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Biomedical subjects

G M Garmel

Publications and source records attributed to G M Garmel.

10 recordsLinked to original sources
PubMed1999

Acute urinary retention due to ectopic pregnancy.

Two cases of ectopic pregnancy are presented in which acute urinary retention was a salient clinical feature. The emergency physician must consider ectopic pregnancy in the differential diagnosis in any woman of child-bearing age with abdominal, pelvic, or urinary complaints.

Abdominal Pain↗
PubMed1995

Development of ventricular fibrillation after intravenous calcium chloride administration in a patient with supraventricular tachycardia.

The i.v. administration of calcium before or shortly after treatment of supraventricular tachycardia with verapamil has been suggested to counteract a hypotensive response to verapamil. We discuss the case of a patient who presented to the emergency department with an accelerated wide-complex tachycardia and minimal symptoms. Immediately after i.v. administration, of 1 g calcium chloride as pretreatment for verapamil administration, ventricular fibrillation developed. Emergency physicians should be aware of potential dangers after the administration of i.v. calcium preparations when trying to prevent known hypotensive side effects of i.v. verapamil administration.

Calcium Chloride↗
PubMed1994

Environment-dependent sports emergencies.

As more individuals participate in sports and outdoor activities, the frequency of environmentally related illnesses will increase. Participants in sporting events of long duration and those requiring particularly inclement weather and adverse conditions are especially prone to developing injury. Hypothermia, heat-related illnesses, and high-altitude illnesses are multisystem emergencies that require immediate, specific therapeutic maneuvers. Physicians must be able to recognize the signs and symptoms of these medical emergencies and institute definitive care. Rapid core rewarming, airway control, and prolonged cardiopulmonary resuscitation are the key factors in managing the hypothermic patient. Adequate cooling and volume resuscitation provide the basis for treating the hyperthermic patient. The patient with high altitude-related illness should be returned to a lower elevation and given supplemental oxygen. Specific intervention depends on the patient's presentation. Environmental illnesses cause severe morbidity and mortality and are frequently within the control of the sport participant. Thus physicians must educate their patients on basic preventive measures if they are going to participate in outdoor sporting activities.

Altitude Sickness↗
PubMed1993

Hysterical stridor: a diagnosis of exclusion.

Two stridorous patients who presented to the emergency department with respiratory distress are discussed. Thorough history, physical examination, and direct visualization of the larynx failed to detect any anatomical upper airway abnormalities; therefore, the etiology of airway obstruction in both patients was determined to be psychogenic. Stridor caused by psychogenic causes is uncommon and, probably, underrecognized. Stridor caused by structural and pathological causes must be considered and excluded before it can be attributed to psychogenic causes, thereby making this a diagnosis of exclusion.

Adult↗
PubMed1992

Tonic status epilepticus: an unusual presentation of unresponsiveness.

We report an unusual cause of unresponsiveness in a 73-year-old woman seen in the emergency department. Extensive evaluation, including an emergency EEG that demonstrated rhythmic, high-voltage spike-and-wave discharges characteristic of convulsive activity, confirmed the diagnosis of generalized tonic status epilepticus. The patient's persistent subclinical seizures terminated after the IV administration of diazepam. Varying presentations of generalized tonic status epilepticus have been described in the neurology literature, with EEG confirmation of this diagnosis. Review of the emergency medicine literature does not describe a similar presentation of altered mental status in the adult population. This case illustrates one necessary role for ED EEG in the identification of occult status epilepticus causing altered mental status.

Aged↗
PubMed1992

Didelphic uterus and unilaterally imperforate double vagina as an unusual presentation of right lower-quadrant abdominal pain.

Imperforate hymen should be considered in girls of menarcheal age with a history of amenorrhea and vague abdominal discomfort, particularly if associated with symptoms of urinary obstruction or constipation. Patients may present with severe dysmenorrhea and localized pain mimicking appendicitis if hematocolpometra is due to unilaterally imperforate hymen with duplicate vagina and didelphic uterus. Although this condition is exceedingly rare, the case presented stresses the importance of a careful history and physical examination of an adolescent girl presenting with symptoms of abdominal pain associated with menstruation.

Abdominal Pain↗
PubMedDate not supplied

Objectives to direct the training of emergency medicine residents on off-service rotations: neurology.

This is the twenty-first article in a continuing series of objectives to direct resident training in emergency medicine. Presented is a set of objectives with references for curriculum goals in neurology. Knowledge of neurology and clinical skills in diagnosing neurological illness is important in the practice of emergency medicine. Not all emergency residents have adequate exposure to the subspecialty of neurology. Many residents who have exposure to a neurology elective often spend only two weeks on the service. Therefore, a clear set of goals and objectives is essential for the resident to obtain a comprehensive knowledge of this complex specialty.

Curriculum↗