The American journal of emergency medicine
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Letter Randomized Controlled Trial Comparative Study
A comparison of the Macintosh laryngoscope and blind intubation via I-gel in intubating an entrapped patient: A randomized crossover manikin study.
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We present an acute apixaban overdose without reported coingestants; it is the first such case report associated with multiple serum drug levels to assist in determining overdose kinetics. A 62 year old female presented to an emergency department (ED) 2 hours after ingesting sixty 5 mg tablets (5mg/kg) of her spouse's apixaban medication. She denied coingestants, and did not take her prescribed medications that day. ⋯ There was no utilization of blood products or factor replacement. There was never any bleeding, and her hemoglobin did not decrease. This case demonstrates that a single ingestion of apixaban can occur without any complications occurring.
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Letter Randomized Controlled Trial Comparative Study
Comparative analysis of five methods of emergency zipper release by experienced versus novice clinicians.
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According to the NIH, about 275000 patients receive treatment with 5-Fluorouracil (5-FU) and more than 1300 die from 5-FU toxicity every year from life-threatening myelosuppression, gastrointestinal complications, and neurotoxicity. Immunocompromised persons are at higher risk of developing toxicity. Recently uridine triacetate (Vistagard®) has been approved by the Food and Drug Administration (FDA) as the only specific antidote available for 5-FU poisoning. ⋯ After receiving treatment the patient was asymptomatic and had an uncomplicated hospital course. 5-FU poisoning must be recognized early as uridine triacetate is approved by the FDA for use within 96h following the end of 5-FU administration. Emergency medicine physicians should promptly recognize and treat 5-FU poisoning. However, this may be challenging as patients may not seek medical attention until many hours or several days after last administration since symptoms are often delayed with 5-FU poisoning.
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Case Reports
Ventricular tachycardia and prolonged QT interval presenting as seizure-like activity: A case report.
Seizures can be difficult to distinguish from other causes of transient cerebral hypoxia in the emergency department. We present a case of seizure activity in a woman in whom EKG led to a diagnosis of intermittent monomorphic and polymorphic ventricular tachycardia (torsades de pointes), highlighting the need for careful consideration of alternative causes of seizures, even in patients with known epilepsy.