J Emerg Med
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Multiple studies illustrate the benefits of waveform capnography in the nonintubated patient. This type of monitoring is routinely used by anesthesia providers to recognize ventilation issues. Its role in the administration of deep sedation is well defined. Prehospital providers embrace the ease and benefit of monitoring capnography. Currently, few community-based emergency physicians utilize capnography with the nonintubated patient. ⋯ Capnography is a quick, low-cost method of enhancing patient safety with the potential to improve the clinician's diagnostic power.
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Aortoenteric fistula (AEF) is a rare diagnosis that is often considered only in older patients with histories of abdominal aortic aneurysm. ⋯ This case highlights the importance of suspecting and quickly recognizing AEF based on history and physical examination alone. After extensive preoperative imaging to confirm the diagnosis, this patient nearly died in the operating room as surgeons took down adhesions trying to reach the fistula to repair it.
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During natural and manmade disasters, the hospital is perceived as a central rallying and care site for the public, for both those with and without emergency medical needs. The expectations of the public may outstrip hospital plans and abilities to provide nonmedical assistance. ⋯ There is a high public expectation that hospitals will provide significant nonmedical disaster relief. Understanding these expectations is essential to appropriate community disaster planning.
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Wounds, particularly chronic wounds, are a common presentation to the Emergency Department (ED), and in severe cases can contain maggots. Maggot debridement therapy is a popular technique for wound debridement, but is limited to the use of sterilized larvae due to concerns of contamination and invasion of "wild" maggots into healthy tissue. Wild maggots in chronic wounds, therefore, should be removed, yet there is no reported literature that describes a technique for their removal. ⋯ The technique described in this article is a simple, safe, and efficient way for the Emergency Physician to remove "wild" larvae from wounds.