The American journal of emergency medicine
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A 44-year-old woman presented to the Emergency Department with abdominal pain. She had a history of fibroids and no prior surgeries. ⋯ The patient required laparotomy to relieve the intestinal obstruction after conservative therapy failed. Massive uterine fibroids is a rare cause of small bowel obstruction which requires the vigilance of Emergency Medicine physicians.
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Supraventricular tachycardia is a common cardiac arrhytmia with recurrent episodes. The rapid resolution of supraventricular tachycardia remains a challenge. Vagal manoeuvres are simple and non-invasive but yield positive results in less than half the cases. ⋯ We report in this series 11 cases of supraventricular tachycardia, 10 of which were effectively reduced after the completion of the reverse Valsava manoeuvre. The very encouraging results of this series of cases will have to be quickly evaluated by a randomised controlled trial. This new technique, which is simple to learn and carry out, could be easily taught throughout the world, including in regions with few health-care resources.
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Though point-of-care ultrasound (POCUS) is recognized as a useful diagnostic and prognostic intervention during cardiac arrest (CA), critics advise caution. The purpose of this survey study was to determine the barriers to POCUS during CA in the Emergency Department (ED). ⋯ While our study demonstrates that most attending and resident physicians utilize POCUS in CA, barriers to high-quality implementation exist. Top attending physician barriers relate to POCUS education, while the top resident physician barriers relate to logistics and the machines. Interventions to overcome these barriers might lead to optimization of POCUS performance during CA in the ED.
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Melkersson-Rosenthal syndrome is a rare condition characterized by a triad of orofacial edema, facial paralysis, and fissured tongue. Histopathological examination of the disease has demonstrated areas of inflammation involving mast cells. Activated mast cells also play a part in the pathogenesis of COVID-19 infection, as they release cytokines in the lungs. ⋯ We present a case of a female patient presenting with edema. Her examination revealed edema in the right lower lip, right facial paralysis, and fissured tongue. COVID-19 may be associated with which was not previously included in the etiology of the disease.