J Emerg Med
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Review Case Reports
Case Report and Literature Review of a Dissecting Thoracic Aneurysm in a 16-Year-Old Boy Presenting to the Emergency Department.
Aortic dissection is a rare occurrence in the pediatric and adolescent population. It has numerous etiologies, including congenital cardiac abnormalities. Aortic dissection has a high mortality rate; therefore, it is essential for the physician to at least consider this diagnosis in the setting this patient presented within their differential of atypical chest pain in the pediatric and adolescent population. ⋯ It is important to consider aortic dissection as a possibility when assessing the sick adolescent patient. The D-dimer is quite useful as a rapid and inexpensive test in the evaluation and stratification of adolescent chest pain patients in the ED.
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Hydrogen peroxide is a commonly available product and its ingestion has been demonstrated to produce in vivo gas bubbles, which can embolize to devastating effect. ⋯ As demonstrated by both our experience as well as the current literature, HBO has been used to successfully treat gas emboli associated with hydrogen peroxide ingestion. We recommend consideration of HBO in any cases of significant hydrogen peroxide ingestion with a clinical picture compatible with gas emboli.
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Review Case Reports
Are Plain Radiographs Sufficient to Exclude Cervical Spine Injuries in Low-Risk Adults?
The routine use of clinical decision rules and three-view plain radiography to clear the cervical spine in blunt trauma patients has been recently called into question. ⋯ The consistently poor performance of plain radiographs to rule out cervical spine injury in adult blunt trauma victims is concerning. Large, rigorously performed prospective trials focusing on low- or low/moderate-risk patients will be needed to truly define the utility of plain radiographs of the cervical spine in blunt trauma.
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As medical schools seek to standardize ultrasound training and incorporate clinical correlations into the basic science years, we proposed that ultrasonography should have a greater role in the anatomy curriculum. ⋯ Ultrasound can be effectively incorporated into an anatomy course for first-year medical students by utilizing didactics and hands-on exposure. Medical students found the addition of ultrasound training to be valuable, not only in enhancing their understanding of anatomy, but also in increasing their interest and experience in ultrasound imaging.
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Diarrhea and chest pain are common symptoms in patients presenting to the emergency department (ED). However, rarely is a relationship between these two symptoms established in a single patient. ⋯ Campylobacter-associated myocarditis is rare, but performing the appropriate initial diagnostic testing, including stool cultures, is critical to making the diagnosis. Identifying the etiology of myocarditis as bacterial will ensure that appropriate treatment with antibiotics occurs in addition to any cardiology medications needed for supportive care.