The American journal of emergency medicine
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Hyperkalemia due to crush syndrome after trauma is a well known fatal clinical condition, but early hyperkalemia with hemorrhage after trauma is a rare phenomenon. We report on a 5-year-old boy who bruised from the lumbers, had cardiopulmonary arrest caused by hyperkalemia, and underwent perihepatic packing twice before being discharged without any neurologic deficits. Clinicians should be vigilant for signs of hyperkalemia accompanying hemorrhagic shock, even in the early phase of trauma.
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Case Reports
The electric Kool-Aid NBOMe test: LC-TOF/MS confirmed 2C-C-NBOMe (25C) intoxication at Burning Man.
Designer drugs are constantly evolving, with the NBOMe derivatives of the 2C class of phenethylamines recently emerging in the US market. Cases of 2C-I-NBOMe toxicity have recently been reported in the literature. No reports to date describe the clinical effects 2C-C-NBOMe toxicity.
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Target stroke guidelines recommend a door-to-needle time of ≤60 minutes for acute ischemic stroke (AIS) patients treated with intravenous (IV) tissue-type plasminogen activator (tPA). We sought to analyze all diagnostic steps involved in the acute evaluation and treatment of AIS with IV tPA and to look for causes of delay in door to needle time (DNT). ⋯ An ECG performed before the head CT is completed increased CT time by 6 minutes and a chest radiograph obtained before the head CT increased CT time by 13 minutes. DNT ≤60 minutes for AIS patients are affected by the order of diagnostic studies. In a minority of patients the DNT is affected by non-modifiable issues.
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Parasite infestation is still associated with significant morbidity and mortality. Hookworm infestation is a very rare cause of pancreatitis. This parasitic infestation might be asymptomatic. ⋯ The patient was treated with mebendazole. He was asymptomatic and had gained weight at the 3-month follow-up. Our case demonstrates that pancreatitis secondary to hookworm infection can occur and may resolve after anthelmintic treatment.