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"Sodium Bicarbonate" AND "Emergency"

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https://www.readbyqxmd.com/read/30043448/ear-drops-for-the-removal-of-ear-wax
#1
REVIEW
Ksenia Aaron, Tess E Cooper, Laura Warner, Martin J Burton
BACKGROUND: Ear wax (cerumen) is a normal bodily secretion that can become a problem when it obstructs the ear canal. Symptoms attributed to wax (such as deafness and pain) are among the commonest reasons for patients to present to primary care with ear trouble.Wax is part of the ear's self-cleaning mechanism and is usually naturally expelled from the ear canal without causing problems. When this mechanism fails, wax is retained in the canal and may become impacted; interventions to encourage its removal may then be needed...
July 25, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29978296/severe-ketoacidosis-in-a-patient-with-spinal-muscular-atrophy
#2
Bassel Lakkis, Alissar El Chediak, Jana G Hashash, Sahar H Koubar
Spinal muscular atrophy (SMA) is a genetic neuromuscular disease characterized by progressive muscle weakness and atrophy. We report a case of a 36-year-old man with SMA type 3 who presented to our emergency department with epigastric pain and vomiting. He was found to have severe ketoacidosis on laboratory evaluation. The patient's symptoms and ketoacidosis resolved after dextrose infusion and a relatively small amount of sodium bicarbonate infusion. Given the severity of the ketosis that seemed inconsistent with moderate starvation alone, we postulate that there must have been other contributing factors besides moderate starvation that might explain the severity of acidosis in this particular patient...
July 5, 2018: CEN Case Reports
https://www.readbyqxmd.com/read/29973999/central-pontine-myelinolysis-in-pediatric-diabetic-ketoacidosis
#3
Hannah Kinoshita, Leon Grant, Konstantine Xoinis, Prashant J Purohit
Central pontine myelinolysis (CPM) is rarely reported in pediatric patients with diabetic ketoacidosis (DKA). We report this case of a 16-year-old female with new onset diabetes presenting with DKA, who received aggressive fluid resuscitation and sodium bicarbonate in the emergency department. Later she developed altered mental status concerning for cerebral edema and received hyperosmolar therapy with only transient improvement. Soon she became apneic requiring emergent endotracheal intubation. MRI brain showed cerebral edema, CPM, and subdural hemorrhage...
2018: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29850134/sodium-bicarbonate-on-severe-metabolic-acidosis-during-prolonged-cardiopulmonary-resuscitation-a-double-blind-randomized-placebo-controlled-pilot-study
#4
Shin Ahn, Youn-Jung Kim, Chang Hwan Sohn, Dong Woo Seo, Kyoung Soo Lim, Michael W Donnino, Won Young Kim
Background: Sodium bicarbonate administration during cardiopulmonary resuscitation (CPR) is controversial. Current guidelines recommend sodium bicarbonate injection in patients with existing metabolic acidosis, but clinical trials, particularly, those involving patients with acidosis, are limited. We aimed to evaluate the efficacy of sodium bicarbonate administration in out-of-hospital cardiac arrest (OHCA) patients with severe metabolic acidosis during prolonged CPR. Methods: Prospective, double-blind, randomized placebo-controlled pilot trial was conducted between January 2015 and December 2015, at a single center emergency department (ED)...
April 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29746361/prolonged-qrs-widening-after-aripiprazole-overdose
#5
Maryann Mazer-Amirshahi, Robert Porter, Kayla Dewey
BACKGROUND: Aripiprazole is an atypical antipsychotic with a long half-life. Overdose can result in protracted somnolence and cardiac disturbances, particularly QT interval prolongation. METHODS: This is a single case report of a 14-year-old boy who took an overdose of aripiprazole and developed QRS widening. CASE: A 14-year-old boy intentionally ingested 20 tablets of aripiprazole (5 mg). He was brought to the emergency department when his ingestion was discovered...
May 5, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29698339/disparities-in-adherence-to-pediatric-diabetic-ketoacidosis-management-guidelines-across-a-spectrum-of-emergency-departments-in-the-state-of-indiana-an-observational-in-situ-simulation-based-study
#6
Kamal Abulebda, Samer Abu-Sultaneh, Erin E White, Michele L Kirby, Brian C Phillips, Courtney T Frye, Lee D Murphy, Riad Lutfi
BACKGROUND: Diabetic ketoacidosis (DKA) is a common presentation to an emergency department (ED), with the majority presenting to community EDs. Adherence to clinical guidelines in these EDs can reduce morbidity and mortality. Few methods to describe practice gaps for DKA management have been reported. OBJECTIVES: We hypothesized that high-fidelity in situ simulation can be used to measure and compare the quality of the care provided to pediatric patients with DKA presenting to community EDs in the state of Indiana...
April 24, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29661658/is-transcellular-potassium-shifting-with-insulin-albuterol-or-sodium-bicarbonate-in-emergency-department-patients-with-hyperkalemia-associated-with-recurrent-hyperkalemia-after-dialysis
#7
Brian E Driver, Lauren R Klein, Chaitanya Chittineni, Ellen K Cales, Nathaniel Scott
BACKGROUND: Emergency department (ED) treatment of hyperkalemia often involves shifting potassium into the intracellular space. There is uncertainty whether transcellular shifting causes insufficient potassium removal during hemodialysis, resulting in a subsequent need for further medical therapy or multiple sessions of hemodialysis. OBJECTIVE: We sought to determine whether transcellular potassium shifting in ED patients with hyperkalemia who undergo hemodialysis is associated with recurrent hyperkalemia with or without repeat hemodialysis within 24 h...
July 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29534919/the-association-of-emergency-department-administration-of-sodium-bicarbonate-after-out-of-hospital-cardiac-arrest-with-outcomes
#8
Yi-Chuan Chen, Ming-Szu Hung, Chia-Yen Liu, Cheng-Ting Hsiao, Yao-Hsu Yang
BACKGROUND: Sodium bicarbonate administration is mostly restricted to in-hospital use in Taiwan. This study was conducted to investigate the effect of sodium bicarbonate on outcomes among patients with out-of-hospital cardiac arrest (OHCA). METHODS: This population-based study used a 16-year database to analyze the association between sodium bicarbonate administration for resuscitation in the emergency department (ED) and outcomes. All adult patients with OHCA were identified through diagnostic and procedure codes...
March 5, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29390373/ozone-therapy-induced-sinus-arrest-in-a-hypertensive-patient-with-chronic-kidney-disease-a-case-report
#9
Wen-Juan Tang, Long Jiang, Ying Wang, Ze-Min Kuang
RATIONALE: Ozone autohemotherapy as an alternative treatment method has been applied to the treatment of several diseases. Here, we report a patient used ozone autohemotherapy to treat her hypertension and diabetes. Nevertheless, the patient occurred sudden dizziness and black haze due to hyperkalemia. PATIENT CONCERNS: A 54-year-old woman who was admitted to our emergency department complaining of sudden dizziness and black haze for 5 hours. DIAGNOSES: The blood potassium test showed hyperkalemia...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29350673/glyphosate-ingestion-causing-multiple-organ-failure-a-near-fatal-case-report
#10
Edoardo Picetti, Michela Generali, Francesca Mensi, Giampaolo Neri, Roberta Damia, Giuseppe Lippi, Gianfranco Cervellin
A 55 years old man self-presented to our Emergency Department (ED) reporting an attempted suicide by cutting the left forearm veins and ingesting approximately 200 mL of an herbicide (Myrtos®, containing 36% of glyphosate as isopropylamine salt). Laboratory tests showed metabolic acidosis. Hydration with normal saline and alkalinization with sodium bicarbonate was started according to suggestion of the poison control center, since an antidote was unavailable. Cardiorespiratory condition gradually worsened, so that non-invasive positive pressure ventilation (NIPPV) was applied and infusion of fluids was established...
January 16, 2018: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29340313/treatment-of-severe-hyperkalemia-confronting-4-fallacies
#11
REVIEW
J Gary Abuelo
Severe hyperkalemia is a medical emergency that can cause lethal arrhythmias. Successful management requires monitoring of the electrocardiogram and serum potassium concentrations, the prompt institution of therapies that work both synergistically and sequentially, and timely repeat dosing as necessary. It is of concern then that, based on questions about effectiveness and safety, many physicians no longer use 3 key modalities in the treatment of severe hyperkalemia: sodium bicarbonate, sodium polystyrene sulfonate (Kayexalate [Concordia Pharmaceuticals Inc...
January 2018: KI Reports
https://www.readbyqxmd.com/read/29336990/failure-of-intracardiac-pacing-after-fatal-propafenone-overdose-a-case-report
#12
Ivan Zeljković, Nikola Bulj, Matea Kolačević, Vedran Čabrilo, Diana Delić Brkljačić, Šime Manola
BACKGROUND: Propafenone is a sodium-channel blocker, class IC antiarrhythmic drug, frequently used to manage supraventricular dysrhythmias, especially atrial fibrillation. We report a self mono-intoxication with propafenone. CASE REPORT: A 68-year-old woman presented with a decreased level of consciousness, hypotension, and electrocardiogram showing QRS widening with atrial asystole and extreme bradycardia < 20 beats/min. After initial stabilization with transcutaneous pacing, laboratory findings detected normal electrolyte ranges and metabolic acidosis, and her medical history revealed availability of propafenone due to paroxysmal atrial fibrillation and depressive syndrome, which led to the suspicion of intoxication...
April 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29328017/-hydration-to-prevent-contrast-induced-nephropathy
#13
E J Hoorn, R Zietse
In 2007, a national guideline was issued in the Netherlands to prevent contrast-induced nephropathy. This guideline recommended preventive hydration with 0.9% NaCl in patients with reduced estimated glomerular filtration rate (eGFR 30-69 ml/min/1.73 m2) prior to administration of contrast. The recent AMACING study compared hydration versus no hydration, and found that hydration did not prevent contrast-induced nephropathy but did lead to complications and higher costs. The latest 2017 guideline recommends hydration only for patients with eGFR < 30 ml/min/1...
2018: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29226898/severe-cardiac-toxicity-following-alcohol-intake-in-a-patient-using-therapeutic-dose-of-propafenone
#14
Zübeyde Bayram, Ahmet Güner, Cem Doğan, Fatih Yılmaz, Nihal Özdemir
An unconscious, 25-year-old, male patient was brought to the emergency department. The patient's electrocardiography demonstrated a wide QRS interval and first-degree atrioventricular block. He was being treated with propafenone twice daily (450 mg) for paroxysmal atrial fibrillation. The patient had consumed a substantial amount of alcohol the day before. He recovered after supportive management with sodium bicarbonate and inotropic therapy. In the presently described case, treatment resulted in quick normalization of QRS interval and stabilization of hemodynamic status...
December 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28927481/a-system-wide-solution-to-antidote-stocking-in-emergency-departments-the-nova-scotia-antidote-program
#15
Nancy G Murphy, D Ruth Bona, Theresa A Hurley
OBJECTIVE: Inadequate stocking of essential antidotes in hospitals is an internationally documented problem. A concrete and sustainable system-wide solution for easy access to antidotes in emergency departments (EDs) was developed and implemented in Nova Scotia, Canada. METHODS: Antidote stocking guidelines and a systemwide antidote management strategy were established. A standardized collection of antidotes housed in highly visible containers in provincial EDs was implemented for timely access...
September 20, 2017: CJEM
https://www.readbyqxmd.com/read/28920564/intentional-overdose-of-the-novel-anti-epileptic-drug-eslicarbazepine-presenting-with-recurrent-seizures-and-ventricular-dysrhythmias
#16
Jesse Thompson, James D Powell, Daniel H Ovakim
Eslicarbazepine is a novel anti-epileptic agent indicated for the treatment of partial-onset seizures. We present the case of an 18 year old female that presented to the Emergency Department four hours after a reported intentional ingestion of an estimated 5600 mg of eslicarbazepine. Although initially hemodynamically stable and neurologically normal, shortly after arrival she developed confusion, rigidity and clonus, followed by recurrent seizures, hypoxemia and cardiac arrest which responded to cardiopulmonary resuscitation and wide complex tachycardia requiring defibrillation...
September 18, 2017: CJEM
https://www.readbyqxmd.com/read/28851715/oesophageal-mastocytosis-eosinophilic-oesophagitis-without-eosinophils
#17
Donevan Westerveld, Jian Li, Sarah Glover
A 59-year-old male with a history of lifelong asthma, allergic rhinitis and hypercholesterolaemia presented to the emergency department for management of severe substernal chest pain with radiating pain to his left arm, nausea and diaphoresis. Physical examination was unrevealing and a cardiac workup including cardiac enzymes, ECG, chest radiographs were negative for an underlying ischaemic event. A subsequent gastrointestinal workup including oesophageal manometry and oesophagogastroduodenoscopy revealed elevated lower oesophageal pressures and histopathology suggestive of mast cell proliferation, respectively...
August 28, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28763772/ph-responsive-chitosan-nanoparticles-from-a-novel-twin-chain-anionic-amphiphile-for-controlled-and-targeted-delivery-of-vancomycin
#18
Rahul S Kalhapure, Mahantesh Jadhav, Sanjeev Rambharose, Chunderika Mocktar, Sanil Singh, Jwala Renukuntla, Thirumala Govender
The design and synthesis of novel pH-responsive nanoantibiotics is an emerging research area to address the antibiotic resistance crisis. The purpose of this study was therefore to synthesize a new anionic gemini surfactant (AGS) that could result in the formulation of pH-responsive chitosan nanoparticles (CSNPs) to treat methicillin-resistant Staphylococcus aureus (MRSA) infections. The coupling of oleic acid with 2,2-dimethyl-5,5-bis(hydroxymethyl)-1,3-dioxane and subsequent deprotection followed by a reaction with succinic anhydride and sodium bicarbonate yielded AGS...
October 1, 2017: Colloids and Surfaces. B, Biointerfaces
https://www.readbyqxmd.com/read/28755998/loperamide-induced-torsades-de-pointes-a-case-series
#19
Kenneth D Katz, Robert D Cannon, Matthew D Cook, Alexandra Amaducci, Ryan Day, Joshua Enyart, Glenn Burket, Lauren Porter, Timothy Roach, Jennifer Janssen, Karl E Williams
Loperamide is an over-the-counter, inexpensive, antidiarrheal opioid that can produce life-threatening toxicity at high concentrations. CASE REPORT 1: A 28-year-old man with a history of depression and substance abuse disorder (SUD) presented to the emergency department (ED) with shortness of breath and lightheadedness. He ingested large amounts of loperamide daily. The patient's initial electrocardiogram (ECG) demonstrated sinus rhythm, right axis deviation, undetectable PR interval, QRS 168 ms, and QTc 693 ms...
September 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28730935/effect-of-directly-compressible-excipient-and-treated-agar-on-drug-release-of-clopidogrel-oral-disintegrating-tablets
#20
Kambham Venkateswarlu, Manyam Nirosha, Budideti Kishore Kumar Reddy, Badithala Siva Sai Kiran
AIM: In the present investigation, oral dissolving/dispersible/disintegrating tablets (ODTs) of clopidogrel were designed with a view to enhance the bioavailability and patient compliance by two different methods, namely, direct compression and effervescent methods using directly compressible excipient and treated agar (TAG). MATERIALS & METHODS: In the direct compression method, TAG was used as a disintegrant and another method used a mixture of sodium bicarbonate and tartaric acid along with TAG as disintegrants...
July 2017: Therapeutic Delivery
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