European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Over a period of 5 years, 101 patients were treated for abdominal stab wounds at our emergency department. Exploratory laparotomy was performed in 41 of these cases. The indication for laparotomy was set by clinical investigation in 20 cases, instrumental exploration in six patients, ultrasound in six, paracentesis in seven and computerized tomography scanning in two cases. ⋯ Routine laparotomy for this type of penetrating trauma to the abdomen proves to be no longer warranted. Clinical and especially diagnostic studies should be able to select patients in whom laparotomy should be performed. When these studies are unable to exclude severe injury, laparotomy remains more prudent than expectant observation.
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Intentional hydrocarbon inhalation can be fatal. Death can be secondary to hydrocarbon's cardiopulmonary effects. We present a case of a patient who survived ventricular fibrillation after inhalation of Glade Air Freshener, which contains short chain aliphatic hydrocarbons (butane and isobutane). Unlike our case, myocardial sensitization and hypoxia are more commonly described with aromatic, halogenated or longer chain hydrocarbons.
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Emergency medical care, both prehospital and hospital-based, is currently provided by general practitioners in over 90% of the emergency departments in Turkey. In the early 1990s, government and university leaders recognized that Turkey needed to improve its emergency medical care system, and they chose to adapt the mature and tested Anglo-American model of emergency medicine (EM). EM was declared to be an independent specialty by the Ministry of Health in 1993. ⋯ The connection between departments is improving with annual meetings organized by EMAT. In addition, EMAT is developing international collaboration in the Middle East region. The Turkish government is trying to promote EM specialist physicians and paramedics in the national emergency care system.
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The spineboard (SB) and the vacuum mattress (VM) are utilized for prehospital and emergency department (ED) immobilization of the spine. While permitting excellent pictures to be taken, the SB is a very painful device that can only be used for a limited time. The current study investigated the feasibility of different models of the VM for radiography. ⋯ This was related first of all to a high contrast of the sac in comparison with its contents and to a sometimes considerable shrinkage of the latter that resulted in further folding into the sac and, secondly, also to very broad mattresses, additional chambers within the VM and various grips and supports for lifting the mattress. Therefore, some features designed for prehospital use of the VM are actually acting against its use for diagnostic purposes. The aim of this study was to discuss and identify possible properties of a device that is useful for both immobilization and diagnostic purposes.
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Withholding administration of narcotic analgesia in patients with acute abdominal pain for fear of masking pathology is still pervasive in current medical practice. We reviewed all the prospective trials that investigated the safety, adverse affects, and ultimate outcome in patients with acute abdominal pain receiving narcotic analgesia within the emergency department (ED). No adverse outcomes or delays in diagnosis could be attributed to the administration of analgesia. Based on this research, we propose that it is safe and humane to administer narcotic pain relief to patients presenting to the ED with acute abdominal pain provided no contraindications exist.