J Emerg Med
-
Comparative Study
Difficult airway management in the emergency department: GlideScope videolaryngoscopy compared to direct laryngoscopy.
Videolaryngoscopy has become a popular method of intubation in the Emergency Department (ED), however, little research has compared this technique with direct laryngoscopy (DL). ⋯ For difficult airways with the presence of blood or small mandible, or a large tongue or obesity, GVL had a higher success rate at first attempt than DL.
-
Human immunodeficiency virus (HIV) screening is cost-effective and recommended in populations with low disease prevalence. However, because screening is not cost-saving, its financial feasibility must be understood. ⋯ This analysis adds a new component of support for HIV screening by demonstrating that rapid, non-targeted testing does not cost significantly more than a diagnostic testing approach.
-
Case Reports
Fracture of a GlideScope® Cobalt GVL® Stat disposable blade during an emergency intubation.
Emergency airway management is a diverse discipline, often utilizing advanced equipment with video technology to enable the intubator to visualize a patient's vocal cords that would be difficult or impossible to see with routine direct laryngoscopy. The GlideScope® Cobalt (Saturn Biomedical Systems, Inc., Burnaby, BC, Canada) is one type of video laryngoscope with disposable plastic GVL® Stat blades (Saturn Biomedical Systems) that can improve glottic view over direct laryngoscopy. It also benefits from rapid turnaround time and few infection control issues due to its disposable blade. ⋯ Twisting forces on the distal flat segment of the GVL® Stat may have caused its failure. Because this was only a single occurrence of breakage, it is not clear if design issues or atypical insertion of the blade was responsible for breakage. Care must be exercised when midline insertion is not possible, which can occur in obese patients with limited mouth opening.
-
Case Reports
Penile incarceration secondary to an S-shaped lead pipe: removal with Dremel Moto-Tool.
Penile incarceration or strangulation is a urologic emergency. ⋯ A hospital-based Emergency Medical Services and Rescue program is a valuable resource to provide the tools needed for management of penile strangulation. Features of safe removal, including protecting the tissues from heat damage and mechanical injury from the cutting blade, are described.
-
Case Reports
Accidental poisoning after ingestion of "aphrodisiac" berries: diagnosis by analytical toxicology.
A large number of plants, seeds, and berries have been used for medicinal, psychotropic, or aphrodisiac purposes for a thousand years. Mandragora officinarum belongs to the family of Solanaceae and is traditionally known as an aphrodisiac and is closely associated with witchcraft. ⋯ This case report indicates the importance of analytical toxicology in diagnosis of intoxications after the consumption of unknown plants or plant products and presents the clinical aspects of Mandragora intoxication.