J Emerg Med
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Prehospital blood gas analysis (BGA) is an evolving field that offers the potential for early identification and management of critically ill patients. However, the utility and accuracy of prehospital BGA are subjects of ongoing debate. ⋯ Prehospital BGA holds significant potential for enhancing patient care in the prehospital setting, though technical challenges need to be considered. However, further research is required to establish optimal indications and demonstrate the benefits for prehospital BGA in specific clinical contexts.
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Observational Study
Tracheal Intubation and Mechanical Ventilation in Adults with Severe Salicylate Poisoning.
Salicylate poisoning may lead to critical acid-base disturbances. Tracheal intubation and mechanical ventilation for patients with severe salicylism has been strongly discouraged. ⋯ In our single-center experience managing adults with severe salicylate poisoning, tracheal intubation and mechanical ventilation were not associated with substantial perturbation of serum pH or severe complications. These findings challenge the current paradigm that these interventions should be avoided in salicylate-poisoned patients.
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Shoulder dislocations and elbow dislocations are common presentations to the emergency department (ED). Simultaneous ipsilateral elbow and shoulder dislocations are rarely reported and typically occur secondary to trauma. ⋯ A 45-year-old female presented to the ED after a fall from standing and complained of upper right extremity pain. Radiographs revealed posterior dislocation of the right elbow and anterior dislocation of the right shoulder without fractures. Successful reduction of the elbow and shoulder were both achieved, and the patient was placed in a long-arm splint and sling. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case describes the unique mechanism of injury of a simultaneous ipsilateral shoulder and elbow dislocation without trauma.