The American journal of emergency medicine
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Pediatric forearm fractures are a common presentation in emergency departments in Papua New Guinea. Often these children undergo "blind" closed reduction with reduction adequacy assessed by standard radiographs. This study aims to demonstrate the safety and efficacy of ultrasound (US) in guiding closed reduction of pediatric forearm fractures in a resource-limited setting. ⋯ This small-scale study has demonstrated the safe and efficacious use of US-guided close reduction of pediatric forearm fractures in a low-resource setting. Using US, real-time visualization of reduction efforts can reassure the clinician in decision making, thus reducing the rate of repeated reductions and allowing shorter hospital stay.
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Synthetic cannabinoids (SC) have exploded on to the scene. With this rise in SC use, the number of complications and potential adverse effects are also well documented in the literature and is on the rise. The most frequently cited side effects are behavioral in nature and range for severe agitation to psychosis and delirium. We report a case of hyperthermia with severe rhabdomyolysis from SC use.
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Trauma-related embolic events in pulmonary vascular bed are generally due to fat or thrombus embolism. In this report, we present a patient who had severe hypoxia and tachycardia at postoperative period after surgery of an open tibia fracture. ⋯ Because of persistent hypoxemia, we performed transthoracic echocardiographic examination to exclude an intracardiac shunt. In transthoracic echocardiographic examination, we found an atrial septal defect with intermittent right-to-left shunt due to high central venous pressure.
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Previously, analgesics were avoided in suspected appendicitis to avoid masking the diagnosis. We determined use of analgesia in patients with appendicitis to determine recent trends over time and explore predictors of use of analgesia. ⋯ Use of analgesia and opioids analgesia has remained stable over time. Factors associated with prescription of any analgesia and opioids were older age and payment source. Use of CT was associated with prescription of analgesics.