J Emerg Med
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Although procedural pain is effectively treated with analgesics, managing anxiety during laceration repair is more challenging. ⋯ Immersive VR is a safe and effective distractive technique to reduce procedural anxiety during laceration repair in the pediatric ED.
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Case Reports
High-Pressure Injection Injury to the Hand With Resulting Pneumomediastinum: A Case Report.
High-pressure injection injury is an uncommon but potentially limb-threatening presentation that in many cases should be treated as a surgical emergency. ⋯ We present a 46-year-old patient with a high-pressure injection injury from SCUBA equipment who developed pneumomediastinum. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: High-pressure injection injuries are rare and may have significant morbidity. Injection injuries from air are uncommon, may be managed differently than injection with other materials, and may be associated with unique complications.
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Case Reports
Severe Vertebral Body Fracture-Dislocation as a Result of Chest Compressions: A Case Report.
Although high-quality chest compressions are an essential, lifesaving component of cardiopulmonary resuscitation, injuries are common with both manual and mechanical chest compressions. ⋯ We discuss the case of a 77-year-old woman who sustained thoracic vertebral fractures after cardiopulmonary resuscitation involving both manual and mechanical chest compressions. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Routine post-cardiac arrest care should include evaluation for chest compression-related injury. If a patient has back pain, focal vertebral tenderness, or paraplegia after chest compressions, imaging to evaluate for vertebral fracture should be performed. If unable to assess for back pain or tenderness, consider imaging to evaluate for vertebral fracture in patients with kyphosis or osteopenia, as these patients are at higher risk for chest compression vertebral injury.
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The LMA Fastrach (LMA North America, Inc; hereafter termed the intubating laryngeal mask airway [ILMA]) is an extraglottic device designed to facilitate endotracheal intubation. After the endotracheal tube is placed through the lumen of the ILMA into the trachea, the ILMA is removed, using a proprietary stabilizer rod to hold the tube in place. ⋯ The traditional method of ILMA removal around an endotracheal tube is not designed for critically ill patients or the physicians taking care of them. This novel technique is designed to improve the usability of the ILMA for physicians and improve airway outcomes for patients.