The American journal of emergency medicine
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Case Reports
Neurologic toxicity of carbamazepine in treatment of trigeminal neuralgia: A case report.
Carbamazepine is a medication used to treat a variety of neurological and psychiatric conditions including seizure disorders, neuropathic pain syndromes, and bipolar disorder. Unfortunately, its pharmacokinetics and side effect profile may lead to significant toxicities due to its sodium channel blockade. ⋯ In this article, we describe a case of a 40-year-old female who presented to a local emergency department with focal neurological deficits after repeated supratherapeutic dosing of carbamazepine.. This case highlights a key cerebrovascular accident mimic that emergency physicians should consider from acute toxicity that can be seen with carbamazepine in a patient who was taking the medication as prescribed.
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Over the last decade, tranexamic acid (TXA) has been incorporated into treatment algorithms for a multitude of emergent conditions and the evidence surrounding its role in emergency medicine continues to evolve. ⋯ Tranexamic acid appears to be a reasonable adjunct for the emergency medicine clinician to consider in the management of many hemorrhagic conditions and angiotensin converting enzyme inhibitor-induced angioedema. Additional high-quality research in these areas is needed to further identity patients who may benefit most from TXA.
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On June 24, 2022, the Supreme Court overturned Roe v. Wade, which will limit legal abortion in many areas of the U.S. Over half of abortions in the U.S. are performed using medication as opposed to surgical techniques. With widespread access to agents that are used for medication abortion, there may be an increase in emergency department presentations related to improper or unsupervised use of these medications. ⋯ Agents used for medication abortion have unique contraindications and adverse effects. Improper or unsupervised use may occur in the setting of limited abortion access and emergency medicine physicians are on the front lines in managing these presentations.
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Meta Analysis
Outcome of cardiopulmonary resuscitation with different ventilation modes in adults: A meta-analysis.
The optimal airway management strategy for cardiac arrest remains unclear. This study aimed to compare the effects of different initial airway interventions on improving clinical outcomes based on the 2010 cardiopulmonary resuscitation (CPR) guidelines and later. ⋯ Opening the airway is significantly associated with improved clinical outcomes, and the findings suggest that effective ETI based on mask ventilation should be implemented as early as possible once the patient has experienced cardiac arrest.
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The first objective of this systematic review was to investigate the effectiveness of ketamine compared to opioid analgesics for pain management in children aged two months to 18 years who have acute pain in the emergency department. The second objective was to compare the adverse events and side effects associated with ketamine with those associated with opioids used for pain management. ⋯ In this systematic review, the Joanna Briggs Institute standards [14] have been followed. is advisable for the Emergency Department health professionals to determine the appropriate dose for ketamine based on the child's characteristics, such as weight, age, and disease condition.