The American journal of emergency medicine
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Case Reports
Tension pneumocephalus and bilateral orbital compartment syndrome relieved by lateral canthotomies.
Traumatic tension pneumocephalus and orbital compartment syndrome are rare, tend to be associated with severe craniofacial injuries, and can occur following both blunt and penetrating injury. Early recognition and high index of clinical suspicion are important in both cases. Emergency decompression results in improvement in vast majority of cases.
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Minor head injury (MHI) in children is a common emergency department (ED) presentation. It is well established that majority of these patients don't require imaging and can be safely discharged. What is less known is how often these children come back to the ED and the outcome of their revisits? The objective of this study was to describe the frequency and outcome of unscheduled return visits (RVs) for MHI in a pediatric ED. ⋯ RVs secondary to MHI in children remain low and are associated with good outcomes.
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Case Reports
Probable parenteral and oral contrast-induced Steven Johnson syndrome/toxic epidermal necrolysis: A case report.
We report a case of contrast-inducted Steven Johnson Syndrome (SJS)/Toxic Epidermal Necrolysis (TEN). The patient had received parenteral iopamidol and oral iohexol five days prior. The patient's chief complaint at the Emergency Department (ED) presentation was shortness of breath and blisters throughout body. ⋯ Complete metabolic panel was normal with serum creatinine 0.77 mg/dL. The patient was initially treated with diphenhydramine, methylprednisolone, ondansetron, sodium chloride, lorazepam and oxycodone-acetaminophen. Hemotology/Oncology and Trauma/Burn consult identified possible SJS/TEN and the patient was transferred to another facility for dermatologic/burn follow up.
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Drug and alcohol use are risk factors for trauma among operators of motor vehicles and contribute to trauma in pedestrians and bicyclists. We describe the prevalence of drug and alcohol use and clinical consequences in a cohort of pedestrians and bicyclists with trauma. ⋯ Our study builds on previous literature which suggests that intoxicated bicyclists and pedestrians suffer frequent and more severe injury than their sober counterparts. Public health campaigns should educate bicyclists and pedestrians about the risks of cycling or walking in areas of road traffic while under the influence of alcohol or illicit drugs.
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Ketamine is a versatile analgesic that has become an increasingly popular recreational drug. Chronic ketamine use has been found to cause biliary duct damage and bladder dysfunction. ⋯ We report a case of a teenage patient with the rare simultaneous presentation of ketamine-induced cholangiopathy and ulcerative cystitis. Due to increased recreational and chronic ketamine use, cases of ketamine-induced cholangiopathy and ulcerative cystitis are likely to rise with the increased knowledge, awareness, and reporting of these entities by radiologists and emergency physicians.