50-year-old Male With Chest Pain

Fernandez, MD, et al.

This case takes the reader through the differential diagnosis and systematic work-up of the deadly causes of chest pain, ultimately leading to this patient’s diagnosis.

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Arrow to the Chest

Wangdi, MD, et al.

A 33-year-old male was brought to the emergency department after a penetrating arrow injury to the chest. Initial evaluation revealed the arrow was penetrating the sternum, lung, and aortic arch. Because the patient was in a remote area, timely transfer to a specialized center for definitive operative repair was delayed approximately 24 hours.

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Defensive Medicine: A Case and Review of Its Status and Possible Solutions

Katz, MD, et al.

Malpractice liability systems exist, in part, to provide compensation for medical malpractice, corrective justice for those injured by it, and to incentivize quality care by punishing substandard care. Defensive medicine is loosely defined as practice based primarily on the fear of litigation rather than on expected patient outcomes.

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Importance of Multiple-window Assessment for the Diagnosis of Ascending Aortic Dissection Using Point-of-care Ultrasound: Report of Three Cases

Zarama, MD, et al.

We present three cases of acute, type A aortic dissection in which the dissection flap was only evident in the apical five-chamber and subxyphoid views. These cases suggest that POCUS may play a pivotal role in the initial diagnosis of acute ascending aortic dissection and highlight the importance of viewing multiple windows to fully evaluate this possibility.

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Cardiac Arrhythmia Following an Epileptic Seizure

Kuttab, MD, et al.

We present a unique case of a patient presenting with ventricular tachycardia shortly following a seizure, along with corresponding laboratory data. Awareness of high risk arrhythmias in seizure patients could lead to advances in understanding pathophysiology and treatment of this complication of seizure disorder and ultimately prevention of SUDEP.

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Mango Dermatitis After Urushiol Sensitization

Yoo, MD, et al.

We present a case of an otherwise healthy man, with a remote history of poison ivy exposure, who presented with a delayed but significant reaction to mango fruit. Obtaining the patient’s history of prior plant exposures and reactions was key to isolating the likely underlying causation of his presentation.

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Varicella Zoster Virus Encephalitis

Lizzi, DO, et al.

In this case report, we review the history and physical exam findings that should raise clinical suspicion for varicella zoster encephalitis, as well as the epidemiology, risk factors, treatment, and prognosis of this type of infection.

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Kawasaki Disease Presenting as Acute Acalculous Cholecystitis

Lipe, MD, et al.

We describe an eight-year-old boy who presented to the emergency department with severe abdominal pain and was diagnosed with AAC and KD. He was treated with IVIG and high-dose aspirin, achieving good response with complete symptom resolution. He had no coronary artery aneurysms or further complications and was discharged after three days.

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Pitfalls and Pearls in Delusional Parasitosis

Gold, DO, et al.

In this case report we review the appropriate steps for initial evaluation of patients with suspected delusional parasitosis, differential diagnoses, and increase awareness for prudent treatment strategies.

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Difficult Intraoperative Heparinization Following Andexanet Alfa Administration

Watson, MD, et al.

We present a case of a 70-year-old man taking rivaroxaban with hemodynamic instability from a ruptured abdominal aortic aneurysm. He received AnXa prior to endovascular surgery, and intraoperatively he could not be heparinized for graft placement. Consideration should be given to the risks and benefits of AnXa administration in patients who require anticoagulation after hemorrhage has been controlled.

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Ketamine Implicated in New Onset Seizure

Meaden, MD, MS, et al.

We present a case where ketamine likely induced a seizure in a patient on whom it was used as a single agent in procedural sedation. Seizure is not a known side effect of ketamine in patients without a seizure history. Given the eagerness over additional uses for ketamine, this novel case of a seizure following procedural sedation with ketamine should be of interest to emergency providers.

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Postmortem Sperm Retrieval in the Emergency Department: A Case Report and Review of Available Guidelines

ZInkel, MD, MBA, et al.

Postmortem sperm retrieval (PMSR) requests and retrievals are increasing in the emergency department (ED) setting. Few EDs have protocols in place, and many emergency physicians (EP) lack the knowledge of how to proceed when such situations arise. We report the case of a 31-year-old male cardiac-arrest victim who expired in the ED, after which his wife requested PMSR.

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A Rare Case of Hemorrhagic Shock: Morel-Lavallée Lesion

Claassen, MD, et al.

Hemorrhage is a major cause of death among trauma patients. Controlling the bleeding is essential but can be difficult when the source of bleeding remains unidentified. We present a 67-year-old healthy male with a hypovolemic shock after a suicide attempt by jumping from a height.

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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


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.