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https://www.readbyqxmd.com/read/29905048/-diagnosis-and-treatment-of-crush-syndrome-of-chest-and-arm
#1
Haojie Cui, Ge Xiong, Chunlin Zhang, Zirun Xiao
Objective: To investigate pathogenesis, diagnosis, and treatment of crush syndrome of chest and arm. Methods: Between January 2010 and January 2015, 5 cases of crush syndrome of chest and arm caused by pressing oneself in a coma after CO poisoning or alcoholic intoxication were treated. There were 4 males and 1 female with an average age of 36.7 years (range, 28-46 years). Two patients involved left upper limb and chest, while the other three patients involved right upper limb and chest...
June 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
https://www.readbyqxmd.com/read/29903635/a-new-chest-compression-technique-in-infants
#2
Emilio Rodriguez-Ruiz, Victoria Guerra Martín, Cristian Abelairas-Gómez, Fátima Sampedro Vidal, Candela Gómez González, Roberto Barcala-Furelos, Antonio Rodríguez-Nuñez
OBJECTIVE: To compare the quality of chest compressions performed according to the classical technique (MT) versus a new technique (NM) (compression with 2thumbs with closed fists) in an infant manikin. DESIGN: A controlled, randomized cross-over study was carried out in professionals assisting pediatric patients. SETTING: A University Hospital with a Pediatric ICU in the north of Spain. PARTICIPANTS: Residents and nurses in Pediatrics who had completed a basic and an advanced pediatric cardiopulmonary resuscitation course...
June 11, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29889952/management-of-suspected-tension-pneumothorax-in-tactical-combat-casualty-care-tccc-guidelines-change-17-02
#3
Frank K Butler, John B Holcomb, Stacy Shackelford, Harold R Montgomery, Shawn Anderson, Jeffrey S Cain, Howard R Champion, Cord W Cunningham, Warren C Dorlac, Brendon Drew, Kurt Edwards, John V Gandy, Elon Glassberg, Jennifer Gurney, Theodore Harcke, Donald A Jenkins, Jay Johannigman, Bijan S Kheirabadi, Russ S Kotwal, Lanny F Littlejohn, Matthew Martin, Edward L Mazuchowski, Edward J Otten, Travis Polk, Peter Rhee, Jason M Seery, Zsolt Stockinger, Jeremy Torrisi, Avi Yitzak, Ken Zafren, Scott P Zietlow
This change to the Tactical Combat Casualty Care (TCCC) Guidelines that updates the recommendations for management of suspected tension pneumothorax for combat casualties in the prehospital setting does the following things: (1) Continues the aggressive approach to suspecting and treating tension pneumothorax based on mechanism of injury and respiratory distress that TCCC has advocated for in the past, as opposed to waiting until shock develops as a result of the tension pneumothorax before treating. The new wording does, however, emphasize that shock and cardiac arrest may ensue if the tension pneumothorax is not treated promptly...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/29872865/-successful-prehospital-emergency-thoracotomy-after-blunt-thoracic-trauma-case-report-and-lessons-learned
#4
Janosch Dahmen, Marko Brade, Christian Gerach, Martin Glombitza, Jan Schmitz, Simon Zeitter, Eva Steinhausen
BACKGROUND: The European Resuscitation Council guidelines for resuscitation in patients with traumatic cardiac arrest recommend the immediate treatment of all reversible causes, if necessary even prior to continuous chest compression. In the case of cardiac tamponade immediate emergency thoracotomy should also be considered. OBJECTIVE: The authors report the case of a 23-year-old male patient with multiple injuries including blunt thoracic trauma, which caused a witnessed cardiac arrest...
June 5, 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29866625/benchmarking-emergency-department-thoracotomy-using-trauma-video-review-to-generate-procedural-norms
#5
Ryan P Dumas, Kristen M Chreiman, Mark J Seamon, Jeremy W Cannon, Patrick M Reilly, Jason D Christie, Daniel N Holena
INTRODUCTION: Emergency department thoracotomy (EDT) must be rapid and well-executed. Currently there are no defined benchmarks for EDT procedural milestones. We hypothesized that trauma video review (TVR) can be used to define the 'normative EDT' and generate procedural benchmarks. As a secondary aim, we hypothesized that data collected by TVR would have less missingness and bias than data collected by review of the Electronic Medical Record (EMR). METHODS: We used continuously recording video to review all EDTs performed at our centre during the study period...
May 23, 2018: Injury
https://www.readbyqxmd.com/read/29749582/naloxone-induced-non-cardiogenic-pulmonary-edema-a-case-report
#6
Nasheena Jiwa, Himesh Sheth, Richard Silverman
A 22-year-old man was admitted for an elective right-shoulder open subacromial decompression and distal clavicle excision. He received a single intravenous dose of fentanyl 50 μg for anesthesia. His procedure was completed without intra-operative complications; however, he developed post-operative respiratory depression in the setting of narcotic administration. He was given naloxone 0.2 mg intravenously once to reverse this effect, which subsequently led to acute hypoxic respiratory failure secondary to pulmonary edema shortly after administration of naloxone...
May 10, 2018: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/29703561/tension-hydrothorax-emergency-decompression-of-a-pleural-cause-of-cardiac-tamponade
#7
E E Vinck, J C Garzón, T Peterson, R Villarreal, L Cabrera, L Van den Eijnden
INTRODUCTION: A tension hydrothorax is defined as a massive pleural effusion presenting with hemodynamic abnormalities secondary to mediastinal compression. In these patients pleural volume increases intrathoracic pressure to the point of compromising diastolic filling and cardiac output simulating a cardiac tamponade physiology. This is an uncommon yet potentially fatal medical emergency that if left untreated may progress to cardiac arrest. Early detection and rapid intervention of these patients prevents cardiorespiratory collapse...
April 21, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29690910/haemodynamic-outcomes-during-piston-based-mechanical-cpr-with-or-without-active-decompression-in-a-porcine-model-of-cardiac-arrest
#8
Mikkel T Steinberg, Jan-Aage Olsen, Morten Eriksen, Andres Neset, Per Andreas Norseng, Jo Kramer-Johansen, Bjarne Madsen Hardig, Lars Wik
BACKGROUND: Experimental active compression-decompression (ACD) CPR is associated with increased haemodynamic outcomes compared to standard mechanical chest compressions. Since no clinically available mechanical chest compression device is capable of ACD-CPR, we modified the LUCAS 2 (Physio-Control, Lund, Sweden) to deliver ACD-CPR, hypothesising it would improve haemodynamic outcomes compared with standard LUCAS CPR on pigs with cardiac arrest. METHODS: The modified LUCAS delivering 5 cm compressions with or without 2 cm active decompression above anatomical chest level was studied in a randomized crossover design on 19 Norwegian domestic pigs...
April 24, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29687909/breath-hold-diving
#9
John R Fitz-Clarke
Breath-hold diving is practiced by recreational divers, seafood divers, military divers, and competitive athletes. It involves highly integrated physiology and extreme responses. This article reviews human breath-hold diving physiology beginning with an historical overview followed by a summary of foundational research and a survey of some contemporary issues. Immersion and cardiovascular adjustments promote a blood shift into the heart and chest vasculature. Autonomic responses include diving bradycardia, peripheral vasoconstriction, and splenic contraction, which help conserve oxygen...
March 25, 2018: Comprehensive Physiology
https://www.readbyqxmd.com/read/29606684/en-route-care-provided-by-us-navy-nurses-in-iraq-and-afghanistan
#10
Virginia S Blackman, Benjamin D Walrath, Lauren K Reeves, Alejandra G Mora, Joseph K Maddry, Zsolt T Stockinger
BACKGROUND: US Navy nurses provide en route care for critically injured combat casualties without having a formal program for training, utilization, or evaluation. Little is known about missions supported by Navy nurses. OBJECTIVES: To characterize the number and types of patients transported and skill sets required by Navy nurses during 2 combat support deployments. METHODS: All interfacility casualty transfers between 2 separate facilities in Iraq and Afghanistan were assessed...
April 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29530471/whiptail-stingray-injury
#11
Simon Laurent, Olivier Martinet, Helene Cuq, Alain Rind, Philippe Durasnel, Claire Lenne, Renaud Blondé
Stingray injuries to the chest are rare but potentially life-threatening. They may occur in remote areas where advanced emergency healthcare services are unavailable. We describe the case of a 24-year-old man with tension pneumothorax due to a Himantura fai stingray injury to the left chest. The chest wound was unremarkable, with no external bleeding or evidence of a foreign body. Decompression was performed at the scene with an improvised knife procedure and a hollow writing pen, which served as a chest tube...
March 9, 2018: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/29506496/extragonadal-germ-cell-tumor-of-the-posterior-mediastinum-in-a-child-complicated-with-spinal-cord-compression-a-case-report
#12
Dong Keon Yon, Tae Keun Ahn, Dong Eun Shin, Gwang Il Kim, Moon Kyu Kim
BACKGROUND: Germ cell tumors (GCTs) in children are rare neoplasms with diverse pathological findings according to the site and age of presentation. The most common symptoms in children with mediastinal GCTs, which are nonspecific, are dyspnea, chest pain, cough, hemoptysis, vena cava occlusion syndrome, and fatigue/weakness. Because of these nonspecific symptoms, it is difficult to suspect a mediastinal mass. A posterior mediastinal tumor causing spinal cord compression is an important example of an oncologic emergency arising from a neurogenic tumor...
March 5, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29502130/primary-thoracic-giant-cell-tumor-of-bone-sensitive-to-steroids
#13
Huiliang Yang, Gi Hye Im, Gunnlaugur Petur Nielsen, Arvin Kheterpal, Joseph H Schwab
Spinal giant cell tumor of bone (GCTB) is a rare benign, but locally aggressive, entity. We report the case of a 40-year-old man diagnosed with GCTB of the thoracic spine. The only symptom upon presentation was progressive back pain with pain radiating to the chest. Magnetic resonance imaging showed that the soft tissue mass extended posteriorly into the spinal canal, causing severe spinal cord compression. We initially treated this case with Decadron (Fresenius kabi, Bad Homburg vor der Hohe, Germany) for 1 week...
March 3, 2018: Skeletal Radiology
https://www.readbyqxmd.com/read/29501016/management-of-extensive-surgical-emphysema-with-subcutaneous-drain-a-case-report
#14
Quoc Tran, Ryo Mizumoto, Daniel Mehanna
INTRODUCTION: Subcutaneous emphysema (SE) is a frequent and often self-limiting complication of tube thoracostomy or other cardiothoracic procedures. On rare occasions, severe and extensive surgical emphysema marked by palpable cutaneous tension, dysphagia, dysphonia, palpebral closure or associated with pneumoperitoneum, airway compromise, "tension phenomenon" and respiratory failure require treatment. PRESENTATION OF CASE: A 67 year old lady presented with a large spontaneous pneumothorax on the background of end-stage chronic obstructive pulmonary disease (COPD) and newly diagnosed lung cancer, developed extensive surgical emphysema following insertion of a chest drain...
2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29486576/excision-of-thoracic-vertebral-chondrosarcoma-after-spinal-decompression
#15
Ayaka Asakawa, Hironori Ishibashi, Masashi Kobayashi, Tsuyoshi Hachimaru, Hirokuni Arai, Kenichi Okubo
A 44-year-old man presented with an abnormal chest shadow. Computed tomography-guided biopsy showed a chondral tumor of the thoracic vertebrae. Five years later, he developed a walking disorder, left leg numbness, and a vesicorectal disorder. Emergency orthopedic spinal decompression was performed. Eight months later, the residual tumor had become larger and was adjacent to the aorta. Prior to thoracotomy, an intraaortic stent was inserted. The 4th and 5th ribs were invaded by the tumor. The entire tumor and chest wall were excised with the aortic adventitia...
May 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29477681/surgical-missteps-in-the-management-of-venous-thoracic-outlet-syndrome-which-lead-to-reoperation
#16
Meena M Archie, Johnathon C Rollo, Hugh A Gelabert
BACKGROUND: Surgical management of spontaneous subclavian thrombosis due to venous thoracic outlet syndrome (vTOS) results in durable relief of symptoms. The need to reoperate is rare. We report our experience with reoperation for vTOS. METHODS: Patients evaluated for vTOS between 1996 and 2016 were identified in a prospective database. Data recorded included demographics, initial presentation, initial surgery, recurrent presentation, reoperation, and final outcomes...
May 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29463357/point-of-care-ultrasound-for-pulmonary-concerns-in-remote-spaceflight-triage-environments
#17
REVIEW
Benjamin D Johansen, Rebecca S Blue, Tarah L Castleberry, Erik L Antonsen, James M Vanderploeg
INTRODUCTION: With the development of the commercial space industry, growing numbers of spaceflight participants will engage in activities with a risk for pulmonary injuries, including pneumothorax, ebullism, and decompression sickness, as well as other concomitant trauma. Medical triage capabilities for mishaps involving pulmonary conditions have not been systematically reviewed. Recent studies have advocated the use of point-of-care ultrasound to screen for lung injury or illness. The operational utility of portable ultrasound systems in disaster relief and other austere settings may be relevant to commercial spaceflight...
February 1, 2018: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/29402359/-predictive-value-of-partial-pressure-of-end-tidal-carbon-dioxide-on-the-effect-of-active-abdominal-compression-decompression-cardiopulmonary-resuscitation-and-serum-s100b-protein-on-cerebral-function
#18
Hongwei Wang, Xin Sha, Sisen Zhang, Xianfa Jiao, Longxian Zhao, Yingxin Cen, Wei Song, Jing Li, Lixiang Wang
OBJECTIVE: To explore the predictive value of partial pressure of end-tidal carbon dioxide (PET CO2 ) on the effect of active abdominal compression-decompression cardiopulmonary resuscitation (AACD-CPR) and serum S100B protein on cerebral function. METHODS: 142 adult patients with in-hospital cardiac arrest (IHCA) AACD-CPR in Zhengzhou People's Hospital, Affiliated Southern Medical University from September 2014 to December 2017 were enrolled. Patients were divided into successful group and failure group according to restoration of spontaneous circulation (ROSC) or not; and then according to Glasgow-Pittsburgh cerebral performance categories (CPC) one month after ROSC, the successful group was divided into good prognosis group (CPC 1-2) and poor prognosis group (CPC 3-5) further...
February 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29369843/smartwatch-feedback-device-for-high-quality-chest-compressions-by-a-single-rescuer-during-infant-cardiac-arrest-a-randomized-controlled-simulation-study
#19
Juncheol Lee, Yeongtak Song, Jaehoon Oh, Youngjoon Chee, Chiwon Ahn, Hyungoo Shin, Hyunggoo Kang, Tae Ho Lim
OBJECTIVE: According to the guidelines, rescuers should provide chest compressions (CC) ∼1.5 inches (40 mm) for infants. Feedback devices could help rescuers perform CC with adequate rates (CCR) and depths (CCD). However, there is no CC feedback device for infant cardiopulmonary resuscitation (CPR). We suggest a smartwatch-based CC feedback application for infant CPR. PARTICIPANTS AND METHODS: We created a smartwatch-based CC feedback application. This application provides feedback on CCD and CCR by colour and text for infant CPR...
February 12, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29305711/early-management-of-retained-hemothorax-in-blunt-head-and-chest-trauma
#20
Fong-Dee Huang, Wen-Bin Yeh, Sheng-Shih Chen, Yuan-Yuarn Liu, I-Yin Lu, Yi-Pin Chou, Tzu-Chin Wu
BACKGROUND: Major blunt chest injury usually leads to the development of retained hemothorax and pneumothorax, and needs further intervention. However, since blunt chest injury may be combined with blunt head injury that typically requires patient observation for 3-4 days, other critical surgical interventions may be delayed. The purpose of this study is to analyze the outcomes of head injury patients who received early, versus delayed thoracic surgeries. MATERIALS AND METHODS: From May 2005 to February 2012, 61 patients with major blunt injuries to the chest and head were prospectively enrolled...
January 5, 2018: World Journal of Surgery
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