Annals of emergency medicine
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A tracheal-esophageal airway for field or hospital use is described. The airway consists of a clear plastic mask and endotracheal low pressure cuffed tube with a Murphy tip. ⋯ The endotracheal tube is attached to the mask by a tubular coupler and easily disconnected by removing a metal clip in the event of tracheal insertion of the tube. Our four-year experience with the tracheal-esophageal airway in 400 cardiac arrests has shown it to be safe, simple, and useful.
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Traumatic rupture of the tracheobronchial tree is an increasingly occurring complication of blunt chest trauma. Early detection and surgical repair are important for definitive and successful reconstruction. ⋯ Use of a rigid bronchoscope is difficult and traumatic to the patient, and the flexible fiberoptic bronchoscope, with its greater technical simplicity, is more easily applied. We report the case of a patient who suffered bronchial stenosis and total atelectasis before discovery of a fracture was made.
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The development of modern cardiopulmonary resuscitation (CPR) is an exciting and surprising history to modern health professionals who rarely are aware of how new CPR really is. Artificial respiration began in the 16th century with Vesalius's work on living animals; progressed with the rise and fall of mouth-to-mouth, manual, and positive pressure ventilation methods of the 18th and 19th centuries; and culminated in 1958 with demonstration of the superiority of the mouth-to-mouth technique. ⋯ The technique was applied to man internally in 1947 and externally in 1956. The simultaneous use of all these modern CPR methods dates back only 20 years.
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Photography is a rapid, relatively simple, and inexpensive means of documenting patient care and enhancing medical education. Because of its use in medical records, photography affords the physician added defense against claims of medical malpractice. The emergency physician should have ready access to a photographic system as well as a basic knowledge of camera operation, filming procedures, picture composition, and medico-legal implications. These topics are discussed and specific recommendations are offered concerning the purchase of essential photographic equipment.