J Emerg Med
-
Review Case Reports
Tangential gunshot wound to the chest causing venous air embolism: a case report and review.
This is a case report of a 53-year-old woman who presented to the Emergency Department after sustaining a tangential gunshot wound to the left anterior chest wall. On arrival, the patient was somnolent, hypotensive, hypoxic, and had impaired speech. The patient's cardiopulmonary status stabilized quickly after fluid resuscitation and supplemental oxygen. ⋯ There are numerous case reports of venous air embolism (VAE) after penetrating neck, chest, and abdominal injuries, surgical procedures, or secondary to unintentional air injection through venous catheters. Due to the wide range of neurological and cardiopulmonary clinical presentations, the non-specific signs and symptoms of VAE may frequently be attributed to other causes, especially in the setting of trauma. An overview of the pathophysiology, clinical presentation, diagnosis, and treatment of VAE is presented, with emphasis on diagnostic imaging modalities.
-
Because arterial punctures are more painful, venous blood gas analysis has been proposed as an alternative. ⋯ There is significant variability in the arteriovenous difference of pCO(2) readings, hence, arterial punctures are still needed to specifically determine the arterial pCO(2).
-
Drug abuse is a common problem in the United States. Drugs can be acquired in many ways, and can be knowingly or mistakenly misrepresented when sold. Propafenone is an uncommonly encountered class IC antidysrhythmic that is a look-alike for the opioid, oxycodone/acetaminophen 5/325. ⋯ Pharmaceutical drugs are often sold on the street, and often misrepresented. Propafenone HCl 225-mg is an uncommonly encountered pharmaceutical, but is a look-alike for oxycodone/acetaminophen 5/325. An overdose due to propafenone ingestion may present with seizures and a widened QRS complex.
-
Case Reports
Cardiac arrest with residual blindness after overdose of Tessalon® (benzonatate) perles.
The extent to which benzonatate (Tessalon®), a structurally similar agent to other local anesthetics including tetracaine and procaine, poses a risk to the public is not fully appreciated as it is still one of the most widely prescribed antitussives available. ⋯ Ingestion of Tessalon®, a seemingly innocuous and widely prescribed antitussive, may pose a risk to patients due to its potential for the rapid development of life-threatening adverse events and limited treatment options in the overdose setting. Rational prescribing and patient education is needed.
-
The extrauterine migration of an intrauterine device (IUD) can be life threatening and require emergent surgical intervention and treatment. Migration is usually the result of IUD expulsion or uterine perforation. ⋯ This article presents the case, discusses the incidence, potential causes, predisposing factors, diagnostic modalities, and the course of treatment for this particular diagnosis.