A Consequence of an Electrical-Burn Injury: Atrial Fibrillation.

Cardiac arrhythmias following electrocution injuries can accompany high-voltage or high- intensity currents. Contributing factors to electrical hazard are the type of current, voltage, resistance, and duration of contact and pathway through the body. It is important to monitor for delayed arrhythmias in patients with an electrical injury. We describe a case of a 52-year-old man who presented after an electrical shock injury while grabbing a 5,000-voltage wire at work. In this case report, we discuss the presentation, management, and follow-up recommendations for this type of injury.

Multiple Hospital In-Situ Mass Casualty Incident Training Simulation for Emergency Medicine Residents: A Sarin Bomb Scenario.

INTRODUCTION: We simulated an on-site, multi-hospital mass casualty incident (MCI) to educate emergency medicine providers in the principles of trauma resuscitation and collaboration with administration and staff during an MCI. METHODS: We implemented high-fidelity manikins, inflatable manikins, and actors to simulate a sarin gas bombing. Learners triaged patients at a decontamination tent using the simple triage and rapid treatment (START) tool, or they participated in a simulation in a resuscitation bay. RESULTS: Forty participants anonymously rated the learning impact of the exercise, the clinical relevance to emergency medicine, and the effectiveness of the faculty facilitation and debriefing on a 1-5 Likert scale. The average responses to all questions were 4.45 or greater, and 98% of respondents recommended adding the scenario to the standard curriculum. DISCUSSION: We successfully executed a novel, multi- hospital, MCI drill that was rated to be a better alternative to sequential simulation in a simulation center.

Recurrent Appendicitis Caused by a Retained Appendiceal Tip: A Case Report.

BACKGROUND: Acute appendicitis is one of the most common surgical emergencies, and it is treated definitively with appendectomy. Recurrent appendicitis is a rare entity, being reported after approximately 1 in 50,000 appendectomies. It is typically caused by inflammation of the appendiceal stump. Inflammation of a retained appendiceal tip is a unique entity that can also cause recurrent appendicitis and presents similarly to primary appendicitis. CASE REPORT: We present a case of a 50-year-old man who had undergone laparoscopic appendectomy 1 year earlier and who subsequently presented with a chief complaint of right lower quadrant abdominal pain. The diagnosis of recurrent appendicitis caused by a retained appendiceal tip was made after a computed tomography scan. The patient underwent successful laparoscopic removal of the retained appendiceal fragment. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: The etiology of recurrent appendicitis is separate from the stump appendicitis that has been well described in the literature. Retained tip appendicitis poses a diagnostic dilemma because it is uncommon and, if missed, can lead to complications, such as perforation and severe sepsis. Recurrent appendicitis must be in the differential diagnosis for patients who are post-appendectomy and who present with right lower quadrant abdominal pain.

Early postnatal ethanol administration does not affect prepulse inhibition in rats.

Human prenatal ethanol exposure is associated with relatively widespread cognitive deficits but it is unclear whether general deficits in responsivity to sensory stimuli contribute to or underlie the deficits in later or more complex stages of information processing. The present experiment assessed the effects of early postnatal ethanol administration in rats on prepulse inhibition, with animals tested in adolescence (postnatal day (PD) 35) and early adulthood (PD 70). Animals were assigned to receive ethanol (5.25 g/kg) via intragastric intubation on PD 4-9, sham-intubation, or to a naive control group. Pre-exposure to ethanol did not differentially affect the magnitude of the response to the startle stimulus alone nor did it affect the percent inhibition of the startle response on trials with a prepulse stimulus. Male rats exhibited a greater percent inhibition than female rats on PD 35 at all interstimulus intervals (ISIs) except the shortest, 4 ms. Female rats exhibited a greater percent inhibition than male rats at all ISIs on PD 70. Collectively, these data demonstrate that cognitive deficits associated with early exposure to ethanol may not be attributable to deficits in sensorimotor gating, at least to the extent this construct is measured by prepulse inhibition.