Notes

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Barthel indexes were significantly lower in the hypoxia group on discharge. Age (adjusted odds ratio [OR] 1.07; 95% confidence interval [CI], 1.00-1.14;
=0.038), D-dimer (adjusted OR 1.02; 95% CI, 1.00-1.03;
=0.005), and transtricuspid pressure gradient (adjusted OR 1.03; 95% CI, 1.00-1.07;
=0.015) were independently associated with the hypoxia.

We found that hypoxia, including undetermined hypoxia, was commonly encountered in the emergency department. Hypoxia in elderly patients with femoral neck fractures was associated with age, D-dimer, and transtricuspid pressure gradient and needs further investigation.
We found that hypoxia, including undetermined hypoxia, was commonly encountered in the emergency department. selleckchem Hypoxia in elderly patients with femoral neck fractures was associated with age, D-dimer, and transtricuspid pressure gradient and needs further investigation.
Infected aortic aneurysm secondary to streptococcal toxic shock syndrome caused by
is uncommon and associated with high mortality.

A 75-year-old man with metastatic lung cancer and an abdominal aortic aneurysm presented with high fever for 3days. He was diagnosed with septic shock and was admitted to our hospital. The blood culture was positive for
, and streptococcal toxic shock syndrome was diagnosed. During treatment, enhanced computed tomography revealed an increase in the size of the abdominal aortic aneurysm, leading to the diagnosis of an infected aortic aneurysm. Replacement of the aneurysm with a synthetic graft was carried out successfully. The patient gradually recovered after the surgery.

We successfully managed an infected aortic aneurysm secondary to streptococcal toxic shock syndrome. Infected aortic aneurysms should be considered in patients with a medical history of aortic aneurysms and presenting with streptococcal toxic shock syndrome.
We successfully managed an infected aortic aneurysm secondary to streptococcal toxic shock syndrome. Infected aortic aneurysms should be considered in patients with a medical history of aortic aneurysms and presenting with streptococcal toxic shock syndrome.
Esophageal hiatal hernia is commonly encountered in clinical practice. We describe a case of cardiac compression caused by an esophageal hiatal hernia that resulted in circulatory failure and cardiac arrest.

An 82-year-old woman presented to our hospital with vomiting, which progressed to cardiac arrest in the emergency room after computed tomography (CT) imaging. CT revealed gastric herniation into the mediastinum, with marked cardiac compression. Cardiopulmonary resuscitation was performed, and a nasogastric tube was inserted for gastric decompression, which resulted in the return of spontaneous circulation and subsequent hemodynamic stabilization. However, the patient died of aspiration pneumonia 4days later.

Gastric decompression can lead to rapid improvements in respiration and circulation in patients with an esophageal hiatal hernia. Nonetheless, to prevent complications, such as those observed in our patient, definitive surgical treatment is warranted.
Gastric decompression can lead to rapid improvements in respiration and circulation in patients with an esophageal hiatal hernia. Nonetheless, to prevent complications, such as those observed in our patient, definitive surgical treatment is warranted.
We evaluated the status of the allocation of medical emergency equipment suitable for pediatric patients of all ages.

In 2019, we surveyed the emergency medical officers from 728 fire defense headquarters around Japan. The questionnaire was designed to evaluate the kind and size of equipment available to ambulance crews for prehospital emergency care of injured pediatric patients. A complete pediatric equipment set was defined as a set containing equipment suitable for children aged 0-14years.

Overall, 599 (82%) fire defense headquarters responded to our survey. Of these, 596 (99.5%) declared that pediatric equipment was available to ambulance crews. The allocation rates of complete pediatric sets were considerably low blood pressure cuff, 5%; nasopharyngeal airway, 1%; oropharyngeal airway, 7%; laryngoscope, 6%; supraglottic airway device, 13%; endotracheal tube, 0.2%; and bag-valve-mask, 23%. Moreover, none of these fire defense headquarters had complete pediatric equipment sets for all 14 devices assessed in this study.

Although most Japanese ambulances can provide prehospital emergency care to pediatric patients, this survey revealed the dispersion and deficiencies in the availability of complete pediatric equipment sets.
Although most Japanese ambulances can provide prehospital emergency care to pediatric patients, this survey revealed the dispersion and deficiencies in the availability of complete pediatric equipment sets.New innovative high-fidelity simulation (HFS) technologies, including augmented reality and virtual reality, have begun being used for disaster response and preparedness. However, few studies have assessed the merit of these technologies in disaster simulation. This integrative literature review of 21 studies assesses the role of HFS technology in disaster. Most studies used a quantitative methodology (71.4%), followed by mixed (19%) or qualitative methods (9.6%). Nearly 60% covered only disaster preparedness phase, whereas 10% addressed disasters in middle-income countries without including low-income nations. The four most frequently mentioned technologies were immersive virtual reality simulation, computerized virtual reality simulation, full-scale simulation, and augmented reality wearable smart glasses simulation. Nearly 50% of the studies used technology for purposes other than disaster simulation education, including telemedicine (14.3%), risk planning (14.3%), high-risk map generation for preparedness purposes (9.5%), or rehabilitation medicine (4.8%). HFS technologies must be further evaluated outside of high-income countries and in different disaster phases to better understand their full potential in disaster simulation. Future research should consider different health professions and more robust protocols to assist disaster response professionals and agencies in the adoption of HFS technologies.
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