Local anesthetics are drugs that are commonly used by physicians in simple interventional procedures. O-toluidine, a degradation product of the local anesthetic agent prilocaine, oxidizes hemoglobin and may cause methemoglobinemia. Normally, hemoglobin is comprised of 1% to 2% methemoglobin in the human body [1]. In this study, we presented a case of methemoglobinemia after local anesthesia with prilocaine, including clinical findings of respiratory distress in the early period.American Journal of Emergency Medicine xxx (2014) xxx-xxx 0735-6757/
We analyzed the data on the seasonal variation, demographic characteristics and symptoms of the cases. Results: Six hundred and forty-eight patients were reported to emergency department, where 60% of them were female. Mean age of female and male were 39.7 ± 18.7 and 41.3 ± 19.4 years, respectively. Most of the poisonings occurred in autumn (51.4%). Abdominal pain was the most common sign (44.4%) followed by diarrhea (30.6%), nausea (9.3%), anorexia (9.3%), vomiting (5.6%) and weakness (0.9%). Conclusion: Mushroom poisoning still remains as an important public health problem. Mushroom poisoning in Bolu and around were mostly diagnosed in patients younger than 40 years and in autumn. Most of the patients recovered without any problems. Anahtar Kelimeler: Acil servis, mantar zehirlenmesi, demografik.
Aim: The utility of ultrasound in assisting with the presentation of undifferentiated shock is becoming widely accepted as an invaluable tool with triaging both etiology and treatment. We believe this case highlights the utility of ultrasound in assisting with the clinical care of patients with anaphylactic shock. Case:Here, we present a 29-year-old man with no medical history, who was brought to our emergency department (ED) as intubated due to unconsciousness, hypotension, severe dyspnea and pruritus. On arrival to our ED, his pulse was filiform, and his extremities were cold and cyanotic. FAST examination to rule out trauma revealed anechoic cysts in liver. His abdominal CT revealed ruptured pouch of a hydatid cyst. He was admitted to ICU after 2-day follow up in the surgery clinics. He was discharged with full recovery. Conclusion:In conclusion, when critically ill patients with undifferentiated shock present in areas where animal husbandry is common, anaphylaxis due to hydatid cyst rupture should be kept in mind. Given the age, local agricultural practices, and presentation of distributive shock with concomitant liver cysts on ultrasonography we were able to triage the patient to abdominal computerized tomography scan and ultimately to definitive treatment.
Nervus abdusens lezyonu yaralanmaya eğilimi nadir olup genelde aniden gelişen kafa travmasından sonra meydana gelmektedir. 11.01.2014 tarihinde iş kazasına bağlı yüksekten düşme hikayesi olan 43 yaşında bir hasta sunduk. Kraniyal tomografisinde bilateral epidural hematom saptanmıştı. Epidural hematom cerrahi olarak boşaltıldı. Cerrahiden sonraki göz muayenesinde bilateral lateral bakış kısıtlılığı dışında görme kaybı saptanmadı. Diplopi nedeniyle hasta yürüyemeyince hastaya tek gözünü kapatması tavsiye edildi. Sağ yüzünde santral fasiyal sinir ve bilateral abdusens sinir paralizisi bulguları vardı. Kafa travmasından sonra birden fazla kraniyal sinir hasarı olabilir. Bu yüzden tüm kraniyal sinir muayeneleri ayrıntılı biçimde yapılmalıdır.Anahtar Kelimeler: kraniyal sinir, abdusens paralizi, fasiyal paralizi Lesions of the nervus abducens, the 6th cranial nerve tend to be rare, usually occur suddenly following head injuries. A 43-year-old male patient presented with a history of fall from a height due to an occupational accident on the date of 11.01.2014. Cranial tomography demonstrated bilateral epidural hematoma.The epidural hematoma was drained during the operation. After the surgery, eye examination showed no vision loss, except limited bilateral lateral gaze.When the patient was unable to walk due to diplopia, he was advised to close one eye. On the right side, there were findings suggesting central facial paralysis. There may be multiple cranial nerve damage following head injury.Therefore, all cranial nerves should be thoroughly examined.
Amaç: Yanık nedeniyle acil servisimize başvurup yatarak tedavi edilen hastaların epidemiyolojik özelliklerinin araştırılması amaçlandı. Yöntem: Şanlıurfa Eğitim ve Araştırma Hastanesi acil servisine 01.01.2012-31.12.2012 tarihleri arasında yanık nedeniyle başvurup yatırılarak tedavi verilen 636 hastanın bilgileri geriye dönük olarak tarandı. Hastaların yaşı, cinsiyeti, yanık nedenleri, anatomik olarak yanık lokalizasyonları, toplam yanan vücut yüzey alanları, akıbetleri, yattıkları servisler ve yatış süreleri ile ilgili veriler kaydedilerek analizi yapıldı. Bulgular: Çalışmaya dahil edilen hastaların 383 (%60.2)' ü erkek idi. Yaş ortalamaları 10.8 idi. Yanıkların 441 (%69.4)' i sıcak sıvılar ile gelişmişti. Hastaların 568 (%89,3)' unda 2-3. derece yanık mevcuttu. Hastaların ortalama yanan vücut yüzey alanı %14.72 idi. En sık yanığa maruz kalan vücut bölgesi üst ekstremitelerdi. Sonuç: Yanıklar daha çok erkeklerde ve çocuklarda görülmektedir. Ekstremiteler yanıktan diğer bölgelere göre daha fazla etkilenmektedir. Yanıkların çoğu sıcak sıvılara bağlı olup, yoğun bakıma yatış en sık elektrik yanıklarında görülmektedir. Objective: The aim of this study is to search the epidemiologic characteristics of burns in the patients that are admitted with burn to the emergency department and hospitalized. Method: The hospital records of 636 patients that are admitted with burn to the emergency department in 2012 and hospitalized in Sanlıurfa Education and Research Hospital, were investigated. Age, sex, burn causes, burn degree, anatomic localizations of burns, burn rate, and hospitalization duration were examined. Results: 383 (60,2%) of the patients were male. The mean age was 10,8. 441 (69,4%) of the burns were aroused from hot liquids. 568 of the patients had 2 to 3 degree burns. Mean burned body area was 14.72%. The most seen burn location was upper extremities. Conclusion: Burns are seen mostly in men and children. Extremities are effected more than other parts of the body. Burns are mostly caused by hot liquids and the most frequent cause of burn that should be followed in intensive care unit was electrical injuries.
Kalsiyum kanal blokeri; hipertansiyon, aritmi ve koroner kalp hastalıklarında kullanılan, hücre zarında bulunan L tipi kalsiyum kanallarını bloke eden ilaçlardır. Yüksek konsantrasyonlarda kalsiyum kanalları bloke olur ve L tipi kanallardan kalsiyum girişi tamamen engellenir. Yazımızda yüksek doz kalsiyum kanal blokeri alım sonrasında acil servise başvuran hastanın taburculuğuna kadar olan dönemdeki klinik durumundaki değişimler ve tedavi yaklaşımlarının sunulması amaçlanmıştır.Calcium channel blockers are drugs used in hypertension, arrhythmia and coronary heart diseases by blocking L type calcium channels. At high concentrations, calcium channels are blocked and calcium entry from L type channels is totally prevented.. In our study, we aimed to present the changes and the treatment approaches for the hospitalization period of a patient who applied to the emergency unit following the intake of high dose of calcium channel blocker, until the discharge.
A difficult intensive care unit monitorization case: a suicidal attempt at 13 years of age by hanging Suicide among young population is a global challenge increasing over time. Family problems, drug addiction, increased risk of childhood depression may lead to suicidal attempts by hanging with a rope, which is a rarely selected method at younger ages. Increased suicidal attempt rates cause increased rates of intensive care unit monitorization. Psychosocial support is quite important at this age group. In this report, a 13 years old girl, who was monitorized at the intensive care unit after she attempted suicide by hanging, would be discussed. Psikososyal destek bu yaş gruplarında oldukça önemlidir. Bu sunumda onüç yaşında ası ile özkıyım girişimi sonrası yoğun bakımda takip edilen bir kız çocuğu tartışılacaktır.
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