Annals of emergency medicine
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To determine the clinical efficacy and safety of IV adenosine administration in the field for the treatment of paroxysmal supraventricular tachycardia (PSVT). ⋯ Adenosine appears to be effective and safe for the pre-hospital treatment of PSVT.
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The purpose of this study was to determine the number of eligible prehospital thrombolytic candidates and to estimate the potential time saved if field thrombolysis had been initiated in a series of prehospital chest pain patients. ⋯ Prehospital 12-lead ECGs provide an ECG diagnosis 40 to 50 minutes earlier than ED ECGs. However, with current exclusion criteria, the number of prehospital r-TPA candidates is limited.
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Identification of reliable landmarks for supraclavicular subclavian vein catheterization that requires no patient manipulation and is easily located. ⋯ The new landmark for supraclavicular subclavian vein catheterization is reliable, requires no patient manipulation, and is as successful as the standard landmarks.
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A 32-year-old asthmatic man developed a life-threatening Clostridium perfringens infection after subcutaneous epinephrine suspension injection. Extensive surgical debridement, including forequarter amputation, hyperbaric oxygen therapy, and appropriate antibiotics were used as life-saving measures. ⋯ We could find no previously reported cases of gas gangrene following subcutaneous injection in otherwise healthy individuals. The pathogenesis and treatment of this infection are discussed.
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Case Reports
Massive upper airway bleeding after thrombolytic therapy: successful airway management with the Combitube.
We present the case of a patient who required immediate intubation because of increasing upper airway bleeding. Endotracheal intubation failed because the glottis could not be visualized. An airway control device designed for cases of difficult emergency intubations was used successfully. This device can be inserted without the use of a laryngoscope.