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https://www.readbyqxmd.com/read/28919813/a-prospective-double-blinded-randomized-comparison-of-ultrasound-guided-femoral-nerve-block-with-lateral-femoral-cutaneous-nerve-block-versus-standard-anesthetic-management-for-pain-control-during-and-after-traumatic-femur-fracture-repair-in-the-pediatric-population
#1
Nicole M Elsey, Joseph D Tobias, Kevin E Klingele, Ralph J Beltran, Tarun Bhalla, David Martin, Giorgio Veneziano, Julie Rice, Dmitry Tumin
BACKGROUND: Traumatic injury of the femur resulting in femoral fracture may result in significant postoperative pain. As with other causes of acute pain, regional anesthesia may offer a benefit over conventional therapy with intravenous opioids. This study prospectively assesses the effects of femoral nerve blockade with a lateral femoral cutaneous nerve block (FN-LFCN) on intraoperative anesthetic requirements, postoperative pain scores, and opioid requirements. MATERIALS AND METHODS: Seventeen pediatric patients (age 2-18 years) undergoing surgical repair of a traumatic femur fracture fulfilled the study criteria and were randomly assigned to general anesthesia with either an FN-LFCN block (n = 10) or intravenous opioids (n = 7)...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28918181/flared-sign-of-flail-mandible-on-computed-tomography-an-unstable-fracture-associated-with-a-compromised-airway
#2
I Papadiochos, L Goutzanis, K-I Karydi, E Kalfarentzos, N Papadogeorgakis
A mandibular fracture alone rarely causes a life-threatening injury. The aim of this paper was to emphasise the importance of prompt identification of the radiological signs of a flail mandible in a patient with maxillofacial trauma who eventually needed definitive management of her airway.
September 13, 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/28913284/comparison-study-of-the-use-of-absorbable-materials-as-internal-splints-with-airway-silicone-splint-and-absorbable-materials-as-internal-splints-alone
#3
So Young Ji, Seung Soo Kim, Ki Sung Park, Bong Soo Baik
BACKGROUND: Packing after closed reduction of nasal fracture causes uncomfortable nasal obstruction in patients. We packed the superior meatus with synthetic polyurethane foam (SPF) to support the nasal bone, and packed the middle nasal meatus with a nasal airway splint (NAS) and SPF. The aim of this article is prospectively to compare the subjective patient discomfort of SPF (Nasopore Forte plus) packing alone and SPF with NAS. METHODS: We compared the prospectively subjective patient discomfort of SPF packing alone (group A) and SPF with NAS (group B) via visual analog scale (VAS; 0, no symptom; 100, most severe symptom)...
December 2016: Arch Craniofac Surg
https://www.readbyqxmd.com/read/28893016/comparison-of-intubating-conditions-using-fentanyl-plus-propofol-versus-fentanyl-plus-midazolam-during-fiberoptic-laryngoscopy
#4
Parmod Kumar, Tripat Kaur, Gurpreet Kaur Atwal, Jatinderpaul Singh Bhupal, Ajay Kumar Basra
INTRODUCTION: Awake nasal or oral flexible fiberoptic intubation is the airway management technique of choice in known or anticipated difficult airway, unstable cervical fracture, limited mouth opening (as in temporomandibular joint disease), mandibular-maxillary fixation and severe facial burns. Both optimal intubating condition and patient comfort are important for fiberoptic intubation. Optimal intubating conditions provided by an ideal sedation regimen would ensure haemodynamic stability, patient comfort, attenuation of airway reflexes and amnesia...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28879322/difficult-airway-management-in-a-patient-with-a-thin-mandible
#5
Hong-Seok Choi, Jong-Shik Oh, Eun-Jung Kim, Ji-Young Yoon, Ji-Uk Yoon, Cheul-Hong Kim
A 47-year-old woman was referred for surgical treatment of osteomyelitis of the mandible. She had already undergone three previous surgeries. Pre-anesthetic airway evaluation predicted a difficult airway, due to the thin, retro-positioned mandible, tongue, and atrophic changes in the lips and soft tissue. We inserted packing gauzes in the buccal mucosa for easier mask fitting and ventilation. During direct laryngoscopic intubation with a nasotracheal tube (NTT), fracture of a thin mandible can easily occur...
December 2016: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/28864483/cadaveric-study-of-movement-in-the-unstable-upper-cervical-spine-during-emergency-management-tracheal-intubation-and-cervical-spine-immobilisation-a-study-protocol-for-a-prospective-randomised-crossover-trial
#6
Shiyao Liao, Erik Popp, Petra Hüttlin, Frank Weilbacher, Matthias Münzberg, Niko Schneider, Michael Kreinest
INTRODUCTION: Emergency management of upper cervical spine injuries often requires cervical spine immobilisation and some critical patients also require airway management. The movement of cervical spine created by tracheal intubation and cervical spine immobilisation can potentially exacerbate cervical spinal cord injury. However, the evidence that previous studies have provided remains unclear, due to lack of a direct measurement technique for dural sac's space during dynamic processes...
September 1, 2017: BMJ Open
https://www.readbyqxmd.com/read/28858549/submental-intubation-in-cases-of-panfacial-fractures-a-retrospective-study
#7
Willian Caetano Rodrigues, Willian Morais de Melo, Rafael Santiago de Almeida, Shajadi Carlos Pardo-Kaba, Celso Koogi Sonoda, Elio Hitoshi Shinohara
Surgical treatment of panfacial fractures usually requires intraoperative temporary occlusion of the teeth and simultaneous access to the nasal pyramid. In such cases, the standard method of airway management is to perform a tracheostomy, but this may be associated with a significant number of perioperative and late complications. This study aimed to determine if submental endotracheal intubation (SEI) is a viable alternative to tracheostomy, especially when short-term postoperative control of the airway is foreseen...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/28857990/andy-gump-fracture-of-the-mandible-in-a-pediatric-patient
#8
Gabriel Mulinari-Santos, Valthierre Nunes Lima, Xiomara Mónica Johanna Palacio-Muñoz, André Hergesel de Oliva, Gustavo Antonio Correa Momesso, Tárik Ocon Braga Polo, Francisley Ávila Souza, Idelmo Rangel Garcia-Júnior, Leonardo Perez Faverani
The mandibular fractures in pediatric patients are rare, and they can need a fast and safe treatment. We present a case of a pediatric patient with "Andy Gump" fracture, resulting in a retrognathic mandible, distress to breathe, and functional discomfort to the patient caused by a cycling accident. The treatment was successful with the fast release of airway path and use of titanium plates to fix the fracture.
August 28, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28846011/how-to-overcome-the-challenges-of-non-detachable-connector-tubes-in-submental-intubation-for-panfacial-fractures
#9
Sahand Samieirad, Hussein Khalife, Mehrdad Noroozi, Elahe Tohidi, Maryam Alsadat Hashemipour
INTRODUCTION: Armored removable connector tubes are not always available in operating rooms for routine Altemir submental intubation (SMI) technique. The present study addresses a fiber-optic glidoscopy assisted 2-tubes modification of Green & Moore sequence for submandibular intubation. METHODS: The sample was composed of 11 patients (8 males and 3 females) with panfacial fractures where neither the oral and nasal intubation techniques nor tracheostomy were feasible...
August 2017: Archives of Iranian Medicine
https://www.readbyqxmd.com/read/28838826/dental-injury-associated-with-anaesthesia-an-8-year-database-analysis-of-592-claims-from-a-major-french-insurance-company
#10
Giraudon Antoine, Guillaume de Saint Maurice, Matthieu Biais, Dan Benhamou, Karine Nouette-Gaulain
Introduction Dental injury is the most common incident associated with anaesthesia. Regarding recent recommendations on informed consent and changes in airway management practices, a large series of claims related to dental injury has not been recently described. The aim of this study was to analyse a recent database in order to describe the characteristics of dental injury in France. Methods A database that prospectively collected claims reported to Le Sou Médical-MACSF between January 2003 and December 2010, was analysed...
August 21, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28818179/multiple-trauma-and-emergency-room-management
#11
Michael Frink, Philipp Lechler, Florian Debus, Steffen Ruchholtz
BACKGROUND: The care of severely injured patients remains a challenge. Their initial treatment in the emergency room is the essential link between first aid in the field and definitive in-hospital treatment. METHODS: We present important elements of the initial in-hospital care of severely injured patients on the basis of pertinent publications retrieved by a selective search in PubMed and the current German S3 guideline on the care of severely and multiply traumatized patients, which was last updated in 2016...
July 24, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28756495/percutaneous-dilatational-tracheostomy-using-the-etview-tracheoscopic-ventilation-tube-%C3%A2-a-teaching-course-in-a-pig-model
#12
Alfonso Fiorelli, Fausto Ferraro, Elisabetta Frongillo, Pierluigi Fusco, Matteo Pierdiluca, Francesca Nagar, Angela Iuorio, Mario Santini
OBJECTIVE: We planned a training course for trainees of different specialties with the aim of teaching the skills of a new procedure for performing percutaneous dilatational tracheostomy (PDT) with an ETView tracheoscopic ventilation tube instead of standard bronchoscopy in an ex vivo pig model. METHODS: The endotracheal tube, with a camera-embedded tip, was used as an alternative to standard bronchoscopy for visualization of patient airways. The procedure was performed on a home-made animal model...
July 29, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28738936/favorable-outcomes-in-blunt-chest-injury-with-noninvasive-bi-level-positive-airway-pressure-ventilation
#13
Pascal Udekwu, Sahill Patel, Meagan Farrell, Rhonda Vincent
Recent clinical research in patients with blunt chest injury has focused on the benefits of surgical fixation of rib fractures. Noninvasive ventilation (NIV) has been demonstrated to prevent the need for intubation and ventilation in posttraumatic respiratory failure. The preemptive use of NIV in patients with rib fractures has not been extensively studied. Our study evaluated the outcomes of patients with ≥3 rib fractures and hospitalized for ≥ 4 days. Seventy-one patients treated with NIV were compared with 270 patients without NIV...
July 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28713750/comminuted-laryngeal-fracture-following-blunt-trauma-a-need-for-strict-legislation-on-roads
#14
Shraddha Jain, Pragya Singh, Minal Gupta, Bhavna Kamble, Suresh S Phatak
Laryngeal fracture is a rare condition with potential life-long implications related to airway patency, voice quality, and swallowing. Rarity of the condition leads to lack of consensus on the most suitable way to manage this injury. The mode of injury can be prevented by strict legislation on the roads. We report a case of a 28-year-old Indian male who sustained a comminuted displaced fracture of the thyroid cartilage with disruption of anterior commissure due to blunt trauma caused by the metallic side rod of a ladder projecting from the rear of a vehicle in front of the bike on which he was riding...
January 2017: Annals of Maxillofacial Surgery
https://www.readbyqxmd.com/read/28692625/a-new-craniothoracic-mattress-for-immobilization-of-the-cervical-spine-in-critical-care-patients
#15
Micha Holla, Mitchel Driessen, Thomas G E Eggen, Robin A Daanen, Allard J F Hosman, Nico Verdonschot, Gerjon Hannink
Current immobilization techniques of the cervical spine are associated with complications including pressure ulcers, discomfort, and elevated intracranial pressures with limited access to the thorax and airway. In this study, a newly developed craniothoracic immobilizer (Pharaoh mattress) for critical care patients with cervical injury was tested for its restriction of cervical movement, peak interface pressures, comfort, and radiolucency, and compared with headblocks strapped to a spineboard. Cervical movement was measured by roentgen stereophotogrammetric analysis in 5 fresh frozen cadavers...
July 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28675112/the-relationship-of-paranasal-sinus-opacification-to-hospital-acquired-pneumonia-in-the-neurologic-intensive-care-unit-patient
#16
Phillip Huyett, Nicholas R Rowan, Berrylin J Ferguson, Stella Lee, Eric W Wang
BACKGROUND: The association between intensive care unit (ICU) sinusitis and the development of lower airway infections remains unclear. The objective of this study was to determine the correlation between the development of radiographic sinus opacification and pneumonia in the neurologic ICU setting. METHODS: A retrospective review of head computed tomography or magnetic resonance imaging of 612 patients admitted to the neurocritical care unit at a tertiary care center from April 2013 through April 2014 was performed...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28671066/lesions-found-at-routine-meat-inspection-on-finishing-pigs-are-associated-with-production-system
#17
H Kongsted, J T Sørensen
Pigs raised under free-range conditions are expected to experience a higher level of animal welfare than conventionally raised pigs. However, free-range conditions may challenge prevention and treatment of diseases. In order to identify disease problems associated with raising conditions, this study compared slaughter lesions in pigs from conventional indoor, conventional free-range and organic free-range production systems. The study used data from 1,096,756 pigs slaughtered at one Danish abattoir from 1 January 2013 to 31 December 2015...
May 2017: Veterinary Journal
https://www.readbyqxmd.com/read/28595674/blunt-laryngeal-trauma-secondary-to-sporting-injuries
#18
REVIEW
D Mendis, J A Anderson
BACKGROUND: Laryngeal injury after blunt trauma is uncommon, but can cause catastrophic airway obstruction and significant morbidity in voice and airway function. This paper aims to discuss a case series of sports-related blunt laryngeal trauma patients and describe the results of a thorough literature review. METHOD: Retrospective case-based analysis of laryngeal trauma referrals over six years to a tertiary laryngology centre. RESULTS: Twenty-eight patients were identified; 13 (46 per cent) sustained sports-related trauma...
August 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28591509/-double-pneumotorax-secondary-to-single-proyectile-weapon-one-case-report-and-review-of-literature
#19
Mario Quintero-Amaya, Francisco Flores-Orozco, José Herrera-Maldonado, Jorge Miño-Bernal, Edna López-Morales, Abigail Juárez-Ugalde, Marisol Flores-Gonzaga, Débora Aguilar-Sánchez
BACKGROUND: The 25% of traumatic deaths are due to chest trauma with a mortality of 28%, and closed trauma is the most common mechanism of injury. The use of firearms increases the relative risk of death. The five more frequent specific chest injuries are lung contusion (31.8%), hemothorax/pneumothorax (19.4%), rib fractures (13.2%), and diaphragmatic injury (7.5%). CLINICAL CASE: Patient of 25 years with a single firearm projectile wound in the chest who assisted to the emergency room (ER) with significant respiratory distress and meriting surgical emergency airway, documenting double pneumothorax, aortic laceration and rupture of the trachea, which required management in the ER with bilateral chest tube placement and subsequent surgical repair...
July 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28582298/flail-mandible-and-immediate-airway-management-traumatic-detachment-of-mandibular-lingual-cortex-results-in-obstructive-dyspnea-and-severe-odynophagia
#20
Ioannis Papadiochos, Lampros Goutzanis, Vasileios Petsinis
Isolated mandibular fractures usually represent themselves as non-life-threatening injuries and are not treated in emergency setting. However, some rare patterns of them may result in airway obstruction as a result of displacement of bony fragments. The authors report a patient of an open comminuted fracture of mandibular symphysis which exhibited an uncommon split pattern with retrogression of lingual cortical plate, and thereby induced glossoptosis, painful deglutition, and obstruction of the upper airway within a few hours...
July 2017: Journal of Craniofacial Surgery
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