The American journal of emergency medicine
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Traumatic arthrotomy (TA) is a rare but serious condition associated with a high morbidity and mortality that can be mitigated with prompt diagnosis and appropriate management. ⋯ An understanding of an evidenced-based approach to TA can assist emergency clinicians in diagnosing and managing this challenging clinical presentation.
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Review
Unrecognized cardiac arrests: A one-year review of audio from emergency medical dispatch calls.
Immediate recognition of out-of-hospital cardiac arrest (OHCA) by Emergency Medical Dispatch (EMD) operators is crucial to facilitate timely initiation of telephone cardiopulmonary resuscitation (T-CPR) and to enable the appropriate level of Emergency Medical Services (EMS) response. The goal of this study was to identify patterns that can increase EMD-level recognition of cardiac arrests prior to EMS arrival. ⋯ Lack of recognition of OHCA by EMD occurred in most calls due to difficulty communicating the subject's respiratory status. Further emphasis should be placed on identifying non-viable respirations in unconscious patients in EMD training and algorithms to increase recognition of OHCA and initiation of T-CPR. A multi-year review of a comparable dataset from geographically and socioeconomically diverse regions in the United States can validate and expand these preliminary trends.
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Coronavirus disease of 2019 (COVID-19) has resulted in millions of cases worldwide. As the pandemic has progressed, the understanding of this disease has evolved. ⋯ This review provides a focused update of the presentation and evaluation of COVID-19 for emergency clinicians.
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Review Case Reports
Local anesthetic systemic toxicity in the pediatric patient: A case report and review of the literature.
Lidocaine and prilocaine are local anesthetics, a class of medications which are frequently used in clinical medicine to minimize pain in a variety of procedures. They are commonly found in over-the-counter products such as topical anesthetic creams advertised to relieve localized muscle and joint pain. While safe and well-tolerated when used appropriately, an overdose of these anesthetics increases the risk for local anesthetic systemic toxicity (LAST), which in severe cases can present with seizures, cardiac dysrhythmias, and ultimately cardiovascular collapse. ⋯ After stabilization, the patient was transferred to the Pediatric ICU and ultimately made a complete recovery. LAST is a life-threatening presentation which requires early recognition by clinicians, as well as an understanding of the appropriate treatment modalities. We review the assessment and management of LAST, with special focus on the pediatric patient.
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Managing neurological emergencies is an essential element of emergency physicians' armamentarium, irrelevant of the specific nature of their practice. The combination of evolving literature and advances in imaging fuel the rapidly changing standards of care, especially in high-stakes diagnoses such as stroke. Navigating the emergency neurology literature to stay abreast of the current updates is becoming more challenging with the sheer volume of publications, combined with the recent dominance of COVID-19 on the literature and media attention. This review article summarizes emergency neurology literature updates that can help you improve your care of these high-risk presentations; articles covering stroke, dizziness, intracerebral hemorrhage, head trauma imaging, headache, seizures, and COVID-19 are reviewed.