The American journal of emergency medicine
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A tracheobronchial rupture can be lethal. Its etiology in children varies and includes blunt trauma and iatrogenic injury. ⋯ We herein reported the first case of tracheobronchial rupture caused by chest compression during cardiopulmonary resuscitation. The present case highlights the importance of close follow-up after cardiopulmonary resuscitation, even if the patients are not intubated.
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Case Reports
Ventricular fibrillation in a 21-year-old after inhalation of an isobutyl nitrite "popper" product.
Alkyl nitrite analogs known as "poppers" have been inhaled recreationally for decades. They are available to be purchased from gas stations marketed as "nail polish remover not for human consumption". These rapid-onset, short-acting, vasodilators cause the user to experience euphoria, dizziness, tachycardia and flushing. While chronic use may lead to problems such as methemoglobinemia or neuropathy, nitrites rarely lead to acute life-threatening side effects such as ventricular dysrhythmias. ⋯ Alkyl nitrite "popper" users and clinicians should be aware that products labeled to contain nitrites may contain volatile hydrocarbons along with nitrites and have the potential to cause arrhythmia.
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Following initial stabilization, critically ill children often require transfer to a specialized pediatric hospital. While the use of specialized pediatric transport teams has been associated with improved outcomes for these patients, the additional influence of transfer mode (helicopter or ground ambulance) on clinical outcomes remains unknown. ⋯ Among critically ill pediatric patients without traumatic injuries transported by a specialty team, those patients who would have been transferred by helicopter if available but were instead transferred by ground ambulance reached their site of definitive care approximately 2.5 h later. Helicopter transport for these patients was not associated with in-hospital mortality, but was potentially associated with reduced hospital length of stay.