J Emerg Med
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Emphysematous cholecystitis (EC) is a form of cholecystitis with high mortality rates more commonly seen in patients with medical histories such as diabetes, hypertension, and peripheral vascular disease. The common features of these medical diseases are impaired pain perception, particularly abdominal pain, due to advanced age and peripheral neuropathies. Accurate evaluation of characteristics observed at ultrasonography, the method of first choice in the diagnosis of EC, is therefore highly important in these patients. ⋯ This study reports a case of the champagne sign, rarely seen in EC, together with other EC findings. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: The champagne sign is a little-known sonographic finding that is evidence of the presence of gas in the gallbladder. The champagne sign that will be detected while evaluating the hepatobiliary system on bedside ultrasound is one of the valuable findings in the diagnosis of emphysematous cholecystitis with high mortality.
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Lateral canthotomy is a vision-saving procedure. However, the low incidence of orbital compartment syndrome and the expense of simulators to practice this procedure can lead to low confidence and delays in the performance of the procedure by emergency physicians. ⋯ This simple task trainer is practical, inexpensive, quickly assembled, and useful as a tool for practicing emergency medicine providers.
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Randomized Controlled Trial
Video Laryngoscopy Improves Intubation Times With Level C Personal Protective Equipment in Novice Physicians: A Randomized Cross-Over Manikin Study.
The use of video laryngoscopes by novice physicians may improve first-pass success rates compared with direct laryngoscopy. ⋯ First-pass success and insertion time with the video laryngoscope were not affected by PPE donning. However, both were negatively affected with the Macintosh laryngoscope.
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Case Reports
Delayed Spontaneous Bilateral Pneumothorax in a Previously Healthy Nonventilated COVID-19 Patient.
The novel coronavirus disease 2019 (COVID-19) is a recent viral outbreak that has rapidly spread to multiple countries worldwide. Little is known about COVID-19 infection-related complications. ⋯ We report a patient who developed spontaneous bilateral pneumothorax after a recent COVID-19 infection. To our knowledge, this is the first reported case of spontaneous bilateral pneumothorax in a patient with recent confirmed severe acute respiratory syndrome coronavirus-2 infection without any risk factors for pneumothorax and who had not received positive pressure ventilation. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: There may be a possible correlation between a recent COVID-19 infection and the development of spontaneous pneumothorax. The diagnosis of spontaneous pneumothorax should be considered in any patient with known or suspected recent COVID-19 infection who presents with new acute symptoms consistent with pneumothorax or sudden clinical deterioration.