The American journal of emergency medicine
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Chemical restraint is often required to control agitation induced by methamphetamine. Dexmedetomidine is an α-2 adrenergic receptor agonist with sedative, analgesic, and sympatholytic properties. Its use in the emergency department (ED) to control methamphetamine-induced agitation has not been reported. ⋯ Dexmedetomidine can be considered as an adjunct for chemical restraint when standard treatment fails to control the agitation induced by methamphetamine, but patient's hemodynamic state should be monitored closely during administration. Its efficacy and safety in the ED warrant further evaluation with prospective controlled trials.
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Case Reports
Emergency lumbar puncture in a patient receiving dabigatran after antagonization with idarucizumab - A case report.
Idarucizumab is an antibody fragment which is used to reverse the anticoagulant effects of dabigatran. We report on the first successful use of idarucizumab before performing an emergency lumbar puncture in a patient on effective anticoagulation with dabigatran thought to have infective cerebral disease (such as temporal encephalitis).
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Case Reports
Not all ST-segment elevations are myocardial infarction: Hyperkalemia and Brugada phenocopy.
Several clinical conditions other than Brugada syndrome (BrS) can mimic acute ST-segment elevation myocardial infarction and Brugada phenocopies are a part of those conditions that can mimic either true BrS or acute myocardial infarction. Our manuscript shows an interesting and didactic case report of type-1 Class A Brugada phenocopy (BrP) induced by hyperkalemia and allow us to teach the systematic approach to the proper diagnosis of BrP. A prompt recognition of this clinical and electrocardiographic entity may expedite the initiation of appropriate treatments as illustrated in this case report.
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Negative T waves in electrocardiography have been widely studied. We presents a case of Wellens' syndrome which is a pattern of global inverted T waves with QT prolongation on ECG due to transient proximal LAD occlusion and pointed out other differential diagnosis.