The American journal of emergency medicine
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Dislocation of the mandible occurs commonly. Most patients present to the emergency department for treatment. This article discusses the normal temporomandibular joint (TMJ) anatomy and the etiology, types, and diagnosis of mandibular dislocation. It also describes the initial management, including techniques for reduction of the acute anteriorly dislocated mandible.
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A patient with chronic renal failure presenting to the emergency department with acute pulmonary edema has a true life-threatening emergency. Whereas conventional treatment modalities may prove useful, more unusual therapeutic measures may be necessary. A case is presented followed by useful recommendations for the emergency physician faced with such a patient.
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A technique to enhance difficult percutaneous radial artery cannulations using Doppler ultrasound is described. A series of 12 patients (nine hypotensive and three normotensive patients with poorly palpable or absent radial pulses) was assembled and the radial arteries were cannulated using standard intravenous catheters and a hand-held Doppler ultrasound device. Localization and cannulation of the arteries was facilitated by noting the characteristic sounds using the Doppler. ⋯ In one case the artery was localized but the catheter could not be advanced. No complications were encountered. It was concluded that the use of a common Doppler ultrasound on selected patients with poor peripheral pulses may facilitate percutaneous radial artery cannulations and minimize the number of catheter punctures before successful placement.
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Review Case Reports Comparative Study
Blunt scrotal trauma: emergency department evaluation and management.
Blunt scrotal trauma may result in a variety of injuries, including testicular rupture, torsion, dislocation, hematoma, or contusion, as well as epididymal, scrotal, and urethral injuries. Testicular rupture occurs in 50% of patients with traumatic hematocele, and is probably frequently misdiagnosed. If not aggressively diagnosed and surgically repaired, testicular rupture may lead to testicular atrophy and loss. ⋯ Testicular scan, when rapidly available, is indicated in any case of suspected traumatic torsion. If testicular scanning is unavailable or equivocal, surgical exploration is indicated. Once torsion is ruled out, ultrasound is a useful diagnostic technique in acute scrotal trauma to differentiate those scrotal and testicular injuries requiring surgical intervention.