No abstract

Acute posterior shoulder dislocation is rare, and its early diagnosis remains a challenge to the emergency physician. This report describes two cases of acute posterior shoulder dislocation confirmed by bedside ultrasound scan performed by the emergency physician. Bedside ultrasound for diagnosis of posterior shoulder dislocation is accurate, noninvasive, repeatable, convenient, and without ionizing radiation. Dynamic ultrasound sign of posterior shoulder dislocation and using bedside ultrasound for verification of successful reduction of posterior shoulder dislocation are described.

Introduction: Refractory ventricular fibrillation is not uncommon and can be extremely difficult to abort. There is currently no standard guideline to effectively manage this electrical storm. Case Presentation: We hereby present the first successful reported use of dual simultaneous external defibrillation on a patient with refractory ventricular fibrillation in Hong Kong. Conclusion: Given the numerous successful cases with intact neurology in literature, dual simultaneous external defibrillation should be employed in indicated patients.

Introduction: Fulminant myocarditis is uncommon. Making the diagnosis in the emergency department is difficult due to the nonspecific clinical presentation and electrocardiogram results. Case presentation: A 58-year-old Chinese woman presented to an emergency department with dizziness and malaise for 2 days. She was hypotensive and afebrile. Initial electrocardiogram showed isolated nonspecific intraventricular conduction delay. Despite resuscitation, she rapidly deteriorated in the emergency department and eventually succumbed. Autopsy and histological examination of heart muscle found acute inflammatory cell infiltration and multifocal necrosis, suggestive of acute fulminant myocarditis. Discussion: There is a wide range of differential diagnosis of nonspecific intraventricular conduction delay. Clinical presentation of mycoarditis is also often non-specific. Rapid and accurate recognition of the condition is essential to save life. Conclusion: Fulminant myocarditis presenting with cardiogenic shock and isolated intraventricular conduction delay on electrocardiogram poses a diagnostic challenge as illustrated in this case report.