J Emerg Med
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Prehospital ultrasound has been shown to aid in the diagnosis of multiple conditions that do not generally change prehospital management. On the other hand, the diagnoses of cardiac tamponade, tension pneumothorax, or cardiac standstill may directly impact patient resuscitation in the field. ⋯ Paramedics were able to perform the PAUSE protocol and recognize the presence of pneumothorax, pericardial effusion, and cardiac standstill. The PAUSE protocol may potentially be useful in rapidly detecting specific life-threatening pathology in the prehospital environment, and warrants further study in existing EMS systems.
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Hypermagnesemia is a rare condition that is usually iatrogenic. Magnesium oxide (MgO) ingestion by constipated patients with prolonged colonic retention contributes to hypermagnesemia. Treatment of hypermagnesemia includes discontinuation of the magnesium use, gastrointestinal (GI) decontamination, and removal of magnesium from the serum by dialysis. Calcium acts as an antagonist in hypermagnesemia. ⋯ This report demonstrates that MgO tablets retained in the GI tract without adequate decontamination result in continuous absorption and rebound of hypermagnesemia. This report also addresses the importance of GI decontamination in the treatment of hypermagnesemia.
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The Emergency Department (ED) has been shown to be a valuable location to screen for family violence. ⋯ This study investigates the victim profile of a large cohort of a Chinese population, providing a unique data set not previously released in this cultural or medical system. The findings give insights to early identification of victims of family violence in the EDs and suggest that screening techniques focused on multiple forms of family violence would improve identification of violence cases. Multidisciplinary collaboration between health, legal, and social service professionals is also warranted to meet the various needs of victims and to reduce hospital readmissions.
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Sore throat is a common complaint for patients presenting to the emergency department (ED). Although most are caused by viral and bacterial sources, an ingested foreign body must be considered in the right patient population. Retained foreign bodies occur in both children and adults. In children, the objects are usually non-food items, whereas adults are more likely to have impacted food boluses. Typically, patients present acutely, and chronic foreign bodies are rare, especially in adults. ⋯ Complaints related to sore throat commonly have a simple explanation. Recurrent symptoms and a physical examination inconsistent with common explanations require the differential to be broadened and less common causes considered.
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Knee dislocation is an uncommon but serious injury that has traditionally been associated with high velocity injuries such as motor vehicle accidents. More recently, individual cases of obese individuals sustaining knee dislocation from a low velocity mechanism have been noted. Associated injuries of knee dislocation are common and include popliteal vessel damage requiring surgical repair and injuries to the peroneal nerve. Prompt diagnosis and reduction is essential to reduce the risk of these complications. ⋯ This is the first series of such injuries that we are aware of and highlights a potential future increase in incidence of these major injuries as body mass in society increases, placing more strain on health care resources. Practitioners in the Emergency Department need to be aware that serious injury can be present in morbidly obese patients that have sustained no more than a fall from standing height. Prompt investigation and management is essential.