Ultrasound has been accepted as an important initial screening tool for diagnosing severely traumatized patients. The discovery of free fluid in the abdomen and chest can lead to appropriate and timely definitive care. Mass trauma in disasters may occur in remote places where routine radiological diagnostic tools are not available. The portability, small size, light weight, improved quality and low price are advantages of the new hand-held portable ultrasound machines. Focused Assessment Sonography for Trauma (FAST) can be used as a quick adjuvant method for triaging patients. It accurately, and rapidly provides objective information on injured victims, which ultimately aids in assessment, triage and allocation of resources. Furthermore, it can be repeated during transportation. Satellite and mobile wireless transmission of FAST has also been tested using hand-held units. Interpretation of these images was correct in more than 90% of the studied cases. These new developments in technology have a tremendous potential in disaster situations, allowing accurate field triage and direction of patient care, in even the most austere of environments. Ultrasound use can be maximized with adequate training, experience, and appreciation of its technical limitations.

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It is important for clinicians to be aware of the sensitivity and limitations of commonly used methods to confirm endotracheal tube placement. Overreliance on insensitive indicators can lead to delayed recognition of esophageal intubation. The case presented highlights this concern.RÉSUMÉ Il est important pour les cliniciens de connaître la sensibilité et les limites des méthodes couramment utilisées pour confirmer la position de la sonde endotrachéale. Une trop grande confiance accordée à des indicateurs insensibles peut conduire à une identification retardée d'une intubation oesophagienne. Le cas présenté dans cet article met en lumière une telle préoccupation.

Tetanus is a life threatening infection that is rarely encountered in clinical practice. Knowledge of the condition is necessary to ensure optimal management. A 30-year-old male presented with classic signs and symptoms of the disease, including trismus, risus sardonicus, paroxysmal muscle spasms and autonomic instability. The pathophysiology and modern management of this condition are reviewed.

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