Journal of emergencies, trauma, and shock
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J Emerg Trauma Shock · Jan 2009
Emergency intubation using a light wand in patients with facial trauma.
Airway management in the operating room is the responsibility of anesthesiologists, although a variety of personnel may be responsible for airway management outside the operating room. Emergency department physicians are prominently involved in airway management in the emergency room both independently and with anesthesiologists. Airway management in trauma patients remains the domain of anesthesiologists. ⋯ He had to undergo emergency tracheotomy, debridement, and closure of facial lacerations under general anesthesia. The injuries made the patient's airway management a complex issue. We present the use of the light wand to manage the difficult airway of this patient with complex facial trauma.
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Cardiopulmonary arrest in pregnancy is rare occurring in 1 in 30,000 pregnancies. When it does occur, it is important for a clinician to be familiar with the features peculiar to the pregnant state. Knowledge of the anatomic and physiologic changes of pregnancy is helpful in the treatment and diagnosis. ⋯ The specialties of obstetrics and neonatology should be involved early in the process to ensure appropriate treatment of both mother and the newborn. This article will explore the changes that occur in pregnancy and their impact on treatment. The common causes of maternal cardiac arrest will be discussed briefly.
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To examine the on-call emergency workload of a general surgical team at a tertiary care teaching hospital to guide planning and provision of better surgical services. ⋯ Major workload of on-call surgical emergency team is dealing with the acute conditions of abdomen. However, significant proportion of patients are suffering from other conditions including trauma that require a holistic approach to care and a wide range of skills and experience. These results have important implications in future healthcare planning and for the better training of general surgical residents.
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Emergency cricothyrotomy is a technique used to secure an otherwise compromised or inaccessible airway and has been recommended for use in the battlefield under certain circumstances. This case reports an acute complication of emergency cricothyrotomy. ⋯ At the Combat Support Hospital, the patient became more difficult to ventilate and was taken to the operating room for tracheostomy. The cricothyrotomy tube was found to be occluded with blood.
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J Emerg Trauma Shock · Jul 2008
Complication following primary repair of a penetrating bull horn injury to the trachea.
A 22-year-old male patient was admitted to the casualty with a bull horn injury in the lower zone of the neck in the midline. The patient was conscious and distressed but hemodynamically stable. Local examination revealed a lacerated wound. ⋯ The patient was weaned off the ventilator within 24 h and transferred to the surgical ward on spontaneous ventilation with the tracheostomy tube in situ. The size of the patient's tracheostomy tube was reduced gradually by the serial exchange method. The wound ultimately healed with minimal scarring.