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Medic Evacuation

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https://www.readbyqxmd.com/read/28536800/causes-and-preventive-measures-of-symptomatic-spinal-epidural-haematoma-after-spinal-surgery
#1
Xiao-Jun Zeng, Wei Wang, Zhou Zhao, Ming Li
STUDY DESIGN: This was a retrospective study to evaluate clinical characteristics of patients who developed symptomatic spinal epidural haematoma (SSEH) after spinal surgery. OBJECTIVE: The objective was to determine clinical parameters associated with the development of SSEH after spinal surgery, and to discuss clinical management and possible preventive measures. Although the incidence rate of SSEH is low, the neurological sequelae are devastating. There are limited reports which identify risk factors for SSEH because of the rarity of the condition...
May 24, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28518009/aeromedical-evacuation-using-extra-corporeal-life-support-after-resuscitated-cardiac-arrest
#2
David Gerard, Hervé Raffin, Guillaume Lebreton
BACKGROUND: Extra corporeal life support (ECLS) is presently first line therapy for refractory cardiogenic shock. Mobile circulatory support teams implant ECLS or extra corporeal membrane oxygenation (ECMO) in patients in the hospital without circulatory support. These patients are then transported to specialized centers. Here we report a case of sending a mobile circulatory support team abroad, followed by air ambulance evacuation, which, to our knowledge, has never been used as part of medical assistance abroad...
April 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28518007/patient-centric-side-effect-risk-assessment-for-medications-used-during-aeromedical-evacuations
#3
Shana A Huntsberger, William P Butler, Richard R Chapleau
BACKGROUND: The U.S. Air Force performs more than 6000 aeromedical transport flights annually, both internationally and domestically. Many of these flights include patients requiring pain relief medications. The risk of side effects from such medications administered at altitude is unknown, but understanding these risks is vital when selecting the safest pain management strategies to achieve optimal postflight outcomes. METHODS: Using an evidence-based medication side effect risk assessment model, we compared our patient-centric approach to an aircrew-centric approach using medications approved for use in U...
April 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28515710/resistant-hypertension-after-hypertensive-intracerebral-hemorrhage-is-associated-with-more-medical-interventions-and-longer-hospital-stays-without-affecting-outcome
#4
Daojun Hong, Dana Stradling, Cyrus K Dastur, Yama Akbari, Leonid Groysman, Lama Al-Khoury, Jefferson Chen, Steven L Small, Wengui Yu
BACKGROUND: Hypertension (HTN) is the most common cause of spontaneous intracerebral hemorrhage (ICH). The aim of this study is to investigate the role of resistant HTN in patients with ICH. METHODS AND RESULTS: We conducted a retrospective study of all consecutive ICH admissions at our medical center from November 2013 to October 2015. The clinical features of patients with resistant HTN (requiring four or more antihypertensive agents to keep systolic blood pressure <140 mm Hg) were compared with those with responsive HTN (requiring three or fewer agents)...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28512614/postoperative-contralateral-hematoma-in-patient-with-acute-traumatic-brain-injury
#5
Myeong-Jin Oh, Je Hoon Jeong, Dong-Seong Shin, Sun-Chul Hwang, Soo Bin Im, Bum-Tae Kim, Won-Han Shin
OBJECTIVE: Head injury is a leading cause of death and disability in subjects who suffer a traumatic accident. Contralateral hematomas after surgery for traumatic brain injury are rare. However, an unrecognized, these hematomas can cause devastating results. We presented our experience of these patients and discussed diagnosis and management. METHODS: This study included 12 traumatic patients with acute traumatic brain injury who developed delayed contralateral hematoma after evacuation of an acute hematoma...
April 2017: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/28509699/penis-transplantation-first-us-experience
#6
Curtis L Cetrulo, Kai Li, Harry M Salinas, Matthew D Treiser, Ilse Schol, Glen W Barrisford, Francis J McGovern, Adam S Feldman, Michael T Grant, Cigdem Tanrikut, Jeffrey H Lee, Richard J Ehrlichman, Paul W Holzer, Garry M Choy, Raymond W Liu, Zhi Yang Ng, Alexandre G Lellouch, Josef M Kurtz, William G Austen, Jonathan M Winograd, Branko Bojovic, Kyle R Eberlin, Ivy A Rosales, Robert B Colvin, Dicken S C Ko
OBJECTIVE: We describe the first successful penis transplant in the United States in a patient with a history of subtotal penectomy for penile cancer. BACKGROUND: Penis transplantation represents a new paradigm in restoring anatomic appearance, urine conduit, and sexual function after genitourinary tissue loss. To date, only 2 penis transplants have been performed worldwide. METHODS: After institutional review board approval, extensive medical, surgical, and radiological evaluations of the patient were performed...
May 15, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28499687/erratum-to-air-medical-evacuations-from-the-german-north-sea-wind-farm-bard-offshore-1-traumatic-injuries-acute-diseases-and-rescue-process-times-2011-2013-air-medical-journal-35-2016-216-226
#7
https://www.readbyqxmd.com/read/28499454/risk-for-intracranial-pressure-increase-related-to-enclosed-air-in-post-craniotomy-patients-during-air-ambulance-transport-a-retrospective-cohort-study-with-simulation
#8
Helge Brändström, Anna Sundelin, Daniela Hoseason, Nina Sundström, Richard Birgander, Göran Johansson, Ola Winsö, Lars-Owe Koskinen, Michael Haney
BACKGROUND: Post-craniotomy intracranial air can be present in patients scheduled for air ambulance transport to their home hospital. We aimed to assess risk for in-flight intracranial pressure (ICP) increases related to observed intracranial air volumes, hypothetical sea level pre-transport ICP, and different potential flight levels and cabin pressures. METHODS: A cohort of consecutive subdural hematoma evacuation patients from one University Medical Centre was assessed with post-operative intracranial air volume measurements by computed tomography...
May 12, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28499011/fatal-case-of-chikungunya-and-concomitant-thrombotic-thrombocytopenic-purpura-in-french-guiana-during-air-flight-medical-evacuation
#9
Loïc Epelboin, Bastien Bidaud, Emilie Mosnier, Paul Le Turnier, Guillaume Vesin, Gaëlle Walter, Philippe Abboud, Stéphanie Houcke, Maïa Forgues, Gérald Egmann, Alain Stepanian, Félix Djossou
Thrombotic thrombocytopenic purpura (TTP) is a thrombotic microangiopathy associated to severe ADAMTS13 deficiency. It has been linked to various viral infections. Among arboviruses, only Crimean-Congo haemorrhagic fever and dengue fever have been linked to this severe disease. We report the first documented case of TTP concomitant to Chikungunya virus infection.
September 1, 2017: Journal of Travel Medicine
https://www.readbyqxmd.com/read/28484551/self-inflicted-stab-with-a-knife-an-unusual-mode-of-penetrating-brain-injury
#10
Zeeshan Qazi, Bal Krishna Ojha, Anil Chandra, Sunil Kumar Singh, Chhitij Srivastava, Nishant Verma, Tushar B Patil
Self-inflicted penetrating injuries have been very rarely described in the medical literature. We describe a middle-aged woman, who had driven a long knife inside her skull with the help of a brick. She had done this to get relief from chronic headache, which was troubling her for 10 years. Patient was hemodynamically stable and had Glassgow Coma scale score of 15. She was immediately operated to remove the knife and evacuate the acute subdural hematoma. Patient made a steady postoperative recovery. Psychiatric and neurological evaluation in the postoperative period revealed features of mixed anxiety and depressive disorder with migraine, for which she was started on treatment...
April 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28474610/blunt-rectal-trauma-case-report-and-literature-review
#11
Michele Marini, Giorgio Fratus, Pierluigi D'Amore, Fabio Tagliabue, Pierpaolo Mariani, Luisella Spinelli, Lorenzo Novellino
Blunt colorectal traumas are rare clinical entities with a challenging diagnostic and operative management. We describe the case of a 40-year-old man, victim of an accidental fall from a height of four meters who was subsequently diagnosed to have a blunt rectal trauma. A first CT scan showed fracture of the skull and an extensive subcutaneous haematoma of the lower back associated with a fracture of the left transverse processes of lumbar vertebrae. No other visceral abdominal lesions were recognized and patient was admitted to our department for observational studies...
December 20, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28467281/chronic-refractory-constipation-due-to-neurogenic-bowel-dysfunction-can-be-successfully-treated-by-sacral-neurostimulation
#12
Frederiek Nuytens, Mathieu D'Hondt
INTRODUCTION: In the last few decades, sacral neurostimulation (SNS) has proven to be an effective treatment option for functional bowel disorders. Experience concerning the role of SNS in the treatment of chronic constipation due to neurogenic bowel dysfunction (NBD) however is limited. METHODS: In this report, we present the case of a 44-year old patient, with chronic refractory neurogenic constipation after a spontaneous cerebral hemorrhage, who was treated with SNS...
May 3, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28464968/prehospital-interventions-during-mass-casualty-events-in-afghanistan-a-case-analysis
#13
Steven G Schauer, Michael D April, Erica Simon, Joseph K Maddry, Robert Carter, Robert A Delorenzo
BACKGROUND: Mass-casualty (MASCAL) events are known to occur in the combat setting. There are very limited data at this time from the Joint Theater (Iraq and Afghanistan) wars specific to MASCAL events. The purpose of this report was to provide preliminary data for the development of prehospital planning and guidelines. METHODS: Cases were identified using the Department of Defense (DoD; Virginia USA) Trauma Registry (DoDTR) and the Prehospital Trauma Registry (PHTR)...
May 3, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28459953/early-clinical-predictors-of-5-year-outcome-after-concussive-blast-traumatic-brain-injury
#14
Christine L Mac Donald, Jason Barber, Mary Jordan, Ann M Johnson, Sureyya Dikmen, Jesse R Fann, Nancy Temkin
Importance: The long-term clinical effects of wartime traumatic brain injuries (TBIs), most of which are mild, remain incompletely described. Current medical disability cost estimates from world conflicts continually surpass projections. Additional information regarding long-term functional trajectory is needed to reduce this extensive public health burden. Objectives: To examine 5-year clinical outcomes leveraging existing clinical data collected at 1 year after injury in the same patients and to identify early risk factors for long-term disability...
May 1, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28458751/patient-tracking-in-earthquake-emergency-response-in-iran-a-qualitative-study
#15
Nahid Tavakoli, Mohammad H Yarmohammadian, Reza Safdari, Mahmoud Keyvanara
BACKGROUND: After a disaster, all victims have to be rapidly and accurately identified for locating, tracking and regulating them. The purpose of this study was to summarize people's experiences that how the patients were tracked in past earthquake disasters in Iran. METHODS: A qualitative study was carried out in 2015. This was an interview-based qualitative study using content analysis. The interviewed people included physicians, nurses, emergency medical technicians, disaster managers, Red Crescent Society' first responders and managers...
2017: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28452879/aeromedical-evacuation-relevant-hypobaria-worsens-axonal-and-neurologic-injury-in-rats-following-underbody-blast-induced-hyperacceleration
#16
Julie L Proctor, Kaitlin T Mello, Raymond Fang, Adam C Puche, Robert E Rosenthal, William L Fourney, Ulrich H Leiste, Gary Fiskum
BACKGROUND: Occupants of military vehicles targeted by explosive devices often suffer from traumatic brain injury (TBI) and are typically transported by the aeromedical evacuation (AE) system to a military medical center within a few days. This study tested the hypothesis that exposure of rats to AE-relevant hypobaria worsens cerebral axonal injury and neurologic impairment caused by underbody blasts. METHODS: Anesthetized adult male rats were secured within cylinders attached to a metal plate, simulating the hull of an armored vehicle...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28437783/evacuation-of-a-tertiary-neonatal-centre-lessons-from-the-2016-kumamoto-earthquakes
#17
Osuke Iwata, Akihiko Kawase, Masanori Iwai, Kazuko Wada
BACKGROUND: Newborn infants hospitalised in the neonatal intensive care unit (NICU) are vulnerable to natural disasters. However, publications on evacuation from NICUs are sparse. The 2016 Kumamoto Earthquakes caused serious damage to Kumamoto City Hospital and its level III regional core NICU. Local/neighbour NICU teams and the disaster-communication team of a neonatal academic society cooperated to evacuate 38 newborn infants from the ward. OBJECTIVE: The aim of this paper was to highlight potential key factors to improve emergency NICU evacuation and coordination of hospital transportation following natural disasters...
April 25, 2017: Neonatology
https://www.readbyqxmd.com/read/28435989/aggressive-medical-management-of-acute-traumatic-subdural-hematomas-before-emergency-craniotomy-in-patients-presenting-with-bilateral-unreactive-pupils-a-cohort-study
#18
Arturo Chieregato, Alessandra Venditto, Emanuele Russo, Costanza Martino, Giovanni Bini
BACKGROUND: The outcome of patients with severe traumatic brain injury (TBI) and acute traumatic subdural hematoma (aSDH) admitted to the emergency room with bilaterally dilated, unreactive pupils (bilateral mydriasis) is notoriously poor. METHODS: Of 2074 TBI patients consecutively admitted to our facility between 1997 and 2012, 115 had a first CT scan with aSDH, unreactive bilateral mydriasis, and a Glasgow Coma Score of 3 or 4. Sixty-two patients were unoperated and died within hours or a few days...
April 24, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28427975/surgical-management-of-vertex-epidural-hematoma-technical-case-report-and-literature-review
#19
David T Fernandes-Cabral, Ali Kooshkabadi, Sandip S Panesar, Emrah Celtikci, Hamid Borghei-Razavi, Pinar Celtikci, Juan C Fernandez-Miranda
BACKGROUND: Vertex epidural hematoma (VEH) is an uncommon presentation of extra-axial hematomas. It can represent a surgical dilemma regarding when and how to operate, particularly considering the potential implication of the superior sagittal sinus (SSS). OBJECTIVE: Here, we illustrate the surgical technique for VEH as well as review of the existing literature. METHODS: A 60-year-old male sustained a ground level fall resulting in complete diastasis of the sagittal suture with underlying large VEH causing significant mass effect on the SSS and bi-hemispheric convexities...
April 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28422911/do-vented-chest-seals-differ-in-efficacy-an-experimental-evaluation-using-a-swine-hemopneumothorax-model
#20
Bijan S Kheirabadi, Irasema B Terrazas, Nahir Miranda, Spc Amber N Voelker, Francoise Arnaud, Harold G Klemcke, Frank F Butler, Michael A Dubick
OBJECTIVE: Hemopneumothorax (HPTX) is the second leading cause of potentially preventable death among combat casualties. We investigated the ability of five FDA-approved non-occlusive chest seals (CSs) to seal a bleeding chest wound and prevent tension HPTX in a swine model. METHODS: Following instrumentation, an open chest wound was created in the left thorax of spontaneously air-breathing anesthetized pigs (n=26, 43 Kg). Autologous fresh blood (226 mL) was then infused into the pleural cavity to produce HPTX...
April 18, 2017: Journal of Trauma and Acute Care Surgery
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