The American journal of emergency medicine
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The purpose of this study is to determine whether point-of-care (POCT) urinalysis (UA) is as accurate as laboratory-performed UA in diagnosing urinary tract infections (UTIs) in the pediatric emergency department (PED). ⋯ Although POCT UAs offer more rapid turnaround times, the sensitivity is greater for laboratory-performed UAs. Given the difficulty in following up PED patients after discharge as well as the potential morbidity from untreated UTIs, the rapidity of the POCT UA must be balanced against the lower sensitivity of this assay. The benefit of more accurate diagnosis may outweigh the potentially longer PED length of stay associated with a laboratory-performed UA.
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Ultrasound-guided procedures are becoming very common in emergency medicine and critical care. Ultrasound guidance for pericardiocentesis has been shown to reduce errors as compared with the landmark-based technique. A simplified in-plane ultrasound-guided pericardiocentesis allows the clinician an opportunity to visualize the needle and the guide wire during the procedure. In addition, post procedure ultrasound of the pericardial effusion, right ventricle and inferior vena cava allow the clinician confirmation of improvement of physiologic parameters that can lead to cardiovascular collapse from impending pericardial tamponade.
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To assess stress-echo (SE) diagnostic performance in patients presenting to the emergency department (ED) with spontaneous chest pain, especially in subgroups in which exercise ECG diagnostic performance has been questioned (women, elderly, history of coronary artery disease). ⋯ SE had a very good diagnostic performance in ED patients with suspected Isch, both overall and in selected high-risk groups.
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Sildenafil is a drug used for male erectile dysfunction. Sildenafil's fatal cardiac effects except due to hypotension with simultaneous nitrate use have not been reported. ⋯ Electrocardiogram showed inferoposterior ST-segment elevation. In angiography, total circumflex artery occlusion has been seen.
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Acute cerebellitis is a rare inflammatory disease involving the cerebellum and is characterized by acute compromise of cerebellar functions. It most frequently originates from infectious causes, although cases of cerebellitis associated with other causes have also been reported. ⋯ There are no previous reports of cerebellitis after tricyclic antidepressant. This case shows that cerebellitis can develop in patients with poisoning of this kind.