Can J Emerg Med
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Anterior shoulder dislocations are the most common major joint dislocation seen in emergency departments. Intra-articular lidocaine is a useful method of analgesia for facilitating the reduction of anterior shoulder dislocations. ⋯ We present the case of a posterior shoulder reduction in an elderly female whose reduction was performed following the intra-articular injection of lidocaine. Intra-articular lidocaine represents a useful alternative to facilitate the reduction of shoulder dislocations, particularly in patients at higher risk for complications from sedation.
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Frequent soaking of lacerations closed with tissue adhesives is not recommended for fear of premature adhesive sloughing and wound dehiscence. This recommendation is based on studies of sutured lacerations, and may not be directly relevant to wounds closed with tissue adhesives. The objective of our study was to determine whether frequent soaking of octylcyanoacrylate would result in premature sloughing of the adhesive. ⋯ Daily immersion accelerates the sloughing of low viscosity octylcyanoacrylate applied to intact skin.
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There is an increasing awareness of unvaccinated adults presenting with epiglottitis to the emergency department. This study examines the clinical presentations and outcomes of diagnosed cases of adult epiglottitis presenting to all emergency departments in Hamilton, Ont., between 1999 and 2003. ⋯ Adults presenting with epiglottitis to the emergency department in Hamilton have good outcomes, with less airway management required than previously reported in children. Further study is needed to see if these conclusions are similar in other populations.
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To determine the proportion of patients vaccinated with pneumococcal (PVAX) and influenza (IVAX) vaccines under an emergency department (ED) vaccination program, that would not otherwise have been vaccinated by other primary care resources. ⋯ An ED-based program can result in the vaccination of a significant proportion of patients eligible for IVAX and/or PVAX who would otherwise likely go unprotected.
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Orf is a parapoxvirus infection of sheep and goats that causes blistering lesions on the lips, nostrils, udders or toes of affected animals. Human contact can cause transmission by direct inoculation. Human orf has typically been confined to rural settings. ⋯ The lesions resolved completely after 1 month without treatment. Although relatively rare and benign, this infection is probably under-reported and over-treated in this country. This case highlights the fact that urban physicians can expect to encounter once rare or solely rural-based infections with increasing frequency.