J Emerg Med
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Exotic animal importation and trade has the potential to expose the public to a variety of injuries and diseases not endemic to the United States. Bonnet Macaque monkeys are a fairly common primate illegally held in captivity. These monkeys become aggressive as they age past 2 years and are known to carry asymptomatic Cercopithecine herpesvirus 1 infection. ⋯ Simple wound management alone may not be enough in patients bitten by exotic animals. Consultation with local zoo officials, veterinary medical schools, or the Centers for Disease Control and Prevention is recommended in these cases.
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Currently, less than half of all U.S. states require helmets for motorcycle operators. Although research has demonstrated the effectiveness of helmets, less is known about the characteristics of individuals who choose to ride motorcycles unhelmeted. ⋯ Unhelmeted motorcyclists sustain more severe injuries and adverse outcomes. Motorcyclists who are intoxicated, uninsured, or passengers are less likely to wear a helmet. Education and prevention strategies should be targeted at these high-risk populations.
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Case Reports
Successful tracheal intubation through an intubating laryngeal airway in pediatric patients with airway hemorrhage.
This case report describes the use of the air-Q intubating laryngeal airway (air-Q ILA; Cookgas LLC, St. Louis, MO) for airway rescue and a conduit for blind tracheal intubation in two pediatric patients with failed rapid sequence intubation and difficult airways secondary to airway bleeding in the emergency department (ED). ⋯ Two cases of failed laryngoscopy in pediatric patients with blood in the airway are described. In each case, insertion of an air-Q ILA was followed by successful blind tracheal intubation via the lumen of the air-Q ILA.
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Ehlers-Danlos syndrome (EDS) is a rare connective tissue disorder, usually characterized by the triad of hypermobility of the joints, hyperextensibility of the skin, and tissue fragility. Numerous gastrointestinal complications have been reported with this syndrome. ⋯ We report a case of a 22-year-old woman with EDS who presented to the Emergency Department complaining of shortness of breath and left-sided chest pain. She was ultimately found to have a spontaneous diaphragmatic rupture after forceful emesis.
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Case Reports
Supracondylar radial nerve block for treatment of distal radius fractures in the emergency department.
Patients with acute distal radius fractures are frequently treated in the emergency department (ED) with closed reduction and splinting. Many of the anesthesia methods frequently employed may either lack efficacy or require additional monitoring and resources. ⋯ Ultrasound-guided supracondylar block of the radial nerve proximal to the origin of the deep and superficial branches provides safe and efficacious anesthesia for distal radius fracture reduction in the ED.