Emergency medicine journal : EMJ
-
Compartment syndrome as a result of simvastatin-induced myositis is extremely rare. This case discusses a patient with spontaneous onset compartment syndrome that necessitated four-compartment fasciotomy. ⋯ When investigating a patient with unexplained spontaneous compartment syndrome it is important to consider drug-induced myositis. This case reinforces the difficulty faced in diagnosing spontaneous compartment syndrome.
-
Case Reports
Massive pulmonary embolism with cardiac arrest treated with continuous thrombolysis and concomitant hypothermia.
This case report describes the clinical course in a 49-year-old man with repeated cardiac arrests due to massive pulmonary embolism. He was successfully treated with intravenous tenecteplase followed by catheter-based alteplase infusion during external cooling. The case illustrates that vitally important bolus thrombolytic therapy may be continued as catheter-based treatment along with hypothermia without significant bleeding complications.
-
Randomized Controlled Trial Multicenter Study
Mitigation of pain during intravenous catheter placement using a topical skin coolant in the emergency department.
Although intravenous (i.v.) line placement is a common procedure in the emergency department (ED), it is an uncomfortable experience for many patients. Topical analgesic agents are rarely used because they have long onsets of action and thereby cause unacceptable treatment delays. Cryoanaesthesia, the use of cooling agents to reduce pain, has been recognised for many years as a potential pain management strategy. The purpose of this study was to determine whether an instantaneous topical skin coolant spray reduces patient's pain during i.v. cannulation and represents a feasible alternative for cutaneous analgesia in the ED setting. ⋯ Our study failed to detect a difference in pain perception resulting from the pre-procedural application of a skin coolant associated with i.v. placement in the ED setting.