Purpose: Cervical traumas are frequent in emergency department and X-ray, CT, and MRI are the essential imaging modalities in the diagnosis. However, especially for pregnant and morbid obese patients and children, these techniques can be challenging. We tested the success of point-of-care ultrasound in the evaluation of cervical traumas. Methods: This is a case series of cervical vertebra imaging with ultrasound in emergency department. We used linear probe and placed it anterolaterally to the neck, parallel to cervical spine. Images were obtained by an ultrasound-certified emergency physician. The height of the anterior wall of vertebral body, irregularity in vertebral body, and intervertebral space were assessed. Results: We presented a case series of six patients. Ultrasound images of cervical vertebral bodies and intervertebral spaces were able to obtain for all the patients. Any pathology was not observed in ultrasound imaging. This finding was compatible with cervical X-ray and CT scans and all the patients were discharged. Conclusions: However, this is a case series report of minor cervical trauma, and we were able to obtain ultrasound images of cervical vertebra bodies with point-of-care ultrasound examination by an emergency physician. This technique can be important for the patients contraindicated to CT or MRI. Also, it can give additional information to X-ray and CT scans especially for soft tissues. A2 A new technique in verifying the placement of a nasogastric tube: obtaining the longitudinal view of nasogastric tube in addition to transverse view with ultrasound

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Objective: Aromatherapy is ancient practice of using natural oils to enhance psychological and physical well-being. Despite its long history there is paucity of scientific evidence regarding autonomic response to aromatherapy. Purpose of this prospective study is to evaluate potential beneficial effects of aromatherapy using essential oils Ylang Ylang and Citrus on blood pressure and heart rate in real life practice. Design and method: In this prospective study 52 subjects were involved (mean age 59,2; 71% men) with verified and treated hypertension. The subjects were divided into two groups. Treatment group (N = 21) received aromatherapy and a control group (N = 31) did not receive aromatherapy prior to seeing a nephrologist. Blood pressure measurements were taken before and after aromatherapy. Blood pressure was measured using Omron M6 device as defined by ESH/ESC guidelines and central blood pressure and Pulse Wave Velocity were measured using MobiloGraph. Due to statistical requirements blood pressure was analyzed separately by systolic and diastolic component through paired samples t-test. Statistical differences were tested on significance level of 5%. Results: Statistically significant reduction in systolic (t(20) = 6.338, p = 0.000)) and diastolic blood pressure (t(20) = 4.557, p = 0.000) was found in the treatment group. There was statistically significant improvement in heart rate within treatment group (t(20) = 5.206, p = 0.000)). Heart rate was lowered from 79 ± 12 bpm to 72 ± 11 bpm. Control group had significantly higher systolic (135 ± 18 mmHg) and diastolic (92 ± 13 mmHg) central blood pressure compared to the treatment group (119 ± 10 mmHg and 77 ± 10 mmHg respectively). T-test (students’ t-test) was used for statistical analysis. Conclusions: This pilot study suggests there may be a beneficial effect of short term aromatherapy on blood pressure and heart rate reduction. This practice could be utilized in variety of clinical scenarios such as lessening the white coat effect. Additional studies with larger patient population and longer follow up are needed to gain better insights into the effect of aromatherapy on autonomic system.

Objective: The purpose of this analysis was to evaluate cardiovascular profile of military veterans with confirmed diagnosis of PTSD Design and method: We evaluated cardiovascular risk of military veterans in relation to their history of combat exposure and targeted a specific group of veterans with confirmed diagnosis of PTSD. All subjects underwent physical examination which included measurement of vital signs. Blood pressure was measured using Omron M6 device, central BP and PWV were determined by MobiloGraph. CV risk was calculated using Heart Score chart for high-risk countries. Results: Mean age was 53,40 ± 6,95. 90,0% were active or former tobacco users, while 20,0% drank alcohol. Mean cholesterol level was 5,89 ± 1,36; mean levels of LDL and triglycerides were 3,65 ± 1,35 and 1,81 ± 0,75 respectively. Body mass index mean was 28,25 ± 4,02. 10,0% of all subjects had left ventricular hypertrophy. Mean value for Pulse Wave Velocity was 8,90 ± 1,03. Average value measured in estimated glomerular filtration rate (eGFR) was 98,20 ± 11,73. 30,0% had diabetes; 10,0% had coronary heart disease; 10,0% had previous myocardial infarction. Analysis showed 40,0% of PTSD veterans had hypertension, 20,0% had well controlled hypertension with pharmacotherapy while10% had uncontrolled but treated hypertension. 60,0% of PTSD military veterans had resting heart rate below 80/min, 10,0% had heart rate between 80 and 84/min and 30,0% had heart rate equal or higher than 85/min. Conclusions: There is limited data regarding cardiovascular risk in veterans with history of PTSD. A possible explanation for insufficient data is veterans’ avoidance of Croatian healthcare system due to social stigma associated with PTSD. Veterans prefer to obtain support and assistance through various veterans’ associations and religious organizations. Eliminating stigma around PTSD, its’ early detection and appropriate treatment could improve registration of veterans with Croatian healthcare system and allow better understanding of their cardiovascular profile while ensuring optimal management of their cardiovascular risks.