Can J Emerg Med
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To compare 5 active torso-warming modalities in a human model of severe hypothermia with shivering heat production inhibited by intravenous meperidine. ⋯ In non-shivering subjects, external heat application was effective in attenuating core temperature afterdrop and facilitating safe core rewarming; this was more evident when heat was delivered preferentially to the chest, and dependent upon the amount of heat donated. The modalities studied appear sufficiently practical and portable for pre-hospital use and should be considered for such situations, particularly in rural or wilderness locations where anticipated transport time to the hospital exceeds 30 minutes.
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Anterior shoulder dislocations are the most common major joint dislocation seen in emergency departments. Intra-articular lidocaine is a useful method of analgesia for facilitating the reduction of anterior shoulder dislocations. ⋯ We present the case of a posterior shoulder reduction in an elderly female whose reduction was performed following the intra-articular injection of lidocaine. Intra-articular lidocaine represents a useful alternative to facilitate the reduction of shoulder dislocations, particularly in patients at higher risk for complications from sedation.
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We report an acute thrombosis of an abdominal aortic aneurysm presenting with paralysis of a lower extremity. The usual presentation of such thrombosis is vascular compromise of the lower extremities. When the thrombus obstructs the artery of Adamkiewicz, the main blood supply to the lower spinal cord, spinal ischemia and paralysis can occur. Mechanisms of aortic occlusion and treatment of aortic thrombosis are briefly outlined.
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Frequent soaking of lacerations closed with tissue adhesives is not recommended for fear of premature adhesive sloughing and wound dehiscence. This recommendation is based on studies of sutured lacerations, and may not be directly relevant to wounds closed with tissue adhesives. The objective of our study was to determine whether frequent soaking of octylcyanoacrylate would result in premature sloughing of the adhesive. ⋯ Daily immersion accelerates the sloughing of low viscosity octylcyanoacrylate applied to intact skin.