The American journal of emergency medicine
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Case Reports
Thermal burn resulting from prolonged transcutaneous pacing in a patient with complete heart block.
Temporary transcutaneous pacing devices are used to treat symptomatic bradyarrhythmias that are unresponsive to medical therapy until it resolves or a more stable pacing device is established. Pain is the most common complication. Skin burns as a complication are uncommon. ⋯ Bradycardia is a common complaint in the emergency department. Temporary transcutaneous cardiac pacing is a widely available treatment modality that serves as initial management for these cases and allows us to keep patients stable until a more stable pacing solution is available. Burns as a complication of transcutaneous pacing are uncommon.
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A tension hydrothorax is defined as a massive pleural effusion presenting with hemodynamic abnormalities secondary to mediastinal compression. In these patients pleural volume increases intrathoracic pressure to the point of compromising diastolic filling and cardiac output simulating a cardiac tamponade physiology. This is an uncommon yet potentially fatal medical emergency that if left untreated may progress to cardiac arrest. Early detection and rapid intervention of these patients prevents cardiorespiratory collapse. ⋯ Although these life-saving decompressive interventions appear simple, not having proper training is an independent factor for chest tube and thoracentesis complications. Courses and simulation training can benefit physicians to minimize potential complications when managing emergency conditions such as tension hydrothoraxes which continue to be a medical challenge. Whether thoracentesis or thoracostomy is superior in managing this condition remains in debate and a clinical dilemma.
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Fluoroquinolones, including levofloxacin, exhibit desirable antimicrobial characteristics, including broad spectrum of activity and excellent bioavailability. This widely prescribed class of antibiotics has come under scrutiny due to a new black box warning of adverse reactions. Central nervous system effects have been sparsely described in previous literature. We present a case of levofloxacin-induced psychosis in a patient without underlying psychological history.
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Beaches are a popular destination for recreation activities. Surf zone injuries (SZI) can occur resulting from a variety of in-water activities. Little is known regarding the sustained injury types, or demographics of injured persons and activities leading to injuries. ⋯ To the authors' knowledge, this study is one of the first to investigate long-term trends in SZI data, injury activity, and demographics. Better understanding of the characteristics of injuries will allow for improved awareness techniques, targeted at populations with higher injury rates.
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Reducing or reversing the toxicity effects of new oral anticoagulants is an important question.The purpose of the present study is to evaluate the effect of lipid emulsion (LE) and Activated Charcoal (AC) therapy on the intoxication of rivaroxaban, on mice. ⋯ Although the administration of either AC or LE alone or in combination resulted in a decrease in the mean values of PT and anti-Factor Xa, in case of rivaroxaban toxicity, but one-to-one comparison of the groups was not statistically significant.