Abdominal pain and collapse in the emergency department.

Rupture of a splenic artery aneurysm is a rare but life-threatening presentation to the emergency department. This case demonstrates the importance of swift resuscitation and the benefit of bedside imaging in a highly unstable patient. The definitive management of this condition in patients who are refractory to resuscitative attempts is immediate surgery with the diagnosis often only confirmed at laparotomy.

Morbidity in adults with a normal limited scaphoid MRI: a retrospective cohort study and follow-up questionnaire.

Introduction: The scaphoid bone is the most commonly fractured carpal bone. MRI is now recognised to be more sensitive and specific than serial plain films in the diagnosis of occult scaphoid fracture. What is not known is whether it is safe to discharge, without follow-up, those with a normal limited extremity MRI.

Carotid sinus massage: is it a safe way to terminate supraventricular tachycardia?

A 63-year-old women with a history of palpitations presented to the emergency department with a supraventricular tachycardia; the patient was cardiovascularly stable. Carotid sinus massage (CSM) was performed to help identify the underlying rhythm. During massage the patient had an immediate cerebrovascular accident, resulting in a left hemiplegia.

Tension pneumothorax secondary to automatic mechanical compression decompression device.

The details are presented of the first published case of a tension pneumothorax induced by an automatic compression-decompression (ACD) device during cardiac arrest. An elderly patient collapsed with back pain and, on arrival of the crew, was in pulseless electrical activity (PEA) arrest. He was promptly intubated and correct placement of the endotracheal tube was confirmed by noting equal air entry bilaterally and the ACD device applied.