The American journal of emergency medicine
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Hyperkalemia due to crush syndrome after trauma is a well known fatal clinical condition, but early hyperkalemia with hemorrhage after trauma is a rare phenomenon. We report on a 5-year-old boy who bruised from the lumbers, had cardiopulmonary arrest caused by hyperkalemia, and underwent perihepatic packing twice before being discharged without any neurologic deficits. Clinicians should be vigilant for signs of hyperkalemia accompanying hemorrhagic shock, even in the early phase of trauma.
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Case Reports
Acute pediatric stroke-what's the hurry? A case for emergency physician-performed echocardiography.
Acute ischemic stroke in a pediatric population is uncommon and has a different etiology from the adult population. We describe a case of acute ischemic stroke for which emergent, physician-sonographer–performed transthoracic echocardiography (TTE) changed his outcome. The patient in this case presented with left-sided hemiparesis,with subsequent CT Angiography (CTA) imaging and follow-on neurosurgical embolectomy for a proximal middle cerebral artery occlusion after which showed early recovery of muscular deficit. The cause ultimately was from an atrialmyxoma that was identified early by emergency physician-performed TTE and led to early resection possibly preventing recurrence of stroke.
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Little is known about the diagnostic accuracy of systemic inflammatory response syndrome (SIRS) criteria for critical illness among emergency department (ED) patients with and without infection. Our objective was to assess the diagnostic accuracy of SIRS criteria for critical illness in ED patients. ⋯ Systemic inflammatory response syndrome at ED triage, as currently defined, has poor sensitivity for critical illness in medical patients admitted from the ED.
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Case Reports
The electric Kool-Aid NBOMe test: LC-TOF/MS confirmed 2C-C-NBOMe (25C) intoxication at Burning Man.
Designer drugs are constantly evolving, with the NBOMe derivatives of the 2C class of phenethylamines recently emerging in the US market. Cases of 2C-I-NBOMe toxicity have recently been reported in the literature. No reports to date describe the clinical effects 2C-C-NBOMe toxicity.