The American journal of emergency medicine
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A case of accidental oral poisoning with hydrofluoric acid in an adult is presented. The patient ingested the product from a drinking glass, mistaking it for water, and died approximately 90 minutes after the exposure. Severe acidemia and hypocalcemia were present, which resulted in refractory asystole. A plasma fluoride determination showed an extremely high fluoride level.
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A 64-year-old man presented to an emergency department with a two-week history of intermittent, bilateral lower extremity paralysis without associated chest, abdominal, or back pain. He subsequently deteriorated and died as a result of a thoracic aortic dissection. This unusual case is reported, and the pathophysiology, diagnosis, and management of aortic dissection are discussed.
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Several studies have evaluated the effect of large-bore tubing and various intravenous (IV) catheters on rapid fluid resuscitation. This study combines available equipment, which has been demonstrated to increase IV flow rate, into a system. This system is then compared with one commonly used for IV fluid infusion in hypovolemic patients. ⋯ The improvement in flow rate can be attributed to the use of a rapid inflation/deflation pneumatic pressure device instead of the conventional hand-pumped pressure bag and the decrease in resistance through both the large-bore IV tubing and 12-gauge catheter. The rapid manipulation of IV bags is made possible by the rigid structure and the rapid inflation/deflation ability of the external pump. The possibility of faster change of IV bags and an increase in flow rate make this system a practical tool in the treatment of severely hypovolemic patients.
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A case of oral penicillin anaphylaxis is described, and the terminology, occurrence, clinical manifestations, pathogenesis, prevention, and treatment of anaphylaxis are reviewed. Emergency physicians should be aware of oral penicillin anaphylaxis in order to prevent its occurrence by prescribing the antibiotic judiciously and knowledgeably and to offer optimal medical therapy once this life-threatening reaction has begun.