Conversely, the relative frequencies of rupture for rare or novel causes are likely over-estimated. Conclusions Both traumatic and pathological rupture of the spleen are frequently reported

in journals and documented in textbooks of emergency medicine. However, other causes of rupture are largely ignored in the emergency literature. We have documented a diverse range of patients for whom the presenting Inhibitors,research,lifescience,medical complaint for a disease was rupture of the spleen. We have also documented a number of medical procedures and medications that appear to have contributed to a rupture of the spleen, including some that have presented after the patients had been discharged from the facility conducting the procedure. Finally, we have documented several cases of trivial trauma associated with splenic rupture. Although these categories at first glance seem unrelated, they

share the characteristic of having Inhibitors,research,lifescience,medical causes of rupture that would either be very subtle or completely unapparent on the presenting history, and are thus directly relevant to the practicing emergency physician. We hope that increased awareness of these phenomena will improve the ability of emergency clinicians to diagnose similar cases of splenic rupture in a timely fashion. Competing interests The authors declare that they have no competing interests. Authors’ contributions Both authors were involved Inhibitors,research,lifescience,medical in the literature search, review of the papers for inclusion, and Inhibitors,research,lifescience,medical the drafting of and revisions to the manuscript. KA takes full responsibility for the content. Both authors read and approved the final manuscript. Pre-publication history The pre-publication history for this paper can be accessed here: http://www.biomedcentral.com/1471-227X/12/11/prepub Acknowledgements The authors wish to thank Shahil Sood for his assistance with some of the paper reviews and Ms Alison selleck kinase inhibitor Farrell for her assistance with the literature search. This research was conducted with

funding from the Primary Healthcare Research Unit and the Faculty Inhibitors,research,lifescience,medical of Medicine both at Memorial University of Newfoundland. Author details 1Primary Healthcare Research Unit, Memorial University of Newfoundland, Health Sciences Centre, St. John’s, Newfoundland and Labrador, St Johns, Canada. 2Discipline of Emergency Medicine, Memorial Cilengitide University of Newfoundland, St. John’s, Newfoundland and Labrador, St Johns, Canada.3Discipline of Family Medicine, Memorial University of Newfoundland, St. John’s, Newfoundland and Labrador, St Johns, Canada. 4Department of Emergency Medicine, Dalhousie University, Halifax, NS, Canada.
Emergency medical technicians and paramedics (EMT/paramedics) are subject to critical incidents, defined as stressful workplace incidents that evoke acute distress and which may impair functioning in the short- or long-term [1].