J Emerg Med
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Hydatid cysts are caused by Echinococcus granulosus infection, and hydatidosis is recognized as a re-emerging zoonotic disease globally. While the liver is the most commonly affected organ, other organs can also be affected, including the heart. Because of the low sensitivity and specificity of serologic diagnostic tests, ultrasound and echocardiography are increasingly used to make the diagnosis of cardiac hydatid cyst. ⋯ We report the case of a cardiac hydatid cyst, detected by point-of-care ultrasound (POCUS), in a 79-year-old woman who presented with shortness of breath and was in ventricular tachycardia. The diagnosis was further confirmed with a computed tomography scan. Although cases of alveolar and liver hydatid cysts are seen, this is the first case of a cardiac hydatid cyst in Bhutan. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case illustrates the importance of POCUS in reaching a diagnosis, particularly in resource-poor areas where other sophisticated diagnostic tools are not easily available. A cardiac hydatid cyst must be in the differential for structural causes of dysrhythmias. This is especially so because treatment of unstable dysrhythmias in the acute setting of an emergency department has to be modified from the usual algorithm in the presence of a cardiac hydatid cyst, due to the potentially fatal risk of cyst rupture and anaphylaxis.
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Injuries from multiple magnet ingestions in the pediatric population have been increasing in both incidence and morbidity. This trend will likely continue after a 2017 court ruling that overturned a ban on the sale of magnet sets marketed as "adult desk toys." Depending on the arrangement of the ingested magnets in the gastrointestinal tract, the consequences can range from benign to life threatening. ⋯ This article uses cases and illustrative medical imaging to describe the most common scenarios and their management. This is especially relevant considering recent U.S. court rulings that overturned the U.S. Consumer Product Safety Commission's ban on the sale of toys containing multiple miniature magnets.
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Randomized Controlled Trial
Patient Navigation to Reduce Emergency Department (ED) Utilization Among Medicaid Insured, Frequent ED Users: A Randomized Controlled Trial.
Some Medicaid enrollees frequently utilize the emergency department (ED) due to barriers accessing health care services in other settings. ⋯ An ED-PN program targeting Medicaid-insured high ED utilizers demonstrated significant reductions in ED visits and hospitalizations in the 12 months after enrollment.
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Randomized Controlled Trial
Reducing Pain During Emergency Arterial Sampling Using Three Anesthetic Methods: A Randomized Controlled Clinical Trial.
Taking a sample of arterial blood is widely reported as a cause of significant pain. ⋯ The results of this study encourage the use of anesthetic methods like cryoanalgesia or mepivacaine for their proven effectiveness in reducing or eliminating pain during arterial puncture.