J Emerg Med
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We present the case of a 47-year-old man who presented to the Emergency Department (ED) with complaint of left-sided neck pain. He was thought to have a musculoskeletal sprain on his initial visit. However, he returned the following evening with worsening symptoms. On further investigation, he was found to have a non-traumatic retropharyngeal abscess (RPA), a rare infection in the adult patient population. ⋯ The majority of data on diagnosis and treatment of adult RPA have come from the pediatric population. However, the same essential treatment principles apply: airway stabilization, resuscitation, initiation of IV antibiotics, and consultation with an otolaryngology specialist.
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Patients with recurrent ventricular fibrillation (VF) have a high mortality rate, which may be partly due to hemodynamic instability. ⋯ With repeated episodes of VF, BP increased transiently and then gradually returned to baseline values, but HR stayed elevated. Serum DA levels increased, EPI and NE levels gradually decreased.
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The population's migration from urban to suburban areas has resulted in a more dispersed population and has increased traffic flow, possibly resulting in longer emergency response times. Although studies have examined the effect of response times on time to definitive care and survival, no study has addressed the possible causes of slowed response time from the point of view of emergency medical services (EMS) first responders. ⋯ The results of the survey suggest that the best methods for reducing emergency response times are those that are easy to implement (e.g., public education).
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Hair toe tourniquet syndrome is a condition in which a hair or thread encircles a digit and results in acute digital ischemia. It usually occurs in children under the age of 1 year. Prompt recognition and surgical removal of the constricting material can save the digit from irreversible tissue necrosis and the loss of digit. ⋯ We suggest that hair toe tourniquet syndrome should be considered as a cause of acute digital swelling and discoloration in children of all ages.
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Spontaneous coronary artery dissection (SCAD) causes acute coronary syndromes or sudden death in young patients who are often lacking classic coronary disease risk factors. Systemic inflammatory and connective tissue diseases have been suggested as risk factors for SCAD. ⋯ SCAD is a rare but important cause of acute coronary syndromes and sudden death. It commonly occurs in young women. Although pregnancy is the most well-established risk factor, systemic inflammatory and connective tissue diseases have also been suggested as risk factors.