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Self extrication

Roger W Byard, Allan D Cala
Young children are at risk of head entrapment because they often do not understand potentially dangerous situations or have the intellectual or physical capabilities to self-extricate. Two cases of head entrapment due to hinged lids are presented to demonstrate another rare lethal situation specific to the very young. Case 1 was a 14-month-old boy found suspended by his neck in a semikneeling position under a toilet seat. A horizontal linear bruise measuring 0.6 × 20 mm was present on the right side of the neck with petechial hemorrhages of the forehead...
March 2018: American Journal of Forensic Medicine and Pathology
Alan Cowley, Ashley Hague, Neal Durge
Techniques for extricating vehicle occupants after road-traffic collisions have evolved largely through fear of worsening a cervical spine injury, rather than being evidence-based. Recent research has looked at the safety of allowing the alert patient to self-extricate, rather than being assisted with equipment such as long spinal boards and semirigid cervical collars. This review aims to elucidate whether it is safe to allow an alert, ambulant patient to self-extricate from a vehicle with minimal or no cervical spine immobilization...
June 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
Dolan Power
In this paper I describe through detailed clinical material the challenges posed by patients who employ entangled autistic defenses. I discuss the complicated nature of treating a patient who employed entangled autistic defenses and utilized my voice in an effort to preserve an undifferentiated state of dual unity. My patient's pursuit of dual unity took a very concrete form in her attempt to mitigate the terror of separateness. This concreteness was expressed via the patient's urgent request that I read letters she wrote to me between sessions...
August 2016: International Journal of Psycho-analysis
Louise Dunphy, Mohamed Maatouk, Mazhar Raja, Richard O'Hara
A 37-year-old incarcerated man presented to the accident and emergency department following the deliberate ingestion of eight cylindrical batteries. He also admitted to inserting a razor blade wrapped in cling-film into his rectum; in addition, he sustained a self-inflicted laceration to his left antecubital fossa, using the metal casing from a battery. His medical history included a borderline and emotionally unstable personality disorder. He had ingested several batteries 12 months previously and required an emergency laparotomy to retrieve them...
September 29, 2015: BMJ Case Reports
Mark Dixon, Joseph O'Halloran, Ailish Hannigan, Scott Keenan, Niamh M Cummins
BACKGROUND: Spinal immobilisation during extrication of patients in road traffic collisions is routinely used despite the lack of evidence for this practice. In a previous proof of concept study (n=1), we recorded up to four times more cervical spine movement during extrication using conventional techniques than self-controlled extrication. OBJECTIVE: The objective of this study was to establish, using biomechanical analysis which technique provides the minimal deviation of the cervical spine from the neutral in-line position during extrication from a vehicle in a larger sample of variable age, height and mass...
December 2015: Emergency Medicine Journal: EMJ
Yoonsook Ha, Sarah C Narendorf, Diane Santa Maria, Noel Bezette-Flores
Rates of shelter use among homeless youth are low compared to use of other supportive services, yet research on barriers to shelter use has been conducted in limited regions, specifically in West Coast or Midwest cities. Additionally, while studies have generally focused on barriers to shelter use, studies on what might facilitate shelter use are lacking. This study explores barriers and facilitators to shelter use among homeless young adults from a large city in the Southwest region. Focus groups were conducted with a diverse sample of 49 homeless young adults ages 18-24...
December 2015: Evaluation and Program Planning
Louise Dunphy, Farah Syed, Mazhar Raja
A 52-year-old woman presented to the accident and emergency department 5 h after deliberately stabbing herself with two pens through her midline laparotomy scar. Her medical history included an emotionally unstable (borderline) personality disorder and she was currently an inpatient in a psychiatric hospital. She had multiple accident and emergency attendances with previous episodes of self-harm. Clinical examination revealed evidence of trauma to her midline laparotomy scar with congealed blood covering the puncture site...
August 5, 2015: BMJ Case Reports
Apoorva Aekka, Rohit Abraham, Michael Hollis, Elizabeth Boudiab, Gieric Laput, Harshadha Purohit, Richa Kumar, Arpita Vyas, Marc Basson, Dinesh Vyas
BACKGROUND: A major factor contributing to global trauma mortality and morbidity is the lack of effective prehospital trauma services in developing settings. We developed a 2-d training course for nondoctor first responders featuring high-fidelity simulation and video-assisted debriefing, self-directed learning videos, and native language instruction. MATERIALS AND METHODS: A pilot session was conducted in Jodhpur, Rajasthan. Eighteen local instructors were recruited to train 48 layperson first responders in 10 essential subjects...
August 2015: Journal of Surgical Research
John B Ruder, Jeanette G Ward, Scott Taylor, Karon Giles, Thomas Higgins, James M Haan
First popularized in Japan, hydrogen sulfide (H2S) gas suicide is an underreported form of suicide with known risk for secondary disaster. Mortality rate commonly exceeds 90% because of the gas's lethal, noncontained nature. Instances in the United States are increasing, up from 2 cases in 2008 to 18 in 2010. Because H2S poisonings remain rare, there exists a lack of knowledge regarding the residual effects of gas venting after victim extrication. Identifying instances of the efficacious use of personal protection equipment (PPE) is critical in the effort to alleviate risks faced by hospital and rescue personnel...
March 2015: Journal of Burn Care & Research: Official Publication of the American Burn Association
Andrew C Stevens, Terry R Trammell, Geoff L Billows, Lauren M Ladd, Michael L Olinger
BACKGROUND: Extrication and spinal immobilization in the trauma patient with unknown injuries is a common practice of emergency medical services. High-speed crashes occurring in open-wheel racing seldom result in extrication or spinal immobilization. OBJECTIVES: To evaluate the safety of self-extrication in IndyCar® (Indianapolis, IN) by comparing drivers self extricated with full spinal immobilization and subsequent radiation exposure. METHODS: A retrospective review of prospectively collected de-identified IndyCar® crash and drivers' medical records was performed at treating Level I trauma centers...
February 2015: Journal of Emergency Medicine
Sabina Fattah, Anne Siri Johnsen, Jan Einar Andersen, Trond Vigerust, Terje Olsen, Marius Rehn
BACKGROUND: Road traffic injury (RTI) is a global problem causing some 1,2 million deaths annually and another 20-50 million people sustain non-fatal injuries. Pre-hospital entrapment is a risk factor for complications and delays transport to the hospital. The Rapid Extrication (RE) method combines winching and cutting of both front poles and utilising two larger vehicles to pull car wreckage apart to extricate patients. A previous study indicates that RE is an efficient alternative to previously existing methods...
July 3, 2014: BMC Emergency Medicine
Mark Dixon, Joseph O'Halloran, Niamh M Cummins
BACKGROUND: In most countries, road traffic collisions (RTCs) are the main cause of cervical spine injuries. There are several techniques in use for spinal immobilisation during prehospital extrication; however, the evidence for these is currently poor. OBJECTIVE: The objective of this study is to establish which technique provides the minimal deviation of the cervical spine from the neutral inline position during the extrication of the RTC patient using biomechanical analysis techniques...
September 2014: Emergency Medicine Journal: EMJ
Eva Janssen, Liesbeth van Osch, Hein de Vries, Lilian Lechner
This study aimed to extricate the influence of rational (e.g., 'I think …') and intuitive (e.g., 'I feel …') probability beliefs in the behavioural decision-making process regarding skin cancer prevention practices. Structural equation modelling was used in two longitudinal surveys (sun protection during winter sports [N = 491]; sun protection during summer [N = 277]) to examine direct and indirect behavioural effects of affective and cognitive likelihood (i.e. unmediated or mediated by intention), controlled for attitude, social influence and self-efficacy...
2013: Psychology & Health
Frances Reynolds, Claire Shepherd
OBJECTIVE: Previous qualitative research into the experience of intimate partner violence (IPV) has largely focused upon mature women's accounts. The objectives of this interpretative phenomenological analysis (IPA) were to explore three young women's understandings of why they had been vulnerable to IPV in mid-to-late adolescence, their experiences of IPV, and their recovery processes. DESIGN: This study followed guidelines for IPA, largely focusing upon shared aspects of the experience of IPV as narrated by three young women who considered that they had since recovered from the experience...
September 2011: Psychology and Psychotherapy
Guang-Ming Liu, Guang Sun, Hong-Shun Ma
OBJECTIVE: To describe the use of a technique of suture traction and Dundee in penile entrapment in the polyethylene terephthalate (PET) bottle case. MEASURES AND METHODS: The technique of suture traction in conjunction with Dundee was performed for the management of penile entrapment in PET bottle neck. First, the technique of Dundee (manual compression after multiple prepuce punctures) was used to alleviate and resolve the preputial edema; second, the persistent suture traction power was applied to achieve the removal with lubrication...
October 2012: International Urology and Nephrology
Yechiel Soffer, Jonathan Jacob Wolf, Menachem Ben-Ezra
During large-scale, sudden-onset disasters, rescue personnel experience severe stress due to the brief window of opportunity for saving lives. Following the earthquake in Haiti, rescue personnel worked in Port-au-Prince under harsh conditions in order to save lives and extricate bodies. Reactions to this disaster among rescue personnel were examined using self-report questionnaires. Correlations between psychosocial factors and psychological trauma (dissociation and post-traumatic stress disorder (PTSD) symptoms) were examined in a sample of 20 rescue personnel who worked in Haiti...
June 2011: Prehospital and Disaster Medicine
Iqbal Singh, Mohit K Joshi, Maninder S Jaura
INTRODUCTION: Penile strangulation is rare and usually results following placement of constricting objects to enhance sexual stimulation. It requires urgent treatment as delay may lead to irreversible penile ischemia and gangrene. Various objects causing penile strangulation have been reported. Nonmetallic and thin metallic objects can be removed easily as compared to heavy metallic objects. Cutting is the commonest method described, although procuring special cutting tools may be difficult and the process of cutting may be tedious with the possibility of iatrogenic penile injury...
November 2010: Journal of Sexual Medicine
G Prati, L Pietrantoni
OBJECTIVE: Fire-fighters, paramedics and civil protection volunteers routinely confront potentially traumatic events in the course of their jobs. The frequency of exposure to critical incidents and the relationship between critical incident exposure and quality of life (Professional Quality of Life Scale, PROQOL, Stamm, 2005) SUBJECTS: A sample of 586 Italian emergency workers. RESULTS: The data indicated that the most frequent critical incidents were incidents involving multiple casualties (65% three or more times), prolonged extrication of trapped victim with life-threatening injuries (64% three or more times), verbal or physical threat by public while on duty (41% three or more times), and victims known to fire-emergency worker (40% three or more times)...
July 2009: Giornale Italiano di Medicina del Lavoro Ed Ergonomia
Susan Kavaler-Adler
This study of the modern film version of "Phantom of the Opera" employs a mythic theme to illustrate how women can involve themselves with charismatic and eroticized narcissistic men, who are unavailable for true relationship within the conscious world of societal connection. How can the healthy-heroic woman extricate herself from the seductive web of such men, men who seek to own the women--not through sexual relations--but through ownership and control of the women's creative talents? What are the developmental, internal world, dynamics that spell out the muse turned demon/lover theme in British and American Object Relations terms? Similar to the mythic vampire who entrances women to suck their blood, the male muse haunts the female artist to possess her talents...
June 2009: American Journal of Psychoanalysis
C K Ooi, H K Goh, K T Chong, G H Lim
We report two cases of penile strangulation that presented to our emergency department. In the first case, a 60-year-old man, the object of strangulation was a metallic ring that was extricated using an orthopaedic cutter in the operating theatre. The patient recovered uneventfully. In the second case, a 77-year-old man, the object of strangulation was a plastic bottle, which was extricated using surgical instruments in the emergency department, but the patient subsequently developed postobstructive diuresis...
February 2009: Singapore Medical Journal
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