Annals of emergency medicine
-
A 25-year-old woman developed bilateral lower abdominal and pleuritic chest pain radiating to the shoulders 30 min after oral-genital insufflation and conventional coitus. Radiographic evaluation demonstrated a pneumoperitoneum. ⋯ Mild symptomatology and the absence of peritoneal irritation should suggest a vaginal etiology for pneumoperitoneum, and allow consideration of conservative management. Post-coital pneumoperitoneum after abdominal hysterectomy has been reported; however, we believe this to be the first such reported case after vaginal hysterectomy and associated with oral-genital insufflation.
-
We retrospectively reviewed 135 presentations (114 patients) of urban hypothermia treated at the discretion of the emergency department staff over a nine-year period from February 1971 to March 1980. Rewarming treatment options included passive external, active external, and heated oxygen aerosol administered by mask or intubation. The rates of rewarming were statistically similar for passive external (0.71 C/hr) and heated aerosol via mask (0.74 C/hr). ⋯ The group of survivors had a higher mean arrival temperature (31.33 C) than did the non-survivors (27.55 C) (P = 0.01). Active core rewarming with heated aerosolized oygen via nasotraheal tube is a safe technique for the rapid rewarming of selected hypothermic patients. The arrival temperature and the presence of serious underlying disease, in addition to the method of rewarming, appear to be major determinants of prognosis.
-
The development of an organized filing system for referencing articles pertinent to emergency medicine is presented. This simple and flexible system allows for modification for the individual needs of the emergency physician.