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Clinical Practice and Cases in Emergency Medicine Clinical Practice and Cases in Emergency Medicine Clinical Practice and Cases in Emergency Volume IV, Number 2, May 2020 Open Access at www.cpcem.org ISSN: 2474-252X Clinical Practice and Cases in Emergency Medicine In Collaboration with the Western Journal of Emergency Medicine Clinicopathological Cases from Maryland 111 55-year-old Male with Exertional Dyspnea Friedman ER, Gatz JD, Bontempo LJ, ZDW Dezman Clinicopathological Cases 116 55-year-old Woman with Headache, Vomiting, and Visual Disturbance Shaker L, Ripper J, Murano T Case Series VOLUME 4 ISSUE 2 May 2020 121 Heroin Adulterated with the Novel Synthetic Cannabinoid 5F-MDMB-PINACA: A Case Series Ershad M, Cruz MD, Mostafa A, Khalid MM, Arnold R, Hamilton R Case Reports 126 Novel, Inexpensive Portable Respiratory Protection Unit (PRPU) for Healthcare Workers Sampson CS, Beckett A 129 Early Multi-organ Point-of-Care Ultrasound Evaluation of Respiratory Distress During SARS-CoV-2 Outbreak: Case Report Farrow II R, Becherer-Bailey G, Mantuani D, Nagdev A INSPIRED 134 Urethral Calculi Lee P, Haber J 137 An Early Holiday Suprise: Cholecystitis Wrapped in Takotsubo Cardiomyopathy Gould K, Miller S, Moll J CALIFORNIA ACEP’S ANNUAL CONFERENCE 2020 142 Acute Jaundice in a Six-year-old: An Unusual Presentation of Atypical Kawasaki Disease Bylund LCDR W, Zarow GJ, Ponce LCDR DM Education is targeted to Medical Students and Residents, but all 146 Topical Tranexamic Acid for Hemostasis of an Oral Bleed in a Patient on a Direct Oral Anticoagulant are welcome to attend. Boccio E, Hultz K, Wong AH 150 The Ultimate Poker Face: A Case Report of Facial Diplegia, a Guillain-Barré Variant Lowe J, Pfaff J P Friday, September 25, 2020 AGES 111-271 Contents continued on page iii Westin San Diego Gaslamp Quarter A Peer-Reviewed, International Professional Journal JOIN CAL/AAEM! Championing individual physician rights and workplace fairness BENEFITS - Western Journal of Emergency Medicine Subscription - CAL/AAEM News Service email updates ACOEP stands with all emergency - Discounted AAEM pre-conference fees - And more! CAL/AAEM NEWS SERVICE physicians and providers on the - Healthcare industry news - Public policy front line. We thank you for your - Government issues - Legal cases and court decisions tireless work and effort. In collaboration with our official journal www.acoep.org FACEBOOK.COM/CALAAEM FOLLOW US @CALAAEM HTTP://WWW.CALAAEM.ORG AAEM-0618-652 Clinical Practice and Cases in Emergency Medicine Indexed in PubMed and full text in PubMed Central Rick A. McPheeters, DO, Editor-in-Chief Austin Smith, MD, Section Editor Kern Medical/UCLA- Bakersfield, California Vanderbilt University Medical Center-Nashville, Tennessee Manish Amin, DO, Associate Editor Christopher Sampson, MD, Section Editor Kern Medical/UCLA- Bakersfield, California University of Missouri- Columbia, Missouri Joel Moll, MD, Section Editor Mark I. Langdorf, MD, MHPE, Associate Editor Virginia Commonwealth University School of Medicine- Richmond, Virginia University of California, Irvine School of Medicine- Irvine, California Scott Goldstein, DO, Section Editor Shadi Lahham, MD, MS, Associate Editor Sidney Kimmel College of Medicine- Philadelphia, Pennsylvania University of California, Irvine School of Medicine- Irvine, California Steven Walsh, MD, Section Editor Einstein Medical Center Philadelphia-Philadelphia, Pennsylvania Shahram Lotfipour, MD, MPH, Managing Associate Editor John Ashurst, DO, Section Editor University of California, Irvine School of Medicine- Irvine, California Kingman Regional Health Network, Arizona Anna McFarlin, MD, Section Editor Melanie Heniff, MD, Section Editor Louisiana State University Health Science Center- New Orleans, Louisiana University of Indiana School of Medicine- Indianapolis, Indiana Amin A. Kazzi, MD, MAAEM Editorial Board Robert Suter, DO, MHA The American University of Beirut, Beirut, UT Southwestern Medical Center Lebanon Edward Michelson, MD Khrongwong Musikatavorn, MD Texas Tech University King Chulalongkorn Memorial Hospital, Robert W. Derlet, MD Anwar Al-Awadhi, MD Chulalongkorn University, Bangkok, Thailand University of California, Davis Mubarak Al-Kabeer Hospital, Jabriya, Edward Panacek, MD, MPH Kuwait University of South Alabama Leslie Zun, MD, MBA Rosidah Ibrahim, MD Chicago Medical School Hospital Serdang, Selangor, Malaysia Arif A. Cevik, MD Erik D. Barton, MD, MBA United Arab Emirates University Icahn School of Medicine, Mount Sinai, Linda S. Murphy, MLIS Samuel J. Stratton, MD, MPH College of Medicine and Health Sciences, Al New York University of California, Irvine School of Orange County, CA, EMS Agency Ain, United Arab Emirates Medicine Librarian Francesco Dellacorte, MD Scott Rudkin, MD, MBA Abhinandan A.Desai, MD Azienda Ospedaliera Universitaria “Maggiore Nadeem Qureshi, MD University of California, Irvine University of Bombay Grant Medical della Carità,” Novara, Italy St. Louis University, USA College, Bombay, India Emirates Society of Emergency Medicine, Scott Zeller, MD Francis Counselman, MD United Arab Emirates University of California, Riverside Bandr Mzahim, MD Eastern Virginia Medical School King Fahad Medical City, Riyadh, Saudi Niels K. Rathlev, MD Steven Gabaeff, MD Arabia Gayle Galleta, MD Tufts University School of Medicine Clinical Forensic Medicine Sørlandet Sykehus HF, Akershus Barry E. Brenner, MD, MPH Universitetssykehus, Lorenskog, Norway Pablo Aguilera Fuenzalida, MD Steven H. Lim, MD Case Western Reserve University Pontificia Universidad Catolica de Chile, Changi General Hospital, Simei, Singapore Hjalti Björnsson, MD Región Metropolitana, Chile Brent King, MD, MMM Icelandic Society of Emergency Medicine Terry Mulligan, DO, MPH, FIFEM University of Texas, Houston Peter A. Bell, DO, MBA ACEP Ambassador to the Netherlands Society of Jacob (Kobi) Peleg, PhD, MPH Liberty University Emergency Physicians Daniel J. Dire, MD Tel-Aviv University, Tel-Aviv, Israel College of Osteopathic Medicine University of Texas Health Sciences Center Vijay Gautam, MBBS San Antonio Jonathan Olshaker, MD Peter Sokolove, MD University of London, London, England Boston University University of California, San Francisco David F.M. Brown, MD Wirachin Hoonpongsimanont, MD, MSBATS Massachusetts General Hospital/Harvard Katsuhiro Kanemaru, MD Robert M. Rodriguez, MD Siriraj Hospital, Mahidol University, Bangkok, Medical School University of Miyazaki Hospital, Miyazaki, Japan University of California, San Francisco Thailand Advisory Board Editorial Staff Amal Khalil, MBA Jorge Fernandez, MD UC Irvine Health School of Medicine California ACEP Leila Danishgar, BS Cassandra Saucedo, BS American College of Emergency Physicians Editorial Director CPC-EM Publishing Director Elena Lopez-Gusman, JD University of California, San Diego California ACEP American College of Emergency Physicians Peter A. Bell, DO, MBA Joseph Bui, BS Argineh Shahbandari, BS American College of Osteopathic Emergency CPC-EM Associate Editorial Director CPC-EM Associate Publishing Director Adam Levy, BS Physicians American College of Osteopathic Emergency Liberty University, College of Osteopathic Medicine Physicians Maria Nguyen, BS Dana Le, BS Robert Suter, DO, MHA WestJEM Associate Editorial Director WestJEM Publishing Director John B. Christensen, MD American College of Osteopathic Emergency California Chapter Division of AAEM Physicians UT Southwestern Medical Center Tushank Chadha, BS Lori Winston, MD Christine Louis, BS Marketing Director to Media and WestJEM Associate Publishing Director California ACEP Shahram Lotfipour, MD, MPH Communications Director American College of Emergency Physicians UC Irvine Health School of Medicine Kaweah Delta Healthcare District Brian Potts, MD, MBA Mark I. Langdorf, MD, MHPE California Chapter Division of AAEM Alissa Fiorentino, BA June Casey, BA UC Irvine Health School of Medicine Alta Bates Summit-Berkeley Campus WestJEM Staff Liaison Copy Editor Official Journal of the California Chapter of the American College of Emergency Physicians, the America College of Osteopathic Emergency Physicians, and the California Chapter of the American Academy of Emergency Medicine Available in MEDLINE, PubMed, PubMed Central, Google Scholar, eScholarship, DOAJ, and OASPA. Editorial and Publishing Office:West JEM/Depatment of Emergency Medicine, UC Irvine Health, 333 City Blvd, West, Rt 128-01, Orange, CA 92866, USA Office: 1-714-456-6389; Email: [email protected] Volume IV, NO. 2: May 2020 i Clinical Practice and Cases in Emergency Medicine Clinical Practice and Cases in Emergency Medicine Indexed in PubMed and full text in PubMed Central This open access publication would not be possible without the generous and continual financial support of our society sponsors, department and chapter subscribers. Professional Society Sponsors AMERIcaN COLLEGE OF OSTEOPATHIC EMERGENCY PHYSICIANS CALIFORNIA CHAPTER DIVISION OF CALIFORNIA ACEP AMERIcaN AcadEMY OF EMERGENCY MEDICINE Academic Department of Emergency Medicine Subscribers Albany Medical College INTEGRIS Health Robert Wood Johnson University Hospital University of Florida, Jacksonville Albany, NY Oklahoma City, OK New Brunswick, NJ Jacksonville, FL American University of Beirut Kaweah Delta Health Care District Rush University Medical Center University of Illinois at Chicago Beirut, Lebanon Visalia, CA Chicago, IL Chicago, IL Arrowhead Regional Medical Center Kennedy University Hospitals Southern Illinois University University of Illinois College of Colton, CA Turnersville, NJ Carbondale, IL Medicine Augusta University Kern
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