J Emerg Med
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Aspirin overdose may result in acid-base disturbances, electrolyte abnormalities, pulmonary edema, chemical hepatitis, seizures, and mental status alteration, but myocardial depression has not been reported following aspirin overdose in children. In addition to these more typical features, the 13-month-old boy reported here developed clinical, radiographic, and echocardiographic evidence of myocardial impairment with pulmonary edema and moderately severe global left ventricular dysfunction (estimated shortening fraction of 23%). Complete resolution of the myocardial dysfunction was demonstrated on follow-up echocardiography as the child recovered from the aspirin intoxication. This case suggests that myocardial dysfunction can occur as a result of toxic aspirin ingestion, and that it may contribute to salicylate-induced pulmonary edema.
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Rapid sequence intubation (RSI) has recently gained wide acceptance among emergency physicians (EP). The debate regarding the safety of neuromuscular blocking (NMB) agents in the hands of EPs nonetheless remains open, as objective studies are few, and all data available so far come from tertiary care centers. This retrospective study was done to review our experience with RSI and assess the related morbidity and mortality. ⋯ All patients were successfully intubated. No mortality was attributed to the use of muscle relaxants. Our results support the safety and effectiveness of RSI in the hands of emergency physicians.