scholarly journals Flushing of an intravenous catheter

2019 ◽  
Vol 29 (3) ◽  
pp. 614-618
Author(s):  
Rutger C.C. Hengeveld ◽  
Bianca E. Olofsen ◽  
Edmée C. van Dongen-Lases ◽  
Peter A. Leenhouts ◽  
Victor F.H.A. Hakkenberg van Gaasbeek ◽  
...  
Keyword(s):  
Emergency Department ◽  
Renal Function ◽  
Case Report ◽  
Sodium Chloride ◽  
Continuous Infusion ◽  
Intravenous Catheter ◽  
Blood Samples ◽  
Close Proximity ◽  
Laboratory Results ◽  
Life Threatening

Introduction: Phlebotomy is an error-prone process in which mistakes are difficult to reveal. This case report describes the effect on laboratory results originating from a blood sample collected in close proximity to an intravenous catheter. Materials and methods: A 69-year-old male patient was referred to the Emergency department where pneumonia was suspected. Phlebotomy was performed to collect blood samples to assess electrolytes, renal function, liver function, infection and haematological parameters. Results: The laboratory analysis showed reduced potassium and calcium concentrations. To prevent life-threatening cardiac failure the clinician decided to correct those electrolytes. Remarkably, the electrocardiogram showed no abnormalities corresponding to hypokalaemia and hypocalcaemia. This observation, in combination with an overall increase in laboratory parameters with the exception of sodium and chloride, led to the suspicion of a preanalytical error. Retrospectively, an intravenous catheter was inserted in close proximity of the puncture place but no continuous infusion was started prior to phlebotomy. However, the intravenous catheter was flushed with sodium chloride. Since potential other causes were excluded, the flushing of the intravenous catheter with sodium chloride prior to phlebotomy was the most probable cause for the deviating laboratory results and subsequently for the unnecessary potassium and calcium suppletion. Conclusion: This case underlines the importance of caution in the interpretation of laboratory results obtained from specimens that are collected in the proximity of an intravenous catheter, even in the absence of continuous infusion.

scholarly journals Thermal burns in electroconvulsive therapy

2021 ◽  
pp. 201010582110310
Author(s):  
Ernest Weisheng Ho ◽  
Eng Leonard ◽  
Lee Tih-Shih ◽  
Gregory James Meredith
Keyword(s):  
Case Report ◽  
Mood Disorders ◽  
Electroconvulsive Therapy ◽  
Ignition Source ◽  
Thermal Burns ◽  
High Impedance ◽  
Temporal Placement ◽  
Close Proximity ◽  
Life Threatening

Electroconvulsive therapy (ECT) is effective for mood disorders and schizophrenia. Thermal burns, while rare, are potentially sight and life threatening. The three elements necessary for a fire are often in close proximity during a session: an oxidiser (oxygen), an ignition source (faulty electrodes, poor contact with skin producing a spark) and fuel (hair, residual alcohol cleanser). This case report describes one such incident when a patient sustained a burn during ECT, with poor contact of electrode pad with skin, high impedance and an oxygen-rich environment possibly contributing. Given that ECT is conducted relatively frequently (once every 2–3 days) in a usual regimen, we make recommendations for safe application of electrode pads for temporal placement ECT.

scholarly journals Life–threatening Pulmonary Oedema Secondary to Tracheal Compression

2002 ◽  
Vol 30 (6) ◽  
pp. 804-806 ◽  
Author(s):  
H. Butterell ◽  
R. H. Riley
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Airway Obstruction ◽  
Pulmonary Oedema ◽  
Negative Pressure ◽  
Upper Airway ◽  
Tracheal Compression ◽  
Negative Pressure Pulmonary Oedema ◽  
Life Threatening ◽  
Thyroid Goitre

We present a case of negative pressure pulmonary oedema due to an overlooked cause. A 45-year-old female patient presented to the emergency department unconscious with severe pulmonary oedema. Subsequent investigations revealed a thyroid goitre causing significant tracheal compression. This case report highlights an extremely rare but potentially dangerous sequela of upper airway obstruction.

scholarly journals Case report: MRI findings of acute uremic encephalopathy in a 1-year-old boy

2021 ◽  
pp. 20210057
Author(s):  
Amar Ajay Chotai ◽  
Dipayan Mitra
Keyword(s):  
Emergency Department ◽  
Renal Function ◽  
Case Report ◽  
Extracellular Potassium ◽  
Neurological Abnormality ◽  
Normal Range ◽  
Mri Findings ◽  
Intracellular Space ◽  
History Of ◽  
Function Profile

We present a 1-year-old boy who presented to the emergency department with a 7-day history of diarrhoea and vomiting. The initial renal function profile demonstrated a urea of 55 mmol l−1 (normal range between 5 and 20 mmol l−1), creatinine 695 micromol/L (normal range between 62–106 micromol/L) and potassium 9.1 mmol l−1 (normal range between 3.5–5.0 mmol l−1), with a profound metabolic acidosis. Upon examination, there were no significant findings, specifically no neurological abnormality. He was prescribed back-to-back Salbutamol nebulisers, to increase the shift of extracellular potassium into the intracellular space, followed by i.v. calcium gluconate, with some improvement in potassium levels. A further 5 mmol of sodium bicarbonate was given, as well as a stat dose of 1 mg/kg furosemide, and per rectal calcium resonium. He was then commenced on an infusion with 10% dextrose with insulin. He was subsequently found to be in urinary retention and a catheter was inserted, which drained 1700 ml. A subsequent renal function profile, 24 hours after admission, demonstrated improvement with urea 39 mmol l−1, creatinine 300 micromol/L and potassium 3.0 mEq/L.

scholarly journals Spontaneous Heterotopic Pregnancy: Case Report and Literature Review

Medicina ◽  
2020 ◽  
Vol 56 (8) ◽  
pp. 365 ◽  
Author(s):  
Miglė Černiauskaitė ◽  
Brigita Vaigauskaitė ◽  
Diana Ramašauskaitė ◽  
Mindaugas Šilkūnas
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Laboratory Tests ◽  
Heterotopic Pregnancy ◽  
Fallopian Tubes ◽  
Lower Abdomen ◽  
Healthy Baby ◽  
Extrauterine Pregnancy ◽  
Threatening Condition ◽  
Life Threatening

Heterotopic pregnancy is defined as a condition when intrauterine and extrauterine pregnancy occur simultaneously. It is a life-threatening condition that requires immediate and accurate diagnostics and treatment. We present a case of a 28-year-old primigravida female who conceived spontaneously and at her seventh week of gestation and was presented to the emergency department with weakness and acute pain in lower abdomen. Laboratory tests and transvaginal ultrasonography revealed the diagnosis of heterotopic pregnancy. Urgent laparoscopic salpingotomy was chosen as a treatment option. The ectopic pregnancy was successfully removed with the preservation of the intrauterine embryo and fallopian tubes. The course of pregnancy after the surgery was without complications, and a healthy baby was delivered at the 39th week of gestation. When treated properly and on time, a heterotopic pregnancy can result in live childbirth with favorable outcomes for both the child and the mother.

scholarly journals An Unusual Presentation of Postpartum Spontaneous Coronary Artery Dissection

2019 ◽  
Vol 3 (3) ◽  
pp. 228-232
Author(s):  
Jonathan Alterie ◽  
Francis Villanueva ◽  
Mohamed Arekat ◽  
April Brill
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Coronary Artery ◽  
Cardiac Biomarkers ◽  
Artery Dissection ◽  
Spontaneous Coronary Artery Dissection ◽  
Chest Discomfort ◽  
Coronary Artery Dissection ◽  
Life Threatening ◽  
Multiparous Female

The postpartum population is one with a unique physiologic profile that predisposes these patients to rare and often life-threatening conditions. Herein, we discuss a case of a 37-year-old, multiparous female who presented to the emergency department with vague chest discomfort 14 days after delivering her sixth child via vaginal delivery. The patient was found to have elevated cardiac biomarkers and was ultimately diagnosed with pregnancy-related spontaneous coronary artery dissection (P-SCAD). This case report discusses the evaluation, pathophysiology, workup, and management of P-SCAD.

scholarly journals Case Report of Necrotizing Fasciitis Associated withStreptococcus pneumoniae

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Lei Jiao ◽  
Zain Chagla ◽  
Reham Mohammedsaeed Kaki ◽  
Gabriela Gohla ◽  
Marek Smieja
Keyword(s):  
Case Report ◽  
Streptococcus Pneumoniae ◽  
Necrotizing Fasciitis ◽  
Neutrophil Infiltration ◽  
Skin Lesions ◽  
Blood Samples ◽  
Surgical Exploration ◽  
Lower Back ◽  
Life Threatening ◽  
The Right

Necrotizing fasciitis, caused byStreptococcus pneumoniae, is an extremely rare and life-threatening bacterial soft tissue infection. We report a case of early necrotizing fasciitis associated withStreptococcus pneumoniaeinfection in a 26-year-old man who was immunocompromised with mixed connective tissue disease. The patient presented with acute, painful, erythematous, and edematous skin lesions of his right lower back, which rapidly progressed to the right knee. The patient underwent surgical exploration, and a diagnosis of necrotizing fasciitis was confirmed by pathological evidence of necrosis of the fascia and neutrophil infiltration in tissue biopsies. Cultures of fascial tissue biopsies and blood samples were positive forStreptococcus pneumoniae. To our knowledge, this is the first report of necrotizing fasciitis resulting fromStreptococcus pneumoniaediagnosed at early phase; the patient recovered well without surgical debridement.

scholarly journals Refractory Status Epilepticus Following Ingestion of Organochlorine Pesticide Endosulphan- A Case Report

1970 ◽  
Vol 1 (1) ◽  
pp. 59-61
Author(s):  
S Bhattarai ◽  
SC Kohli
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Status Epilepticus ◽  
Continuous Infusion ◽  
Organochlorine Pesticide ◽  
Refractory Status Epilepticus ◽  
High Morbidity ◽  
Medical Sciences ◽  
Refractory Status ◽  
Appropriate Treatment

A 22 years old female was brought to emergency department of Manipal teaching hospital, Pokhara, Nepal with suicidal consumption of 35 grams of endosulphan .She presented with status epilepticus not responding to intravenous benzodiazepine, loading doses of phenytoin and phenobarbitone and was managed by intravenous propofol and subsequently with continuous infusion of midazolam. Refractory status epilepticus is a common problem following ingestion of endosulphan and unless aggressively treated, it is associated with high morbidity and mortality. Endosulphan poisoning is often completely reversible with immediate and appropriate treatment. Keywords: Endosulphan poisoning; seizure; refractory status epilepticus; benzodiazepine; propofol. DOI: http://dx.doi.org/10.3126/njms.v1i1.5801   Nepal Journal of Medical Sciences. 2012; 1(1): 59-61

scholarly journals Life-threatening Anemia Diagnosis Due to Myoma Uteri in the Emergency Department: A Case Report

2019 ◽  
pp. 24-25
Author(s):  
Abdullah Algin ◽  
İsmail Tayfur ◽  
Mustafa Ahmet Afacan ◽  
Şahin Çolak ◽  
Mehmet Sarıaydın ◽  
...  
Keyword(s):  
Emergency Department ◽  
Case Report ◽  
Life Threatening ◽  
Myoma Uteri

Benign asymptomatic pneumoperitoneum in the patient after CT colonography

2021 ◽  
Vol 75 (2) ◽  
pp. 165-169
Author(s):  
Radim Gerstberger ◽  
Matej Straka ◽  
Jiří Pánek ◽  
Filip Marek ◽  
Lumír Kunovský ◽  
...  
Keyword(s):  
Case Report ◽  
Ct Colonography ◽  
Rare Case ◽  
Abdominal Cavity ◽  
Free Air ◽  
Laboratory Results ◽  
Life Threatening ◽  
Low Incidence ◽  
Carbon Dioxide Co2 ◽  
Degrees Of Severity

Pneumoperitoneum is a condition that refers to the presence of free air (gas) in the abdominal cavity. Differential diagnosis of the causes of pneumoperitoneum varies widely and represents varying degrees of severity. In the patients who have not recently underwent laparotomy or laparoscopy, the finding of pneumoperitoneum is usually a sign of gastrointestinal perforation that requires immediate surgical approach due to the risk of peritonitis with subsequent life-threatening sepsis. However, not all causes of pneumoperitoneum require surgery. In our case report, we present a rare case of clinically asymptomatic pneumoperitoneum that developed in a 66-year-old patient after CT colonography. In this diagnostic method, we inflate colon with carbon dioxide (CO2 ); therefore this kind of pneumoperitoneum can de facto be called capnoperitoneum. In this patient, free air (gas) in the abdominal cavity manifested itself in the so-called benign pneumoperitoneum, which is defined as asymptomatic free air in the abdominal cavity and pneumoperitoneum without peritonitis. Despite the fact that CT colonography is considered a method with a very low incidence of complications, it is necessary to take into account the presence of risk factors in its indication and to contraindicate to avoid the number of postoperative complications. The fundamental message of our case report is that extensive pneumoperitoneum after proven CT colonography can be asymptomatic and can be treated conservatively (if clinical and laboratory results are favorable).

scholarly journals Spontaneous Isolated Celiac Artery Dissection: A Case Report

2020 ◽  
Vol 4 (3) ◽  
pp. 414-416
Author(s):  
Clifford Freeman ◽  
Aaron Lacy ◽  
Aubrey Miner ◽  
Devin Rogers ◽  
Austin Smith ◽  
...  
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Case Report ◽  
Celiac Artery ◽  
Chief Complaint ◽  
Diagnostic Tools ◽  
Artery Dissection ◽  
Emergency Physicians ◽  
Threatening Condition ◽  
Life Threatening

Introduction: Abdominal pain is a common chief complaint that can represent a wide breadth of diagnoses, ranging from benign to life-threatening. As our diagnostic tools become more sophisticated, we are able to better identify more causes of potentially life-threatening diseases. One such disease that is relatively unfamiliar to clinicians is spontaneous isolated celiac artery dissection (SICAD). Case Report: We describe a case of a 46-year-old man who presented to our emergency department with a chief complaint of abdominal pain and was found to have a SICAD and was successfully treated with anticoagulation, antihypertensives, and observation. Conclusion: It is important for emergency physicians to keep this potentially life-threatening condition in mind and to know the appropriate first steps once identified.

Sign in / Sign up

Export Citation Format

Share Document