Eschmann introducer through laryngeal mask airway: a cadaveric trial of an alternate means of rescue intubation.

Study Objective: Laryngeal mask airways (LMAs) are often used as airway rescue devices where laryngoscopy is difficult. The LMA does not protect the airway and is preferably replaced with a cuffed endotracheal tube. There are reports of cases where an Eschmann tracheal tube introducer (ETTI) was successfully used to bridge between a standard LMA and an endotracheal tube.

Randomized evaluation of octreotide vs prochlorperazine for ED treatment of migraine headache.

Unlabelled: Patients with headaches account for approximately 2% of all ED visits, with migraines being the most common defined primary headache syndrome. Our goals were to evaluate the efficacy of intravenous octreotide (OC) for the treatment of migraines, when compared to standard therapy with prochlorperazine.

Methods: The study was conducted as a double-blinded, randomized controlled trial.

The effects of an accelerated triage and treatment protocol on left without being seen rates and wait times of urgent patients at a military emergency department.

To combat increasing wait times and left without being seen (LWOBS) rates, our emergency department (ED) implemented an accelerated triage and treatment (TNT) protocol. A TNT team was allocated treatment rooms to begin management of urgent patients if a bed in the main ED was not available. A retrospective database study was performed using three separate 6-month periods: two control periods before the intervention (P1, P2) and one period after the intervention (P3).

Bedside ultrasound for the detection of soft tissue foreign bodies: a cadaveric study.

The objective of this study was to evaluate the sensitivity and specificity of bedside ultrasound, as performed by emergency physicians with typical equipment, in detecting small, soft tissue foreign bodies, using a cadaveric model. This was a prospective study, using 6 unembalmed human cadavers and 6 ultrasound-credentialed, emergency medicine residency-trained physicians as sonographers. Incisions were made in 150 total sites of the extremities and each site was randomly assigned one of five groups: wood, metal, plastic, glass, or no foreign body.

Chest injury while wearing a bullet-proof vest.

Ballistic protective vests and garments have evolved into important life-saving measures for members of police forces and militaries. Although effectively reducing morbidity and mortality from projectile injuries, significant injuries still do occur. We report a case demonstrating an example of the effects of transmitted forces through a protective vest resulting in a significant chest contusion.

Transdermal patch medication delivery systems and pediatric poisonings, 2002-2006.

Transdermal drug delivery systems are an increasingly popular method of medication delivery containing large quantities of medication and presenting new opportunities for toxicity. To provide a description of exposures to transdermal medications in a pediatric population, we studied exposures in individuals less than 12 years of age. This is a retrospective database study in which the Texas Poison Center Network database from 2002 to 2006 was reviewed.

Colchicine exposures: the Texas experience.

Objectives: Colchicine is a relatively uncommon toxin, but is known to precipitate severe multiorgan failure in overdose. Little is known about exposure patterns and outcomes in cases of colchicine ingestion. Our goal was to add to toxicologic knowledge through a database review and descriptive study of colchicine exposures.

Two cases of contact dermatitis resulting from use of body wash as a skin moisturizer.

The use of liquid skin cleanser or body wash has become common in the United States. We report 2 cases of contact dermatitis secondary to the application of Dove Body Wash (Unilever US, Inc., Englewood Cliffs, NJ) with the consumer misconception that the product was a skin moisturizing cream.

Trauma-induced pneumothorax after "bear-hug back crack" home remedy: attempted spinal manipulation by a layperson.

Spinal manipulation, as practiced by US-trained osteopathic physicians, is a safe and effective method of resolving patient pain and encouraging desirable physiologic improvement--often without pharmacologic intervention. Though novices, laypeople, and other clinicians also use manual techniques with similar goals in mind, their results are varied and sometimes dangerous to those they would help. The authors describe a case in which a layperson attempted spinal manipulation on a 20-year-old woman who later required a chest tube thoracostomy and hospitalization as a result of a pneumothorax.

A procedure for soft tissue foreign body removal under real-time ultrasound guidance.

A 16-year-old, dependant, female patient presented to the emergency department complaining of a sewing needle stuck in her right great toe. The needle was removed with real-time ultrasound guidance, with no complications. The use of ultrasonography for localization of foreign bodies is discussed.

Isopropyl alcohol pad use for blood ethanol sampling does not cause false-positive results.

This was a retrospective analysis of prospective data collected from a study of blood ethanol levels after the use of the alcohol-based hand sanitizer (ABHS). A total of 5 male volunteers were enrolled. Eight of the 10 total blood ethanol level measurements were drawn after skin preparation with Kendall WEBCOL Alcohol Preps (APP) containing 70% isopropyl alcohol.

Experience with bandage contact lenses for the treatment of corneal abrasions in a combat environment.

Corneal abrasions are a common result of eye trauma. Although they usually heal well with conservative therapy, they still tend to be a source of morbidity, in terms of pain and lost work time. We reviewed 15 cases in which a bandage contact lens was used as the primary treatment for corneal abrasions in an austere environment.

A descriptive analysis of authorship within medical journals, 1995-2005.

Introduction: The emphasis on publications for promotion in academic medicine would lead one to the theory that authorship numbers would increase proportionally with this emphasis. To investigate authorship trends across a number of periodicals, we performed a descriptive study comparing two full years of published articles spaced ten years apart from five medical journals.

Methods: Physician reviewers each reviewed all articles of one medical journal for the 1995 and 2005 publication years.

Does the clinical use of ethanol-based hand sanitizer elevate blood alcohol levels? A prospective study.

Background: Ethanol-based hand sanitizers (EBHSs) are used in most health care facilities in the United States. Infection control personnel advocate the use of generous quantities of EBHS before and after contact with patients. Although it is assumed that little systemic absorption of ethanol occurs during EBHS use, many alcohols are absorbed to varying degrees via the transdermal route.

Cardiovascular collapse from low dose bupivacaine.

Bupivacaine is a long-acting local anesthetic agent that is very widely used for cutaneous infiltration, peripheral nerve blocks, epidural anesthesia, and spinal anesthesia. Well-described cardiotoxic effects of bupivacaine and other members of its class include dysrhythmias, hypotension, and depression of cardiac output. The minimum IV dose of bupivacaine previously associated with significant toxicity in humans is 1.

Bradycardia-associated torsade de pointes and the long-QT syndromes: a case report and review of the literature.

We report a case of bradycardia-associated torsade de pointes in which the underlying long-QT syndrome appeared to be attributable to primary cardiac conducting system disease. Our patient presented complaining of presyncope and syncope. Serial electrocardiograms obtained over a period of 10 years demonstrated slowly progressive conduction system abnormalities, and evaluation revealed no other cause.

Colchicine-related death presenting as an unknown case of multiple organ failure.

A 45-year-old man presented to the emergency department (ED) with acute renal and hepatic failure as well as hypotension and metabolic acidosis. Despite aggressive intensive care, he had continued hypotension, leukocytosis, fever, renal and hepatic failure, and lactic acidosis. On hospital day 3, pancytopenia was noted.

SARS and its impact on current and future Emergency Department operations.

A long-standing concern for international spread of new, virulent pathogens became a reality with the advent of Severe Acute Respiratory Syndrome (SARS). This respiratory syndrome, caused by a coronavirus, spread rapidly across 30 nations since its first recognition in late 2002. SARS has presented the greatest recent threat to U.