Clinical Images in Emergency Medicine: Cushing's Disease.

Case Presentation: A 22-year-old female presented to the emergency department with a two-month history of worsening fatigue, unintentional weight gain, and progressive facial swelling. Physical examination findings included hirsutism, moon facies, and abdominal striae. Subsequent brain magnetic resonance imaging revealed the presence of a 2.

The lifesaving potential of specialized on-scene medical support for urban tactical operations.

Since the 1980s, the specialized field of tactical medicine has evolved with growing support from numerous law-enforcement and medical organizations. On-scene backup from tactical emergency medical support (TEMS) providers has not only permitted more immediate advanced medical aid to injured officers, victims, bystanders, and suspects, but also allows for rapid after-incident medical screening or minor treatments that can obviate an unnecessary transport to an emergency department. The purpose of this report is to document one very explicit benefit of TEMS deployment, namely, a situation in which a police officer's life was saved by the routine on-scene presence of specialized TEMS physicians.

Conductive electrical devices: a prospective, population-based study of the medical safety of law enforcement use.

Background: To examine police compliance with policies for the proper use of conductive electrical devices (CEDs) and, in turn, track any associated medical events following CED application.

Methods: Prospective, population-based, 15-month study of police activations of CEDs after their introduction into the police force of a large U.S.

Recurrent life-threatening ventricular dysrhythmias associated with acute hydrofluoric acid ingestion: observations in one case and implications for mechanism of toxicity.

Introduction: Hydrofluoric acid (HF) is a weak inorganic acid used for etching and as rust remover. Systemic toxicity is manifested as ventricular dysrhythmias. The mechanisms for these dysrhythmias are not well elucidated.

Retinal detachment diagnosed by bedside ultrasound in the emergency department.

This case study describes a patient who presented with vague visual complaints in the right eye, decreased visual acuity in the affected eye, and a difficult initial eye evaluation, including fundoscopic and slit lamp examinations, in the emergency department (ED). The preliminary finding included a darkened-appearing area of the retina on fundoscopic exam. The patient subsequently had bedside sonography of the eyes done by an emergency medicine (EM) intern which revealed a thin and serpentine strip appearing as a hyperechoic representation of the retina floating freely into the vitreous from the superior-lateral section of the posterior globe.

Mechanical devices for cardiopulmonary resuscitation.

Purpose Of The Review: For over 40 years, manual chest compressions have been the foundation of cardiopulmonary resuscitation and recent studies have clearly reconfirmed the hemodynamic significance of delivering consistent, high-quality, infrequently-interrupted chest compressions. However, there remain multiple inadequacies in the actual delivery of manual chest compressions during cardiopulmonary resuscitation. One potential solution is use of adjunct mechanical devices.

Serotonin syndrome with elevated paroxetine concentrations.

Objective: To describe a case of serotonin syndrome due to paroxetine and ethanol.

Case Summary: A 57-year-old white man was brought to the emergency department one day after ingesting paroxetine 3600 mg and a pint of hard liquor. He denied the use of any other drug or herbal products and regular use of alcohol.

Death by quinine.

We report a case of a man with a 9.75 g ingestion of quinine. The patient presented with recurrent pulseless wide complex tachycardia for which he received sodium bicarbonate, defibrillation and overdrive mechanical pacing.

Role of the physician in prehospital management of trauma: North American perspective.

To some extent or another, physicians have been involved in emergency medical services (EMS) systems in North America for decades. Over the years, physicians from different specialties have been involved with EMS, occasionally as full-time or part-time employees of the EMS system but more often on a voluntary or small contractual basis. Regardless of the employment relationship, most states and provinces now require by statute that each EMS system, particularly those providing advanced life support (ALS) services, have a designated EMS medical director.