Severe hypothermia in a patient with spinal cord injury without radiological abnormality.

We report a case of a 64-year-old caucasian male who was transported to the emergency department (ED) after being found unconscious on the side of the road. On arrival to the ED the patient went into ventricular fibrillation and advanced cardiac life support was started at that time. Thirty minutes into the resuscitation, after multiple rounds of code drugs and defibrillation attempts, the patient was found to be severely hypothermic with a rectal temperature of 24.9°C (76.9°F). Through the use of passive and active re-warming measures the patient's temperature increased enough to allow successful cardioversion and stabilization. Within minutes of cardiac stabilization the patient regained consciousness and was able to follow commands, but was found to be paralyzed from the neck down. Subsequent CT scans revealed no acute fractures, subluxations or acute spinal cord injury. This case represents the rare finding of severe hypothermia secondary to occult spinal cord injury. Case report was taken from case at Bayfront Hospital, St. Petersburg, Florida.

Ultrasonography in preclinical education: a pilot study.

CONTEXT: Ultrasonography is a valuable diagnostic tool in the clinical setting. Yet, medical students often have minimal familiarity with this technology. OBJECTIVE: To evaluate the ability of second-year medical students to use ultrasonography for identification of anatomic structures and pathologic conditions. DESIGN: A self-directed approach that reduced facilitator involvement, encouraging learning that mimicked the medical school's problem-based learning pathway program. METHODS: Five students were each given 10 hours of instruction in ultrasonographic techniques by three certified ultrasonographers in outpatient and hospital settings. Each student performed 40 hours of organ-specific ultrasonographic scans on another student in 2-hour sessions during 20 weeks. Images were archived for future evaluation and quality rating. Students took a 35-question posttraining examination with 10 contrived case scenarios. Questions were designed to test student knowledge in three categories: anatomic structure, technical skill, and clinical diagnosis. RESULTS: Posttraining examination results, expressed as the percent of correct answers for all five participants by category, were as follows: anatomic structure, 70%; technical skill, 70%; clinical diagnosis, 68%. Evaluations of the archived images, which were graded for proper anatomic identification and image clarity, yielded the following scores indicating "good" or "fair" quality for each anatomic region: abdominal, 80%; pelvic, 63%; cardiac, 73%. CONCLUSION: Second-year osteopathic medical students can attain a sufficient degree of proficiency in limited ultrasonographic technique.