The American journal of emergency medicine
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A device designed to augment venous filling by applying a vacuum to the arm during tourniquet application was evaluated in adult patients considered to have difficult peripheral venous access and in need of nonemergent venipuncture or intravenous cannulation. Patients taking medications that affected platelet activity or who had venipuncture attempts within 1 week in the same extremity were excluded. A total of 21 patients (age, 38.8 +/- 15 years; weight, 77.3 +/- 22.5 kg) were studied. ⋯ Seven patients had unsuccessful attempts at venipuncture or intravenous cannulation on the opposite extremity immediately before use of the device. In these 7 patients, subsequent use of the device was 100% successful (p = 0.0003, Fisher's exact test, assuming all attempts using standard techniques would have been unsuccessful). When conventional tourniquets are unsuccessful for venipuncture, the use of the venous distension device may obviate the need for more invasive forms of venous access.
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Compression of the chest causing facial petechiae, violaceous facial hue, subconjunctival hemorrhages, and frequent mental status abnormalities has been termed traumatic asphyxia. We identified 35 such cases occurring in the State of New Mexico from 1980 to 1985 from records of the Office of the Medical Investigator (n = 30) and from cases presenting to the University of New Mexico Trauma Center (n = 5). ⋯ Traumatic asphyxia following a moving motor vehicle accident was significantly associated with alcohol ingestion (p less than 0.001). Preventive and therapeutic strategies should focus on the groups and events identified.