Canadian Journal of Emergency Medicine: Volume 5 -

Neurologically normal survival after fibrinolysis during prolonged cardiac arrest: case report and discussion
Kevin Clark, Riyad B. Abu-Laban, Peter J. Zed, Lois Graham
Published online by Cambridge University Press:

21 May 2015, pp. 49-53
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Cardiac arrest secondary to pulmonary embolism is a devastating condition with a high mortality rate. It is currently unclear whether fibrinolysis (thrombolysis) is beneficial in this setting. We report the case of a 28-year-old woman with a pulmonary embolism who developed return of pulses following the administration of tissue plasminogen activator after 38 minutes of pulseless electrical activity cardiac arrest. She went on to make a full neurologic and cardiopulmonary recovery. This case is discussed with reference to the current literature on the subject.

An attractive approach to magnets adherent across the nasal septum
Lance Brown, Andrew Tomasi, Gerardo Salcedo
Published online by Cambridge University Press:

21 May 2015, pp. 356-358
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We report a case of an 8-year-old boy who presented to the emergency department with small jewelry magnets adherent across his nasal septum. Prompt removal of these foreign bodies is important to avoid septal necrosis and perforation. We report our success in using the metal handle of bayonet forceps to break the attraction between the magnets. The magnets were removed painlessly and without trauma to the nasal septum.

Benign pneumatosis intestinalis: a cause of massive pneumoperitoneum in the adult
David M. Liu, William C. Torreggiani, Kevin Rowan, Savvas Nicolaou
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21 May 2015, pp. 416-420
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Pneumatosis intestinalis (gas in the bowel wall) is often a benign condition, but it may mimic bowel ischemia or infarction and lead to unnecessary surgical intervention, especially when associated with pneumoperitoneum. We present a case of benign pneumatosis intestinalis with massive pneumoperitoneum and discuss various distinguishing features that may aid in its diagnosis.

Medical myth: Bimanual pelvic examination is a reliable decision aid in the investigation of acute abdominal pain or vaginal bleeding
Todd Brown, Mel E. Herbert
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21 May 2015, pp. 120-122
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Reliance on the accuracy of the pelvic examination is upheld in many medical textbooks, but review of the literature does not support the accuracy or reproducibility of this examination. That this “test” is useful for ruling out serious disease will be exposed for the myth that it is.

Acute allergic reaction due to the administration of fibrinolytic therapy for ST-segment elevation myocardial infarction: case report and discussion
Geoff C. Mills, Robert T. Arntfield, Robert J. Sedran
Published online by Cambridge University Press:

21 May 2015, pp. 421-423
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Although a rare phenomenon, acute allergic reactions to fibrinolytic and heparin therapy have been described in the literature. We report the case of a 63-year-old woman who experienced a severe anaphylactic reaction while undergoing fibrinolytic therapy with tissue plasminogen activator for an ST-segment elevation myocardial infarction. Overall outcome was successful, but patient morbidity was increased because of the reaction and the subsequent therapy administered.

Canadian Journal of Emergency Medicine