Using portable ultrasound, EMTs correctly detected the presence or absence of simulated long bone fractures with a high degree of sensitivity and specificity. Future studies may evaluate the ability of other groups to use ultrasound to assist in the diagnosis of fractures and examine the clinical impact of this skill in environments where conventional imaging modalities are limited or unavailable.
SUMMARYLoperamide is a common over-the-counter antidiarrheal considered safe in a broad range of dosages and thought devoid of abuse potential. We describe the first case of a patient with loperamide dependence due to misuse of its opiate-like effects achieved by chronic massive oral ingestions. A 26-year-old man who was taking 800 mg of loperamide per day presented requesting detoxification referral. Loperamide has potential for euphoric effects and information on how to facilitate such effects is easily available. It is important for physicians to be aware of the potential for misuse of and dependence on loperamide, with symptoms mimicking opiate use.
BACKGROUND
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