The American journal of emergency medicine
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We sought to evaluate the effectiveness of the "Timed Up and Go" (TUG) and the Chair test as screening tools in the Emergency Department (ED), stratified by sex. ⋯ There were no sex specific significant differences in TUG or Chair test screening performance. Neither test performed well as a screening tool for future falls in the elderly in the ED setting.
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A 27-year-old man presented with an intentional overdose of concentrated caffeine powder that he bought over the internet. The patient received benzodiazepines and ondansetron for symptomatic treatment when he arrived in the Emergency Department (ED). ⋯ The patient's caffeine level was >90 mg/L. This is the first known report of treatment of caffeine-induced supraventricular tachycardia with metoprolol.
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A 52-year-old lady presented to the emergency department with recurrent episodes of dizziness and near-syncope on awakening up or swinging her left arm. Initial rhythm strips demonstrated intermittently non-conducted p waves corresponding to inappropriate pacemaker inhibition and oversensing malfunction. ⋯ The patient was diagnosed with pacemaker lead failure supported by correlating pacemaker lead variation with homolateral arm movement. The patient was referred to an electrophysiologist and underwent new right ventricular lead placement with the resolution of symptoms.
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Synovial lactate is a promising biomarker to distinguish septic from aseptic arthritis. If available as a point-of care test, synovial lactate would be rapidly available to aid the emergency provider in clinical decision making. This study assesses the test characteristics of synovial lactate obtained using an EPOC© point-of-care (POC) analyzer to rapidly distinguish septic from aseptic arthritis in the emergency department. ⋯ It is feasible to obtain a synovial lactate level using the EPOC© POC device. In our study, POC SLL performs similarly to other markers used to diagnose septic arthritis. Further study with larger sample sizes is warranted.
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Compartment syndrome is a potentially limb-threatening disease process, leading to decreased tissue perfusion and cellular death [1]. The following presentation is believed to be the first reported case of thenar compartment syndrome, which occurred without an identifiable cause. A 67-year-old male presented with 12 h of left-hand pain, located at the base of the thumb and worsened with movement. ⋯ The diagnosis was confirmed and successfully managed in the operating room. While relatively uncommon, clinicians should consider the diagnosis of compartment syndrome of the hand when patients present with acute hand pain. A missed or delayed diagnosis can lead to severe morbidity, which can profoundly affect patients' functional outcomes and quality of life.