The American journal of emergency medicine
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Triptans are potent serotoninergic vasoconstrictors. They are generally avoided in elderly patients age greater than 65 or in patients with a history of CAD. Although there are reported cases of Acute Coronary Syndrome (ACS) or Transient Global Amnesia (TGA) in patients after ingesting therapeutic doses of triptan or dihydroergotamine, this is the first case report, up to our knowledge, of a patient, who had no previous cardiac history, that was diagnosed with both ACS and TGA. ⋯ There is an increasing number of reports delineating sumatriptan's adverse effects. Emergency medicine physicians should promptly recognize the toxic effects and adverse reactions from triptans. Sumatriptan-induced vasoconstriction may lead to cardiac and cerebral ischemic events.
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Angioedema is an allergic reaction that has rarely been associated with haloperidol. There are 3 case reports in the literature, including one involving a child. Angioedema is mediated by increased capillary permeability and plasma extravasation, either related to histamine/IgE or bradykinin. When triggered by a medication, it typically presents within a few hours of medication administration. Histamine-mediated angioedema is generally treated with corticosteroids, antihistamines, and/or epinephrine. ⋯ Clinicians should be aware of potential dangerous adverse effects of commonly used medications. Patients with angioedema may need to be monitored for up to 36 h.
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To explore trends and patterns of laypeople's activity for seeking telephone number of emergency medical services (EMS) based on analysis of online search traffic, including changes of the search activity with onset of the coronavirus disease 2019 (COVID-19) outbreak, in five countries - the United States of America (USA), India, Brazil, the United Kingdom (UK) and Russia. ⋯ Laypeople's activity for seeking EMS telephone number greatly varies between countries. It clearly responds to the spread of COVID-19 and could be reflective of public need for obtaining emergency help. Further studies are required to establish the role of GT for conducting real-time surveillance of population demand for EMS.
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Case Reports
Autonomic dysfunction with areflexic quadriplegia: An unusual presentation of snake envenomation.
Rapidly progressing descending areflexic quadriplegia with autonomic dysfunction in the form of hypertension, tachycardia, hypersalivation, sweating and lacrimation in the absence of proper history from attendants poses a challenge in emergency area. Neuroparalytic snake envenomation by elapid species has been known to produce autonomic symptoms and even locked-in states. Here we present a case of young male with rapidly progressing areflexic quadriplegia with autonomic dysfunction; with no documented history of snake bite who improved after antisnake venom and ventilatory support.