J Emerg Med
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Case Reports
Bilateral simultaneous traumatic upper arm compartment syndromes associated with anabolic steroids.
Acute compartment syndrome, a surgical emergency, is defined as increased pressure in an osseofascial space. The resulting reduction of capillary perfusion to that compartment requires prompt fasciotomy. Treatment delay has a poor prognosis, and is associated with muscle and nerve ischemia, resultant infarction, and late-onset contractures. ⋯ We suggest consideration of a history of anabolic steroid use when evaluating patients with extremity trauma.
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Review Case Reports
Amatoxin poisoning: case reports and review of current therapies.
Diagnosis and management of Amanita mushroom poisoning is a challenging problem for physicians across the United States. With 5902 mushroom exposures and two resultant deaths directly linked to Amanita ingestion in 2009, it is difficult for physicians to determine which patients are at risk for lethal toxicity. Identification of amatoxin poisoning can prove to be difficult due to delay in onset of symptoms and difficulty with identification of mushrooms. Consequently, it is difficult for the Emergency Physician to determine proper disposition. Further, treatment options are controversial. ⋯ We present the successful treatment of 2 patients who ingested what we believe to be an Amanita species never before identified in the northeastern United States.
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Review Case Reports
Spontaneous compartment syndrome of the upper arm in a patient receiving anticoagulation therapy.
Compartment syndrome is a condition in which elevated pressures within an osseofascial compartment cause vascular compromise, leading to ischemia and possible necrosis. It commonly occurs after a traumatic event (e.g., fracture, crush, burn); however, compartment syndrome can happen spontaneously and in any compartment of the body. The objective of this case study is to present the signs and symptoms of upper arm compartment syndrome along with a review of the diagnosis and treatment. ⋯ Although uncommon, spontaneous compartment syndrome can occur, and prompt recognition and intervention are limb- and possibly life-saving.
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Review Case Reports
Bilateral anterior dislocation of the shoulder: review of seventy cases and proposal of a new etiological-mechanical classification.
Although anterior shoulder dislocation is common in everyday practice in Emergency Departments, bilateral presentation is a rare entity. ⋯ The bilateral anterior shoulder dislocation may not be as rare as previously thought and must be taken into account in emergency services. The authors propose a new etiological-mechanical classification. Also, the importance of radiologic diagnosis must be highlighted.
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Review
A systematic review of patient tracking systems for use in the pediatric emergency department.
Patient safety is of great importance in the pediatric emergency department (PED). The combination of acutely and critically ill patients and high patient volumes creates a need for systems to support physicians in making accurate and timely diagnoses. Electronic patient tracking systems can potentially improve PED safety by reducing overcrowding and enhancing security. ⋯ Support exists for the use of barcode-, IR-, and RFID-based patient tracking systems to improve ED patient safety and efficiency. A lack of methodologically strong studies indicates a need for further evidence-based support for the implementation of patient tracking technology in a clinical or research setting.