J Emerg Med
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As early as 1826, divers diving to great depths noted that descent often resulted in a phenomenon of intoxication and euphoria. In 1935, Albert Behnke discovered nitrogen as the cause of this clinical syndrome, a condition now known as nitrogen narcosis. ⋯ The syndrome remains relatively unchanged in modern diving when compressed air is used. Behnke's use of non-nitrogen-containing gas mixtures subsequent to his discovery during the 1939 rescue of the wrecked submarine USS Squalus pioneered the use of non-nitrogen-containing gas mixtures, which are used by modern divers when working at great depth to avoid the effects of nitrogen narcosis.
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Among currently available surgical options for the first stage of surgery for infants with hypoplastic left heart syndrome (HLHS), the hybrid procedure is relatively new and less well known among primary care and emergency physicians. This procedure involves placement of a stent within the ductus arteriosus to maintain systemic blood flow and bands around both pulmonary arteries to prevent pulmonary overcirculation. As the number of infants undergoing this procedure increases, emergency physicians will likely encounter them in their practice and should be familiar with their unique physiology and potential complications. ⋯ This case highlights the potential of infants who undergo the hybrid procedure for HLHS to present to the ED with high acuity and, accordingly, the importance of adding this disease process to the vast burden of knowledge facing ED physicians.