The American journal of emergency medicine
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Case Reports
Ultrasound-guided spinal accessory nerve block for intractable trapezius pain: A case series.
Myofascial pain affects about 10% of the United States population, often involves the trapezius muscle, and can be difficult to manage using conventional analgesic medications in the Emergency Department (ED). The use of ultrasound-guided nerve blocks performed by emergency physicians is well-documented, but this is the first report describing the technique and effectiveness of an ultrasound-guided spinal accessory nerve block for acutely treating trapezius myofascial pain in the ED setting. In this case series of three patients with intractable trapezius pain, the ultrasound-guided spinal accessory nerve block proved feasible and offered substantial therapeutic benefit.
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Meta Analysis
Adverse events during intrahospital transport of critically ill patients: A systematic review and meta-analysis.
Intrahospital transport of critically ill patients is often necessary for diagnostic procedures, therapeutic procedures, or admission to the intensive care unit. The aim of this study was to investigate and describe safety and adverse events during intrahospital transport of critically ill patients. ⋯ Our findings suggest that adverse events can occur during intrahospital transport of critically ill patients, and that the frequency of critical adverse events is relatively low. The results of this meta-analysis could assist in risk-benefit analysis of diagnostic or therapeutic procedures requiring intrahospital transport of critically ill patients.
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Hyperkalemia represents a widespread and potentially lethal condition that affects millions of people across their lives. Despite the prevalence and severity of the condition, there are no consensus guidelines on the treatment of hyperkalemia or even a standard definition. ⋯ Additionally, we review the pathophysiology of the electrocardiographic effects of hyperkalemia and how intravenous calcium preparations can antagonize these effects. We conclude each section with recommendations to aid emergency physicians in making safe and efficacious choices for the treatment of acute hyperkalemia.
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The incidence of alcohol and recreational drug use is increasing. The impact on penetrating trauma is unknown. This study was undertaken to identify the incidence of alcohol and recreational drug use prior to penetrating trauma, and to identify ISS and outcomes among patients with penetrating trauma. ⋯ Positive screens for alcohol and recreational drugs were common among penetrating trauma patients in this setting. The most common identified recreational drugs included marijuana, benzodiazepine, opiates, alcohol, cocaine, and amphetamine.