J Emerg Med
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Rapid sequence intubation (RSI) is performed by helicopter emergency medical services (HEMS) providers to establish airway control. Common induction agents are etomidate and ketamine, both touted to have relatively stable hemodynamic profiles. Limited data comparing these medications in the air medical setting exist. ⋯ Both ketamine and etomidate are appropriate for intubation of HEMS patients. Ketamine was preferentially selected for hypotensive patients with statistically significant improvement in SBP. Although statistically significant, both ketamine and etomidate had relative low incidences of hypotension.
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Oral endotracheal intubation is a procedure performed by emergency medical services (EMS) providers-who are stationed on ground ambulances, rotor-wing air ambulances (helicopter), and fixed-wing air ambulances (airplane)-for the purpose of securing a patient's airway. ⋯ Our data show that flight crew members-either on fixed-wing or rotor-wing air ambulances-are associated with significantly higher rates of intubation success than ground ambulance providers. There are a number of possible explanations for this trend, including more opportunities to intubate in the air medical setting, increased clinical education focused on airway management in the air medical setting, or assistive technologies being more commonly used in the air medical setting.
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Case Reports
Bilateral Hyphema - An Unexpected Complication of Exercise Resistance Band Use: A Case Report.
Resistance bands commonly used for strength training exercise come with an unexpected risk for ocular trauma. ⋯ In this report, we describe an unintended consequence of a 28-year-old man sustaining an unusual injury-bilateral hyphema-as a result of the use of elastic resistance bands. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Resistance bands are commonly used for strength training exercise and, in this case, a potentially severe, vision-threatening injury-traumatic hyphema-occurred. Traumatic hyphema occurs when blood pools in the anterior chamber of the eye, usually as the result of blunt force trauma or penetrating injury. Early recognition of this condition is imperative, as complications of traumatic hyphema, such as intraocular hypertension or rebleeding, can lead to permanent vision loss.
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Political rhetoric from the former U.S. president influences Latinx adults' feelings of safety and their decisions to seek care in the emergency department (ED). ⋯ Most parents heard statements against undocumented immigrants by the former U.S. president and most believed measures were being enacted. This rhetoric had a substantial negative impact on ULF parents in terms of safety concerns for their child and fear of accessing health care.