J Emerg Med
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Case Reports
Ultrasound-Guided Clavipectoral Plane Block for Analgesia of Acute Clavicular Fracture in the Emergency Department.
Clavicle fractures are commonly encountered in the emergency department and require effective analgesia to facilitate appropriate management and disposition. ⋯ We present the case of a 52-year-old man who presented with an acute, mildly displaced midshaft fracture of his right clavicle. After minimal improvement in pain from oral and topical analgesics, he underwent an ultrasound-guided clavipectoral plane block which completely relieved his pain. He did not require additional analgesics for 36 hours after the block. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: The ultrasound-guided CPB may be a safe and effective analgesic strategy for uncomplicated clavicle fractures in the ED.
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Dehydration is a primary cause of visits to pediatric emergency departments (PED). ⋯ In this PED cohort, we found no predictors for RV to the PED. However, HCO3 ≤16 mmol/L, physician-estimated dehydration >5%, ≥1 IV fluid bolus, and PED antibiotics were associated with increase hospital admission. If replicated, these findings can help clinicians make faster disposition decisions when caring for dehydrated pediatric patients.
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Multicenter Study
Characteristics of Intracranial Hemorrhage and Acute Aortic Syndromes Resuscitated with Extracorporeal Cardiopulmonary Resuscitation (ECPR).
Intracranial hemorrhage (ICH) and acute aortic syndrome (AAS) are etiologies associated with unfavorable outcomes in patients with out-of-hospital cardiac arrest (OHCA), even with extracorporeal cardiopulmonary resuscitation (ECPR). ⋯ ICH and AAS should be considered potential causes of cardiac arrest, especially in cases with a nonshockable initial cardiac rhythm. However, differentiating them from cardiac causes of arrest remains challenging.
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Comparative Study
A Prospective Crossover Study Comparing Six Current Generation Supraglottic Airway Device's Ability to Seal During CPR in Human Cadavers.
Supraglottic airway (SGA) devices are frequently used during cardiopulmonary respiration (CPR), but little is known about their ability to consistently seal the airway during CPR. ⋯ In this human cadaver model, the ability to generate negative ITP varied with different SGAs during aCPR with an Impedance Threshold Device.