Biomedical subjects
Publications and source records attributed to K C Jackimczyk.
The emergent treatment of dysrhythmias in the ED continues to evolve. Classic medications such as bretylium and lidocaine are given with newer drugs like amiodarone, ibutilide, and sotalol. Studies in progress will examine their efficacy in the ED. The emergency physician must keep abreast of the growing body of literature.
A variety of pearls, pitfalls, and updates related to the extremities and spine are discussed. Tricks of the trade regarding shoulder dislocations, easily missed fractures, radial head subluxation, and the approach to deep lacerations are discussed. In the pitfall section, potential difficulties in the evaluation of suspected nonaccidental trauma, compartment syndromes, partial cord syndromes, and hip pain in children are discussed. Finally, new information regarding cost-effective evaluation of knee and ankle injuries, as well as advances in ultrasound evaluation of shoulder and extremity injuries, is presented in the clinical updates section.
We report an unintentional thiopental-facilitated interview in a patient presenting with apparent respiratory failure as a manifestation of Munchausen's syndrome. Unnecessary intubation was avoided and correct diagnosis was made using the thiopental interview. Patients with suspected Munchausen's syndrome represent a difficult dilemma for the emergency physician. Use of the barbiturate-facilitated interview in the emergency department may reveal the diagnosis and prevent unnecessary procedures and hospitalization.