The American journal of emergency medicine
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Tonsillectomy is a common and relatively safe pediatric surgery. However, common and emergent complications from this procedure include hemorrhage, airway obstruction, and local infection. A rare but equally emergent complication is infection from hematogenous spread. We present a rare case of septic arthritis in a 6-year-old female of the ankle 3 days following tonsillectomy.
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Tattooing is associated with a handful of potential complications. Short-term complications such as pain, pruritus, erythema, or swelling at the tattoo-site commonly occur from local skin trauma. ⋯ However, in a small number of individuals, the granulomatous change in the tattoo and uveitis occur in the absence of any evidence of sarcoidosis. A case is presented of a tattoo granuloma with uveitis (TAGU) without sarcoidosis.
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Observational Study
Rapid correction of hyperkalemia is associated with reduced mortality in ED patients.
Hyperkalemia (HK) is common and associated with mortality. Our purpose was to determine if the rapid correction of elevated serum potassium level (K+) was associated with reduced mortality in emergency department (ED) patients. ⋯ Normalization of K+ during the ED stay in patients with HK is associated with a 50% mortality reduction. Efforts to rapidly identify and treat HK in the ED are needed.
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Intranasal cooling by the evaporation of perflourcarbon is almost exclusively used for the induction of therapeutic hypothermia in post-resuscitation care. This method has proven to be effective and safe. This case presents a successful application to a patient with external heatstroke. ⋯ After endotracheal intubation intranasal evaporation cooling was performed and the patient's core temperature was reduced efficiently. We recorded an excellent cooling rate of 2.8 °C per hour. 16 h later the patient was successfully extubated with a good neurological outcome. This case shows that although intranasal cooling is mostly known for post-resuscitation care, there is a sensible application in heatstroke with imminent cerebral oedema.
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In toxicology literature, snake bites were the second toxicology-relevant cause mimicking brain death. A 57-year-old woman with history of cobra snake bite. On examination, the brain stem reflexes were absent with Glasgow coma score of 3. ⋯ Thus, intensivist should exclude neuroparalytic effect of snakebite before considering withdrawal of ventilatory support or organ donation. Also, the life-threatening presentation of cobra envenomation mandates the use of higher doses of PSA to reverse the neuroparalytic toxicity. We should consider the rule of anticholinesterase as an adjunctive therapy to PSA in severe cobra envenomation.