J Emerg Med
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Occasionally, difficulty with standard urethral catheterization is encountered. ⋯ In some male patients in whom performing standard urethral catheterization is difficult, TAUS reveals the tip of the catheter and TAUS-guided catheterization with transrectal pressure can be safe and useful.
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Telemetry monitoring in patients with low-risk chest pain is highly utilized, despite the lack of quality data to support its use. ⋯ Insufficient data exist to support telemetry use in low-risk chest pain patients. Telemetry monitoring is unlikely to benefit low-risk chest pain patients with a normal/nondiagnostic electrocardiogram, a normal first set of cardiac enzymes, and none of the following: hypotension, rales above the bases, or pain worse than baseline angina.
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Hydrogen peroxide is a commonly available product and its ingestion has been demonstrated to produce in vivo gas bubbles, which can embolize to devastating effect. ⋯ As demonstrated by both our experience as well as the current literature, HBO has been used to successfully treat gas emboli associated with hydrogen peroxide ingestion. We recommend consideration of HBO in any cases of significant hydrogen peroxide ingestion with a clinical picture compatible with gas emboli.
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Review Case Reports
Case Report and Literature Review of a Dissecting Thoracic Aneurysm in a 16-Year-Old Boy Presenting to the Emergency Department.
Aortic dissection is a rare occurrence in the pediatric and adolescent population. It has numerous etiologies, including congenital cardiac abnormalities. Aortic dissection has a high mortality rate; therefore, it is essential for the physician to at least consider this diagnosis in the setting this patient presented within their differential of atypical chest pain in the pediatric and adolescent population. ⋯ It is important to consider aortic dissection as a possibility when assessing the sick adolescent patient. The D-dimer is quite useful as a rapid and inexpensive test in the evaluation and stratification of adolescent chest pain patients in the ED.
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Review Case Reports
Are Plain Radiographs Sufficient to Exclude Cervical Spine Injuries in Low-Risk Adults?
The routine use of clinical decision rules and three-view plain radiography to clear the cervical spine in blunt trauma patients has been recently called into question. ⋯ The consistently poor performance of plain radiographs to rule out cervical spine injury in adult blunt trauma victims is concerning. Large, rigorously performed prospective trials focusing on low- or low/moderate-risk patients will be needed to truly define the utility of plain radiographs of the cervical spine in blunt trauma.