J Emerg Med
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A 54-year-old man presented with a deep zone II neck injury accompanied by profuse bleeding secondary to attempting suicide by slashing his anterior neck with a knife. Blind passage of the endotracheal tube (ETT) into the glottis through the open anterior neck was unsuccessful. ⋯ The patient underwent operative repair and tracheostomy, and he left the hospital 2 days later with his baseline mental status. The use and the benefits of the GEB are reviewed.
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Numerous studies have described the pathophysiology, clinical manifestations, and treatment of the many forms of congenital heart disease (CHD), but none has specifically addressed the reasons CHD patients present to the Emergency Department (ED). The objective of this study was to provide a descriptive analysis of the ED presentations of acute and seriously ill pediatric CHD patients. We intended to capture a subset of acutely ill CHD patients who had presenting signs and symptoms that were potentially attributable to their underlying CHD. ⋯ Patients with complex CHD are often very difficult to correctly diagnose and manage in the ED. They often require extensive inpatient observation and evaluation. A low threshold for inpatient management of these high-risk patients is warranted.
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Blood samples may be collected subsequent to the establishment of a working i.v. line. When collected incorrectly, such blood samples can yield spurious results of serum electrolyte and chemistry determinations. We present such a case and, further, show that serum chemistry values can be altered by contamination with i.v. fluids in the emergency patient and that such alterations can be of sufficient magnitude to affect treatment. Recommendations are given regarding aspiration of blood samples from working i.v. lines to minimize the risk of spurious measurements.
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Cephalhematomas rarely lead to serious complications such as infection, osteomyelitis and skull fractures. However, we present a newborn infant with hyperkalemia in the context of a serious complication believed to be caused by hemolysis of a large cephalhematoma. The patient was treated with urgent peritoneal dialysis and discharged with a successful outcome. In conclusion, neonates with massive cephalhematoma should be closely examined in terms of bilirubin counts as well as electrolyte counts.