J Emerg Med
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Blind nasotracheal intubation (BNTI) is an effective procedure for the intubation of trauma patients. The presence of major facial trauma has been considered a relative contraindication due to the perceived risk of intracranial placement. The purpose of the present study was to assess the risk of intracranial placement in patients with facial fractures who undergo BNTI. ⋯ There were no cases of intracranial placement, significant epistaxis requiring nasal packing, esophageal intubation, or osteomyelitis. Three patients (4%) developed sinusitis and eight (10%) developed aspiration pneumonia. We conclude that the presence of facial trauma does not appear to be a contraindication to BNTI.
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We report two patients who presented to the emergency department with pneumothorax related to acupuncture. The first patient developed pleuritic chest pain and shortness of breath while undergoing acupuncture therapy, and the second patient developed similar symptoms 10 min after acupuncture therapy. Neither patient had a previous history of pneumothorax, and both were undergoing acupuncture along the spine, paraspinal region, and shoulders. A review of the literature follows.
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There are a growing number of emergency physicians (EPs) working in health care abroad. There are, however, no formal training programs for EPs in international health. An International Health Fellowship has been developed to provide training for EPs in public health and international medicine. ⋯ This article outlines the philosophy of a training program in international health, provides an overview of the goals and objectives for such a program, and describes the development of an existing fellowship. The International Health Fellowship will develop leaders in the field of global health by combining clinical expertise, practical field experience, formal public health training, and research and education in international health. Physicians completing a fellowship will be prepared to work within foreign health systems to develop, integrate, and evaluate health care programs on an international scale.
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Medical emergencies may arise on board commercial airlines. Although infrequent, such events annually affect a substantial number of air travelers. ⋯ This article examines the incidence of in-flight emergencies, surveys the onboard medical kit, and explores various in-flight medical problems and treatments. It concludes with a discussion of various methods of prevention.
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Review Case Reports
Hematoma of the rectus abdominis muscle: case report and review of the literature.
Hematoma of the rectus abdominis muscle, although a well-described clinical entity, is commonly misdiagnosed. A case of abdominal pain associated with the subjective perception of a "lump," which proved to be a rectus abdominis hematoma, is presented. The pathoanatomy, presenting symptoms, investigation, and treatment options for the condition are reviewed.