CPC-EM: Volume 3 Issue 3

Beware of the Zebra: Nine-year-old with Fever

Lupez, MD, et al.

A nine-year-old female arrived to the emergency department (ED) with her parents who described a chief complaint for their daughter of “fever and vomiting.” They elaborated on the case and described that the patient had been experiencing diffuse abdominal pain, vomiting, intermittent subjective fevers, and decreased energy, with development of a mild headache earlier that day.

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Symptomatic Pericardial Cyst: An Atypical Case of Pleuritic Chest Pain

Sallade, DO, et al.

Emergency physicians should consider mediastinal mass, and in this case pericardial cyst, in the differential diagnosis of chest pain because of the risk for tamponade, sudden cardiac death, or other life-threatening complications. Here, we describe a novel presentation of a pericardial cyst presenting as atypical chest pain.

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Head of the Bed Down: Paradoxical Management for Paradoxical Herniation

Bender, MD, et al.

Emergency physicians are well versed in cerebral herniation, pathology that typically results from increased intracranial pressure; however, paradoxical herniation is less common and requires opposing treatments. We describe a case of paradoxical herniation following lumbar puncture in a patient with previous hemicraniectomy.

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A Case of Thiazide-induced Hypokalemic Paralysis

Schell, BS, et al.

We describe the case of a patient presenting with odd neurologic symptoms initially thought to represent somatization who was found to have critical hypokalemia manifesting as hypokalemic non-periodic paralysis.

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Capsaicin: An Uncommon Exposure and Unusual Treatment

Yenigun, MD, et al.

Capsaicin, the active component of chili peppers, is an alkaloid that causes tissue irritation and burning especially upon contact with mucous membranes. While favored in certain cuisines around the world, it has also been weaponized in the form of pepper sprays and bear repellents.

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Severe Cutaneous Findings in a Woman with Dermatomyositis

Wang, MD, et al.

Here we present the case of a woman with a particularly severe form of the cutaneous signs. It is important to recognize the potential severity of this condition as the uncontrolled progression of this disease can lead to respiratory compromise and cardiac involvement.

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Polymethylmethacrylate Pulmonary Embolism Following Kyphoplasty

Morris, DO, et al.

We report a case of polymethylmethacrylate cement pulmonary embolism (PE) that occurred two days following a minimally invasive kyphoplasty procedure. Our patient developed non-specific rib pain postoperatively followed by dyspnea, prompting presentation to the emergency department.

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Novel Application of Balloon Tamponade in Management of Acute Lower Gastrointestinal Hemorrhage

Neeki, DO, et al.

We present a case of acute lower gastrointestinal (GI) bleeding in the emergency department, in which specialists were not emergently available to render their support. A quick intervention using balloon tamponade technique with a Minnesota tube helped stabilize the patient until intensive care, gastroenterology, and surgical specialists could intervene.

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A Novel Technique to Reduce Reliance on Opioids for Analgesia from Acute Appendicitis: The Ultrasound-guided Erector Spinae Plane Block

Mantuani, MD, et al.

Here we describe a single injection, lower ESP block performed by emergency physicians that successfully alleviated pain from acute appendicitis in an ED patient awaiting definitive surgical treatment. Along with allowing clinicians to actively manage pain without reliance on opioids, this novel ED technique may improve patient care outcomes.

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Misdiagnosed Spontaneous Carotid Cavernous Sinus Fistula

Canellas, MD, et al.

A 63-year-old female presented to the emergency department with worsening left-sided blurry vision and diplopia. She had previously seen several physicians and had been diagnosed with common ocular conditions – keratoconus and dry eye.

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Atraumatic Back Pain Due to Quadratus Lumborum Spasm Treated by Physical Therapy with Manual Trigger Point Therapy in the Emergency Department

Grover, MD, et al.

Given the current epidemic of opiate use, addiction, and death from overdose in the United States,1-3 non-opioid therapies to treat pain are needed to avoid exposing patients to the risk of opioid dependence. We discuss the use of manual trigger point therapy by emergency providers and physical therapists in the emergency department (ED), as an underused non-opioid treatment for pain management in the ED.

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Contact Information

WestJEM/ Department of Emergency Medicine
UC Irvine Health

333 The City Blvd. West, Rt 128-01
Suite 640
Orange, CA 92868, USA
Phone: 1-714-456-6389
Email: editor@westjem.org


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

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.