The American journal of emergency medicine
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A person consists of a variety of immune reactions as a result of bee stings, depending on his/her immunologic structure. A 49-year-old male patient was brought to the emergency department because of generalized tonic clonic seizure and loss of consciousness after an hour of wild bee bite from the anterior abdomen in a rural area. After cardiopulmonary resuscitation, he was admitted to intensive care unit. ⋯ The patient was diagnosed as SAH due to exposure to bee stings. The patient was treated for a month in an intensive care unit and discharged in a vegetative state. We present and discuss the case that had epileptic seizures and SAH after a bee bite, with the review of the literature.
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Case Reports
Severe hypercalcemia in nonobstructive pyelonephritis with acute renal failure: hit or miss?
Severe hypercalcemia in the course of renal failure is quite unusual. If unrecognized, irreversible inexorable attrition of renal function takes place, carrying a substantial morbidity and mortality. ⋯ We report a case with severe hypercalcemia after acute renal failure caused by fulminating bacterial pyelonephritis. To obviate unnecessary intervention, preserve organ function, and achieve better outcomes, clinicians should not miss this entity.
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Use of online formulas to treat hyponatremia is a common practice. We report here that while using the same goal of correction and type of infusate to treat a patient with hyponatremia, a large discrepancy in infusion rate is obtained from using the 2 commonly available online equations. ⋯ When the therapy fluid is hypertonic saline (3%), these formulas may result in overly rapid correction. We should, thus, never use these formulas blindly in the management of patients with hyponatremia.
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In recent years, significant growth has been seen in the field of emergency medicine. However, the national productivity to the field of emergency medicine remains unknown. This study aimed to reveal the national contributions in the field of emergency medicine. ⋯ United States is the most productive country in the field of emergency medicine.
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The objective of this study is to determine whether creatine kinase-MB (CK-MB) index (CK-MBi) is useful in the evaluation of acute myocardial infarction (AMI) in patients with indeterminate troponin (Tn) in the emergency department (ED). ⋯ Initial results identify rare cases of AMI where CK-MBi is positive in the setting of indeterminate Tn. However, most patients with indeterminate Tn and positive CK-MBi were not judged to be having AMI. In most cases, CK-MBi is not positive with indeterminate Tn and when positive more commonly confuses the picture. This suggests CK-MBi could be eliminated in patients with indeterminate Tns.