Management of pediatric wounds.
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Anesthetics, Local↗
Biomedical subjects
K Jackimczyk
Publications and source records attributed to K Jackimczyk.
Injuries resulting from bungee-cord jumping.
A 19-year-old woman sustained a nonfatal hanging injury and a 28-year-old man sustained a unilateral locked facet with resultant quadriplegia as a result of bungee jumping. Injuries due to this sport have not been reported previously.
Adult↗
Blunt chest trauma.
The spectrum of injuries after blunt chest trauma presents a challenging problem to the emergency physician. The clinician must select among a number of diagnostic tests and therapeutic options after the initial history and physical examination has been performed. Nine clinical entities are discussed: sternal fracture, flail chest, pulmonary contusion, tracheobronchial injuries, myocardial contusion, myocardial rupture, aortic disruption, esophageal perforation, and diaphragm rupture. Emphasis is placed on newer diagnostic modalities available for these conditions.
Aorta, Thoracic↗
Endotracheal tube whistle: an adjunct to blind nasotracheal intubation.
To perform blind nasotracheal intubation, the physician feels or listens for air movement through the endotracheal tube to facilitate the tube's passage into the trachea. The tube whistle is a device that attaches to the endotracheal tube adapter and produces whistle sounds of different pitches during inspiration and expiration, enhancing the detection of air movement and possibly allowing for easier intubation. This article describes the use of the whistle and presents information collected from a nine-month prospective study of the endotracheal tube whistle.
Emergency Medical Services↗
Cyclic antidepressants, lithium, and neuroleptic agents. Pharmacology and toxicology.
Cyclic antidepressants, lithium, and phenothiazines are frequently prescribed to psychiatric patients. Emergency department physicians must be familiar with these medications, and the pharmacologic and toxicologic characteristics of them are discussed. Cyclic antidepressants are the primary cause of drug-related death in the United States, with sodium bicarbonate recognized as the treatment of choice. Lithium toxicity may be subtle, and treatment is generally supportive in addition to volume replacement with normal saline and hemodialysis for significant intoxications. A neuroleptic overdose is managed primarily with supportive care. Neuroleptic malignant syndrome must be considered in any psychiatric patient presenting to the Emergency Department.
Antidepressive Agents, Tricyclic↗
Aspiration following a cave-in.
Reported is a case of massive aspiration of particulate matter after a cave-in. A 14-year-old boy was buried beneath 18 inches of dirt while playing at a construction site. After extrication he was breathing spontaneously and was transported to the emergency department on supplemental oxygen. Physical examination revealed cough, tachypnea, and diminished breath sounds of the right lung field. Chest radiographs showed multiple radiopaque densities filling the right mainstem bronchus and a left-to-right shift of the mediastinum. The patient was treated with bronchodilators followed by postural drainage and percussion. Chest radiographs and physical examination both returned to normal within 24 hours. Reports of massive aspiration of sand are scarce, and have emphasized the need for bronchoscopic removal of particles to restore ventilation. This case was managed with bronchodilators and postural drainage alone, with complete resolution of pulmonary abnormalities.
Accidents↗
Diagnosis of ruptured ectopic pregnancy with peritoneal lavage.
A case of ruptured ectopic pregnancy with a nondiagnostic culdocentesis is presented. Diagnosis was made by using open diagnostic peritoneal lavage. The patient underwent laparotomy, left salpingectomy, and cornual resection, and had no postoperative complications. In selected patients with suspected ectopic pregnancy, peritoneal lavage may serve as a helpful diagnostic procedure.
Adult↗