The American journal of emergency medicine
-
Mexiletine is a class IB antiarrhythmic agent. Although it is primarily used in treating ventricular arrhythmias, recent indications for use of mexiletine include chronic and neuropathic pains. At high doses, mexiletine causes drowsiness, confusion, nausea, hypotension, sinus bradycardia, paresthesia, seizures, bundle branch block, atrioventricular heart block, ventricular arrhythmias, asystole, cardiovascular collapse, and coma. ⋯ Patient then underwent hemodialysis. His vital signs and overall condition improved rapidly following hemodialysis treatment. In this case report, we aimed to emphasize hemodialysis as a useful alternative therapy for severe mexiletine intoxications.
-
Cervical collar brace protection of the cervical spine at the scene of the incident is the first priority for emergency medical technicians treating patients who have sustained trauma. However, there is still controversy between over- or underprotection. The objective of this study was to survey the cervical spine injury of lightweight motorcycle accident victims and further evaluate the neck collar protection policy. ⋯ The incidence of cervical spinal injuries in the urban area lightweight motorcyclists is very low. Prehospital protocol for application of a cervical collar brace to people who have sustained a lightweight motorcycle accident in the urban area should be revised to avoid unnecessary restraint and possible complications.
-
Anion gap (AG) and serum bicarbonate concentration (BICARB) may help confirm a diagnosis of seizure in an unwitnessed collapse; however, little data exist to support this practice. Our objective was to assess the association between AG metabolic acidosis and generalized seizure and to derive a simple score to predict seizure. ⋯ Anion gap metabolic acidosis is associated with generalized seizure. A Denver Seizure Score greater than 20 predicts generalized seizure in the emergency department and may be useful for differentiating patients with unwitnessed loss of consciousness.
-
Clinical Trial
Visual-aided directions are superior to verbal instruction only in obtaining hand position for cardiopulmonary resuscitation.
The aim of the study was to test if instruction without visual directions is sufficient to obtain the recommended hand position for cardiopulmonary resuscitation (CPR). ⋯ Instruction including visual direction was superior to verbal instruction only in obtaining hand position for CPR.
-
Our aim was to evaluate the clinical effectiveness of transcatheter arterial embolization (TAE) in the management of hemodynamically stable blunt hepatic trauma (BHT) patients with contrast material extravasation into the peritoneal cavity, known as type I contrast material extravasation, on computed tomography (CT) scan. ⋯ With TAE, nonoperative management of hemodynamically stable BHT patients with type I contrast material extravasation on CT scan was achieved in half patients.