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https://www.readbyqxmd.com/read/29744387/dexamethasone-treatment-for-bilateral-lingual-nerve-injury-following-orotracheal-intubation
#1
Saeyoung Kim, Seung-Yeon Chung, Si-Jeong Youn, Younghoon Jeon
Lingual nerve injury is a rare complication of general anesthesia. The causes of lingual nerve injury following general anesthesia are multifactorial; possible mechanisms may include difficult laryngoscopy, prolonged anterior mandibular displacement, improper placement of the oropharyngeal airway, macroglossia and tongue compression. In this report, we have described a case of bilateral lingual nerve injury that was associated with orotracheal intubation for open reduction and internal fixation of the left distal radius fracture in a 61-year-old woman...
April 2018: Journal of Dental Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29707498/management-of-laryngotracheal-trauma
#2
REVIEW
Philicia Moonsamy, Uma M Sachdeva, Christopher R Morse
Laryngotracheal trauma is a rare but potentially life-threatening injury. It is usually seen in multiple-trauma patients and can go unrecognized and undertreated due to its scarcity. The presenting symptoms often do not correlate with the severity of the injury and injuries may range from an endolaryngeal hematoma to a complete tracheal transection. Accurate diagnosis of the extent of the injury can be achieved with a combination of high resolution computed tomography, flexible fiber optic laryngoscopy and flexible bronchoscopy...
March 2018: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29655592/development-of-a-blunt-chest-injury-care-bundle-an-integrative-review
#3
REVIEW
Sarah Kourouche, Thomas Buckley, Belinda Munroe, Kate Curtis
BACKGROUND: Blunt chest injuries (BCI) are associated with high rates of morbidity and mortality. There are many interventions for BCI which may be able to be combined as a care bundle for improved and more consistent outcomes. OBJECTIVE: To review and integrate the BCI management interventions to inform the development of a BCI care bundle. METHODS: A structured search of the literature was conducted to identify studies evaluating interventions for patients with BCI...
April 7, 2018: Injury
https://www.readbyqxmd.com/read/29651626/current-topics-in-the-management-of-acute-traumatic-spinal-cord-injury
#4
Christopher D Shank, Beverly C Walters, Mark N Hadley
Acute traumatic spinal cord injury (SCI) affects more than 250,000 people in the USA, with approximately 17,000 new cases each year. It continues to be one of the most significant causes of trauma-related morbidity and mortality. Despite the introduction of primary injury prevention education and vehicle safety devices, such as airbags and passive restraint systems, traumatic SCI continues to have a substantial impact on the healthcare system. Over the last three decades, there have been considerable advancements in the management of patients with traumatic SCI...
April 12, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29644546/imaging-of-urgencies-and-emergencies-in-the-lung-cancer-patient
#5
REVIEW
Bruno De Potter, Jef Huyskens, Birgitta Hiddinga, Maarten Spinhoven, Annelies Janssens, Jan P van Meerbeeck, Paul M Parizel, Annemie Snoeckx
Lung cancer patients often experience potentially life-threatening medical urgencies and emergencies, which may be a direct or indirect result of the underlying malignancy. This pictorial review addresses the most common thoracic, neurological and musculoskeletal medical emergencies in lung cancer patients, including superior vena cava syndrome, pulmonary embolism, spontaneous pneumothorax, cardiac tamponade, massive haemoptysis, central airway obstruction, oesophagorespiratory fistula, malignant spinal cord compression, carcinomatous meningitis, cerebral herniation and pathological fracture...
April 11, 2018: Insights Into Imaging
https://www.readbyqxmd.com/read/29644297/negative-pressure-in-treatment-of-persistent-post-traumatic-subcutaneous-emphysema-with-respiratory-failure-case-report-and-literature-review
#6
Jakov Mihanović, Ivan Bačić, Nina Sulen
Subcutaneous emphysema may aggravate traumatic pneumothorax treatment, especially when mechanical ventilation is required. Expectative management usually suffices, but when respiratory function is impaired surgical treatment might be indicated. Historically relevant methods are blowhole incisions and placement of various drains, often with related wound complications. Since the first report of negative pressure wound therapy for the treatment of severe subcutaneous emphysema in 2009, only few publications on use of commercially available sets were published...
February 2018: Trauma Case Reports
https://www.readbyqxmd.com/read/29574816/current-and-evolving-trends-in-the-management-of-facial-fractures
#7
N Vujcich, D Gebauer
The oral and maxillofacial region has a complex regional anatomy including hard and soft tissues. Trauma in this region may affect the airway, cause potentially life threatening bleeding and head injuries. The senses of olfaction, sight and hearing can also be disrupted as well as a profound psychological impact following disfigurement. This oral and maxillofacial trauma update provides information on demographics, incidence, pathophysiology, diagnosis, fracture patterns and management of facial trauma. It also discusses the role of new advancements in the management of facial trauma...
March 2018: Australian Dental Journal
https://www.readbyqxmd.com/read/29572374/case-of-a-fractured-human-bone-fragment-as-an-endobronchial-foreign-body-following-a-traffic-incident
#8
Kouko Hidaka, Tetsushi Takeda, Masamichi Nakayama, Hirohisa Yano
Endobronchial foreign bodies (EFBs) are present in various settings, such as eating or dental procedure. Accidental aspiration of foreign bodies is more common in children; however, cases of adult foreign body aspiration exist. Traumatic incidents can precipitate endobronchial aspiration of foreign bodies. Loss of consciousness, such as in coma, can result in foreign bodies being easily inhaled into the airways. Teeth or vehicle parts have been reported as EFBs following traumatic incidents. We report on a patient with chronic, sustained cough following maxillofacial trauma...
March 22, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29561488/submental-intubation-an-underutilized-technique-for-airway-management-in-patients-with-panfacial-trauma
#9
Adam Kaiser, Adam Semanoff, Louis Christensen, Rory Sadoff, Jody C DiGiacomo
PURPOSE: To evaluate submental intubation compared with secure airways of patients who have sustained significant maxillofacial trauma. PATIENTS AND METHODS: Patient series of 3 patients who underwent submental intubation prior to open reduction internal fixation of fractures associated with the mid and lower face. All of these patients were initially orally intubated, and then converted to submental intubation prior to the reparative procedure. Detailed description of the procedure is discussed in each patient...
March 20, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29561482/improving-postoperative-nasal-airway-patency-in-le-fort-based-maxillofacial-trauma-patients-via-a-modified-nasal-packing-technique
#10
Amir Wolff, Gabriel F Santiago, Micah Belzberg, Omri Emodi, Chad R Gordon
INTRODUCTION: Combined mid-face and nasal apparatus trauma injuries pose a significant challenge to airway patency (AW), in the immediate postoperative setting following fracture reduction. As such, the authors describe a modified technique with the goal of maintaining a patent nasal AW, while at the same time, minimizing nasopharyngeal bleeding and nasal AW edema-which can complicate patients requiring intermaxillary fixation (IMF) in the setting of pan-facial trauma. METHODS: A modified technique was devised to assist the reconstruction surgeon in avoiding the risks associated with tracheostomy placement...
March 20, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29560077/higher-mallampati-scores-are-not-associated-with-more-adverse-events-during-pediatric-procedural-sedation-and-analgesia
#11
Maya S Iyer, Raymond D Pitetti, Melissa Vitale
Introduction: Procedural sedation and analgesia (PSA) is used by non-anesthesiologists (NAs) outside of the operating room for several types of procedures. Adverse events during pediatric PSA that pose the most risk to patient safety involve airway compromise. Higher Mallampati scores may indirectly indicate children at risk for airway compromise. Medical governing bodies have proposed guidelines for PSA performed by NAs, but these recommendations rarely suggest using Mallampati scores in pre-PSA evaluations...
March 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29556460/retrograde-intubation-through-nasal-route-in-patients-with-limited-mouth-opening-undergoing-oral-and-maxillofacial-surgery
#12
Ashwant Kumar Vadepally, Ramen Sinha, A V S S Subramanya Kumar
Background: Patients with limited mouth opening (LMO) often associated with difficult intubation. Retrograde intubation is an alternative technique of establishing definitive airway in these patients when blind nasal intubation fails and fiberoptic bronchoscope is not available. We tested the retrograde intubation through nasal route in patients with LMO less than 2 cm. Materials and methods: The procedure was performed with some modification with regard to retrograde guide on 18 patients requiring maxillofacial surgical procedures to increase mouth opening...
January 2018: Journal of Oral Biology and Craniofacial Research
https://www.readbyqxmd.com/read/29489401/cervical-spine-injury-from-unrecognized-craniocervical-instability-in-severe-pierre-robin-sequence-associated-with-skeletal-dysplasia
#13
Xiao Zhu, Kelly N Evans, Areeg El-Gharbawy, Jonathan Y Lee, Jack E Brooker, Noel Jabbour, Elizabeth C Tyler-Kabara, Suneeta Madan-Khertarpal, Joseph E Losee, Jesse A Goldstein
Pierre Robin Sequence (PRS) can be associated with skeletal dysplasias, presenting with craniocervical instability and devastating spinal injury if unrecognized. The authors present the case of an infant with PRS and a type II collagenopathy who underwent multiple airway-securing procedures requiring spinal manipulation before craniocervical instability was identified. This resulted in severe cervical cord compression due to odontoid fracture and occipitoatlantoaxial instability. This case highlights the importance of early cervical spine imaging and cautious manipulation in infants with PRS and suspected skeletal dysplasia...
May 2018: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/29481499/respiratory-obstruction-due-to-richards-type-4-fracture
#14
Willian Ricardo Pires, Gabriel Mulinari Santos, Erik Neiva Ribeiro de Carvalho Reis, André Hergesel de Oliva, Ricardo Garcia Mureb Jacob, Leonardo Perez Faverani, Francisley Ávila Souza, Idelmo Rangel Garcia Júnior
Facial fractures can be potentially fatal in polytraumatized patients due to retropositioning tissues to upper airway obstruction. In the first aids, this situation can be reversed using a tracheostomy procedure to break out the airways. However, fractures leading to airway obstruction are rare and according to Richards Classification can be classified into 5 types. The purpose of this article is to report a clinical patient with a bilateral condylar and mandibular symphysis fractures that resulted in airway obstruction and severe mandibular rear projection...
February 23, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29398999/the-fascia-iliaca-block-as-the-primary-intraoperative-anesthesia-for-hip-fracture-surgery-a-preliminary-study
#15
Joseph J Ruzbarsky, Elizabeth B Gausden, Elan M Goldwyn, Isaac P Lowenwirt, Vitaly Kotlyar
Background: Early surgical intervention for hip fractures in the elderly has proven efficacious. However, surgical delays commonly occur in this patient population due to comorbid conditions that put these patients at a high risk for hypotension-related complications of general or neuraxial anesthesia or anticoagulants that delay the safe use of neuraxial anesthesia. Questions/Purposes: The questions/purposes of this study are (1) to investigate if a fascia iliaca block in conjunction with light to moderate sedation could provide adequate analgesia throughout open surgery for intertrochanteric hip fractures (AO/OTA 31-1) without requiring conversion to general anesthesia with airway support and (2) to assess its perioperative complication profile...
February 2018: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/29342420/-use-of-bronchial-blocker-in-emergent-thoracotomy-in-presence-of-upper-airway-hemorrhage-and-cervical-spine-fracture-a-difficult-decision
#16
Carlos Almeida, Maria João Freitas, Diogo Brandão, José Pedro Assunção
Female, 85 y.o., weighting 60kg, multiple trauma patient. After an initial laparotomy, an emergent thoracotomy was performed using a bronchial blocker for lung isolation (initial active suction was applied). During surgery, bronchial cuff was deflated, causing a self-limited tracheal blood flooding. A second lung isolation was attempted but it was not as effective as initially. Probably, a lung collapse with the same bronchial blocker was impaired in the second attempt because of the obstruction of bronchial blocker lumen by intraoperative endobronchial hemorrhage...
January 13, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29326127/skill-sets-required-for-the-management-of-military-head-face-and-neck-trauma-a-multidisciplinary-consensus-statement
#17
John Breeze, R Blanch, J Baden, A M Monaghan, D Evriviades, S E Harrisson, S Roberts, A Gibson, N MacKenzie, D Baxter, A J Gibbons, S Heppell, J G Combes, R F Rickard
INTRODUCTION: The evolution of medical practice is resulting in increasing subspecialisation, with head, face and neck (HFN) trauma in a civilian environment usually managed by a combination of surgical specialties working as a team. However, the full combination of HFN specialties commonly available in the NHS may not be available in future UK military-led operations, necessitating the identification of a group of skill sets that could be delivered by one or more deployed surgeons. METHOD: A systematic review was undertaken to identify those surgical procedures performed to treat acute military head, face, neck and eye trauma...
January 10, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29324632/chair-lift-falls-and-injuries-in-children
#18
Eric W Glissmeyer, Ryan R Metzger, Robert Bolte
OBJECTIVE: The objective of this study was to compare demographic injury and treatment characteristics of hospitalized pediatric cases of falls from chair lifts to cases of other ski and snowboarding injuries and identify potential interventions for preventing falls from chair lifts. METHODS: Retrospective query of the trauma registry of Utah's only pediatric trauma center for children younger than 18 years requiring hospitalization for a ski or snowboarding injury from November 2004 to February 2014...
February 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29278538/a-fire-extinguisher-death-the-macklin-effect
#19
Ryan Blumenthal, Brigitte Hänert-van der Zee
We present the case of an adult white man found dead in a psychiatric institution with fine white powder (monoammonium phosphate) deposited over the entire face after he insufflated the contents of a dry chemical fire extinguisher. Fine white powder was present within the mouth and sinuses and lined the upper airways. On opening the thoracic cavity, approximately 500 g of fine white powder was present within the right thoracic cavity. The esophagus was ruptured. Traumatic emphysema of the posterior sternum wall was present (pneumomediastinum)...
December 22, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29242030/large-retropharyngeal-haematoma-airway-management-with-airtraq%C3%A2-laryngoscope
#20
M D Mira, M I Valldeperas, A Socias, H Sarasíbar, J L Aguilar Sánchez
Retropharyngeal haematoma is a life-threatening clinical situation that can lead to a potential obstruction of the upper airway and requires rapid diagnosis. Clinicaly, it can be presented in different ways, depending on its size and growing speed. The first measure is to protect and manage the airway: in most cases this is a difficult airway situation. A retropharyngeal haematoma can be formed due to a previous traumatic history, with or without associated cervical fracture. Treatment of the haematoma is conservative in most cases, with close monitoring until it is reabsorbed in 3-4 weeks, although they can sometimes require surgical evacuation...
December 11, 2017: Revista Española de Anestesiología y Reanimación
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