officials from the California Department of Health Services have recognized epidemics of three types of Clostridium-associated diseases: wound botulism, necrotizing soft-tissue infections, and tetanus. These emerging infections and intoxications have been associated with the use of contaminated black tar heroin, an association known as "the clostridial connection."
  • Special Feature: Neuroleptic Malignant Syndrome

    Neuroleptic malignant syndrome is a disease process usually occurring in patients who use neuroleptic agents; classically, it is characterized by altered mental status, muscular rigidity, fever, and autonomic instability.
  • ECG Review: What a Difference a Lead Makes

    The telemetry rhythm strip shown in the Figure was obtained from a 67-year-old woman who presented with heart failure. A permanent pacemaker had been implanted a number of years earlier. Interpret the tracing initially by looking only at lead MCL1. How does the addition of a second simultaneously recorded lead (lead II) help in your interpretation? How many findings can you identify on this two-lead telemetry tracing? (Hint: Some of these findings are very subtle.)