The American journal of emergency medicine
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Octylcyanoacrylate (Dermabond) is approved by the Food and Drug Administration for laceration closure. International studies have shown its utility in wound closure and have shown it to be as good or better than suture closure for speed, patient preference, and cosmesis, with no difference in the rate of dehiscence or infection. We sought to determine whether it retains its tensile strength, durability, and skin apposition when an athlete is allowed to reenter competition, where it is subject to recurrent stress, moisture, and trauma. ⋯ Of the 32 lacerations, 31 (97.6%) had good results at the conclusion of the game. Of these 31, all had good results at 7 days following repair. Dermabond retained its strength, durability, and skin apposition when the athlete was allowed to reenter competition following wound repair.
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Fluid resuscitation of infants and children is a common management problem in prehospital and emergency department care. We present two cases of children who received 5% dextrose in water as the initial resuscitation fluid. Bolus administration of hypotonic fluid contributed to fatal outcomes in these cases. Recommendations are made for eliminating hypotonic fluids as stock items in both the prehospital and emergency department settings.
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The Republic of the Seychelles enjoys a sophisticated health care system by developing country standards. Basic food, water, sanitation, and preventative health care needs have been addressed and the Seychelles Ministry of Health has recently focused on the need to improve the country's emergency medical services (EMS). ⋯ This report profiles the current health care system in the Seychelles, with special emphasis on EMS. It also describes an international collaborative effort between the Seychelles Ministry of Health and the UCLA Center for International Emergency Medicine designed to improve existing EMS.
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Luxatio erecta is an uncommon disorder and presents in a unique, unusual manner. Luxatio erecta is often misdiagnosed as an anterior dislocation. The presentation is unmistakable and classic: the arm hyperabducted and locked above the head. ⋯ Reduction is done with the traction and countertraction maneuver. Once it is reduced the arm is then placed and maintained with a sling in adduction to the chest. Orthopedic referral is required because of the high incidence of rotator cuff injury.