J Emerg Med
-
To gather information about paramedic use of 11 advanced life-support (ALS) procedures, 74 emergency physicians and 171 paramedics practicing in Utah were surveyed. Response was 66% and 65%, respectively. Performance difficulty, frequency of use, and success rate were evaluated. ⋯ The number of attempts and the success rate was significantly higher (P less than .05) for paramedics with secondary medically affiliated employment. Paramedics were significantly more willing to perform 7 of the 11 procedures (P less than .001) than physicians were willing to order. We conclude that paramedic and physician difficulty ratings were generally similar, that many types of ALS procedures are rarely performed, that a small percentage of paramedics perform the largest number of ALS procedures, that secondary employment increases paramedics' procedural attempts and improves success rates, and that they are more willing to perform ALS procedures than physicians are to order them.
-
Case Reports
Retropharyngeal calcific tendinitis: report of five cases and review of the literature.
Retropharyngeal calcific tendinitis is an inflammation of the longus colli muscle tendon, which is located on the anterior surface of the vertebral column extending from the atlas to the third thoracic vertebra. Five cases of acute retropharyngeal calcific tendinitis seen in the emergency department (ED) over a 15-month period are reported. In addition, a retrospective review of four cases diagnosed as retropharyngeal abscess and admitted to the hospital revealed that two of these cases actually represented retropharyngeal calcific tendinitis. ⋯ For those primary care physicians who must evaluate patients with acute cervical pain, sore throat, or odynophagia, an x-ray study of the neck revealing retropharyngeal calcium deposition should raise the question of the diagnosis of acute retropharyngeal tendinitis. Clinical characteristics of this entity include a painful condition which is treatable and is often mistaken for retropharyngeal abscess, pharyngitis, or peritonsillar abscess. In our opinion, this condition may be more prevalent than the literature suggests.
-
We report a case of a 7-year-old boy who sustained a ruptured right mainstem bronchus in a motor vehicle accident. The clinical presentation, pathophysiology, and diagnosis of tracheobronchial injuries secondary to nonpenetrating thoracic trauma are discussed.