Case Report

Central Venous Catheter-directed Tissue Plasminogen Activator in Massive Pulmonary Embolism

Gulati, MD, et al.

We present the case of an 88-year-old female who presented to the emergency department (ED) with suspected massive pulmonary embolism (PE) causing respiratory failure, right heart strain, and shock, who despite early and aggressive resuscitation with vasopressors and continuous peripheral infusion of tissue plasminogen activator (tPA), suffered a cardiac arrest in the ED.

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Not All Sore Throats Are Pharyngitis

Sadowski, DO, et al.

This case provides insight into a common chief complaint seen everyday in the ED – “sore throat.” Not until the patient was seen on several subsequent encounters was a further work-up initiated and the diagnosis made.

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Myasthenic Crisis In Pregnancy

French, MD, et al.

This case reviews the management of a 27-year-old pregnant female in myasthenic crisis. She presented to the emergency department in respiratory distress refractory to standard therapy, necessitating airway and ventilatory support and treatment with plasmapheresis.

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25C-NBOMe Ingestion

Zygowiec, MD, et al.

We report the case of a 27-year-old male with two emergency department visits with confirmed ingestion of a relatively new synthetic drug of abuse. We discuss symptom management as well as the identification process of the ingestant.

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Anterior Urethral Laceration from a Human Bite

Shirk, MD, et al.

Isolated anterior urethral injuries in males related to sexual activity have rarely been reported. Human bites to the penis are also rarely discussed in the medical literature. We report an isolated anterior urethral laceration in a male caused by a biting injury sustained during fellatio.

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Dead Legs: A Case of Bilateral Leg Paralysis

Quenzer, DO, et al.

This case describes AOD complicated by a Stanford Type B aortic dissection leading to multi-system organ failure. A brief review of the literature further elucidates the key risk factors in identifying and treating Leriche syndrome.

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The Case of Ketamine Allergy

Bylund, MD, et al.

This case presents a clinical reaction to ketamine consistent with anaphylaxis due to histamine release, but it is uncertain whether this was immunoglobulin E mediated. This is the only case reported to date of allergic reaction to IM ketamine, without co-administration of other agents.

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Contact Information

WestJEM/ Department of Emergency Medicine
UC Irvine Health

3800 W Chapman Ave Ste 3200
Orange, CA 92868, USA
Phone: 1-714-456-6389
Email: editor@westjem.org

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WestJEM
ISSN: 1936-900X
e-ISSN: 1936-9018

CPC-EM
ISSN: 2474-252X

Our Philosophy

Emergency Medicine is a specialty which closely reflects societal challenges and consequences of public policy decisions. The emergency department specifically deals with social injustice, health and economic disparities, violence, substance abuse, and disaster preparedness and response. This journal focuses on how emergency care affects the health of the community and population, and conversely, how these societal challenges affect the composition of the patient population who seek care in the emergency department. The development of better systems to provide emergency care, including technology solutions, is critical to enhancing population health.