Objective: Accidental hypothermia (AH), a condition in which the deep body temperature is incidentally lowered below 35˚C, often shows an Osborn J wave (OW) on ECG. The purpose of this study was to determine if there is association between OW and the severity of illness in patients with AH.

Methods: A retrospective chart review was conducted on all patients who were admitted to the emergency department between May 24, 2013 and March 31, 2022 and diagnosed with AH. The Sequential Organ Failure Assessment (SOFA) score and 5A score (age, activities of daily living (ADL), albumin level, pH, and “near cardiac arrest”) were used to evaluate severity of illness.

Results: Comparing 21 OW-positive cases with 51 OW-negative cases, the 5A score differed significantly only in “near cardiac arrest cases” (p=0.046). The SOFA score was not significantly different in two groups (p=0.69), and when examined by organ, only the cardiovascular system showed a significant difference (p=0.01).

Conclusion: The results suggest that the presence or absence of OW was not associated with the severity of AH patients.

Background: The American Heart Association (AHA) Basic Life Support (BLS) Healthcare Provider Manual was updated with new scientific evidence for resuscitation. The purpose of this study was to clarify the changes in keywords associated with guideline updates of the 2000, 2005, 2010, and 2015 AHA-BLS Healthcare Provider Manuals using a quantitative text analysis method.

Methods: Using quantitative text analysis software (KH-coder), we analyzed the word frequency, co-occurrence network, and correspondence analysis of the AHA-BLS Japanese version of the Healthcare Provider Manual.

Results: The top 20 extracted words were listed based on word frequency, and eight topics appeared in the co-occurrence network. Correspondence analysis extracted the following keywords: risk factors for cardiac arrest, foreign body airway obstruction, and heart massage in 2000, cardiac heart attack factors in 2005; assisted rescue breathing, agonal gasps, and CPR procedure in 2010; and team in 2015. The keyword common to all was CPR.

Conclusions: Quantitative text analysis revealed keywords associated with the updates of the AHA-BLS guidelines in different years.

A man in his 50s was transferred from another hospital’s emergency department to ours due to a suspicion of acute epiglottitis. He had a medical history of gastrointestinal stromal tumor for which he was taking imatinib. On admission, the patient was conscious but showed difficulty breathing. Neck contrast-enhanced computed tomography revealed swelling of the epiglottis and retropharyngeal abscess, and laryngeal endoscopy revealed a swollen and red epiglottis. Hence, the patient was diagnosed with acute epiglottitis and received emergency airway management. A blood culture on admission confirmed the presence of Pasteurella multocida. Antibiotics and steroid administration gradually improved the condition of epiglottitis, and we extubated the patient after 7 days. Detailed history taking revealed that the patient lived close to a cat but had not been bitten or scratched. Physicians should be aware of the potential zoonotic risk of acute epiglottitis.