The American journal of emergency medicine
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Review Case Reports
Stroke-mimicking unilateral hypokalemic paralysis: A case report and literature review.
Unilateral paralysis is an alarming symptom with broad differential diagnoses, including stroke, Todd's paralysis, myelopathy, and peripheral neuropathy. Hypokalemic paralysis (HP), a neuromuscular disorder associated with muscle dysfunction, is caused by hypokalemia and manifests as symmetric proximal extremity muscle weakness. ⋯ Delayed diagnosis and treatment may result in fatal consequences. Here, we report an atypical case of unilateral weakness along with a review of the literature on unilateral HP.
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Emergency medicine (EM) research is growing at a rapid pace. It is important to understand the scope and trends over time in order to identify gaps and future areas for growth. This study aimed to describe trends in scientific publications within EM over the past decade. ⋯ This bibliometric study is a quick snapshot of research in the EM field in the last decade and may provide insights into the scientific agendas of the EM professionals.
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Eclampsia is a rare partum and puerperal condition that carries a high rate of morbidity and mortality. ⋯ An understanding of eclampsia can assist emergency clinicians in rapid recognition and timely management of this potentially deadly disease.
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Randomized Controlled Trial
Safety and practicality of high dose inhaled nitric oxide in emergency department COVID-19 patients.
Inhaled nitric oxide (iNO) is a selective pulmonary vasodilator and mild bronchodilator that has been shown to improve systemic oxygenation, but has rarely been administered in the Emergency Department (ED). In addition to its favorable pulmonary vascular effects, in-vitro studies report that NO donors can inhibit replication of viruses, including SARS Coronavirus 2 (SARS-CoV-2). This study evaluated the administration of high-dose iNO by mask in spontaneously breathing emergency department (ED) patients with respiratory symptoms attributed to Coronavirus disease 2019 (COVID-19). ⋯ A single dose of iNO at 250 ppm was practical and not associated with any significant adverse effects when administered in the ED by emergency physicians. Local disease control led to early study closure and prevented complete testing of COVID-19 safety and treatment outcomes measures.
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Point-of-care ultrasound (PoCUS) is expanding as a diagnostic tool in pediatric emergency medicine. Pediatricians are apprehensive to take on the risk of malpractice from incorrect interpretation of PoCUS imaging, therefore limiting its use. Although current studies provide reassurance to this concern, none look directly at the risk for pediatric emergency medicine physicians. Our study aims to evaluate the current medicolegal risk landscape posed by PoCUS in pediatric emergency medicine. ⋯ PoCUS does not appear to pose a significant risk of malpractice litigation in pediatric emergency medicine.