Archives of emergency medicine
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Interscalene brachial plexus block is a simple and effective alternative to intravenous benzodiazepines or general anaesthesia for manipulation of the dislocated shoulder. Thirty interscalene brachial plexus blocks were performed on 29 patients with dislocations of the shoulder to provide regional anaesthesia for reduction. Pain was abolished by 14 out of the 30 blocks performed, improved by 13 and unchanged by three. ⋯ In 26 cases the block allowed reduction of the dislocation without additional analgesia or sedative. Reduction was not possible in four cases. There were no significant complications.
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Letter Case Reports
Primary dislocation of the shoulder in a snooker player.
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Review Case Reports
Conjunctival oxygen monitoring during cardiopulmonary resuscitation.
The conjunctival oxygen tension (CjO2) sensor is a non-invasive, continuous index of oxygen delivery in the haemodynamically unstable patient. Human and animal studies have indicated that CjO2 reflects cerebral blood flow and oxygenation. Simple insertion, rapid stabilization and reaction time less than 60 s allow use in the initial stages of cardiopulmonary resuscitation (CPR) where invasive monitoring is often impracticable. ⋯ This study suggests that closed CPR has no value in maintaining or improving cerebral oxygenation during cardiac arrest. Further studies are required to determine the precise relationship of CjO2 to cerebral blood flow and oxygenation during CPR using open and closed techniques of cardiac massage. Open chest cardiac massage (open CPR) has been shown to produce near normal cerebral perfusion and if patients are to survive prolonged resuscitation neurologically intact guidelines for open CPR must be reviewed.
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This study was undertaken to assess the accuracy of clinical examination in predicting significant injury following blunt chest trauma and to determine whether more selective use of frontal chest radiography could be achieved.