Clinical practice and cases in emergency medicine
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Clin Pract Cases Emerg Med · Aug 2021
Erector Spinae Plane Block in the Emergency Department for Upper Extremity: A Case Report.
The erector spinae plane block (ESPB) has been described as an effective analgesic modality in the emergency department (ED) for thoracic pain. It has not previously been described to treat ED patients with pain in the upper extremity. ⋯ A significant portion of patients who present to the ED have underlying chronic pain; however, opioids are a potentially dangerous and ineffective modality to treat chronic pain. In addition to avoiding opiates, the ESPB has the advantage of preserving motor function, thus avoiding the complications associated with brachial plexus blockade.
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Clin Pract Cases Emerg Med · Feb 2021
Case Report: Bilateral Ultrasound-guided Serratus Anterior Plane Blocks for a Chest Wall Burn.
The serratus anterior plane block (SAPB) has been shown to effectively treat pain following breast surgery, thoracotomies, and rib fractures. We present the first reported case of a bilateral ultrasound-guided SAPB in a multimodal analgesic regimen after an acute large, thoracic, deep partial-thickness burn. ⋯ The ultrasound-guided SAPB may be an excellent addition to the multimodal analgesic regimen in superficial and partial-thickness burns of the anterior chest wall.
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Clin Pract Cases Emerg Med · Nov 2020
Morel-Lavallée Lesion Following a Low-speed Injury: A Case Report.
Soft tissue injuries are a common presenting complaint seen in the emergency department following trauma. However, internal degloving injuries are not commonly seen by the emergency provider. ⋯ The emergency physician should consider Morel-Lavallée lesions in patients with a traumatic hematoma formation to avoid complications that come from delayed diagnosis.
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Clin Pract Cases Emerg Med · Aug 2020
A Rare Case Report of Lemierre Syndrome from the Anterior Jugular Vein.
Lemierre syndrome is a rare, potentially fatal, septic thrombophlebitis of the internal jugular vein. Treatment includes intravenous antibiotics for Fusobacterium necrophorum, the most common pathogen, as well as consideration for anticoagulation therapy. ⋯ Based on an individual's clinical symptoms, history, and radiologic findings, it is important for physicians to consider Lemierre syndrome in the differential diagnosis, as the condition may rapidly progress to septic shock and death if not treated promptly. The use of anticoagulation therapy remains controversial, and there is a lack of established standard care because the syndrome is so rare.
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Clin Pract Cases Emerg Med · Aug 2020
Euglycemic Diabetic Ketoacidosis Precipitated by SGLT-2 Inhibitor Use, Pericarditis, and Fasting: A Case Report.
Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus. Less prevalent is euglycemic DKA (eDKA)-DKA with serum glucose less than 200 mg/dL; however, it is increasing in frequency with the introduction of sodium glucose cotransporter 2 (SGLT-2) inhibitors for treatment of type 2 diabetes. ⋯ Prompt recognition of eDKA in the emergency department may allow earlier diagnosis and treatment directed at one or more of its underlying causes.