The American journal of emergency medicine
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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.
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Randomized Controlled Trial
Oxycodone induced euphoria in ED patients with acute musculoskeletal pain. A secondary analysis of data from a randomized trial.
Some opioid-naïve patients with acute musculoskeletal pain who are treated with opioids develop persistent opioid use. The impact of opioid-induced euphoria on this transition to persistent use has not been explored. We determined whether opioid-induced euphoria could be measured as a phenomenon distinct from relief of pain. ⋯ "How high" and "how blissful" but not "how good" were associated with opioid use after controlling for improvement in pain.