The American journal of emergency medicine
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Synthetic cannabinoids (SC) have exploded on to the scene. With this rise in SC use, the number of complications and potential adverse effects are also well documented in the literature and is on the rise. The most frequently cited side effects are behavioral in nature and range for severe agitation to psychosis and delirium. We report a case of hyperthermia with severe rhabdomyolysis from SC use.
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Trauma-related embolic events in pulmonary vascular bed are generally due to fat or thrombus embolism. In this report, we present a patient who had severe hypoxia and tachycardia at postoperative period after surgery of an open tibia fracture. ⋯ Because of persistent hypoxemia, we performed transthoracic echocardiographic examination to exclude an intracardiac shunt. In transthoracic echocardiographic examination, we found an atrial septal defect with intermittent right-to-left shunt due to high central venous pressure.
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Central venous catheterization is often necessary for the safe administration of medications that are caustic to peripheral veins, to place temporary transvenous pacemakers and to provide invasive hemodynamic monitoring in the critically ill. While a wide range of complications are known to occur with insertion of these catheters, there is a paucity of cases associated with cardiac arrest during the catheters placement. We describe an unusual case of sustained ventricular tachycardia and subsequent cardiac arrest that occurred during an ultrasound guided central venous catheter placement for a patient in septic shock. This case serves as a reminder of the rare, but potentially fatal complication of central venous access placement.