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Trauma And Anesthesia

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https://www.readbyqxmd.com/read/29437503/a-novel-treatment-of-nasal-stenosis-using-steel-gauging-earrings
#1
Julie Le, Nicholas S Adams, John A Girotto, John W Polley, Robert J Mann
Nasal stenosis is an uncommon and challenging deformity. Most common etiologies for nasal stenosis include congenital, iatrogenic, trauma, and infection. Repair techniques typically include tissue replacement with grafts or flaps with subsequent stent placement. These procedures often require general anesthesia and carry high rates of restenosis. We describe a case of a 10-year-old girl with Teebi syndrome and iatrogenic nasal stenosis who underwent successful nasal dilation with inexpensive, minimally invasive steel gauge earrings...
March 2018: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/29428034/impact-of-trauma-certified-registered-nurse-anesthetists-team-on-intra-operative-resuscitation-and-postoperative-outcomes-of-trauma-patients
#2
Juan Duchesne, Chad Majoue, Marquinn Duke, Rosemarie Robledo, Chad Achord, Leslie McHale, Brandy Davis, Lusine Nahapetyan
A Trauma Certified Registered Nurse Anesthetists Team (TCT) was created and trained to provide trauma-focused anesthesia and resuscitation. The purpose of this study was to examine patient outcomes after implementation of TCT. We conducted retrospective analyses of trauma patients managed with surgical intervention from March to December 2015. During the first five months, patients managed before the development of TCT were grouped No-TCT, patients managed after were grouped TCT. To assess outcomes, we used hospital and intensive care unit length of stay, ventilator days, and a validated 10-point intraoperative Apgar score (IOAS)...
January 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29416199/rhythm-disturbance-after-myocardial-revascularization
#3
Nedzad Kadric, Enes Osmanovic
Introduction: Heart rhythm disorders are common in the post-operative period following surgical myocardial revascularization (CABG). The incidence of any type of arrhythmia in the postoperative period can go up to 85%. While most are transient and short-term, it does not lead to deterioration of the postoperative course, in a smaller number of patients they can be predictors of various events that result in fatal outcome. Arrhythmias occur suddenly and need to be recognized and reacted in time...
December 2017: Medical Archives
https://www.readbyqxmd.com/read/29403246/surgical-management-of-c-type-subaxial-cervical-fractures-using-cervical-traction-followed-by-anterior-cervical-discectomy-and-fusion-within-12-h-after-the-trauma
#4
Pasquale Donnarumma, Vincenzo Bozzini, Gaetano Rizzi, Arturo Berardi, Gaetano Merlicco
Study Design: This was a retrospective cohort study. Objective: To report our 10-year experience of closed reduction using Crutchfield traction followed by anterior cervical discectomy and fusion within 12 h from injury for C-type subaxial cervical fractures (according to the AOSpine classification system). Methods: Clinical records and neuroimaging were retrospectively reviewed. Surgical details were provided. Results: A total of 22 patients were included in the study...
October 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/29384419/procedural-sedation-and-analgesia-in-trauma-patients-in-an-out-of-hospital-emergency-setting-a-prospective-multicenter-observational-study
#5
Michel Galinski, Laure Hoffman, Delphine Bregeaud, Mounir Kamboua, François-Xavier Ageron, Catherine Rouanet, Jean-Christophe Hubert, Jacques Istria, Mirko Ruscev, Karim Tazarourte, Florence Pevirieri, Frédéric Lapostolle, Frédéric Adnet
BACKGROUND: The quality of procedural analgesia and sedation among trauma patients has not been studied much in the prehospital setting. The main objective of this study was to characterize the quality of procedural analgesia sedation practices in prehospital settings in trauma patients. METHODS: This was an open-label observational prospective multicenter study (January 01, 2012-December 31, 2013). We included all consecutive trauma victims undergoing a potentially painful procedure on the accident scene...
January 31, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29374291/intracardiac-echocardiography-for-percutaneous-patent-foramen-ovale-and-atrial-septal-defect-occlusion
#6
C Kavvouras, M Vavuranakis, S Vaina, K Lampropoulos, G Bazoukis, G Tse, D Tousoulis
BACKGROUND: Transesophageal echocardiography (TEE) plays a unique role in transcatheter closure of atrial septal defects (ASD) and patent foramen ovale (PFO). However, problems such as the need for general anesthesia, possible trauma from endotracheal intubation, presence of "blind spots," and occasional inadequate imaging of some cardiac structures have necessitated better imaging techniques. Our study aimed to compare the findings of TEE during the initial diagnostic examination with those from intracardiac echocardiography (ICE) acquired during the interventional procedure...
January 26, 2018: Herz
https://www.readbyqxmd.com/read/29349350/a-comparison-of-the-effects-of-epinephrine-and-xylometazoline-in-decreasing-nasal-bleeding-during-nasotracheal-intubation
#7
Jaegyok Song
Background: Various techniques have been introduced to decrease complications during nasotracheal intubation. A common practice is to use nasal packing with a cotton stick and 0.01% epinephrine jelly. However, this procedure can be painful to patients and can damage the nasal mucosa. Xylometazoline spray can induce effective vasoconstriction of the nasal mucosa without direct nasal trauma. In this study, we aimed to compare the efficacy of these two methods. Methods: Patients were randomly allocated into two groups (n = 40 each): xylometazoline spray group or epinephrine packing group...
December 2017: Journal of Dental Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29332776/compliance-with-a-national-standard-by-norwegian-helicopter-emergency-physicians
#8
Lars Petter Bjørnsen, Andrea Marie Solheim, Oddvar Uleberg, Eirik Skogvoll
OBJECTIVE: The "National Standard Requirements for Helicopter Emergency Medicine Services Physicians" gives recommendations on medical requirements for flight physicians. This study describes the level of formal competence, experience, and guideline compliance of Norwegian helicopter emergency medical service (HEMS) physicians. METHODS: In May 2013, all HEMS physicians with full-time engagement at Norwegian HEMS bases were invited to participate in a cross-sectional survey using a structured, Web-based questionnaire...
January 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29316070/incidence-and-risk-factors-of-severe-lacerations-during-forceps-delivery-in-a-single-teaching-hospital-where-simulation-training-is-held-annually
#9
Yasuko Sano, Chihiro Hirai, Shintaro Makino, Xianglan Li, Jun Takeda, Atsuo Itakura, Satoru Takeda
AIM: This study was conducted to evaluate the incidence of severe lacerations during forceps delivery and the risk factors associated with such delivery in a hospital where simulation training is held annually. METHODS: The medical records of 857 women who underwent forceps delivery at term with singleton cephalic presentation from 2010 to 2015 were reviewed. The relationship between clinical characteristics and birth canal trauma was analyzed. Birth canal trauma included third and fourth degree perineal lacerations...
January 5, 2018: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29312845/transforaminal-percutaneous-endoscopic-discectomy-using-transforaminal-endoscopic-spine-system-technique-pitfalls-that-a-beginner-should-avoid
#10
REVIEW
Stylianos Kapetanakis, Grigorios Gkasdaris, Antonios G Angoules, Panagiotis Givissis
Transforaminal Percutaneous Endoscopic Discectomy (TPED) is a minimally invasive technique mainly used for the treatment of lumbar disc herniation from a lateral approach. Performed under local anesthesia, TPED has been proven to be a safe and effective technique which has been also associated with shorter rehabilitation period, reduced blood loss, trauma, and scar tissue compared to conventional procedures. However, the procedure should be performed by a spine surgeon experienced in the specific technique and capable of recognizing or avoiding various challenging conditions...
December 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/29307442/augmentation-surgery-on-the-cartilaginous-portion-of-the-vocal-fold-in-a-patient-with-cricoarytenoid-joint-ankylosis
#11
Mioko Fukahori, Shun-Ichi Chitose, Kiminori Sato, Hiroyuki Kamimura, Kiminobu Sato, Ririko On, Hirohito Umeno
Surgical management of cricoarytenoid joint (CAJ) ankylosis is challenging and has the risk of worsening voice quality. In the present case, augmentation surgery was performed on the cartilaginous portion of the vocal fold in a patient with CAJ ankylosis. A 24-year-old man sustained blunt trauma to the anterior neck three years prior to developing severe breathiness. Posterior glottal insufficiency resulting from lateral fixation of the right vocal fold was observed during phonation under laryngoscopy. In addition, electromyography and CT scan revealed severe ankylosis of the right CAJ...
January 4, 2018: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/29301653/successful-emergency-pain-control-for-posterior-rib-fractures-with-ultrasound-guided-erector-spinae-plane-block
#12
Josh Luftig, Daniel Mantuani, Andrew A Herring, Brittany Dixon, Eben Clattenburg, Arun Nagdev
The Eastern Association for the Surgery of Trauma and Trauma Anesthesiology Society Guidelines recommend prompt and effective multimodal analgesia for rib fractures that combines regional anesthesia (RA) techniques with pharmacotherapy to treat pain, optimize pulmonary function, and reduce opioid related complications. However, RA techniques such as epidurals and paravertebral blocks, are generally underutilized or unavailable for emergency department (ED) patients. The recently described serratus anterior plane block (SAPB) is a promising technique, but failures with posterior rib fractures have been observed...
December 28, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29297814/coagulation-assessment-underutilized-diagnostic-tools-in-zoo-and-aquatic-animal-medicine
#13
Trevor J Gerlach, Ashley Barratclough, Bobbi Conner
Veterinarians specializing in nondomestic species are faced with unique challenges regarding research and diagnostic capabilities given the wild and frequently dangerous nature of their patients. Standard diagnostic techniques used in small or large animal practice are not always possible due to anatomical constraints, size, tractability, or the inherent risk of anesthesia in highly valued, rare species. Diagnostic modalities that utilize simple, relatively noninvasive techniques show promise in evaluating nondomestic species and elucidating the pathophysiology behind poorly characterized disease processes in both wild and captive populations...
December 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/29295798/pneumocephalus-after-epidural-injection
#14
Jerel Chacko, Kelly Levis, Barry Hahn
BACKGROUND: Pneumocephalus, or air in the intracranial space, is most commonly encountered after trauma or surgery. Epidural injections are commonly performed in obstetrics and pain management. Complications are uncommon and include hemorrhage, cerebrospinal fluid leak, and infection. A rare complication is pneumocephalus, described in only a few case reports of epidural anesthesia. CASE REPORT: We describe a 34-year-old woman complaining of a generalized headache 6 days after an unremarkable vaginal delivery that was assisted by an epidural injection...
December 30, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29288841/management-of-severe-traumatic-brain-injury-first-24-hours
#15
Thomas Geeraerts, Lionel Velly, Lamine Abdennour, Karim Asehnoune, Gérard Audibert, Pierre Bouzat, Nicolas Bruder, Romain Carrillon, Vincent Cottenceau, François Cotton, Sonia Courtil-Teyssedre, Claire Dahyot-Fizelier, Frédéric Dailler, Jean-Stéphane David, Nicolas Engrand, Dominique Fletcher, Gilles Francony, Laurent Gergelé, Carole Ichai, Etienne Javouhey, Pierre-Etienne Leblanc, Thomas Lieutaud, Philippe Meyer, Sébastien Mirek, Gilles Orliaguet, François Proust, Hervé Quintard, Catherine Ract, Mohamed Srairi, Karim Tazarourte, Bernard Vigué, Jean-François Payen
The latest French Guidelines for the management in the first 24hours of patients with severe traumatic brain injury (TBI) were published in 1998. Due to recent changes (intracerebral monitoring, cerebral perfusion pressure management, treatment of raised intracranial pressure), an update was required. Our objective has been to specify the significant developments since 1998. These guidelines were conducted by a group of experts for the French Society of Anesthesia and Intensive Care Medicine (Société Francaise d'Anesthésie Réanimation (SFAR)) in partnership with the Association de Neuro-Anesthésie-Réanimation de Langue Française (ANARLF), the Société Française de Neurochirurgie (SFN), the Groupe Francophone de Réanimation et d'Urgences Pédiatriques (GFRUP) and the Association des Anesthésistes-Réanimateurs Pédiatriques d'Expression Française (ADARPEF)...
December 27, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29286969/simultaneous-ipsilateral-dislocation-of-the-hip-and-the-knee-a-case-report
#16
Antonio Arenas Miquelez, Filippo Familiari, Lucas Arbeloa, Andrea D'Arrigo Azzarelli
CASE: A patient was struck by an agricultural vehicle and sustained ipsilateral hip and knee dislocations. Closed reduction of the hip was accomplished in the emergency department; the patient required general anesthesia in the operating room to reduce the knee dislocation. Nonoperative treatment was used for both injuries, with a good long-term outcome. CONCLUSION: Simultaneous ipsilateral hip and knee dislocations are rare and complex injuries that usually result from high-energy trauma...
October 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29279839/limited-approach-in-endoscopic-dacryocystorhinostomy-of-pediatrics
#17
Seyyed Mostafa Hashemi, Afrooz Eshaghian
Background: Limited spatial nasal cavity in children, make pediatric dacryocystorhinostomy (DCR) a difficult surgical procedure. We apply a limited approach to pediatric DCR and follow them for their consequences. Materials and Methods: An experimental study was done in pediatric DCR with limited approach (age < 14-year-old). After written consent, with general anesthesia, with nasal endoscopic surgery, lacrimal bone is exposed and extruded. In contrast with routine procedure, ascending process of maxillary sinus reserve; and marsupialization and wide exposure to lacrimal sac was done only by lacrimal bone defect; and cannulation preserve with temporary silicone tube...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/29279780/locked-central-fracture-dislocation-of-the-hip-in-a-child-after-low-energy-trauma
#18
Alexandre H Nehme, Jack C Daoud, Hicham G Abdelnour, Jad N Bou Mounsef, Ramzi C Moucharafieh, Joseph W Wehbe
We present the case of a 13-year-old boy who sustained a locked central fracture dislocation of the right acetabulum following a bicycle fall. Immediate external reduction maneuvers under general anesthesia were unsuccessful due to intrapelvic entrapment of the femoral head. Open reduction internal fixation was achieved 48 hours later. After an initial satisfactory postoperative course, the patient ended up developing severe hip osteoarthritis 16 months after the procedure. The rarity of this injury in children is discussed, with its possible implications on joint congruity and potential growth injury...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/29279655/outcomes-of-pneumatic-retinopexy-for-the-management-of-rhegmatogenous-retinal-detachment-at-a-tertiary-care-center
#19
Mohammad A Hazzazi, Saba Al Rashaed
PURPOSE: The purpose of the study was to report the outcomes of pneumatic retinopexy (PR) for rhegmatogenous retinal detachment (RRD). METHODS: A retrospective chart review of all patients with RRD who were managed with PR at the King Khaled Eye Specialist Hospital between 2000 and 2014. Data were collected on preoperative ocular history, characteristics of the RRD, postoperative anatomical and visual outcomes, and secondary surgeries. RESULTS: Sixty-five eyes comprised the study sample with mean a follow-up of 42 months...
July 2017: Middle East African Journal of Ophthalmology
https://www.readbyqxmd.com/read/29275235/endovascular-treatment-of-renal-arterial-perforation-after-blunt-trauma-case-report
#20
Kyoung Hoon Lim, Hun Kyu Ryeom, Jinyoung Park
INTRODUCTION: Isolated renal arterial perforation is a rare consequence of blunt abdominal trauma. Meticulous surgical control of retroperitoneal active bleeding is difficult due to oozing of soft connective tissue, the deep position of operative field, and the presence of friable vascular tissue. Therefore, endovascular treatment is often preferred. PRESENTATION OF CASE: An 83-year-old man was transferred to our trauma center due to retroperitoneal active bleeding after a car accident, in which his right upper abdomen struck the steering wheel...
December 16, 2017: International Journal of Surgery Case Reports
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