The American journal of emergency medicine
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Case Reports
Inhaler intoxications developed during autopsy of the corpse due to cyanide intake: Case series.
The primary cause of cyanide intake is suicidal attempts, most of which result in death. People who interfere with suspicion of cyanide intoxication may also be exposed to cyanide poisoning. ⋯ Meanwhile, a 36-year-old patient who had come into contact with the patient at night also presented to the ED. Some of the precautionary measures to be taken against inhalation of cyanide may be wearing appropriate masks as well as suitable clothes and keeping the surroundings below 28 °C when exposed to cyanide.
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Case Reports
A change of heart: Transformation of the electrocardiogram in a patient with apical hypertrophic cardiomyopathy.
An asymptomatic 83-year-old man with a history of hypertension, prior stroke with no residual deficits, and bilateral carotid artery stenosis, presented for evaluation prior to cataract surgery. His transthoracic echocardiogram was typical for apical hypertrophic cardiomyopathy (AHCM), and his electrocardiograms (ECG) showed large precordial R-waves and inverted T-waves, previously associated with AHCM, while his ECG 7 years earlier was normal. Mechanistic explanations for the developed ECG abnormalities, and their importance for the detection and monitoring of patients with AHCM are provided.
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Capnocytophaga canimorsus, commonly transmitted by dog bites, can cause severe sepsis, and the mortality rate is very high. We experienced a case of hemophagocytic lymphohistiocytosis (HLH) complicated by severe sepsis caused by C. canimorsus. A 58-year-old man with no remarkable medical history was admitted to another hospital with fever and mild consciousness disorder developed 3 days after being bitten by his dog. ⋯ Once antibiotic and steroid therapy was started, the patient's infection and cytopenia improved. Unfortunately, the patient's fingers and toes required amputation, but his life was saved, and he was discharged from hospital. Because HLH may be hidden in such cases, it may be necessary to measure serum ferritin and perform bone marrow aspiration if hyperferritinemia is suspected.
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Prehospital limb amputation is a rare but potentially life-saving intervention. When patients cannot be extricated due to limb entrapment or have hemodynamic compromise that precludes a prolonged extrication, they may benefit from an emergent prehospital amputation. The objective was to experimentally compare three prehospital amputation techniques on porcine legs. ⋯ Prehospital limb amputation with a hacksaw or reciprocating saw may result in faster completion of the time-sensitive procedure with fewer instrument malfunctions.